This is Africa and I am stilling trying to comprehend two things…. one is the length of time it takes to get anything done….. it still surprised me the amount of time and energy it takes to find an answer to a problem. What appears to be a simple problem often turns out to be more complicated that I would have imagined. The second thing is that there is always crisis which somehow I am expected to resolve. 

The clinic is open Monday to Friday from  8 am to 5 pm and on Saturdays from 8 am to 12 noon…. So I  usually arrive at the clinic around 8 am Monday through Saturday and I leave anytime after 5:30 once the clinic is closed…. except Saturday which is a half day and I leave around 1 pm.

Each morning, I am expected to go around and greet each of the staff….. and hear their news. There are 14 staff working in the clinic: three nurses, three assistant nurses, two laboratory techs, two house cleaners, one receptionist, one health and safety coordinator, one comprehensive nurse who can diagnosis, treat and prescribe, and a part time medical officer who works Monday, Tuesday and Wednesday. This little clinic sees  between 1,600 and 2,000 patients monthly…. that includes students, staff and members of the community. All this information has been kept on pieces of paper which  I am now attempting to find and put on an excel spread sheet…. It is huge learning curve for me as to what data is available, obtain it and then input it….. but it is coming together slowly. I am collecting data on who comes to the clinic each day: the number of students, the number of staff members, the number family of staff, and the number of community members plus the daily clinic receipts…… as well as our expenditures like cost of medications, salary for the medical officer, fuel and transportation costs for referrals and transfers to another facility for continued care.  

I work in my small office answering emails, preparing medications orders, input any new data and attempt to put order to the clinic….. it seems that the staff have gone many months without proper supplies and they have learned to live with less…… or learned to go without………. like proper mugs for tea and dish soap for washing up, towels, laundry soap, uniforms, boots, buckets and many more things I would consider an essential which they did not think to ask for.

Each morning the clinic needs power to function…. light to assess a patient, or insert an intravenous catheter or for the lab to process blood work…. power is essential. When we do not have power….. it becomes a crisis and now my responsibility to discover the reason….. for the past few months there have been numerous reasons why there has been no generator power….. from there is no fuel, the operator slept in, they cannot find the operator,  there is water in the fuel, someone is going to Kyotera a 90 minute round trip for fuel, and the breakers for the clinic have somehow been switched off. Searching for power can take me at little as  30 minutes but more likely most of a morning……….. 

Our receptionist daily needs change even though she has been told to keep 20,000 shillings in small bills in the safe……she comes asking advice for each patient who comes with no money or some money and need to be helped even though she knows what to do…… Just for your information, every person who comes to the clinic is served whether they have funds to pay or not.

The pharmacy staff come frequently throughout the day requesting one item at a time which they somehow cannot find in the pharmacy in spite of me stocking it well weekly…..even though each medication is in alphabetical order as per their decision, and labelled…… it seems that if the packaging is changed in anyway they cannot see it and therefore, assume that they do not have it. It is taking time … and they are learning to look for the label and check the designated spot but when the clinic gets busy and the work load increases the old habits pop back up.

After working in the clinic for almost 6 months, I am still amazed that I have not discovered every medication or medical supply required…… just this week, one of the nurse ask me if I had Vitamin K in my store room……… I was stunned, all I could think to say was that if I had it then you would have it.  Later this week,  I was told we were out of surgical blades. I did not know we used blades. A few months ago, I found scalpel handles in one of the store rooms and asked if these were ever used and did we need blades to go with the handles and was told “NO”….. it seems that at that time we had many blades and I misunderstood the answer. Now, Vitamin K and blades on my list of clinic needs and purchases.   

It has been come clear that there are times in the school year when many of the students are stressed over exams and getting good marks… their stress comes out in many forms from headaches, to upset stomachs and nausea and vomiting and as a result they arrive in the clinic…..  these symptoms are treated but the real cause also needs to be addressed…. the stress. The staff work hard to support their needs, talking to them, praying for them and now we have pastoral care once a week in the clinic for these types of issues both for the students as well as everyone else.

There was a young 7 year old student who presented herself to the clinic staff everyday for almost two weeks with various complaints……. all examinations, and lab tests were negative and this had the clinic staff wondering what was wrong. Finally, the family were called in…….. the staff were wondering if she was mistreated at home but the parents showed love and compassion for their child. They stated that she did not want to go to school……. after much discussion with the girl and her family it became clear that she did not like school and especially her teacher. The parents were told to bring their daughter back to the clinic the next day by which time, I was expected to have discussed this issue with the administer of her grade. The rest of that day, I spent  finding out who was responsible for the student/ who was the principal for her grade, discussed what we discovered in the clinic and ask if this student could be moved to a different class. Once the information was presented, the administer was very willing to move the student…..a week later, I checked up to learn that the girl was busy catching up on her homework, happy and making friends. 

My job takes me all over the compound and I get to speak with many interesting and caring teachers, administers, and staff ……each want only the best for the students.

Some told me that my life and job in Kibaale was a soap opera…. unfortunately, the stories are not the imagination of a writer but real………. real lives are touched each day by the clinic staff….. they do an amazing job with the little they have….. 

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