Siiba bulungi! (Good day!) This post is brought to you by Autumn & Mike. Autumn will cover Wednesday 11/14, and Mike will cover Thursday 11/15.
Wednesday morning all nine of us hopped into a van and visited Kijujubwa, which is about 45 minutes out into the Masindi district country side. Thus far in our trip, we’ve been to city clinics/hospitals and a town hospital, so Kijujubwa was our opportunity to see medical care on the village level. Most of Uganda is made up by small villages, so this hospital was meant to show us a true idea of how most Ugandans receive medical attention.
We started at Kijujubwa-Kitara Medical Center (KKMC) which is another private clinic funded by One World Health. This center is rated as a Level 2 medical center, but honestly performs more like a “2.5” (which doesn’t actually exist). The difference between level 2 & 3 are that a level 3 has a ward and is able to host patients overnight. KKMC is open 24 hours a day, so if a patient comes in at midnight with an injury, they will allow them to stay until morning before leaving (hence the “2.5” rating).
The staff in total (between nurses, midwife, a lab tech, and doctors) is only 8 people, and they all live on site. This hospital did not have a pharmacist on staff, but their dispensing room was still impressive. We were told that they must order enough supplies and medicine to last them a month at a time, unlike in the US where most pharmacies have daily deliveries.
The clinic itself had 2 consultation rooms, a lab, dispensing room, and delivery room for childbirth. They averaged about 5 births a month. After going through each of they rooms the doctors showed us their means for garbage/infectious material disposal. Most of their waste was incinerated and the ashes poured into underground pits, but the most interesting disposal method shocked us Uganda first timers. One disposal pit was dedicated to placentas. That’s right I said placentas. It’s biodegradable, so why not!
After touring the private hospital, we walked down the road to the Kijujubwa government run facility. The two hospitals were honestly like night and day. Right away we could tell that most of the villagers went to the free government hospital instead of the private KKMC. The dispensing room had very little medicine, and they received shipments every 2 months. The delivery room was bigger, and they had free baby vaccine clinics monthly. Even though the facility was in the middle of some upgrades, it was physically still rough around the edges.
On Thursday, we traveled to Masindi-Kitari Medical Clinic with the automatic blood pressure cuffs. Thank you to ASHP, NCPA, PPAG, Rho Chi, and CPFI for donating the automatic blood pressure cuffs! When we arrived we prepared to greet the community drug shop owners to teach them how to take blood pressures with automatic blood cuffs and teach drug shop owners about screening patients medications to make sure they are safe for pregnancy and lactation.
We began by having Dr. Prelewicz take the drug shop owners names and shops that they owned so we could raffle off the blood pressure cuffs and prizes we had at the end. Once we had a decent number of owners, we began the presentation at 10:15am, 15 minutes after our scheduled 10:00am to try to account for those on “Ugandan time” (there were still quite a few that showed up late!). As the drug shop owners filed in, we noticed that they all sat one next to another filling front to back even though they could have spread out through the open room. In the United States, we all would have opted to spread out unless we knew someone we wanted to sit near. In Uganda, people are not afraid to sit near each other, whereas, in the United States, we often prefer as much personal space as possible. Beth and Rubi began the presentation by teaching the drug shop owners about what blood pressure is, the problems high blood pressure could cause, what questions to ask a patient before taking a blood pressure, and how to read a blood pressure result.
After teaching about blood pressure, we all broke for a morning tea break. After the tea break, we split up the owners and did a hands on teaching session of how to take a blood pressure with an automatic blood pressure cuff. The drug shop owners were very receptive to the teaching, and, specifically, with the owners I was teaching the owners who understood me the first time would teach each other, before I could assist! This was one of the shining examples for me on this trip that showed how strong the Ugandan sense of community is compared to the United States.
Once the hands-on session was finished, Mayi and Dr. Manning taught the drug shop owners about asking patients if they were pregnant or breastfeeding and what medications they should screen for in patients who are pregnant or breastfeeding. This presentation seemed to us like it was much need, because, when asked, most of the owners did not ask their patients this before dispensing medications. Many of the owners were very excited to learn to do these things because they want their patients to know that they have the patient and her baby’s health in mind. Once the presentation was complete, we raffled off the automatic blood pressure cuffs we had and the gifts we got for the presentation, including our close friend Katy (the chicken). It was difficult giving Katy away, just as it is when any child. It feels like it was only Saturday that Autumn and I carried Katy 3 miles, while he cuddled us. We are glad that we were able to make someone’s Christmas better with Katy’s sacrifice. After the presentation was over, we all ate lunch made with the chickens that Autumn and I helped prepare.
Late in the afternoon, we had the opportunity to see wild chimpanzees in a Ugandan forest bordering a sugarcane field. We made a 3 miles trek through the muddy, uneven forest filled with streams to see the chimps. We were able to see two chimpanzees trying to court each other and others using tree tops as sofas. We also saw monkeys during the trek and baboons in the road on the drive back! After this busy day, we were all exhausted and retired early.
Webale, until next time!