Sunday, May 4, 2014

Uganda-The Pearl of Africa

I know it's about 6 months after the fact but I am finally ready to write about my experiences in Uganda! I was able to travel to Uganda last November with a group called International Medical Relief to provide medical care to the people of Uganda. The experiences I had and the people I met were both educational and humbling and I would like to share with anyone who wants to know!

I have a good friend, Michelle, who is a nurse practitioner, who does a medical mission trip about once a year. I heard a lot about her experiences and decided that it would be really cool to accompany her on a trip, especially since my circumstances in life allowed me to afford the money and time it would take. It would also be more comfortable for me to go with someone I know, plus really fun to travel with a buddy! Last year Michelle decided that Africa would be her destination and I decided that now would be the time to go. I applied to go as a non-medical volunteer and I got accepted. Preparations included many vaccinations, learning as much as I could about Uganda, weekly conference calls to learn about the trip and lots of errands to pick up supplies. Before I knew it, Michelle and I were hopping an airplane to fly across the US to meet our team in DC where we would fly Ethiopian Air on a 13 hour flight to Ethiopia and then another 2 hour flight to Uganda.
One of the first things I learned about was "Africa time." Our flight from Ethiopia to Uganda didn't leave anywhere close to on time. It's pretty normal for things to start/leave late and I realized how "American" I am for wanting things to start and leave when they are supposed to! This lead us to arrive in Entebbe, Uganda about 3 hours late, we still had to travel to Jinja by bus, that took us another 4 hours so I was exhausted by the time we got to our hotel. Even though I managed to sleep on the bus with all the potholes we were hitting I still slept well that night thanks to jet lag.

Our Team-the team consisted of about 7 practioners (doctors and ARNPs), 10 nurses, 1 dentist and about 5 non medical volunteers. We also had Jean, who was our team leader from IMR and another gal who was her "assistant." On top of that we had a bus with a driver (Moses), about 6 translators and Pastor Frederick who was kind of our African guide.
Clinic-For five days we packed up all our supplies and headed to a different village each day. Once there we would set up an area for the doctors to see patients, an intake/triage area, a pharmacy area and our dentist would set up another area to see dental patients. It was tough the first day figuring things out, and each day depended on what kind of buildings/rooms we had available. By the end of the week we finally had a good system down and knew what worked and what didn't. Too bad it was the end!

Day 1-Massese
The first day of clinic we went to The Help School in Massese. We had gotten in so late the night before that we didn't have time to go through all the supplies and organize them. So that was a big job to do that morning. I worked in intake that day, I took down the people's names, ages, what their complaints were, and tried to weigh them, with the help of a translator. They also got their temperature and blood pressure taken. We saw so many people! A good majority of the patients we saw were children. Something like 60% of the population of Uganda is 14 or under. Because of AIDS a lot of the middle aged people are dying off and the kids are looked after by grandparents. And they have a short life expectancy, so 50s-60s is old for Ugandans. It was an interesting day because I was just thrown in with all these people in a place on the other side of the world, not speaking their language and not knowing their customs. I learned a lot. It was so much fun to play with the kids. You became their instant BFF if you took their picture and then showed it to them. And then "Selfies"? Their minds were blown. An opportunity we had that day was to help the albino population. The albinos are treated like lepers in Uganda. People think they are of the devil and they are shunned. They are interesting because they have the same ethnic features as the other Ugandans, but instead they are white with blond hair.There was a small population near where we were so the word was spread for them to come to our clinic. We had a room just for them so they would feel comfortable and not be stared at by everyone else. It was amazing because some of them hadn't been around other albinos before and it was especially good for the kids to know there were others who looked like them. Their needs included chapstick, sunscreen, hats, and sunglasses because they are so susceptible to the sun. I only wish we had known because I would have brought them a ton of that!! I was not one of the team selected to help the albinos but I'm very glad we were able to help. I think they may start a group or community of some kind for support.
 
 

Day 2
We learned another lesson about "Africa time" this day. We were told that the village we were going to was half an hour away. 3 hours and a somewhat painful bus ride later we finally pulled into the village. Not to mention a potty stop at the side of the road where a random African came up and started playing us a song on his homemade violin and singing to us. But even though we were late the kids were so excited to see us-what a welcome!


Because we were late there was already a meeting going on, something like the UN was there educating about Jiggers (a nasty bug that infects their feet when they don't wear shoes) so we had to wait for that to get done. Which meant we could play with the kids! Bubbles, photos, soccer balls, and they sang a song for us. The kids were so happy and energetic!

We still saw a ton of people that day. I was able to give some education on Oral Rehydration; I learned how hard it was to teach something and then have to have it translated. I hope someone understood it! I saw some tooth extractions in the dental area (Our dentist wasn't able to do much else because of equipment and supplies, so if something hurt or was infected, out it came!), and I was able to have a good playtime with some kids. It was actually one of my most favorite memories of the whole trip. I had a group of kids following me so I decided to try to play a game with them. I did a version of Simon Says for a few minutes and then running out of ideas started taking pictures with them. They loved "selfies" and kept trying to touch themselves on the camera, which meant I got a lot of fingers in the pictures but that makes me love them even more. :)
 

On the way back to Jinja our driver took a "shortcut" only to be stuck behind a semi truck that had gotten stuck in a ditch. This could have been disastrous but the truck was able to get out and Moses drove the bus expertly and didn't get stuck. The "shortcut" must have worked because the ride back was a lot shorter. It started raining on the way home and yes, I did "Bless the rains down in Africa."

Day 3
Another long bus ride took us to a different village (we passed so many, we often wondered how/why a particular village was chosen for us to come to). They greeted us in their church with song and dance. It was so cool!! I really felt like I was in some kind of National Geographic episode. And those kids can move! Then they took us to their school where we set up clinic again to see patients. I was kind of a runner/crowd control this day. (Not my best day, I got frustrated with people and didn't feel very helpful.) We had another albino show up and he was so overjoyed to see other white people. I think he also might have been a little mentally handicapped. There were a few kids who held my hands for a few minutes and I think they would have held on all day if I let them! I also saw a little boy who must have had polio, his legs were so crooked. I spent a lot of the day in the sun, and I was very dehydrated so I didn't feel well that night.

Day 4
Clinic as usual again. I tried sugar cane, you just chew it and the sugar comes out. I worked in the pharmacy and felt better about my usefulness. I filled Rx orders for the docs and helped keep things organized. It was fun being in the same room as the doctors because I got to see how they examined the patients. Dental took place outside under a big tree, no big deal. I saw a kid with a BYU t-shirt on but didn't see him until we were driving away so I got a picture of him, but I wish I had seen him earlier so I could've taken a picture with him.

Day 5
Our last day of clinic. I was exhausted by this day and wasn't sure the end would come. But at the same time I didn't want the end to come. This time we literally pulled of the side of the road and set up clinic in a corrugated metal shack. It was a shorter day because we were exhausted but also it was Thanksgiving and we wanted to get back a little earlier. I worked in the pharmacy again, we were starting to run out of supplies. For a minute we were handing out meds in rubber gloves with instructions written on the finger-you have to get creative! We were also working with fewer meds as we had run out of things like children's Tylenol, but we tried to send everyone away with at least some vitamins. After clinic we went in search of baboons-there is a stretch of highway where the baboons know to come out in the evening and sometimes people will throw them bananas. They aren't afraid of cars because it means food. We pulled up and started chucking bananas and eventually they came. The baboons were so cool to see, they were exotic and not in a zoo. I even saw a baby riding on its momma's back. They also told us we were about 10 Km from Kenya! The bus driver also took us to this hidden side of the road memorial where a group of students were gunned down by Edi Amin's soldiers back in the 70's. It was sad, and the memorial is hidden and not well taken care of. But I guess they don't have money to spend on that kind of stuff.

Thanksgiving
We had one bang up of a party for Thanksgiving. We ate chicken and mashed potatoes, as well as pineapple, watermelon, and this banana-potato starchy combo called Matoke. And then we danced. All. Night. Long. It was epic. The African women came in their traditional dresses and they enjoyed celebrating our American holiday. I loved being able to celebrate the end of our hard work with the African friends we had made. Speeches were made, thanks was given, and friendships were celebrated.
 Me and Rachel, one of our interpreters, she was an amazing lady!

Coming home
We had one touristy day in Jija, we went to the Help School and watched their end of the year program. We also bought necklaces and bracelets from a group of women who make these paper beads out of magazines for their business. The jewelry is very pretty and it was cool to meet the women who actually made it! Then we went to the Nile River (!) and took a boat ride out to where Lake Victoria meets the Nile and saw the source of the river. Then back to Jinja where we picked up some great souvenirs and savored some ice cream. The next day we started our journey around the world in reverse, 15 hour flights, ugh.

Health Issues-My inner Public Health comes out
We saw various ailments and diseases in clinic each day-here are a few.

Malnutiriton and Dehydration-a lot of their pains and aches stem from this. Many patients told us their chest hurt, joints hurt or had a headache. They just can't drink enough clean water. They also have very poor nutrition. Almost no protein so we saw many kids with distended stomachs (Kwashiorkor's disease). Many had diarrhea. We tried to send everyone home with vitamins.

Jiggers-mentioned above. The thing is that a simple thing like shoes is what's needed to prevent this infection. We did see the Toms shoes on day 3 and I was happy to see the business actually worked.

AIDS/HIV-Very widespread. The people become sexually active at a very young age, like 12-14. The young parents die and the kids have to be taken in by their grandparents or other relatives. I think better education would help, I think a lot of myths and "traditions" are common which doesn't help the prevention of this disease.

Fungus-the people don't bathe very often so fungus like ringworm is common. One nurse had to remove it from a toddler girl's head and she screamed and cried the entire time. A lot of kids were sent home with anti-fungal cream.

Cataracts-this was hard to witness because these older people were blind from cataracts and a surgery could help restore their vision, but they just don't have access to that kind of medical care. We couldn't really do anything for them.

Malaria-didn't see too much of this as it was not rainy season, but it is widespread and a serious disease. Stupid mosquitoes.

Maternal care-one interpreter told us that sometimes the mothers just go out to the bush behind their huts and have their babies solo. Then when it's all over, they go back inside and get on with life. They usually don't have a proper tool to cut the umbilical cord and tie off blood flow to the cord so that is why all the kids we saw had "outie" belly buttons. The people of Uganda need better access to maternal care, better education of providers (they use outdated and archaic labor and delivery practices), cleaner environment, etc, etc. The moms are good at breastfeeding though, 'cause that's all they got.

Vaccinations-I'm pretty sure the children get vaccinations through the government (potentially sponsored by something like UNICEF or the WHO), though how well they are being administered is unknown to me. I did see one little boy who was walking around on twisted and crooked legs. I'm pretty sure he had polio and it broke my heart. That disease should be eradicated and I am so thankful that it is not a worry for the mothers of my generation here in the US. But it still has a ways to go. (My mom remembers getting the oral vaccination on a sugar cube in elementary school.)

Ebola-there was an outbreak of this that was declared "ended" a few months before I went to Uganda...so that's cool.

Worms-most people got "de-worming" meds, their bodies are used to them a little, but it's good for them to get cleaned out every so often. I just would not have to go through that. It would be so crazy. Let's just say the worms have to come out any way they can...

Michelle saw a little boy who had hydrocephalus, he'll probably not live as long as he could with good medical care.

And then there were things like the common cough and cold which things like Tylenol and antibiotics works wonders because they aren't used to those drugs.

My little public health heart would love to get the Ugandans better access to clean water, better nutrition, better education, and better maternal care. So much would be helped by that!

Thoughts
So I saw this thing circulating the internet about "voluntourism" stating that people who go on trips like mine don't really do any good and that it's more about tourism than effecting change. I agreed with some of it, but disagreed with more. Yes, it would be more effective to educate the people we were trying to help, or other leaders so that the knowledge would be passed on and spread around. And we did try to do some of this with our health education. And I would agree that there was part of me who wanted to go because I wanted the tourist experience. But the money I spent there is going towards the local economy. But I believe we did do some good and help some people. From the drastic: we saved a few lives, to the simple: some of those children just needed to be shown some love. It also changed my life and my world-view and made me more aware of the needs of others. I'm glad I went on this trip. Michelle and I talked about how this is like the story of the boy who was throwing starfish back into the sea and how for each "one" it had made all the difference. I don't know if my trip was as dramatic as that, but I know I did some good.

Because of how I traveled I was able to go to places in Uganda that I never would have as a tourist. Literally out in the middle of nowhere in a small village made of mud huts. It was crazy to think that I was halfway around the world. I also got to see how the Ugandans lived and witness how much joy they have in their lives.

I wasn't expecting to, but I made a lot of new friends, both American and African. I'm glad the translators rode with us on the bus because we got to learn about Uganda from them.

I learned that the Ugandan people are very happy. They genuinely enjoy life and are pretty easy going for the most part. They are also very humble. Every village we went to we were treated so well and they thanked us so much for coming. Ugandans also love their country and want it to succeed.

We had a chat as a team before we left Jinja to take our flight home. Our team leader talked about how it would be hard to go home and not ask "Why?". Why do we have so much and they have so little.Why is my life so easy and theirs so hard. And as I sat thinking I did wonder a little at why I am so fortunate to live the life I do and have the opportunities I do. But I also felt very strongly that Heavenly Father is aware of all His children, including His children in Uganda. He is aware of their challenges and sacrifies in life and that the Atonement of Jesus Christ will make everything alright in the end. They are watched over and looked after and part of that looking after was my being able to help my brothers and sisters in Africa.

It was a trip of a lifetime and Uganda will always have a little piece of my heart! Jambo!
-Meagan

 
PS.
I was told that you can find jewelry like the stuff I bought online. I didn't find the exact group that I bought from, but I found another website that I think is doing important work. It's called 31 Bits and it is located in northern Uganda where there is a war going on, children being kidnapped and forced to be soldiers, and a ton of refugees from the civil war in Sudan/South Sudan. The organization employs the women to make beads and then sells the jewelry for them. The women are taught business skills, how to read, given meals, access to medical care, and many other things. After their allotted time many start their own businesses with their earnings or buy land and are able to provide for themselves. I plan on supporting it soon, plus the jewelry is so pretty as well!

Also, if you have interest in doing something like this yourself, let me know and I can tell you about my experience and preparation.