One Mzungu's Perspective: Written by Brooke

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Last time you heard from me, I was just leaving Rugazi with Shania and Kari. We left Rugazi on June 23rd, but before we left I do have some last bit of experiences to share. We were woken up bright and early by our Ugandan colleagues urging us to clean as the bus would be there soon (we were later informed that it did not show up until 2 pm that afternoon- classic Africa time). As everyone was rushing to clean and pack, Kari and I were informed that there was an emergency C-section taking place in the theatre (Ugandan for operating room). We nonchalantly decided to go observe the procedure, we first scrubbed up, threw on some crocs and were ready to head into the theatre. I got to help with setting up the overhead lamp so the doctor was able to get a good view of what she was doing. Halfway through suturing, the power went out, so my lamp setup no longer mattered. At first I was really intrigued by what was happening and was watching with ease, but when it came to the part where they have tug the skin open, I had to leave the room. I thought vaginal births looked uncomfortable, now I am very sure I would prefer that method over the latter. Eventually, I was able to get back in there and hold the new baby girl! It is crazy to think I was one of the first people to hold her, it was quite a thrilling experience.

Before leaving Rugazi, it was very bitter sweet as we all said our good-byes and took many group photos. I thought the community placement was going to be one of the hardest experiences I would have in Uganda, but it turned out to be the most rewarding three weeks. I got to witness things I never would have been able to, I made new friendships (even if we didn’t speak the same language), and tested my comfort zone. Upon coming to Mbarara, I found I missed the comforts of Rugazi. In Rugazi, I knew where to get everything I needed such as, cold soda, shortbread cookies, chocolate, and my morning Rolex. It was comforting to get chased down and mocked by all the school children when we would do the Twin Lakes walk. Although it can be difficult to be constantly noticed when you go beyond your compound, I became very use to the excitement of children who are seeing a token “mzungu” for the first time!

However, now that I have been in Mbarara for two weeks, it is starting to feel more like home. We got to reconnect with our other roommates, although Shania, Kari and I are all in the same house (hope they are not sick of me yet haha). On June 27^th, we started our hospital rotations. Currently, Stephanie and I are in the malnutrition unit which is a corner in the pediatric ward. Usually malnutrition patients are separated as being either Phase 1 or Phase 2. Phase 1 patients are those that are admitted with severe acute malnutrition (SAM) and are seen in the malnutrition corner. Phase 2 patients are those transitioning onto higher feeds and are stable, those patients are usually seen in the Natasha Ward. However, there is a current Measles outbreak, therefore all measles patients are kept in “isolation” in the Natasha Ward. This means, that all Phase 1 and 2 patients are currently residing in the malnutrition corner. The corner is not much bigger than 400 square feet, so you can imagine that it is quite overcrowded. Add doctors, nurses, family members, students, it can be pretty impossible to move around at times. Additionally, some families are left to find spots on the floor as there are not enough beds for everyone- and by this I mean there are already 3 patients and their caretakers to one bed. Our morning in the malnutrition corner begins with taking weights with the nurses and other nutrition students. Following weights is vitals and ward rounds with the doctors. It is mostly us asking questions when we can and helping take temperatures, pulses, and respiratory rates. I found it interesting that the family members are in charge of feeding their children the high energy milk every 2 or 3 hours. When the babies fail to gain weight, the healthcare workers seem to blame the parents for not feeding their child, but to me it seems the responsible should be placed with the healthcare professionals. However, I need to remember where I am and how limited the resources really are.

When I need a break from the hot, smelly corner of the pediatric ward, I find my new friend Josh. He does not speak a word of English (I am still not sure if his name is actually Josh), and is probably 3 or 4 years old. His sister is sick with measles, so we met in the measles ward one day. He was shy at first, but now when he hears Stephanie and I coming in the morning, he is at front door waiting for us, giggling. It really does make my morning. Josh and I take walks around the hospital and play games, he does not seem to tire and will try to follow me home when I have to leave for the day. Stephanie and I have also tried to brighten the days of some of the children in the malnutrition corner. As the corner is not exactly filled with toys (or anything really besides the odd cockroach), the children do not receive much stimulation. To help bring some life to the room, we have fashioned some balloons out of rubber gloves and draw on them. Stephanie has also become quite adept at making paper airplanes. Sometimes our balloons or airplanes can make them smile or stop crying, when this happens it really makes me feel like we have done something worthwhile- it really is the little things.

From a nutrition student perspective being in the malnutrition ward has been very enlightening. In Canada, primary malnutrition cases in children are not the norm and the way that malnutrition would be dealt with in the health care system would be drastically different. For example, family members would not be in charge of providing nutrition therapy- the dietitian and the healthcare team would be at the forefront. The healthcare team would work with the family to provide nutrition education and continue monitoring the child’s progress. However, I was pleasantly surprised that there is a kitchen in the Natasha Ward, where families are brought to learn how to prepare nutritious, high-energy foods for their children. We observed the nutrition students providing education to these families, using cheap and traditional foods. During my time in the malnutrition ward, I have really enjoyed being with other nutrition students as they are very easy to talk to you and can answer our questions. We also got invited to join them to a community outreach day next week, where we will providing health education to a community outside the hospital. We are not quite sure what it is going to be about, but if Ugandans are good at anything it is making Matooke and pulling together a successful presentation last minute.

As mornings are spent in the hospital, our afternoons are free for community work. This week we were at Divine Mercy Orphanage and Bright Future- a transition home for children who have been taken out of their homes or were abandoned. The contrast between these homes are very apparent. To begin, Divine Mercy is an orphanage that houses about 90 children from the ages of 3 months to 14 years old. The first time we went there, I thought we would pay a quick visit to set up a contact. We did, but we also got to meet about 50 kids. You can imagine the amount of chaos that was placed on the 4 of us. No one would listen to us, kids were fighting for our attention and climbing all over us, and they would mock the way we would say things. I left feeling sad and angry, I just could not understand how these children were made to live in these conditions and how this would affect their outcome in the long run. Although I was hesitant to go back, I realize the importance of just being there for them and trying to make an impact to the best of my ability- Dr. Andrew assured us that sometimes the best thing we can do is just make someone smile and I believe it. We went back to Divine Mercy on Friday morning when we were prepared and were greeted by 20 bright smiling toddlers- safe to say some of us did get peed on. Bright Future was a completely different experience as they only have 13 children and a massive play room full of toys. We spent the afternoon playing games, laughing, and snuggling the kids. I was a little jealous of Shania, as she got to rock a baby to sleep for most of the afternoon. All the kids at Bright Future were so well behaved and it was definitely a highlight of my week, I am very excited to go back.

Next week, Stephanie and I are working our last rotation in the malnutrition ward. The following weeks you will find us in pediatrics and maternity. We also are all excited to continue our work in the community. On Tuesday, Stephanie and I will be going to Mobile Hospice and on Wednesday is our community outreach day. Also, our group has established a connection with Shy, who works on many projects, one being bringing Afripads to schoolgirls who are in need. We are excited to get the opportunity to educate girls on their menstrual cycles and to reduce the stigma in the hopes that less girls will miss school due to having their periods. We will also continue to visit Divine Mercy and Bright Future regularly. This is all I have for now, Gabi will be posting next week on her experiences.



As always,



XoXo, Uganda Girl

Brooke

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Photos

Team Rugazi
Saying goodbye to our group members in Rugazi!

Malnutrition Corner
Our tight workspace

Friends!
My new friend Josh and I

Cheering up the kids
Our balloon art at work!

Happy Canada Day!
We also have fun from time to time