The older Ugandan woman told Dr. Dan, Camila and I that, after dealing with the pain for quite some time, she was told that she had cancer somewhere in her abdomen. This diagnosis was subsequently changed to a couple of herniated disks and pelvic pain of unknown etiology. Her stack of “records” (a bunch of small dirty papers stapled together) revealed a string of misdiagnoses, but that did not seem to matter so much to Florence. As I looked intently at her face and into her eyes, all I saw desperation and it was all I could do to keep from crying. Many of the faces here seem resigned to the uncomfortable nature of life in Uganda; they are used to the heat and the pain and the dirtiness and lack of convenient anything. However, her agony seemed far more than Florence could bear. In the US, we are prescribed and take medication to ease almost any ailment. Here, they just deal with it.
Yesterday, Camila, our newest eCare team member, and I traveled via matatu then boda to the Soft Power Health (http://www.softpowerhealth.org/) clinic near Jinja in Bujagali. This is right up the street from the NRE campsite (http://www.raftafrica.com/), the company that does the white water rafting thing. Dr. Jessie is the founder of Soft Power Health, which is an organization that began six years ago, originally to do education with malaria outreach. It quickly grew and they began to do family planning as well. Three and a half years ago they opened a clinic. I will try to post photos as this place is incredible and you have to see how cute it is. You can check out the website as well. They have three Ugandan doctors and Jessie, an American physician, who essentially seems to do consults and run the organization. Dr. Dan allowed me Camila to sit in and observe him talk to, examine and treat patients. He was a fantastic teacher and I would love to go back and do a rotation 4th year there if possible. I learned a lot about malaria treatment, including during pregnancy and peptic ulcer disease in Uganda. I also learned that patients are the same everywhere. They don’t come to follow-up appointments, don’t take the medication as prescribed and when they run out of meds, they don’t come back for refills.
At this clinic, the patients can come without an appointment and the cost is 5,000 Ugandan shillings, roughly $2.50, to see the physician.
After spending the morning with Dr. Dan, the rest of my team arrived, minus Karly who has not been feeling good, and we went to visit a traditional birth attendant who is famous in Uganda. Woman even come into this tiny little village from Kampala to see Mama Jamira, who began delivering babies in 1982, the year I was born. The work that she does is incredible and I think I could probably learn more from her than most physicians. Mama Jamira has been on her own for many years but recently, January of this year, an organization called One Mama came to help her expand the “clinic.” For more information, you should check out http://www.onemama.org/. Honestly, I don’t know much about the organization but there is a link to Jamira’s story on there. She showed us how she counsels mothers with the use of herbs for all sorts of things – malpresentation, nausea and vomiting, postpartum hemorrhage, induction of labor. It was incredible. (And I’m sure a lot of it works… although I'm not sure I totally buy the one that you smear on the abdomen to make the baby flip so she/he is head first.)
All in all, it was a long day with tough traveling down really rough roads but very worth it.
Tuesday, June 23, 2009
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