A real life education at a rural Ugandan health clinic, by Katie Bishop, One School at a Time volunteer

Katie Bishop accompanied her Dad, One School at a Time board member Joe Bishop, on a visit to the 5 One School at a Time Ugandan partner schools this February 2016. While there, she volunteered to work at the local health clinic.

I visited the Kassanda Health Clinic 3 times to volunteer and although I didn’t get to do very much helping, I learned quite a bit.

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My first day volunteering I was asked to help in the lab. I didn’t actually help with anything; I watched what the lab manager and two lab technicians were doing. One of the lab technicians was cleaning the counters while I was there. By the amount of dust that was on the counters and lab equipment, I could tell it hadn’t been cleaned in a while. The manager was telling patients their lab results and explaining the results to them. This wasn’t done in a private area. In the U.S., because of Hippa laws, this sort of information is shared in a private place so other people will not overhear. The tech that was drawing blood from the various patients never changed her gloves, which defeats half of the purpose of the gloves. While she was protected from the risk of coming into contact with bodily fluids, she wasn’t protecting her patients from the risk of transmitting diseases to one another. I also noticed that one of the hazardous material bags was full and just sitting on the ground waiting to be brought to the proper location. Not only was it on the ground, it was in the doorway where patients were walking through to get their lab results. The lab had a room that had a blood freezer and blood fridge, however neither was in use and both were unplugged. There was also a room that had equipment to run more complex specimen tests, but it all looked as though it hadn’t been used anytime recently. Along with sitting there and watching the three people work, I read through the lab manual a few times. While reading through it, I learned that there was supposed to be a doctor on the grounds at all times and two others on call- the doctor whom I had still yet to see that day.

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The health clinic serves about 29,000 people in this rural area.

The second day that I went to the clinic, I was in the outpatient building working with the head nurse. She explained to me that there wouldn’t be many patients that day because the president had declared the elections a national holiday. The nurse would examine the patients and ask them what had brought them into the clinic that day. Most of them had symptoms of malaria so they were sent to the lab to have a blood test. There was one little girl who had been sick for at least a week and a half before her mother took her to the clinic (which is free). The little girl had an extremely high fever. She was sitting less than a foot away from me and I could feel the heat radiating off of her. The nurse had sent her to the lab for a blood test. She had severe malaria and severe anemia- her lips, conjunctiva (the pinks of her eyes), and nail beds were white. The head nurse then tried to figure out how they could rush this girl to Mityana to go to the hospital. The clinic had no one to drive the ambulance and she needed to go right away. Here at this Ugandan clinic, the nurses could diagnose patients and write prescriptions and fill them. In the U.S., this is only done by doctors or nurse practitioners, The head nurse explained to me that normally the doctor does all of that, but he often wasn’t at the clinic and she wasn’t going to let people die because of that. The room where the patients were being seen was the same room where the medications were being filled. I noticed a sign on the wall that said wear gloves when you handle medications, yet I saw none of the nurses doing that. There was also a list of the clinics filled positions and open positions. They had three doctors listed, by this time I had only met one of them once, for not even 5 minutes.

The third day I was at the clinic, everyone was thoroughly cleaning the maternity clinic. While I was helping scrub the walls and the bed frames I noticed old, dried blood on the frames and the walls. Clearly this building didn’t get cleaned as often as it should have. There was so much dust that everyone cleaning was wearing a mask to keep the dust out of their airway. I too had a mask on and was still coughing from the amount of dust that was being agitated into the air. When I was told to assist in the maternity building, I had assumed I would be helping the patients or the nurses, which is what I had come to do, not cleaning. Since I wasn’t there to clean and I wasn’t actually helping people, I only stayed for one hour. In that hour, I did not see the doctor. I learned it’s very common in the rural government clinics for the doctor to not show up very often. That doesn’t do any good for the sick people who go to the clinic to see a doctor and he isn’t even at work. With the nurses doing his job, which is out of their scope of practice, they are putting the patients at risk and they are putting themselves at risk. I was completely shocked by how the clinic was run and what was going on in it. I was not used to seeing any type of practice like this and I learned a lot from being there.

 

 

 

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