Connor just observed that it's seven-seven-eleven. We don't know what that means, but it sure sounds exciting.
Anyway, just so no one actually worries, I'm totally fine. I just had this weird dizziness yesterday and a really glamorous UTI which antibiotics have happily helped with greatly.
I want to second what Connor said about the masala chips, sipi falls, and Ugandan men. They are, respectively: delicious, beautiful, and extremely forward. I also want to emphasize the extreme joy that we both felt when Ben K texted us to let us know about the birth of Brugh, which was the real highlight of our weekend. Ben also deserves a shout-out for most encouraging big-brotherly phone call ever. Many of our medical experiences here have been overwhelming to me- the difficulties are so much more systemic than just resource management. For example, today in the male ward, Connor and I were making rounds with the head nurse and visited an elderly man who has a seriously obstructed bowel, a life-threatening condition should it rupture and spill it's bacteria-laden contents into his abdomen. When the surgeon stopped by to obtain consent to operate on him, the patient was extremely confused and unable to speak clearly, but his many sons were there adamantly refusing consent for the surgery. When we were making rounds, the patient could speak, was lucid, and clearly wanted the surgery, but there were no doctors of any kind around, and the sons still didn't want their father to have the surgery. The head nurse talked at length with the family, who seemed pretty well-off and relatively urbane for Iganga, but who then launched into a full-on tirade about their father being bewitched, being poisoned (possibly by the hospital?) and that what he needed was a witch doctor. Their father, it seemed to me, was probably just having difficulty with his lucidity as a result of his medical condition, a common, reversible, and in fact already reversing condition. Instead of listening to the nurse's explanation of this, they loaded him onto a gurney and took him out of the hospital, probably sensing that Connor and I were planning to run down to the operating theater and grab a surgeon to obtain consent and book the surgery, which we damned well were about to do, in accordance with the ethical principle of patient autonomy. They took him away.
This all goes to say that the problems with healthcare here, as in the united states, are systemic and confusing. They are cultural, financial, organizational...and they make the scale of suffering almost unbearable to imagine. When Connor and I went out into the village Tuesday, we drove out of Iganga, across an hour of countryside, then through a very small town called Namatumba, where we turned off onto a little dirt road that journeyed on further through miles of cornfields, and scattered through these cornfields was hut after hut occupied by people living as subsistence farmers in a country with no infrastructure to help them have safe, happy births, lives or deaths. I like Uganda a great deal, and I'm not saying any of this to imply that people here and elsewhere aren't trying to improve these problems- it's actually the opposite. It's disheartening that even with so much goodwill and so much money being poured into NGOs and government efforts here, we still arrived Tuesday afternoon, three med students expecting to see twenty or so kids with some gnarly wounds, and instead we sat in those rooms Connor talked about and each saw student after student, about seventy or eighty each. The teachers there made lunch for us but didn't bring it out because we were working so hard, and they wanted so much for the kids to get some kind of medical attention. And so did we. But we're not doctors yet, and we were in a school with dirt floors in the middle of miles of fields full of corn, sugar cane, bananas, coffee, tea, where people live without much that we take for granted every minute of every day.
I don't really remember what Ben said to me in response to some of my more hopeless thoughts about all of this, but it really did encourage me to learn as much as I can from this journey.
Also, we could really use some assistance with web-based research about basic preventative/maintenance healthcare recommendations for kids. Are there any good protocols for schools in underserved parts of the world that address how to instate cost-effective programs to promote general health? We're especially interested in nutrition, tooth hygiene, vision correction, de-worming, wound care, hand-washing...really basic things like this. If you are looking for a time-killer at work, give this a quick google or pub med or whatever else for us. Thanks so much! Please email one of us with whatever you find.
Anne- Really thoughtful and interesting post. When I was in India I had the opportunity to visit a women's empowerment group run by an Indian catholic nun. She was working with local women in Bihar, the poorest, most corrupt part of India, to make changes in communities through the mostly untapped resource of women. There were beautifully artistic posters created by the local women about more efficient cooking methods, basic health care and even dealing with husbands. One thing that I was really struck by was that in the third world there did not seem to be the same correlation between pain and unhappiness that there is in the west. I saw incredible pain and suffering but it was not always matched with unhappiness. That separation was inspiring- is that something you and connor are experiencing? sounds like it is an amazing journey.
ReplyDelete(this is Ben H. by the way!)