Finally, there is light at the end of the tunnel. After having a shortfall of doctors at Kiwoko Hospital for many months, our team is finally expanding with three new doctors. One started this week and the other two are expected next week. This relieves the work pressures that the remaining medical team have been under in recent months (hence the delay in newsletter writing!).
It has been a busy time at the maternity ward with patient numbers growing and we are increasingly doing more deliveries by caesarean section. Recently we had a meeting with local authorities to discuss services within the catchment area of the hospital. It was a fact-finding exercise, which has opened my eyes to some of the challenges that hospitals like Kiwoko are going to face in the future. The hospital serves three districts: Nakaseke, Ngoma and Nakasongola.
Looking at the population statistics it is estimated that each district will have approximately 4,000 babies born each year and at the moment Kiwoko is the only hospital within the Ngoma district. Nakaseke has a government hospital where services are limited and sometimes resources and staff capacity are oversubscribed. Nakasongola has a health centre level 4, which in theory means that they should be able to do caesarean sections, but the necessary drugs and staff capacity are not always available. Currently Kiwoko has had between 2,500 and 3,000 deliveries this year.
What do all those statistics tell us? Well, that most women still deliver at home without any medical input. The death rate of women delivering in the community remains high. However, if they were all to deliver their babies in the various health institutions available, existing medical provision and overall capacity would be totally insufficient and simply not able to cope. Just looking at the Ngoma district, if all those women came to the only hospital, Kiwoko, we would not have the beds, staff or theatre capacity. This throws up a lot of questions about the way forwards for Kiwoko Hospital. It has long been my dream to have a specific operating theatre set aside exclusively for maternity patients as we currently share with the general surgeons, which sometimes leads to congestion in theatre. The hospital management team has also realised this and seen what a problem it is and so the idea of a new maternity theatre is thankfully moving up the priority list and coming a bit nearer to land.
Moreover, the neonatal unit is now sometimes full to overflowing, so much so that last week workmen had to make new improvised baby cots to house them all. This is a direct response to the good results we have achieved with premature babies compared with other health facilities, leading to babies being referred to us from wide and far.
Maternity is not the only department which is growing. At the moment there is building work going on to extend the out-patient department, expected to be finished at the end of this year. It is widely expected that this new facility will attract more patients across all medical disciplines. Exactly how much increase we will see is unclear, but it makes it even more necessary to expand our medical team as well. With all this in mind, I am thankful for the new staff and look forward to working with them.
Much of the work in Kiwoko Hospital remains dependant on external donations. This is not only monetary but also with goods and people. Kiwoko was recently given a new ECG machine as the old one had been repaired again and again but hadn’t been functional for a good period of time. One of the difficulties facing hospitals like Kiwoko is the lack of diagnostic tools, other than the very basic laboratory testing ones, as well as ECG machines.
In the photograph above, you can see Dr James, the current stand-in medical director and surgeon, and Dr Peter, the other surgeon. Both these doctors have been working at Kiwoko for many years and are following their call to mission by staying in Kiwoko rather than working for a much better wage package in one of the Kampala hospitals. I have a huge respect for these guys, because their workload is enormous and yet they never seem to get frazzled by it all.
When you work day in day out in a maternity department, it is easy to forget how special a birth is and what hardships some women have to reach that point. Recently we admitted a lady with such a story and situation. A Rwandan, she was just 17 and had come to the area to marry. She could not speak the local language and quickly got pregnant.
She then delivered at home but sadly it was a stillborn baby, and she then got very sick. Quickly falling unconscious, she was brought in by neighbours (the husband had disappeared at the first sign of trouble, never to be seen again). She recovered, but being in hospital, not able to communicate, having lost her baby, her husband gone, no food or money, her outlook in life was not good.
Thankfully she had a good neighbour who remained with her and fed her. Somehow the neighbour was able to contact relatives in Rwanda and it was decided that she would go back there. The neighbour took her halfway to meet relatives and hand her back.
That is the last I know, but I pray that she will have a better life in her own country. It also demonstrates that in the community here there is still a spirit of looking after one another, such as this neighbour did. She really was a Good Samaritan who went much further than we would normally ever see in western society. We often talk about going the extra mile, but this neighbour really did go the extra mile, especially as she herself was poor. Such a great example to us all.
Finally, last week we had the pleasure of attending the traditional wedding of our colleague Dr Ritah. Please see the photos above and below.
I will end by sending you my best wishes for Christmas, when we remember that God in his love for each one of us sent his Son to be a saviour to us all. John 3:16.