Mission Doctors Association

Finding Hope and Progress in Nyakibale

My family and I traveled to Uganda to work in a small rural hospital in Nyakibale, in the southwestern part of the country. We traveled to this hospital as part of the Mission Doctors short-term physician placement program.

Upon arrival, we could see the immediate needs. While Nyakibale and Rukunjiri, the neighboring trading center, had a brand new road, the infrastructure of the country is inadequate. Most of the roads are unpaved. The two lane main highway connecting the capital to the south was rife with pot holes. The pedestrians shared the road with the crowded, speeding Kamikaze bus drivers. Accidents, overturned vehicles, injured at the side of the road lying on banana leaves are common.

We were highly impressed by the people. They were strong, cheery, and polite. In the capital, we would ask directions and the person would politely escort us to our destination. It happened so often that we felt we were imposing to ask directions though the people were extremely enthusiastic and asked nothing in return. We were warmly welcomed by the people of Nyakibale.

Dr. Ronnie, a Ugandan physician, impressed me because of his AIDS clinic. HIV in the US is very specialized and removed from the general mainstream practice. In Uganda, it is so widespread, everyone who was not diagnosed with AIDS is worried that they have it. They refused to be tested since it is a death sentence in their mind. Positive HIV status causes isolation and in many cases, abandonment. With Dr. Ronnie’s clinic, people are being restored to health who had come to the hospital with end stage HIV. He diligently sees people once a month, takes pictures of them, reviews their side effects and refills their meds for free through the clinic. He is also sending data to Johns Hopkins, and the Clinton Foundation.

There is a group of recovering HIV patients who have started outreach to the villages to try to encourage the people to get diagnosed earlier; to show that with proper treatment they no longer need to be a burden to their families. He recently sent me follow-up photos of a woman I cared for who was dying of HIV. As can be seen by the photos, she was cadaveric, barely able to stand, suffering from a hepatic abcess which had to be drained. She had no money and her family was nowhere around to help her. Eventually, money was found for her surgery and for further HIV testing. (The HIV test is free, but the CD4 test costs $20 and has to be done to qualify people for antiretroviral therapy). She solemnly promised to follow-up and continue her HIV meds which she did. The pictures show her actually becoming a little fat over time. She is smiling in her last picture and looks quite healthy. Dr. Ronnie introduced me to many of these people while I worked in his clinic. He has much to be proud of in his work with these patients.

The work and the problems of Uganda are endless but the people are strong and optimistic. They show a graciousness and basic sense of happiness in the face of nearly overwhelming problems. They crave education and are determined to better themselves. Our family was so moved and we will always remember our time in Nyakibale, the stories we heard and the people we met.

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