We had diligently researched and studied the Ugandan health landscape in our months leading up to our HIV-TB market study. We knew about the different tiers of healthcare delivery; understood the incidence of HIV-TB in the country; gathered scientific data on sputum induction (the technique needed to get TB specimen samples for diagnosis). I was even fortunate enough to attend the AIDS 2012 conference in Washington D.C. where I got acquainted with a superb individual, Dr. Moses Kamya – the Medical Director of Makarere University, Kampala – who drummed up my anticipation for our fieldwork in Uganda that was to follow in a month.
A week has gone by and what an enlightening, informative week it has been. It feels like we have barely scratched the surface, however – because every conversation we have unearths a new layer of complexity in an issue that on the surface and from our bookish studies prior had seemed somewhat simplistic.
Thus far, in the chain of command – we have examined top government Ugandan hospitals and rural level IV health centers.
Is there a health system? Yes. Is it functioning? To some level, yes. Is it bogged down with lack of resources, finances, and increasing incidences? Yes. Is it bloody difficult and depressing to try to implement something? Yes, yes, yes.
And yet, late night conversations with my friends here – both working on the project and those exploring similar areas in social entrepreneurship – underline the fact that there is tremendous potential. In fact, on all the rungs of healthcare here – we have spoken to persons who are passionate, dedicated, and really committed to this collective thought of eradicating suffering. Through whatever skills that they are able to contribute. We have talked with healthcare workers, medical doctors, pharmacists – who all greet us with warm smiles and then engage in a sincere conversation about the issues that Uganda is facing today.
I met a man today who left a strong impression on me. A health care worker at a Center IV, he is the individual responsible for facilitating HIV patients through the diagnosis – education – treatment – adherence process at the health center. His core responsibility, however, lies in empowerment. Asking him how he manages to truly connect with the patients, he responds that it is because he is one. And has been HIV+ for the last 10 years. And he has, first-hand, seen his CD4 count grow from 20 to 500 in the matter of months due to the work of ARVs (antiretrovirals).
I have been through this – I know the suffering, the denial, and the longing to just give up. And by revealing my own status to them, I want to show them that there is hope – there is a healthy, thriving life – if all they do is comply.
He is fervent, and strongly emotional. We feel his strength and can-do spirit affecting us, especially as we try to unravel the myriad of strings that a jumbled healthcare system initially presents us. It is this man and many, hundreds of others like him that will lead Uganda to a better tomorrow. This country is not called the Pearl of Africa for no reason – it is precious, gorgeous – and its shine only brightens with men like my friend from Health Center IV.