From spotlight - Winter 2017 - Esther Chevassut's elective to Uganda [p12-13]
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The chance to visit Kisiizi Hospital for my elective this summer was a definite highlight of my nursing training so far. With two friends, I stepped out of my familiar, Western, British context into South West Uganda to experience nursing in a different culture. Kisiizi is a mission hospital community, set on a dust road, in a valley surrounded by beautiful, banana-tree covered hills. Although I've been to developing countries before, the bumpy truck rides, evening power-cuts, opposite attitudes to punctuality and urgency, and all the differences of working in a rural African hospital compared to the UK, didn't fail to hit me. I can't articulate how much I learnt; it was one of the most memorable experiences of my life and one that I will always treasure.
From our first morning, as we hurried in our nursing dresses to 8am Chapel at the hospital, the whole village walking to join us en-masse, we were warmly welcomed by harmonious and loud Rukige worship songs! It was wonderful starting each day in worship, prayer and hearing from God's Word, united as a body of hospital staff and nursing/midwifery students, and as a church family with a shared mission of sharing Christ whilst delivering healthcare.
It did, however, take some time to adjust to nursing in Kisiizi. We are used to our systems, ward routines, protocols and paperwork; organisation felt a bit of a mystery there. Handover was verbal (no printed handover sheets!), there's little documentation and no whiteboards or patients' names on beds. However, before long I learnt how they managed their work. They are resourceful; at home we're spoilt, having everything at our disposal we don't think twice about cost before treating patients. In Kisiizi, I learnt to question why we do what we do and what is in the best interests of the patient and their family. Another difference was the role of the nurse. In the UK, a large part of nursing is basic care, while in Uganda this is the responsibility of the 'attendant' (a relative or friend). It taught me what a role family has in their culture, but it was a challenge seeing some unmet needs that we might have prioritised at home.
Over my four weeks in Kisiizi I had the privilege of spending time in the surgical and gynae ward, theatre, paediatrics and maternity (as an Adult Nursing student, it was my first time working with children and mothers). I soon learnt that people leave problems much longer before presenting to hospital, possibly for fear of having to pay for healthcare, or superstitions, as witchdoctors are still rife in the villages. Kisiizi is a beacon of hope in many ways with an insurance scheme where the equivalent of £2.50 a year enables patients to be admitted free. On the surgical ward I saw many more extreme and sad cases than I'd seen before, such as boda-boda (moped) road-traffic accidents that resulted in broken bones and trauma wounds. There were patients with extensive burns from cooking fires and head injuries from alcohol abuse. It was both shocking and interesting seeing these and learning how to treat them when resources are more scarce. In paediatrics, it was common to see two babies in one bed (and possibly also two mothers) and conditions varying from pneumonia and burns to HIV and malnutrition.
Going into maternity was so memorable, as it was the first time I'd seen births, as well as witnessing the resourcefulness of the midwives and the calm of mothers in an overflowing maternity unit! Alongside the eye-opening hospital experience, we relished getting involved in the community activities outside of work, especially playing sports with students/staff, joining in Bible study groups and exploring some of the beautiful surroundings. If you get a chance to do an elective abroad, GO! You'll learn so much and will be challenged in nursing, culture, personally, emotionally and spiritually.