…And Up and Up

Stephen had heard through his church that an orthopedic surgeon from the Czech Republic was to operate on patients at a nearby clinic for a few days. Postponing the boy’s surgery with the Kampala doctor, we went to see the foreign one earlier this week. He looked at the boy and recognized the problem instantly, even identifying the duration of the boy’s suffering. This doctor’s been here a lot, I thought; western doctors I imagine not being so comfortable with infections generally exotic to clean, modernized environments.

“You bring him on Wednesday,” he said quickly, glancing at me with piercing blue eyes; light ones I haven’t seen for months.

“Should he not eat or drink that morning?”

He paused. “Let’s do the surgery that afternoon. No food or water that day. You bring him in the morning.”

The hospital is in the Buikwe sub-county, about 15 kilometers from Lugazi, situated half between us and the banks of Lake Victoria. It rests on a plateau next to a dirt road, and like most hospitals it’s gated, but with an unusually neat lawn and freshly painted buildings. Most rural or town hospitals are no good, but this one is different.



Erected a few years ago by Czechs, the hospital is clean, and the staff professional, helpful and organized, unlike what I have witnessed in the Lugazi clinic and what I hear about most clinics in Uganda. It seems a few Eastern European doctors work there regularly, providing quality care and ensuring a higher standard of service hospital wide. It is wonderful to see Western aid working so efficiently and positively. There are many misguided foreign aid endeavors and completely corrupt charity schemes by Ugandans, the latter of which being especially disheartening; however, projects such as this hospital and the orphanage I visited several weeks ago, which focus on serving a relatively small population exceptionally well, are absolutely inspiring.

In addition to more Western style care at this hospital, the services are also highly subsidized by the Catholic Church. Medications are from Europe, rather than cheap Asian versions found in the majority of Ugandan pharmacies, and are at a fraction of the typical costs. Most doctor visits are free, and more complicated procedures or treatment, such as birth, surgery or post-operative care, are inexpensive even by Ugandan standards. I saw a sign for rabies vaccines totaling about $15; I believe it’s around $900 in the States.

As another example, Richard was selected for surgery and his entire treatment, including the hospital stay, mediations, etc., was only about USh 35,000, or about $17! We are overjoyed!!

In the hospital the night before surgery


The surgery actually happened yesterday (Thursday) and he is doing well, although his pain management hasn’t been exemplary. Ester stayed the night with him and I came this morning to bring them food. About an hour after I arrived the surgeon surrounded by a team of other mzungu and Ugandan doctors brought us to a separate room and unwrapped the dressing, digging into the boy’s large gaping wound that went all the way to the bone, pulling out gauze soaked in iodine stuck between the open flesh and fat; the gash not yet sutured so medicine could be inserted into the tissue.

If they had given Richard pain medication it was pathetically small. The boy who had the strength to hobble on a leg filled with puss and dead bone for over a year not flinching, denying he hurt, was clenching and moaning, tears pouring down his face. Ester eyes became wet witnessing his excruciation. We tried to hold and soothe him.

“Can I start him on the pain medication now?”

“Yes,” answered the Ugandan doctor standing next to me as they finished wrapping the leg.

We went back to the pediatric ward, which was one small room with a handful of beds holding a few small, bandaged patients, sitting next to them their caretakers. I gave Richard another pink pill and his antibiotic. The boy was still crying. I went to look for the Ugandan doctor.

“Sebo. Sorry to disturb you, but the boy is in so much pain. Can I get another prescription?” The doctor looked up from his desk.

“You can give him two of the pink pills.”

“That is just Ibuprofen, right?”

“Yes.”

“I don’t think that is enough.”

“Each is 200 mg.”

“What?” I asked shocked. “You were only giving him 200 mgs for that pain? Even 400 is not enough. I take 600 to 800 when I have a headache or back pain.”

“That is too much.”

“Whatever. The boy has a gaping hole in his leg. He needs something else.”

The man wrote another prescription for me to have filled outside of the hospital and I ran back to give the boy the other measly 200 mgs of Ibuprofen. I felt horrible for not intervening before, ensuring that he had enough pain medication. I can’t imagine the torture of a person sticking their fingers through my layers of tissue down to my tibia with little to no medication.

I had to quickly leave after giving him the second tablet; Sylvia and Rachel were about to get of nursery with nowhere to go. As I was waiting for a taxi on the dirt road a boda boda driver drove up and offered me and an old woman standing next to me a ride. He spoke to her in Lugandan and she smirked and looked at me.

“He wants 40,000.”

“What?” I asked assuming I misunderstood her.

“He wants 40,000.”

“To Lugazi?”

She nodded. I turned to the young man on the motorbike.

“You want 40 to Lugazi,” I said gesturing the number with my hand.

“Hmmmm.”

I repeated the question and he nodded a second time.

“You’re always trying to rip off a mzungu. Gen da! (Go!)” The other boda boda drivers sitting next to us starting laughing.

A boda boda to Lugazi from Buikwe is only 3,000; he was trying to charge me about 13 times the typical cost. As an aside, I am trying not to, but can’t help but tire of the constant, more than daily, attempts to outrageously overcharge me as well as the incessant asking for money or any item I might have in my hand in any given moment: water, headphones, maize, cell phone. And they never ask actually. They tell you, which is even more maddening. Mzungu! You give me... You give me money… You buy me chipati. You give me pineapple. I know that my irritation is slightly callous considering that compared to those around me I am ridiculously wealthy, but the persistence is frustrating as well as somewhat dehumanizing that so many don’t see me as a person, but just a walking money sign.

Okay, so my rant is over; most people treat me very well. Focusing on the good, Richard was discharged in the early afternoon, is back in the house and seems to be in less pain. We will have to go to the hospital almost daily to have the wound checked and redressed, and they tell us another surgery will probably be required in October; but in the meantime I am excited about his recovery and even more thrilled about what this will do for his dismally low confidence. Beatrice and Agnes I know already have friends at school, which is just across the street; I see my girls and their schoolmates walking around together, but not Richard. Ester tells me that the other children make fun of him because of his leg. I can’t wait for early next year when his second operation is over, he has fully recovered, is in school full time and running around with other boys his age.

Resting the morning after surgery


For those of you that have donated so far, thank you, thank you, thank you! Your interest and support means a great deal to me and certainly to the children! I am so touched! The money is obviously not critical at this point for the boy’s treatment, but I still want to build the children a home, create a sustainable project for them, most likely piggery, buy and plant crops to feed them and in the meantime I need to pay for their food, medicine, school fees, and other living expenses until they are self-sustaining; although it’s not nearly as expensive as in America, it’s quickly adding up. I promise to have more information on my total costs in the next couple of weeks, but this project will most likely be several thousand.

Thank you again!!!!