Medical Care in Midigo

I should probably describe Midigo town a bit better.  It is really more of a trading center than a town.  As I have mentioned before, there is no public services, at all…  There is a elementary school, and a secondary school.  A small health clinic is just at the edge of town.  The center of life is the market.

The health clinic has really improved a lot since I first visited.  When I first saw it, there was no food.  Each patient was responsible for their own food.  There was no medicine.  Getting medicine would require a 30 mile walk to the nearest town.  Even then there was only the most basic of medicine.  There was a single trained health care worker.  What they called a medical officer, something similar to nurse practitioner.

As I mentioned before, the child mortality rate was about 40%.  This little center had about 4-5 deaths per month from just snake bites!  They tried, they really did, but this was at the end of the line.  Midigo was the last stop before the frontier.  The Ugandan government just did not get up there.  Any supplies sent to them would get stopped at several larger towns on the way, and badly needed meds taken for emergencies there.

One of the first items on our list of work there was to get an idea for situation.  We brought a team of two MD’s and two RN’s, plus several lay people.  We set up camp in the secondary school (they were on break) and created an outdoor clinic in front of the medical center.  The local official sent word that we were giving a free clinic and waited to see what would happen.

The next morning we were astounded!  A minimum of 4,000 people were waiting for us to get started.  I drove down the roads and found a constant stream of people walking towards the clinic for miles around.  We had our answer, the problem was overwhelming.

The picture above is just part of the line waiting for medical care. A couple of things to note. First, the people are well dressed. This was a big occasion for the community. A social event as much as a serious medical clinic. So each person wore their "Sunday Best". The second thing to notice is the line of men on one side and women and children on the other.

This was something that would frustrate me to no end. Probably as much as anything drive me to anger. The priorities always went to the strongest. Whoever could push their way to the front wanting to get some free medicine, for really no medical reason. Left behind, and sometimes left to die were the weak who could not force their way front.

To deal with this problem, we would form at least three lines. One for the men, one for the women and small children and one for the school children (the teachers would bring them from class in hopes of getting them some help). I would stand and choose people from each line as I saw fit, trying to take as many of the really sick before the healthy men would start to complain. Then I would take a token man from the line.

Additionally, I would send our nursing staff to quitely walk through the crowds of people. They would greet the women and without drawing too much attention, examine the babies. Many, many times they would find desperately ill children, sometimes hours from death being shoved out of the way. So the nurses would take them one by one around the back of the clinic and bring them in for treatment. A lot of live were saved this way.