Uganda: “When the madness of an entire nation disturbs a solitary mind, it is not enough to say the man is mad.”

Uganda: “When the madness of an entire nation disturbs a solitary mind, it is not enough to say the man is mad.”

A statement made popular by the writer Francis Imbuga in Betrayal in the City is a political play. The writer examines the problems of independence and freedom in post-colonial states in Africa. A timeless piece of work that forever resonates with the current affairs in my country. In times of economic hardships, the manifestation of a capitalistic state reveals itself in the most selfish, traumatic and horrifying manners, its face is ugly.

A capitalistic state is one where there is private property ownership, capital accumulation, wage labor, voluntary exchange, a price system, and competitive markets. Unfortunately in Uganda some of the crucial social service sectors have been left in the hands of private sector because most government facilities are not reliable. Health care is one of them, majority of the citizens would opt for private health care with their meagre resources, hoping that they would be guaranteed good quality service as would be assumed.

A few days ago, I visited an old missionary founded hospital, now privately owned. Both my daughter and I had some eye allergy that caused constant itching and redness of the eyes, we had previously visited private clinics where we were both given eye drops, mostly steroids and antibacterial eye drops. A friend advised us to visit this popular hospital which is prized for its popular eye clinic, for a thorough examination. Having avoided hospitals, because of the perceptions of long queues poor service, lack of equipment and so on, it had been long since I had visited a hospital. On this particular day, which was a Saturday, I visited the hospital. My first task was to find out where the eye clinic was located in the huge complex of different faculties and clinics of the hospital. That was not one of the most difficult tasks as my daughter and I easily located the clinic, because the signs were clear and boldly written. But on getting to the building that housed the clinic, we were confronted by the most demotivated of employees I have ever come across, patients with all kinds of eye ailments sat in a large plain looking waiting hall, the patients looked desperate , some bent over their hands covering their eyes, others with plasters on one eye, appearing to be on a follow-up visit, others hunched over appearing to be sleeping but others visibly irritated by their condition and of course the majority of us who were occasionally rubbing at our itchy eyes. The sight in this hall was more sickening than the condition my daughter and I had. The pain and sorrow that gripped my heart was unbearable, I broke down in moments – given that my eyes were already red and itchy it was not possible to tell whether I was crying or just hurting from the pain in my eyes, I cared that my daughter should not notice – she is 6 years old. The scene reminded me of the 80’s when infrastructure had broken down after the war and hospitals ballooned with distressed numbers of ailing patients, growling with different sorts of pain.

I almost walked out in desperation, but my daughter more than me needed the service, the sight of patients languishing in pain and desperation made me stay. ‘What about all these people, calmly waiting, and yet must have been referred from far out of the city, travelled long distances and had not many choices, if any” I thought, “What actually happens in this place”, I asked myself. Initially, curiosity gave me strength to stay, but later, I saw an opportunity to understand better what goes on so I can be of part of the solution. In the confused state of not knowing where to start from, I asked one of the patients next to me what the procedure was. The first person I asked had no idea where to start from , he told me to sit and wait, out of respect, I sat for a minute or so , but wondered how my unknown existence would enable my daughter and I receive treatment, ,so I decided to walk out of the building in search for help. I couldn’t get anyone to ask so I walked back in, randomly entered into the first office that had someone in ,it turns out that it was the dispensary , there was a man in a white coat – I could tell he was not a doctor by his name tag , when I asked him of the procedure to get attended to, he told me that I needed to pay a consultation fee at an unlabeled counter outside the building and put my receipt at a table which was awkwardly placed at the centre of the waiting hall. It had no attendant, moreover it was a windy day. Papers kept flying and I noticed patients guarding their papers by placing a stone on it, so it wouldn’t fly away. As annoying as it was, I grudgingly did the same. At this point I was still doubtful of being called in to any one of the many consultation rooms as they were marked, although I still had some hope, because our names had been entered into the computer which printed the receipts we had placed on the table. In about 10 minutes my daughter and I were called in, alongside 7 other patients - I wondered why all of us had to enter the consultation room at once, when they were many doors! While inside, each one of us was asked: How old are you? What is your problem? And then made to read the vision testing eye chart, children, adults alike in the presence of everybody else, including those who had accompanied the 7 patients, in some cases I noticed some adults who were not comfortable reading in English being subjected to this grueling experience, children were shy and failed to read , adults were embarrassed including myself. I first refused to read the chart, as I found it inappropriate, but the nurse warned that I would not proceed to the next stage if I did not complete the preliminary examination, so I did. To cut the long story short , at the end of the day, I concluded that, as surprising as it was, the place was clean and hygienic, there were adequate staff and equipment but there was a very bad attitude by the staff and customer care was at zero!.

I decided that I would not sit back and just complain as is I have no power to at least complain for starters. After receiving our diagnosis and treatment, I decided to talk to the manager on duty as the name and number were displayed on the board. It took me another 20 minutes to locate the lady, who turned out to be a wife to a friend with whom I had been to school with. I narrated my experience to her, she empathized and explained to me how she too had been embarrassed by the manner in which her staff behaved, she had repeatedly informed them but it all fell to deaf ears. She requested that I join their staff meeting that was going to happen at 1pm as the clinic worked half day on Saturday ( a few minutes from the time we were talking) and share my experience which would enable her tackle the issue with evidence. I gladly joined the meeting, shared my experience, which was not disputed by the staff, luckily, with the moderation of the manager I was asked to suggest what I would wish to improve as a patient. I suggested simple things like having a reception desk, clearly labeled and with an attendant who can explain what the procedures are to clients, I requested that the consultations should be carried out, one person at a time and that a safe place be designated for dropping the receipts once payments have been made. My daughter said she wanted the clinic to have a table with crayons and papers for her to draw pictures while she waited to see the doctor. I also added one luxurious one, I requested that since the waiting hall was plain, empty and dull, some charts, pictures or paintings could be pinned up especially in the children’s waiting area! The staff of about 8 all agreed to my suggestions but said the last one would take a while and that they would have to fundraise to provide a constant supply of paper and crayons for the children. I was then invited to check this out in my follow-up visit which is up in a months’ time. I was so thrilled that my daughter and I were part of making the change we wanted to see. I can’t wait to see whether the changes have been effected or at least some of them. My daughter and I are now fundraising from friends to start the provision of crayons and paper for drawing. It is extremely exciting for my daughter to be part of this project, she can’t stop telling anyone who cares to listen – on her own she has raised packets of crayons! (See in picture some of the materials we have managed to get for children visiting the clinic) We now have about $125 for crayons, paper and other materials - still counting.

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