Uganda's forgotten...

For almost 20 years now the people of Northern Uganda have been terrorized by a rebel group, the LRA, and ignored by their own government. Just under 2 million people are forced to live in camps seeking safety. Northwest Medical Teams provides a mobile medical clinic to as many of the camps as donations allows, I am here, April/May 2006, as a nurse helping to provide health care to these camps.

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Location: Seattle, Washington, United States

Mahatma Ghandi once said that “with every true friendship we build more firmly the foundation on which the peace of the whole world rests.”

Saturday, April 29, 2006

Disturbed by mediocraty!

I love traveling to these far off places as I get to meet fantastic people! This past week we met a couple from northern Ireland by the names of Bobbie and Diane. They are in their 50's and have led fairly normal lives working and raising a family. Just a few months ago as they were sitting in front of the television after dinner, Diane looked over at her husband and said, "You know, Bobbie, I've been thinking..." Those are dangerous words indeed! She went on to tell her husband that she felt like life was just going to work, coming home, fixing dinner, and watching television, and that if this is all that there is to life that "Jesus could just take her home now". There didn't seem any point to going on any further.

Bobbie came home from work the next day and told Diane that he had been thinking about what she said, and that he agreed with her. He didn't know where this was all going to lead them, but somehow he felt that they would be going to Africa. Diane is involved in her local church and Bobbie doesn't consider himself a "churchgoer". So, Diane went to church and mentioned to someone there that they were considering going somewhere to help do something. The woman said the church had contact with someone in Africa. Turns out there was someone praying for a mature couple to come and run an orphanage in Uganda, northern Uganda. But, they apologized and said, it is in a war zone. Bobbie and Diane laughed and said, "We have lived in a war zone our whole lives!" Their grown children were all supportive and gave their blessing, and their house was put up for sale. Their house sold in 5 days, which is highly unusual where they live.

One incredible event after another, just 12 weeks after Diane shared her thoughts with her husband in front of the television, they are here recounting their story to Sally and I on a busy street in downtown Lira. They have just been here a few days more than us, and are adjusting well to this new life of running an orphanage for some of the children of northern Uganda. They are lovely, joyous people, with an incredible sense of humor and adventure! Bravo, Bobbie and Diane! May God bless you on this new chapter of your lives!

Friday, April 28, 2006

Aler Camp, end of the week...

Today is Friday, April 28th and the end of our first week of working in the camps. It was a good day as once again we were able to see all of the patients that came seeking healthcare, close to 400, and we finished by 2:45 PM. It is nice to be done early and not wiped out. This is the first camp that we came to last year and I was overwhelmed by the sheer masses awaiting our arrival, it is one of the largest camps in northern Uganda and I don't remember if there are 50,000 or 60,000 people here.

The nice thing is knowing that with just over a year of having our mobile medical clinic attend to this camp, the situation has improved drastically. The things we were treating for today were many children with bronchitis, many cases of malaria as the rainy season has brought out the mosquitoes, and more STD's, TB, and Immosuppressed Syndrome patients. I think we had only one severly dehydrated child that needed IV therapy for malaria.

I enjoyed seeing many small babies today, they are just adorable and smile at me so easily. Their black, curly hair is as soft as lamb's wool. I was totally shocked when one mother came and unwrapped her tiny little bundle for me. It was a 2.2 pound preemie, that was already 3 weeks old! You have no idea what a marvel this was to me, as by the mother's dates this child was only about 31-32 weeks when it was born at home in a hut in the most inhospitable type of setting. And it had already survived to three weeks of age! It was breastfeeding well and it looked great! The lungs were clear and the heart strong. I spent more time than I needed to cooing over it as I was just fascinated by its survival. I congratulated the mother on a job well done. She had come to see us as had many of the other mother's with new babies because they thought their babies' were crying too much! I laughed and told her that even "muzungu" babies cry a lot! Muzungu or Mono is the word they use for white people. They were impressed to know that even our babies can cry a lot.

We now have a three day weekend before us as Monday is the Ugandan Labor Day. However, we will be going in to the office for a few hours on Monday to organize supplies shipped over by Northwest Medical Teams with the purpose of distributing them to the local hospitals and clinics that are always terribly short on supplies. We are so spoiled in the U.S. as I know that we dispose of so many things that in other countries would make a huge difference.

Enjoying my time here, Brenda

Thursday, April 27, 2006

Orit Camp...

Today was a good day. We actually were able to see all of the patients that lined up to see us, and that was a good feeling. The weather didn't even threaten to shut us down again, but we were still feeling the effects of the previous days' downpour, because as the tents dried all of the dirt and debris left in them fell on us throughout the day. The flies and heat were still there, but not as bad.

Once again, I don't know how they are assigning the patients to the different tents, but all of my 70 patients today were men, except for maybe six. Elaine, our pediatrician, has of course requested children only, so I get to see few of the cute, little ones. I continue to get cases of TB, and today, most assuredly at least several infected with HIV/AIDs. With mango season in full swing, we have already had half a dozen boys with fractured clavicles and arms. Daily we get patients that require surgery for hernias, knees, hips, and so much more. I wonder where I could pull a surgical team together from? Hmmmm.

As I sit here typing I hear thunder rolling outside and rain coming down in sheets, we were hoping to walk to Pan Afrique for supper in about 20 minutes, as we are weary of the menu and service at our hotel. The last time we ventured to this restaurant we got caught in a deluge and walked into the restaurant like drowned rats.

I understand that yesterday on the Oprah Winfrey show her emphasis for the hour was on the situation in Northern Uganda, yeay! The word is finally getting out! Also this coming Saturday is another event to help with awareness of the situation here, it is called the Global Night Commute, and you can read about it at www.invisiblechildren.com.

Thank you for your thoughts and prayers on behalf of the beautiful people of northern Uganda! Brenda

Wednesday, April 26, 2006

Rained out!

We headed to Alito Camp today, where the population of the camp is about 20,000. Once again we set up clinic under some lovely mango trees, but knew that towards the end of the day we would get the sun. I started prespiring right away as I began to see patients. The number of people awaiting our arrival was small, but grew quickly as people heard word and came in from working in the fields.

The flies were the worst ever! I was constanly brushing them away and they were dive bombing my eyes and ears. I kept my mouth closed when not speaking so as not to inhale one. Some of the people seemed to bring in swarms with them. The mangoes are ripening nicely and children seem to be sticky with the juice, attracting even more flies. The heat and flies made for a tiring day, even before lunch.

Today I was able to keep my emotions in check, however, it really does hit you in the gut to see people crawling into your tent for care. They are people who are disabled or disfigured and have no alternative way to get around. One man I saw said that he had suffered from an accident and injured his back, his left leg was left useless. He had no children or family to help care for him. I did not begin to see the sick babies until after lunch, and then I got so many children with severe malnutrition and anemia. I always used to think that Kwashiorkor was in nursing text books to show something that had been eradicated. If you could see these babies with pencil thin arms and legs, with rapid breathing, feet puffy with edema, and a far away look in their eyes, you would be ashamed and outraged that this is being allowed to happen in 2006, with the knowledge that there is more than enough food in the world to feed everyone.

We knew that we would once again not be able to see everyone who had come seeking medical help, but we were not expecting our day to be cut short by a terrific down pour with much thunder and lightning. This was the kind of rain that drenches in less than 5 seconds. After the first round of storm we thought that we should attempt to break camp/clinic during the lull and I was soaked by round two. I have been in tropical storms before, and we are almost over the equator here, but here the temperatures cool down probably 20 degrees from this cold rain. This was like a camping trip gone bad. Everything and everyone soaked and needing to be thrown in the vans for the long drive home. Not even all the people we were able to see were able to receive their medications, as the pharmacy is usually the first disrupted by storms. So what was the challenge of your day?

Tuesday, April 25, 2006

The desperate masses...

How do I even begin to describe my day? We arrived at Acokora Camp with about 100 people waiting for us under two very large shay trees, under which we set up our clinic. As we were doing so, the camp mobilizer started using a hand held loud speaker (the type used at pep rallies) to announce that there would be a medical clinic, and by the time we were ready, at least three hundred had arrived and were jostling for a position in the long lines forming behind the perimeter ropes.

I went into my tent with David, my interpreter and began to see patients, mostly men! How did this happen, I wanted the pregnant women and babies! Oh well. Half way through the morning, David, the clinical officer came to get me to show me the absolute worst case of osteomyelitis he has ever seen in a 16 year old boy, and he has seen a lot! This young man's left lower leg from the knee down was about twice its normal size and had multiple areas were pus was draining directly from the bone, all we could do was to give him oral antibiotics, we all knew that he needed to be hospitalized and treated differently, but had no altrernative. Throughout the day I saw more cases of syphyllis than I ever dreamed, I am also quite positive of several cases of cancer in some ladies I saw. Several men were probably suffering from enlarged prostates, and many other aches, pains, infections, and undiagnosable things that would take equipment we don't have.

The thing that was overwhelming was that the noise level went up significantly through the morning, and by lunch time the masses of people were innumerable and pressing in around the edges of the clinic. The deworming station was going non stop all day until I believe they finally ran out of medication. I believe we saw about 460 patients and had to turn away well over 300 people.

The hardest point in my day was when a woman that did not even know her own age (probably in her 30's) came in and sat on the floor of the tent, her eyes down cast, and only a stump at the end of her left wrist. David beckoned for her to sit on the stool, and she scooted closer, still on the floor, and then after more encouragement she got onto the stool. Her eyes never met mine, nor David's, she was so hopeless and spoke in a whisper behaving as if she was not worthy enough to even be there. I don't even remember now what her diagnosis ended up being or what medications I gave her, I had to touch her and I stroked her face. I was overwhelmed with emotion and tears started falling down my face. David looked up at me and was shocked, he didn't know what to say, I don't think that it was appropriate for me to show such emotion but I couldn't help myself as it seemed that the condition of norther Uganda was embodied in this one woman. She had obviously been beaten down, disfigured, and cast away, she had no sense of hope whatsoever. It was hard to regain composure, but she never did look up so she never did see my tears. I will work at maintaining my compsure and save it for when I am gone like last year.

Monday, April 24, 2006

First day of clinic...

The internet connection is painfully slow here at the cafe where I am blogging so please excuse any spelling or grammatical errors, I am also not able to post pictures at the present.

This was our first day of clinic and today we awoke to sunshine and a clear sky after a weekend of heavy rainstorms and cool temperatures. We drove for over and hour over rough, pot holed, dirt roads to Walela Camp. This is a new camp to me from last year, and it seemed dirtier, and less organized. We received word before we left the office this morning that 4 people had died there last week from starvation, and we were taking no food, only medicines. It seemed depressing to not be able to take some food, but it will be brought up at a meeting of all of the NGO's (non governmental organizations, i.e. Action Against Hunger) today.
As soon as we arrived in the camp everyone piled out of our two vans and began setting up tents, and the pharmacy. There was a group of people already lined up when we arrived, probably 150 people. As soon as everything was in place I started to see patients with my interpreter, David. It seemed like all of my patients in the first hour were little old ladies with aches and pains of every variety. Then I started to see younger patients, many with malaria, parasites, and rashes. I also saw at least one patient with active TB, a child and mother with chicken pox, and many pregnant women with no prenatal care. It was a full and tiring day and I think that David and I saw over 50 patients.
The flies were terrible, they were everywhere and I had to constantly brush them away from my face. The sun eventually hit the tent we were sitting in and it got very hot, it was hard to stay hydrated, and very hard to feel sorry for oneself, as the daily condition of the people I was seeing was so much worse. I knew that there would be an end to my day and I would drive away, take a cool shower, step into clean clothes and eat a full meal.
I understand that tomorrow we will be going to Acokora Camp, the one we walked through on Saturday. They have not received any medical help from anyone, and they are expecting us, so we predict there will be large masses awaiting our arrival. It will be an even longer and busier day with possibly sicker patients. I just hope we don't run out of medications.
So glad we can help alleviate some of the suffering by attending to some of their medical needs, but it would be so nice to have Lab, x-ray, MRI, surgery, dentistry, and so much more available.
I continue to find the Ugandan people beautiful and hard working, and I am thankful to be meeting many other foreigners here leaving behind comfort and predictability to make even a small difference in the lives of a very forgotten and abandoned people.

Praying for strength and wisdom, Brenda

Sunday, April 23, 2006

Flip flops, and mosquito net...

Things common to living in a third world country I don't usually think about are: wearing flip flops in your hotel room, having to get in and out of the mosquito net during the night to use the toilet. Using a flashlight to look at your flip flops to make sure there is no creepy crawler to step on. Brushing your teeth with bottled water. Having armed guards walking through the hotel. Having to pay 3,000 Ugandan Shillings for one hour on the internet. Knowing how much 3,000 shillings are. I could go on and on but it seems that these things are so common place now.

Things I am thankful for: my own bathroom with a European toilet (no squatty potty!), an internet cafe with generator power, the cooling rains that bring the temperature down, a team mate that wants to get up and walk with me before the sun rises, avocadoes, mangoes, passion fruit, bananas, tomatoes, eggplant, safet and so much more!

There are so many things I take for granted when I am at home in the U.S. that being abroad always reminds me of. It is different here and in some ways hard, but it really doesn't seem to bother me. Brenda