Tuesday, September 29, 2015

Good Morning Uganda!

Woke up to an almost cool morning with a breeze and there is electricity. Life is coming back to normal and I have had some great chats of late with my support system and appreciate those volunteers that were here in the past with GHSP who are now in the US as they truly understand how frustrating life can get at times and have walked the same streets of Lira and they know the cast of characters and scene so well. They understand things do not work perfectly but if it did why would we be here?  This is a unique effort that has come into an incredibly challenged place to do good.

Next week is Ugandan Independence day so I am planning on a trip out of here to try to see some wildlife and water. It seems that many other people are taking advantage of the weekend off too so rooms are difficult to come by but I will find something some time soon. I feel a great need to be near water.

I have had so many good things to say about my students of late they came to class totally believing that they were as perfect as I told them they are and forgot to study for a quiz and then told me I had not told them there was a quiz. Ha ha. They have it in writing plus a powerpoint, plus verbally. I have taught quite a few lessons in my lifetime as well as raised ten kids. I asked them why it was that students who could not make it to class had emailed asking if they could please take the exam late and they seemed to know that there was a quiz. Anyway, as it was it worked out okay and I just gave a firm but kind warning that we can have fun, we can share our stories in class but we are here to learn. I also told them that I don't want to need help someday and find out that I have the nurse taking care of me who didn't study. This is not a complex class but it is a vitally important one perhaps even more important here then any place else in the world because people need to stop and think, and use critical thinking and plan ahead. I have written about pain medication and I lecture constantly about pain being the 5th vital sign and how important pain control is to good patient care. I might just make the next quiz 10 questions about why pain control is important. If they do not walk out of this semester using a bit more in the way of  critical thinking and planning then it is not because I am not pushing them as hard as  I can and I will keep striving to make them reach higher.  I also make their attendance at the hospital critical as half of them are already nurses and don't feel they need more time in a hospital. Trying to get someone to unlearn something is much more difficult then learning it and I am not at all impressed with the way things are being done. If I go back to school again, and who knows I might, I will be treated like a student with no points off for the fact that I have "life experience." I tell them, firmly that they are not sitting in their chair to keep the seat warm, they are here to learn something new, this isn't about getting a paper so you get a pay raise this is about learning how to be a better nurse.  Critical thinking and planning ahead are desperately needed skills as well as good pain control and monitoring. I teach that people need to plan ahead and to see their patients in a more comprehensive light and will keep teaching and preaching it. There is so much preaching here anyway when someone says they are "praying" about something, which happens at least 5 times a day I now respond by saying,  "Oh and don't forget to pray for oxygen, bandages, better hospitals, and well trained nurses." My close support system now understand that this will be my response so when people make that statement my ever vigilant family know what my response will be, and start laughing (in a good natured way) I know that this can be taken out of context in writing but trust me I say it with the best of intentions. They brought the minister over to visit a few days ago and I also told him that prayer is good but that prayer and action is better. We can make all the noise we want all weekend but we should rally around and make noise about malaria and the lack of basic things if we really want to do good. Anyway, I chose my sermons carefully and try never to offend but my "mother" has been here so much of late and she knows what I am going to say before I say it and it usually relieves some tension and leads away from grave conversations with lengthy prayers into action directed conversations about better care. The attitude of "well what can we do?" shrugs needs to be replaced with we are going to do something positive to change things.

Anyway, my conversation with my students was tough love. I didn't come over here to be there buddy and if they aren't learning something then I am wasting their time and mine and I told them so. Many students contacted me afterwards to say how grateful they were that I shook things up. Many of them are very good students and I am convinced that within my class room there are several people who will change the face of nursing in Uganda, there are some incredibly bright students and I know that they are hearing every word I say. The Universities in the South were very well represented during our Kampala orientation and I hope at some point the people from up here are given an opportunity to be heard. Some of these people who are really working with nothing at all need to be represented in any talk about Ugandan health care.  We can't just shrug and say "Oh things are so bad up there" Yes, so let's change that! It is not acceptable. We have some very good doctors that I know for fact I have seen them in action but just having them walk about lecturing will not be the only thing that will change things, attitudes about what is acceptable also must change.  I am in the right place at the right time in my life and I know it. I am not suggesting we take to the streets but they need to advocate for themselves if it is just through a Facebook group where they can support each other and plan because many of them are active online. I can deal with anything except apathy, I think. There are moments when we are asked to do something and the rest of the hospital doesn't have running water or gloves. Fine and dandy that I have a pocket full of gloves and my own hand sanitizers but seriously this gets complicated.  I am going to keep trying to find a way to get a student nursing kit for my students. I contacted AlLNurses but the best they could come up with for what I wanted was a hundred dollars a kit, too much.

The area has had some tough times and I love the Peace Corps and the people who are involved and I know that people care about us and they are trying to do their best and of course there is always areas that can be improved.  No one came to Uganda expecting a perfect health care system. Not sure I was quite prepared for how challenging it is but there are some things you have to live with to come to understand and it just can't be explained.  I hope that I have the opportunity to help facilitate positive discussions in any manner that is helpful.

This morning Mary Hogan one of the volunteers who was here in the past called and I saw Douglas in the lawn and called him over to the window and handed him the phone. They had a wonderful chat and he was able to talk with her for about five minutes and he was in tears when he handed the phone back.  Just so happens at that moment he was wearing his Bronco shirt that Sue sent over and Dr. Mary lives in Colorado. I am forewarning the next GHSP volunteer that is coming over  if Orange is not your colour bring whatever you like :) These kids would wear any new shirt from America, even if it isn't orange. Douglas is going to watch the next game with me. I have assured him that he will love it he is a great soccer fan he will soon understand REAL football rules. When all else fails water calms me and if no water, Bronco's.  My family is right here in my laptop with me and we "watched" the game together on Sunday even though my power went out and my battery died I had my phone and their hilarious updates, it was the greatest stress relief. I just kept reading their comments and being "with them" through each play makes me feel so much closer. I have missed my kids so much of late but where to go to see my kids? The price we pay for raising international third world kids and now my grandkids is that they scatter all over the world. I hope most of us can be together for Christmas this year. .Just a tad homesick for somewhere and everyone wherever they are and I want them to be safe. They are on my mind every minute and I worry about them and the craziness of where they live.

My daughter Beth who is an incredibly great mom and a very good nurse launched and managed a wonderful fund raising effort on Gofundme for one of our best nursing sisters in Kolkata who has cancer of the throat. We were informed that her situation was urgent by Dr. Dadina in India who began working with us in the 70's and helped us train so many of our nurses.  When Sister Madhu came to us she wan't a nurse but just a very bright woman working in health care. We trained her into one of the finest nurses in India and she also helped me with taking care of the older and handicapped children and continues to work with abandoned and vulnerable preemies today. Through some bleak moments I was able to see Beth raise her goal of thousands of dollars  and am so proud of her effort to take on this project. It was nice to see our IMH India kids giving back to those who loved and nurtured them.  Beth changed the direction through just reaching out to people and is an example of what can be done when someone takes a little time out and as a busy working mom this wasn't easy for Beth, but it was important. and a great deal of her effort was reaching out on Facebook. So proud of my kids, be the change!

Douglas the compound caretaker for the landlord