In the UK, waiting in a queue of people to be seen by a doctor is a common experience. But what if you arrived in the consultation room to find there was no equipment to treat you – and no qualified medical professional, either?

Carla-Marie Grubb is a newly qualified doctor who, in her final year of medical school, undertook an elective to Uganda. In February 2019, she arranged for the delivery of an Essential Health Pack to the Kasangati public district health facility, to tie in with her own five-week stint there.

 

The Kasangati public district health facility waiting room, many people tavel far for treatment.

Patients wait to be seen at the Kasangati public district health facility 

 

Set up in 1959, this centre is located 10 miles north of Kampala, in the heavily populated district of Wakiso. It’s funded entirely by the Government of Uganda and provides maternal and child health services, immunisation, dental and eye services, management of non-communicable diseases such as diabetes and hypertension, HIV/AIDS services, and community outreach.

Arriving there was a culture shock for Carla, who “hadn’t travelled much before. “There was no water, no electricity, no equipment, and very few drugs. The only medicines from the government were for HIV. When people came in, they had shopping lists of things they needed, such as gloves, and sheets to cover the bed. Even then, often there was no doctor available. Healthcare staff, who had varying degrees of training, ran the centre.”

 

The challenge to supply high-quality care

 

Carla spent much of her time on the labour ward, helping women in childbirth. 

Carla with a newborn in her armsShe reflects: “I delivered a lot of babies, learning on the spot, often with no equipment. We didn’t have oxygen, only a mask that wasn’t attached to anything. We had emergency situations where a C-section was needed, and on one occasion we didn’t have clean tools or equipment and had to use a circumcision pack. The doctors at the centre are very good at thinking on their feet and using what they have, in order to make do. On the equipment side of things, there was a lot of ingenuity.”

For emergency C-sections, there was a small supply of medicines, “but a lot of the time there was no analgesic (painkiller)”.

On one occasion, Carla delivered a stillborn baby to a woman travelling alone to see family members. “The woman had gone into labour prematurely. She came in with nothing, and we had to go into the waiting room to ask patients if they could donate gloves so I could examine her. The other patients were very kind, but even after the delivery, we didn’t have anything to cut the cord or wrap the baby up. It took three or four hours before a family member came.”

The challenge of providing high-quality medical care to patients in an environment where resources and medicines were lacking was very obvious.

Maternity services are hugely over-subscribed in Uganda,” says Carla, pointing out that donations of maternity-related medicines are very much needed. Carla also witnessed a pressing need for medicines such as metformin and gliclazide, which treat diabetes, a chronic disease; and for antibiotics and antivirals, to treat sexually transmitted infections. In addition, medical supplies are constantly in demand. “I popped my head into a few pharmacies and the medicines were very expensive. Pharmacies appear to be less regulated in Uganda, which obviously has a huge impact on how available medicines will be in the community.”

 

The health facilitys operating theatre

 The operating theatre at the Kasangati public district health facility

 

"These packs can really help"

 

Now back in the UK and working as a doctor, Carla wants medical students to know that Essential Health Packs are available for electives. She says it is relatively easy to take one out.

“To any medical students or healthcare professionals travelling to countries where there is need, I would wholeheartedly recommend taking a pack. I was very impressed with the support I received from IHP, who were always happy to answer my questions. The process was smooth and I was supported at every stage.”

The trip to Uganda made Carla “aware of how lucky I am to practise medicine in a setting where I have easy access to the resources I need” – and she adds: “I get frustrated about waiting times here in the UK, but it’s nowhere near as bad as what people are dealing with elsewhere.”

While Carla acknowledges “the Essential Health Pack donation doesn’t help solve the problems responsible for an overall lack of resources”, she adds: “I hope it enables the staff I met to continue to provide essential services for their community for a while. These packs can really help. The medicines will run out and not help to tackle the problem longer-term, but I would definitely use one again and on another trip, I would take as many packs as I could physically carry.”

 

Find out how more about Essential Health Packs and how to apply to be a carrier here

 

 

Donate today to help us deliver more Essential Health Packs, providing life-saving treatments in the world’s poorest and most challenging places

Please select a donation amount: *
Set up a regular payment Donate