This was as short as i could make it. There are some things which have been left out, but for the most part, this is it. Hope you take the time to read thru. Also, the summary on what we did at the vocational school will be coming up shortly...Enjoy...
The St. Francis hospital is the hospital run by HOSFA to serve the locals of Mityana. The hospital is spread out over two levels, with all the in-patients housed on the ground floor and the out-patients department on the 1st floor (American 2nd floor). The cashier, ultrasound room and the dental department are also located on the 1st floor while services such as maternity and x-ray are located on the ground floor. On the first day, we got a tour of the facilities, and immediately it became evident that the space and the machinery were not even close to being optimally used. On the ground floor, we had to get the key to open up the x-ray room which was a surprise. The reason this room was locked up turned out to be because the x-ray machine itself was non-functional. The machine had been donated to St. Francis a few years back by a German donor, and had since been sitting idle in this room which was meant specifically for it. Going forth, we came across the operation theatre which was also locked up. What we found here was a dusty old room with one surgery bed in the middle. When the planning had been done, they had definitely budgeted for an active surgery room, but as it turns out, they never got the money to finance an operational one. Hence it was abandoned and the room has been in its present form since 1998. The maternity ward was next on the list. The ward itself where the women were housed before and after birth were well lit, with the only complaint being that the corridors were too narrow. The big issue we came across here was that of privacy in the delivery room. The room was full of windows and overlooked a small village dwelling. Standing in that room I could hear and almost see children shouting and screaming right outside the window. I really wondered how comfortable women would be in such an environment at such a crucial time in their lives. We also stopped by at the women’s and the children’s wards which were quite airy and well-lit. Those were probably my favorite rooms of the hospital, but then I went on to my least favorite rooms of the hospital which were the secondary women’s ward and the men’s ward. These rooms were almost without any light at all and quite crowded. The second women’s ward (which was necessary as there are more women patients than any other on average) was especially dingy. I peeked in and saw what could’ve qualified as a dungeon. The only source of light in the room was a solitary bulb hanging from the roof as there were no windows looking out. This was a major concern as even that bulb finds itself without electricity for the most part of the average 24 hour cycle. As we trudged up to the first floor we were informed of the staff situation at the hospital. At this hospital, there is one doctor, a clinician, 5 nurses, an ultrasound technician, a lab technician, and a dental technician. On any given day, there is only one person present that has the diagnostic authority, whether it is the doctor or the clinician. This poses a problem as the doctor is overloaded with work and in such cases the in-patients may not be given the amount of attention they require. Also, there is no backup in case one of these persons gets sick for an elongated period or goes on vacation. Also, the hospital itself is a level 3 hospital. This is a rating given by the government on a scale of 1 to 5, where a level 5 gets the highest grant money.
On the first floor we came across equally shocking discoveries. There was a huge store-room (also locked) filled with all sorts of machinery. As it turns out, all of this was donated at some point of time, and has just been lying idle because the parts were either incompatible, or the machines just refused to work. All of these machines were from the same donor in Germany. The room next door was a chapel which was also locked, but was quite a pleasant room and was surprisingly large, with windows letting in a lot of sunlight. Another room that took us by surprise was the room adjoining the doctor’s office. This room was completely empty and also connected to the drug store which led into the main building. The only other shock we got on this floor was thanks to the ultrasound department. The ultrasound facility itself is the best asset of the hospital since no other hospital in the entire state offers it, but the machine itself was in the tiniest room possible. It was with difficulty that 3 of us managed to fit in, and it was obvious that a pregnant woman could not possibly maneuver around in that tiny room and spare a thought for the husband that would want to get a first peek at his child.
After much thought and deliberation, and many more visits to the hospital, we came up with some suggestions which we put forth for discussion. As far as short-term planning goes, the first step definitely needed to be to get rid of the machinery that was lying idle. This idea itself took Noa and the doctor by surprise. For them, a donation was a gift, and a gift is not something you part with, especially sell. It took a little convincing, but they saw that what was more important was to look out for the best interest of the hospital and put the machinery to its best use, which in this case was to sell it off. By selling off the excess machinery, they could also finance new x-ray machinery which was definitely an urgent requirement seeing as TB is seen in big numbers in the country and the only x-ray department in the area is at the government hospital. The x-ray room is already ready; hence it would not require any architectural modifications.
Another major suggestion that was put forth was the switching of certain rooms. We suggested that the drug store be switched with Ultrasound room. This was because the Ultrasound room was extremely small for the purpose it currently served; however, it was big enough to hold all the drugs the hospital had (which weren’t too many). This allowed for a better, bigger room for the ultrasound machine (this was the empty room next to the doctor’s office) with a waiting room (old drug store). Because the ultrasound room was now next to the doctor’s office, he could now be consulted whenever required which was a problem before due to the physical distance. We also suggested a switching of wards, with the end result being that the men were moved out of their little “hole-in-the-wall” and put in the children’s ward. The kids were moved up to the first floor in the present chapel which was a room just as big. The chapel was moved down to the second women’s ward, which in-turn moved to the present men’s ward. Hence completing a full circle where everyone is happier except potentially the people that use the chapel. These can’t be very many seeing as the chapel was always locked up. It definitely could serve a better purpose as a children’s ward.
Apart from a few other small suggestions that were made, we also made a few long-term goals to keep in mind. The first one would be to move the OPD downstairs and the in-patients upstairs to make it easier for emergency patients to access without having to climb a bunch of stairs. Moving the children’s ward upstairs is a step in this direction. Also, we asked of HOSFA to keep in mind the future need for a surgery room. This we found was the reason why women would not prefer St. Francis for delivery and not because of privacy issues with the delivery room as we had previously thought. As it turns out, women were ready to deliver on the roadside, as long as there were facilities for performing a c-section nearby. This was what was lacking since St. Francis had no surgery room to speak of. Plan for the future then was to look into micro-finance options to get an operation theatre up and running.
The St. Francis hospital is the hospital run by HOSFA to serve the locals of Mityana. The hospital is spread out over two levels, with all the in-patients housed on the ground floor and the out-patients department on the 1st floor (American 2nd floor). The cashier, ultrasound room and the dental department are also located on the 1st floor while services such as maternity and x-ray are located on the ground floor. On the first day, we got a tour of the facilities, and immediately it became evident that the space and the machinery were not even close to being optimally used. On the ground floor, we had to get the key to open up the x-ray room which was a surprise. The reason this room was locked up turned out to be because the x-ray machine itself was non-functional. The machine had been donated to St. Francis a few years back by a German donor, and had since been sitting idle in this room which was meant specifically for it. Going forth, we came across the operation theatre which was also locked up. What we found here was a dusty old room with one surgery bed in the middle. When the planning had been done, they had definitely budgeted for an active surgery room, but as it turns out, they never got the money to finance an operational one. Hence it was abandoned and the room has been in its present form since 1998. The maternity ward was next on the list. The ward itself where the women were housed before and after birth were well lit, with the only complaint being that the corridors were too narrow. The big issue we came across here was that of privacy in the delivery room. The room was full of windows and overlooked a small village dwelling. Standing in that room I could hear and almost see children shouting and screaming right outside the window. I really wondered how comfortable women would be in such an environment at such a crucial time in their lives. We also stopped by at the women’s and the children’s wards which were quite airy and well-lit. Those were probably my favorite rooms of the hospital, but then I went on to my least favorite rooms of the hospital which were the secondary women’s ward and the men’s ward. These rooms were almost without any light at all and quite crowded. The second women’s ward (which was necessary as there are more women patients than any other on average) was especially dingy. I peeked in and saw what could’ve qualified as a dungeon. The only source of light in the room was a solitary bulb hanging from the roof as there were no windows looking out. This was a major concern as even that bulb finds itself without electricity for the most part of the average 24 hour cycle. As we trudged up to the first floor we were informed of the staff situation at the hospital. At this hospital, there is one doctor, a clinician, 5 nurses, an ultrasound technician, a lab technician, and a dental technician. On any given day, there is only one person present that has the diagnostic authority, whether it is the doctor or the clinician. This poses a problem as the doctor is overloaded with work and in such cases the in-patients may not be given the amount of attention they require. Also, there is no backup in case one of these persons gets sick for an elongated period or goes on vacation. Also, the hospital itself is a level 3 hospital. This is a rating given by the government on a scale of 1 to 5, where a level 5 gets the highest grant money.
On the first floor we came across equally shocking discoveries. There was a huge store-room (also locked) filled with all sorts of machinery. As it turns out, all of this was donated at some point of time, and has just been lying idle because the parts were either incompatible, or the machines just refused to work. All of these machines were from the same donor in Germany. The room next door was a chapel which was also locked, but was quite a pleasant room and was surprisingly large, with windows letting in a lot of sunlight. Another room that took us by surprise was the room adjoining the doctor’s office. This room was completely empty and also connected to the drug store which led into the main building. The only other shock we got on this floor was thanks to the ultrasound department. The ultrasound facility itself is the best asset of the hospital since no other hospital in the entire state offers it, but the machine itself was in the tiniest room possible. It was with difficulty that 3 of us managed to fit in, and it was obvious that a pregnant woman could not possibly maneuver around in that tiny room and spare a thought for the husband that would want to get a first peek at his child.
After much thought and deliberation, and many more visits to the hospital, we came up with some suggestions which we put forth for discussion. As far as short-term planning goes, the first step definitely needed to be to get rid of the machinery that was lying idle. This idea itself took Noa and the doctor by surprise. For them, a donation was a gift, and a gift is not something you part with, especially sell. It took a little convincing, but they saw that what was more important was to look out for the best interest of the hospital and put the machinery to its best use, which in this case was to sell it off. By selling off the excess machinery, they could also finance new x-ray machinery which was definitely an urgent requirement seeing as TB is seen in big numbers in the country and the only x-ray department in the area is at the government hospital. The x-ray room is already ready; hence it would not require any architectural modifications.
Another major suggestion that was put forth was the switching of certain rooms. We suggested that the drug store be switched with Ultrasound room. This was because the Ultrasound room was extremely small for the purpose it currently served; however, it was big enough to hold all the drugs the hospital had (which weren’t too many). This allowed for a better, bigger room for the ultrasound machine (this was the empty room next to the doctor’s office) with a waiting room (old drug store). Because the ultrasound room was now next to the doctor’s office, he could now be consulted whenever required which was a problem before due to the physical distance. We also suggested a switching of wards, with the end result being that the men were moved out of their little “hole-in-the-wall” and put in the children’s ward. The kids were moved up to the first floor in the present chapel which was a room just as big. The chapel was moved down to the second women’s ward, which in-turn moved to the present men’s ward. Hence completing a full circle where everyone is happier except potentially the people that use the chapel. These can’t be very many seeing as the chapel was always locked up. It definitely could serve a better purpose as a children’s ward.
Apart from a few other small suggestions that were made, we also made a few long-term goals to keep in mind. The first one would be to move the OPD downstairs and the in-patients upstairs to make it easier for emergency patients to access without having to climb a bunch of stairs. Moving the children’s ward upstairs is a step in this direction. Also, we asked of HOSFA to keep in mind the future need for a surgery room. This we found was the reason why women would not prefer St. Francis for delivery and not because of privacy issues with the delivery room as we had previously thought. As it turns out, women were ready to deliver on the roadside, as long as there were facilities for performing a c-section nearby. This was what was lacking since St. Francis had no surgery room to speak of. Plan for the future then was to look into micro-finance options to get an operation theatre up and running.
Upon arriving at the particularly beautiful church that reminded me a little of the Lotus temple back at home in Delhi, we mingled with the locals and found seats at the very end of the massive hall. This was by far the most colorful church I had ever seen as it had streamers and blinking lights all over the place, on the inside, serving as decoration. The sermon itself was quite boring for me frankly as it was carried out in the local language and had songs that I could not otherwise identify though. On the other hand, I took interest in observing the people that had showed up for this day in their very best clothing with children that were extremely well behaved for their age. Religion was evidently one of the important facets of life in small-town Uganda. On the way back to the hotel, we found ourselves swamped with kids who wanted to observe us from as closely as possible. We managed to get a few initial pictures with them, after which they immediately warmed up to the occasion and started posing and running around calling to their other friends to join the. After this tiring yet equally fun escapade, breakfast was eagerly awaited, which turned out to be nothing short of fantastic. We had sausages which were cooked with a crusty outer layer, along with possibly the best omelet I have ever had. Trim could learn a lesson or two. This was followed up by watered-down pineapple juice and sweet bananas. Here is where I must take a moment to really appreciate this banana. It was the perfect size: pocket size; and it was by far the sweetest, most perfect banana I had ever had. The best thing about it was that once you were done with one, there was another just as perfect banana waiting for you. Good things really do come in small packages. Moving along, Noa came to pick us up at 10:30 with the promise of showing us around the little town of Mityana and really seeing how it works. Minea, Sarah, and I got into his car as headed through the city to allow us our first glimpse of the place. It was a place that seemed to be even smaller than Kabalagala but apparently had 30,000 residents. We quickly moved from a smooth-ish road to a complete dirt track which evidently makes up most of the local roads around here. As we rattled along this particularly bumpy road, Noa kept pointing out certain areas of interest with some history related to them. One of these was his own Aunty’s house who he said had not been feeling well recently. The house itself was built out of dirt and pieces of wood with an aluminum roof which did not look sturdy at all. Soon we came into the presence of the local tea-estate which was stop number one on this little journey. Unfortunately however, there had been some sort of a mix up and they had not been expecting us, hence we were asked politely to come back another day which we had to oblige to.
