Trip Report from Talia Cohen, a Medical Volunteer to Uganda
This report was shared with Imaging the World by Talia Cohen, a medical volunteer who recently spent two weeks in Uganda under the guidance of ITW.
I was recently able to visit Uganda thanks to Imaging the World. ITWA staff designed an itinerary for my two-week visit. I spent time at two different hospitals around the country.
The first place I visited was Mubende Regional Referral Hospital and the second was Nyakatare Health Center. Coming into this experience I didn’t know what to expect. I had a little idea what I would be doing or where I would be going. I had only studied nutrition in a classroom setting and had yet to gain clinical experience.
The hospital in Mubende is considered a large hospital in Uganda. There were numerous wards and a wide array of medical students, interns, doctors and the likes running between the different wards. I spent most of my time in the Pediatric ward shadowing a medical intern doctor named Luke who became a good friend. He explained to me the process of nutritional assessments and I saw first hand many of the things I had learned previously in the classroom.
I saw children suffering from malnutrition, HIV, Ebola, malaria, measles, typhoid, and other life-threatening diseases. In this ward, specifically the nutrition section, the children ranged from about two weeks to five years old. They stayed in the ward for an average of a month to receive proper nourishment.
Every morning nutritional assessments were taken on the children. The assessments consist of taking the weight, height/length and MUAC (middle upper arm circumference) of the child. The child’s progression was tracked on charts and graphs and the measurements were assessed on a chart filled with different z-scores. The z-scores were used to compare the child to an average child of the same age to assess the level of malnourishment and determine the appropriate care.
So, each morning I helped measure the children and recorded their measurements on charts. I learned the difference between a child with edema and a child without and how the treatment process differs.
Some rewarding things I witnessed in this ward was helping to track a child’s recovery from edema and seeing the look on a father’s face when he heard that his son was a healthy weight and ready for discharge. Overall, being in this ward and seeing severely malnourished children firsthand, rather than on a PowerPoint slide in a classroom, was both upsetting and incredibly powerful. I remember holding a six-month-old child who only weighed four kilograms.
I also spent some time in the outpatient ward. There, I went into the nutrition room and learned how to pass out the RUFT packets. These packets were made of ground peanut and some other ingredients. They are given out to children who are in the outpatient phase of their treatment. They are rich in protein and therefore effective in continuing to treat malnourished children. I was in charge of calculating the appropriate number of these packets to give out for a two-week period.
Even though this was a very simple job, I enjoyed it because the caretakers receiving the packets for their children were incredibly grateful and happy their children were on the road to recovery. I was happy to help on that journey any way I could. I could’ve stayed at this hospital observing and helping in any way I could for much longer than the short week I was there.
Nyakatare Health Center was quite a different experience. The location was a lot more remote, situated in the mountains of the western region of the country. The cold took some getting used to for me. The hospital was much smaller and the doctors and staff seemed like more of a family to me. They would sit and eat morning porridge and lunch together every day and everyone knew one another’s name.
People had heard I was there helping out before I had even met them. Since the hospital was so small, it was mostly outpatient care. There was a small inpatient section with a female side and a male side. Most of the daily patients would come in for a small check up and possible testing and would leave with the appropriate medications.
Although I didn’t do anything directly nutrition-related at this center, besides measuring a few MUACs on some children, I got a good sense of how the health center was run. I observed many different people presenting with a wide range of diagnoses from headaches to HIV. I learned the different tests conducted for each diagnosis and the proper paths for treatment that the doctors at the center are able lay out.
The staff at the hospital was extremely welcoming and eager to explain to me any process I was interested in hearing. It was an equally emotional and powerful experience having the opportunity to sit in on check ups with patients and learn about the common symptoms and diagnoses patients in rural Uganda are experiencing.
One of the most difficult parts of my experience in these hospitals was connecting with the patients through tthe language barrier. Very few of the patients I interacted with spoke any English. In Mubende, most of the people spoke Luganda and in Kanungu (where Nyakatare was located) most of the people spoke Rugika. I made an effort to learn how to greet someone in each of those languages to make the patients more comfortable. I found that this small effort on my part pleased the patients greatly.
In addition to my visits to the hospitals, I made some friends and was able to experience the way Ugandans live their lives. I hiked the hills in Mubende at sunset, took a motorcycle around Queen Elizabeth National Park and saw many elephants, I cooked in a traditional African kitchen, ate countless Rolexes, I experienced the vibrant nightlife of Kabalagala and so much more.
I am so thankful for my time in Uganda. It is a beautiful country filled with some of the friendliest people I have ever met. I learned more in the two hospitals I visited than I ever could have in a classroom setting. My new knowledge and the things I saw will stay with me for life.
I hope to be back in Uganda after I finish school to not only learn more, but come back with more of my own nutritional knowledge to make even more of a difference.