Amagara Ga’ Boona Please!
Uganda is a country rich in culture. It is lush with fruitful vegetation, colorful flowers, and amazing creatures. The people are warm, friendly, inviting and generous despite their lack of essentials, creature comforts or even necessities. In June of this year I was privileged to experience Uganda from Eastern Jinja and the beginning of the Nile, the Western Uganda Fort Portal area, and the Southwestern Uganda - Kamwenge- Kohondo area to Murchison Falls in the Northwest. Two things were consistent: the poverty and the needs of the people. Whether the mud huts were round or square or the roofs thatched or metal, the needs were overwhelming. Despite seeing it firsthand, it is hard to understand the depth of the poverty in today’s world of decadence and plenty.
Ottawa Noon Rotary has an extensive history of supporting and developing the Kamwenge area. When I was approached to go to Uganda to assess the emerging medical clinic as a health care professional, I could scarce believe it. Through the generosity of a District stipend, I was privileged to join a dedicated group from Ottawa to experience the country and the people at a very personal level. I have much to share and I trust words will be adequate to describe what I witnessed, experienced and observed.
The new, unfinished Amagara Ga’Boona Medical Clinic is situated in the Kahondo- Kamwenge area in western Uganda. The name means ‘health for all’. After our arrival, hours of jostling along the main (dirt) road, deeply eroded with ruts and irregularities, brought us to a small village where the Glory Primary School sign indicated where to turn. Another path, barely suitable for foot traffic, brought our bus to our destination. On the right is the school where hundreds of people were waiting. We gathered in the Church building where introductions were made, supplies unloaded, and designations of rooms for medical treatment determined; a long day began. By night fall, an astounding 386 people were seen, evaluated, received lab services and had medications dispensed, the last hours by flash light.
Over the course of two days I interacted, observed, participated in, and interviewed people regarding their hope for the new medical clinic. The buildings are directly across from the Glory Primary School and the local church. One is L-shaped, complete with walls, a roof, doors and windows (sans glass). This building will house the pediatric ward, the mothers ward, and the consultation (exam) room. The second building has brick walls, doors, a roof, and windows, again with no glass. This building will house the surgical room, the lab, the pharmacy and the cashier/accountant.
Interviews with 16 people of varying positions in the community were conducted over the course of two days with the use of an interpreter. Questions were created with the input of Milton Tusingwire, developer and creator of Initiatives for Transformation Innovations*, (ITI), a Non-Government Organization. Milton and his colleagues at ITI, alongside the members of the Kabarole, Uganda, Rotary Club were instrumental in working with Ottawa Noon Rotary members to secure and implement a Global Grant in 2012 that provided clean water; furnished a school, library and playground; provided hygiene training, and allowed the community at large to become more sustainable through the donation of a maize milling machine, the products of which are feeding so many. The Rotary Clubs of Rochelle and Ottawa Sunrise made donations to the Grant project as well. The generous contributions from RI and our District also combined to create solutions and change lives for the Kohondo community. The provisions from the Grant are still functioning and well-used today, and the region has been declared a “model community” by the Ugandan government. The new medical center will provide yet another life-changing entity to the region. All this, originally started by two women in Ottawa who had a dream to make life better for our neighbors in Uganda by building a school, has forever transformed a community.
My interviews with local residents determined the consensus that having access to health care locally will once again significantly impact the infrastructure of the community as it improves the quality of life for all and saves lives for many. Villagers shared stories of how many women and their babies die during the trip to the hospital or during child birth when unable to travel. Prenatal care is currently non-existent. The recommendation is that all pregnant women be seen at least once every 2 months during pregnancy to identify issues and causes for concern before the delivery. At least one woman I encountered was 7 months pregnant and had never been seen for prenatal care.
The nearest hospital (government owned and operated) is 45 minutes away via bodaboda (motorcycle) over a rough dirt road. Transportation is expensive and not everyone can afford it. When going to a government hospital, you must bring your own caregiver, provide your own food and if expecting to deliver, you must provide your own labor and delivery supplies. You may be aware of the Mama Kit project, also supported by Ottawa Noon Rotary, who has funded hundreds of labor and delivery kits to the women in Kohondo. Some local residents stated that government hospitals are not always open after 5pm or on weekends, nor do they always have required medications.
While at the medical clinic, a young boy approximately 4 years old was brought to us unresponsive, listless, and burning with fever. His lungs were full with noisy respirations due to aspiration of vomitus. We cooled him as best we could with wet cloths while waiting for a motorcycle to take him to the village where he would transfer to a taxi for the 45 minute ride to the hospital in Fort Portal. I feared for his survival. A second child experienced the same problem a short time later. A week later, the first boy was still at the hospital ready for discharge, but was unable to do so until the bill was paid. The hospitals I saw in Kampala and Fort Portal were surrounded by walls topped with broken glass and/or barbed wire and had armed guards who walked the grounds and guarded the gate for a secure entry.
Without a local health care facility children die of malaria or worms on a fairly regular basis. Many children at the clinic showed signs of severe anemia- always associated with advanced cases of malaria and worms. Immunizations are not currently available locally. Travelling is required and therefore is seldom completed. Skin infections and fungal infections such as ringworm are also common due to lack of hygiene. It was not uncommon to see a child with numerous white patches on their heads: a sign of ringworm infestation. This is contagious and seen in families with one bed to share and no clean linens. When the new medical center is operational, community education will be vastly improved on subjects as simple as setting mattresses out in the sun to decrease the spread of infection, and the need for regularly cleaned linens.
Most diseases observed during my trip, as well as at the clinic, are preventable. Education is greatly lacking and sorely needed. One woman interviewed shared she struggles to get people to understand mosquito netting must be used to prevent malaria not after the illness is present. Sixty two people were treated for malaria at the clinic. Something as simple as boiling water and reheating leftovers could prevent worms. Twenty adults were treated for lower abdominal discomfort and 122 children were treated for worms; some experiencing bloody stools, swollen stomachs, diarrhea and pain.
Ottawa Noon Rotary will once again be submitting a Global Grant application, this time to complete the new medical center, Amagara Ga’ Boona. We already have the outstanding support of the Rotary Club of Dixon, and we are grateful and honored by their contribution of $3000 to this new initiative. A new local ministry, Believe in Uganda, has been mobilized by the original women who built Glory Primary School, and are making semi-annual visits to our project site. They are raising funds to support the purchase of two ambulances, and we anticipate their assistance with the cash contribution required in the Global grant. The Rotary Club of Kabarole will again serve as the host Club.
As seen in the pictures, the buildings are in place. Our grant application will request funds for another well, generators, medical supplies and equipment; we will also request a supply of medications as well as staffing expenses for one year. Through fees charged to patients, the clinic is expected to be self-sustaining by the end of the first year.
Frankly, we need your help and that of your Club. The initial cash outlay to secure the Grant funding will likely be $18,000 plus. We have secured $8,000 to date. We are seeking financial partners for this Global Grant, and hope your Club will join us at whatever level you are able. It’s an easy way to participate in a Global Grant project. I will be delighted to visit with your Club to share a PowerPoint presentation about the evolution of the Kohondo community and our commitment to bring desperately needed medical services to them.
As a registered nurse for over 42 years, I have never seen or experienced anything like Uganda. I left a changed person. It made me grateful for what I have. I left with an intense desire to do more, to share their story and convey their needs. Mostly I want to make a difference. I believe if we band together and combine our resources to make Amagara Ga’Boona a reality we can save the lives of the residents, particularly mothers and children as we also combat disease, improve sanitation and hygiene, support education and continue to grow the local economy. This is why I am a Rotarian.
Cindy Duncan RN, LNHA and Ottawa Noon Rotarian can be reached at crdrnms@hotmail.com
*Innovations for Transformation Initiative - ITI - is a community based non-governmental organization, registered in Uganda. They work in poor communities adjacent to protected areas such as natural forests, water bodies, national parks, game reserves, major rivers and swamps which are at risk of devastation as a result of human activities. Their aim is to bridge the gap between the young and old, marginalized and the privileged, the haves and the have-not, the sick and the healthy, the harassed and the favored, the rich and the poor, through enhancing social justice, gender equality, social inclusion and participation of minority groups, promoting exchange of information and best practices through vocational training, research, education and building strategic partnerships within and outside Uganda