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Brother Yusuf,
Thanks for sharing your experience in Uganda. I wish all forumists write pieces like this. There is a lot to learn from them.
Generally speaking, the toilets at petro stations in Uganda are hygienically ok. I have only had a bad experience when I used one on my way to Iganga. I can't remember the exact name of the place but it is operated by Muslim sisters, all were covered up in Hijab and looked like wives of only one man. I may have been paranoid but ,inside the petro station building, there was an atmosphere of "my husband loves so much. olaba yankolela ne business". There is/was a pharmacy, supermarket and other businesses inside the building. The toilets were so filthy but allihamudulilah they still served the purpose, and I wasn't charged anything.
Please share more stories with us, Ssebo! And Ramandhan kareem, brother!
Abbey
Sent from my iPad
Sent from my iPad
On 13 Jul 2014, at 14:54, "'Yunus Lubega' via Uganda Muslim Brothers and Sisters" <uganda-muslim-brothers-and-sisters@googlegroups.com> wrote:
Wa Alaikum Assalaam Brother Rahim, and thank you for sharing the below piece.
To begin with, if taken in a rural hospital in Uganda, the picture accompanying your contribution speaks volumes. It is simply inconceivable that the type of task being happily executed by a foreign-looking professional could not be done by a native Ugandan. But then again who knows? The young professional in the photo might well be a 3rd generation Ugandan. Looks can sometimes be deceiving, especially in today's globalizing world.
The issue of sometimes 'disgusting' hygiene standards in some public hospitals in Uganda has more frequently been popping up in the local media than ever. It is indeed a serious issue that needs to be addressed right from the village level. I would like to emphasize the village level in this context because of what I witnessed during my recent international development project monitoring visit to Bushenyi and Nakasongola Districts in Uganda. In both districts there were, of course, challenges commonly associated with healthcare provision in rural settings. However, it was very encouraging to know that basic hygiene was not among the most pressing issues in health centres participating in the target projects. The medical facilities I visited were far from being on par with those we see in Canada, the US or Western Europe and similar regions, but they served the purpose based on local realities.
One of the things I noticed in both districts was that there were dynamic village health teams (VHTs) working side by side with highly qualified Ugandan medical professionals. Among other things, the VHTs actually served as informal external monitors regarding how things were going in their health centres, let alone hygiene standards in their villages. They were locally organized, and had no remuneration for their work. In fact, they had even created local funds from their extremely meagre incomes to help with patient transfer, as remote and hard-to-reach rural communities virtually have no access to publically funded ambulance services. Something good was happening in rural Uganda through empowering local communities; and with that kind of empowerment, images like those I believe many have recently seen in the local media may simply have no place. (Please see: http://119.82.71.117/bukeddedemo/news/79146-Embeera-y-eddwaaliro-ly-e-Kayunga-ekaabya--Livunze.html ) These unacceptable images have been seen in Kayunga and Bugiri. There was even one report out of somewhere in Rakai where patients and snakes shared residence. I believe it was on Bukedde TV's Youtube channel, many months ago.
The things we see in life either teach us, remind us, or reinforce what we have already learnt in some way or another. If the monitoring visit to Bushenyi and Nakasongola reinforced anything to me, it was the fact that broken things do not fix themselves; they are fixed by people who take both individual and collective responsibility to a level that transcends petty egotistic interests. A medical professional, a local politician or a self-respecting mwananchi needs to speak out when they see unacceptable things happening in their health centres, if they really care. We are very fortunate that in this digital media revolution, even those whose voices never used to matter now do have a chance to be heard. In fact, with this newfound voice, I even get the feeling that it won't be long before the title 'Honourable' is demanded to be taken away from MPs in whose constituencies highly 'dishonourable' things happen, including deteriorating healthcare standards and services.
Before I sign off, and still on the issue of public facility hygiene, and in the context of the monitoring visit mentioned above, my travel companion and I made an emergency stopover at a petrol station in Masaka Town. While he consulted the local mechanic on an unexplained 'low engine oil' alarm, I decided to renew my wudhu / ewuzu. There was a public washroom a few meters away; and I must confess I almost always dread visiting such facilities especially in unfamiliar localities, geographic considerations notwithstanding. Masaka was no exception, but I had no choice. Was I surprised when I concluded my 'Allahumma inni a'uthu bika minal khubthi wal khaba'ith'? You bet I was. First, there was a young man on a white plastic chair with a cashbook and a bucket full of local currency coins and notes. Upon payment, I was cleared to explore the spotlessly clean facility with running water, toilet paper, functioning sinks with liquid soap on the side, in addition to small and medium size jerry cans full of water for emergencies. Above all, the facility was well-lit and well-ventilated. There were no disgusting smells usually associated with public washrooms whatsoever. Perhaps this is one 'made-in-Uganda' approach to facility maintenance that public institutions in Uganda, including some health centres, can learn from. (To one young program director on this forum, you know who you are; your administrative premises at Mengo where I was also hosted in the same monitoring context were very impressive in all respects, despite the fact that no user fees are collected. This is further proof that you practice what you preach on the forum!) In any case, the truth is there is no shortage of young people (both urban and rural) looking for employment opportunities in Uganda, and I am sure many would rise to the occasion if a hospital, university or ministry edifice contract is given to them with clear terms and conditions; and where performance expectations are not met, simply give another young person a chance.
Wassalaam Alaikum,
Yunus
*** *** ***
Yunus Lubega
"Everybody is ambitious. The question is whether he is ambitious to be or ambitious to do." (Jean Monnet, 1888-1979)
"Everybody is ambitious. The question is whether he is ambitious to be or ambitious to do." (Jean Monnet, 1888-1979)
On Sunday, July 13, 2014 9:22:42 AM, rahimu jabendo <rahimujabendo@googlemail.com> wrote:
When Doctors multi-task in rural hospitals. From the surgical ward to mopping the floor?
Truth be told, a lot of Uganda doctors used to do that at Hospitals in rural areas but it has its downs - the surgeon often gets very tired especially if you have 3-6 procedures for a day and what about the aseptic conditions that you'd like the patient to enjoy yet u are busy contaminating yourself. The surgeon's linen ought to be clean and fairly sterile.
In the 19th Century, Joseph Lister discovered antiseptics but there was no knowledge of bacteria. Theater related deaths shot to 80% of all operations because most patients became infected. In fact, the saying that 'the operation was successful but the patient died' started at that time. Unfortunately, these conditions are what we have in our operating rooms in Africa in the 21st Century. The operating room should be a 'place of sanctity' not a kraal!
While surgeons can go about cleaning the Theatres, Theaters ought to be cleaned in a through way that leads to an aseptic environment. Have you ever conducted a study on how many patients are lost in these village operating rooms due to sepsis? When will Africans stop thinking about traditional medicine all the time and get to invest properly in systems?
In the main operating room, everyone should have a mask on their nose - including the Theatre cleaners whether during the operation or not.There are billions of deadly bacteria that come from one's nose. When surgeons and cleaners go about such cleaning duties without masks, they release all these nosocomial microbes into the air of the operating room. It is only in Africa where we always practice bush medicine that we pay no meticulous attention to asepsis. And the blame is not on doctors - it is to Government for under staffing and under-supplying the health sector.
When we talk about extra-judicial killings, we don't only mean political assassinations - we should include deaths to citizens due to infections from dirty theatres. One doctor was doing operations in Kayunga recently - they drew water from a rusty metallic drum, in plastic cups to scrub their hands when prepping for surgery; the theatre had an anthill in one corner and a nest of angry wasps in another; plus a broken window covered with polythene. The operating table was stuck in half-length and could neither move up or down due to death of its hydraulic system; despite his height. He had to use that damn table; it was also permanently tilted to the right side because most people are right-handed and operate on the right side of the table - because he's left handed, he had 'okukangabala' throughout the surgery!!!! I don't know whats wrong with Africans, our rotten systems and our 'victim' mentality.
But Statehouse would not shy away to pay a presidential secretary shs.96m per month as salary when hospitals in most of the country are in this state. How many lives would be saved with that kind of money invested in health care? Do your math , please!Truth be told, a lot of Uganda doctors used to do that at Hospitals in rural areas but it has its downs - the surgeon often gets very tired especially if you have 3-6 procedures for a day and what about the aseptic conditions that you'd like the patient to enjoy yet u are busy contaminating yourself. The surgeon's linen ought to be clean and fairly sterile.
In the 19th Century, Joseph Lister discovered antiseptics but there was no knowledge of bacteria. Theater related deaths shot to 80% of all operations because most patients became infected. In fact, the saying that 'the operation was successful but the patient died' started at that time. Unfortunately, these conditions are what we have in our operating rooms in Africa in the 21st Century. The operating room should be a 'place of sanctity' not a kraal!
While surgeons can go about cleaning the Theatres, Theaters ought to be cleaned in a through way that leads to an aseptic environment. Have you ever conducted a study on how many patients are lost in these village operating rooms due to sepsis? When will Africans stop thinking about traditional medicine all the time and get to invest properly in systems?
In the main operating room, everyone should have a mask on their nose - including the Theatre cleaners whether during the operation or not.There are billions of deadly bacteria that come from one's nose. When surgeons and cleaners go about such cleaning duties without masks, they release all these nosocomial microbes into the air of the operating room. It is only in Africa where we always practice bush medicine that we pay no meticulous attention to asepsis. And the blame is not on doctors - it is to Government for under staffing and under-supplying the health sector.
When we talk about extra-judicial killings, we don't only mean political assassinations - we should include deaths to citizens due to infections from dirty theatres. One doctor was doing operations in Kayunga recently - they drew water from a rusty metallic drum, in plastic cups to scrub their hands when prepping for surgery; the theatre had an anthill in one corner and a nest of angry wasps in another; plus a broken window covered with polythene. The operating table was stuck in half-length and could neither move up or down due to death of its hydraulic system; despite his height. He had to use that damn table; it was also permanently tilted to the right side because most people are right-handed and operate on the right side of the table - because he's left handed, he had 'okukangabala' throughout the surgery!!!! I don't know whats wrong with Africans, our rotten systems and our 'victim' mentality.
--
"War is nothing but a continuation of political intercourse, with a mixture of other means. Man will never be free until the last king is strangled with the entrails of the last priest."
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