After the super intense storm last night, I was able to get a good 5 hours of sleep. I woke to chickens and roosters and bright sunshine this morning. I felt rested and ready to take on the day.
Winnie, our surrogate mom/sister and another young lady named Julie prepared breakfast for us. Chapati, sliced bread with butter, watermelon, and tea. As we set off to the hospital, they were already prepping for lunch.
We went to the hospital with Dr. James, met with the most senior Sister (for a minute I felt like I was back in the UK!), as well as some other doctors and nurses and took a tour. The hospital has a Men's Ward, Women's Ward, Pediatric Ward, Labor & Delivery Ward, an Operating theatre and a trauma receiving area. We spent time with nurses triaging patients as well as the counsellors and doctors during the HIV Clinic that is held on Thursdays.
There was a constant flow of patients; I'm guessing at least 35 came in while we were there this morning. We had an interactive introduction on HIV in Uganda: The prevalence is high with the most common modes of transmission being thru sexual contact and vertical transmission from mother to baby. We discussed treatment regimes and indications, the stigma associated with having HIV, and what could/should be done to help reduce the spread of the virus. The country is trying to educate the people but it's extremely difficult because no one wants to openly talk about it. It's a very taboo subject. Husbands & wives, partners, family members, & kids often conceal their HIV status from one another for fear of social isolation and the stigma associated with having HIV.
With so many people infected, the only way I see things changing is by people openly talking about HIV, prevention, treatment and gaining more access to medications. Currently, most patients are started on Antiretroviral (ARV's) drugs once their CD4 T-cell count drops below 500, if they are pregnant, or if they are seriously ill/already immune suppressed. Once patients are started on treatment it continues for life. All of the drugs are provided free of cost to the patients here. With that being said, the sad reality is that there isn't enough funding to start every newly diagnosed patient on ARV's right away which could potentially increase their life span. The patients that came into the clinic ranged in age from 2-65yrs old. One of the most heartbreaking is one little girl who came in alone with her clinic visit log book & medications, info on drug compliance and any new symptoms she was experiencing. This is the unfortunate reality for many kids here in Uganda.
After leaving the HIV clinic we watched a C-Section performed. The operating staff consisted of 2 doctors, Anesthetist, Nurse, a gentleman keeping the room clean, plus the 3 medical students watching. All of the basic instruments needed to operate were present. Notably absent was any electronic monitoring equipment for the patient and baby. The patient was put under general anesthesia and within 10 minutes a 3.4kg baby boy was delivered. The entire surgery was over in about an hour and we were told the patient would be walking to the antenatal area later this afternoon. Whew! I can't imagine. I don't think many women in the USA could imagine having a C-section and walking themselves from the recovery room to the antenatal section just a couple hours later. I salute all the mothers that do this each and every day....there are approx 3,000 babies born in Uganda every single day!
Until next time...
Until next time...