Mulago

There are some situations for which you can never prepare yourself. We had been warned. We had been told some of the worst aspects. It is still awful. And it is awful because it is human.

We had just entered the gates to Mulago Hospital in Kampala – Loraine, Jon, Mardi, Kelly and I. Jon had called his local friend to take us through, as going without a translator or a sense of navigation would have been most difficult. Mulago is large, with many different wards, and is the hospital where all doctors work during their residency. At the entrance, outside the hospital doors, there were metal and plastic beds with patients lying in them. People without beds, were sitting or lying, blankets and food beside them...waiting. This scene was not reserved for the outside of the hospital. Every new floor to which we climbed, more people were parked outside wards and in the hallway. Many looked quite sick; some were heavily pregnant.

Entrance to Mulago

Although we were within visiting hours, and many Ugandans are able to freely get around, we were stopped outside the first ward. The official ask what we wanted, speaking in the native tongue. I noticed a sign hanging above the officials head, “ATTENTION TO ALL VISITORS! Doctors cannot examine & treat patients while visitors are in the ward.”

“They get worried whenever they see Mzungus,” he explained. “They know what they are doing here is not right...”

That is when we entered the first ward. He was only allowing two of us to proceed, and as Mardi and I were a part of the medical field, we went ahead. A man lay on a metal bed with no mattress, about four doctors in lab coats stood around him, a kidney basin was below his eye. Something may have penetrated one, as it was bleeding and they were squirting solution in, letting the drips fall into a metal kidney basin below. I walked a few steps further, hesitating for what I might be walking on. Next to one metal bed, was a large clear bucket, the bottom filled with dark blood. Beside that, another empty bed stood, older blood stains splattered on the floor around it. Sharp containers, buckets and towels were scattered on the ground around the room.

Having seen enough there, we headed back to meet up with the group. We walked across the hospital, outside and down to a separate building for infants, passing many people along the way. I spotted a sign saying “Mulago Hospital. Services here are free.”

“That is only on paper,” the local explained. “Then they come here and if they want to be seen, they need to bribe the doctors with money.”

“How long will people wait?” I asked.

“As long as two months.”

He told us, it is not uncommon that people die while waiting. They are sick, but unable to pay and therefore, left to die in the corridors.

The government of Uganda built this hospital, especially directing it towards poor people who need free health care. However, the gorvernment has little money to pay staff, and they require doctors to work there for at least three years after they have finished residency. Hence, doctors will work elsewhere, where they make more money, and come to Mulago for as a second job. The staff are overwhelmed with the amount of people to be treated and the lack of funds, so bribes have become an only way to get proper treatment. If you do not have money, you often do not get care.

“Then are the officials and doctors here trying to hide the corruption from the government?”

“Many of them are government.”

He told us about the donated medicines to Uganda. The government sells all the valuable ones to private clinics. They only give cheap medication, like Paracetamol (Tylenol), to the patients along with a prescription to go buy their other medications. Obviously, many of them cannot afford it.

Our local had grown up in the slums, and worked his way out, starting an organization to help give slum children a better life. We entered a children's ward, a separate building around the back of Mulago. Mothers sat in the waiting room with their babies on their laps. As I looked around, I spotted a little boy, maybe one year old. His legs and arms so thin, and his bones showing through his skin. His mother was helping him eat a snack, but he was severely malnourished. He looked like Calvin.

“Many mothers have been in here since 6am,” the local said. “My brother came here...”

“Did he get seen?”

“He did.”

It had been too late, He had died shortly after.

Just then, a middle-aged nurse walked out of her office, in a blue dress, and spoke to the waiting crowd, in Ugandan, holding up her fingers and rubbing them together

“She's saying that anybody who can give her money now, will be seen before 6pm.” He explained. One of the mother's stood up and started speaking loudly and quickly at the nurse. One of them looked as if she would cry.

Patient Filing

One of the better filing rooms

Mardi wanted to visit the labour and delivery ward, but the guard would not permit us entry. However, our local kept talking with her, and found out a further reason. She really wanted money from us, if we were to visit the ward.

Cardiology and General Surgery were open wards, lined with beds on either side of the rooms, included two beds down the centre – just enough squeezing space for medical staff to get by. I walked by a faucet to wash my hands – none of them were functioning. There was a strong smell of urine in many areas, patients lying on the floor beside beds, family members attending on their sick – as this was the only way they would be fed. In some instances, there was more than one person to a bed. Online, it is said that Mulago holds around 1,700 people; however, there are over 3,000 patients there.

I thought in asking about visiting the Cancer unit, as this is where I have had my main nursing experience. However, we were getting ready to go – we had seen enough to process for the next week. In meeting with Fred later, we went through the events of the day. One of the volunteers was very quiet for the evening that followed – just processing they said. Nobody blamed them.

“When I heard you were going, I really hoped you would not visit certain wards.” Fred said.

“Like which one?” I asked.

“The Cancer ward.”

I desperately wanted to do more – I know we all did. There is a Hope that lives inside each one of us, even in the most dire of situations. This is what I wanted to be able to communicate and show– not just go to be a spectator. Such corruption has been far from my own reach in the Western World, that it is a challenge in itself to process during first-hand experience. However, showing care and reaching out for individuals is what holds true value. I believe we all hope to return. If our hearts were heavy when walking the hallways of Mulago, I know the cries of God's heart were and are, that much more.