By Dr. Alice Guggino
I am a 29 years Old Italian doctor and this is my first experience as a volunteer in a developing country. I came to Uganda a few months ago because I wanted to drift away from my daily routine, witness a different reality and help my neighbour at the same time. For this reasons, last December I got in touch with an Italian NGO that supports some Ugandan Hospitals, named: Italian Doctors for Emerging Africa (IDEA). It partners with Dr. Ambrosoli Foundation, which sends young volunteer doctors to the Dr. Ambrosoli Memorial Hospital Kalongo in Northern Uganda. It is a private, non-profit, community Hospital serving Kalongo town and the surrounding areas of: Agago, Pader and Kitgum Districts. This hospital started as a dispensary in 1934 by a Comboni Missionary nun. In 1957, Fr. Dr. Giuseppe Ambrosoli, an Italian Physician and Catholic priest, transformed the dispensary into a full-fledged hospital. Today, the Hospital has a 302-bed facility that admits patients in the disciplines of Internal Medicine, General Surgery, Paediatrics and Obstetrics/Gynaecology.
Every year the hospital helps about 40,000 persons. In 1959, Fr. Dr. Ambrosoli also established St. Mary’s School of Midwifery whose population is now 120 and is the finest midwifery training facility in Uganda. Since it was my first experience in Africa I didn’t know what to expect exactly. I was warmly received in Kalongo and I have slowly, I’ve learnt to appreciate, love and even to understand the African people better. At the beginning, it was hard because I completely faced a different reality. First, because of the communication/language barrier, as most of the patients don’t speak English and a local interpreter was often needed. Secondly, the different work management and organization undermined by limited diagnostic and therapeutic resources.
Besides, this has been a thrilling challenge to me to gain the best using the limited available means. I’ve spent one month in the Hospital sustaining local doctors in the management of the patients. It has made me feel so good, reflecting daily on the challenge of helping sick people to the best of my ability. Any patient either improving or being discharged is a substantial success. It’s very important to nurse to your best every patient, especially if he/she is poor and has inadequate resources. One determining factor is the distance: many patients come from small villages several kilometres far away, often walking and just helped by some attendants who also care about them when hospitalized. Attendants care for primary needs such as bathing and cooking, as the hospital can’t supply food.
So, despite being normal for them, it was quite strange to me seeing women gathering wood and lightening fires for cooking besides the main building; as well as washing their clothes or resting with their own babies in the courtyard, under the trees. This also means that some patients ask for to be dismissed as soon as they run out of food supplies. That could be a worthy point to improve: to warrant wider care both to patients and their families, including food and easy accommodation.
Obstetric is one strong point. The St. Mary’s Midwifery School represents an essential help to the Obstetric ward: students learn and work daily under the guide of both doctors and qualified “tutors”, enforcing a virtuous circle for teaching and health assistance. This is not a negligible item: in Northern Uganda, traditional midwives care for pregnancy and delivery in the rural areas, by directly reaching pregnant women into their houses; most of Ugandan women, in fact, rely on the few available health-care facilities just in case of emergency and this unfortunately, is often too late.
A still big problem in developing countries, like Sub-Saharan Africa, is the HIV scourge that even today is a severe plague. Kalongo Hospital has a specific project against HIV, named AIDS Care and Treatment (ACT) made up of several activities like prevention, nutritional counselling and a mobile clinic for the community. There is also a project for the pregnant women named Prevention of Mother-to-Child Transmission (PMTCT), designed to prevent the virus transmission from mother to child. I took part in the mobile clinic activity, going to the villages with nurses in charge of checking on children born from sick mothers: after having found them, we examined and took the rapid blood test for HIV. This project allows bringing necessary care also to those who live far from the hospital.
It has been a very interesting experience; it gave me the opportunity to know the conditions that people live in like the grass-thatched huts. The recent civil war still has big influence on the people’s precarious lifestyle. Nowadays, agriculture is the main source of livelihood but lack of water is a trouble: many more wells have been built in the last years but people are still compelled to travel long distances to gain access to water. Water supply is strictly matched to latrines, schools and health-care facilities implementation as well as to cultivation and breeding. Nevertheless, sanitation and quality of life are a long way from being adequate.
Kalongo sees several schools and more and more families are driven to let their children attend them, despite costs and populous families. Easy access to the primary school is raising the number of students willing to keep on studying and attending the university.
It has been an extremely positive experience: it has made me know a suffering population needing help to overcome the effects of the war. Me, my little help has been to give qualified health-care assistance through treatment and prevention of common diseases, in order to improve populations and individuals’ quality of life. I hope this one is going to be the first of several other collaborations and I heartily suggest it to all my colleagues: both to be useful to our neighbour and to change our approach to daily life, especially with patients. A special thanks to the Comboni missionary priests for hosting me during this month and for their strong commitment toward Acholi people since tens of years, especially during the very hard time like the civil war was.
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