Written by Vinussa Rameshshanker
FullSoul celebrates the resilience of the midwives who operate under such challenging circumstances within public healthcare settings. Today, on International Midwives’ Day, I would like to share a story with you about a midwife whom I’ve had the pleasure of getting to know over the course of my internship. By doing so, I hope to bring to you – wherever you may be – a little piece of the endless inspiration I am exposed to on a daily basis and the motivation that drives me in my work with FullSoul.
Meet Sister Namaala Alex, a Senior Midwife and the Department Head for maternity services at Mukono Health Centre IV. Sister Alex’s professional journey to become the midwife that she is today started when she was in her mid-teen years. Her mother had fallen ill and had been admitted to the hospital. While there, her mother was tended to by nurses in both pink and blue uniforms. It was the nurses in blue uniforms (whom were also trained as midwives) that really stood out to Sister Alex’s mother. As a patient, it was their quality of care that she truly appreciated. And so, she told Sister Alex that she wished her daughter to be like the blue uniformed nurses when she grew up.
“As I move ahead, I am focused on building my career and I keep looking for more opportunities.”
Over the years, Sister Alex has prioritized furthering her education, upgrading her initial certificate from a local school of nursing and midwifery to a diploma, and then finally to a bachelor’s degree in nursing. These efforts were fuelled by her experiences in the field. As she was given more responsibilities on the ward, from standing in-charge to becoming a department head, it was the gaps she realized in her training that fuelled her drive to better equip herself as a healthcare provider. Now, Sister Alex wishes to build the younger generation, helping to mould midwives in-training into confident, competent healthcare workers that are able to provide high quality care to mothers. True to her passion for education, she recently returned to school to complete a postgraduate degree in medical education.
Being a midwife has its challenges, as does managerial positions such as the role Sister Alex holds on the maternity ward. For instance, as a midwife, you hold great accountability when providing care in a public setting with limited resources and a high workload. Sister Alex is acutely aware of how the environment in which midwives provide care greatly impacts their ability to perform their duties and is extremely passionate about lobbying to address these challenges. Yet, these issues cannot be addressed alone. Every Monday morning, the maternity ward staff and students at Mukono Health Centre IV come together as a group (or as a family as Sister Alex puts it) to share their problems, but also to rejoice in their successes.
Without question, our midwives, including Sister Alex, are not solely healthcare providers. They are the superheroes fighting for the lives of mothers and children, the advocates lobbying for improved healthcare for all, and the protectors of healthcare workers and their rights – the list is endless. So today on International Midwives’ Day, above all other days, FullSoul and all of our partners would like to take the opportunity to appreciate and celebrate the midwives who show selfless dedication to their profession. On behalf of all of us, thank you.Read More
Written by Vinussa Rameshshanker
Let us take a few steps back in time to my third visit at Kawolo Hospital, one of FullSoul’s three pilot facilities in which we first implemented our Maternal Medical Kit (MMK) project. It’s early February (which means it’s scorching hot in Uganda), Meron and I are outfitted in our hospital scrubs, and we’ve come to Kawolo to conduct an observation shift in the delivery room of the maternity ward. These shifts were extremely valuable to me at the start of my internship, as it helped me immerse myself in the context and learn about the inner workings of the hospitals.
Tentatively, I greet the head midwife of the ward and make my way into the delivery room to the back wall so that I can avoid being in the way. It is a cramped space with low air circulation, three delivery beds, and a small stand of basic medical equipment. There is a mother already on one of the beds and she is howling in pain more so than other mothers I’ve observed with previous deliveries. I can tell by her moans and restlessness that she is almost fully dilated and ready to push. As the midwife starts to make her way over, I lock eyes with the mother and for a moment I feel it all – her pain, her anxiousness, her fear, and her anticipation – as if it were my own. Without realizing it, I walk across the room, take her hands in mine, and try to soothe her as she pushes new life into this world. Just for a moment, the three of us are fighting and pushing together, wishing so deeply that in a few moments, she will be holding her pride and joy in her arms. Minutes which feel like hours pass and with a final push, a final squeeze of the hand, and one last scream, a baby boy weighing in at 2.8kg is born. As soon as this happens, I can feel the mother’s body relax as she loosens her grip on my arm. Yet, I am still tense as I wait to hear the baby’s first cry signalling that the he is alive and well, complete with a pair of pumping lungs and strong, kicking legs. Soon enough, I hear a high-pitched cry ring through the room. The mother’s fear and pain that I felt so deeply within me has now been replaced by relief and pure joy. We share a shy smile before I step back to make room for the midwife, who is calmly cleaning up the baby before placing him gingerly in his mother’s embrace.
Now, I’d like to bring us to the present – it’s nearing the end of April and I’ve come a far way in terms of finding comfort within my new home here in Uganda and my role with the monitoring and evaluation team for FullSoul. Despite the weeks that have passed, all the experiences I’ve had, and the lessons I’ve learned, I am constantly brought back to those few tense yet precious moments I shared with the midwife and mother in the delivery room on that hot February morning. What transpired was a true expression of empathy by both myself and the midwife. We allowed ourselves to step outside our own existence to join the mother in her experiences and emotions. Expressing empathy is an extremely powerful and significant act – one that places you in the life of another, where you are not only walking in someone’s shoes but rather feeling the ground beneath their feet at the deepest level.
Personally, I view the ability to experience empathy as analogous to a light switch. Like a switch that triggers a series of steps in an electric circuit to brighten a room, empathy has the ability to move us within, to touch us so deeply that we learn how to intertwine our lives and views of the world with those around us. To put it simply, empathy works to drive us to take action in the world. In fact, I feel that empathy might be the single most important ingredient for global citizenship, igniting our capacity to understand the workings of the greater world beyond our own circles and reflect on one’s role within these these complex systems. Without a doubt, empathy awakens the global citizen within us, pushing us to engage with the world and accept our part in protecting global welfare.
Since February, I’ve had several experiences similar to the one I recounted above from Kawolo Hospital. Some disheartening, some joyful, and some utterly frustrating; yet all which caused me to experience such intense emotions and drove me to act in some way. For instance, I have recently been spending quite a bit of my time working at a desk as opposed to within the hospital settings immersed in analyzing data from our recent efforts to assess the evaluation readiness of FullSoul’s maternal health project. Despite my physical distance from the healthcare facilities, its these experiences that evoked such strong emotions within me that serve as a constant reminder that every ounce of effort dedicated by myself and the rest of our FullSoul team towards achieving FullSoul’s mission matters. Whether in the field or in the office, its expressions of empathy and the recognition of myself as a global citizen that allow me to approach my work with drive, compassion, and a full soul, regardless of the task at hand.
Written by Meron Samuel
“You Are Welcome”, a common phrase that I have heard most people say in Uganda and one that is used sincerely. Whenever you travel to a different country or interact with individuals from different backgrounds, culture is always a topic of conversation. Culture is the foundation for differences and commonalities between people and the locals in Uganda are delighted to share their culture and language to visitors. This sharing was foreign to me as I did not experience it growing up.
Growing up in a small city in Canada, where the population of people of African descent is low, I never felt like I truly belonged. My heritage includes East African and it was challenging to create personal connections with people that came from the same culture as me. My elementary and secondary school experiences have not significantly contributed to my understanding of African history and culture. My knowledge was only limited to stories from my immigrant family members. I remember during my time in history and social science classes, these topics were either minimized or glossed over. The lack of emphasis on African history, culture, and legacy led me to believe that these issues were unimportant. Yet as I grew older and began to watch more news media, I became increasingly aware of the dissonance between what was reality and what people wanted to believe. I was itching to learn more about the diversity of Africa and to understand real life there. I wanted to learn beyond the struggles that I’ve seen from Western media, which can often shape the public’s view and misrepresent African identity. These representations have become rooted in the consciousness of most individuals I have met in North America. I sought out anything that I could learn—from books to university classes—but it wasn’t enough for me. Soon after, I came across an opportunity to work with FullSoul and the Maternal Medical Kit (MMK) program as a Project Manager Intern and was immediately hooked on the idea of experiential learning. The chance to interact with people in Uganda would give me invaluable insight that goes beyond what I would learn from school or news articles. Exploring and branching off into new environments have always been an aspiration of mine and I’m very grateful that life has brought me here.
From the moment I arrived in Uganda, I was greeted with warm smiles and friendly hellos. When you are in an unknown environment, your sense of awareness starts to increase. Residing in our guest house in Mukono, you are awoken by the sound of roosters crowing and the birds chirping in the early morning. The call of prayer from the mosque nearby is also a reminder to me of the diversity of religions that are within this community. The sound of taxi conductors yelling names of cities and the honking of cars gets increasingly louder throughout the day. Our neighborhood is filled with young children with wide grins and endless giggles who run up to you each time they see you walk by. Around the corner of our guest house, there is a music school with a performing band that plays almost every evening. The sound of trombones, drums, and laughter in the air fuels my soul.
Because of these features, community cohesion is stronger than ever. You never feel alone here. So many of these aspects are like the glue that holds the community together. I constantly learn from the people around me through daily interactions, which helps me better understand diverse perspectives within the world we live in. My new friends share what is important to them, from their dreams to aspirations. This makes me believe that we are not quite different from one another. The interactions with people that I have met here have given me comfort knowing that storytelling strengthens relationships. It is also a reminder of the similar stories I grew up listening to as a child of immigrant parents. The harmonious connections that have been created is something that I have always been searching for back in my hometown. I am planting my feet firmly on the ground with confidence, knowing that I feel a sense of belonging here in Mukono and grasping the narrative of my family cultural roots. I am constantly exposed to an environment that continues to teach me some of the most essential values and lessons. These values include developing open mindedness and communicating effectively with people from diverse backgrounds, which have become increasingly significant than they ever were before in today’s diversity and culturally aware society.
The two months working with FullSoul with my fellow intern Vinu have been a whirlwind. Adjusting to our new environment has kept us pretty occupied. From getting accustomed to the hot weather and busy streets, trying the local food, and finding our way around health facilities, moving to Mukono with numerous things happening all at once felt like an emotional rollercoaster.
I remember the feeling of shock during my first time walking into FullSoul’s partnered hospitals for introductions. The waiting rooms were crowded with people. The equipment were either old or not functioning properly. Other resources, such as beds and mosquito nets, were scarce since the hospital is low-funded. The fast-pace environment and the surplus of patients and low-staff can give you a sense of panic. Despite the conditions in which they are in, the midwives continue to push through and work with what they have. I continue to witness both patients and midwives greet each other with smiles and friendly conversations from all around the facility. It is evident that this is a part of Ugandan culture, which made me feel at home with my family again. It was encouraging to see how receptive healthcare staff were towards the work that FullSoul is trying to do in providing instruments and improving maternal health. However, I am learning so much more from the midwives and their tremendous efforts to be as efficient as possible to keep mothers and babies safe and healthy.
Part of the work that Vinu and I do is conducting a needs assessment in the labour wards to see how instruments in the MMK and other resources are used. This is done through observations. Observation is one of the best ways of learning. It allows you to see exactly how a process is done and understand the technicalities of it. Learning through observation wasn’t easy for me initially. I caught myself deliberating Western practices, which greatly impacted my learning ability. Having discussions with the midwives and letting us into their world as to what they perceive as challenges has opened my mind in ways I never thought it would. For people living in the developed world, it is hard to swallow the truth that solutions to problems may look different in other places around the globe. Due to the lack of resources in hospitals, improvisation is common among midwives. Allowing yourself to take a step back and comprehending the bigger picture to the problem is tough but truly rewarding. I am grateful for the amount of patience from the people I am learning from and to have the opportunity to connect with the midwives while understanding the problems they face when working in the labour ward. Working alongside with them has been an enlightening experience as their resiliency and perseverance is always inspiring. I am growing strong roots in Mukono by making connections here that will last a lifetime and I look forward to what the future has in store.
Who am I? For starters, my name is Vinussa (Vinu for short), I’m 21 years old, and I identify as a woman. To add, I’m also a student at the distinguished University of Waterloo in Canada, I come from a middle class family who can provide food on the table and a roof over my head, and I’ve been fortunate enough to be influenced by numerous role models and mentors in my life that have inspired me to realize my own potential and shoot for the moon. Come to think of it, I’m more than just a young woman. Rather, I’m a young woman of privilege.
Privilege is an interesting concept though, ebbing and flowing in unison with the context you’re in. For instance, although not all Canadians are fortunate enough to attend post-secondary, my status as a Canadian university student carries a lot more weight in Uganda, where educational attainment rates are low and poverty is pervasive, than it does in Waterloo. In the past couple of months, realizations like the one I’ve described above have led me to question the role I play as a FullSoul intern and how the weight of my privilege impacts my work.
Coming to Mukono Town, Uganda, it is evident to both myself and those around me that I am a Westerner. I don’t look like, sound like, or speak like the Ugandans that surround me. Experiencing this stark contrast in my day to day life, especially through working within the global health discipline with FullSoul, I am constantly reflecting on the concept of white saviourism. Or in my case as a minority woman, Western saviourism. Rooted in centuries of colonialism and racism, the Western saviour complex operates under the assumption that those from the Western world should be or are able to ‘save’ those from lesser developed countries such as Africa. The Western saviour complex can take many forms, from creating social media narratives that feature a Westerner amongst a group of young African children to the absence of critical reflection on behalf of the Westerner working within the international development sphere in regards to their work and its true impact on the greater society.
Working within FullSoul’s partner health facilities, it can be inspiring to learn from the healthcare workers that face such strenuous circumstances in their daily lives, delivering babies without the proper tools or finding the needed medications when there is none in stock at the hospital. At the same time though, it can also be frustrating to see the needs within the facilities and the stresses of the workers. When those frustrations become too much to handle, sometimes it can feel like the only solution is to simply provide the funds to fill the gaps that I am observing in the moment, such as purchasing some medications for a mother with high blood pressure or some new medical instruments for a delivery. But would solely throwing money at the problem of poor maternal health in the country address the larger, more complex issues rooted in the country’s political and social systems that are at work? It may be the easier solution, but it’s not necessarily the correct path to take.
It is times such as these when I reflect back on Western saviourism. As a FullSoul intern, the concept of ‘helping’ in the developing world means a lot more than providing funds to address immediate challenges within the healthcare settings. Although based in Canada, FullSoul as an organization does not work alone, but rather with communities. Whether it be partnering with the local Rotary Club of Mukono to expand FullSoul’s Maternal Medical Kit (MMK) program or listening to healthcare staff to understand both the challenges that are spoken of and those that are unsaid, FullSoul aims to catalyze local communities to take ownership of both the problem of poor maternal health, as well as the solution. By working with these communities, we can create enabling environments that are conducive to supporting better maternal health in Uganda, through supplying medical instruments, providing training on proper sterilization techniques appropriate to each partner facility’s capacities, and adopting participatory approaches for evaluation of the MMK program to support growth and improvement in the future. With those considerations, the efforts to address the issue of maternal health reach beyond immediate gaps to support long-term impacts, helping to create a brighter future for mothers, children, and communities at large.
When I return to Canada, it’s not the stories of my work and my presence within the Ugandan healthcare facilities that I’ll share. In the end, I, as a FullSoul intern, am not the main character of the story. Neither is it FullSoul, standing alone as an organization to ‘help’ strengthen the healthcare system in Uganda. Instead, I will be sharing stories of the work accomplished by the communities I engaged with during my internship as they are the real protagonists in this narrative. Stories of the enthusiasm from Mukono Rotary Club members as they work towards supporting the MMK project or of the collaboration between healthcare staff to improve service delivery practices will fill the room when it comes time to share about my experiences in Uganda and my work with FullSoul. Just wait and see…Read More
We’re here! We’ve arrived safely from a journey close to 24 hours long. 10:50 PM and bedtimes have never been so exciting.
But of course, we have yet to meet our new friends Asha and Bersh, ‘Bash’.
Two lovely Ugandan young people who we soon learned have passion beyond their years to change their country and see it to become the best it could be. And since life is all about opportunities, to work with FullSoul and have a chance to make a difference one way or another, they became part of our team. They guide us through everything cultural and all things Uganda.
We took our private hire car-a luxury as we soon learned- with 4 people at the back, the driver and one person at the front, no seat belts and loads of speed bumps. The car ride alone was an adventure.
We arrived at the Gorilla Guest House (it’s still crazy to think that’s it’s named ‘Gorilla,’ because there are real Gorillas in this country- like the ones you grow up watching on National Geographic).
We unloaded the car, and made our way to the cafeteria. We hung out with Asha and Bash for a while, talking about everything from our plans for the next day to child soldiers and world economics! Quite the dinner conversation.
Our accommodations that night couldn’t have been any more comfortable, in comparison to sleeping on a chair for a whole flight. Thankfully, we also had our mosquito nets to protect us. And a guard with a ginormous gun standing at the guest house gate.
The next morning, we head to Kampala, the capital of Uganda. Kampala is one of the 2 most visited cities in Africa, a city known for its nightlife.
Another adventure. The drive to Kampala was nothing we could have expected.
First there are a few rules one has to keep in mind:
– There will be traffic. A LOT of traffic. And so you can never have your phone out..
‘Wait, what? Why..?’
‘Oh, because there will be people who want to take them. If they see them, they’ll put their hands through the windows, and just take them’ ‘…Oh, Okay.’
And so, the journey to Kampala continues. We go to get our new Ugandan numbers, and we finally get our beloved- cannot-live-without-internet.
We’re finally there. We’re in Mukono, at the HIHU Guest House. Our new home!
Now, it’s time to meet our neighbours. On one side, we have a music school with a performing band, where we get our very own show. Every day, around sunset, the band comes out to practice their music. The daily sound of drums, trombones and cymbals fills the air with music. Another reason to love Uganda!
Around the corner we have our other neighbors, the kids. They’re a group of about 10 children who live on the same street. Their ages range from 4-10 years old. Daily, Devina and I would stand in our balcony (with amazing views) and say ‘hi’ to the kids. They will start waving so excitedly, jumping up and down, with smiles so wide and laughs so loud, you’d think they’re going to Disneyland! Then, they’ll call for us to come downstairs and play with them. It has become part of our routine around sunset, and they’re the most joyful, energetic group of kids you can meet.
These are some of my first impressions on Uganda; but, enough on my recollection of memories. The following are some of Madhav’s and Devina’s thoughts on this beautiful country that we’re calling home for the next while,
“Uganda, you’re not what I expected. But in the best way! It’s definitely been an adjustment to live here, and I can already feel my heart and worldviews shifting. Learning to get around using taxis and boda-bodas… Trying food that my taste buds have never been so happy to discover… Making new friends with the best sarcastic humour… Finding my way around the health centres and hospitals… It’s a lot of new things all at once. Yet, there’s something about finding comfort in the uncomfortability that helps me see the beauty in unfamiliar places and things. I’ve always been very in touch with my senses – and let me tell you – they are registering new sounds and sights at such a fast pace. Roosters crowing in the morning, dogs barking at night. Drivers honking at pedestrians, taxi conductors yelling town names. Little kids laughing, newborn babies crying. Mothers in labour screaming, midwives silently focused on delivering. There are rare times in my life when my current circumstances or surroundings will leave me in shock, but when it happens, I’m left speechless in awe. Settling into Mukono and into the role of Fullsoul’s Project Manager has been exactly that. I may not have many words to explain everything I am experiencing right now, but all I can say is that I’m very excited that life has brought me here.”
“To visit new places around the world has always been my dream, and when the opportunity to work in Mukono, Uganda, as a field engineer and consultant arose, I couldn’t resist applying. In no time, I was already here, making new friends, and meeting people who grew up in a completely different world! My impulse to learn and achieve new experiences has contributed to my growth, and this trip so far has given me many opportunities to do such. I’ve realized this when I met several kids in school at the floor below, first showing them how to juggle, and then teaching them! By doing this, they’ve reminded me that sometimes the best way to learn is with a playful spirit. Uganda is an amazing country, with some of the friendliest people I’ve ever met. I was very excited to visit Rotary, they’ve shown me that there are people out their working hard to make their own communities better. A truly inspiring club, with motives and actions that don’t get enough attention. I know the adventure has only begun, but if feels like it’s been on for the longest time, welcome to Uganda!”
And there you have it! Some of our insights on the first few weeks here in Uganda! 🇺🇬Read More
A re-occurring issue I have seen in Uganda, these past few months, is inconsistent support from non-government organizations. Within the Global South in general, organizations, both government and nongovernment, run in to donate aid, and then run right back out. Some organizations look like they provide a large amount of support through the aid they give, but aid can be pointless if you do not also provide the support needed to use the aid. If a contact is given to a health centre or hospital, chances are, in a couple months, that contact will have changed and healthcare facilities are left with their “aid” sitting in the corner to collect dust. As FullSoul Canada Co-found Hyder Hassan would say, “we want to provide good giving”, which is the giving that will have a lasting positive impact on as many people as possible. As I mentioned above, it is not just about providing the aid, but creating strong partnerships that allow for support to be given as well. Which is exactly what FullSoul is working towards.
FullSoul does not wish to only donate the Maternal Medical Kits (MMK). Neither does the MMK program just consist of the kits. In order for the Maternal Medical Kits to be used to their full potential, in the delivery room, the reason for their existence must be understood and appreciated! Through the implementation of the MMK program in health centres and hospitals, FullSoul has strengthened their relationship with each of the healthcare facilities. Providing support to midwives and nurses throughout the continuation of the program is an integral part of FullSoul mission to success!
This is where the Midwife Minutes presentation comes in. One of the biggest projects I worked on during my time in Uganda was a presentation that I would show to midwives in Mukono Health Centre IV and Kawolo Hospital. I named the presentation Midwife Minutes, and this particular segment was about The Three W’s (Why, why and why). The purpose of creating this presentation for midwifes was to encourage the use of FullSoul’s Maternal Medical Kits by providing an understanding of their importance. Midwifes are skilled and comfortable using their improvisation techniques when they do not have access to delivery instruments. However, Ryan, Breanna and I observed that even when sterile instruments are available, midwifes still improvise. A large contributor to maternal death is infection, which can arise from not using sterile medical instruments. Through my Midwife Minutes presentation, I explained why using the MMK can benefit mothers giving birth, midwifes conducting the birth, and also the hospital or health centre the birth is taking place in (the three whys)! Not only does the MMK equip midwives with sterile instruments to deliver babies, it also creates a safer birthing and working environment, decreases infection, increases work efficiency, and gives credibility to hospitals and health centres! It is important for midwifes to understand that the impact of their work surpasses just the mother and baby. It is also important for midwifes to feel supported throughout their work, and the Midwife Minutes presentation allowed for FullSoul to show its dedication to their partners. As I repeated many times, it is not just a health centre or hospital on its own, and it is not just FullSoul Canada on its own. FullSoul partners with health centres and hospitals to create relationships that will allow for progress to be made! This is something that I have experienced firsthand living and working in Uganda.
During my final Midwife Minutes presentation at Kawolo Hospital, a midwife made a comment about how the MMKs would be much easier to use if they came as a “kit”. Although the Maternal Medical Kits have the word “kit” in their name, they do not stay together past the time of donation. The midwife went on to explain that it would be ideal to be able to grab a “kit” off a shelf, put it on the delivery bed, and then you’re ready to deliver a baby! Her idea seemed to be agreed upon throughout the audience because shortly after, Head Midwife, Sister Beatrice, was running to grab a government provided safe circumcision “kit” to show me. They told me that FullSoul should provide an actual kit, similar to the circumcision kit, explaining how it could work in the delivery room and allow their work to be more efficient. I was really amazed by their ideas and passion to work with FullSoul! This is a real-life example of how positive partnerships between those giving aid, and those receiving aid, can allow for action to be taken not only by an organization such as FullSoul, but by the people living the real need!
Working with FullSoul Canada and living in Uganda these past few months has really opened my eyes to the NGO industry. Although giving aid is important, it is equally as vital to ensure that you are giving the right aid. This is a concept that took me a while to fully understand, and I still struggle with defining what “good giving” is. More than anything, those who are living the need will be the ones who are best equipped to identify the need. Even though I’ve been living and working in Uganda, I do not work as a midwife delivering 15 babies a day. FullSoul’s partnerships with hospitals, health centres, midwifes, nurses and doctors allow for our efforts to be steered in the right direction, proving the best “good giving” we can!
Author: Lauren McLennanRead More
You’re an expecting mother and it’s time for the baby to arrive. We have all seen the drill either first hand, second hand or in one movie or another. Water breaks and all involved bee-line it to the hospital without stopping for a moment to ask why? Surely it is not for the scenery or ambiance, and it’s definitely not for the food. We go to the hospital because we need the help of medical professionals. We need them to use their training, compassion, and tools at hand to help us through and keep us safe.
What if you arrived at the hospital and they had little to nothing to offer you? The medical professionals are available to provide care but there is no gauze, no forceps, no clamps, no gloves and nothing is clean. This is a reality for many pregnant women in developing countries.
According to the World Health Organization, approximately 830 women die every day from preventable causes related to pregnancy and childbirth. These deaths are not dispersed around the world. These deaths are concentrated in the rural areas of developing countries. Rural Uganda is one of these places.
The many reasons women in rural Uganda are 49 times more likely to die in childbirth than their Canadian counterparts are complicated and vast. There are multifaceted issues including local cultural practices and beliefs, along with the lack of adequate infrastructure that create barriers to accessing maternal health care. However, within this complexity there are simple, actionable solutions.
In Uganda, women must arrive to the hospital with their own supplies and women arriving empty-handed have to pay for supplies or are often turned away. A shortage of supplies also means that disposable items get re-used between mothers, potentially spreading dangerous infections. This is why FullSoul chose to intervene with a maternal medical kit program. FullSoul is a not-for-profit organization equipping hospitals in rural Uganda with medical supplies. The program provides hospitals with toolkits containing necessary non-disposable tools needed for childbirth and are able to be sterilized and re-used again and again.
Rotarians have been at the heart of this project from an early stage. With many of the FullSoul Team being Rotarians and most of the cost of the initial kits coming from the generosity of clubs across Canada, it is fair to say that none of this could have been done without Rotary. In developing countries, having friends on the ground is integral to success and these friendships have been formed with the Rotary club of Mukono.
There is a lot of work to be done if the world is going to reach the UN’s Sustainable development goal of reducing maternal mortality to 70 deaths per 100,000 births by 2030. FullSoul’s maternal medical kits are part of the solution but they are not stopping there. Through Rotary partnerships they have received a global grant to expand the program in the coming year.
So if you find yourself in a maternity ward take a moment to look around and appreciate how lucky we are to live in a place where medical professionals can use their training, compassion, and, of course, tools at hand to help us through and keep us safe. Every child and mother deserve that, and organizations like FullSoul are essential to ensuring families in every corner of the world have a chance at a healthy start.
Author: Emma McDonaldRead More
Wow! It is unbelievable that three weeks have already passed. At the same time, it is equally baffling that we have only spent three weeks here in Mukono, Uganda! Truly, now, our accommodations at the Ugandan Christian University feel like home. These past three weeks have been nothing less than an exciting whirl of events. Events much different than what we are used to back in Canada! In order for these blog posts to not be too terribly long, we will be reporting on a weekly basis, so stay tuned!
It all begins with our arrival at Entebbe Airport in Uganda on January 16th. Breanna and I had travelled from Toronto together, and Ryan, coming from Vancouver, had arrived earlier the same day. Dragging our luggage behind us—well somewhat, my luggage was unfortunately left behind in Amsterdam—we were met by our first two Ugandan friends, Asha and Vincent. As a side note to this, Breanna and I were lucky that Ryan had arrived first so that he could serve as a familiar Canadian face among a sea of waving Ugandans! Since it was late at night, Vincent and Asha took us to the Entebbe Gorilla Guest House, where we were to experience our first taste of what it is like to live in Uganda. As exhausted as I was, after settling into bed covered safely by mosquito netting, instead of falling straight asleep, I couldn’t help but think about how my journey had just begun! I was excited, yet nervous and anxious of the unknown yet to come. Most of all, however, I was grateful. Grateful for this opportunity to travel to Uganda, to work with Fullsoul Canada to improve maternal health, and to have two awesome people by my side the entire time—meaning Ryan and Breanna if you did not catch on.
The following morning, after a brief—cold—shower, Asha, Vincent, Ryan, Breanna and myself were served breakfast. If you’re wondering what we had, it was not much different from a typical Canadian breakfast! There was cereal, toast, scrambled eggs, fresh fruit, coffee, and tea. More than enough food to fuel us for our trip all the way to Mukono. The drive from Entebbe to Mukono is just less than 60km, but with the awful traffic here in Uganda, that can take over 2 hours. I was extremely thankful that I was not the one navigating through the seemingly impenetrable stream of cars, taxis, and motorcycles—called Boda Bodas. Vincent honked his way all down Entebbe and Jinja road, where we took a brief pit stop at his home, and then finally arrived at our destination of the Ugandan Christian University (UCU) in Mukono.
I am not sure what I expected our accommodations to look like, but I was definitely not disappointed! Ryan, Breanna and I all stay together in a residence style housing unit in the Tech Park community. Our unit has two bedrooms—Breann and I share—a bathroom with a shower, common sitting room with two couches, and a kitchen equipped with a fridge, toaster, and gas stove and oven. Tech Park is a little friendly community consisting of 8 units decorated by flowering gardens and surrounded by lizards, exotic birds, and monkeys! The neighbors we have met so far come from Toronto, Nebraska, and Uganda, all equally as welcoming as everyone we meet.
Once we had settled ourselves in, Asha guided us on our first walk across UCU campus and down the hill into Mukono Town, where we were nothing short of overwhelmed! In the more populated and developed areas of Uganda, the streets are busier than a Canadian mall on boxing day. Asha showed us around Mukono town, allowing us to get acquainted with our new home. She showed us the market, where you can find basically anything you may need, and the grocery stores, where you can find products similar to Canadian stores. I was happy to find some foods I was unsure were available in Uganda, including cake! On the way back, we ate at the campus canteens for the first time, experiencing all the traditional Ugandan foods including beef, chicken and fish—bones included—beans, peas, lots of rice, matooke, cassava and posho—a type of cooked bananas, a root vegetable, and a dense, white, spongey bread. At this time, we also learned that the serving sizes in Uganda are even larger than they are in Canada! After this initial meal, we usually opt to share.
After our brief introduction to Ugandan life in Mukono Town, we got right to work! Asha introduced us to our new primary mode of transportation; Ugandan taxis. This is not the typical Canadian taxi you may be picturing. Taxis in Uganda are large vans able to seat 12+ people along with chickens, produce, and mattresses. To figure out where a taxi is going, all you need to do is listen for the conductor yelling out their destination, and then simply wave a hand or node your head in their general direction and the taxi will stop for you. We traveled to Lugazi our first taxi ride. Lugazi is a small town about 30km down the road from Mukono, that is home to Kawolo Hospital, one of three locations of the maternal medical kits (MMK) Fullsoul provides. This was the first hospital we had encountered so far, and we were quick to observe the differences between Canadian public and Ugandan public hospitals. Built in the 1950s, Kawolo is definitely due for a facelift, but of course the hospital has much greater concerns to deal with first. We met with Kawolo hospital administrator, Dr. Wamala, who was very welcoming and open to Fullsoul’s presence over the next three months. Dr. Wamala discussed with us the concerns of the hospital. He informed us that not only did they act as a referral hospital, but that they also had to commonly refer patients to larger hospitals due to lack of staff and equipment. As representatives of Fullsoul, Ryan, Breanna and I explained to Dr. Wamala exactly why we were there, and what we were looking for—our goal to assess the MMK program Fullsoul has implemented by observing delivery techniques, sanitation practices, and instrument conditions. Shortly after our meeting with Dr. Wamala, we made our way to the Maternity Ward where we met Sister Beatrice, the head midwife at Kawolo. We also met Sister Juliet, another dedicated midwife, who took us on a tour of the Maternal Ward. In our short time at Kawolo, we observed crowded rooms, rusted beds, and broken equipment, all which the staff of Kawolo did their best each day to work around. Needless to say, after only one visit to Kawolo we already knew we had some big problem solving to do!
The next hospital Asha introduced us to was Mukono Health Centre IV. As said in its name, this hospital is located in the heart of Mukono, much closer to UCU than Kawolo, so no taxi needed! We had a brief meeting with Dr. Geoffrey, the hospital administrator, and then went on to meet the head midwife Sister Alex. Again, we communicated as best we could what our intentions were for the next three months, explaining that we did not want to hinder their work, but work alongside them. We also had the pleasure of meeting Sister Jessica, another senior midwife. Every staff member we met greeted us with warm hearts! Mukono, although different from Kawolo, shares many of the same disadvantages. The delivery and post-natal beds are rusty, waiting areas are overcrowded, and the sever lack of equipment and instruments leaves patients at risk every day. But just like Kawolo, the midwives of Mukono work through their shortcomings to provide the best possible care. After visiting Mukono Health Centre IV, we finally understood Ugandan time, meaning time is never scheduled, and things will get done when they get done, no pressure!
Our first week living in Mukono, Uganda has given all three of us a good dose of culture shock! There is no doubt that as each week passes, we grow more and more familiar with our new settings, and cultural practices. We have monkeys in our trees, lizards in our kitchen, and an occasional chicken in our yard, but we can see the sunset every night and it is always amazing. Thank you for reading this increasingly long blog post, there is just so much to say and so little time! Make sure you stay tuned each week for more updates on our amazing experiences in Uganda!Read More
On a quiet Wednesday morning I took a break from my work at home to do some laundry in our basin behind the house. Having grown up with a washing machine always on hand, I will note that handwashing has been a struggle for me. I often find spots of residual red dust on my freshly washed shirt as I am heading out to the hospital in the morning. As I began filling the basin and working the washing powder into my clothes, I heard rustling in the bushes behind me. I turned to find five monkeys staring down at me from the hedges behind the house. A few dropped down to the ground out of curiosity, while the larger monkeys began to screech and snarl down from the upper branches. I shuffled myself inside and decided it was best to do my washing once Lauren and Breanna were back from the hospital… just in case.
It has been the smaller challenges and idiosyncrasies of life in Uganda that have been the most difficult to adapt to. The heat, unfamiliar smells, and chaotic traffic provided a shock to the system but we quickly adjusted. Learning to move with the slower pace of life, crossing the road while truck drivers shout “Mzungu!” at you, or becoming comfortable when a grown man continues to hold your hand for an uncomfortable period of time have been the real struggles.
Lauren encountered difficulty communicating to nurses and midwives during her first week. Not because they could not understand her accent, rather she would petrify them with her enthusiasm. A young nursing student was sat down in front of us to interview on our second day in Mukono Health Centre. Lauren managed to stun Nurse Susan in a handful of sentences and I found myself relaying her questions in a lower, slower tone of voice. We can say she has made progress on the communication barrier though. Last week Nurse Susan approached Lauren in the hospital and stated “We are friends now, Lauren!” This time Lauren’s ecstatic response was welcomed.
I have a feeling we will find ourselves at the end of our internship a couple months from now, just beginning to move with the rhythm of Uganda. For now, we remain the perpetually confused mzungus, seemingly infinite entertainment for the locals.Read More
I was in Uganda’s Mukono Health Centre IV the first time I saw a woman give birth. The hospital’s delivery suite was about the size of a single private room in a Canadian hospital, yet at that moment it hosted 1 midwife, 4 nurses, 4 occupied beds, medical supplies, and myself. The woman’s delivery was difficult and as I watched, I experienced a rollercoaster of emotions – worry, amazement, relief, and, finally, elation. During the delivery, the midwives and nurses worked in a well-practiced manner, improvising when certain materials, such as forceps or surgical scissors, were not available. I was surprisingly unfazed by the conditions; I had already mentally accepted that hospitals in Uganda are often insufficiently funded. However, I was shocked by the implications of this reality. For the first time, I saw what it meant for a woman to deliver a baby without adequate medical facilities, privacy, or support.
FullSoul Intern, Alyna Moosabhoy, interviews the head midwife at Mukono Health Centre IV, one of the locations of the FullSoul Kits.
Unnecessary delays are believed to be a significant cause of otherwise preventable maternal deaths and they occur all too often when hospitals are not properly equipped. I travelled to Uganda this past summer to evaluate FullSoul Canada’s Maternal Medical Kit project, which supplies essential delivery tools to under-funded rural Ugandan hospitals. Throughout my internship, I recognized first-hand the relevance and significance of the work FullSoul does. A large portion of my role entailed listening and observing. From site visit observations, audits, and interviews with healthcare workers, I gained insights on the specific needs and challenges of our partner hospitals regarding maternal health. Simultaneously, through conversations with newfound Ugandan friends I furthered my understanding of the context of FullSoul’s work, as we discussed the fundamentals of national politics, economics, and healthcare.
FullSoul partners with local stakeholders and institutions to practically and appreciably improve maternal healthcare and decrease the number of preventable maternal deaths in a country that has one of the world’s highest maternal mortality rates. Using the DMIAC (Define, Measure, Analyze, Improve and Control) approach, I evaluated the efficacy of the program’s implementation, the details of which can be found in the published Evaluation Report. I am grateful to have gained insight on the state of maternal healthcare in Uganda from my internship, as it now enables me to contribute informed ideas on how FullSoul may best progress and grow. I have taken this opportunity to work with an organization that saves lives by implementing a feasible solution to the immediate problem many rural Ugandan hospitals face: lack of basic medical tools. I also developed personal and professional skills, and was immersed in a spectacular cultural experience. I worked alongside local Ugandans, some of whom became my closest friends. I learned of cultural differences that challenged my perceptions, beliefs, and values. In such a beautiful country, surrounded by lush greenery, I was welcomed by its people and free to discover its many charms; ultimately I had a uniquely wonderful two months.
In the two short months I was there, I came to love Uganda. I cherish my time there and the people I met, and I hope to return soon. In the meantime, although I am back in Canada my journey with FullSoul has not ended. FullSoul does great work and I can clearly envision its bright future, which I am excited to work towards with the rest of the team.
Alyna Moosabhoy served as a FullSoul Intern in Uganda for May-July 2017, evaluating the kits and the needs surrounding maternal health in these facilities. She continues to work with FullSoul in their evaluation, development and implementation of projects since returning to Canada.