Friday, December 2, 2011

Mulago Hospital 4 - Giving Birth

When I visited the birthing ward at Mulago Hospital - I was greeted by about fifteen women - all in various stages of labor - all on a concrete floor in a dimly lit room.  There was blood - alot of it - and women were begging and asking me to hold them and pray for them.  I was astounded at the sheer hopelessness I felt in that room - where new little humans are being brought into the world - which should be a time of joy and happiness!

The hospital runs short on supplies frequently - and because there were no clips to clamp off the umbilical cords for new mothers - a nurse was running around with a regular tarnished pair of shears and some bread bag twists to do the job.  No gloves -clean sheets - beds - Only terror in a dark room.




Train Wreck!!





OK - here it is... I had no intentions of falling in love with Uganda and was not anticipating the intense train wreck heading straight for my heart. I was really excited to serve and explore a new country, having never traveled outside the US (with the exception of Canada) I was nervous - having read extensively about the country and the blood soaked reign of Idi Amin, but still really wanted to go.. Here are some of the things I found out about the country:

 Uganda is a country of stunning beauty and heartbreaking history of persecution. It is a landlocked country in East Africa. It is bordered on the east by Kenya, on the north by Sudan, on the west by the Democratic Republic of the Congo, on the southwest by Rwanda, and on the south by Tanzania. The southern part of the country includes a substantial portion of Lake Victoria, which is also bordered by Kenya and Tanzania.





Between them, Ugandans speak an impressive forty or more different languages. This is a result of Uganda’s ethnically diverse history, and the adoption of English as the main language during Uganda’s colonial years. Uganda is a fascinating country, with a complicated history far too often involving bloodshed, violence and betrayal. Yet the people are among the most welcoming and determined to be helpful that you could meet anywhere in the world.

However, what soon became transparent to me was that Google failed to mention a single thing in any of the articles I read, about the kindness, hospitality, service, joy and love I would witness at every corner we turned. I had no clue reading from my Google notes, that the children who are suffering atrocities on a daily basis, could still have such sweet, innocent hearts.







My heart was immediately lost to the wise eyed children we encountered everywhere. Due to the AIDS pandemic, (AIDS was first discovered in Rakai, Uganda) There are multitudes of child headed households. Children of 10 taking care of younger siblings and struggling to survive. In the Rakai district alone, there are 40,000 child head of household families. Incredible. We soon learned, that the children of Uganda love to sing! They sing doing their chores, going to school, playing, worshiping… and even at bedtime. The emptiness of their bellies and the bleakness of their existence does not hit you when they are singing and dancing and are so happy to see you.. it did hit me hard, though, as our team traveled back to have a good meal at our lodging, and to fall asleep in a mosquito netting covered bed, while those precious children were going to bed hungry and lying on hard packed soil. What we are so used to taking for granted here in the United States is something never experienced by these children.. so please....







Join me in celebrating the heartbeat of a country that is rich in spirit and love and unlike any place I have visited on earth. I hope that by reading this blog, and becoming more informed about 'the pearl of africa', that you fall deep deep in love with Uganda, too. My goal is to finish nursing school, obtain midwife training, and move to Uganda to serve full time in ministry there.







Come Along With Me!

Friday, October 21, 2011

Wif or Wifout a Midwif...e




She had been in labour all day, and her baby’s head was halfway out when the poorly equipped clinic decided it could not help her. It sent her to Uganda’s biggest hospital Mulago Hospital, where nurses rushed to put her on a gurney and wheel her to the operating theatre.


But at the door of the operating theatre, she was turned away. “We’re already closed,” the staff said. “Our schedule is done.”


At least the mother survived. In several infamous cases recently, Ugandan women have died when they were denied treatment at hospitals – sometimes because they were unable to pay bribes to the staff, or because the staff claimed to be overworked. One woman, an elected politician named Jennifer Anguko, bled to death in a major public hospital when nobody examined her for 12 hours.The woman, Hadja Nansubuga, spent the night in agony. The operation was finally performed the next morning, 14 hours later. By then, her baby was dead, and her uterus had to be removed.




Perhaps the biggest scandal of African health care is the inequity of it. The risk of dying in childbirth is more than 300 times greater for African women than for Canadian women. For every 10,000 women in Canada, only one will die in pregnancy or childbirth. Among the same number of African women, 355 will die from entirely preventable causes.


In Uganda, for example, only 42 per cent of women deliver their babies under professional supervision in a clinic or hospital. Nearly 6,000 women in Uganda die in childbirth every year, and 70 per cent of those deaths could be prevented by proper health care. Meanwhile, wealthy and politically connected Ugandans routinely fly out of the country for treatment in expensive private hospitals abroad.


While the rich can fly to another country for abortions, ordinary Ugandan women have little access to basic contraceptives. Only 24 per cent of married women use family planning, and 58 per cent have never used a modern contraceptive. As a result, Uganda has one of the highest rates of population growth in the world, with an average of 6.7 children per woman.


Technically, health care is free in Uganda, yet many pregnant women who seek admission to hospital are ordered to buy the medical supplies that the hospital will need to treat them – everything from surgical gloves and delivery mats to razor blades and cotton wool. In other cases, doctors or nurses demand bribes from the patients. Faced with those costs, many women give up and go home. “When they’re told to buy those supplies, they just don’t come back,” says Denis Kibira, an activist at the Coalition for Health Promotion and Social Development in Uganda.


More than a year after the Muskoka summit at which the G8 leaders announced a $5-billion plan for maternal and child health, most African countries are suffering the same crisis of death and injury that they’ve always seen.


Maternal health seemed to be an obsession for global leaders last year. It was the focus of major summits by the G8, the African Union and the United Nations, and it was announced as one of the priorities for the U.S. administration’s $63-billion global health initiative. “It is no exaggeration to call 2010 the year of maternal and child health,” the University of Washington said in a report on health financing.

The reasons for this concern are obvious: Hundreds of thousands of women are dying in childbirth worldwide every year, and the number has declined by barely 2 per cent annually since 1990. About 80 per cent of the world’s maternal deaths are occurring in just 21 countries, of which 15 are in sub-Saharan Africa.







The Majority of Births in Uganda are at Home - Read these facts!




Blog from a group of Canadian Nurses who worked in Mulago Hospital in the low risk ob ward




http://birthinuganda2009.blogspot.com/




Article from Guest 'Seane Corn' on Oprah Show:




Giving birth in Uganda is a dangerous and dirty business. The clinics where the impoverished can afford to give birth are so awful, unclean and ill equipped that many women would rather take the chance and birth at home, even though they may not have the proper or sanitary instruments necessary to guarantee a healthy and safe delivery.




As a result, both infant and mother mortality are heartbreakingly high because of infection and lack of proper care. Lost is the art of birthing in a sacred and compassionate way and often the mothers are left alone, in their pain and without support, only to be treated indifferently and harshly during the birth itself. Many women are even hit by their midwives if they cry out or scream. Also, because of high instances of untreated malaria, mothers often miscarry in the second trimester.







Caesareans are practiced with unnecessary frequency, abortions are primitive, and often mother's with HIV/AIDS aren't given the drugs available to prevent mother to child transmission at the time of delivery. All too commonly, the disease is passed to the child through her breast milk as a result. Natalie's description of the standard birthing practice sounded barbaric and frightening, and I couldn't imagine what giving birth for the Ugandan poor must be like




Read more: http://www.oprah.com/spirit/Seane-Corn-Blogs-from-Kasana-Uganda/4#ixzz1fPE6v5bD

Cholera, Dysentery and Malaria, Oh My!



Sub-Saharan Africa


65% of all deaths in Sub-Saharan Africa come from infectious diseases. Rudimentary health care delivery and response systems, the unavailability or misuse of drugs, the lack of funds, and the multiplicity of conflicts are exacerbating the crisis. According to the AFMIC typology, with the exception of southern Africa, most of Sub-Saharan Africa falls in the lowest category. Investment in health care in the region is minimal, less than 40 percent of the people in countries such as Nigeria and the Democratic Republic of the Congo (DRC) have access to basic medical care, and even in relatively well off South Africa, only 50-70%t have such access, with black populations at the low end of the spectrum. It will remain the most vulnerable region. The death rates for many diseases, including HIV/AIDS and malaria, exceed those in all other regions. Sub-Saharan Africa's health care capacity—the poorest in the world—will continue to lag.[6]


Four-fifths of all HIV-related deaths and 70 percent of new infections worldwide in 1998 occurred in the region. Although only a tenth of the world's population lives in the region, 11.5 million of 13.9 million cumulative AIDS deaths have occurred there. Eastern and southern African countries, including South Africa, are the worst affected, with 10-26% of adults infected with the disease.[1][7]

Sub-Saharan Africa has an estimated 90 percent of the global malaria burden. Cholera, dysentery, and other diarrheal diseases also are major killers in the region, particularly among children, refugees, and internally displaced populations. Forty percent of all childhood deaths from diarrheal diseases occur in Sub-Saharan Africa. The region also has a high rate of hepatitis B and C infections and is the only region with a perennial meningococcal meningitis problem in a "meningitis belt" stretching from west to east.[1][8] Sub-Saharan Africa also suffers from yellow fever, while trypanosomiasis or "sleeping sickness" is making a comeback in the DROC and Sudan, and the Marburg virus also appeared in DRC for the first time in 1998. Ebola hemorrhagic fever strikes sporadically in countries such as the DRC, Gabon, Cote d'Ivoire, and Sudan.


Sources:   Central Intelligence Agency, CDC Website