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Let me begin by extending my sincere thank you for taking the time to read this. Five of us nurses have teamed together to compile this anthology to document our three months together in Uganda, and I (Carrie) have volunteered to write our pilot entry.
We have been in Uganda for just over two weeks; we spent the first four days adjusting to the time change and settling into the rhythm of life in Uganda. Entebbe was our point of arrival, a small city on a peninsula jutting into the splendorous Lake Victoria. We enjoyed various activities such as taking in the Wildlife Education Centre (including the “Behind the Scenes Tour – $70 US, highly recommend!), the Botanical Gardens, and some of the group took in some swimming at the Victoria Hotel pool while three of us embarked on a bike tour all around the city (again, highly recommend for $25!). We are adapting to the heat and local food, and to the variation in concepts of time. Overall, we are doing well.
The following week we made our way to Mbarara, a couple of hours southwest of Entebbe. Here, we began our week of intensive training in Community
Village Research Day
Ambrose, Simon Peter, Marius, Brooklyn, Stevo, Tenielle Leadership Development. It was grueling to say the least, certainly more than I had bargained for. Personally, I took a lot out of the learning and am grateful for the experience; a privilege afforded to me that I don’t take for granted. That being said, I would not be eager to take it again anytime soon….
We were split into our groups in the afternoon of the first day of school; after a few changes here and there, the final groups ended up being: Ian, James, Montana, and Richelle to Kabale, and the remaining of us to Rugazi. I am in Rugazi Team A with Joline, Brittany (fellow nurses), and Jillian (a dietician), and the Ugandan students Stevo, Ambrose, Stephen, Brenda, and Rehema. The other girls, Joline, Dayna, and Brooklyn (fellow nurses) and Sarah and Tenielle (dieticians) are on Team Rugazi B. We completed our training in our respective groups, but ultimately will spend the four weeks living and working together at the same site.
Upon completing of our training at MUST, we departed for our respective villages on Saturday, May 30, 2016. Our bus left late – or early, depending how you look at it – and
Team Rugazi
Team A and B, with our VHTs after a few stops to reclaim the mattresses that escaped from their ties on the bus roof, we arrived at Rugazi Health Centre IV around 3:00. We were delighted to find western toilets, proper showerheads, electricity, and rooms that sleep only two. The other group is having a more…rustic experience. Pros and cons to both!
We spent the first couple days getting acquainted with our new surroundings, shopping for plates and cups that some of us neglected to bring, soaps, and other necessities. We arranged for a cook to prepare our meals for the month, but on our first night we were required to prepare our own meal. The local Ugandan students cooked for us a nice meal of rice, groundnut sauce and “eggplants” – a much different variety than what we grow at home. It was delicious.
On Sunday we enjoyed some leisure time – the first day since we have left that nothing has been on the agenda. I took advantage of the resting time, anticipating the workweek ahead of us.
Monday morning we met for orientation to the health centre with the Clinical Officer, Michael. The clinic has outpatient, inpatient, and maternity wards spread
Team Discussion
First day orienting at the clinic throughout different buildings within close proximity of one another. The centre holds different clinics throughout the week, for example a dentist on Monday, HIV treatment clinics on Wednesdays and Fridays, and antenatal clinics throughout the week.
The U of S students organized ourselves into three teams of three, and will rotate weekly through each ward. We have been busy to varying degrees. Tragically, the centre routinely runs out of the medications, which are provided by the government; the community members are aware of this ebb and flow of resources, and thus access the clinic accordingly. The shipment of drugs is due to arrive the Tuesday following this post; it is likely we will be seeing more clients at that time.
Of course we expected differences in treatment and care when we were preparing for our internship, yet no matter how much your prepare yourself experiencing the reality of health care in lower income countries can be quite harrowing. The health care providers I have had interaction with thus far have been nothing short of wonderful, that is not the issue; it is the lack of diagnostics and treatment on hand that I struggle with. My clinical team, assigned
to the inpatient department, assisted Stevo with an incision and drainage for a woman with an abscess to her upper arm. Brooklyn held the basin that collected the pus, Sarah the woman’s legs, and I her hand. The only pain relief she was given was a mild IM injection to the dorsogluteal site. It was difficult to watch, but as I always tell myself “We do the best we can with what we have.” At home we always advocate for pain relief, but what do you do when there is literally nothing available? Bless our sweet, sweet narcotics of home.
Britany and Dayna spent their week at the Out Patient department conducting assessments and care. Joline was on the maternity ward, although she did not witness any deliveries.
We began working on our community health projects by organizing a meeting with the Village Health Team (VHT) members (Abuyu, Amos, and Devina) who will be important partners for us and will provide much needed advice and guidance. We also met with our site supervisor, Dr. Ida, whom we will present our community diagnoses and proposed interventions to on Monday. Our VHTs guided us on a “transect” walk (windshield survey
as we know it) through our respective communities. We spent the next afternoon formulating a basic research survey to carry out with households in our assigned village, which Stevo, Ambrose, and I conducted the following afternoon while Britany, Joline, and Jill spent time going through the hospital records to find data about our village. We managed to visit five households, averaging twenty-five minutes per visit. Each home was incredibly welcoming and receptive to our project; of course I loved the children especially. They are so blatantly curious but so shy, more hesitant than their urban counter parts. After collecting data from our VHTs, clinic records, and house hold visits, we prioritized four main areas to present to our faculty and site supervisors: malaria, which is rampant in this area, HIV, sanitation and hygiene, and health clinic improvement projects. We will meet our supervisors on Monday, and upon receiving their feedback will have a clearer understanding of where to focus our energy and research.
The time is passing quickly, and before we know it we will be done at Rugazi and on our way back to Mbarara. I am motivated, by my scholarship and responsibility of representing our university and
Brooklyn and Sarah
Morning rounds on the paediatrics ward country, to work hard and do as much good as I can in the remaining three weeks left here at Rugazi. It is easy to disengage when things are frustrating, but we must remember why we are here, and work to the best of our abilities with what we have. All ready I am so proud of my peers, I can see them shining and doing what we have been trained to do. This will be a profound and life changing experience for us all, and I am eager to meet the women who emerge at the end of our internship in nine weeks.
Love and peace,
Carrie
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