Lenten Witness at Ministry of Defence 2 April 2012

 

 

 

Working in Africa as a doctor is of course a great privilege but also a great challenge. It is hard to believe the extreme poverty of many of the sub-Saharan African countries. Even after 20years of African experience there are times I am shocked myself. The life expectancy in Uganda is 54 years whereas in UK its 82 yrs. This simple statistic represents most inadequately the suffering of and grieving for many thousands of premature deaths. Watching helplessly while many young people die is the medical reality. At a recent medical meeting in London I presented the data of the age groups in our intensive care unit, ICU. Overall about 30% of our patients in the intensive care unit die and of all the patients in our ICU 44% are under 18 years of age. I hope shortly to place on the web page of African Mission a more detailed analysis of our ICU outcomes for those who would wish to see the specific areas and diseases the ICU is able to help.

It’s not just a matter of the many diseases which are prevalent in Africa, diseases which we hardly ever see in Europe such as malaria and tetanus and typhoid but also the entire infrastructure is inadequate for what we in Europe would consider essential. Getting normal email, boxes by normal post, phone calls, driving on normal tarred roads, water and electricity at the hospital and in your own living quarters cannot be taken for granted. All of these essential logistical support structures have to be built from scratch. African Mission in London is my most significant logistical and donor support group which makes it possible for me to function with some efficiency in such an environment. It is also a special privilege to work in St.Mary’s Hospital Lacor Gulu Uganda which has as its special mission to bring quality care to the poorest. All patients are subsidised significantly for the hospital costs and there is no special fee to be admitted to ICU. Over the last year the African Mission Charity has been a support in many significant areas where the hospital in its overall plan has not been able to focus where I, in my close working contact with my colleagues, have been able to identify special needs. Our anaesthetists in theatre perform a very essential and skilful task but are often without adequate books of the correct level to study and reflect on their wide experiences. African Mission has assisted with book purchases. Acquiring a laryngoscope for each anaesthetist, a special instrument for the
anaesthetist to place safely a tube in the lungs of patients, has improved the safety of surgery in the operating theatre.

Surgical mortality in Africa is an area which is gaining more international support and is where African Mission has assisted me over the 10 years that I have been at St.Mary’s Lacor. The question which faces the physician in the context of extreme poverty is whether any form of ICU care can be sustainable. Hospital care of any sort is not cheap and is ICU care sustainable? Physicians have to face the reality that their resources are limited. The most complex equipment that the ICU possesses is the Glostavent ventilator for those patients who are too weak to breath on their own. Often this weakness is only a short interval and many of these patients recover. African Mission has been crucial in keeping our Glostavent machines in good working order with spares and upgrades that build a strong capacity for this facility. The electricity for the ICU is from solar power and the oxygen is mainly from concentrators which filter ordinary air, removing nitrogen and leaving almost pure oxygen. In this way our machines consume hardly any disposables and run cheaply. This means when I ask African Mission for spare parts it is a very considered request for an item that will maintain our hospital care with sustainability. Your donations are making the hospital care efficient and sustainable and reaching direct patient care and supporting those on the very face of critical patient care. We now have a good supply of antibiotics which means we can reduce delays in the treatment of septic conditions thus giving the patient a better chance of survival. I have included 3 photos of interest. The first is a mother and child whom the ICU cared for after a major operation. Mortality after any kind of surgery in a small baby is high in Africa and we are grateful to all the staff who contributed to this child’s recovery. The photo of a boy who has recovered from tetanus after being on a Glostavent ventilator for 4 weeks shows him now in the process of rehabilitation. His poor nutrition is another area of challenge which we have to face in the future.

The third photo is of the team of people who contribute to the sustainability of our ICU care. Anaesthetists know their debt to engineers so that their life saving equipment works well. This third photo shows our hospital engineer getting instructions from the Glostavent engineer who was able to visit us this year from UK. African Mission has supported many developments of life saving significance in the ICU and operating theatre. In the future we will need to maintain this momentum. Our anaesthetists and nurses need more educational opportunities if they are able to sustain the care they are giving now and this is an area we may need to focus on soon. Thank you for your prayers and financial support.
http://africanmission.pwp.blueyonder.co.uk/index.htm

Ash Wednesdsay 2012. I had time to write this on 22 February at the Ministry of Defence. I didn't have time to finish it which would have been, " Choose Life". A small chance to speak truth to power. No charge at that time but later in Lent, 2 April 2012, I was charged with Criminal Damage for trying to do the same.