Thursday, October 05, 2006
What exactly are we meant to be doing?
Two days on from my last blog. Yesterday we drove 2 hours towards the democratic republic of the Congo through some beautiful countryside and past this crater lake. We were visiting some 4th year medical students on their 4 week community health placement in a remote level 4 health centre. (Level 4 is one level of sophistication lower than a district hospital and is run by a medic supported by a clinical officer -like a nurse practitioner- and a nursing team).
We're beginning to learn what our job might entail.
We’ve met most of the people in the department at the university. The theme is “You are welcome” followed by slight mystification at what a family doctor/GP is. We seem to have been recruited to re-energise the masters course in community health and family medicine. This course is meant to be a kind of 3 year vocational training scheme for generalist doctors to run remote health centres. The curriculum for these doctors is daunting. They need to be general surgeons, obstetricians, anaesthetists, registrar grade paediatricians and general physicians as well as having training in ENT, ophthalmology, psychiatry...there is no money for training and if they were to take up the posts they would be paid appalling wages (less than £200 per month) to live in a remote spot doing a 1 in 1 with iffy power and water supply etc etc. Many qualified docs prefer the higher wages of private practice in Kampala or abroad. Mark and I keep looking at each other helplessly wondering what on earth we can do that might be of any use!
There is pressure (but no resources) from the Ministry of Health to introduce family medicine/community care and decentralise health services. This clearly needs doing. The health stats are still appalling.
One in 200 women die in and around childbirth. Infant mortality is 87/1000.
320 people a day (mostly children) die from malaria.
In 2001 1.05 million people were known to be living with HIV/AIDS.
80% of the population live on less than $1 a day (96% live on less than $2 a day).
Only 50% of the population have access to clean water.
Only 49% live within 5km of any health facility.
There is less than one doctor per 10,000 of the population.
But I HAVE found the most wonderful aerobics class! Its hard work and fun. Its run by a lovely Ugandan man with a big pot belly. Most of the class are Ugandan men, very serious and totally anarchic, rarely doing what the teacher is, but dancing around and seemingly having a ball. Much needed light relief every Monday Wednesday and Friday at 7.30pm.
We have our first Runyankore lesson tomorrow with an 80 year old retired bishop and have bought some primary 1 level reading books to try to crack it.
We’re planning to get away this weekend to Lake Bunyoni. Its about a two hour drive. We’re told its very beautiful and the good news is that it’s OK for swimming in without risk of bilharzia, crocs or hippos because its very steep sided. I’m taking a novel and a swimsuit and I’m going to be a tourist for the weekend.
Quote of the day yesterday from the Health Minister. “Be careful about being encouraged to use condoms, those are selling gimmicks. Condoms have quite a significant failure rate, they are not completely effective. Let nobody tell you young people about condoms and AIDS. Don’t be victims of marketing.”