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.

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.

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!

Mulago Hospital III and Health Care in Uganda

There is definitely a huge medical need in Uganda. Most of the people do not have access to any type of health care or medication.

People and children die every day from treatable illnesses such as malaria and respiratory infections. Malaria is easily treatable with $5.00 worth of medication available over the counter, and fluids. However, Malaria is still the number one killer in Africa. To us, $5.00 seems a paltry sum, to those who don't make that amount in a month, and have families to feed, it is impossible to come up with.

Parasites are another medical issue that is easily treatable with medication. The majority of children suffer from worms, which grow inside of their stomachs and can make any attempt at helping with food and nutrition become insignificant as the parasites absorb whatever the children eat.

Ugandan hospitals are incredibly different than those in the Western world. I visited Mulago Hospital, in Kampala, and spent a day touring and visiting with patients. I have written about how deeply I was affected, and will post those writings, soon. For now, though, it was one of the darkest, and most heart wrenching places I have ever seen. Although there are incredibly gifted doctors and nurses, they often suffer from frustration - whether it be having zero pain medication or only two working respirators - and the power may go out.. I saw family members physically operating a hand respirator - with no signs of any other one coming - cancer patients with no cancer fighting drugs available.. women giving birth on a concrete floor, a tiny baby one mother handed to me with spina bifida - hoping I would take her with me to help her before she died - there were no options for surgery.

One interesting fact about Ugandan hospitals is that they do not provide meals for their patients; instead, the family or friends are expected to bring them food. If there is no family - there is no food. A patient could literally die of starvation.






This is just a snapshot - so much more to tell..

Soap and Water

The child in the arms of her father was skin and bones. Her face was hollowed out, her skin shrunken, in a state of dehydration, whimpering in pain and agony. He asked for help, his daughter had been ill with stomach problem, diarrhea for days, she has had this before, but this was the worst it had ever been.



There are not facilities for medical care like we are used to and take for granted here in the States. There are no emergency rooms in slum and rural areas.. sometimes there are mud huts where desperate people come who have no money, no hope.



The girl’s name was Elizabeth and she was five years old. Her parents lived in the slum of Kibera that houses nearly a million desperate people existing on next to nothing, lacking the very basics of life such as water, food and proper shelter, but this slum was home for Elizabeth and others like her. She was moaning in pain and there was nothing for her father to do.. it was too late, another child became a statistic for the World Health Organization and UNICEF.



Each year over 800,000 children like Elizabeth die needlessly in Africa, they die before their time, die of something preventable - that could and can be prevented with a simple antidote such as soap and water, the miracle is not some modern medicine, but the washing of hands, sadly, too late for Elizabeth whose lifeless body laid upon the roughhewn table. Her father cried, why was Elizabeth born in a part of the world where things that we take for granted, like clean water, soap, food, medicine, health care are just not there??

It is estimated that children in this part of the world have at least five bouts of diarrhea per year most often accompanied by under-nutrition and childhood diseases like measles. It is the leading cause of death in children in Africa and all is needed is water and soap a few times a day before eating. 20% of Africa’s children die before the age of six from diarrhea, dehydration, malaria, measles, pneumonia, etc, things that in the west would be a simple thing to deal with.

In Kampala 60% of slum dwellers do not have access to pit latrines or toilets and the result is plastic bags being thrown onto roofs to waste away, children simply go anywhere, disease and childhood illnesses abound.

Water like in most slums in Africa costs money and is carried away in plastic jerry cans where mold and mildew can easily grow in. Washing of hands becomes costly, since water costs money.

The result is never ending illnesses and death in children that could be avoided through the inexpensive use of soap and water.


Sources:  New Vision Online

I am a child in Africa

Life in Africa is a struggle for anyone but the life of a child is even harder.

Imagine, growing up in a world where you lack the very basics in life, food, clean water, medicine, shelter, safety, a bed of your own. Beyond that, there are no toys, no dolls, no soccer balls, no sweets and treats, at best, a bed of reeds to sleep on.

School would be wonderful to attend, the path out of poverty, but there is no money for school fees, so you stay home and wait for a miracle, but for most there is none, life is simply survival, staying alive.

Death is very common to you (20% of Africa's children do not reach the age of six). Life is hard, and yet, most of the world is unaware of your plight or of any of Africa's children. They are amongst the voiceless of the world, needing others to speak on their behalf. .