A squashed journey and a clinic

I don’t know what the Guiness Book of Records has to say about how many people can fit into a Landrover which then hurtles down dirt roads alongside huge cliffs but I think the Kisiizi outreach clinic crew must come pretty close to setting a new record. There were 18 of us today crammed in.

I hope no-one from UCL risk assessment is following this, if you are, look away now! Anyway we made it there and back, although I am not sure exactly where “there” is apart from yet another village set in some of the most stunning scenery you could find anywhere in the world, though not so easy to live in if your house is a 25 minute walk from anywhere a vehicle can reach and you are a pregnant woman, as was the situation of one of the ladies I interviewed today, or if fetching water necessitates a 40 minute round trip on foot when you are heavily pregnant.

Jackie, my translator, and I interviewed half a dozen women while the clinic staff saw a good 30, not to mention the mothers and babies attending the immunisation and baby weighing clinic which runs simultaneously. We met several pregnant teenagers and one 20 year old well into her third pregnancy.

Most people are subsistence farmers who grow what they eat, and if they don’t slave away digging the soil they go hungry. One woman was expecting her 6th child. She has always delivered at home, without the benefit of any sort of skilled birth attendant beyond her mother-in-law. Sometimes she has delivered completely alone. She saw no reason to do anything differently this time despite the admonishments of the clinic sister who issued her with dire warnings about various obstetric disasters which may befall her. It is fair to say these warnings are not without substance as another village woman of similar parity recently bled to death in her home after delivering there without a midwife to help her. It is not as if they can dial 999 and get an ambulance to take them rapidly to hospital should the need arise, the best they can expect often is the back of a motorbike taxi, not ideal in labour.

Meanwhile we have at last got our first residents in the mother’s home in Kisiizi. They moved in even while we were frantically hanging their mosquito nets yesterday afternoon, following my shopping trip to Kabale on Saturday to buy them. I ended up having to buy black market nets which came in USAID wrappers and which were obviously destined to be distributed across the border in Rwanda. How they got to Kabale over the border in Uganda is anyone’s guess, but safe to say not by legitimate means. Still at least they have ended up doing what they were intended for, protecting vulnerable women, even if by a circuitous route.