Teso Safe Motherhood Project
Yoga Noi (a very good Hello) to all my fellow Lions Bay residents:
I have been home now for almost 4 months from my second volunteer trip to the TSMP (Teso Safe Motherhood Project) clinic in Soroti, Uganda....delayed by a cancelled flight when the storms over Europe played havoc....and life seems to continue to fly.
Some of you may have remembered the write-up of the clinic in the Community News last summer. TSMP was a clinic set up in Uganda to service the Internally Displaced Persons, running from the Lord’s Resistant Army and Karamajong of northern Uganda, who, after having their homes destroyed, and family members killed, kidnapped or maimed, ran to settle in the safer areas of Soroti.
Many of you donated monies to help provide medical care, prenatal services, a safe birthing suite and immunizations to the inhabitants of the huge camps that had been established here and in the outlying districts where they are trying to reestablish some kind of life. And for this I thank you, and so do the many men, women, and children that have received that care. I cannot tell you enough of the gratitude that these people feel that they can have some hope for a future.
I thought that you would like an update of the clinic.
I was so relieved to find Martin and Nathan of TSMP on my arrival, waiting for me at the small airstrip in Soroti. I was whisked off to the guest house, where I changed, and was taken to the clinic….no rest for me….to start the long and laborious task of documenting the arrival of the thousands of drugs that had been brought in the day before from Kampala. All had to be checked and double checked and placed in the locked storage room in some kind of order, where they could be easily found, and accessed by the pharmacy. This was one of my biggest chores, and biggest headaches, to keep track of every pill. The organization is very diligent to prevent any corruption, and to reassure their board that the money spent for these medications is not wasted. An elaborate system of check and double checks assures that all meds are accounted for.
I found, as usual, the clinic to be running smoothly, but was so very much busier than my previous visit of 2008..... many more desperately sick people.....Malaria remains a huge problem (a bigger killer than AIDS) exacerbated by the increase in the rains, and government funded clinics without the resources previously available. Many camps had been bulldozed in June by the government and the people had scattered to double up, settle in shantytowns or just relocated to areas bordering other camps, often without clean water, and with latrines in a terrible state, or non existent.
The increase to the very much busier clinic was also due to more established programs that have grown to service the needs here. The antenatal clinic (we would call it Prenatal) was in existence in 2008, providing the women with checkups, vitamins and prophylactic malaria drugs, malaria nets, food, and a safe place to deliver their babies, but now also provides testing for HIV, and treatment for babies born to HIV mothers. There are three more midwives, making seven in total to provide for the HIV clinic, Family Planning and the 24 hour coverage necessary for the birthing suite.
It is not unusual to have a young pregnant couple come in to be tested, and find that one or both, are HIV positive......they do not leave without a result. With much tact and discretion, our midwives counsel the devastated couple, and they leave with some hope for a future and their options, to ensure the best for their developing family. The same compassion is given to the mother who has not felt her baby move for several hours.....an ultrasound is done at the hospital, and she comes back to the news that the baby has died in utero. Support is given in a most uplifting way, by our dedicated staff.
I was so encouraged to see that the immunization clinic that I established with staff help in 2008 was flourishing, with so many more mothers and babies coming in to receive the preventative immunization to Polio, TB. Diphtheria, Tetanus, Hib, Heb B and measles. Vitamin A and deworming meds are also given at this time. And the staff does also still provide these lifesaving measures to the families in the outlying districts to which they travel once per week......but now do so in a larger rented van, rather than in the truck. It is still a crowded affair, to load the supplies and staff to travel the 1-2 hours over rutted and dusty roads to deliver care......where children would die if not seen.
One of the greatest additions to the clinic was the progress made by Family Planning. Contraception pills and Depo-Provera had been available, but now 3 of the midwifes were trained to insert implants, and IUD’s to provide the women with at least 3 years of pregnancy prevention. There is much superstition regarding birth control, and it is blamed for all manor of ills, and is generally not supported at all by the men. With the campaign of “Fewer, Healthier Babies” women are encouraged to space their babies, so that they, and the children benefit.....but convincing the people is a huge task. Our midwives go to the outlying districts to talk to the women there and talk also to those who come into the clinic to have their babies immunized, to consider their options. There has been also a number of young men trained in the education of the women, in the hopes of bringing the men on board. This strategy seems to be working.
One Monday morning, I went with the midwives to help with a contraceptive clinic. The education had been previously been started, and we had been informed that many women were wishing to have the implants or. IUDs. Supplies and sterilized kits were loaded into the truck and off we went, expecting only a few........but to our surprise there must have been 35 waiting for contraception, and another crowd wanting to know more. Working all day, we ran out of sterilized kits, and so, resterilized equipment on a small charcoal stove, and continued. As darkness fell and as there is no electricity, we could not finish, but one woman begged us not to send her away without contraception, and so, as I held the flashlight, we inserted the last IUD for the day.
The case histories told a story of women desperate to take some control over their lives. In a patriarchal society they have few choices, abortion is illegal…if they need a C/S….the husband has to sign for a tubal ligation, and many won’t…. and 12 pregnancies are not uncommon. Many children do not live, and the early marriages (often age 15) and repeated pregnancies weaken the women to provide for their families. Often poor or no prenatal care and unsafe birthing practices add to the story of disaster.
One women was quite amusing, as she expounded that “I work, digging in the fields all the morning, gather the vegetables, haul the water (sometimes for miles on their heads) look after the children, and late afternoon I prepare the dinner, and then....in comes my husband, who has contributed nothing, and he wants to...........so I hide in the bushes, until he falls asleep and then I come home” She thought that we saved her life.....well, perhaps we did improve her quality of it. She had 12 children, 2 sets of twins among them. Similar stories were:
-40 year old, 10 children, 2 died, and I am a grandmother.....I do not want to get pregnant again.
-35 years old....married age 17, has had 12 pregnancies...one spontaneous abortion, and one of the twins died, so has 10 living children.....4 grandchildren
-married at age 14, now 31 and has 5 living children....... on and on
The clinic has outgrown its present home, and there are moves made to relocate in a larger house…..again to rent. Hopefully there will then be a larger birthing suite and post natal area, with separate areas for Family Planning functions. As the current Dr’s office was in the garage, there should be an improved office for the privacy of clients, for an improved pharmacy and laboratory. The van was rented each week, at a great cost….the dream includes, possibly, the purchase of their own vehicle so that reliability is ensured….as sometimes the rental van just did not show up, with disastrous consequences.
All are goals for the future of this remarkable clinic. For those interested in more information, please go to www.midwifeassist.org to view newsletters of the parent organization. For those that would like to donate and receive a tax receipt, please make cheques out to Canadian Physicians for Aid and Relief, (The CPAR is an organization that handles donations for a number of organizations, and is the vehicle for giving Canadian donors tax receipts) with “Soroti clinic-JC” in the bottom left memo area and mail to me to send on: J Clayton, Box 4, Lions Bay, BC, V0N 2E0. Or please mail directly to CPHR at 1425 Bloor Street, West, Toronto, Ontario M6P 3L6. It would be good to let me know so that I can let them know to expect this. All is confidential. Again….THANK YOU FOR YOUR SUPPORT
Click here to visit the Teso Safe Motherhood Project Photo Gallery
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