Too often, government hospitals in Africa are a challenging environment to work.
Neurosurgeon Dr Mukasa is explaining the situation for children with Spina Bifida and Hydrocephalus in Mulago National Referral Hospital. A tired, overworked nurse next to him was taking a rest after preparing a pile of dressings out of a large bandage roll. One has to be creative.
While the old hospital is being renovated (it has been close to finishing for months now), a temporary ward is in a dilapidated, overcrowded part of the hospital. There was literally no place in the ward for another bed. The department head's office was in between a huge pile of carton board boxes used as an announcement wall. The unit sees annually about 300 newborn with SB and about the same amount of H, next to hundreds of serious trauma (check ou the Ugandan favorite method of transportation, the boda boda: https://en.wikipedia.org/wiki/Boda_boda). This could be the beginning of a very sad post. But!
In Dr Mukasa's colleague, Dr Alex, we have found a great partner, willing to help develop a comprehensive programme at the hospital. Ruth Cynthia is the chairperson of the Shynea Uganda bringing together over 5000 families in this wonderful country and pushing for reform. With Dr Mukasa's support, we managed to meet the executive director of Mulago hospital who pledged his support for a multistakeholder approach (it still has to happen, I know).
This was following a very positive roundtable at the Ministry of Health, where the permanent secretary with her staff presented to some 40 press people nutrition programmes in the country, including some Folic Acid supplementation and fortification programmes.
The situation is still not good. A lot of work still needs to be done. But it is incredible to see the maturity of our network, the very active involvement of the people concerned and the credibility that was built over the years. Where in some countries, I am disappointed in the lack of possibilities and the amount of human suffering that is left unaddressed, here there is energy and trust and the willingness to improve the situation.