Days Like this Make Me Particularly Proud of Our Mission

I have experienced a few particularly poignant moments which powerfully embody the critical nursing shortage in countries like Uganda and why TGF is here to do what we do. For example, the moment when I turned the corner in the maternity ward, or, "the factory" at Mulago hospital where I saw over a dozen women in active labor lying on the floor with no medical assistance. 60-80 births a day happen here with only a few nurses on hand. Watching these women, powerless, much like the overworked nurses, continues to be haunting memory. Today, left another indelible mark.

Daily at Butibika there are over 750 patients with each day bringing more. No one is turned away. All patients suffer from some form of mental illness with 15% being treated for medical conditions as well. Of the approximate 300 nurses needed to cover all shifts, there are only 90. At night they have to close the children's ward and bring them to sleep in one of the adult wards. One women's ward has an average of 70 patients but only 2-3 nurses a shift. These are just a couple of examples of the struggles this hospital faces every day. But the acute ward is where we were struck the hardest.

This ward holds the hospital's most ill. Many stay here until they are stabilized and until they are transferred to other wards. For obvious reasons, we didn't take pictures but I'll try to recreate the image that is searing in my mind.

We first walked through a heavily locked gate surrounding the ward and then up the walkway to what must have been a reception area. To the right was a large ward with dozens of empty beds. There were only a couple of patients in the room; one sitting in the far corner alone on the floor, and the other, heavily sedated. To the left, was one nurse standing next to a large tray of pharmaceuticals. Directly past her was a locked gate door leading to another room where there were a multitude of patients; clearly the ones meant for the vacant ward to the right. All were what clearly to me seemed to be severely mentally ill. Where there was an inch to spare, the patients clung to the gate bars, while the rest gathered closely behind. It was the time of day to dispense medications. To complete this task this sole nurse was left to her own resourceful devises. She had rounded up all the acute patients into one room and locked them in behind the gate door. Then she would let out each one, one by one, give them their medications, and then direct them to the other room. Amazingly, she seemed undaunted, even speaking warmly to one patient who was still standing by her side. As the hospital director pointed out to us, "She must be creative."

Now I don't want to mis-characterize Butibika. Her director and all the nurses and other staff are very dedicated to providing the best care. Each ward and the entire facility and grounds were clean, in order and the overall atmosphere, surprisingly calm. I can't tell you how or why. Somehow this place manages to pull off a miracle each day, and the nurses are key in this.

Days like this make me particularly proud of our mission...and nurses always, of course.

Visit to the Uganda Nurses and Midwives Council

Traffic and getting around continues to be an exciting experience. Just walking around means taking your life into the hands of boda bodas (motorcyclists masquerading as mass transit) and cars which along with the boda bodas don’t always respect the notion of a pedestrian and their place on sidewalks, such as they are.

While dodging near-death experiences, I saw a truck jam-packed with cows and people. The truck was so full that there wasn’t enough room for all the bovine limbs. We learned that the cows had traveled from far away, Mbarara, and were on their way to slaughter just a few blocks from the hotel. Well that did it for me. I’m going vegan!

We found a reliable cab driver who goes by the name Captain Bravo. Somehow his name seems appropriate.

We visited nursing’s regulatory body, the Uganda Nurses and Midwives Council (UNMC). The appointed Registrar, Mr. Wakida, was extremely informative and helpful. We met with him during our last trip in 2008. It is very critical that we keep him apprised of our work and collaborate with the council as we progress. His office is the vessel of all information nursing practice/nursing education and he gives us updates on what is happening in the profession. For example, we learned that the council has put together a consortium comprised of university representatives that will act as a think tank to discuss key issues in nursing education. It is not hard to see why we must stay plugged-in.

We had a wonderful lunch at a place called Ekitoobero which serves traditional Ugandan food. On lovely tropical grounds under massive trees we sat at a bench and ate yams, pumpkin, cassava, matooke (fried plantains,) beans, rice and a sauce made of ground peanuts and mushrooms which kind of looked like purple paste, but gave the matooke a much need boost.

We visited a school of nursing on Rubaga Hill but will report further when we tour fully next week. Tomorrow we will be touring more nursing schools and tweeting and providing further updates.

Bye for now.

Lack of Nursing Educators in Uganda

Well today was a day for ministry meetings…and would-be ministry meetings.

I had a very exciting meeting with Dr. J. Okou of the Ministry of Education and Sports. Ugandan Universities are under the umbrella of this ministry so they are very important to our work. We discussed in great detail government sponsored scholarships (not full scholarships) and how we can work together. There is particular excitement over partnering together to support the tutor (nursing educators in this case) program in Uganda. There is only one such program in Uganda and they have an average annual enrollment of only 20-30 students. This is a real problem.

The lack of nursing educators is the biggest bottleneck in nursing education here….and globally I might add. For example, the largest nursing school in Uganda has over 800 students but only 9 tutors!! I will be touring this school later next week. It is agreed that supporting this program is a priority for TGF.

Unfortunately my date with the Ministry of Health did not materialize. I can’t say that this is a huge surprise. It is not uncommon to run into challenges (more common than not) scheduling commitments here. I have plans to visit for another day.

Signing off for now...

Day One in Kampala

Today was a first of many busy days.

At 9:00 sharp, we toured a new hospital called CoRSU which is 20km outside Kampala. It specializes in orthopedic and plastic surgery. We met a great crew of dedicated workers from the admin Irene to chief nurse Joy, to Michael, potentially our next new Gretta Scholar. They toured us throughout the facility and I must say that it surpasses anything that we have seen touring any hospital in Uganda to date.

We met many babies that suffer from birth defects such as cleft palates to club feet to injuries such as burns. It is heart breaking to see a baby malnourished because it can’t feed adequately from its mother’s breast or see a small child wrapped in bandages with missing fingers due to severe burns. Wounds are sometimes slow to heal and bone infections are everywhere. Some wards are dedicated to septic patients alone.

I was particularly touched when meeting a 17 year old girl named Barbara. She has cerebral palsy. She has been neglected most of her life because her mother is weak from AIDS. Her father died of AIDS so the mother is taking care of the family alone and she is overwhelmed. It was Barbara’s little sister, only 15, who sat by her side at the hospital. Barbara is there because she developed bed sores and no one at home is able to attend to her adequately. The nurses at CoRSU are not only providing loving care to Barbara, but teaching her sister how to care for her as well. Although Barbara can’t speak, her lovely spirit spoke volumes to me. We spent a few minutes passing a piece of red plastic back and forth. This random object was precious to her and she seemed to want to interact and play with me. No one knows what her chances are, but at CoRSU, they are doing their best.

They also showed us the morgue and were proud to inform us that it was empty and they were determined to keep it that way. I left feeling intense pride in the personal care the nurses and doctors gave there. They introduced me to each and every patient by name. What a testament to their commitment.

The afternoon was spent with our friends taking care of business at the International Health Science University (IHSU). Dee (Vice Chancellor), Dorothy (Finance), Evelyn (Registrar), and Gerald (Head of SON) are key to the success of our work in Uganda. IHSU is the home of our 5 Gretta Scholars. We will have more to report on the scholars and the crew‘s work on Sunday when we meet again. But I continue to marvel at the personal investment that they make with the scholars. They attend to their needs like they are their own children.

It is evening again and time to get ready for tomorrow.

Good night from Kampala.

Day One in Uganda

Well we finally made it safely. It was late at night when we arrived and we had the thrill of another harrowing drive from Entebbe(airport) to Kampala. This kind of driving is for adrenalin junkies only. Thank goodness we weren’t driving.

If you can imagine, there are virtually no street lights except in the city centre so all headlights are blinding. That wouldn’t be so bad if it weren’t for the hundreds of people who walk along the roadsides only inches from the cars. And then there is the head-on traffic which are the impatient many who pass from the other lane, blinding you further so that missing the persons walking seems more like a game of Frogger. It is a real E-ticket ride. Approximately 50% of all hospitalizations at the injury clinics are from traffic related incidents. I can believe it.

The streets are really something to see. They bustle with people coming and going and hanging out at the multitude of small businesses which aren’t much bigger than shacks. Most are only lit by a single candle. Businesses range from meat shops, cellular minute stores, barber shops to bars (“bottle shops”). Who would think that there would be so much need for a haircut so late at night. The bottle shops are very busy too; large or small, candle lit or electrified; they are filled with people.

We have a busy day tomorrow, so off for much needed rest.

Goodnight from Kampala!

Off to Uganda - Stopover in Amsterdam

Our founder, Meg Styles, left on her journey to Uganda yesterday. Here's day 1's journal entry...

Janet Pinto, a faithful TGF friend and supporter, and I left SFO yesterday afternoon. After a long but easy flight, we have arrived safely in Amsterdam for an overnight layover. I took the opportunity to do one of my favorite things; walk for miles exploring a new city. Amsterdam is beautiful and exciting and I look forward to coming back one day and giving it the time it deserves. The streets are packed and Amsterdam's many cafés spill out onto every sidewalk. Evidence of the holiday season is everywhere. As you can see from the picture, the streets are littered with lights.

I made sure that this day included a visit to Anne Frank's home. It was a somber visit and a very powerful experience. No one should visit Amsterdam without visiting this place. Anne was a brave and beautiful girl. It is right that her memory lives on in this way.

We leave tomorrow for Uganda. Until then, good-bye!

Meg Styles

Our Mission

The Gretta Foundation’s mission is to provide in-country nursing education to impoverished persons living in disease-burdened nations while bolstering depleted healthcare workforces and improving patient care and outcomes.

About The Global Health-Care Worker Shortage

Healthcare shortages affect everyone, everywhere with critical shortages equivalent to a global deficit of over 4.3 million doctors, nurses, and other health-care professionals.

Nowhere are these conditions more evident than in Africa. According to the WHO World Health Report 2006, sub-Saharan Africa has 24% of the global disease burden but only 3% of the health care workforce worldwide and 1% of the global health expenditure. Where the need is most dire, the health-care resources are nearly nonexistent.

Exacerbating the health-care crisis is a problematic trend of the nursing “brain drain.” Due to higher pay and better workplace conditions, many skilled nurses are migrating from disease-burdened countries to more industrialized countries in the north. As a result, the loss of this essential human capital gravely affects health-care availability and patient’s quality of care.

Always more information on our website too...
http://grettafoundation.org

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