Engeye Experience: Reflections on Uganda from an Anne C. Carter Global Health Fellow

Through the sponsorship of the American Medical Women's Association I had the wonderful opportunity to go to East Africa to work in a primary health care clinic from February 4-18, 2012. As a member of the Anne C. Carter Global Health Fellowship, I worked alongside another Carter Fellow, Nisha to promote health literacy and education in Ddegeya Village, Uganda. Our primary goal was to create a series of videos that would be displayed in the clinic for patients to watch while they waited for care. On ground Nisha and I created two videos -- an introduction to Engeye Health Clinic Video that oriented patients to the clinic and helped navigate their experience, and a malaria education video that would be shown not only in the clinic, but to surrounding primary schools. 

To be honest, my first few days in Uganda were not pleasant. I was frustrated with the use of latrines (yes, I missed using toilets!), the widespread corruption of the Ugandan government, and the glaring poverty. It was evident by the myriad of children we saw with fuzzy red hair (due to vitamin deficiencies) and distended abdomens (due to Kwashiorkor), that the government didn't adequately address the needs of its citizens. An overwhelming majority of Ugandan citizens live in rural areas with no access to running water or electricity. 

I began to ask myself: what is the point of helping a group of people that receive no help from their actual government? Would any work we do here be sustainable? 

Then I started to slowly realize the impact that Engeye clinic and its foundation have provided for the people in Ddegeya. Every morning when I woke up, I would already see a row of patients lined up waiting to be seen by physicians as early as 6:30 am. The patients would dress in their best garb, despite their economic conditions, to look respectable to the physician. Patients traveled from not only Ddegeya village but surrounding villages to be seen because they realized even with transportation costs, their total costs would be considerably lower than attending a nearby clinic. The patient does not pay a fee to see a physician and the medications are heavily subsidized. Children as young as a few weeks old to adults in their 90's were being treated. Patients would wait patiently, often times many hours to see a physician with no complaints and exceptional gratitude. It was difficult for me to imagine an American patient waiting several hours to see a physician and still have feelings of gratitude for services provided to them. This was indeed a different experience. 

As Nisha and I progressed through our first week together, we transitioned from working in the clinic to creating our series of videos. Creating the malaria video was incredibly fun although we definitely faced some challenges. It is absolutely true: anything you do in global health is considerably more difficult! We dealt with limited electricity, limited lighting, and problems with casting our local community. However, it came out wonderfully and we even added popular music from Jay-Z and Kanye West to the background to keep the children interested. 

Malaria continues to be an incredible source of mortality and morbidity in Africa. In Engeye health clinic, it is our number one pediatric diagnosis. Any child presenting with a fever gets a blood smear and an overwhelming majority of these children test positive. Malaria health education was not only necessary for the children but a rewarding experience for me. 

We started traveling to primary schools in the area: Sydney Paul, St. Gertrudes, and Bunyere. We went from classroom to classroom, showing the video we created about malaria that included the signs and symptoms, common myths about transmission, the actual route of transmission, preventative techniques and proper treatment. The children were glued to our computer screen and even mouthed the words of "Forever Young" by Jay-Z as it played in the background. 

We then showed the students posters that we created in the United States about malaria (signs/symptoms, treatment, prevention) and tested their knowledge. The children were bright and caught on quickly. At the end, I asked how many children wanted to become physicians - about 70% of each class would raise their hand. I would chose a student and help them listen to my heart and lung sounds with my stethoscope. It was magical. 

From seeing patients in Engeye health clinic to working with children in the primary schools, my trip to Africa was incredible. I went from being frustrated about the widespread poverty to realizing the immense impact that the Engeye foundation has for its community. Not only does the foundation run a clinic, but it also provides educational funding for children who are extremely bright with limited resources. Through Engeye Scholars, 25 students in the village are being funded to attend school via private donations from the first world. Next year the program is expanding to 50 children. We worked alongside many Engeye scholars through our malaria education and they are absolutely amazing children. 

To help any society rise up from the devastating effects of poverty you must have two components: health care AND education. Without the two, you are not creating sustainable solutions for a community. The Engeye foundation does just that. 

After coming back from Uganda, it was difficult for me to adjust back to the first world. I never realized how excited I would be to use a toilet or turn on a faucet to get warm water or turn on a light switch to get electricity. This trip definitely pushed me out of my comfort zone and gave me the opportunity to experience life in the third world. I was born in the third world (India) but the poverty in Africa was larger in scale and up-close. It made me view my life in a different manner: I have been blessed with an incredible life and a wonderful education, but how will I use it? 

On a lighter note, much to my surprise, I was informed that all the malaria nets in the clinic were sold out within a few weeks after our return to the states. Whether this was due to our education or not, I will not know, but it did make me glow inside. 

One of my favorite quotes of all time is by a doctor in India, founder of the non profit Aravind Eye Care System, named Dr. Venkataswamy. They perform thousands of free cataract surgeries for Indians who live below the poverty level. He states, "When we grow in spiritual consciousness we identify with all that is in the world. So there is no exploitation, it is ourselves that we are helping, it is ourselves that we are healing."

In many ways, I feel that this quote describes my experience in Uganda by working alongside adults and children of Ddegeya Village. So, thank you Ddegeya, for helping me heal just a little bit.