On the Road: Our Clinic in Depth

After the rousing and heart warming welcome I received on my first day’s visit to Kiryandongo, I spent the next two days immersed in our projects and meeting everyone I’d heard from in the community meetings one on one.  Partly to make personal connections with those who manage our projects, but also to gauge the effectiveness of our funding and prioritize the rest of our year.

The majority of our year’s funding was already committed to the operating costs of our primary clinic (staffing, medicine, and other supplies) and the school fees for the students we support, with a small amount left over for the many other needs of the community. I am learning quickly that this is, of course, the hardest part of the job: no matter how much funding you gather, there will always be something or someone you have to turn down.

Even so RMF’s impact is enormous here, though we are a lot smaller than people here think—the phrase “punching above our weight” definitely comes to mind.  Looking through the eyes of the community, our projects touch almost every area of life in this settlement, from providing health care, to fixing bore holes, to supporting their children and schools. They imagine we are an organization with hundreds of people running our operation back in the US.

Though we may not be as large as some might imagine, “punching above our weight” has helped foster continued support in these tight economic times. The impact of the world’s economic recession is felt triply in developing countries, as even the loss of $25,000 in funding can mean the end of a project.  As I have been seeing and hearing again and again this past week, many foreign funded development projects don’t wind down slowly, they pull out all at once and with little warning, with devastating impacts on the community

While many other NGO’s across Africa are forced to shut down because of their donor’s pulling out, The World Children’s Fund has continued funding for our operations here through next March.

Panyandoli Health clinic

Our centrally located clinic, about three miles into the settlement, is a bustling hive of activity, and despite the illness and pain of the waiting patients, it is a peaceful, clean and orderly place, where the patients know that they will eventually be seen and the medicine they need should be in place.

This clinic used to be known as the “half dose” clinic a couple of years ago, as the medicine supply was never adequate to the demand, so doctors did the best they could with the meager supply.  Keeping up the medicine supply is an enormous challenge, especially with the ongoing treatment of things like malaria that doesn’t ever take a break from year to year.

With the money invested in upgrading the clinic however, we have made great progress this past year, including repainting, repair of the bore hole for water supply, new mattresses, mosquito nets/screens, continued maintenance of grounds, keeping medical supplies stocked up, and two restocks of medicine.  The constant flow of people using the clinic’s newly repaired bore hole, filling their bright yellow water cans one after the other, made one wonder how on earth they managed without it before it was repaired.

Sitting down with Dr. Simon, the head doctor running the clinic, I listened carefully to his list of concerns for the year and areas where they could use some help.

The first thing he mentioned was that while his medical staff was grateful for the opportunity to work in such a valuable and well stocked clinic, they were also working unbelievably long stressful days, much more than any normal clinic. This wasn’t hard to believe with the long line of patients waiting outside as we spoke.  He mentioned that it might be nice to give them a little bonus to keep their morale and spirits high, even something simple like some sugar at the end of the each month or some supplementary training.

Funny to think about all the divisive arguments/debates we all heard about health care reform in the US over the past months, and then look at a group of unbelievably hard working doctors and nurses just asking for more training or a small gift of some sugar.  Sounds obvious, but one’s perspective is forever altered in a place like this.

Dr. Simon also mentioned that they were in desperate need of a resupply of emergency treatment formula for severely malnourished babies called Nan 1, and supplemental food supplies for their HIV positive patients.  Our current budgeted funds weren’t allowing him to buy these once he’s bought all the basic drugs and supplies needed every couple of months.

Other projects suggested included creating a proper cooking area for the patients families as they often lived to far from the clinic to go home for each meal, upgrading his staff’s accommodation to also include a kitchen area, and repairing the fence surrounding the perimeter.

Meeting Kamyoni and Victor

After reviewing all of this with Dr. Simon, he found a couple of patients recently treated successfully that were still on the clinic grounds. The first was a very shy 4 year old Kenyan girl named Kamayoni, whose mother had brought her to the clinic three days earlier, unconscious and with severe malaria complications, fever and hallucinations. Dressed in a frilly white dress, and initially frightened of me (she ran away when she first saw me with my camera) she bravely stood with her mother as I filmed her and the description of her successful treatment with IV treatment of Chloroquine.  Here she was three days later, looking healthy and energetic again, and ready to go back home to her family.

The next patient I met was a friendly and towering Kenyan teenager named Victor, proudly wearing a 50 Cent (the rapper) t-shirt and a huge smile, who was getting ready to walk home.  He had been feeling ill for a couple of weeks and had arrived at the clinic a week earlier with a severely infected wound on his leg and a swollen groin as a result of infection. After 5 days of treatment with penicillin and a careful cleaning and monitoring of his wound, he was healthy again, smiling happily and ready to return home to get ready for school’s second term.
From there I was introduced to some of the mother’s with malnourished babies at the Malnourishment ward, these were the some of the ones that needed the Nan-1 formula.  They were making do with a mixture of milk and rice but it was not nearly as effective as the expensive formula.  Advanced cases are pretty rare in this camp, but Dr. Simon said he might see one a month that needs emergency treatment.

At end of the day’s tour I made sure to tell Dr. Simon that he could go ahead an order more medicine, and that I would return to the US and try and find a way to address some of the issues he had mentioned.

If you’d like to donate to this or any of Real Medicine’s causes, you can click the donate button on this page or through our website at realmedicinefoundation.org

Clinic funding ideas:

• $50: gifts for overworked nurses
• $100 or more: Additional Mosquito netting for wards
• $250: Emergency treatment with Nan-1 formula for one child with Chronic Malnutrition
• $500: Additional Anti-Malarial medications or Penicillin
• $1,000: Kitchen built for Health Care workers.

Read more about Kiryandongo Refugee Settlement, Uganda

Read past On the Road journals by Jonathan White or view his Picasa album