Lessons learned in Uganda


It’s hard to believe that it is only three weeks since I returned from my last visit to Uganda ….. it seems like a life-time ago, the disconnection with here and there remains as strong now as it did after my first visit 6 years ago.

The first ten days were the hottest that I have known it to be; the rains were late and people were anxious about their ‘gardens’ ….. which means their food supply and the cost of foods if they had to try and buy. During the trip there were many other ‘anxieties’ that became evident, although very few affecting me directly, which just highlights the lottery of life and leaves me feeling guilty and grateful all at the same time.

We were soon thrown into Ugandan life as far as TUSC is concerned. The first full day was a ‘Friday Friends’ day, when we transport children with profound disabilities and their carers, for Physiotherapy. This service has become in great demand and there was no room for myself and Jo-Ann (a TUSC friend from Canada) in Billy-bus …… so we made our way up to Bugagali on a Boda-boda taxi – or a motorbike to you and I! It was lovely to see our little passengers, the progress that they are making and the camaraderie amongst the mothers and Jaja’s (Grandmothers); in fact, the friendships that have grown amongst these ladies is a joy and unexpected bonus. Two years ago when we first visited Arthur (not his real name) he was dirty, sick and malnourished and had cockroaches in his chair; and I wanted to shake his mother into action and realisation that his care was not good enough ….. although I know that I am not in a position to judge but I am a mother and so couldn’t not do! Now Arthur is growing, clean, well and his mum laughs and chats with the other ladies. The afternoon group was short of one child, Favour, who was in hospital with a sickle-cell crisis and at the end of the session the ladies asked Yakub if they would take them to the hospital before taking them home. Yakub later reported to me that each lady gave Favours’ mum a few shillings or a bottle of water or a piece of fruit; I don’t have words but touched to say the least.

Later that evening, just as we were settling down for a cup of tea with a friend a phone call came in; could we do an emergency transport from Mpumudde Clinic to the Main Hospital of a young girl who was having problems in labour. When we got there we found Esther, a 17 year old girl who had presented in premature labour with no carer. She had delivered the baby who was having breathing problems but had another baby stuck inside (undiagnosed twins!) and was almost collapsed herself. The staff called us as no baby would survive that journey on a bike and there was nobody to take him; and mum was in no fit state to sit up so a vehicle was the only option. Many years ago I worked as a midwife and although I have forgotten much I know that this is a dreadful and dangerous situation and I quietly asked Yakub to drive as fast as he safely could. Whilst Mum was carried into delivery I ran with her son to the Special Care Baby Unit, briefly described his condition and then they told me that they had no cannula or tape or antibiotics for him ….. so I found Yakub and we went and bought these items from a pharmacy (crazy that you can just do that on a Friday night at 8.00pm!). When we returned we found a doctor waiting for us ….. the girl would need a caesarean section and he needed money to do it! I was FURIOUS I will admit; he should have been doing the operation rather than trying to extract money from us! I left Yakub to talk to him (it is often the fact that a ‘mzungu’ is present – a white person, that causes this opportunism!) and explain that we can only provide transport. However, I do know that often wages are delayed by the Ministry of Health and perhaps he also had ‘challenges’ so perhaps I am wrong to judge as I did. Yakub soon rejoined us, having explained our project, and also after getting a contact number for the girls’ family. Sadly, we later learnt that Esther lost both of her babies…..that the second baby had died inside her before they got her to theatre and that her son died a few days later.

This is just to give a flavour of the work that we get involved with. The dilemma of buying/paying for healthcare is always there. We cannot be seen to be paying for healthcare otherwise everybody would demand of us and we would not be able to run the project. We also have to be very sure that the costs quoted to us are real costs and not just staff (or our passengers!) being hopeful! And there is the extra consideration that we have to give to being human, so when we were asked to transport Salama, a VHT (Village Healthcare Team worker) to follow-up Rachel we found ourselves giving in to our basic humanity. Rachel is ten years old, smaller than her 8 year old sister and living in a slum area of Jinja. Her mother had died a few months ago after a long illness that her Jaja had nursed her through. This meant that her Jaja had not been able to work and so was behind with her rent and the landlord was ‘on her neck’. Both Rachel and her sister are HIV positive and Salama had been involved in counselling the family and starting them on medication just two months before. However, Rachel was very sick and there was no food for the family ….. so we transported the Jaja and Rachel to Whisper Hospital (more later) where we paid for her to be seen, have blood tests and medication given and a follow-up appointment arranged; whilst I waited with the family somehow some money ‘jumped’ out of my hands and into Yakub’s pocket and he was able to buy food to cover for a couple of weeks for this family….. because how can you walk away with money in your purse and know that this child will be taking antibiotics and HIV medication on an empty stomach, and how can you expect her to improve when she is starving away? Later, obviously touched by the plight of this family Yakub asked if there is any way that we can start to provide ‘kick-starts’ for Grandmother led families …… but whilst that would be brilliant where do we draw the line; what about other single-parent and desperate families; the needs are beyond us to manage and we don’t expect it of ourselves or Tusc, but when you are seeing the reality of it, it is hard to say no.

The trip was definitely NOT all gloom and doom though. We were put in touch with a gentleman called Mintu who we had been told sourced vehicles for Embassies and Charities …. And he agreed to help us. He did the leg-work of trawling/contacting the car bonds and found a vehicle for us. It was lovely to meet this little Ugandan Asian man – who shocked me with his Cockney accent! During the 70’s he and his family had ‘left’ Uganda and arrived in London, where his dad ran several garages; Mintu had been pulling car engines apart since he could reach a bonnet! He asked more about our work and what we wanted of the vehicle, and when we said that we needed the back seats removing and bench seats fitting ….. he offered to do it FREE !!! He said that his brother (who has a body-work business) would throttle him but he was going to do it anyway. And he also waived his ‘brokers’ fee so we got our new ‘Nellie-Ann Van’ for 2million Shillings less (about £1000) !!! I have to admit that his spontaneous kindness made my eyes leak….. as I type this Nellie is in the workshop having some alterations and I am excited to see the outcome!

Friends do lots for us and I took out cases filled with medical supplies and children’s clothes. I was also given money to ‘use for the trip’ and this went on standing frames for some of the Friday Friends (eventually we hope that all the children who attend will have one), mattresses for some families, and mosquito nets, which we try to supply when funds allow. We were also able to ‘obtain’ from a Rep, some colostomy bags for a young 17 year old boy. Hospice Jinja (www.hospicejinja.org) had told us about Waswia, who was not under their care but who had been given a permanent colostomy (an opening in the stomach to allow bowel action) and who was making his own bags using sellotape and carrier bags; it was such an honour to share his delight and hear him say, ‘ I can go to school now without worrying all the time’ …… nobody should have that worry, and especially not such a young person.

Our link with Hospice Jinja also enabled a ‘global’ effort to help young Annet. Tusc were contacted at the beginning of the year by Hospice asking if we could help 12 year old Annet in any way; she was born with bladder extrophy, where her bladder was not enclosed within her body, and she was permanently in pain and leaking urine, not able to go to school because of this, isolated and had been abandoned with her Jaja by her parents. Tusc was able to contact Jo-Anne who has links with Corsu Hospital, and she asked their founder. He was able to identify a surgeon in Uganda and provided her contact details; these were passed onto Hospice staff who made the arrangements and in March Tusc transported Annet for the first of her operations to start to repair her abdominal wall and start to attain some bladder control. We also collected her from Mulago Hospital (in Kampala) and returned her to her village; she would have not been fit for that journey on public transport! During work like this, Yakub is able to impart advice, knowledge and motivate the carers to do some simple healthcare actions like improving hygiene, enriching diets simply, using mosquito nets (which we supplied her with) and sharing our contact numbers in case of any sudden healthcare issues.

Uganda continues to elate and deflate me if I am honest. This is a tiny snap-shot of the trip, the stories, the lives. The corruption infuriates me but the beauty of the people reinforces my faith in humanity, the ingenuity and the tolerance and the strength humbles me, the smiles and the inherent joy of the children are a gift ….. and I am already planning and saving for the next trip!

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