Monday, June 12, 2017

Health Care

After 3 weeks in Uganda, my perspective on health care has changed immensely. To start off, I recognized the savior complex in myself, in which I was just assuming what the problems in Uganda were based on the phrase "developing country." However, after doing research by talking to locals as well as Dr. Isaac and Dr. Dixon, I learned that the two biggest problems with health care in Uganda are that 1) Lack of resources and staff in hospitals and clinics, and 2) people cannot afford health care. Another problem that I saw arise from these previous two is, who is responsible for fixing the health care system? The government seems to be useless in this area, as well as many others, so the question is who steps up?

After talking to MUBS students and locals, it was learned that government hospitals are where people go for services and diagnosis, and private hospitals are where they go to pick up medication. Private hospitals are very expensive, and while government hospitals are supposed to be free, they are not. Wait time at government hospitals are extremely long, unless you have the money to pay your way through. Many of us made observations of back-alley clinics and non-regulated facilities, present because of the expensive costs of medical care. MUBS students also enlightened us about witch-doctors, in which many people prefer the traditional, herbal methods of health care. It is evident that there is a lack of education when it comes to health care, whether it be how to take care of one's body, what rights one holds in a medical facility, and expectations they should have of medical staff.

However, despite these issues, I am quite surprised with health care in Uganda. I thought quality of care was a major problem, but after interviewing locals at Kikandwa, they all seemed to be quite happy with the care received by Dr. Isaac. Some said that the quality of medication was not always the best, but in spite of long waits, they were still happy with the care they received. In regards to affordability, Kikandwa clinic is one of few that offers payment plans for services that are too expensive. When shadowing Dr. Dixon, while a private hospital run by a church, Mukono hospital waves fees for minor services that they can, and offer some kind of payment plan only if the patient suggests it first. Yet, there are times where they have to turn a person away for not being able to afford a service.

Personally, after shadowing Dr. Isaac and Dr. Dixon, I am blown away by their knowledge and creativity. Their ways of accommodating for the lack of technology is absolutely incredible. With Dr. Isaac, he was able to tell the position of the fetus' head, the alignment, the heart placement, and due date, all with his hands and use of one hour-glass shaped object to hear the baby's heart. Dr. Dixon, a general practitioner, allowed us to observe him perform a C-section. It is quite uncommon to witness a general practitioner conduct surgical manners, but doctors are needed to be fairly knowledgeable in Uganda since there is an insufficiency of them. Both experiences were amazing, and makes me wonder if we really need all that we are accustomed to in the U.S. whether it be in health care, or other aspects.


Questions:

How have your personal initial thoughts about Uganda's health care system (or other aspects) changed since your time in Uganda?

Do you think that in the U.S., we rely too heavily on technology for basic check ups and such? Are there any Ugandan methods that should be applied to U.S. medical practices?

Is any part of Uganda's health care system sustainable? Which parts are/are not? Why/ why not? In what ways can it become more sustainable?

2 comments:

  1. Great post, Aryana! My personal thoughts on the Ugandan health care system were changed almost immediately upon arriving at The Surgery when I was seeking treatment for my ear infection. The clinic in Kampala was readily available to treat me, and they had everything they needed to do so. This was a surprise to me originally, and was not necessarily consistent with the lack of supplies I had perceived both before arriving and early on in the trip. While I think that this system is very efficient, I have noticed that it still struggles to reach large portions of the population. Clinics require immediate payment for service, and this may steer people away from care if they are unable to pay.

    In the US, I have not generally had much technology involved in my general check-ups, aside from the computer system used to maintain patient records. This is one technology that could be implemented to increase sustainability of the Ugandan health care system, one example being Karl's project in Kikandwa. The general infrastructure behind Uganda's health system is very sustainable, with seven different levels of facilities and a referral system in place. One part that is not sustainable is the lack of consistent supply to health facilities around the country. We witnessed it in Kikandwa, where some services were only available on certain days or some drugs were not able to be stocked on a consistent basis. There are many ways to go about solving these challenges to sustainability. One thing that could be done is the development of generic pharmaceutical manufacturers in various parts of Uganda to keep prices low with competition and increase access across the country.

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  2. Great Reflection Aryana! To answer your first question, my perception of the health care system in Uganda has changed dramatically. My initial thoughts were highly influenced by what I have seen in the news, read in books or the newspaper, and on what I have seen on TV and movies. I expected there to be lack of hospitals, poorly trained staff members, very unsanitary facilities and that the hospitals would be completely overcrowded. Since going to Uganda I learned that many hospitals are being built but there aren’t supplies and staff members to fill these facilities. For my research project I got the opportunity to go to Butabika mental institute in Kampala. Going here made me realize how much Uganda is in need of doctors especially psychiatrists. At Butabika there is a total of 900 patients with approximately 30 trained staff members.

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