How did you learn about REMI East Africa?

I was blessed to learn about REMI East Africa through the founder herself.-Rose Nakame whom I met in Madison, Wisconsin when she was completing her Mandela Washington fellowship. She immediately intrigued me, and I was drawn in by her commitment to the poorest communities and expertise in the field of public health; working towards health equity. As an MPH student, I was required to complete a capstone project of my interests to attain a Global Health Certificate. And, this meeting availed me the chance to undertake the monitoring and evaluation of  REMI East Africa’s multi-award winning “The Health Equity Voice” Project.

What parts of REMI East Africa’s work excited/motivated you to work with them?

Having a passion for global health, I have always sought opportunities to gain international experience. The opportunity to work with REMI East Africa excited me most because it was founded through a commitment and drive to help people. The organization’s mission was felt every time I talked to Rose and read stories on their website. I knew I was doing good work and my small contribution can help, despite never having set foot in Uganda thus working remotely. Knowing that motivated me. I felt a connection and an obligation to do my part for REMI East Africa because people’s lives are impacted.

How was the working online/collaboration feel and go?

It was interesting to work remotely. With REMI East Africa based in Uganda and I being in the United States, there was some getting used to the time difference. Rose and I kept communication via phone, email, or WhatsApp. She was always responsive to any questions I had, which I am very thankful for and eased my evaluation of “The Health Equity Voice” Project. I remain hopeful that one day, I will visit Uganda and get involved in the day-to-day work of  REMI East Africa staff and feel the culture of the country.


What insights or learnings did you find out about REMI East Africa’s work with the poorest and Health Equity in general?

REMI East Africa’s work, especially with The Health Equity Voice, provided me insight into Uganda’s healthcare system. Like many healthcare systems around the world, including the United States, there is a shortage of healthcare workers, especially in primary care. Because of this, communities are feeling the impact and are unable to live the healthiest of lives. I learned that rural healthcare workers in Uganda are working with limited resources, sometimes not paid, are working under poor conditions, and are viewed by the government and people as corrupt. Despite all this, healthcare providers are often determined to provide the best care they can to their communities with the resources they do have. Reading the stories of rural healthcare workers collected by REMI East Africa illustrated to me the good the providers are doing. Yes, the stories all advocated for change, highlighted the downfalls of the healthcare system, and detailed stories of struggle, but the larger message was a plea to improve the country’s healthcare system so that individuals and their families and communities can thrive and live their healthiest.

Any last thoughts?

I am forever grateful for the opportunity to work with REMI East Africa. I hope to see REMI East Africa flourish and continue the amazing work they do. There is no doubt the staff are doing incredible work and are changing lives and are on the course to improving the country’s healthcare system.

I hope my time with REMI East Africa doesn’t end and that additional collaboration can be continued.

By Ryan A Rhode,

MPH Student,

University of Wisconsin-Madison, USA

It was a usual day on the ward in the rural facility I work in (kapelebyong Rural Health Center,in north eastern Uganda), as I was doing a ward round. Like other normal days it is characterised by children having malaria and usually I review them to make sure the dosages are right and they receive the right treatment.
This particular day I noticed a chicken walking through the ward and of course I was furious(given that infection control is very important) why would a chicken be moving through the ward. Then I chased it out. The African local chicken are quite fast and of course it got away.
Surprisingly after sometime I noticed the same chicken coming back to the ward. This time I asked the nurse on the ward what was wrong with the chicken.
She then revealed to me that the chicken is for one of the elderly patients on the ward. “It has even laid eggs and it must be trying to come back to lay another one”, the nurse added!!!
This made me even angrier. How can a chicken just want to lay eggs in a hospital!!!
I matched to the patient with my eyebrows up and I noticed next to her was an old sink that was not in use, with a box and about 11 eggs. The chicken had already laid 11 eggs!!! I asked her in shock, ‘’why is your chicken laying eggs in the ward?” She replied to me, I was admitted to be in hospital for 2 weeks and unfortunately I stay alone at home. This is the 3rd time my chicken is laying eggs and the 2 previous times I wasn’t home to protect it from the neighbours who stole all the eggs. I am not willing to take any chances this time so I have decided to carry the chicken to hospital with me this time, she humbly replied. I told her that unfortunately chicken are not allowed to live in the hospital next to patients because it could cause diseases and she just kept quiet. She looked at me in confusion as to why the doctor wouldn’t understand her concern.
She put me in a dilemma I couldn’t send this lady back home because we needed to monitor her meds and it was unfortunate that she stays at home alone and all her children had moved to the city, like most of the elderly women.
We ended up having to organise for her a separate empty room to be with her chicken. I am still wondering whether it was the right decision. What would you do in the same position?

   
Above you can see the eggs in the broken sink!!                 Above you can see the patient’s bed!! Next to the sink!! With the chicken seated on the eggs below!!


I am Dr. Etonu Joseph, Junior medical doctor from Uganda 29 years of age, I've been practicing for 2 years in a rural area in Uganda in a county called Kapelebyong county. I Started my work when I was 26 years old in the facility. Iam the only doctor there covering the health of 89,000 people. Being a very rural area very few doctors attempted to work there but so far i am the one who has lasted the longest in the facility..The people I serve are the humble indigenous rural people of Karamoja and also Kapelebyong county..I graduated in 2012 at the University of St. Petersburg Pavlov,the Russian Federation. But i started working in this rural area in late 2014. I ride a motorcycle to work because the roads are soo bad in the rains that sometimes it rains on me! BUT I LOVE MY WORK and I have learnt a lot from the people I serve.

By. Dr. Etonu Joseph

As a public health specialist, my work continues to improve the lives of the rural population. We utilize radio, community distributors and edutainment to health educate the masses and engage in advocacy for better health systems.

However, our efforts are still a drop in the ocean and the rural health system is faced with a number of challenges including; inadequate supply of drugs, fewer staffs, brain drainage, drug stockouts and long distances to the health centers. In addition, most specialists aren’t available in the rural areas since they aren’t well facilitated thus the population in need of their services resorts to crude methods.

I believe that good health is wealth and prevention is better than cure. This implies that as a nation, we should invest a lot in the health of our people and borrow best practices to improve our system. The health workers should not discriminate their patients or clients while offering health services to all the people.

Communities should be empowered to realize a community-owned and based healthcare insurance.

This will ensure that people don’t suffer while trying to make ends meet when desperately needing health services.

 

Written by,

Ssesanga Ernest

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Public Health Technologist in Uganda

The government sends only 30% of the total funding requirements for the health facilities leaving them struggling to meet their day to day operational needs.

There many challenges facing the rural healthcare system and these include; limited staffing that in turn leads to work overload, lack of motivation of the healthcare workers in hard to reach areas, for example, health workers sharing toilets with communities, no water sources within a walkable distance to the health facilities. In addition, constant drug stock-outs that insinuate accusations of theft from the public to the health workers.

Furthermore, there is inadequate moral support from political leaders. Most of the political leaders take in what their voters say as the gospel truth to protect their votes thus not making strides to improve the health system.

If we are to turn back the clock of our rural health system, all stakeholders including communities and political leaders must be proactive on matters pertaining their health.

There is a need for dialogue with community members, political leaders, religious leaders and clan leaders among others on the challenges facing health facilities and address the community expectations.

Empowerment of the community to become active participants and advocates for the health system they deserve. Health facility monitoring visits should also, involve the political leaders to feel part of the system and listen to the health worker’s side of the story.

 

Written by,

Ajok Betty Lanyero

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Biostatistician

Working towards a world where everyone can access quality health care irrespective of their socioeconomic status or location.

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