Bringing People to Healthcare & A Holiday

Kelly Austin is an Assistant Professor of Sociology at Lehigh. She is in Bududa, Uganda this summer with a group of students pursuing her research in community health. You can see her previous posts here.

So, the word is out. The Lehigh “mzungus” are back in Bududa and thus people are showing up again at the Zaale compound. This all started about 2 summers ago, as I began actively researching health issues in the area. Many locals incorrectly conflate my understanding of public health with being a trained doctor or medical practitioner. What they do understand is that we are willing to do what is needed to help obviously sick thermometerpeople get the life-saving interventions they need. Every time another “patient” rolls in, I explain to them that I am not a doctor, but that I would be happy to transport them to the private clinic (and pay for their treatments). So far this year, the students and I have helped over a dozen people (mostly children) get to the private clinic on the other side of the district. There are no clinics in our village of Bubiita, and the nearest clinic is run by the government and faces “stock outs” of medicines for 3 weeks out of every month. So most don’t waste their time walking 2 miles to a public clinic without medicines and instead seek out our assistance, when they can, to get them to the private clinic.

Our peak day was about 2 weeks ago, when I drove 6 children to the clinic who just showed up at the gate, with fevers, vomiting, and other active aliments. 4 of these 6 children had malaria (and only 2 of them threw up in the car – yay!). One of them had severe malaria (+++) which would have quickly progressed into cerebral malaria without immediate action. He had to be on IV treatments, but has made a full recovery. I am grateful to have a number of Lehigh students on the team this year that are pre-med or interested in public health. They have been helping me take patients to the clinic when I am busy working on research, as well as following up with their treatments. When children arrive, we take them to the clinic and help them through all the stations (check in, vitals, consultation, lab, etc.), especially the young ones that would be lost without someone to guide them. This is often a feat in itself, as some of them are so young or under-educated that they do not even know their age or last name. For the kids that come from unstable homes, we have them return to the compound whenever they need their next dose of medicine and give them a meal and clean water to take it with. For some of the children, like the very young ones, we find out where they live from Maayi or Papa, then do “house calls” to follow up with their medications or treatments at the proper time. Many children or adults are just simply too poor to pay for the private clinic, so after getting them there and back, we send them on their way, making sure they know how and when to take their medication and stress to them the importance of adhering to the full dose.

I know that this anything but a long term solution for the community. I often think about what happens to these sick children when we are not here for the other 10 months of the year. I know that many of them would end up in really bad shape, likely going to the apocalyptic Bududa hospital where you “walk in with one disease but come out with five more” (quote from a local health inspector) as a last resort once their illness had progressed to devastating stages. Or many of them would treat themselves from a drug shop or local healer, likely not getting an accurate diagnosis (if any) or the proper dosage of treatments. So in the meantime, we take them to the clinic. I don’t have the heart to turn away sick people when they arrive on our door step.

We did get a break over the 4th of July holiday, when Mark and I organized a trip to Sipi Falls. Sipi Falls is a beautiful area on the other side of Mt Elgon that is famous for – you guessed it – the waterfalls. There are over 30 waterfalls in the Mt Elgon area, and Sipi hosts a clustering of 3 of some of the most impressive and scenic falls. We stay at a beautiful resort that is right at the base of one of the taller falls. We all enjoyed seeing gorgeous views of the waterfall right out our door step. And of course, we enjoyed the “simple things” according to American standards, such as hot showers, flushing toilets, pizza, cold beverages, and electricity.

The Lehigh students did a lot of hiking! They had a great time exploring caves behind water falls, climbing on 100+ foot ladders to the base of the most impressive waterfall, and getting to the top of the other falls for stunning views. Mark and I also did some hiking, but spent a lot of time hanging with Maayi and Papa (Elizabeth and David) Zaale. Although they are over 65 years old and have lived in Bududa their whole lives, this was only their second trip to Sipi Falls. I don’t think they had ever stayed in such luxurious accommodations – they were so blown away by their cottage and waterfall view that Papa was “rendered speechless.” I was happy to see them not work for a few days and just relax and enjoy themselves. On the last day of our excursion, Papa did a short hike with Mark and me. I am so impressed by his fitness level and agile footwork, crossing streams on slippery rocks and climbing up steep embankments. Of course, Papa had pearls of wisdom to share with us along the path, naming different flora and telling us their history. It was nice to spend some quality time with him.

We arrived back safely in Bubiita, Bududa last night. Although the accommodations at Sipi are beyond amazing, many of us remarked that it was nice to be “home”. Despite the bucket baths, pit latrines, mud, and other inconveniences, the Zaale compound is lovely and comfortable in its own right. The Zaales see to everything they can to make us feel at home, and it’s clear, we do.

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