Thursday, January 24, 2013

Childhood Illness Group Reflection


Academics
In contrast to all the packed-in schedules that we followed together, our group was given two free days, one to relax and spend leisure time together and the other to conduct independent research in our own theme groups. This was a great experience for a lot us, as it was the first time where we were forced to use public transportation (taxis that were mini-vans) to get around places.  On the first free day, many of us went to church in the morning and then to the recreational center for a great swimming session.  Some of us went to the spa and received pedicures and massages to receive the long-awaited rejuvenating moment for all the fatigue that had accumulated in the past two weeks. For dinner, many of us found our way to the “most American restaurant”- Mish Mash – to grab a burger or grilled chicken in the midst of the amazing live music the restaurant had. On the second day, all of us split into our theme groups and conducted independent research. Pediatric HIV group encountered a group of teenagers who sang together to sensitize the community to bring down the stigma of HIV, and for sure, it was an inspiring experience they shared with the group. The Orphans and Vulnerable Children group traveled 140km to get to the orphanage sponsored by Vision for Africa, only to be shocked by the “palace” that these orphans lived in, not to mention the jungle gym and the nice clinic they had. It was very encouraging to hear that many orphans are in good hands and are being helped to be molded into sociable adults.  
On Monday, January 21st we continued gathering information for our independent study. We first spoke to a specialist in the field of Child and Maternal Public Health, of Makerere University. She discussed many of the interrelated factors that are currently impeding the treatment of childhood illnesses. More specifically, she described the poor attitude of health workers, denial of research, lack of accountability and quality control, desensitization, and the improper allocation of health sector funds. Furthermore she stated that a major problem was the vertical approach to health care. An example of a vertical approach occurs when donors want to give all their money to treat just one illness; despite their benevolent intentions, donors are not improving Uganda’s health sector in a broad sense. She stated that Uganda could solve this problem by following a horizontal approach instead. For instance, Uganda could put their donor funds towards improving the general health care package and making certain that all Ugandans have access this packed, rather towards improving the state of just one disease. Ultimately she suggested that a lack of agreement over which healthcare approach to implement was the underlying interference to her solution.
 
Later on we spoke to a pharmaceutical technician and dispenser at the Mulago Private Patient Pharmacy. Moses revealed many interferences that exist in the healthcare sector. He stated that there is too much bureaucracy and health has become political. He also shared his opinion on the Ministry of Health, an institution he believes is corrupt. He also showed us that there is frustration at all levels of the health system. Patients become frustrated with him when medicine is out of stock. (Three times throughout our interview with him, patients were sent away to a different pharmacy because the Private Patient Pharmacy no longer had a particular medication.) His boss becomes frustrated when he asks for the funds to order more of these fast-moving drugs. Finally he himself becomes frustrated because he is the middleman; his patients attack him and his boss neither appreciates nor understands him. Despite all this frustration, people have generally remained complacent; they give up and accept the system as what it is. No one is channeling this frustration towards effecting positive change. There is a general lack of faith and inspiration. It seems that many of the people we have interview throughout this process are merely waiting for a savior, someone who can get rid of the old system and start from scratch.
 

Tuesday we figured out the direction for our final project and created our presentation. We chose to emphasize seven of the interviews we conducted at either Rakai or Kampala. For each interview, we focused on a healthcare problem, a possible solution and an interfering factor that is preventing the problem from being solved.

Reflection
                Before our reflection session, we were able to listen to a fascinating story about Daniela and her friend Ibra of how they got into a dangerous situation with gangster kids and were able to get away unharmed, wallets untouched and funny as it sounds, escorted by these gangsters back to their hotel. Simply by horsing around with the kids, Daniela and her friend Ibra were able to change the atmosphere that diffused the situation to an enjoyable atmosphere from a stern one. After all, “Kids are kids and just kids.” Realizing the power of one’s reaction that can completely change the situation from a dangerous one to an enjoyable situation truly fascinated us.
                On our free day, many of us went to a spa and others went to a recreational swimming pool. While reflecting on the day later on, we discovered that some of us were uncomfortable going to the expensive spa and fancy restaurant. Although group members had different opinions, we all agreed that it is better to open up about our personal comfort levels so that compromises can be made and our time can be spent together. One colleague observed that one’s ability to compromise reflects how much one is willing to find comfort in places outside one’s comfort zone.
                An important question asked in the reflection session was what people wanted to get out of the last five days of our trip. This question ushered in a premature goodbye atmosphere, causing members to make rosy comments and concluding remarks about the trip. The most appropriate phrase to describe our expectations may just be “carpe diem,” to spend and live each day like it is our last, so that we will have no regrets when leaving Uganda, with everlasting friendships and unforgettable memories to cherish forever.

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