Our UNC Intern Tori Lebrun takes us out of New Life Medical Center and onto one of her visits to the field in Uganda.
In Uganda, what does it mean to “visit the field?” It starts with a bumpy drive down roads that grow in on you until the grasses and brush scrape the undercarriage of your vehicle. The sun is beaming on tall grasses, mango and palm trees, animals and people alike. Around every bend, people are carrying heavy loads of water and wood or beating the earth into neat hills with long hoes. Every now and then, you smell a charcoal fire and you might be tempted to think of the Fourth of July or a camping trip. Instead of the image of hot dogs and hamburgers, picture a pot of boiling ground corn or peanut sauce.
Knowing the context our patients come from, health care makes much more sense. A Village Savings and Loan Group (VSL) meets at the home of one of its members, in a clearing with two round mud and thatch bandas. Kids, chickens, and goats roam free. It immediately reminds me of a story one of our midwives, Florence, told me. She was counseling an HIV-positive mother about the importance of taking her pills at the same time every day, and the client insisted, “I do take them at the same time every day. I take them when the chickens come in.”
The women sit or kneel in a circle on tarps and painstakingly count out their 1,000 and 2,000 shilling notes—40 cents here, 80 cents there, maybe $10 at the most. Many are widows who lost their husbands during the Lord’s Resistance Army (LRA) insurgency. Not one is saving for herself. “I am saving for my children’s school fees,” and “I save for an emergency, like a hospital bill or if I lose some crops,” they say.
VSL groups learn about hygiene and nutrition, but so many hidden dangers lie under this painterly sky. It’s going to be a long, slow fight to wipe out disease. Already, I am tired of saying, “We don’t have that in my country,” every time I talk about health services with the clinic staff. Why do this work when it seems like there is always another threat on the horizon? Because to these women, one less emergency to worry about does not represent missing a vacation or wearing last season’s clothes. It means more food on the table, or another child in school. It makes a big difference.