PROS FOR AFRICA TRIP 2011

The Pros for Africa trip was a major success. During the three day campaign, we operated two medical clinics, one in Gulu and one in Atiak, fitted and distributed hearing aids with Starkey's Hearing Foundation, dug water wells with Restore International and Water4, helped in construction of Mercy's Village International, a primary school located in the bush outside of Gulu, and played soccer and football and shared love with many Ugandan children. I was stationed in at the medical clinic in Atiak all three days, so I did not get to participate in a number of the events, but each evening we would discuss the days events as a large group at dinner, and there is no doubt that we touched many local lives as well as transformed many volunteers' perception of life and purpose.

Between the two medical clinics and the hearing aid fittings, we treated close to and maybe over 3,000 patients. With the dedicated and hardworking medical team in Atiak, I'm pleased to say that we left no patients who came to our clinic without treatment. There was a larger patient flow in Gulu, but fortunately, those patients that were not seen in the three days have access to the St. Monica Medical Clinic in Gulu five days per week year round, whereas in Atiak we only operate our clinic on Saturdays due to funding and infrastructure limitations. God willing, with in the year we will build a permanent medical clinic in Atiak providing reliable access to medical care for the very neglected population.

Personally, last week was a blessing beyond measure because I also got to spend the time with my mother, whom I hadn't seen in almost three months. My mom is an RN so she was a member of the medical team going to Atiak with me. It was really special introducing her to my life here. She is more relaxed and feels more secure with my presence here now that she has witnessed firsthand the love and welcoming nature of the people, especially all of the sisters and St. Monica girls whom I'm blessed to have strong relationships with.

Sending the Pros for Africa team back to Oklahoma was challenging for me. I'm not ashamed to admit that a small part of me wanted to stow away in my mom's suitcase and join them, but as soon as I returned to St. Monica's I was reminded of why I love this place so much. Some of the girls came up to me when I got back and hugged me with giant smiles saying they were so happy that I was still here because they thought I was leaving for good with the rest of the visitors. I knew then that I was not ready to leave this life just yet.

At the last dinner with the Pros for Africa team, I was reminded of the moment my grandma told me about Pros for Africa and my thoughts of how amazing it would be to be a part of the next trip… I never imagined a year ago that I would not only be a part of Pros for Africa, but I would be living in Uganda with Sister Rosemary and the girls for four months.

I'm so grateful to Reggie Whitten and Pros for Africa and of course, God, for this opportunity of a lifetime.

DAY 2: ATIAK MEDICAL CLINIC -- 4 TIMES THE IMPACT

March 5th was day 2 of St. Monica's Medical Clinic in Atiak. We added to our Atiak medical team two wonderful ladies this week, Catherine who works in the Gulu Clinic during the week, and Staci, my fellow Pros for Africa colleague and friend. As we approached St. Monica's in Atiak, we were greeted by at least thirty patients already waiting…last week, we had 30 patients total! Throughout the duration of the nine hour day, we treated 128 patients…four times the impact of day one. All of the new patients were recruited by word of mouth of the first day's patients. This reflects clearly the desperate need of medical care in this area.

Because of the great number of patients, we had to manage the flow more strategically. Therefore, I volunteered to put my little bit of Acholi to the test and greet the patients and collect their basic demographic information such as: Name, Age, Gender, Village, and Weight. The names here are quite a challenge for me to grasp on the first try but by the end of the day I was getting much better at understanding their accent. Fortunately, I had learned numbers in my Acholi lesson last week, which served me well. Every time I correctly interpreted their age on the first attempt they would be pretty shocked, but we definitely shared plenty of laughs at my expense when it came to my language skills. Regardless, I felt privileged to communicate with them in their native tongue as much as I could. Great practice.

When I wasn't collecting the patients' information I was assisting Sister Immaculate and Staci with the dispensing of medicine. This was a challenge as well given that I have had no previous experience as a pharmacist. The pharmaceutical terminology and drug names were so foreign to us. For instance, 8` means every 8 hours, which translates to 3 times a day when multiplying to count out the proper number of pills to dispense ; 5/7 means 5 days; 2/52 means two weeks; so on and so forth. It is more complicated that I originally thought. Staci and I struggled through the first couple of hours but by the end we were "pros," at least in our minds :)

The vast majority of patients were women, which given my passion for women's health, made my heart quite happy. I'm eager to see the turnout next Saturday. I pray we are able to treat them all and that our wonderful doctors are well and as energized as they were this day. We are truly blessed with an outstanding medical team. Everyone understands the necessity of their work and eagerly and happily devotes themselves wholly to their patients all day long. I have yet to experience something as rewarding as using the passion and skills God has given me to reach out to people who really need the care and love. So grateful for the opportunity!

DAY ONE: ST. MONICA MOBILE MEDICAL CLINIC IN ATIAK

Today, Feb. 26, was day one of the St. Monica Mobile Medical Clinic in Atiak. I am humbled and honored to be a part of positive change in the lives of the very neglected around Atiak that I know will continue long after I am back in Oklahoma. This endeavor has provided ample opportunities for my integration and understanding of Ugandan society.

It began a month ago with my day of initiation of purchasing the medicine to open the clinic. We spent 8 long hours fighting through the mass of people in Kampala, a city with literally 3,000 times the population density of Oklahoma City, roaming from pharmacy to pharmacy until we gathered all of the medicine we needed.

Next was a waiting period. We had to postpone the kick-off as the political tension rose around the 2011 National Elections. The instability and threat of violence and riots is a reality that must be respected here. Fortunately, there was minimal demonstration following the elections, and we were able to commence this weekend (finally!).

So today our medical team, Brian and Mike who are medical providers, Sister Immaculate and Alex Robert, medical support, and I, loaded up at 7:00 am to begin our 2 hour journey along the rough dirt road, a drive which never fails to give my internal organs a thorough beating, to the most remote area of Africa I have ventured to.

Atiak is a village in Amuru District, the northernmost district. It is about 15 miles from Sudan. This area was very vulnerable to the last wave of terrorism by the LRA in 2005 when Sudan finally granted the Ugandan government access to its borders to seize the rebels. Thus the far North (aka Amuru District) was the battle ground and became the source of many unwilling soldiers for both sides. Driving into Atiak, I am always overcome with an eerie feeling because the recent devastation is starkly apparent.

This entire district has only one fully functional hospital (based on public hospital standards). Atiak has a health center, but it was recently "restructured" because the inspectors came by and found goats roaming the halls and rooms being rented out and occupied as housing. Needless to say, this population is extremely neglected of quality medical attention.

The settings of our clinic are very humble with just two tables with chairs, one exam bed with a privacy screen, stethoscopes, a thermometer, a scale, and a dispensing table, which fortunately is well stocked with the medicine we purchased in Kampala. At first I was discouraged because it was getting on to 10:00 am and no patients had arrived, but Mike assured me that that was normal in village settings. Villagers always tend to their daily tasks and work before they go to the doctor. Just as he called, our patients started arriving at 11:00 am. By 2:00 pm we had worked through our 31 patients of our first day. We expect the numbers to grow exponentially as the patients of today refer two or three friends and their children to us for next Saturday. For the initial day we had only publicized by word of mouth and were pleasantly surprised by the flow of patients.

I am blessed with the mentorship of two doctors, Brian and Mike, who are both dedicated to the field of medicine because of the service they can provide to the neglected population of Uganda. Even on our long, hot days like today in Atiak, their attitude is one of eagerness and gratefulness to be using the passion and skills they have been blessed with to serve the village locals. They both operate in a humble manner with respect for their patients and with keen observance to provide treatment that is feasible to their patients. These are skills that cannot be learned in the classroom and the ones that truly define a quality physician. I'm very grateful for their patience and willingness to teach me.


Overall, day one of St. Monica's Mobile Medical Clinic in Atiak was a great success!

UNDUE SUFFERING

Today was a very challenging day in the clinic.

A young boy of about 15 came to the clinic with an infected cut on his middle finger of his left hand. He had been pricked by a sewing needle 5 days before and ignored the intensifying signs of infection. He presented with a very swollen hand and cut that was oozing puss filled blood at a steady rate. Mike inspected the wound and decided it required suturing and preferably needed general anesthesia, but the boy would not be seen at the Regional Referral Hospital today as it was too late in the day, so Mike had to make due with the local anesthesia at his disposal and make the best of it. Mike scrubbed in and injected the area with local anesthetics. After giving it time to absorb, he began cleaning the wound. I stayed only through the initial phases of the minor surgery because the boy's suffering was too hard for me to endure.

The only other time I have witnessed such agony was in the labor and delivery ward at the Baragwaneth Public Hospital in South Africa, by women who also did not have the quality and supply of anesthetics we have in the States. It is the disparity in available health services, such as adequate anesthetics, between the States and Africa that becomes more than I can bear. I feel intensely frustrated by the undue suffering that must be endured as a result of lack of resources and an understaffed, overstretched medical system that cannot treat the number of critical patients. Days like today open my eyes to the harsh reality that patients face in Africa everyday.

The underlying reason for the boys agony was his lack of knowledge on what an infection looks and feel like and the importance of seeking medical attention at the first signs of an infection. Even if he had simply known that after being cut by a rusty object it is critical to properly disinfect, clean and maintain the area, this whole ordeal would have been avoided. Lack of health education rests on insufficient public health measures. As Benjamin Franklin said," An ounce of prevention is worth a pound of cure." This is a reality that is undervalued and overlooked too often.

I have been considering getting my MD/MPh for a while now, and I believe that today God showed me just how useful it is to arm myself with the knowledge of public health, especially in Africa where many people simply do not have access to affordable healthcare. Yes, I will medically treat as many patients as possible during my visits to Uganda, but I must leave behind preventative measures, such as health education, health promotion and policy changes, or I have only put a Band-Aid on their problem.

SARAH'S STORY

Sarah was abducted by the Lord's Resistance Army and lived in bush for 3 years. After she escaped she lived at a convent with Sister Margaret (I don't know much about this period). Sister Margaret brought Sarah along with 10 other girls to the St. John Paul Social Justice and Peace Leadership Camp in Jinja organized by Laura Frederick. Sarah felt the desire to share her story of abduction with her peers at the camp even though she had previously experienced animosity from other students due to being abducted. Through her courage she gained a network of friends at the camp and learned social skills such as conflict resolution, teamwork and problem solving. She also pulled on the heart of Laura.
Laura knew about Ocer, a Jesuit Secondary School in Gulu, targeting students who had to abandon studies due to the war/abduction. She felt that Sarah fit the profile well and arranged a scholarship for her to attend the school in 2009. Sarah attended the school and did well (she is very intelligent, which I discerned from our first conversation). Sarah went home for the holidays in May and returned to school pregnant. She finished with P7 (6th grade equivalent) in December 2010.

Sarah was only 7.5 months along when she developed preeclampsia and went into labor. Emmanuel was born 44 days premature at St. Mary's Lacor Hospital at a weight of 1.46 kilograms (3.2 pounds). She did have a sick auntie at the hospital at the time, so she had someone to go to at times but was primarily on her own. She was released from the hospital with Emmanuel a month later when he only weighed 1.5 kgs. Father Tony, the director of Ocer, brought her to St. Monica's in an attempt to find her a safe, stable living arrangement.

St. Monica's protocol is that a baby must be 9 months before the mom and baby can stay here so that the mom can attend classes and the baby can spend the day at the St. Monica Daycare, but they had no where to turn. Sr. Rosemary welcomed them generously.

I was sitting on the couch in the sitting room when Sr. Rosemary came up to tell me we had a new visitor and Sarah and Emmanuel came around the corner. My eyes lit up and my heart warmed instantly. Sarah and I talked for a while that afternoon and quickly developed a close relationship.

Emmanuel is now 2 months and weights 2.07 kgs (4.5 lbs). I went with Sarah and Emmanuel back to Lacor Hospital last week for a check-up. We were so pleased to find that he had gained enough weight for his first inoculation, BCG. We will go back in a month for a second review and round of vaccines.

In just the past week, Emmanuel has really filled out a bit. His cheeks are more round and his arms are a little more than twigs. It’s a wonderful sight. And he is always smiling…unless he is eating, which is often, thankfully.

Sarah is doing a great job as a mother and now that the other moms and babies have arrived at St. Monica's, she is learning through observation and her new friendships with the more experienced mothers.

Now, it is our mission to find her a source of income while she is tending to Emmanuel full time and cannot continue with classes this year. I have become aware of her special talent of weaving. One day I noticed a small basket with white and pink ribbon decorating it. I asked her about it and she said that is what she does during the day when Emmanuel is sleeping. I am thoroughly impressed. This week I am going to the market to find her new ribbon in a variety of fabrics and colors so that she can use her creativity to produce as many baskets, table place mats, coasters, wall decorations, etc. that she can before I come back to the US. I will bring all that I can back to sell and then return the money to her via Pros for Africa.

Sarah has also had 2 years of tailoring education, so we are finding her a sewing machine that she can have in her room to work on during the days as well. I have found a few books on sewing skirts with a variety of simple patterns that I think we can master. Hopefully, I will also be bringing home some skirts to sell.

Where Is The Love?

I am reading Where Are The Girls? which consists of research and accounts of the atrocities endured by women and children at the hands of wicked men full of hatred and the question I keep asking myself is where is the love. How can these men honestly have no love in their hearts? How can these women be expected to produce healthy children and reintegrate back into society with any hope for success and a normal life after escaping captivity? The first answer and response must be love. That is St. Monica's specialty.

I know that most of the girls and sisters I talk, eat and pray with everyday have experienced a world without love at some point in their lives. That reality is hard to swallow, especially when I have always had a life overflowing with love. The most precious gift and support I can give these women is pure love and to treat them with the same kindness, respect, and generosity that I have always been given from my family and friends. I thank everyone in my life who has never let me experience a day without knowing how loved I am. I am passing your love to these women who desperately need and deserve it.

I am including an excerpt from the book so that you can understand the atrocities I am referring to. However, it is incredibly disturbing and heart-breaking. Honestly, I am writing this with tears on my cheeks so only read it if you are prepared.

Susan McKay and Dyan Mazurana. "Where are the Girls?" Girls in Fighting Forces in Northern Uganda, Sierra Leone and Mozambique: Their Lives During and After War. 2004.

"Especially in Northern Uganda and Sierra Leone, atrocities against pregnant girls/women and new mothers and their infants were reported. In Sierra Leone and Northern Uganda, babies or children were reportedly left behind at health clinics or with captor-"husbands" or their other wives in the bush when the girl escaped. Unknown numbers of babies and children died in the bush or were killed by rebels, sometime by cutting them out of the pregnant girl's body or by banging them against trees or killing them with weapons. To survive, or because they hated babies conceived of rape, girls reportedly abandoned their babies by the roadside or left them at health clinics….Dangerous childbirth practices were reported, such as pushing on the pregnant girl's abdomen when labor contractions were strong and beating the mother when she was in labor and giving birth. Girls and women often gave birth alone. "

The researcher goes on to make policy recommendations.

"Conduct epidemiological studies in war-affected countries, in coordination with Ministries of Health, to improve knowledge of maternal, child and infant mortality, its incidence, causes and prevention. Develop, where possible, innovative ways to provide a minimal level of maternal child health care for girls in the bush. "

I will start by giving love, and later I will return and give them much needed, quality maternal health care. May we all give in whatever way we can… even as simple as prayer.

THINGS I PRAY I NEVER GROW TO ACCEPT

• A population of 234,000 people with access to only one hospital- Amuru District only has one governmental hospital… there is a health center in Atiak but its resources and staff are very limited. We are starting a mobile medical clinic in Atiak on Saturdays to provide some health access to the neglected district.
• A population density of 7,514 people/km2- Uganda’s capitol, Kampala has this population density. To put this into perspective try to compare that to Oklahoma City’s population density of 21 people/km2…you can imagine. MAD HOUSE!
• Boda-Bodas- Bodas are small motorcycles used as taxis around Uganda. They rule the road with careless driving and their own traffic laws. It is not a rare occurrence for me to see a woman with a baby strapped to her back with a small child sitting between her and the driver. The most horrifying boda I have seen was carrying a mom, baby, and 2 children plus the driver. Again… these are small motorcycles.
• Malaria
• Illiteracy
• Professors granting high scores based on bribery and sexual solicitation.
• Government assignment of University location and degree pursuit.
• 4 year old sitting on the sidewalk or at intersections begging for money. Some parents….

May God continuously open the eyes and soften the hearts of those of us with the ability to help those less fortunate with whatever gifts He has blessed us with.

THINGS I PRAY I NEVER FAIL TO APPRECIATE

• Convenient access to clean water
• Summertime in January
• The pure joy children can find in simple things like playing with a tire
• The Nile River
• The opportunity to partake in Communion
• Pizza, wine and ice cream
• Fresh, delicious fruit with every meal
• Sleeping without a mosquito net
• Warm showers
• Skype
• Prayer
• The power of a smile and a hug