It’s a cold morning. The usual fog engulfs Muko Health Center IV, obscuring the spectacular view of the beautiful cultivated hills from where the sun rises. The first sun rays penetrate through the fog, shining a warmth on the patients waiting to receive care after traversing hills and valleys to reach the center. Work starts as usual.
Little did I know this was the day when the first ray of hope would shine on Muko!
A staff calls me to receive a visitor, a tall old man with a charming smile. We exchange greetings with a firm hand shake. He tells me he is Dr. Arthur Bikangaga, a retired consultant from the USA. He is quick to add that Kabale, Uganda, where Muko is located, is his home area; but he has been away for over 40 years. This is confirmed by his occasional use of Lukiga, the local language though with an American accent!
We sit on a bench, and he explains to me that he has come to start a longtime partnership with an international organization called Worldwide Healing Hands (WHH), an organization that focuses at improving maternal and child health, especially in the most remote, undeserved and resource-limited parts of the world, through education, skills development and material support. He informs me that the WHH team will be visiting Muko HC IV in the near future to help improve service delivery through trainings and material support. I take him around the health unit, explaining the different challenges we were facing. I later compile a report which I submit to him and WHH.
That day I was anxious to know more about WHH, thinking of the improvements that could be brought by this organization to Muko. I had been at the facility for four months then, but everything was out of place so that I could not do many things I am trained to do because of lack of other personnel, supplies and equipment. For instance, I could not do cesarean section procedures, and I was referring mothers to the regional referral hospital miles away. I turned to the internet to find out about WHH. This was a headache because not only is the connectivity incredibly slow but also expensive.
I found out about the works that WHH had done in Nepal and Haiti, and my expectations and imagination was heightened. I could not wait to have WHH visit Muko.
Months passed without communication and hope started to fade. One morning I received an email from Arthur; but, annoyingly, due to poor internet, only the subject of the email loads: “trip to Muko in mid October.’’ After work I traveled to the nearest town where internet connectivity is better and where I was able to read the email and understand the details of the trip which was to be in October 2015. Another email from Dr. Paula Dhanda a few days later confirmed the same, and she also requested me to compile a list of medical supplies and equipment that they may bring with them. Now, this was what they call a blank cheque, and the list I sent her was as long as my imagination.
The days prior to the visit were full of excitement, anxiety and hope. Everyone was waiting for the WHH team. These days seemed to have more hours than usual or at least longer hours! One warm evening I was called to receive the long-awaited WHH team, having surprisingly arrived by mini-bus from neighboring Rwanda. I was glad to see the warm faces that had traveled afar to come and offer a helping hand.
My appreciation and admiration deepened by learning that these were volunteers who had not only dedicated their time but also sacrificed their finances to come to Muko.
With them they had brought many suitcases packed with vital supplies, notably blood pressure kits, glucometers, surgical instrument sets, medicines, to mention but a few. These have been of great use to our health unit.
The next few days were packed with busy schedules without lunch! Everyone got their hands dirty while cleaning and moving things from place to place to create a working space. Flip Fitch, the theater technician, assembled surgical instruments to constitute different operation sets as well as writing the lists down for future reference. He taught me how to operate the steam sterilizer so I could carry on after he had left. Ken Cartwright took good care of the anesthesia side, and Jasmin Clarke could do about anything that required a helping hand. Carly Alvord and Amber Dems took care of the social part by interacting with the clients and staff to gain a better understanding of the society we serve and the challenges we face. Nathan DeHart is the most incredible photographer I have seen! All the moments were captured with crystal clarity.
Dr. Paula spearheaded the training sessions on helping babies breathe, vacuum assisted delivery and management of PPH (postpartum hemorrhage), which further improved our skills and knowledge. Many thanks to the Canadian resident pediatrician for the contribution in the training. Additionally, Micheal DelValle helped sort out the electrical problems as well as doing an assessment for future improvement, and of course Arthur was the man at the tower. I was moved by the extreme simplicity, dedication and diligence with which this great team worked!
The main aim of the mission was to make sure they left us able to do cesarean sections; and as no patient required a c-section during their short stay, we had a practice drill.
Indeed, when they had left, we started doing c-sections at Muko. Great thanks to everyone for the contributions toward achieving this milestone.
The story would be incomplete if I didn’t mention the home visit we made to one of our patients and another to a traditional birth attendant (TBA). This was in a bid to have a first-hand experience of the challenges faced by our mothers in accessing care, as well as the unrecognized and illegal but yet big part played by TBAs in this society. Having traveled about 40 km through spectacular hills and valleys, and with about 3 km to go, our vehicle could not handle the terrain. We had to walk down steep slippery slopes. I suggested we abandon the visit but no one listened to me as the team was determined to reach the mother’s home. Having failed to convince them to give up, I joined them and we continued. My calf muscles gave up, and I started trembling. The more I tried to conceal it, the more visible it became; but I was encouraged by the fact that Jasmin and Amber were still strong — not to mention the mother who was pregnant but leading the team — so I also pushed on.
We finally got there and no words can explain what we felt when we learned that our mother had walked most of the way to the health unit while she had been bleeding due to a threatening abortion.
She has since stayed at the health unit awaiting delivery, because she cannot risk going home before delivery for the fear of having to make the journey while in labor.
When we visited the TBA, we learned lessons about these unrecognized, illegal practitioners, yet pillars who deliver slightly more than half of the mothers in the communities due to the fact that the health centers are far, there is no transport, and the centers are often ill-equipped in terms of personnel, equipment and supplies to offer better service.
As time is always on the move, the final day came and our visitors packed their bags, but they left us with positive changes, new equipment, better skills and improved quality of care. Some things are small when you have them — for example, being able to take the blood pressure of a patient, test a patient’s blood sugar and, most important, being able to operate on a mother who needs a C-section. These are life-changing things in this part of the world.
Most importantly they left us with hope, the hope that this was not an end in itself but a beginning, promising further missions, to continue improving care at Muko Health Center.
We are looking forward to having you back soon.
Photo credit Nathan DeHart
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