Clinic Day #1: Strong Start
- Emily Graves
- May 7, 2018
- 12 min read
I know that it seems like I'm just jumping into the clinic aspect of things and you might be wondering how did I even get to the clinic, but because of the lack of WiFi (which I am secretly grateful for because it made me focus on everything in front of me), I'm just going to get straight down to the nitty gritty. So just imagine me and my team traveling for a full day and a half of airports, plane rides, pit stops, and finally reaching our hotel at Masindi with eager and anxious little hearts! Here are a few pictures of the hotel. It was beautiful! There were two people to a room with a main area for eating and relaxing. It was our home for most of the week.
So I woke up at 4:45 AM to do a workout with a few other team members. I was happy to have them to hold me accountable for getting a good workout in every morning. If you would have told me that I would be waking up extra early to do a work out while in Uganda before a full day of being on the move, I would have laughed in your face. But here we are! Bright eyed and bushy tailed with sore muscles and a happy heart. We would wake up before the sunrise so it was pretty breathtaking (no but seriously, the workouts literally took my breath away) to see all of the stars and then the sunrise every morning. Totally worth it. We started loading all the buses at around 7AM after we had a good fueling up breakfast at 6AM. The vans were packed in Ugandan style, which we had to get used to real quick. We would have about 12-13 people per van with their bookbags for hours and hours of travel to the sites, so personal space went out the window as soon as we stepped into Africa. The roads were mostly all red clay (which I am still finding in the shower, it's incredible) & mud. If it rained, which it did often due to it being tropical storm season, the roads would be bumpier and harder to navigate, increasing the time of the trips. Imagine an ATV on an old bumpy back road and that's about how our van rides were. No air conditioning, just some windows that you prayed open and good ole fashioned bonding time with the people around you.
On our rides we would pass tons of people, villages, huts, animals and lots and lots of sugarcane. The kids would come running from their houses and huts just to get a wave in and shout their hellos at us. It was an incredible welcoming experience and it hyped us up for our first clinic day. In case you were wondering, the word Mzunga (pronounced Muh-zoon-ga) means "people with white skin" in Africa. So you can imagine we learned that pretty quickly...always with huge smiles on their faces though so all was well.
When we first pulled up to the site, everyone was astounded to see the amount of people who were lined up to see us. It took us about 5-10 minutes in the vans to navigate our way down the lines of people waiting. It was the first time I was able to personally witness the NEED and WANT Ugandans have for medical care. Fortunately, we were able to see and treat 184 people today, & although that number can warm your heart, you are still heart broken for the ~200 people you have to turn away. That was one of the things that stuck with me for a while and still does. Although we do our best to see everyone, it's not realistic, & it's hard to turn away people. But we had to learn to focus on the work we were doing and the patients we were able to see by God's grace and know that He still has a hand on those that we unfortunately could not see.
A note on that and how incredible these people are, the service comes on a first come, first serve basis. People would spend the night just to be able to be one of the first to be seen in the morning and they travel miles and miles on foot to get there. However, if the people in line saw that someone was incredibly worse off than themselves, they would push that person up to the front of the line without any hesitation, frustration, or anger. Does that not just put everything you know into perspective?
The very first patient that stuck out to me was a young man who was on the ground dragging himself through the red clay with cardboard boxes under his knees. He was at the end of the line, by himself, because I imagine it took him a whole day to get there. When he arrived, however, the townspeople pushed him to the front of the line so he was the VERY FIRST patient we had the privilege of meeting. I almost cried within 5 minutes of being at this place. It was truly incredible. It was the first cases of polio I had been exposed to, and when he got to our therapy section, we were able to give him a wheelchair that he was instantly a pro at. I saw so much joy, so much appreciation, and so much love from that first patient. From then I knew that my life would never be the same.
Sorry for going off on a tangent, BUT I will explain how the process of our medical care worked before we dive in. First off, remember that everything we provided for these people was absolutely free of charge. Which is incredible and I'm so fortunate we were able to do that. Our locations would normally be at schools which had different buildings in a central location. We would designate a different building to a different service and we would unload all our boxes in their respective places. We would grab benches and put them together to act as treating tables and we would set some benches outside for waiting. Patients would first go to the TRIAGE building, where they would get their name, weight, height, vitals, and basic information taken. They would then be escorted to the PROVIDERS, where a team of doctors and RAs would assess the patient, figure out their chief complaints, decide what tests need to be done, and get to know the patient. From there, the patient would be taken to our makeshift LAB, where urine samples, blood samples, etc would be taken. Then they would go BACK TO THE PROVIDERS, where the results would be read and decisions would be made about best plan of treatment. The providers would then circle if they should go straight to the PHARMACY, where our pharmacists would provide them with medication (which they called tablets), or they would come to my team at THERAPY, which offered occupational therapy, physical therapy, wound care (which none of us new we would have to do but learned very quickly that we would), or glasses! And then from us we would take them to PHARMACY where they would get their tablets. While they waited at pharmacy, a PRAYER TEAM/ SPIRITUAL HEALING TEAM who were locals that worked with us would talk to the patients and provide them with comfort and prayer. So that was our basic routine. The patients would carry around their charts and when they showed up at our door we would read them quickly and get started on treating them and loving them the best we could. (And if you had to go potty, you walked down to the "latrines" and squat above a hole in the ground; BYOTP & hand sanitizer).
So now it was officially time to start treating people. (Even though I gave you a tease with the first guy we saw). These are just my personal experiences with therapy, so everyone on the team had different experiences, but I'm just going to give some stories of what I saw throughout the day! How our therapy teams worked was that 2-3 people/students were on a team and our 2 professors/wonderful advisors/heroes would walk around and help us out as the day went on. We would also have one person in charge of the glasses station. Every group/pair was assigned an interpreter for the entire day, and these interpreters traded their work for free consultation from us at the end of the work day. They were some of the most incredible people I have ever met. So my first assignment of the week was....GLASSES!!! I know nothing about glasses. So obviously I was very ready and eager to take on this role. Basically my job was to sit with the patient. hand them a Bible in their language, tell them that I would be handing them different glasses, and they tell me which ones help them see better. Afterwards I would teach them how to care for their glasses, when to use them, etc, sign off on their sheet and they would be good to go. Sounds kind of boring, right? WRONG. I was SHOCKED at how much of a difference a pair of glasses could make in a person's life. I had one lady who put a pair on her face, stood up, and started shouting every single word she could find in the room. She did not stop smiling the entire time and it really made me realize how much we take small things for granted. Can you imagine not being able to see well for your whole life, getting constant headaches, and then all of a sudden your whole world shifts just because of two small little circular glass type things? Yeah, it was incredible. We also gave away multiple pairs of sunglasses for those who were sensitive to light or spent multiple hours on their mopeds/"Borda bordas". (Called Borda Borda because they help them travel from border to border..lol). So yes, I had many experiences like that while working with glasses, then I took a short lunch break, came back, and started on some therapy!
(If you hate open wound pictures, I would suggest covering them with your hand as you read on. I would have left them out, but I feel like they are important to see because you can't fathom what is happening if you weren't there!)
After we had the young man with polio who we gave a wheelchair, we had a 15 year old boy come in with a snake bite that he had had open for 2 months. The bite had grown infected, and it covered his entire bottom portion of his leg. Unfortunately, the wound would not be able to close on its own because it would need a skin graft which we could not provide, but some awesome team members (shoutout to Alison and Eme) were able to clean the entire wound (which
took about an hour), wrap it, teach him about proper care, gave him SHOES (which is a big hit here, and we were lucky to have the amount we had) and provided him with supplies and education needed to take care of the wound himself. He was also given a referral to follow up with their local hospital in a week to see how the healing has progressed. Of note, the pain tolerance of the people here was absolutely breath taking. As we poked, prodded, cleaned, drained, etc, the patients would just sit there and thank you for everything you were doing. Even if you asked about the pain, they would say it was okay with a smile on their face. I was floored.
I then saw a patient who had osteomyelitis. This is an infection of the bone that, if not treated, starts to go through the skin and cause very painful open wounds. We learned that it may start with something penetrating the skin through the feet, such as a nail or something sharp, and then slowly progress to be noticeable on the skin. It is common for the patient to have no idea where the wounds came from because the progression from bone to skin is so slow. The patient had two open wounds on her left lower leg, so I began cleaning them slowly with swabs, saline, and antiseptic. The process of cleaning wounds here is a long one, but it is so incredibly worth it. I was able to clean the wounds to the best of my ability, wrap it, give her some supplies, refer her to the hospital for a check up, and give her some nice shoes so hopefully it can be avoided in the future. (PS, if you are bad with pictures of wounds, I suggest you quickly skim down to the next patient...).
I was able to hang out with a little nugget while I was on a break from glasses duty in the morning. In the afternoon when I was on therapy, he came back to get treated for CP (cerebral palsy). He had a great team help him and his mom out with mobilization and teaching him to get moving, and I had the pleasure of jumping in at the last second and giving him peanut butter (this was a hot commodity and a special treat we would give to some of our bravest...& maybe cutest....patients). He would dig his whole hand into the peanut butter and just lick away. He was the most smiley and happy little kiddo I saw all day and I couldn't get enough of him.
Then I saw a little kiddo and her mom. The mom needed glasses and the little girl had wounds on her feet. We were able to get the mom glasses, which she enjoyed very much, and I was able to clean a few chigger bites from the little girls feet and find her some shoes! I was nervous because towards the end of the day, kid shoes were very hard to come by. We had to space the shoes out between the whole week, so we wouldn't carry them all at once. I was praying on my way to the bin that somehow, someway, there was ONE pair of shoes that would help this little girl. I went the first time and didn't find anything. I went back to the little girl and played with her with some bubbles as I waited for her mom to come back so I could tell her the bad news. I decided I would look one last time to see if I could find anything, even a pair of socks. I went back and I saw a small pair of shoes behind the bin. I grabbed them and they were pretty heavy. They were tap dancing shoes with the tap dancing part still on the heel. I laughed because 1) that's hilarious & 2) who thought we would actually try and give these away?? I took them out there and what do you know, she LOVED them. She would not stop dancing away and her mom thought it was so funny. She was the happiest gal. I made her a bracelet and she tapped on out of the room so happy. I could hear her for the rest of the day walking back and forth past the door and she would peep her head in and smile and wave. Gah, it just gets ya.
Although there were definitely great things that happened today, there are also the hard times, which I kind of touched on earlier when we have to tell people we don't have the ability to treat them. A young girl and her sister came into the clinic. The young girl had trouble walking and had to get on her hands and knees to crawl up inclines. Her sister was her caretaker and went with her everywhere. After the assessment, we decided that a walker would be best for this patient. She had the ability to walk, she just needed support to bear down on as she did it. However, they had come in with the belief that they were going to get a wheelchair. It's incredibly hard to explain to a patient that if they have the ability to walk, they need to do it as much as they can so they don't eventually lose that ability. For the patient and her sister, they thought the wheelchair would significantly increase their lives, but from a medical standpoint, we couldn't give her a device that would eventually make her lose all ability to walk/transport herself. In addition, we only took 2-3 wheelchairs to the clinic per day because they were limited and we had to use them wisely and to the best of our judgment. But trying to explain this to 2 young woman who have an incredibly challenging life is impossible to do without your heart breaking into millions of pieces. Eventually, we were able to teach the sister and the girl how to use the walker, and her mobilization looked increasingly better, but after they got the tablets from pharmacy, they came back and returned the walker saying they did not want it and that it was too hard. So they left with what they came with. Throughout the week, we were taught to process everything and to really work through the moments that were hard and that stayed with you. This moment is one that is going to stay with me and one that I will continue to struggle with although I know we used our best judgment for that family. I'm just continuously praying for them and the many other cases similar to that one. We knew it would be incredibly difficult caring for these patients, but one cannot simply put into words the heartbreak you feel. But again, we served 184 beautiful, beautiful people today, & that's something I am extremely grateful for.
It was time to pack up and start the 1.5 hour trip back to our Masindi Hotel. We were tired but running off the adrenaline of the people we saw. When we got back, we had an awesome dinner prepared for us by the hotel staff. Dinners were some of my favorite times because I got to hang out with some incredible people and learn more about God's plans through them. One of my favorite things in life is to learn about people and learn about what makes their hearts on fire, and that's exactly what these dinners entailed. So when I saw that Uganda changed me, I also mean that the people I went to Uganda with changed me. Every night we would hear about ten team member's life stories, & about every night there would be about 40 faces full of tears. I can't thank each person enough for how vulnerable they were because just being who they were allowed me to open out in ways I felt like I couldn't before. I would've never thought I would have been the first ones of the group to give my life story, but through these people's love and a little push from God, I got through it & I grew. And I can't thank these people and this trip enough for that opportunity.
After a day full of laughs, ups, downs, tears, hard work and lots of love, it was time to shower and hit the hay in my little mosquito protected bed. Wake up call at 4:45 AM for another early morning work out!
DAY 1 = COMPLETE <3
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