Rural Healthcare

During the trip, we visited a number of local health facilities ranging from the district hospital in Kigadi down to Health Center III’s – four-room clinics mainly providing maternity services and basic healthcare, plus a lab for testing blood and a dispensary.  At Bwikara Health Center III we met with midwives Ruth and Harriet in the maternity wing.

At Kiryanga Health Center III I spent some time talking to Michael, the Lab technician.  They have recently expanded the capabilities of the lab from 2 tests to 10, and have a brand new microscope for examining blood smears for malaria and sputum smears for TB.  However it’s a tiny room and there is no running water; microscope slides have to be air dried by the window, and when it rains the slides have to be rescued from the raindrops.

I watched Michael test several small children for malaria – they all looked quite poorly and had a high fever.  Blood from a finger prick is placed on a rapid diagnostic test strip and buffer is added, and if both the test and control bands are dark the test is positive.   

This is a positive test; malaria is endemic at the moment with 300 cases last month and incidence expected to peak in August.  I am careful to take my prophylactic drugs, wear insect repellent, and use a mosquito net at night.

The new mystery disease that we heard reports of in the district was later confirmed to be Ebola virus, but at the time we visited it was unknown – we were warned to stay away from the epicenter in Isonga.  The disease is infectious and causes stomach pains, vomiting and diarrhea and antibiotics don’t seem to work.  About a dozen people have died, mainly the members of a single family but there are also rumors that a medical officer and a village health team worker have died.  We are careful to wash hands frequently and use hand sanitizer; the ambulance drivers are scared of the infection and some of the hospital workers are threatening to strike until the cause is determined at the Uganda Virus Research institute in Entebbe, where samples have been sent for culture. The ambulance drivers offered me their wrists to shake ‘hands’ to avoid transmitting any infections.

Apparently during the 2001 Ebola outbreak everyone was scared; if someone had a northern (Luo) accent people would run away to avoid catching the infection.