Day 19 - Last Full Day In Mbale

01/04/09

This morning brought a late start; I was up until 2am working on a grant. I got up around 7:45am, decided I had somehow become cleaner while I slept and no longer needed a shower, and had a slow breakfast – hot water with jinga and sugar as well as a banana. I walked over to the artist next door and spent an hour creating a website business plan for him and taking pictures of his work. This guy is beyond talented and dreams big which I like. I then took a boda bicycle into town, during which the driver thought it appropriate to serenade me with some beautiful African song. That was weird but nice and when I got into town I gave him an extra 200 UGX. I met up with a kid I met this weekend, a Jew who converted from Islam (like Norah, the rest of his family did not convert), in order to copy a music video he created onto my computer to send to some guy in the States that is going to help him publicize it. We sat on the side of the street, on the steps leading up to one of the banks, with my laptop on my lap and a bunch of people gathered behind us to watch. That took about 20 minutes and then I grabbed a boda motorcycle to BCC. It was 11:15am and everyone was still in church so I didn’t have too much work to do. Even when they got back, people didn’t want to give me a project to start since I’m leaving tomorrow so I left early and headed back to the house for lunch at around 2:15pm. I ate quickly – rice, cowpeas, and avocado – and then took a boda bicycle to Mbale Main Hospital to meet Julliet for a tour.
We started out in the casualty ward, or trauma ward, which smelled like urine and was constructed of chipping, drab concrete walls. I felt like I was standing in the tunnels under the tracks of the Metro-North Railroad, the ones with walls painted two colors, divided halfway down, in order to give the place some aura of maintenance. Patients were splayed onto the metal framed-worn mattress beds, some frames half broken and looking as if they would collapse any minute. Blood transfusions were being administered everywhere and there was not much else to see so we walked outside and headed to the surgical ward. Here, patients were kept before and after surgeries for monitoring. Male and female patients were kept on opposite sides of the ward, separated by 3 or 4 private rooms which can be attained for a high fee. Many of the beds had metal frames that extended a few feet above the bed surface, allowing for a rope to be tied from the top to a patient’s fractured limb. And I don’t mean a nice, machine-wound, nylon flat strap like you would see in the States. I mean a rope, handmade, worn and tearing. Patients of all ages lay on the beds which were placed less than a foot from one another. Their families stood crowded around them, mixing with the families of the patient next to them. There was really no semblance of privacy, as we would walk up to any patient and take their medical record from the edge of their bed (there was no plastic holder for it there, it just lay on the bed). There were fractures and tumors and deformities. One patient on the female side was an eight year-old girl with burns on about 40% of her body. A pot of boiling oil fell on her. The next few sentences are graphic so skip them if you’d like. The entire right side of her body, her arm, chest and abdomen were no longer covered in black skin. There were not even blisters. It almost appeared as if she had just been skinned and was left with a useless transparent membrane over her veins and organs. Her mother held her right hand high above the rest of her body in an attempt to keep the burned regions from irritating one another. The girl was shivering, as hot as the day was, because of the heat loss from her no-longer-capable-of-insulating skin. We then moved on to the HIV ward, in which 90% of the patients were HIV+ and the other 10% had some other autoimmune diseases. Again, patients ranged from very young to very old and many had some other infection as is common with HIV. 30% of the patients in this ward had tuberculosis (TB), which is also common among HIV patients in this area of the world. As we walked through this ward, a man and woman were preaching the Bible in English and one of the Ugandan dialects. The patients and their families were joining in, mumbling prayer and crying.
Then we moved onto the pediatric ward; even though the other wards have patients of all ages, the pediatric ward housed only children. There were two sides to the ward, A and B. Children were arranged in beds close together, some touching with the mothers lying across the crack. Ailments ranged from heart conditions to severe malaria, dehydration, malnutrition, and pneumonia. Most of the patients were referred to the hospital by a clinic that was no equipped to handle the case. From the pediatric ward we went to the maternity ward which was spacious and open. One building housed mothers pre- and post-pregnancy while another building was used for the actual deliveries. The delivery unit had approx. 12 beds separated by frosted-plastic curtains, the kind you see in the back of a butcher’s shop (not to say this was a butcher’s shop). The curtains were practical but morbid and I was uneasy my whole time in the unit. We spoke for a few minutes with the Ob-Gyn there and she told me about the 7 types of high-risk delivery which the unit was going to start handling next week – diabetic bothers, breech, premature deliveries, etc. From the maternity ward we went to the malnutrition ward, a place kept dark and quiet due to the heightened level of sensitivity of malnourished children. There were three buildings - one for the doctors and nurses, another for mild malnutrition, and the last for severe malnutrition. There was a fourth building which was used in extreme cases and as an overflow ward. Thank G-d, only two patients were in the malnutrition ward today. But even two was too many. The children were at least 1.5 yrs old and could not lift their heads on their own, they could not speak, had tubes and IV’s dripping into what seemed like every vessel in the body. I couldn’t help but notice that their teeth were the foremost part of their bodies, extending beyond any body part that should have been further forward. It was as if they didn’t even have enough flesh or fat to lower their lips over their teeth. Their eyes bulged and stayed focused on one point in space, as if they did not have the will to even move their eyes. Once again it was hard to walk away but we left the hospital from there and went to town. I got a ride back to the house, showered, and started packing. Dr. Wafula and his brother came for dinner and they, Anne, and I sat at the table while the rest of the family sat around the couch. Fazira made me rice pasta with sauce and everyone else had chicken. We had rice, peas, pumpkin soup (which was delicious), and passion fruit juice. After dinner, everyone stood around the couches and Dr. Wafula led a 15-minute long prayer thanking G-d for my visit and for the family and BCC’s good fortune in having volunteers who work so hard and wishing me a safe journey back home. They said the nicest things and I once again knew I had family in Uganda to whom I can return at any time. After the prayer and a song, I continued to pack, did some work, and went to sleep.