Uganda 2009 Part 2: You Are Well Come

I tried hard to kick off my month optimistically, despite the challenges both ahead of and behind me. I spent the day yesterday with my team, trying to learn all that they have been working on in the past month. This was difficult, as I am working on a team of determined overachievers, who have certainly made me proud. It is never an easy thing to shoulder the task of helping to introduce a new program at a fledgling nonprofit, especially one that is trying to work within a broken healthcare system in rural African villages. They have been faced with the task of trying to improve healthcare delivery and utilization in rural clinics with bare bones staffing, no medications, and no supplies. I can imagine most people looking at this situation and trying to push along a few simple tasks, like meetings, gathering data, planning and executing basic maternal health education, and meeting with obstacle after obstacle, would be beyond daunted and give up. However, I think that the team has flourished despite all this, with much credit due to incredibly effective leadership prior to my arrival.

The team has developed some educational materials and a safe motherhood curriculum that I am very impressed with. I look forward to seeing them present this curriculum in a village on Monday. They have also been busy doing things that, though they are less tangible to picture, are even more valuable: making connections, data analysis, strengthening parterships, and developing assessment tools. This small sketch is a part of one of their education tools designed for an illiterate audience.

I traveled to one of the health centers today to help perform a knowledge assessment on the staff of the Labour Ward there. This rural outpost, despite its location very deep in the villages, has almost reached the designation of hospital by the Ugandan classification of medical facilities. It has small men's and women's wards, and the separate Labour Ward where deliveries occur. The midwives there were kind enough to take a break from their busy schedule and speak with my team about their skills and knowledge. They estimated that they attend 7-10 births per week, in addition to over 100 antenatal visits and a small number of postnatal care visits as well. As we interviewed the first midwife, she showed a very solid knowledge base that gave credit to her 27 years of work at the health center. "The best treatment for any problem is antenatal care, this is what I know," she said. As we ran down a list of topics that we were offering to give workshops on and asked which ones she needed further training on, she laughed. "Medical care is always changing, and we must always continue learning," she told us. "So how can I say that I do not need any further training on this subject?" As we read down the list she continued to smile and answered each time "I would like an update. I would like an update. Yes, and on that one, I would also like an update."

As I rode back on a motorcycle down the dusty road from Kiyunga, wedged between a sweaty boda boda man and a mother holding a child, I noticed a large, block-lettered phrase decorating the smooth tan side of a mud hut. "YOU ARE WELL COME TO THE SOURCE OF LIFE" I smiled. Things are looking up.