My experience as a foreign student promoting health care in rural Uganda in the midst of the COVID-19 pandemic
By Caroline Klyk | During my internship at the Jinja Regional Referral hospital I came across the chance to support the organization Empower Through Health (ETH) in the Buyende district for one week. Empower Through Health is a nonprofit health care organization which constantly works on improving healthcare access to 70,000 people in eastern Uganda. This is achieved by offering direct evidence based medical care, helping build local healthcare capacity, and addressing root causes of poor health outcomes with the full participation of communities. To accomplish this mission, the problems are addressed through interdisciplinary and intercultural collaboration. This is why, I was not only able to benefit from an international and engaged working environment, but also gained insights in the different needs that need to be addressed in the rural setting of Mpunde as compared to the town of Jinja.
Ibrahim Seeklo, who is one of the co-founders of ETH, made it possible for me to get involved in the various projects of the organization by introducing me to the work of ETH. As I joined the team a group of motivated American students was just starting to implement their different research projects.
Students from Williams College focused on rising awareness for mental health issues. Viewing mental health as an integral part of health and well-being is crucial but presents a challenge when the concept of mental illness is stigmatized. After exchanges with a local psychiatrist who supports the team, it became clear that mental illness is not yet widely considered treatable in the district. The stigmatization is to be countered with a play performed by village health team members. The play will be followed by a survey and educational talks in cooperation with the psychiatrist.
Students from the University of Washington are addressing the issue of parasitic diseases in the district through their work. More specifically, they conduct a detailed survey regarding helminthic infections. Their long term goal is the eradication of schistosomiasis within the Busoga subregion of Uganda and to increase public support for and value of health interventions.
As I am passionate about women’s health I eventually I decided to join the team from the University of Michigan in particular. Their goal is the empowerment of women through contraception. There I was able to participate in the finalization of their survey as well as conduct and participate in interviews with villagers. We wanted to identify what modern and natural methods of family planning are known to the women in the district. Furthermore, we were interested in the questions and problems that the women have on the subject of contraception. Following the survey, educational talks will be conducted in small groups to address the gaps in education regarding contraception and family planning. I found it particularly striking that the underlying problem often seemed to lie within the social construct of family. The traditional roles of men and women in the family are not easily reconciled with the concept of family planning. Therefore, it is also important to make men aware of the health and economic benefits of family planning.
In addition to my work with the other students, I also had the opportunity to learn from the staff at the local health center in Mpunde. The health center is conducting basic outpatient and inpatient care, maternity services, and family planning. Like the Jinja Regional Referral Hospital, the local Health Center in Mpunde is an important resource for residents. Unlike the hospital, however, the Health Center is more limited in its capabilities and resources. However, the facility is indispensable for local medical care in the Buyende district and enables many villagers to access important medical examinations and items that would otherwise not be available for them. As a medical student at the relative beginning of my career, I found it very rewarding to assist the immunization process of children, perform various tests, and even got the chance to assist in a birth.
Since I only participated at the beginning of the project phases, I cannot judge the impact of their effort. However, I noticed that the people we interviewed had health issues and were grateful to be able to address their concerns to ETH. Despite language and cultural differences, all interviewees were willing to talk openly with us and the translators about contraception and family planning. The handling of the sensitive data and information in the debriefings with the team was also enriching. The organization and coordination of the various projects running in parallel was sometimes difficult but there was a constant effort to improve the work and to respond to local needs. The task of identifying and adequately addressing key health problems and imparting knowledge about global health is a difficult one. I think that foreign students can make an important contribution here. In addition to new perspectives and approaches, the international networking of people working for global health is an important network for future projects. In addition, foreign students’ experiences upon their return draws attention to underreported issues and rises awareness for the health challenges that need to be addressed on a global scale. Moreover, the work can be an incentive and inspiration for future students.
It was a great enrichment to work with the ETH team and get multi-layered insights into the Public Health field in addition to the experience of working at the Jinja Regional Referral Hospital. I have learned in particular that this kind of work only succeeds when there is interdisciplinary cooperation. The local actors are essential to get to know the local structure and to enter into dialogue with the people. The implementation of the research requires the teamwork of all involved. The circumstances of the Covid-19 pandemic were met with special hygiene measures. The educational talks took place only in small groups, the Village Health Team Workers were also met sporadically and, in addition to the implementation of the projects, attention was also paid to reinforce education about simple hygiene measures in the district.
Ms Klyk is student at the Medical University of Wroclaw in Germany and has recently completed her internship with us and Busoga Health Forum.