Jessica’s Monday in Uganda
To maximize their trip, Jessica is visiting different sites than Erin and Christy and sharing her perspective on our work in Uganda. During this week of Every Mother Counts site visits in Uganda, Jessica Bowers, our new Portfolio Manager, is blogging about her experiences traveling with Erin and Christy. To maximize their trip, Jessica is visiting different sites than Erin and Christy and sharing her perspective on our work in Uganda.
Jessica’s blog:
Our group set out today for the long drive to the southwestern part of the country, a remote rural area where we’ll visit health clinics and hospitals being funded by the Saving Mothers, Giving Life (SMGL) partnership.
We bounce along dusty, red dirt roads filled with potholes (thanks to the rainy season). We’re headed to the district of Kibaale (pronounced ChiBALay). The landscape consists of beautiful, lush, green rolling hills. We pass tea plantations, cows and goats tied to trees grazing alongside the road and small brick houses with metal roofs. Groups of children in bright uniforms of pink, blue, and yellow walk to school.
As we’ve mentioned a lot lately on our blog, it’s not unusual for Ugandans to have to walk miles in this region to reach their destination. Most people here don’t have cars, motorbikes or even bicycles. They walk long distances to collect water and firewood and, if they¹re lucky, to get to a health clinic. It is distance that often prevents women from getting vital prenatal care or from delivering their babies in equipped facilities. It can also be a lack of money, education, or fear that prevents women from going to a hospital or health clinic.
That’s why most women give birth at home, without the aid of a skilled birth attendant. Often, by the time they make it to a clinic, it’s too late to save the woman, her baby, or both. Because of this, some women end up with ruptured uteruses, fistulas, or other long-term conditions because they labor for too long unassisted. As a result, Kibaale has maternal and infant death rates higher than the national average, 450 out of 100,000 moms and 80 out of 1,000 infants die in childbirth or pregnancy. The average life expectancy in Uganda is only 48–49 years. The projects we are visiting are trying to change that.
Our first visit is to a private clinic, St. Ambrose Charity Health Centre. St. Ambrose opened in 2009, and with SMGL’s help, was able to scale up services this year. Bonnie, a capable woman with a kind face, gentle smile and years of experience working in this health centre, guides us around the clinic and answers our many questions. Bonnie is no stranger to EMC and our blog and we’re treated like old friends. (You can read more from Bonnie here).
The clinic educates expectant moms about pregnancy and labor. They give up to 300 immunizations per month and are one of the few clinics in the district to provide C-sections. They now have functioning labs and operating rooms, thanks to SMGL’s support.
Transport vouchers are key components that have been successful in getting more women into clinics here. EMC is now funding vouchers in western Uganda and we’ll write more about them specifically in the days to come. The ambulances used by St. Ambrose and many other clinics are basically three-wheeled dirt bikes hauling a giant tented cart with seats inside. Affectionately called boda boda’s by the locals, they look pretty rudimentary, but they do the job and sure beat walking! Midwives ride in the back with the mothers and drivers are trained in first aid.
To ensure success with this new program, volunteer health workers are trained to go out into the communities and raise awareness about services available. They learn who in each community is pregnant, identify and monitor the poorest of the poor and those with special needs (like high-risk pregnancies) and make sure these women get the vouchers and services they need.
Bonnie and the staff at St. Ambrose are understandably proud of their success. In a short time they’ve saved the lives of many mothers and babies in Kibaale, but there are still a lot of challenges. Because the area is so remote it’s hard to attract staff, especially considering that the Ugandan government is now hiring health workers at a high rate and better pay than the clinic is able to offer. That’s a good thing in general, but it makes it hard for this clinic to compete.
St. Ambrose has only one doctor who can perform C-sections, and he is understandably exhausted. The clinic needs an infant resuscitation machine and more ambulances. They only have one operating table and desperately need another, but an operating table costs $10,000, a huge sum for this community health centre. The post-labor rooms are nothing fancy (especially by US standards) and more than a dozen women share a space no bigger than the average American suburban living room.
There’s still a long way to go to reach the ideal level of health care, but this is a great start. Seeing the shy smiling faces of the moms-to-be at the clinic who know they’re in safe, capable hands for perhaps the first time in their lives, I feel certain that Bonnie and her colleagues are on the right track.
