April 4, 2007

Wednesday, 04 April 2007

Hello once again from Uganda!

It is really bothering me that I am unable to attach pictures to this blog as we go along. Unfortunately, our internet access is not broadband, and our connection “times out” before the photo files can upload. I will have to be content with trying to create word pictures, then post lots of pictures when I get home and my bandwidth widens.

Right now it is 5:25 pm. We meet with the Archbishop’s Hospital Committee tomorrow at 10 a.m. and Dr. Hunter is holed up writing a preliminary report. Everyone on the team is out on the lawn with Fr. John Mary, drinking beers and sodas and relaxing. We met as a team earlier this afternoon and were astonished at how much information we have collected. We are in basic agreement with the recommendations we will present to the Archbishop’s committee.

A few words about yesterday . . . we visited the Ibanda Babies Home, an orphanage for children 0-4 years. There were 41 kids in residence, boys and girls, about evenly split between infants and toddlers. All the toddlers wore the same haircut (short), and the same clothing (dark blue playsuits). And they were all about the same size, so I’m glad I’m not the one responsible for telling them apart.

To say that they were adorable would be, well, understating it a bit. They were chattering and running around our legs, hugging us, playing with the few toys Dr. Hunter brought. As far as we could see, they were the only toys around.

Most of these children were abandoned by their parents. Often, when a mother dies in childbirth, the father will take the infant to an orphanage, then return for it when it reaches 4-6 years old. Some kids were AIDS orphans. Some are just left somewhere to die, presumably because their families can’t take care of them. It’s daunting to think of their futures. They’re getting the best care possible, but Uganda has few resources to help these children overcome their beginnings.

Our next stop was Ibanda Hospital, a 180-bed general hospital, known as a district hospital here, run by the Sisters of Good Counsel (I love that name). Dr. Emmanuel Byaruhanga, an OB-GYN, is the medical director there. Sister Grace Kyomuquisha is the administrator. After a nice lunch the sisters waited 3 hours to serve us, we toured the hospital, and it was our first glimpse of inpatient care. This is where photos would come in handy . . .

Can you picture a hospital ward from an old WWII movie, one huge room with beds aligned along the walls? That’s Ibanda. On the beds are men, women or children (in separate wards), and almost all have family members present who meet all their daily needs for food, bathing and all of what nurses call ADLs (activities of daily living).

Ill children have mothers and even their siblings at their bedsides 24/7. Mothers may have their babies with them. Men are sometimes alone, sometimes with their own mothers or other family member. There is no way nurses or other personnel could attend to patients’ every needs, not when the nurse-to-patient ratio is 20-to-1 or more.

Family at the bedside is a fact of life here in Uganda, and something which will definitely need to be factored in to the Holy Innocents project. Families also acquire and cook their family member’s food while they are hospitalised, so Holy Innocents must also provide for this practice.

Care at Ibanda is loving, but basic. Midwives deliver most babies, but Dr. Emmanuel does the high-risk deliveries (breeches, prolapsed cords, etc.) and gynaecological surgeries. (They spell it differently here.) Beyond that, we met a little guy who had punctured his abdomen falling from a tree, and was recovering from peritonitis. But, like most other facilities we have seen, many people and almost all the children were there for malaria and its complications, especially anaemia and dehydration.

Dr. Emmanuel is onsite most of the time, along with several young doctors who are just beginning their careers. But when specialists are needed – almost all of whom are private practitioners – the costs become astronomical. And most patients are charged little or nothing for their care, because they can’t afford any more. And when I say they can’t afford more, I mean it.

Our day ended with a visit to the Water and Sewer Corporation of Uganda, which supplies most of Uganda’s cities with their, um, water and sewer. As always, we had a ceremonial introduction, Dr. Hunter said a few words, we signed the guest book, and the meeting got underway. David Webb is our infrastructure guy, so he and the general manager got down to business, talking backflow, connection diameters, and other water and sewer stuff while the rest of us ate cookies, drank soda and longed to return to Monfort House. We ended with an invitation for Dave to return Wednesday for a tour of the waterworks, and more guy-talk about how the Holy Innocents will get drinking water and dispose of its waste.

More tomorrow, I hope, about our visits to the Mbarara University of Science and Technology Schools of medicine and nursing, and how Sister Margaret has identified Dave’s height (6 foot 3) as a significant advantage when trying to get things done in Uganda.

One last note: last night I identified Matt Simone as a pediatric intensive care nurse. Wrong Matt – that’s Matt Cerchie. Matt Simone is actually an ER nurse.

We sent all our love to everyone at home,

Joanne