Thursday, October 15, 2015

Mobile Medicine, Punching Above their Weight, BKB Battles Disease in Rural Villages

Residents of Kamuli Buzimba village wait to see a nurse at Bega Kwa Bega's mobile clinic.
Edward Mugume distributes malaria medication
in Kamuli Buzimba village

          On the veranda and in the front yard of a local church, healthcare professionals triage symptoms, draw blood, discuss concerns, dispense medication and advice. A large canister of malaria medication dominates the pharmacist’s table as he dispenses a package of the curative to every other patient who turns up for care at the quarterly mobile clinic.

          Bega Kwa Bega’s (BKB, Shoulder to Shoulder in English) crew visits, to date, 50 villages per quarter in an effort to make healthcare more accessible to rural areas of central Uganda.

          That they operate in much the same way much larger, world-wide non-governmental organizations do but with a shoe-string of a budget by comparison, is impressive.
Malaria testing kits

Nurse midwife Nora Nakiwolo distributes
anti-worm pills to children in Kamuli Buzimba.
          In these rural locations, healthcare can be 15 or 20 kilometers away from the nearest level four or level three government health facility.

          If their needs are more serious, those level one and two facilities are even more scarce. Access to decent healthcare is a challenge that can turn a curable, nuisance issue into a fatal one.

          The team tests and treats numerous patients for malaria, worms and many other health issues during their  visit. Not surprisingly, numerous patients present with malaria, a parasitic disease that feels much like a flu on steroids. Malaria claims many lives each year, mostly from lack of treatment,  and is among the most common but treatable illnesses in all of Africa.

          In my years of working with such NGOs, I’ve seen many projects and efforts to make a difference. These operations take their work very seriously, doing all they can to run their programs worldwide to reach as many people as possible while preserve the quality of their programs. They are large, multi-national relief and development organizations that often receive millions of dollars in grants to combat disease, poverty, and hunger while giving local populations a leg up in development so that they may eventually sustain their own needs.
Waiting their turn to talk to a healthcare professional.

          As I witness BKB crews carrying out their work, I'm struck by how much their professionalism and effectiveness makes this feel like a major, alphabet-soup -NGO operation.
BKB operations harness the same knowledge and methods, but on a smaller geographic scale, doing all of their work in central Uganda, with far fewer resources.
 Of the 50 mobile clinic stops, four are funded by a grant from Vibrant Village Foundation, the rest are through general fundraising that BKB supporters do in the U.S. and UK.

          I’m not sure how they do it, but it seems Bega Kwa Bega is punching above their weight, battling health issues with resources that somehow stretch to 50 villages.

Be sure to check out other blogs in the Africa series.
Nurse midwife Nora Nakiwolo distributes anti-worm pills to children in Kamuli Buzimba village
Nurse midwife Nora Nakiwolo distributes anti-worm pills to children in Kamuli Buzimba village
Children wait their turn for anti-worm medication.
Edward Mugume distributes medication to patients in Kamuli Buzimba village .
Edward Mugume makes a patient laugh, while distributing  medication to patients in Kamuli Buzimba village
Testing for Malaria
Testing for Malaria. In some African languages, the word malaria means to be sick. As a result, although malaria is so prevalent, people often decide they have malaria when it is some other common, less serious illness.

Wednesday, October 14, 2015

Waiting for a Life, UN Protection of Civilians Camp

With Family work completed for the morning, the wheelbarrow becomes a toy of the boys.

Water in the Protection of Civilians camps in Juba,
   South Sudan is delivered four times daily by truck from the White Nile.  
     ON the day an agreement was about to be signed, we rode in an International Medical Corps SUV, entering POC 3 through a battered gate, overlooked by Japanese UN Peace Keepers sitting behind a sandbagged bunker wall.

      Protection of Civilians Camp 3, the more organized of the three UN House-compound camps has been home for a varying number of internally displaced South Sudanese people for almost two years. Many had fled in December of 2013, in search of a safe place to survive a new conflict between a number of factions in the nascent country.

      If the peace holds, it is a historic day to be here in the camp for those caught in the middle, their lives interrupted in the infancy of this country's life. If not, it will be more of the same, conflicts exercised by armed disagreement, continued chaos, disruption of basic needs and security, with no end in sight.


                                Water for the morning, POC 1                                    
      Fast-forward a month or so, and the ceasefire has been violated numerous
          Produce stand in a marketplace in POC 3         
times.  The president has discussed plans to tear of the map of states and redraw with twice as many state or districts in the country without consultation with the opposition.  Like politics in many places, they are more complicated that I understand given my short history of more direct engagement in South Sudan. This sort of thing suggests the possibility that this peace agreement may end up at the bottom of one of the many dusty potholes of the deteriorated roads of the capital, Juba alongside many other past agreements.

      Their life in POC 3 is rough.

      Water collection used for all daily needs limited to 11.3 litres, and comes from plastic 2,000 gallon tanks stationed strategically throughout the camp, refilled four times daily by trucks.

      Only women and children are allowed at the taps to minimize conflict and even the potential for conflict and  power games.

     Water drains through the pathways and trenches between the tents, carrying, in theory wash water away, although the odors make you wonder what else may be present.
Emergency School, POC 1
Emergency School, POC 1
People live on top of each other in closely-spaced, dirt-floored, dust-covered tents that are nearing the end of their rated-for two-year life. There are conflicts like in any small city, based on normal daily things, but also on tribal differences.

    What it meant for me while in-country, revolved around concern for potential disruption of the peace and tranquility that seemed to have become the norm in the place I lived and worked for three weeks. To me, it also leads to questions about what happens for people who have been displaced in fear for their lives who do not, like me, have the ability to leave the country and land somewhere safe.

Emergency School POC 3
       With its proximity to the Capital, Juba, food is available, through the many small shops that pepper the camp, and the World Food Program provides vouchers for residents to purchase from their qualified neighbors, reducing the need for food-aid and this supporting local businesses rather than harming them through deliver of food-aid from the outside. That said there is often the presence of malnourishment within the population.

      Through constant vigilance,  groups such as the UN and IMC keep diseases such as Cholera, Malaria and Tuberculosis in check, but they cannot prevent it from making regular appearances in the camp and in the region.

       Babies are born (83 in the past month before I arrive), people die naturally and through violence.

      Children attend emergency schools, from grammar to science taught by dedicated teachers and tented and thatch-walled classrooms, play pool and soccer, wash clothes and sell vegetables and dried fish.

       It is a temporary life with an unknown expiration date in a rough place that no one should have to live.
In one month 83 babies were born
in the POC hospital.
International Medical Corps
tuberculosis patient.
Medical staff discuss recognizing symptoms while working with a tuberculosis and malaria patient.
POC 1 began before the UN arrived, contributing to a more
disorganized landscape than the planned out POC 3
Purchasing roofing repair material in a POC 3 marketplace