The correct induction of narcoses was one Martin Sellesk´s tasks in Uganda. Photo: humedica
Mzungu, how are you?
A review by humedica volunteer Martin Sellesk
A new scope of duties, resourcefulness and adventurous excursions – the first intervention of humedica volunteer Marin Sellesk took him to Uganda. He summarised his experiences in the heart of Africa in a personal report:
„As soon as I left the hospital and walked through the city as a „normal“ pedestrian, I became a true stopper From all sides people called out to me every few seconds: „Mzungu, how are you?“ Mzungu means „white man“. People in Uganda were very friendly, especially the children were happy, shouted and waved to me and followed me around.
Five weeks I stayed for humedica in Uganda at the St. Francis-Hospital Mutolere near the frontier to the Democratic Republic Congo and Ruanda. My work had its ups and downs. Often it was successful, but sometimes I felt powerless. My main focus in surgery was the work as a male anesthesia nurse. As expected, there was a stark contrast to Western or German standards. Opportunities and materials were limited, hygienic conditions were poor. Flies were buzzing through the operating theatre, the available medicaments could be counted on two hands and the suture material crossed its expiry date years ago.
It goes without saying that respiratory tubes were washed and used again and again, the same went for ECC and earthing electrodes. There was no properly trained anaesthetist in the hospital except for one employee, who already had some experience in this field. So I could help out with my six years of expertise in anaesthesia and do some good for the patients by providing better narcoses. For example I took care to measure blood pressure, pulse and oxygen saturation before inducing the narcosis and kept on controlling and documenting these data throughout the anaesthesia.
Another major problem in the hospital were the wound infections caused by the defective hygienic conditions. The male surgery ward comprised only one room, which housed twenty patients placed directly side by side, at least the same number of their family members and twice as much flies. The patient, whose belly was recently operated, lied next to the patient with a septic wound on his leg. There was no recovery room or intensive care unit.
It was this station where I found a new scope of duty: the treatment and mobilisation of freshly operated patients and the corresponding guidance of the student nurses. They often did not know how to do something or even why, but they were nevertheless very committed, interested and cooperative - in spite of the language barrier, which was notably there, especially in the beginning.
Many caregivers do not speak very good English and their pronunciation is often difficult to understand. However, the hospital employees surely had the same problem with me. So we all needed some patience, but in the end we always succeeded in communicating with hands and feet and a good portion of humour. Since most patients spoke no English at all, I usually worked with the help of a translator.
Many patients are very poor and so, after consulting hospital director Pontius Mayunga, I decided to support three especially needy of them. Thanks to the donations of friends and family I had brought along, I could pay for a part of their clinic bills. Especially close to my heart was a fifteen year old boy with severe osteomyelitis, who was operated several times and had to stay in the hospital for many weeks.
Another scope of my duties was the cooperation in the so-called CCMB (Combating Child Mortality among Batwa)“ project. Mobile medical teams visit regularly remote settlements of one of the poorest ethic groups of the country, the so-called Batwa. The pygmy tribe used to inhabit the tropical mountain rainforests of Uganda. But they were dispelled and forced to relocate by the settlement pressure of surrounding bigger tribes, the reduction of woodland and the promotion of rainforests to national parks later on.
Since they could no longer live in, with and from the forests, they also lost an essential part of their culture and tradition along with their habitat and source of food. Today a wide part of the population avoids and discriminates them. The consequences are poverty, alcoholism and violence. During the mobile interventions the Batwa children get weight and vaccinated. Midwives examine pregnant women and sick persons get medicaments.
One of their villages was so difficult to access that after a drive of one hour we had to hike two more hours on muddy trails through a hilly jungle, loaded with medic cases, boxes with vaccines, a scale for the children and books for the documentation. I also brought cloths collected at home to these settlements for especially indigent families.
In retrospect this was a very good and important experience, which changed the significance of a lot of things for me. I often had to be inventive and flexible, but thus I could achieve a lot with little. The patients were very grateful for even the smallest attention and help. I could not the change the great whole, but a lot of smaller things. And it is the sum of it that counts.“
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