Tuesday, July 15, 2014

Reflections from Rural Uganda

Hi again-

I've officially completed the travel installment of my internship, having gone to rural towns in districts in Southwest Uganda, close to the Tanzania border. Despite the potholes, it sure beats 9-5 in an office!

Just another day in the office

We spent time interviewing private drug shops and clinics, along with getting to tour government health centers. On paper, public health centers in Uganda are free of charge to citizens and are tiered according to the services they offer, with National Referral Hospitals like Mulago in Kampala offering the most specialized care, and Health Center Is essentially a village volunteer in rural districts whose job consists of home visits for low-level health scares and education.  I didn't want to take pictures in the hospitals we visited for fear of offending patients and staff, but at the risk of sounding cliche, they were incredibly eye-opening. One hospital we visited cuts the electricity at night (provided that it is running) in order to save costs. While there were beds available, there were no mattresses. Sick individuals need to bring their own mattress or receive treatment and sleep on the floor, the same individuals who are often traveling many miles on public transport often after being told by closer health centers that there is no treatment available for them.

Despite this "free" care, drug and supply stockouts run rampant, particularly with IV fluids, anti-malarials, and blood. Patients report having to pay medical staff under the table to receive care, as many of the staff don't receive their full salaries as promised by the government. A 140+ bed in Rakai district runs on less than $51,000 per year, and hasn't seen a budget increase since the mid-1990s. While the cost of living is certainly lower in Uganda than in the US, such a sum is almost laughable by any standards.

Yet it hasn't been all bleak! We've seen doctors and clinicians find creative ways to solve drug shortages, from arranging swaps with other health centers in their district, and partnering with local private clinics to help administer vaccines. Many of the staff we interviewed expressed frustrations, but also hope for the future, and a true desire to help their community.  I also happened to be the only mzungu many of the children had ever seen before, several coming up to me and rubbing my skin, seemingly convinced I must be covered in something.

As an Upstate New Yorker, I had to document the above sign - Buffalo in Uganda!

Overall, we've been able to get some great information and insights, as well as get to enjoy the countryside. I also got to try some new foods, including jackfruit, which happens to look like something from Willy Wonka's chocolate factory at first sight:

Surprisingly delicious once you get past the spiky outside
Until next time!


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