Saturday, July 4, 2009
Uganda.
It makes you wonder how it all happened, the colonization, the inequality, the poverty, all in such a beautiful country. What series of circumstances, what coincidences, what ideals and ideas came together to shape Uganda the way it did? I was talking to Isaac, a local medical student over tea yesterday, who told me that on the street if someone yelled “thief!” and pointed to a foreigner, everyone would disbelieve or avert their eyes but if someone yelled thievery and pointed to a Ugandan, local bystanders would assault the supposed thief without a second thought. What has shaped society to become this? Why aren't we like this in Canada?
My trip so far is best rememered in snapshots I think. Of the torrential rain every morning followed by sunshine and a warm day. Diesel smoke in the downtown of the capital city, Kampala, from all the diesel fumes of the private cars, matatus, boda-bodas, trucks, making the fumes into a haze so thick you can almost chew and swallow it. Rode a boda-boda for the first time yesterday, those populous little motorbikes that whiz around on small and large roads and weave through weeknight traffic. Even the locals advise against them because of the large number of lives annually they claim, and legs, arms, eyes, but for the short haul into downtown, the shot of adrenaline is worth it.
I'm greeted every morning by Ugandans both familiar and strangers, children and adults, with a “good morning, how are you?” and friendly wave as I walk to work. In the afternoon it's “good afternoon, how are you?”, sometimes a handshake. I have yet to see an elderly person, even walking through the city center in Kampala. I see the other end of the spectrum, the births, every day at work. It's a bit different here, the decisions doctors need to make. Even more poignant are the questions of “what can we do with what we have?”. Can we deliver a malpositioned baby without a c-section, risking a stillbirth? Do we have enough supplies to last the month? Can we deal with labour pains in other ways because narcotics and epidurals aren't available? What do we do with babies who are born with cords around the neck, with bleeding into the brain, with bowel perforations, with malformations and asphyxia? How can we convince mothers to take their HIV status seriously when it's so stigmatized but so easily passed on from mother to child? Childbirth anywhere but in the western world is a messy, bloody, painful, tiring, and traumatic experience. Every baby born alive is a miracle.
I was standing in the neonatal ICU the other day, what they call the “nursery” here, barefoot and dressed in a sanitized hospital gown, looking around at all the tiny incubators with the tiny IV lines, respirators and feeding tubes. I catch myself wondering what these babies have to live for, if they ever make it out of the hospital alive. This one that was born at 1 kg birth weight, that one, who had already undergone surgery for a perforated bowel, the other one, with unexplained liver failure.
Andrew, a local medical student I'm working with in obstetrics, asked me what the meaning of life was in North America. Is it different than here in Uganda?
