The Big Day!

April 9, 2010

The US agency that we have wanted to partner with was coming to our hotel at 8:30am. We set two alarms and asked for a wakeup call!

This is the best part. After two years of great vision and hard work, we got to share our research and the TGF model of putting 1,000 nurses on the ground in the next four years. As mentioned, the plan includes not only the nursing scholarships and everything that goes along with that, but includes capacity building in the nursing libraries and skill labs.

The plan was enthusiastically received. We stressed how if we didn't move quickly, given the nursing school calendar, that we would have to wait another year and half to implement the plan. Again we insisted that this had to succeed if any advances could be made in addressing infant mortality and maternal death rates, family planning, stemming the advance of infectious diseases etc. We were thrilled to hear our contact agree and voice our thoughts that this was a small beginning of the numbers of nurses truly needed in Uganda. He recognized the perfect marriage of our program with the goals of his agency, and possible collaborations with another source. We showed incredible restraint in not jumping up and down!

The US official then went off to meet with the Ministry of Health to discuss the plan and their partnership.

We took off to see Mulago Hospital, one of two national referral hospitals in the country. The hospital was modern looking from the outside. The first thing that struck me was that severely ill and handicapped individuals had to move through the hospital unassisted. The few wheelchairs available were kept in emergency where they have only two gurneys as well! Again, this was a horribly emotional tour.

The most difficult for part of the tour for me was the emergency ward that evaluates 7,000 patients a month and admits 6,000. There is one intake nurse that determines if a patient should be given a red, orange, yellow, or black status; red being the most urgent and no imagination needed to decipher what black meant. Four patients at a time sit behind a screen in front of the nurse as she takes vitals and medical information. While doing intake the lone nurse "has to check on the waiting patients beyond the screen to make sure no one has died". The patients are seen by a doctor (in the hallway), given whatever services they need (x-rays, labs etc. with antiquated equipment), then sent to a ward segregated by sex (children and adults combined), where they are then monitored for an hour and given whatever care they can. I can't begin to describe what it was like to see one person after another laying critically ill or wounded in such deplorable conditions with few nurses or doctors to be seen. These are husbands, wives, fathers, mothers, daughters or sons.

After one hour, the patient is then transferred to a ward specific to their general health issue. In one of these wards there were broken windows, and patients lying on the floor. I saw one person adjust the IV drip for a family member that was on oxygen. All I could think of was the numerous times I have been in emergency with my parents and the stark contrast with their experiences and what these people were receiving.

I could go on about the horrific scenes I saw: women in labor lined up in a hallway without benefit of a bed, family member, or nurse to help. The few nurses were busy transporting a dead baby and removing soiled linens. The strain was evident on the nurses' faces. More women in labor were waiting outside the doors.

What a roller coaster after the wonderful morning. We then met with one of our collaborators from the Minister of Health for dinner. We got to hear more great news about their meeting with the US agency and that the agency is going to work to implement the TGF plan soon! We won't celebrate until it is a done deal but we were so encouraged.

We had an incredible evening and got to learn more about Ugandan culture and our new dear friend. Meg and I arrived back at our hotel about 10pm and realized we had to go celebrate! We headed next door to a local night spot and didn't come home until after 2am. Let's just say that our abilities to bring people together and get them enthused didn't stop at the office. We turned this chic bar into a party with everyone dancing, including the owner! What a day.