Erin’s First Full Day in Uganda

Wow! What a day. I should be totally exhausted except I'm so buzzed on potential I can't be tired. I was last here in March. We were just gearing things up, making what sounded like audacious plans to scale up efforts to save mothers. It felt like a stretch to put it mildly—let's pick four districts and see if we can cut deaths by HALF in a year. Come on, one year? Really? I was almost afraid to admit that goal in public to my maternal health friends. As of this writing, the jury is still out on whether we can actually reach that goal. What I'm seeing so far is just anecdotal, clinic-by-clinic data, but it's happening. I can hardly believe it, but it is.

Today, we started off with a meeting with the District Health Officer and the District Chairperson to talk about the big picture. They dropped a shocking statistic - That deliveries assisted by trained healthcare providers in Kabarole district of Uganda (one of the four districts we're focused on) have increased from just 45% of all births to 91% since this effort began less than a year ago. One caveat is that the 91% is probably high because once people hear that so many services are available in Kabarole, they cross in to the district to deliver here too. Even once that's taken into account however, it's still a major increase and getting women to deliver with trained assistance is one of the biggest factors to improving outcomes.  

During the day we got a much better, first-hand understanding of the sorts of strategies we discussed last night. As we left the District Health Officer, we were instructed to "Now go out and hear with your eyes". What great advice. 

We visited three different facilities. The first was the regional hospital where they can handle basic and comprehensive emergency care. This is where women are sent who are having complicated deliveries beyond just needing the regular C-section. The major success here is that the numbers are DOWN because the lower level facilities are now able to handle more of the regular deliveries and regular C-sections. They aren't as overloaded and told us, with pride, how they didn't have any more "floor cases" (women having to lay on the floor because there are no beds for them). We asked about maternal deaths for this facility. Prior to the start of Saving Mothers, Giving Life programs, they said there were an average of 30-40 deaths per year. When we asked about this year, we were excited to hear the lead doctor, Dr. Kalisa, recite that in January - 0 deaths, February – 1, March – 0, April – 2, May - 0, June - 0. So for six months that’s only 3 deaths. THREE - compared to the annual average of 30-40. Again, this isn't scientific, but it's hard not to get pretty excited. 

While there, I got the chance to meet Nyambusa, a (pretty young-looking) grandmother holding day-old Masika out in the sunshine. The mother, Amina, was 18-years-old and went into labor with her first child only to face an obstructed labor. Thankfully, a new ambulance procured under the SMGL program transported her to the regional hospital for a C-section. She's an example of the women we heard about from neighboring districts who travelled to Kabarole for the services offered here. When we walked inside to meet mom, she was sitting up, smiling and feeling strong. She'll be heading home tomorrow with her healthy child, grateful for the care that had saved her life and grateful for the transport that allowed her to get to the hospital in time. And I couldn't stop smiling at little Masika. Tell the truth, couldn't stop smiling all day.