BY PATTY HUSTON-HOLM
The Uganda Christian University (UCU) nursing programme, in its 10th year, represents such a holistic, sustainable model.
Recorded in November, 2015, these are snapshot stories of two different days with UCU students working on their degrees in nursing science.
November 4, 2015, at
Nsambya Hospital, Kampala
Patient #15627 struggles to breathe. He wheezes from his slightly parched lips with nostrils dripping occasional mucus amidst the sucking from an oxygen-pulling tube. His eyes are open but not registering signals to the brain that, like the rest of him, is waking up on day six after two weeks of life support.
Patient #15627 at this private Catholic hospital is age 27, has two broken ribs, multiple fractures on the left leg and a hole in the neck. He lies in a metallic spring bed Number 15 in a room that separates him and 30 other men only by curtains. His name is Francis Mbogo. For Oliver Buteme, a UCU nursing student, on this November day, he is her patient at one of the better hospitals in Uganda.
Oliver quickly establishes a relationship with Francis and his two relatives, a 23-year-old sister and a woman, age 38, who has the non-biological, elevated status of “grandmother.”
Using the soap, water and plastic bowl brought in by the family, the three women give Francis a bath.
While scrubbing the face, arms, legs, and torso, Oliver learns that less than a year ago Francis moved from his central Uganda village of Gomba, Mpigi, to Salama, a suburb of the capital city of Kampala, to make more money as a bodaboda driver.
The career change from farming to driving was his fate as a car with a drunken driver slammed into Francis as he drove his employer’s bike.
Francis’ father, who has just arrived, smiles slightly as he describes his oldest son of seven children. Before this, he was “always happy,” finding most of his delight in soccer and a six-year-old daughter.
Francis’ father turns serious as two doctors arrive to deliver updated medical and financial news. Francis needs surgery soon or the bones in the leg will form back together abnormally, and he will be lame for life.
They need Shs600,000 to do the operation. Before that, the hospital must have the Shs11.4 million the family already owes for the triage and daily care of the past 14 days. The driver who caused the accident likely will not pay anything as he has already given a financial bribe to police.
The doctors leave behind a small piece of paper that reinforces their message handwritten on several blue lines. Staring from the paper to Francis and back, the silence from Oliver and the family speaks volumes about the poverty that this family shares with roughly 90 percent of Ugandans.
The sister removes a sweat-soiled, adult diaper from the trash. These are so expensive, she explains, that they must only change them if they contain faeces.
- According to the World Health Organization, there is a shortfall in health care workers throughout Africa.
- In 2013, to reach a threshold of 34.5 skilled health professionals per 10,000 people in Africa, approximately 7.2 million more midwives, nurses and physicians were needed.
“We must get him breathing better,” Oliver says. She teaches the grandmother how to prop Francis up with her body. “Once every hour, you sit behind him like this and help free the breathing passages.”
Oliver reinforces that it is important to focus on what you can do to improve Francis’ health – cleanliness, positive attitude, breathing and prayer.
Oliver, one of 30 student nurses working in two different hospitals on this day, is a mid-wife who has delivered about 200 babies over 17 years in Kenya, South Sudan and Uganda.
The UCU nursing degree she receives in October 2017 gives her added skill to be comfortable and help elsewhere while supporting her two boys, now ages 3 and 5. Her goal is to become a United Nation’s nurse.
Francis’ sister pulls out a blanket from home, placing the covering over her brother’s legs. The father opens a plastic container of rice and, like other visitors, rolls out his palm-leaf mat, sitting cross-legged on the floor to eat by his son’s bedside.
The medical and financial clock is ticking as each day is roughly Shs50,000 more and human bones atrophy and heal badly.
November 12, 2015
Namulaba Village, Mukono
The mood is light as more than two dozen nursing students squeeze into seats on the purple and white UCU bus.
While chatting and laughing, they eat G-nuts, bananas and fried grasshoppers from Mukono town to the less-hurried, muddy roads of Namulaba Village.
Jemimah Mutabaazi, director of the Nursing Science department and founder of the programme, is with them.
This is “community day,” with each student or student group (depending on local language communication ability) assigned a household in this extreme-poverty area.
Today is the ninth of 12 weekly visits that supplement the UCU on-campus work. With health care evaluation sheets and pen in hand, they exit the bus that stops shortly after a large orange plastic tent that serves as the village church.
On rainy days like this one, the most able-bodied and ambitious of community residents – the best sources for the students’ reports – likely will not be home, but out harvesting cassava, maize, sweet potatoes, sugar cane and beans.
“Nurses in Uganda are not just medical people,” Mutabaazi explains. Repeatedly, as she observes the students work, she asks, “Did you pray with them?
“Did you teach them proper use of the latrine? Have you shown them how to cook? What do their houses look like?”
From mud-thatched huts to structures of hand-made brick and one in cement, the students document where their assigned family members eat and sleep. Cleanliness is the first line of defence against such common conditions as malaria, cholera, dysentery, skin infections and scabies.
An unswept floor – even of hard dirt – is mostly symptomatic of ignorance about how sanitation and hygiene relate to health. Dirty dishes with hardened food swarming with flies are a more obvious indicator. “Nurses are social workers, teachers, evangelists and health care providers,” Mutabaazi said. “This means they must develop a relationship with the people first. We must function holistically.”
Women, ranging from age 20 to the 50s, are the primary health contacts for the UCU nurses. The women, thin and oftentimes in pain, generally dig their own pit latrines, build their own houses, plant crops and raise and slaughter chickens and pigs for food.
As the nursing students make their way down the forested, rain-soaked, narrow paths, they stop to provide counsel on such matters as the following:
- Faeces of pigs that run downhill and impact neighbours’ clean water.
- Treatment for HIV, skin disease and conjunctivitis.
- Improper disposal of rubbish, which attracts rats’.
“Everywhere we go, we pray,” she said. “We always evangelize and let them know the reason Jesus died – that He died for them,” she sums up.
About the Author:
Patty Huston-Holm and her husband, Michael Holm, of Canal Winchester, Ohio, USA, served as visiting faculty, enhancing writing skills for a group of UCU faculty and honors students in October and November of 2015. Since 2010, they have sponsored four students for UCU scholarships, hosted two UCU students for USA internships and served as visiting faculty for The Standard.