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                                       Medical Outreach Day in Budondo, Uganda 

During my last time in Uganda, I went with John Kirkwood to see the projects and proposed projects of the Rotary Club of Jinja, Uganda - of which John is a Past President. John is a mine of information and experience, so every contact with him resulted in the extension of my personal knowledge of the needs of poor local people and the ways in which they might be helped.

One of the projects John described to me was 'Medical Outreach'. Every year the Rotary Club of Jinja arranges and runs several days of Medical Outreach in the rural areas in the greater Jinja area. This involves a great deal of organisation. Local medical professionals, some of whom are Rotarians, are asked to attend. These professionals will include, doctors, both GPs and surgeons, ophthalmologists, dentists and nurses. Many Rotarians also help with setting up the venue, the patient care and control, equipment management and maintenance.

The first thing that happens is the identification of a community that hasn't had a Medical Outreach visit recently. Rotarians will visit that community to estimate likely patient numbers so that they can arrange the appropriate numbers of medical personnel to attend the Outreach event.

Rural communities need such visits because, in Uganda, even if you are only 6 miles away from a town you can be quite isolated due to the lack of roads, lack of money for transport and inability to walk far due to age, illness or the effort required to transport a sick patient who is unable to walk e.g. children, the very sick or injured or the elderly is simply too arduous.

Most Ugandans are very poor. Rural Ugandans earn as little as $10 a month from the sale of surplus produce from subsistence farming so they can't afford doctor's or hospital fees. There is no 'free at the point of access' medical care in Uganda.

Since becoming friends with many Ugandans, one of the things I have learned is how truly precarious life is for them. In their emails they are always apologising for delays in replying and telling me of this member of the family they have just buried. As I write, the manager of the project I help run there has told me of 3 family members who have died during this past week. A Ugandan friend of mine who lives in the UK recently told me how he had just learned of 5 of his family who had died. They feel it just as we do. It's one of the reasons why they have so many children. At least if they have many, they feel that there will be some left in adulthood. However, it isn't just young children who die. All the people just mentioned were adults. Their stories are common to Uganda and sub Saharan Africa as a whole. They died from such preventable things as malaria, diarrhoea, vomiting, childbirth and road traffic accidents (mainly as pedestrians being knocked down as they have to walk everywhere along the mud roads which become skating rinks when it rains).

The second thing that the Rotary Club of Jinja has to do to set up the Medical Outreach is to find a suitable venue in the identified community where the temporary clinic can be set up.

Next, they contact local medics from many disciplines to arrange a date when they can all attend. Some of these medics are Rotarians. The identified community receives visits ahead of time so that they know when and where all this will happen. The community will also help by spreading this information when they meet people at the water source, the local trading post or along the paths as they move about in their daily lives.

Finally, everyone arrives early at the venue to set up and begin a concentrated day of patient diagnosis and treatment. Even though they arrive early, the queues of people will already be building up. It's normal to diagnose and treat up to 1000 people in a single day.

Children gathered round to say goodbye as everyone left at the end of the day. If you look, you can see the change in the light.