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

You will meet Jesus in 25 minutes!

In 2008 - We stayed with Henry Krabbendam in his beautiful home off of Entebbe Road - about half way in between Entebbe and Kampala - It is a very green and lush area - and we had some visitors in the Men's showers - Three green mambas in the rafters! One was killed and the others slithered away -

We woke to this fellow on the patio - when asking one of the workers how dangerous the green mamba was - our only reply was "You will meet Jesus in Twenty Five Minutes!"

Here is some info I found online about Green Mambas!

Eastern Green Mamba

Getty Images/Martin Harvey
The Eastern Green Mamba (Dendroaspis angusticeps) is a venomous snake related to the highly dangerous Black Mamba. The Green Mamba is less aggressive and smaller than the Black Mamba, they average around 6 feet. The Green Mamba's venom is also significantly less toxic, however a single bite could certainly be fatal to a human. Green mambas are highly arboreal and almost never touch the ground. They are generally found in south-eastern Africa. Like their name, Green Mambas are a lovely grass green color, but yellow when born.

Joseph and the Technicolored Tour Bus

Joseph - Our Driver for all of the years we went except one - We love him - He is one of the kindest, sweetest, most genuine men ever!! He has a beautiful wife, Winnie, and a son -

A 20 Cow Woman

Ugandan Culture and Religion

The culture of Uganda is made up of a diverse range of ethnic groups. Lake Kyoga forms the northern boundary for the Bantu-speaking peoples, who dominate much of east, central and southern Africa. In Uganda they include the Baganda and several other tribes. In the north live the Lango and the Acholi, who speakNilotic languages. To the east are the Iteso and Karamojong, who speak a Nilotic language. A few Pygmies live isolated in the rainforests of western Uganda.

Religion

Christians make up 85.1% of Uganda's population.[1] There were sizeable numbers of Sikhs and Hindus in the country until Asians were expelled in 1972 by Idi Amin, following an alleged dream, although many are now returning following an invitation from the new president, Yoweri Museveni. There are also Muslims.
[edit]Sport

Young boys playing a casual game of football (soccer) in Arua District

The Uganda national football team, nicknamed The Cranes, is the national team of Uganda and is controlled by the Federation of Uganda Football Associations. They have never qualified for the World Cup finals; their best finish in the African Nations Cup was second in 1978. Cricket is also one of major sports having made the World Cup in 1975 as part of the East African cricket team. Furthermore Uganda also engages in basketball however this is not well developed, there is a national league played by college students and a few high school students. Uganda hosted and won a regional tournament in 2006 other countries that participated were Kenya, Tanzania, Rwanda and Burundi. Growing in populariy in the country is rugby, the National team has been growing stronger as evidenced by more frequent victories and close games against African powerhouses like Namibia and Morocco.

The Cuisine of Uganda consists of traditional cooking with English, Arab and Asian (especially Indian) influences. Like the cuisines of most countries, it varies in complexity, from the most basic, astarchy filler with a sauce of beans or meat, to several-course meals served in upper-class homes and high-end restaurants.

Main dishes are usually centred on a sauce or stew of groundnuts, beans or meat. The starch traditionally comes from ugali (maize meal) or matoke (boiled and mashed green banana), in the South, or an ugali made from pearl millet in the North. Cassava, yam and African sweet potato are also eaten; the more affluent include white (often called "Irish") potato and rice in their diets. Soybean was promoted as a healthy food staple in the 1970s and this is also used, especially for breakfast. Chapati, an Asian flatbread, is also part of Ugandan cuisine.

Chicken, fish (usually fresh, but there is also a dried variety, reconstituted for stewing), beef, goat and mutton are all commonly eaten, although among the rural poor there would have to be a good reason for slaughtering a large animal such as a goat or a cow and nyama, (Swahili word for "meat") would not be eaten every day.

Various leafy greens are grown in Uganda. These may be boiled in the stews, or served as side dishes in fancier homes. Amaranth (dodo), nakati, and borr are examples of regional greens.

Ugali which is maize flour is mixed with water to make porridge for breakfast mainly for children. For main means, maize flour is added to some water in a saucepan and stirred into the ugali is firm like American cornbread. It is then turned out onto a serving plate and cut into individual slices (or served onto individual plates in the kitchen).

Uganda is ethnologically diverse, with at least forty languages in usage. Luganda is the most common language. English is the official language of Uganda, even though only a relatively small proportion of the population speaks it. Access to economic and political power is almost impossible without having mastered that language. The East African lingua franca Swahili is relatively widespread as a trade language and was made an official national language of Uganda in September 2005.[2] Luganda, a language widespread in central Uganda, has been the official vernacular language in education for central Uganda for a long time.

In Uganda, the Kanzu is the national dress of men in the country. Women from central and eastern Uganda wear a dress with a sash tied around the waist and large exaggerated shoulders called aGomesi. Women from the west, northwestern drape a long cloth around their waists and shoulders called (Suuka). Women from the southwest wear a long baggy skirt and tie a short matching cloth across their shoulders. Woman also wear a floor long dress called a busuti which was introduced by the 19th century missionaries.

Sources: CIA Factbook: Uganda

Queen Elizabeth

Location

The national park is located in western Uganda, spanning the districts of Kasese, Kamwenge, Bushenyi and Rukungiri. Its location is approximately 376 kilometres (234 mi), by road, southwest of Kampala, Uganda's capital and largest city.^[1] The town of Kasese lies just outside the northeastern edge of the park, while the town of Bushenyi, is situated just outside the park's southeastern boundaries. The coordinates of the park are:00 12S, 30 00E (Latitude:0.2000; Longitude:30.0000).

[edit]Overview

Lion in Ishasha Sector.

Hippopotami in the Kazinga Channel, Queen Elizabeth National Park

Queen Elizabeth National Park occupies an estimated 1,978 square kilometres (764 sq mi),^[2] of which, about 17% lies in Kasese District, 50% in Bushenyi District and an estimated 33% lies inRukungiri District. The area of the park extends from Lake George in the northeast to Lake Edwardin the southwest, and includes the Kazinga Channel that connects the two lakes.

The park is named after Queen Elizabeth II and was established in 1954. QENP is known for its wildlife, although many animals were killed in the Uganda-Tanzania War. Many species have recovered, including hippopotamuses, elephants, leopards, lions and chimpanzees; it is now home to 95 species of mammal and over 500 species of birds. The area around Ishasha in Rukungiri District is famous for its tree-climbing lions, whose males sport black manes, a feature unique to the lions in this area.

The park is also famous for its volcanic features, comprising volcanic cones and deep craters, many with crater lakes such as Lake Katwe, from which salt is extracted.

The national park includes the Maramagambo Forest and borders Kigezi Game Reserve, Kyambura Game Reserve and Kibale National Park in Uganda, and the Virunga National Park in the Democratic Republic of Congo.

The Queen Elizabeth National Park and The Queen Elizabeth Country Park in England are twinned in a project of "cultural exchange, mutual support and has its main emphasis on supporting Conservation through working closely with and empowering local communities".

Services in the park include a telecenter run by Conservation Through Public Heath [1] and the Uganda Wildlife Authority, neighboring The Queen's Pavilion, park lodges, game drives and scenic drives, and boat launches.

[edit]

Jinja and the Source of the Nile

Jinja is the largest town in Uganda, Africa. It is the second busiest commercial center in the country, after Kampala, Uganda's capital and only city. Jinja was established in 1907.
Location

Jinja lies in southeastern Uganda, approximately 54 miles (87 km), by road, east of Kampala. The town is located on the shores of Lake Victoria, near to the source of the Nile River. Jinja is the largest metropolitan area in Jinja District, and is considered the capital of the Kingdom of Busoga.

Nearby towns and villages include Njeru (1.9 nmi/3.5 km; 2.2 mi), Buwenda (2.8 nmi/5.2 km; 3.2 mi),Kimaka (2.8 nmi/5.2 km; 3.2 mi), Mpumudde (2.6 nmi/4.8 km; 3.0 mi), Masese (2.3 nmi/4.3 km; 2.6 mi), Walukuba (2.4 nmi/4.4 km; 2.8 mi) and Bugungu (1.5 nmi/2.8 km; 1.7 mi)
History

Before 1906, Jinja was a fishing village that benefited from being located on long-distance trade routes. The origin of the name "Jinja" comes from the language of the two peoples (the Bagandaand the Basoga) that lived on either side of the River Nile in the area. In both languages "Jinja" means "Rock". In most of Africa, rivers like the Nile hindered migration, this explains the ethnic boundaries along the Nile as one moves north from the river's source on the northern shores of Lake Victoria.

Dave and Darlene Eby

Hope for Uganda

Katie Davis and Amazima Ministries

Please visit Katie and Amazima Ministries - Amazing Young Lady - Amazing Story - Amazing Life

Katies Blog

Starfish

The Starfish Story

adapted from The Star Throwerby Loren Eiseley
(1907 - 1977)

Once upon a time, there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work.

One day, as he was walking along the shore, he looked down the beach and saw a human figure moving like a dancer. He smiled to himself at the thought of someone who would dance to the day, so he walked faster to catch up.

As he got closer, he noticed that the figure was that of a young man, and that what he was doing was not dancing at all. The young man was reaching down to the shore, picking up small objects and throwing them into the ocean.

He came closer still and called out, "Good morning! May I ask what it is that you are doing?"

The young man paused, looked up and replied, "Throwing starfish into the ocean."

"I must ask, then, why are you throwing starfish into the ocean?" asked the somewhat startled wise man.

To this the young man replied, "The sun is up and the tide is going out. If I don't throw them in, they'll die."

Upon hearing this, the wise man commented, "But, young man, do you not realize that there are miles and miles of beach and there are starfish all along every mile? You can't possibly make a difference!"

As if he hadn't heard, the young man bent down, picked up yet another starfish and threw it into the ocean. As it met the water, he turned, smiled and said, "It made a difference to that one!"

Make a difference.

Some history of the Lord's Resistance Army and thoughts on American Troops in Uganda To Fight the LRA

A HISTORY OF AFRICA’S LONGEST RUNNING WAR

The war in northern Uganda has been called the most neglected humanitarian emergency in the world today. For the past 23 years, the Lord’s Resistance Army (LRA) and the Government of Uganda (GoU) have been waging a war that has left nearly two million innocent civilians caught in the middle. The GoU's attempt to protect its citizens from this rebel militia has largely failed, resulting in an entire generation of youth that has never known peace.

The LRA rebel movement can be traced back to a woman named Alice Lakwena. In the 1980s, Lakwena believed the Holy Spirit spoke to her and ordered her to overthrow the Ugandan government for being unjust to the Acholi. Lakwena and her followers, known as the Holy Spirit Movement, gained momentum as resentment toward the government increased. When Lakwena was exiled and no clear leader of the movement was left, Joseph Kony, who claimed to be Lakwena’s cousin, took control and transformed Lakwena’s rebel army into the LRA.

Kony's LRA did not receive the same support as the Holy Spirit Movement from the Acholi people. With dwindling approval for their cause and heightened government offensives, the rebels resorted to abducting children and indoctrinating them into their ranks. It is estimated that more than 90% of the LRA’s troops were abducted as children.

In 1996, as a response to the LRA attacks in the villages, the Ugandan government forcibly evicted thousands from their homes, relocating them into overcrowded camps in hopes of providing protection. But over a decade later, roughly one million individuals still live in these camps and struggle to survive among the effects of abject poverty, rampant disease, and near-certain starvation.

In recent years more and more international attention has been focused on this crisis. In 2001, the US Patriot Act officially declared the LRA to be a terrorist organization - a huge step in drawing attention to the conflict and the atrocities committed by the LRA. In 2004, Congress passed the Northern Uganda Crisis Response Act, the first piece of American legislation to address this disaster. And in 2005, the International Criminal Court (ICC) issued arrest warrants for Joseph Kony and four of his top commanders.

Pressure from the international community (particularly from EU and Canada) combined with a strong desire to secure peace has brought the Government of Uganda and the LRA to the negotiating table on numerous occasions, though they have yet to find a peaceful resolution. The most recent talks commenced in Juba, Sudan in July 2006, and a Cessation of Hostilities Agreement was signed the following month.

In July 2007, in response to an increased concern for peace in northern Uganda by the American people, the US State Department appointed Tim Shortley to Senior Advisor for Conflict Resolution with his immediate focus on northern Uganda. This action solidified the US’s commitment to end this conflict peacefully. That same year, the United Kingdom bolstered their commitment to peace by allocating £70 million in aid, while Germany committed to a 25% increase in aid to Uganda by October 2010. Canada later became more than an international supporter of the peace process in February 2008 by joining the peace talks as an official observer (though the Canadian officer on the ground has since been removed from the region).

At this point in time, the Cessation of Hostilities Agreement has expired and Joseph Kony has failed to sign the Final Peace Agreement for a fourth time, proving his promises to be futile and ultimately disabling the peace talks. Uncertainty lingers, not only for the thousands displaced in northern Uganda but across the entire northeastern border region of DR Congo, South Sudan, and Central African Republic.

Since September 2008, hostility in the Orientale province in DR Congo and Western Equatoria in South Sudan has reached a feverish pitch. LRA attacks have become more frequent and hostile, provoking military action against the rebel group. In an unprecedented joint military operation, the governments of Uganda, DR Congo, South Sudan and the Central African Republic launched an attack on LRA strongholds within DR Congo. “Operation Lightning Thunder”, the name designated for the counteroffensive, was largely unsuccessful in light of both the failure to reach top LRA leadership and the onslaught of violence that followed.

One month later on December 24th, 2008, the LRA launched a retaliatory attack against the people of DR Congo. In apparent desperation and a renewed will to spread terror to DR Congo, the LRA murdered over six hundred and abducted more than one hundred and sixty children to fight amongst its ranks. More than 104,000 Congolese have been displaced since Christmas in attempts to escape the LRA forces.

As the motives of the LRA become more ambiguous and their crimes more horrific, Invisible Children remains committed to seeking sustainable solutions to foster an environment that encourages peace. We are supporting and equipping a generation ravaged by war so that they can finally know peace. Invisible Children addresses the need for access to education and economic development through innovative programs on the ground. To learn more about these programs and how you can contribute to lasting peace and development click here.

Malaria Facts and the power of a mosquito net

What is Malaria?

Malaria is a life-threatening parasitic disease transmitted by mosquitoes. It was once thought that the disease came from fetid marshes, hence the name mal aria (bad air). In 1880, scientists discovered the real cause of malaria: a one-cell parasite called plasmodium. Later they discovered that the parasite is transmitted from person to person through the bite of a female Anopheles mosquito, which requires blood to nurture her eggs.
Malaria Worldwide

3.3 billion people - half the world's population - are at risk of malaria
One million people die each year from malaria
Every 30 seconds a child dies from malaria

Malaria in Africa

90% of all malaria deaths occur in sub-Saharan Africa
1 in 5 childhood deaths are caused by malaria
Malaria is responsible for a 1.3% growth penalty per year in some African countries
10,000 pregnant women and 200,000 infants die from malaria in Africa
Malaria costs Africa more than $12 billion in lost GDP every year

Source: Roll Back Malaria, President’s Malaria Initiative, The World Health Organization, and Centers for Disease Control and PreventionMosquito Nets

Wednesday, February 23, 2011

Mulago Hospital Patients Go On Strike

This is an article published in February in the Uganda Online paper... Unbelievable...

Patients in Mulago Strike over Neglect and Lack of Drugs Hospital

9:29 PM Sandra No comments

Mulago hospital patients have striked over lack of treatment and medicine in the hospital. They have moved their beds outside on the verandas of the hospital to let the world know of their despair.

Yesterday, patients with spinal injuries decided enough was enough and moved their beds to the verandah in a bid to seek recognition from the doctors who had ignored them completely. Many of them claimed that they had become poor since they have to pay for their stay in the hospital and spend a lot of money to sustain them in the hospital.

Many of them say they require surgery while others require immediate attention. The hospital came to a standstill as doctors rushed urgent cases to be attended to. One of those striking said her husband had died from the hospital due to lack of attention from the doctors. After getting involved in a motorcycle accident, he was taken to Mulago to get medical attention. "...we were admitted her for four months. his body had begun rotting. Doctors recommended and operation but nothing was done," she said.

Several others who had the same case looked on as the hospital got disorganized. Those requiring surgery said they had waited too long and now would be the best time to get it as so promised. Baterana Byarugaba, acting deputy executive director blamed the situation on lack of enough anesthesiologists who help in putting the patients to sleep before the operation and at the same time monitors their breathing as the operation goes on.

Baterana said out of the required 40 anesthesiologists at the hospital, only 7 are available yet 3 of these are attached to the Makerere University Medical School leaving only 5 available anesthesiologists. He went on to explain the rest to be diploma holders who can not be trusted to take care of the life of the patients.

"Because of specialized services, we offer in an attempt to achieve our mandate, mission an vision, the hospital requires a lot of man power," Baterana added. Mulago Referral Hospital is a government hospital which is directly under the supervision of the government. It (governement) is supposed to provide medicine, manpower and any other thing that is important to the patients.

Failure to do so has led to the strike which has seen the disorganization in the hospital currently. Upon learning of the situation, a spectator who was on the verge of tears said, "Imagine that life, they are injecting money in the campaigns yet there are people suffering and on the verge of death.

New Patients in Mulago Strike over Neglect and Lack of Drugs Hospital | Uganda Picks http://www.ugandapicks.com/2011/02/patients-in-mulago-strike-over-neglect.html#ixzz1EqD8Taew

Mulago Hospital I

Ok, so i spent time touring Mulago Hospital in Uganda with Dr. Tazelaar.. Actually, he was doing a pathology seminar and one of the pathology residents took me on a tour of this behemoth of a hospital sprawled out over several hills in Kampala.

Once a mighty teaching hospital, the largest in all of east africa, Mulago was mortally wounded during the violent and corrupt reign of Idi Amin and has never recovered. It is like walking into the past about 30 years..or more.

My first thoughts upon entering the casualty ward (emergency room) was 'this is what Hell is like' and for the rest of day, as I traveled through the hospital, even into the surgery theatres, aids units, burn units, cancer units and maternity floor, it only became more hellish and, ultimately almost surreal. I have never felt such a darkness, a almost physical weight of despair, apathy, and death permeating every cracked and tumbling wall, stained and filthy concrete floor, every packed corner filled with families living right in the hospital.. Infants, children, adolescents, adults, elderly.. all coming to a hospital.. a place of hope... to find there is very little.

I think I went into a state of shock midway, because looking back at the things that I saw, I cannot believe that I didn't faint dead away, or run out screaming into the sunlight. But I stayed, and saw.. and now cannot get the images out of my head - they are branded into my very self.

Its been exactly three months since I was there.. I haven't been able to process it enough to write about it.. but I have to..Its like a burning, ripping ache that won't go away.. Maybe this is where I am supposed to be...Maybe this is where I am supposed to work

Anyway, I have posted a couple of articles and a couple of photos, (I was not allowed to take photos, but have found some through a couple of physicians from the UK who spent six weeks working in the hospital)

there is nothing pretty about what I will say, there are extremely graphic photos, almost too much to bear..emotionally and physically wrenching stories, nothing redeeming... nothing that will change the fact that this is literally a hell on earth. but maybe putting it out there will help to raise a bit of awareness. whew.. big breath...

Mulago Hospital II

Mulago Hospital is the national referral hospital, which means this is supposed to be the best public hospital in the country, which I am sure it is. Unfortunately, that statement doesn’t really mean very much. This hospital is the last place the large population of poor Ugandans can be referred if they have a serious medical condition and it is almost the last place anyone in the developing world would want to be found if they needed medical help.

Mulago Hospital, Kampala, Uganda has 6 floors and many wings and corridors, filled to overflowing with families of patients living, yes.. living in the halls.. The stench of unwashed flesh, rotting flesh, urine, blood, and death is overpowering in places.

The patients on the medical wards have a wide variety of illnesses like heart conditions, strokes and tumors, but the majority of them have infections (HIV, malaria and TB). The patients are first seen in casualty (British term for the emergency room) where they are either treated and sent out or die. In the center of the room is a large school desk piled with papers and three red notebooks. This is the casulty log. One book reads "Admitted" One book reads "Discharged" and the final book reads "Morgue" The gurneys have very thin plastic/vinyl mattresses that are torn and filthy - filled with blood stains and mystery fluids that are not cleaned between patients. Tubes for Iv's are shared without being washed, and if there are no more, there is no intubation. This temporary medical ward is filled to capacity each night. The patients that are admitted last are put into beds out in the hallway. The walls of the hallway are made of concrete bricks that have many ‘windows’ in them, thus the hallway is essentially a porch – you are outside, but have a roof over your head. (Uganda fortunately has a temperate climate.) The next morning, a decision is made as to whether the patient can be discharged or needs to be hospitalized further. In the case of the latter, the patient is then transferred from ward 3B to the ward of the team that is admitting them. Patient transport is done similarly to the way it is done in the US, only the gurneys don’t have mattresses and the floor has many seams in it, so the patient is rolled in a jarring manner from place to place.

The patients travel from quite a distance to get help and often times they have family members that travel with them. In fact, nurses do not provide personal care for the patients as there is such a shortage of them. Any personal care, bathing, etc. must be done by the family members. Even tube feeding. A patient also will only get linens, food, and water, if they are brought in by family members!! Medication is very scarce, so any pain medication or antibiotics must be brought in by family as well. Even after surgeries, there is no pain medication for the recovering patients. Sometimes there are numerous family members. The wards would get very crowded if all of the family members were sleeping or staying right next to the patient, so they are periodically removed en-masse from the wards by a physician or guard to the hallways and corridors outside of the wards. This means that there are oftentimes a whole crowd of people waiting by the doors or sleeping on the floors as you walk to the wards. One or two family members are allowed to remain with the patient and many of them end up sleeping on the floor next to the bed.

The floors are washed each day, but still are quite dirty. Some patients and many family members end up sleeping on the floor. The hospital doesn’t provide any food for the patients, so the family members do that. The food, tea and preparation equipment is kept under or beside the bed, along with lab slips, chest x-rays, etc. Thus, there is dirt from people’s shoes on the floor as well as liquid dripping from a rare IV or some dried blood, etc. It is not completely uncommon from a patient to cough up a significant amount of blood or vomit blood on the floor. There is noone to clean up the messes.

There are not many IV poles, only about 10% of the patients have fluids running into their veins. Those that are dehydrated hopefully have one as do those that need IV quinine for suspected malaria. The access to oxygen for those patients that are having trouble breathing is an even rarer commodity. I think there is only one spot on each ward where it can be accessed and the oxygen lines can reach about two of the beds. If a patient suddenly needs oxygen, the beds have to be repositioned to get him within reach of the tank. If there are already two patients receiving oxygen, well, unfortunately, the waiting patient will not get any.

Thursday, February 17, 2011

Matooke

One popular local dish is matooke (bananas of the plantain type) which are cooked boiled in a sauce of peanuts, fresh fish, meat or entrails.

Matooke is served with every meal, its kind of like our potato.. It is very bland and mild, and doesn't have much taste. The best and most respectable way the Baganda cook it is to tie up the peeled fingers into a bundle of banana leaves which is then put in a cooking pan with just enough water to steam the leaves.

When properly ready and tender, the bundle is removed and squeezed to get a smooth soft and golden yellow mash, served hot with all the banana leaves around to keep it hot. In Buganda, the food production process revolves around the banana tree.

Tender banana tree shoots are removed from the plant and singed over fire to make a fine foil into which chunks of pork or beef are tied up and steamed on top of a bundle of bananas.This style of cooking preserves all the flavours and cooks up food like a pressure cooker, if not better. Dry banana leaves are used like bandages when bundles of matooke are being wrapped up for steaming.

Strips and chunks cut from the banana tree stem can be used as a foundation at the bottom of the cooking pan so as to avoid the boiling water touching the bundle of the matooke being steamed.