This past week, after returning from Rakai and our travel break trip to Zanzibar, we were scheduled to spend 5 days in Ssese Island working on a community service project. In past years the students have dug pit latrines for the community to use since very few exist in the area. This is due in large part to the wet soil on the island, which makes it difficult to dig a deep pit latrine that will remain hygienic and functional. Instead, this year the project was to extend piped water to a community with a high number of elderly individuals. The work would require digging a trench, laying the pipe, and connecting the sections.
Unfortunately, the night before we were scheduled to leave I became very sick and could not go on the trip with the rest of the group. Instead, I was left to stay by myself in our apartment and recover. My three days in the apartment shed light on the differences between Ugandan and American settings. At home in the US there is always clean drinking water in the taps, there is usually a good supply of food, and friends around in case of an emergency. Here in Uganda, the context is quite different. My roommate and I had purchased large bottles of water, but I started running out after a few days and it's nearly impossible to go out and buy more when you're really sick. The same goes for food--since purchasing ingredients and cooking here is difficult, we tend to eat out a lot. But, the lack of basic food supplies in the apartment made it difficult to find enough to eat. Luckily, our Professor was around and able to help a bit, but it was clear that the level or preparedness was different. In a foreign country where you only plan to spend 10 weeks, it's difficult to think about stocking up and preparing for a worst case scenario. Subsisting on bottled water, stale bread, and crackers made me appreciate the modern conveniences of the US. While the time here in Uganda has been wonderful, it is admittedly difficult to completely adjust to a different way of life. The expectations that we have developed in the US don't disappear when you step foot in a different country, in fact they tend to make deviations from the familiar and unexpected even harder to accept or to deal with.
After two days of sickness, I decided to get checked out at the hospital. Luckily, we have a brand new hospital about 5-10 minutes from campus that caters to foreigners and people with money. I went late at night, which meant that the out patient area was empty and the entire visit only took about an hour, including lab work. I was able to see a doctor, get lab work done, and get prescriptions--sounds like a typical doctor visit in the US. But, that wasn't quite the case. Much of the time I felt like I was self-diagnosing myself and just going to the hospital for the blood tests. While the lab was high-tech, quick, and helpful, the doctor was not particularly helpful. She didn't tell me anything that I didn't already know and she prescribed two medicines that I didn't end up taking. The lack of explanation as to the purpose of each prescription made me wary of taking them. Since I was already self-administering one prescription, I didn't feel that it was appropriate to take a second one on top of that. Ultimately, the lab work was able to rule out the most concerning illnesses and I was sent home without a problem. Plus, unlike at home, the entire hospital visit was extremely cheap compared to US standards.
Now, I don't want people who are reading this to think that medical care in Uganda isn't safe or effective. I'm sure that if I had been really sick that this hospital would have been able to treat me and give me the proper care. But, my outpatient experience did make me appreciate the Western medicine that I'm accustomed to. Despite the high price, I usually walk away from a doctor in the US feeling fairly confident that I know the diagnosis and the proper course of treatment. The purpose of prescriptions are explained and they are not prescribed lightly. While I'm sure many people would disagree with that assessment, I simply mean to suggest that I walk away from a medical facility in the US feeling more confident in and satisfied with the experience than I do here. Despite the best efforts to provide quality health care in Uganda, Uganda is not a country in which I would ever like to be very sick. I have confidence in the US healthcare system to provide better care for me than I can receive here.
In addition, if I am not satisfied with the quality of care that I can receive as a foreigner with plenty of money to spend, that does not bode well for the quality of public health care available to the average Ugandan. Having toured one of the major public hospitals in Kampala and seeing the state of overcrowding and lack of staff that they experience, I feel guilty complaining about the private hospital care that I received. But, as I said before, it is hard to accept something so different from the standard of care that I'm used to at home. My expectations did not change overnight and I would still choose not to go back to the hospital for medical care unless I really needed it. All of this suggests that a much stronger healthcare infrastructure is necessary in order for Uganda to develop in the future. If all of the money and resources are going into private hospitals and government health budgets continue to get cut, I can't imagine how poor the quality of healthcare will be in the future. On a daily basis I often feel ashamed of my status as a wealthy, white foreigner here in Uganda, but when it comes to healthcare I appreciate the resources and care that my home country provides me.
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