In a chronic state of mourning

flower18News of a celebrity mother in Uganda losing her only son to asthma yesterday morning came on the fresh heels of another celebrity losing her grandchild to a road traffic accident involving a boda-boda.  However this was not the end of such tragic and unnecessary loss of lives to be reported out of the country to come about as a result of inability by citizens to address the causes and take on a proactive approach to limit such occurrences from staying as normality.

What strikes me in this tragic end to a life so young is the issue of a child having to be flown from Uganda to the neighbouring country, Kenya, to seek medical attention for a medical condition such as asthma or complications arising from poor management of this chronic ailment.  Unless there were already pre-existing medical conditions and for which this child was under a specialist(s) care in Kenya, I am left wondering what this has to say for the paediatric care of chronic medical conditions within Uganda in general for persons who can ill-afford being flown out of the country.

At what point will persons/citizens that are educated, financially well-off and/or powerful politically; be able to wake up to investing in the domestic healthcare such that they don’t need to fly out their loved ones abroad for treatment?  With the outpouring of cash donations in condolences, perhaps it is time to revise what such donations could be worth spent on with the aim of long term and sustainable benefit for many.

The issue of poor delivery of healthcare has been lamented on for years albeit some individuals have privately tried to address this and recently more so the funds coming in from WHO will address aspects of this.  The challenge remains three-fold; from the mentality of those that end up requiring the services, those that are employed or tasked to deliver, coupled with insincerity of government political will to regulate this sector transparently at both local and national levels.

We have hospitals (Uganda) built from our colonial past that are not fit for purpose, in deplorable conditions both for those carrying out care management and for those being admitted to receive care. It is true there are building new health centres but the problem of salaries and missing medication that should be given at nominal costs keeps rearing its ugly head…however this is development that keeps my spirits up.

It is definitely to be commended that there are young persons like Esther and Sheila on ground in Kampala who are taking to being proactive in doing what they can to bring about positive change.    Perhaps these actions can be emulated elsewhere in the country by other communities.

Even in developed countries, communities/individuals/private organisations carry out fundraising activities to support local and foreign charities.  Donations do not necessary have to be in monetary terms – volunteers can offer their skills and times to clean up or assist target areas where needed.

The issue of the road traffic accidents and the ensuing loss of lives or injuries sustained is one I’ve had to hand over to the gods!  For they alone can take pity and remove whatever is clogging the minds of every person who assumes they have right of way and urgency to reach their destination by any means necessary whenever they get inside a vehicle or any kind, and hit speeds only rockets vie for.

This complacency in accepting poor practice and relinquishing responsibility over our own contribution to what sustains such unacceptable practice needs to stop…like yesterday.

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The challenge in staying positive amid such negativity

“When somethings go wrong, take a moment to be thankful for the many more things that are still going right.”  Anne Gottlier

Well, when I first read Anne Gottlier on one of my positive affirmation mantras, I had difficulty scanning her.  It’s like I have a huge stone blocking me from seeing anything that is still going right.

Earlier this week on Monday, I read something in a Ugandan newspaper, New Vision that truly made my blood curl…literally. However any emotions that came after reading this article were driven by the lack of reaction, the indifference or should I say apathy; from persons on ground in Uganda, both general public or government officials and respective opposition political party members.  Interestingly, political opposition members are often quick on the mark to use all given opportunities to politicize most issues that arise, pending or past.

The article in question that left me dumbfounded was about the state of Uganda’s blood transfusion services.  An audit done in 2012 had found that most of the nation’s blood supply had been unfit for use. In brief it was contaminated/rotten with visible maggots photographed in some of the stored hospital batches.  In actual fact, there had been cited reports that large numbers of persons had died due to lack of blood.  What the authorities failed to say was that the state of storage or even collection services in the country were part of the problem. It wasn’t that there were short on blood donors, but that rather, the equipment for collection and storage was not fit for purpose.  Like most things and equipment within Uganda’s health infrastructure.

This is a country which has a national hospital Mulago, that is a certifiable place for death. This is not because the staff are incapable of carrying out their profession (although some persons might argue this point too!) but rather it is down to the complete lack of maintenance of existing mostly, colonial equipment and lack of government’s health ministry’s  serious investment in this only national hospital. Medicines and some equipment are siphoned and diverted in to privately run businesses – a regular occurrence which is well known and appears to be condoned by all.  I guess this is why nobody in government or otherwise, was moved to comment or even come out publicly to allay the Ugandan public over what should have been a grave discovery from the auditors.

Life goes on, other issues get fed to the news reel and this becomes just another incident that is part and parcel of life in Uganda’s chaotic and seriously fragmented infrastructure.  Where Uganda is concerned, it is really challenging to look for things that are still going right when sitting on the knowledge that if you happen to be in the country and suffer an accident that requires you to get emergency treatment, you are well and truly screwed and nobody gives a damn.

But one thing that seems to bring all out to feel the need to associate to fame is when an athlete goes on to win a gold medal. That is something worth convening over to even call upon for all to donate generously towards.  Do not get me wrong, I am happy for this athlete and do not in any way begrudge him his time on the podium. I am just disappointed that such national sense of pride cannot be directed towards building and maintaining her health infrastructure to serve her populace.  Instead, those that can afford will seek to use national coffers to get medical treatment abroad when needed and this becomes routine.

HIV+ Synonymous with Africans in UK as opposed to any other ethnic group

It does not come as a surprise to me to note the comments made by Edwin Poots, a senior health minister in Northern Ireland about a ban on blood donations from gay people also being applied to people who have sex “with somebody in Africa or sex with prostitutes”.

It does not come as a surprise to me to note the comments made by Edwin Poots,

Mr Poots is voicing what so many persons within the healthcare industry practice without concealed discretion – only that they do not get to reach the global media exposure.

The other aspect to such voiced prejudice is that it shows the weaknesses in the system that exists with blood screening facilities which would insinuate such facilities if they exist, purely on ethnicity screening or sexual preferences! A point picked up by Mr Conall McDevitt, South Belfast SDLP assembly member, when he further concludes:

Currently all blood donations are subject to rigorous screening for a number of diseases – including HIV – and no blood is used unless it is approved, regardless of the donor. The fact is that we are in constant need of extra blood stocks in the North and this reinforces the need for the government to do all in its power to encourage as many as possible to donate rather than seek to alienate healthy donors based on prejudice. The minister’s comments perpetuate a tired mythology of cultural promiscuity in the gay community which troubles me as an advocate of a more accepting, shared society

http://www.guardian.co.uk/uk/2012/jun/18/northern-ireland-gay-blood-donation I would go further to add to defend Africans too.

The repercussions of such prejudicial/ignorant acts and words is quite harmful to Africans who being labelled as “diseased” simply because there happens to be persons who aside from escaping political persecution from their countries are also fleeing socio-economic hardships. Financial hardships make it difficult for such persons to receive medical care in their homelands. Some of you might have heard of medical tourists? Well, some of these Africans are medical migrants. It does not necessary mean that all of AFrica is diseased – simply that those able to afford to travel abroad to seek help, are the ones predominantly seen in healthcare centres abroad. Most Africans are very healthy and busy just like many other migrant workers working at building economies in these adoptive countries and their homelands and do not need added prejudicial baggage such as voiced or practiced.

Part of what prompted me to write this was a memory of what transpired to a friend of mine last year… He attended his GP surgery presenting with a rash on his penis. The GP having deduced from the initial questioning and possible physical presentation/appearance that he was black, referred him directly to an STD (sexually transmitted diseases) clinic attached to West Middlesex Hospital. Now this took place irrespective to the answered questions that my friend had been in a long-term relationship where neither himself nor his partner had engaged in sexual activities with any other persons, be it in the UK or Africa in the time-scale of their relationship or previous. My friend had in fact had an HIV test just at the start of that particular relationship which for both of them had returned negative results. Still – to be on the safe side and to adhere to his GP’s request, he attended the STD, bracing himself for further intrusive questions enough to make him doubt his current relationship in addition to his sanity. Repeated samples were sent away to be analysed for all possible STDs after once again ruling out HIV. It seemed possible (to them) the laboratory equipment was not functioning properly, as they couldn’t quite believe that this black African man with a rash on his penis didn’t have some form of sexually transmitted disease from his assumed rampant sexual behaviour or of his partner (whom they never once contacted to counsel even at the prompting of my friend). Still, they opted to treat him blindly with medication favoured for STDs irrespective of the results returning no abnormality on all occasions. His rash meanwhile was getting worse and infected…To summise, his rash eventually cleared … was found to have been down to irritants used in laundry as opposed to perceived promiscuity of his ethnic background. You might ask why he never made a complaint of such treatment – I suspect as most persons these days reason – they have become despondent with how their complaints are treated or regarded.

Now imagine if my friend had been rash to jump the bandwagon of suspicion fuelled from the medical practitioners who made him question/doubt that if he hadn’t brought the STD to the relationship, then his partner had a case to answer!

The cleaning lady

It is 5:15 in the morning. In the side mirror of the bus you see her approach, heavy weight yet agile in sustained jogging as she joins the group of others already waiting at the bus stop. She makes to board the bus, gasping as she pleads with the driver to let her on. She is one of six ladies returning from a cleaning job. This being one of many odd jobs she no doubt is returning or going from. The area she boards the bus from requires her to have a pre-paid pass (oyster card) or ticket. Only in her rush or perhaps in the hope of saving some coins from the meagre earnings she has just pocketed on this job, she had bargained on the sympathy of the bus driver to let her travel free. It was not to be.

This time, the driver albeit is making the last run of his shift, acquiescent in reproach affirms that she must purchase the ticket from the outside booths before he lets her proceed any further. In solidarity, the others that had been waiting ahead of her at the bus stop all make an effort to assist her in purchasing the ticket. Yet, at the same time praying silently; that the bus driver does not drive off without any of them on board.

It has happened before and the women are all very much aware of this. Drivers short on time, in their allocated shifts will not wait for you to purchase a ticket that should’ve been done before boarding in some parts of central London. This has been the rule for some good 5yrs but it is not well publicised by the transport authority for reasons only known to them. Worse still – if these women miss this bus, it means loss of earnings at their next job. Clock-work is what this country has taught them. Everything has to start and finish on its allocated time. It is a far cry from the lands they’ve flown away from. The dreams they held of a land like “heaven”.

This “heaven” money does not grow on trees – this they have come to understand and accept. It is earned by making sure you work at all odd jobs going at whatever time, night or day, rain or shine, snow or wind. Jobs you do under constant fear of being picked up by immigration officers, or worse, coming across wicked persons whose aim is to cut short your life. They have learnt that not all white persons are kind, generous or eager to help freely as was the initial take.

Yes. Some have died trying to get this “heaven” money. One of the sisters’s bodies was found floating in the river…At first, no one dared come to identify her. For in doing so, it would reveal their own true identities.

The other sister had died out of sheer exhaustion they thought. She’d returned from work, took a bath and went to bed. Only she never woke up. They all said in hindsight she hadn’t seemed well, some even went as far as guessed she was sick with the dreaded disease. Still. It was no use.The medication required her to rest and eat properly. Only the doctors giving her the medication were not aware of her immigration status. Her irregular attendance to clinic an incovenience at worst. Her sole purpose in coming to this “heaven” had been out of trying to earn some money to put her children to school back home. She couldn’t not afford the luxury of prescribed rest nor the proper food. Instead, she had scraped and saved, surviving on KFC’s mainly and the discounted sandwiches at the closing hours in supermarkets. Now she was on confined rest and diet – eternally.

Money or any known assets to send back to help those left behind soon to be divided up between those that know where she kept them…otherwise to disappear in “heaven’s” system.

One common theme that binds

For the last 7 days, I have been in mourning whilst trying to adhere to the medical advice given me on resting. Sunday 11th July brought the realities of international conflict home to fellow Ugandans and visitors alike. It was a night when most persons had settled down in to the spirit of the closing final football game to the first world cup to be hosted on African soil. The world cup in itself had provided its very own surprises, but much more lasting pain was to be visited upon the residents of Kampala.

In the minutes leading up to extra-time, I received news of the bomb attack at the Kyaddondo Rugby club and at the Ethiopian Village eatery. Not being familiar with either places, I sought clarification in a bemused manner hopping it was a hoax. The phone lines became jammed at this point and I checked the net instead. To my sadness, it proved to be a reality – bombs had gone off and lives had been losts with many injured not getting the rapid emergency help they needed not being able to get through. My medical background took hold and soon I was looking at ways of alerting persons on the ground I knew could be able to assist if they hadn’t already been called upon. The frustration on my part was in knowing so many injured could be helped but the resources and infrastructure was not in place. This frustration soon gave way to anger – why would a developing country like Uganda engage in situations such as the resulting attacks without having adequate cover? The emergency services in place were already pitiful and the nation’s medical system was just about equivalent to a band-aid. For months if not years, the medical service industry has been labouring for more resources and is heavily reliant on donations and charity. The local fire service is virtually non-existent and the police force, save for the top cream is poorly equipped to even handle an immediate crime scene without evidence being corrupted be it knowingly or unknowingly! So the anger in me rose at the very persons in governance for endangering the lives of innocent civilians by opting to engage without proper assessment or planning in issues that have fatal consquences on the security of her people. I had to work hard at remembering I’m on bed rest and shouldn’t allow myself to get over-excited! So I opted to keep myself to what I could do in support of the persons on ground affected by the bombings. But like a child that is fed after a bout of incessant crying – it was hard to focus on the support without the occasional grumblings…

Reflecting back over the loss of lives, injuries and reasons or solutions to what transpired, my mind drifted to the other side of the coin. The thoughts or reasons as to why these persons opt to carry out such devastating acts on others. I recalled an article way back in April 2003 just before Saddam’s regime came to an end and a boy of 12 was orphaned following a shelling of his shack of a home by our Allied armies. Or the continued war in Afghanistan that is affecting countless civilians where the body count is no longer mentioned unless it involves one of our own soldiers here that we know of. Nor of the continued suicide bombings in Pakistan, India and Iraq which still rage – innocent lives continue to be claimed. This is the common theme that binds all of us caught up in this madness of point scoring using arms. Innocent lives are the gambling chips – they are the soft targets of politics.

How befitting therefore would a statement such as this be?
“When people decry civilian deaths caused by the U.S. government, they’re aiding propaganda efforts. In sharp contrast, when civilian deaths are caused by bombers who hate America, the perpetrators are evil and those deaths are tragedies.
When they put bombs in cars and kill people, they’re uncivilized killers. When we put bombs on missiles and kill people, we’re upholding civilized values. When they kill, they’re terrorists. When we kill, we’re striking against terror.” Norman Solomon, “Orwellian Logic 101 – A Few Simple Lessons,” at FAIR: http://www.fair.org/media-beat/980827.html

I don’t condone the acts of those who took away lives of innocent young persons in last Sunday’s attack in the twin bombing strike – indeed, I’ve lost friends and associates in these incidents who were very instrumental to some of the causes I greatly admire. I do implore the Ugandan leader however to put humanity first when making decisions that could have a far deeper detrimental effect on her young developing nation. If not for him, then for his grandchildren he should act; for his legacy is one that will stand to mark his position in history. The challenges Uganda faces are many already – without taking on more armed conflict whereby her citiziens do not fully comprehend the stakes or even share in the loot. Ugandans have been through so many hells – now that the security afforded through decades of civil wars is in place, it would be great for all her people to enjoy this security in ways that are feasible.

I pray to the gods, that the blood of my three brothers in addition to all their co-patriots in battles fought alongside Mr President in the bush war, that theirs was not just waste.

Accessing antibiotics

As a new mother I recall going to the GP on every slight cough my baby showed to be developing. Syrup antibiotics were virtually a routine medical addition to my baby’s toiletry.   The GP could even at times write up a prescription on a repeat basis for me to access as and when I could get to the surgery to collect it, like it were a regular requirement.   Reminded me of the belief in Uganda whereby persons felt if they didn’t get an injection from the doctor for an ailment they complained of, then that doctor was not considered to be a good practitioner.  Accessing antibiotics in the UK through your GP or healthcare service is not such as a huge obstacle course.   You simply report to your GP, you get checked out and if it’s deemed necessary for you to be treated with certain medications, you are prescribed them and you go to the chemist or pharmacy to collect them.  Thanks to the the NHS system in place whereby nearly everyone can have this facility of treatment availed freely or at a reduced cost.  Unfortunately this is not the case in Uganda or other parts within the developing world.  Accessing such therapies like antibiotics is not as easy or even affordable to most, which accounts to a fair number of deaths that can be preventable.

Last Thursday I came down with serious pains almost akeen to labour pains. I was at work and had just rounded off final completion checks for an international conference we’d organised to take part in the City of London.  Earlier on in the week I had visited my GP on Tuesday afternoon for a suspected urinary tract infection (UTI) or cystitis and been started on some oral antibiotics. The need to go to the bathroom every 10-15mins certainly brought new meanings to the need for short-calls in relation to planning your day’s activities. I had to plan everything I did around close proximity access to the ladies. I tell you, this was not funny in any way given I had to carry out my daily and weekly office duties alongside ensuring the conference guests and attendees were taken care of. Coming clean and telling my work colleagues that my bladder had gone to war with me was the best option. The other gauntlet was the journeys to and fro work using public means of transport – I became acquainted to all the available pit-stops and my medical condition became knowledge to all who demanded to check out as to why I urgently needed to use their washrooms.
The pain got so bad on Thursday afternoon; I had to leave work with the aim of checking in to A&E at my work place. There is a belief or is it a saying– that persons from within the medical professions make poor patients – this saying isn’t far off. Looking at the waiting times for a casualty officer, I opted to go home and report in the morning. How I got home Thursday evening, God knows, but by Friday morning, the pain was so severe, I didn’t need a shot gun to do a roll-call at my local A&E. It was here that I was confirmed to have a severe kidney infection requiring IV antibiotics and fluids to hydrate and relieve the pain. The pain is taking some time to recede and I’m feeling somewhat better.

My bout of infection brought to mind my time in Uganda on a previous visit. On my visit there last year, I was called upon to assist in giving medical assistance to a young girl that had presented at our village homestead with a badly injured leg. She had sustained this injury virtually 3 days back but because our local government run health clinic didn’t contain the necessary medication to deal with the injury, the family had resorted to keeping the wound clean and using herbal concoctions. However, the use of such herbal remedies requires knowledge too and a practitioner who can assess and monitor. From the presentation of the girl at our homestead, this clearly was not the case – her leg had become seriously infected and her leg had to be amputated to stop the gangrene spreading further into her system.

From experience, I’ve learned to travel with a medical kit that contains antibiotics along with pain killers on all my trips to Uganda – because these are by far the least availed medications in rural healthcare government run clinics.  Looking back on this, I couldn’t help but wonder how things could have been for me. How could I have been medically cared for had I become afflicted with this infection if I had been residing in Uganda without adequate economical cover. For such infections do occur.