Take-Aways to Date

It’s quite remarkable that after only 10 days of working within Nakaseke District, our team has really come to understand how the health care system works.

Well, sort of.

We’ve visited multiple health centres, Village Phone Providers, and traditional healers in each of Nakaseke’s 8 sub-counties. We’ve toured the district hospitals and spoken with countless nurses, doctors, clinical officers, and midwives. We’ve seen disease incidence reports and noted drug inventories. But as Amanda mentioned, we are constantly plagued by contradictions and inaccuracies in our data collection. More importantly, we struggle at times to actually define what the core issues are.

Somewhere along the dusty roads, however, we have come to a few realizations:

- Communication, in and of itself, is not a silver bullet here. Any communication solution needs to address correlating issues: lack of cellular network, lack of transportation and poor road conditions, understaffing, etc.
- Sustainability and local ownership is the key to any solution. We have seen far too many Western-funded projects here that have fell into ruin due to poor maintenance and expensive ongoing costs. Any community project should use already-identified local leaders, such as the community health mobilizers that are attached to the Health Centre IIIs and who are already doing great work.
- Culturally, communication means different things to different people. This applies to both the difference between communication here and in the West, where a patient may feel comfortable calling a physician to ask for medical advice. It also applies to the difference between urban and rural areas in Uganda, where communication plays differing roles to different people. Physicians at Kiwoko hospital wanted internet access. But for a rural health care provider at the village level, communication meant simply being able to easily access the bigger hospitals with transportation such as motorcycles or pickups.

While these impasses are great, our team sees promise and potential in the health care system here. As infrastructure improves, more health care providers will move to rural areas to live and work. Improved roads will give poor villagers better access to health care in district hospitals. And most importantly, the beautiful and motivated people we have met along the way will continue to work hard to improve the health care system in Nakaseke and Uganda as a whole.