Where I work
With less than two months left in my fellowship, I’m starting to feel nostalgic about my time remaining at Gulu Referral Hospital. It’s difficult to capture the campus in pictures alone. Images cannot convey the atmospheric elements that make this place so distinct.
Gulu Hospital is one of the 13 Regional Referral Hospitals in Uganda that are funded by the Uganda Ministry of Health. Most of the services provided are free. In 2012, the hospital had a mere operating budget of 762 million Uganda Shilling (approx. $290,000) (The Observer, 2012). According to internal records, the funding covered 154, 000 outpatients and 61,000 inpatients (The Observer, 2012). On average, this translated to about 423 patients a day from Amuru, Nwoya, Lamwo, Kitgum, Pader, Gulu, Agago and Oyam districts (The Observer, 2012). Heavy patient flow, coupled with budget constraints naturally contributed to some service delivery failures. With not enough staff, a shortage of available beds and medical supplies, the hospital found itself battling with high infection and mortality rates, which were particularly felt in the maternity ward.
Today some of these issues have been mitigated by higher budget allocations. This translates to at least two staff members on duty on any ward at all times. It also enabled the procurement of necessary equipment such as inverters. Frequent power outages in Gulu have forced the hospital to run generators on an almost daily basis. Generators can however consume up to ten liters of fuel per hour. Inverters offset some of the cost by storing large amounts of power that can sustain a single unit for at least ten hours before it has to switch to generator. The acquisition of a new ICT system also facilitates better tracking of incoming or outgoing supplies. The mental health unit however still chronically stays under supplied. This applies more to equipment (i.e. thermometers, sphygmometer, oxygen tanks, etc.) than psychopharmaceuticals. One of the most simple but poignant changes at the hospital was the introduction of staff incentives such as sugar for tea and a water dispenser. According to colleagues, this simple and small token of appreciation by hospital administration generated a significant positive shift in attitude of employees toward their employer. Contented employees were more likely to pursue the contentment of their patients.
What I will miss most about the hospital is the opportunity to collaborate with colleagues from around the world. Where else can I receive CPR training from nurses from the UK, participate in a workshop involving German, Italian American and Ugandan Psychologists and have access to specialists on conflict related disorders from around the globe? Elie Wiesel, a holocaust survivor and one of my favorite writers once said “Wherever men and women are persecuted because of their race, religion, or political views, -that place must – at that moment – become the center of the universe”. I feel that Northern Uganda has become a manifestation of Wiesel’s sentiments. The atrocities that have happened here because of the LRA have quietly attracted an army of NGO’s, professionals and volunteers who are participating in restoring a community. This peaceful hands on international collaboration is what I feel I will miss the most.