Northern Uganda - a different world
In his previous blog entry for TheLancetStudent.com, Lancet web editor Richard Lane had just arrived in Kampala. He has continued with his journey into Northern Uganda with the human rights charity HART and tells us more about it here. Rhona
Kalongo- Northern Uganda
After the comfort of the Lakeside hotel in Kampala, a major jolt to the system when we touch down in pouring rain in Pade, northern Uganda. Local school children wave and cheer as we stumble off an ancient twin-prop plane. First stop the local Government office a few miles away. There we are briefed about the local situation; hopes of an official peace settlement between the Ugandan Government and the rebel Lords Resistance Army. We hear how the vast majority of the half million people in the district are living in satellite camps and how HIV prevalence is around 40%. Next stop a satellite camp - satellite as they have been created further away from the main camps used during the war when night commuting to the camps was part of daily life. we are greeted by Henry, the Commander of the camp. The place is only half full - 16,000 residents. A strong smell vaguely resembling a farmyard. Families living in mud huts, barely any possessions, often just a woman, her children, and a bag of maize. The smell has now become a stench as we near the pit latrines. We meet a blind woman who is receiving extra help looking after her grandchildren, her daughter and son-in-law dead from HIV-AIDS. And everywhere a feeling of listlessness, of people just existing, but not really living.
Smiling young faces at a Ugandan orphanage
In Patongo we are greeted by a fanfare of schoolchildren who lead us down in a noisy procession to the centre for orphaned children, an establishment created by HART, the humanitarian aid charity I am traveling with. Upon arrival we are treated to traditional dancing from local women, a strange ritual with stamping of feet and a heart-stopping shriek from one of the women, I can only describe the sound as what I imagine to be a horse being strangled. But a local explains how such shrieking is a sign of happiness, of contentment, so that’s ok. Into a bante (straw hut) for supper: rice, beans, beef stew or chicken, and bananas. Then to our lodging 10 mins drive away. Tiny room but the bednet seems ok; however only one semi-working toilet for 10 of us. Kampala seems a million miles away.
Grubby primary care and a sparkling district hospital
Patongo is very much a poor rural setting. A visit to the local primary care clinic reflected the poverty of the area. No patients there when we visited; inside a few dusty rooms and medical remnants, a feeding tube on a counter, an old swab, used ampules, and little medications, just some anti-malarials and some rather old-looking antibiotics. And generally, a dusty and primitive feel to the place. As we reach the door to leave a man enters, he is the clinic officer, equivalent to a prescribing nurse practitioner. We hear how the clinic has been a centre for antiretroviral drugs for the past two years, and offers basic childbirth facilities. He tells us how half of women still choose to give birth where they live, with the help of traditional birth attendants. The state of the clinic does not do much to encourage women in to have their babies.
Two hours later after a bumpy drive north to Kalongo we enter into the district hospital for the area. An attractive setting; neatly cut lawns and colourful flowers in the courtyard leading up to the hospital, not to mention the white light of the moon shining down from a mountain resembling the rock of Gibralter. Inside a sparkling clean hospital, friendly nurses wearing starched white uniforms with a lue belt (‘just how nurses used to look in the UK, comments one of my companions). We tour the maternity unit with its Florence Nightingale wards, 14 beds each side, and wave through a window to a young woman who has just delivered successfully. The nurse guiding us around explains that inpatients pay 500 Ugandan shillings ($0.3) towards their care. On to a busy children’s ward, people sitting on mats next to the beds; a lot of coughing from the children. It reminds me of Bedford General hospital where I had an appendectomy 30 years ago. Other departments in Kalonga seem familiar too: surgical ward, medical ward, theatre, x-ray, pharmacy, children’s unit, and of course the maternity services. Only upon leaving do we learn that the hospital is funded by a charity in Italy…a few days later we will see a government-run hospital…Richard Lane
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