She reminded us of why we are here. In a horrible way. She’d come to the new clinic the night before for an emergency delivery. Tragically, the baby was stillborn. The poor women was sick, weak, and crying. She had malaria at the time the baby was still born, and she’d had it a month earlier too, not treated properly. Malaria killed that baby. She’d been to a government clinic while she was pregnant, but they were out of stock of Fansidar, the drug that all pregnant women should get to prevent malaria. An easily preventable death. Bold, in italics and underlined. Preventable.  Ambrose treated her for malaria, and prayed with her. We won’t make those kind of mistakes. She reminded me why we’re here. Starting clinics, where there are none.

One of the first patients with Nurse Ambrose – Not the mourning mother

The fourth and final new clinic. For now at least. I breathed a sigh of relief as the last cupboard was carried off the pickup into the health center. Not only because we had been stuck in the mud (I thought for a while permanently) 20 minutes earlier, but because starting these wee clinics has been a big, satisfying effort.

P

According to the locals, the village is called Okwoto (Flatulence). But if you ask the Bishop, it’s Obanga Pe Wany (God is not selfish). You’ll find neither name on google maps, but you can find the clinic its right here. The two room rectangle building to the left of the road in the middle of the map, next to a big tree. Note the long grass thatched building 40 meters to the north. That’s the local Anglican church. It’s a small, busy center, next to a swampy river. I find it hard to talk to people here, not because my Acholi has gone downhill, but because they speak a different language, Lango. Its pretty close to Acholi, but some words are completely different, including annoyingly the words for medicine and health center!

Pastor Awele, Ambrose and some of the community in front of the clinic.

Its worth noting all the steps Ambrose has to take with every patient. Its not easy running a high quality clinic all on your own! Its more work for each patient than being a Family Doctor in the western world.

• Talk to the patient, examine the patient, make the diagnoses based on our guidelines book, while you are writing the patient notes.
• Do a finger prick test for malaria
• Collect money from the patient, write a receipt and give it to the patient.
• Write the patient details in our record book (Name, Age, Sex, Village, Diagnosis, Drugs to be given etc.)
• Take drugs out of the box, cut the right amount, package them in a drug envelope and then label the drug envelope with instructions.
• Explain the medication the patient has to take, and advice about the illness.
  “Don’t go in a cooking hut if you have pneumonia”
  “Come back for IV treatment if your child gets seizures”
  “Wipe your bum from front to back” – Very important to stop urine infections.
• Pray with the patient

Church in the foreground, clinic in the background. Ambrose stands with the Reverend.

P.S. The first week was promising, on Labour day (ironically) Ambrose saw 19 patients. That’s a big effort when you consider the list of tasks for each patient. I’ll give a report soon on how the first 3 clinics are going. Its still early days but there’s a mixture of success and slow starts!