UGANDA REFLECTIONS (4) - MEDICAL CLINIC

Last year Hines Ugandan Ministries and Orphan's Heart began discussing the possibilities of opening a medical clinic to serve the medical needs of Kamonkoli.  My name is Jason Holmes, and I am a physician that has had the privilege and blessing of being a part of this project.  The following are some observations and stories from this past week at the clinic and my work with Namai Michael, the Clinical Medical Officer who runs the clinic. 

This was the first time I had gotten to see the clinic in person.  When I came last year, Michael and I talked about his desire to open a medical clinic to provide care for the children, widows, and staff of Hines Ugandan Ministries (HUM) and some day all of Kamonkoli.  He and HUM sent a  proposal to me and Orphan's Heart, and we were able put together resources to open the clinic in April. 

Michael has done a fabulous job of setting up the clinic.  There is an office where he sees patients with an exam table and pharmacy cabinet .  There is a room with two beds for short term stays and overnight therapies.  There is a lab with a refrigerator for reagents, a centrifuge, and microscope.  There is also a room with an autoclave for cleaning instruments.  The clinic is staffed by Michael, a nursing assistant, and a lab technician.  I cannot say enough about how impressed I am with how the clinic turned out and all the potential it has. 

A special thanks to the people of Missio Dei Church for donating the funds to pay for medications I brought this week to replenish the medication stores in the pharmacy cabinet.   And a special thanks to my friends at KDMC Wound Care Clinic for donating wound care supplies that were much needed!

 

(The remainder of this post will be events arranged by day.)

Monday - Clinic Day One

Monday was the first day in the clinic.  An announcement had been made at church that I would be seeing patients this week at the clinic.  As with most countries, when they hear a "Mzungu" Doctor is coming, many people come.  When I arrived at the clinic around 9, there were 20 plus people waiting to be seen.   It was an awesome experience to work with Michael and his staff in the clinic I had the privilege of helping establish.  We saw many patients and treated ailments including skin infections, pneumonia, malaria, to name a few.  

Tuesday  -  Clinic Day Two

I walked to the clinic at 8:45 this morning and when I arrived I was met by over 30 patients waiting to be seen.  We saw ages ranging from 1 month to 75 years. Congestive heart failure, asthma, skin infections, fungal infections, were just a few of the disease processes we encountered.   We only did a half day clinic because of the adult Christmas party that was taking place in the afternoon. 

From a medical standpoint one lady really stuck out to me at the party.  This past August she was diagnosed with gangrene involving the 2nd, 3rd, and 4th fingers of both hands.  She had waited too long to seek treatment because she had no money.  She finally came to the clinic, and Michael sent her to Mbale where her fingers required amputation. Amazingly, her surgical wounds have healed well.   What impressed me was her joy.  Just 3 months ago she had 6 fingers amputated.  Today, she was laughing and hugging people and speaking of how good God is.  She had a pinkie finger and thumb remaining on each hand.  As a result, she could still grip things and carry them.  I believe this is by God's grace.  Her hands are constantly making a "hang loose" sign.   She was very excited when she was told this was a common expression in the States, and went around waving her hands to everyone!   As one of the team activities at the Christmas party we had each of the people trace their hands, and we cut them out using them to create a Christmas wreath.   It was a very touching moment when two "hang loose" signs were taped onto the wreath! 

The second thing her story illustrates is the huge need in Kamonkoli for quality, accessible medical care.  Had she been able to come to the clinic earlier in her disease process, perhaps her fingers could have been saved.  So many in the village when they get sick assume they will just have to suffer because they cannot afford to seek medical attention.  We are working hard to address this unfortunate circumstance, and by God's grace we will be able to meet more and more needs.

Wednesday - Clinic Day Three

Today was the 3rd day of clinic.  Again this morning there were over 20 patients waiting when I arrived at 8:15.  I'm always taken aback when I see these people sitting on the ground or a hard concrete stoop in the hot sun waiting patiently to be seen--no coffee, no TV, no magazines like in the US.  Yet, there is no complaining about long waits.  The other aspect that sticks out is that all of the ladies come dressed in their gomez (a fancy Ugandan dress).  Some of them new and vibrant, some of them old with many holes and ravels. It is part of their culture to dress up for any major event, which does include going to see a mzungu (white) doctor.  So when I see one that is not dressed up or has no shoes, I know I am seeing the poorest of the poor.    

We saw over 40 patients today in the clinic.  Many of them came with chronic conditions of arthritis and other musculoskeletal issues that are the result of the toil and labor they endure  each day.  There were many children with distended abdomens, which is a tell-tale sign of malnutrition and/or worm infestation.  In several cases I saw multiple children from the same family, with the oldest child of 10 or 11 years of age being the one that had walked or carried them there.

Thursday - Clinic Day Four

This morning had an interesting beginning.  It was an example of how God orchestrates situations in ways that only He can, and something that I have experienced been amazed by numerous times on the mission field.  Bryan and Mindy Jackson are missionaries from the US currently serving in Uganda. Prior to coming to Uganda they had been serving in Nepal and India.  They are staying in a house in the same compound where we were staying.  Bryan had injured his great toe a few weeks ago and had been experiencing increased pain and swelling.  He had been reluctant to see a national doctor about it, because of past bad experiences.  He heard that I was working in the clinic and asked if I would take a look.  I was happy to, and it turned out he had an ingrown toe nail that was becoming infected.  He came to the clinic, and I was able to repair it, and by the weekend he was doing much better.  As Bryan worded it, "missionaries helping missionaries."   I love it when God allows me to be a part of his answer to someone's prayer.

It was another busy day in the clinic, and we were able to meet at least some of the medical needs of those we saw.  On busy days like today, it was very beneficial to have the help of Bill Armstrong, one of our team members, who was gracious enough to count and package medication prescriptions for us.

Friday - Clinic Day Five

Today was a half day clinic, as the afternoon was the children's Christmas party at the church.  It was a very busy morning, and we saw  over 25 before closing down.  We saw two very sick children, one only 18 months and the other was 11 years old.  Both had malaria--P. falciparum to be more specific, the most aggressive form of the disease.  Their blood smears, tested in the clinic came back 3+ which indicates a very significant parasite load requiring IV doses of quinine.  Fortunately, the clinic had a supply of the needed medication, and the patients were admitted to the short term ward in the clinic for treatment.  They were reevaluated the next day and both were doing much better.  

That afternoon, after the Christmas party, Ron Gunter and I stopped by the Hines property where there was a group drilling a new well on the property.  When we got out of the car we came upon a gentleman from the UK who was currently living in Jinja, Uganda and working throughout Uganda drilling wells for non-government organizations.  He was attempting to get a compressor loose, and was struck in the chin, sustaining a 2-inch laceration.  His partner was on the phone attempting to find a doctor to repair the wound.  I volunteered my services, and we drove him over to the clinic where I repaired the laceration.  He was very appreciative of our help and even commented how he was amazed at the fact that he could not have gotten the fast service in the UK or the States that he got in rural Uganda!  It was yet another experience of being blessed with the opportunity to be used by God in the work of His kingdom.

One final note on the medical clinic.  Last April we initially opened the clinic to only HUM kids and their families, as well as widows and the HUM staff.  This was a population of about 250 people.  We wanted to start small and make sure we were giving quality, sustainable care.  Our initial efforts were successful, and we realized this week we were at a juncture where it was time to expand.  Starting at the first of the year, the clinic will also make its services available to the members of the Kamonkoli Presbyterian Church and their families.  This expands the services of the clinic to nearly 1000 people.  Praise God!  

Future plans, God willing, are to expand the services to encompass all of Kamonkoli, which is a population of over 10,000.  In addition, there are plans to build a new medical clinic as a part of a community center as well as expand services offered, including further lab testing, ultrasound, etc.  

If you would like to participate in this project, whether it be financially or perhaps traveling to Uganda to work hands-on in the clinic, please contact Orphan's Heart.  We appreciate your prayers and thank God for all He has provided and will provide for the medical needs of the people of Kamonkoli!