Monday May 30th: Today we left for Nawanyago. The drive to Nawanyago took about 4 hours. We were supposed to leave at 7:00, but in actuality we left the town at about 9:30. This is because Americans tell time differently than Ugandans. Ugandan time is very loosely based on a clock and typically allows for a built in grace period of between 1 to 3 hours. When someone says 7:00, you can expect their arrival sometime between 8:30 and 9:00. However, if they say 7:00 sharp, this indicates greater urgency and it is more likely that they will appear by about 8:00. When planning in Uganda, you have two choices, you can get upset by this grievous lack of punctuality, or you can just build the Ugandan grace period into your schedule and roll with it.
The group traveling was the same as the night before sans Debbie and Ron. We went directly to the clinic in Nawanyago, the location where we set up our first working ITW model. Arriving at the clinic felt a lot like going home. This clinic is run by the Catholic Church through the work primarily of nuns in an order called the Daughters of Mary (Bannabikira). As soon as we arrived, Sr. Angela was out to greet us. Sr. Angela is the person we trained last year and the person who has been performing imaging scans for women at their antenatal checkups.
In a way, Sr. has become something of a rock star in Uganda. She has now spoken at high level meetings to discuss the progress in healthcare through her involvement with ITW. I joke with Sr. Angela that the next time I come to Uganda I expect to see her face plastered on the sides of airplanes and on the walls of the airport. Kidding aside, this woman is a saint. She works night and day to do what she can to improve the lives of the very poor people who reside in the clinic’s district. She had malaria multiple times this year and continued to work while being ill. She along with the other sisters planted a garden to grow food to help the people who come to the clinic for care who do not have enough to eat. When you see people like this, it makes it very difficult to complain about our work schedule and load. Such incredible sacrifice!
Our purpose at the clinic today was to review the system setup, discuss any changes to the system instigated by learning throughout the year, copying data files for statistics, and discussing if there are any issues that impeded progress that need to be addressed. Part of what I really wanted was for Paul to start to learn the process. If he is to be able to run the project, he must have more than a superficial understanding of the requirements, logistics, and methodology.
Currently there is an outbreak of malaria in the village and there were several children and babies in the ward. When the children get treatment early, the prognosis is very good. When the parents wait too long to bring in the children, the results are often fatal. Malaria is the number one cause of death in children. Paul and I handed out some of the candy we brought. For many children who were in such misery, the treat brought beautiful smiles to their faces. A few children were too afraid to accept the candy without intervention by their parents. This is not because they are taught to fear strangers as children in the States, but rather because for many this was the first time they have ever seen someone with a white face. Their eyes go wide and quite often they have genuine fear. Sometimes the children get past this fear because of the candy. Other times, the kids just cower and cry, and will only accept the candy when the parents take the candy and hand it to the kids. (the picture shows one of the children who was treated for malaria and is on the mend. Even candy could not bring a smile to his face.)
We left the clinic in the late afternoon and stopped at the Kamuli Mission Hospital. I was hoping to see Dr Alphonsus, but unfortunately he as in the operating theatre. We could not afford to wait until he was done as the drive back is long and the traffic entering the city becomes quite congested later in the day. Ben was telling me that he discussed with Dr Alphonsus his method for treating shattered bones. Since they do not have any hardware, Dr Alphonsus manually drills the holes in the bone fragments and then sutures the fragments together. This I no longer find shocking as my perspective was radically altered during last year’s trip during which time Dr Alphonsus operated on a patient involved in a Bota Bota (motorcycles used as taxis as shown in the picture to the side) accident. The man exhibited symptoms of a cerebral hemorrhage. No CT and no MRI. In fact, no suction. Dr Alfonse ingeniously created a suction system using a series of syringes, drilled a hole, relieved the built up pressure and saved the patients life. Medicine is sure different in developing nations than it is in the States.
