Volunteering to improve basic healthcare in Uganda

A great deal can be achieved in a short visit to Uganda to train and support local health workers, writes volunteer Dr Ann Jay.

In March 2010 I retired. Although I enjoyed being a family doctor in west Wales, it seemed time to move on to do the things I'd always talked about, but never got around to.

I had a lingering desire to be useful. I explored the possibilities of volunteering abroad, but failed to find anything appropriate until one evening, at a local medical society dinner, it turned up under my nose.

Hand-ups, not hand-outs

The talk that night was by Andy Pilcher, CEO of Care for Uganda, and Dr Gordon Lewis, chairman of its medical subsection, FLOW (Friends of Lowero). The charity's motto is 'hand-ups, not hand-outs.' FLOW's aim is targeted interventions to improve the basic standard of healthcare in three areas of Uganda.

In May, passport and visa in hand, I met Andy, Gordon, two midwives, an obstetrician, an anaesthetist and three other GPs at Heathrow airport, for the long flight to Entebbe, Uganda, and a rather different world.

We carried vast quantities of extra luggage - sheets, blankets, baby clothes, pens, pencils, toothbrushes, toothpaste, medical equipment, a water purifier and a Casio keyboard - donated by supporters. Everybody is self-financing - this was my first visit, but others have been as many as seven times.

It was approaching midnight when we emerged from Entebbe airport to meet Saul, our driver, and pile all this baggage on a matatu (minibus) for the ride through Kampala to our guest house, where I enjoyed my first taste of Nile Special beer.

After very little sleep, we travelled up country to Lowero. It is not a long way, but journeys on largely unmade roads in monsoon season take time and are not the last word in comfort.

Pearl of Africa

Uganda is known as the pearl of Africa. From the spectacular views across Lake Victoria to the lush vegetation and gaudy blossoms, and the tangle of people, goats, pigs, chickens and long-horned cattle, it is undeniably beautiful.

Our lodgings at the Care for Uganda headquarters in Bbowa were basic but comfortable, with a stunning view across a green valley and a garland of weaverbirds' nests on a tall tree above the veranda.

Our first visit was to a school at Mawale, where we joined a training programme for community health promoters (CHPs) and traditional birth referral attendants (TBRAs).

The midwives went to talk to the women who assist village women with pregnancy and childbirth. The rest of us took part in a session on dental health. We gave out toothpaste and brushes and the CHPs had a hilarious and instructive encounter with disclosing tablets.

FLOW finances training for the CHPs, TBRAs and operational level workers (CHPs with extra training). Like us, they are volunteers.

I was deeply impressed with their energy, enthusiasm and ability to concentrate, despite their heavy workloads and long walks to attend the training sessions.

Support role

Teaching does not depend on volunteers from abroad, but is chiefly undertaken by skilled Ugandans. Our role is support, although we led sessions on first aid, eye diseases (my responsibility), diarrhoeal diseases, anaemia, malaria and obstetric emergency response pathways.

While some taught, others visited clinics or met local health officials. One evening, a networking dinner was hosted at the headquarters to promote relationships with local politicians and health officials.

There was a wonderful ceremony the next day to hand over three motorbike ambulances, for which FLOW raised the money, to the health clinics in Lowero.

Maternal mortality, which is high in Uganda, is exacerbated by high fertility and teenage pregnancy allied with poor or no care, HIV/AIDS and inadequate nutrition.

The most common causes of death in early childhood are malaria and diarrhoea. It is hoped that FLOW's approach - education and improved access to healthcare by the provision of vehicles able to cope with local roads - will begin to address this.

Too soon my visit was at an end, but I hope to go back next year. I had thought it would be impossible to do much good in so little time, but it's not true. You teach a bit. You learn a lot. You find out what to focus on next.

On the way to the airport we stopped at Katongele, a slum with a view over the largest lake in Africa, and met one of Care for Uganda's sponsored children. Sponsoring is great, or you could volunteer. It's not cheap or easy, but it is fun and you are definitely doing something useful.

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