| Oct 19, 2009
The colors of the entrance to our clinic stood out joyously from the bleak countryside of the refugee camp. Our land rover pulled up to the blue gate. As the guard opened it he smiled and said, “Bonjour.” He was from the Congo, one of the very few refugees who had a job. I felt welcome.
The crowd of people around the door to the clinic parted as I walked in. The waiting room was packed. All the benches were full, children were lying on shawls on the ground. It was 10am, it had taken us a little more than an hour to drive here from Mbarara. The patients had started registering at 8am. For most it would take four hours to be seen and receive their medication.
We were introduced to the fifteen Ugandan staff. Handshakes and smiles, hugs for those I had met before on my trip to Lira in 2006. There was no time to talk, we had work to do. Joey was to be my translator, pitch black skin and bright white teeth. He took me by the arm and showed me our corner in one of the examining rooms. In the other corner sat Angella, a clinical officer. We would work independently in the same room. The room was alive with the noisy movement of patients in an out of the room all morning.
The moment a patient left the room another put their head in the door. If it was to be my patient I motioned to the plastic chair beside my table. Joey was an experienced translator, he spoke six african languages in addition to French and English. He knew to ask about the problem without me prompting him. Too often they answered yes to his every question.
“Do you have chest pain,” he would ask in an African language. “Yes.”
“Do you have abdominal pain.” “Yes.”
“Do you have a headache.” “Yes.”
“Do you have a cough.” “Yes.”
Joey would sometimes turn to me shaking his head. He told me that the patients like to please; a no response might be interpreted as disrespectful. I suggested that he leave his questions open ended. Let the patients tell their story in their own words.
I quickly settled into the familiar practice of medicine. The diseases might be little more exotic than in Canada but the patients were the same. As in Canada many had viral infections that would resolve with a little time. The Ugandan equivalent of tylenol or advil would relieve their symptoms. I saw some strange skin rashes, different from Canada in part because they were on black skin. We had a rapid test for malaria, a finger prick test that gave me an answer in a few minutes. Lots of fevers this morning but none from malaria. Everyone was given treatment of intestinal worms whether or not they had symptoms. They can contribute to malnutrition, especially in young children.
Finally it was time for lunch. We shut ourselves in the examining room and opened our lunch basket. We had been warned, lunch was always the same. the chapatis, pancakes or buns we had been served for breakfast, a hard boiled egg, mango juice and water.
I looked out the window at the brown ramshackle dwelling scattered across the scrub land of the camp. What was I doing here? I have another month of this. The bars on the windows gave me a foreboding sense of being in prison. Perhaps I was already homesick. I had felt this before on the first days in Lira. Life here requires an adaptation, a big adaptation. I’m going to learn a lot about these people and a lot about myself in the coming four weeks.
Have a look at the pictures from my first day.