Wednesday, October 3, 2012

Outreach in Aukot: A Journey to Serve Uganda's Poorest

Petra Kelsey is a first-year medical student at The University of Texas Medical Branch at Galveston. She spent two months in Uganda this summer as a volunteer for International Midwife Assistance.The following is excerpted from her guest essay in the October edition of Texas Medicine magazine.

Patients arrive at a classroom in Aukot for treatment
We park in front of a classroom that is reserved for today's clinic. One room with low walls will serve as a dispensary, another as the doctor's room, another as our antenatal clinic. The malaria, vaccination, and family planning departments set up under trees outside.

A large crowd of mostly women and children has already gathered. I overhear Dr. Eriamu Nathan, a local physician with more than 35 years of experience as a family physician, say, "There are three times as many people here as we will be able to see."

For every outreach, besides the supplies for the pregnant mothers, we bring enough supplies to treat about 70 children: 70 rapid malaria tests, suitcases of medications for 70 children, and 60 of the valuable "white sheets" the doctors pass out to the neediest during triage. White sheets guarantee treatment.

"It's the hardest part of our job," Dr. Nathan says. "We have to walk through these crowds and decide who will get treatment."

A small mob erupts as women hand their fevered, crying babies to Dr. Nathan and Emmanuel, a young local nurse practitioner, begging for a white sheet. They must patiently, yet briefly, assess each one for high fever and other important signs of serious diseases. Richard organizes the crowd, helping to form a line for those who have received the coveted white papers.

A nurse practitioner checks for jaundice
in the eyes of a child with malaria
Each department gradually gains a line of patients and all begin working, calmly and deliberately, patient by patient.

A large group of women sit with babies ready to receive vaccinations. Joyce begins with polio. When she gives the two pink drops, the babies' little mouths pucker. Fortunately, the drops stay in. As I work with her, I notice a growing crowd of young, wide-eyed schoolchildren silently standing around us.

The reaction to a Muzungu (me, the white person) in the village is varied: Some young children immediately burst into tears out of fear, others smile wide-eyed and then run away giggling. Older children stand around silently, just watching. But the distraction also causes them to be late for school, and this prompts one of our staff members to yell periodically, "Hey kids, you must leave. Get back to class now!"

We all worked so efficiently that we were able to see all our patients by midday. We pack up the van, saying "Apwoyo tich" ("Good job") to each other. "We'll see you again next month" the mobilizer says to us. "And God bless you all."

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