Monday, June 22, 2009

Monday, June 22, 2009

Monday, June 22, 2009

Congolese Refugee Camp

A one hour drive from the Lake View Resort Hotel where we are staying in Mbarara. The drive is difficult and dusty, red dust covers everything near. The car is quiet, our apprehension consuming our thoughts and imaginations. Medical Teams-Uganda set up their mobile clinic December 29th of last year. MTI is one of the only medical NGOs (non-governmental organizations) in the 87 square miles of arid land that was given by the Ugandan government as a settlement for the thousands of Congolese seeking refuge. 28,000 people are served by this clinic, it’s staff and the teams of American volunteer medical people who come here to help. Peter points out white tarps with UNHCR markings that are homes for the refugees. These are scattered over the dry landscape in 50 x 100 sq. meter plots. The corn stalks are dry and there is no water for irrigation – this area needs rain badly.

David Alula, MTI-Uganda’s Health Manager, explains that MTI has made a three-year commitment with the goal of sustainability at the end of the three years. The border still has Congolese crossings every day but the numbers are down from the first enormous influx, now averaging about 15 families or 45 people per day. The induction process is detailed and precise, in spite of the critical situation a protocol to track numbers, history and health records is adhered to. Cholera was the most common disease when MTI first began treating the refugees but now general health issues with malaria has the most serious. 200 to 400 patients are seen a day at the Clinic.

A MTI sign and large structures of UN stamped white tarps and we have arrived. Groups of women with babies are sitting in the shade of trees. Dusty, barefoot children quickly gather around our two cars – many have running noses and open sores on their skin, they stare at us with curious but sad eyes and then we emerge with smiles and hand shakes. Our one smile is returned by a hundred dark smiles. Many are missing teeth or they have very discolored teeth – the toothbrushes and toothpaste we brought in hygiene kits will have jobs to do! Color is abundant, the mothers all wear long wrap skirts of colorful patterned fabric, and most have head wraps that may be of a different colorful fabric. The children are mostly ragged, some in old “party” dresses whose seams have given way to an occasional washing.

The staff gathers us into a circle for a prayer, introductions and a brief overview of our tour. Davis leads us into the largest tent – we push our way through the line, many which have been waiting here since morning. There are three areas partitioned off with more white UN tarps. Pregnant women are seated on the floor of the first room. Dr. Leo is examining an infant who has tested negative for malaria but he has a high fever and his lungs are congested. He asks David if he transports the baby by ambulance to Mbarara Hospital would they be equipped to do a spinal tap. David is unsure so a call will be made. The difficulty to diagnosis without adequate facilities and equipment becomes immediately apparent. The volunteer nurses are each seeing patients in the other two rooms, there are Ugandan medical staff with each of them also seeing patients. Malaria… of the four patients we watched being diagnosed three of them test positive. Prescriptions are given or orders to start quinine IV’s. The pharmacy is another tarp-partitioned room where 4 staff sit either recording into large books prescription/patient data or filling prescriptions. They work quietly and efficiently. These records are kept so that statistics and trends can be compiled and analyzed. Amid the cries, colors, smells and apparent chaos is order – again we are reminded that Uganda is a country of contrast.

The UN representative from the Office of the Prime Minister has asked us to come to their compound so we can meet the new Director. Introductions are made, thanks given and we are excused to visit the school.

The school is run by another NGO, Save the Children. Tarp classrooms with pieces of wood make up the benches, there are no desks. The classrooms are layed out around an open compound in a L shape. Some of the rooms hold over 50 children, there were about 20 older boys seated at the first classroom we observed from the half wall on the interior side. Megan joined a teacher who was teaching body parts with the eye, ear, nose, and shoulder song. Again the children were delighted by Megan’s enthusiasm and big smile. Our art project was curtailed due to the shear number of students and the fact that we had supplies enough for around 100 and there were easily 500-600 students here. Of the 1800 school age children at the camp, there are 792 girls who attend school. Sue commented on how many more boys she saw in the classrooms. We unloaded the MTI supply bags we had brought from Portland and the staff will sort and divide among the children after we leave. As we walk to our vehicles we are surrounded by children wanting to touch our mzungu (white) skin, after stroking our arms they all giggled. Do we feel different too? Children are resilient and if these beautiful children can stay healthy and get an education they stand a chance – and with that chance comes a better Uganda and perhaps Congo as well. Our prayers surround this future of hope.

As we drive through the dirt lanes lined with dirt huts or tarp tents the children run to the road “Mzungu, Mzungu” they shout – when the numbers are small enough to allow we stop and blow up balloons for them. The delight to have such a small new toy makes us ache that we can’t do more. I think of the number of toys in American that sit untouched that could help these children escape the day to day monotony of their lives at camp. Families gather together under the shade of trees, you can see the importance of the family unit. Some plots are well maintained but the majority have given in to the harsh environment and to the pervasive red dust. Garden areas are dry and forlorn looking only adding to the feeling of hopelessness that tries to creep into our thoughts. But there is hope, these people have escaped with their lives, they are being given medical treatment that has saved their lives, most are together…. They do have hope. Let us pray that our work here continues to feed that hope, to feed their spirits and to give them the strength to rise from poverty.

Finally we visit a group of new buildings! This former site of Medicins Sans Frontiers (MSF, Doctors Without Borders) was given to Medical Teams when this NGO left the refugee camp. A contractor has been working there for 3 months and we are all very impressed. The clinic itself will have actual exam rooms, a pharmacy, a waiting room with benches that is out of the sun, shower buildings are next to the clinic where patients can wash. There are several new bathrooms, an incinerator, and an area cleared of brush in the middle for children to play or families to gather while they wait for a diagnosis or a family member to be released. This compound is filled with HOPE and to think that within the last 6 months MTI/Uganda has grown from a make shift tarp tent to an actual building. It is truly God’s blessing and a miracle. Our spirits are raised and we are able to leave this refugee camp with that hope in our hearts.

Water is expensive and as we drive out David Alula shares that they pay $11,000. a month to have water trucked in to the holding tanks. Water is distributed on a “as time allows” schedule but if water is needed the refugee has to walk to the tanks to fill their container that is issued when they are registered. $40,000 would allow them to dig a well that allow them to pump fresh water for their use at the clinic. They need to fence the compound before they can open in order to discourage theft - the clinic pharmacy is always in danger. To us these are simple things but when your budget is already stretched to the limit these costs are mountains.

Dinner at the hotel is a good time to reflect, we each share what impacted us the most during our time in Uganda. Most share that Brenda, the 14 year old with HIV at the Ogur Youth Center is the image that is foremost in our minds, she has no hope but she has today and her smile brought both joy and sadness to each of us. Again, that ever present contrast.

Tomorrow we leave for a six-hour drive to the hotel near the Entebbe airport. It will take some time for us to process Uganda, the people, the staff… each other! This experience will change us forever, we hope to return one day to see a stronger, healthier and economically more sound Uganda. That is our hope and our prayer.

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