From a background of being a GP partner for the last 20 years I became interested in contributing to USHAPE following a holiday in Uganda when I was struck by the lack of primary healthcare. I heard about USHAPE at a contraception update and got in touch with Clare Goodhart (USHAPE Clinical Lead) who briefed me on the work I could get involved with and I decided to take on the challenge of becoming a short term volunteer. The last time I had worked in a developing country was a year in the Solomon Islands as a medical officer after completing GP training in my 20s and I remember that year as been the happiest in my professional life.
Thus during a cold UK January I packed a bag with a laptop, printer and projector which were needed for the teaching and boarded a flight. I arrived in Kigali at 2 in the morning, spent a night in a comfortable guesthouse and after breakfast in their beautiful tropical garden, was driven to Kisiizi Hospital by a friendly Ugandan driver called Jason who chatted about Ugandan culture and football. There I met up with Clare and we had tea with Ian Spillman (Medical Superintendent and Consultant Paediatrician) and Hanna Spillman (Senior Midwife) who both gave us a warm welcome. I also met Damari, Eunice, Margaret, Happiness and Amy (UK volunteer) and we enthusiastically exchanged greetings.
We had a day together for planning and as the unlikely ‘IT expert’, I had the task of setting up laptop, printer and projector and printing out handouts for the week. The first week was spent mentoring and supporting Damari, Margaret, Happiness and Amy who had just completed a USHAPE ‘Train the Trainers’ course. Jenny, my fellow volunteer and senior practice nurse specializing in family planning, arrived the following day. The trainers were very enthusiastic and eager to learn as were the 11 attendees on the course. There was a mixture of presentations, case discussions, role plays, brain storming and practical learning. Highlights of the week were the male engagement evening where the attendees gave talks in groups to male employees of the hospital and a talk by Reverend Joshua on sensitive scenarios and counseling. The week culminated in a test followed by a party with a celebration cake and prizes. Everyone passed the test and most had scores of 80% plus.
A night at an eco resort on Lake Bunyonyi gave me the opportunity to see some of Uganda’s natural beauty.
The following week was spent interviewing previous USHAPE graduates and I was impressed with their enthusiasm for family planning and the obvious continuing impact of their training across the hospital e.g. a psychiatric nurse had counseled a patient on long term medication and fitted an implant when she had visited a patient to give her depot psychotropic medication. Other graduates told me of how they had gone back to their villages and given informal talks on contraception.
Jenny spent time supporting the previous week’s graduates in progressing towards their letters of competence for practical experience and looking through the records of family planning procedures in the hospital which had increased greatly over the last 2 years.
One of my personal highlights was a visit to a community outreach clinic on my last day. This involved some preparation, the mini bus was loaded with medical equipment, files and cooking utensils. We had a bumpy ride along dirt tracks covered with red dust. On arrival I was introduced to a group of women of all ages who were very welcoming. I was informed that that they were all part of a cooperative in which they all gave money to a community fund to help individuals in time of need. Damari one of the USHAPE trainers started by giving a talk to waiting mothers on contraception. All of the mothers were engaged and asking questions and there was a lively discussion. Following the talk they queued to be seen. I was unable to speak the local language but made myself useful by taking blood pressures. Meanwhile antenatal patients were seen and babies had their immunisations. All the women seen were given HIV tests if they had not had one in the previous 3months and were given the results an hour or so later. At the end of the clinics we all had a slap up meal prepared by the cook who had accompanied us then we travelled back to Kisiizi hospital where Jason was waiting to take Jenny and I to Kigali airport for the flight home.
Now I’m back to my usual surgeries I look back with fond memories and am already planning future involvement.
I was very privileged to have been part of a team in training Ugandan nurses in contraceptive skills. We had a group of 11 nurses undertaking level 2 training who all passed their exam at the end of the week. On my last day I had an amazing experience of being taken to an outreach clinic. I was dropped at a small maternity hospital about 40 minutes away from Kisiizi hospital. One of our level 2 students worked here as a midwife and the plan was for me to supervise her undertaking as many implant fittings as possible on postnatal mothers. I watched her undertake antenatal clinic and then we managed to get three mothers who decided they would like to use implants for contraception. This meant that I could watch and supervise my student undertaking these fittings. My student was very competent in fitting two implanons and one jadell. When we were talking to one of the antenatal mothers we tried to persuade her to have her baby in the maternity hospital. She had already had three previous pregnancies in her village and two of the babies had died after one week and again after one year. She did not know the reason for this apart that her husband would not take her to the maternity hospital.