Week 9- (Lack of) Safety Nets

This past weekend we went to Jinga to white-water raft and bungee jump right on the Nile River.   While some people in our group were worried or afraid of the rapids, the raft flipping, and bungee jumping in general, I wasn’t really nervous or worried at all.  It’s not because I’m a super macho guy who isn’t afraid of anything.  (Just bring a spider within 4 feet of me and watch me squirm.) I think the level of protection we had was simply so much greater than we’ve seen in other areas of life here. We had safety nets (metaphorically) all around us. We all wore life vests, were taught what to do in case we flipped, had a safety boat no more than 100 ft away, etc.  We were prepared and protected for the worst-case scenarios.  Unfortunately, this kind of protection doesn’t exist in other aspects of life here in Uganda.  Other sectors, like health, are not provided similar levels of supplies for worst-case scenarios.
    In the public hospitals, there are no “just in case” preparations.  Resources are too limited and demand is too high to set up protection systems.  In the emergency rooms, there are no “crash carts.”  There are no “code blue” teams that burst into a room when a child’s heart stops.  There aren’t even defibrillators for the on-call doctor to use to shock a heart back into normal rhythm.  They don’t exist here.  Instead, in their place, there are faulty face-masks to provide oxygen and a limited supply of epinephrine that is properly diluted one dose at a time.  Instead of heart rate monitors that can alert staff of a child in distress, there are their parents who are silent with grief as they watch their child in his or her last moments.  Instead of children with coughs and broken arms, the emergency rooms are filled with children suffering from malaria and sickle cell anemia.  The picture of a public emergency room here in Uganda is drastically different from the ERs I have seen in the United States.  The “Grey’s Anatomy” idea of pristinely clean white rooms aren’t even a fantasy here. 
    I spent two short days at Mulago hospital in the emergency room ward for children seeing some of the saddest situations I’ve ever witnessed.  Doctors work incredibly hard here to save children but they face insurmountable odds.  They seem to have enough training to know what to do in emergency situations but come in contact with these children when it’s too late or at a time when there are simply not enough supplies to allow them to do their jobs.  It’s an incredibly sad situation to watch.  As an American, I questioned our own role in these situations.  Are we focusing on the wrong areas for funding?  I asked the doctors in the ER what they thought about their severe lack of funding.  They told me that the most common things they face are malaria, sickle cell anemia and malnutrition.  They said that these issues simply aren’t the focus anymore due to HIV/AIDS.  All the money goes to drug research, ARV therapies, etc. rather than on basic illnesses and the supplies needed to treat them.  I don’t necessarily blame America or other foreign investors though.  The Uganda government doesn’t provide enough funding for health care.  They just recently further cut the Ministry of Health budget even further limiting the drugs and treatments that can be provided to Ugandans.  As the election comes up, I want someone to make Musevani come to Mulago, come to the acute pediatric ward and tell me why he tolerates children dying that don’t have to.  I want to know why he thinks providing simple services like heart monitors or defibrillators are not worth the government’s money.  I don’t think anyone can see what I saw there and still have respect for that man or his practices.  He would not be okay going to a hospital with the lack of safety nets that Mulago currently has. Yet, he is ok providing this level of care to his people.


Location: Kampala, Uganda