Follow Up to "Getting Sick in Gulu"

While I think I accurately portrayed my personal experience of being sick in Uganda, I sensed as I was writing it that I was not representing what a typical person from Gulu might experience when they are ill. Below is a response paper I wrote about my first days interning at Gulu hospital. The hospital does not charge for its services and therefore is frequented by much of the population in Gulu. I hope these two posts will show a more comprehensive view of health care in Northern Uganda.

The deaths I’ve experienced at the hospital aren’t sad, they are infuriating because they are so preventable. I’d always assumed that the problems with the health care industry in developing nations were primarily technological and financial. The image I had in my head was a hospital with staff who lacked the equipment, the supplies, and the money to assist their patients to the fullest of their abilities. However, at Gulu Hospital most staff leave after lunch due to their extremely low salary (a consequence of a government that regularly lines its own pockets rather than paying its employees). The new ambulance supplied by a government official looking to boost his image lays unused more often than not because he did not consider fuel costs. When it is used it’s solely by administrators looking for a free ride to another section of the city. Nurses have explained to me that frequently wards will be left with only a single nursing student or even totally unattended because of understaffing.

These nursing students have to choose between retrieving blood, labs, or medicine for their patients or remaining with their patients to monitor their status. A student named Florence explained to me that a child came in very ill during the night shift when no one else was there to assist her. She called the doctor on call, but these doctors are rarely available late at night. So she chose to leave her patient to retrieve blood for him. By the time she had returned the child had passed away. Lindsay McClain told me a story of a friend from her work who had given birth in the maternity ward. Her new baby needed oxygen after the birth, however, the cabinet that had the oxygen machine was locked and they couldn't find the key. The baby passed away.

As westerners we have a tendency to pay attention to the horrific symptoms of the massive structural problems that plague many developing nations rather than the economic and political issues that cause them. We see lack of clothing, child soldiers, epidemics, and hunger rather than the source of the rebellion these soldiers are fighting for, the agricultural issues that lead to lack of food, or the government corruption that leaves many without a livelihood. I thought that poverty and lack of medical supplies were the reasons people die. That people die dramatically due to gross injustices carried out by large groups of villainous fighters on either side of the conflict. But the hospital shows me that people are dying quietly. People are dying because of regular, hardworking staff forced into an infrastructure debilitated by small errors, laziness, and greed.

This realization makes me incredibly overwhelmed. There are no simple solutions, because these are not simple symptoms on which Band-Aids can be placed. These are large-scale problems within the health care infrastructure and culture. I do have hope however, I’ve noticed that much of the nursing and medical students within my age group are hardworking, caring, and tenacious. I’ve noticed the same tenacity in the young scholars that have come and spoke to our class. While I do feel overwhelmed by the massive structural adjustments that northern Uganda needs, I feel hopeful for the upcoming generation of scholars and professionals.