The Kibale Health and Conservation Centre

The health clinic - nurse Lucy (right), and her patients (left)

This summer, I again had the fortune of travelling to Kibale National Park, Uganda. The site where I, and everyone else in my lab, conducts their field research. But this year was different. This year, I was exposed to the everyday lives of the local villagers, where hardships, struggle, and death were commonplace in their existence.

A ten minute walk up the red-earth road from my house in the national park was a health clinic, called the Kibale Health and Conservation Centre. It was founded by my supervisor and his wife, also a professor in Biology, in an attempt to cater to the needs of the local population. Nearly two decades of working in Kibale had exposed them to the number of horrors faced by Ugandan villagers, predominantly among them the needless deaths, usually of children, caused by curable illnesses. Only a handful of villagers possess bicycles, even fewer have motorcycles. So when infants became gravely ill, transporting them to the closest hospital, 25km away, was a virtual impossibility. In an effort to help, the Kibale health centre was erected, furnished with basic medical equipment, and staffed by two young, sprightly nurses.

I became involved with the health clinic for research purposes. My thesis straddles the realms of wildlife ecology and social anthropology, because it aims to determine the potential for infectious disease transfer between wildlife, namely non-human primates, and people. To this end, the human research side of my project, which requires blood and stool samples from villagers, was set to occur at the health clinic. I informed the nurses of my project, which involved direct testing for malaria using rapid diagnostic tests (which work on the same principle as a pregnancy test). They were eager to help, since malaria diagnosis up until my arrival was based purely on symptoms – the opportunity to actually test patients, to know for sure whether their prescriptions were accurate, was novel and exciting.

My first day with the nurses at the clinic was far from dull. Lucy (the nurse) saw 14 patients, most notable among them was a boy around the age of 15. Delirious and weak from malaria, he had collapsed on the side of the road and become unable to continue his trek to the clinic. He was picked up by a researcher, and dropped off at our door. My first memory of this boy was him on the ground, having fallen out the vehicle, his purple dress shirt saturated with sweat from his raging fever, crawling slowly towards us. We helped him into the facility. His symptoms had begun five days earlier, and he had not sought help until now. In five days, he had gone from completely healthy to dying. He left the clinic that evening, nearly six hours after having been admitted. Lucy had done all she could for him, and had exhausted the resources available to her at the clinic. When the boy failed to show improvement, she sent him by motorcycle taxi to the hospital in Fort Portal, the nearest town. Two days later, I received news that the boy had died, alone, near his home. He had not gone to the hospital. In this place where everything moved at snail’s pace, where “hakuna matata” dominated African mentality, it struck me that the only thing that came quickly to these people was death.

In the following weeks I counted the number of times the field assistants, also local villagers, left early to attend the funerals of loved ones. In three months, my field assistant attended 15 funerals. That is a death every six days of someone he knew and loved. I can count on one hand the number of people I have loved and lost in my lifetime.

Once a month, a mobile health team would visit the clinic to provide essential services not regularly offered by the nurses, such as an on-site doctor, counseling, and a number of diagnostic tests, including HIV. I assisted the mobile health team on three occasions, each more disturbing than the next. The first was promising – only 3 patients out of 56 diagnosed as positive for HIV. The second was not – 13 out of 23 patients with HIV. The third was poorly attended as a result of a torrential downpour that made travelling to the clinic arduous. Only one patient was diagnosed with HIV – a 12 year old girl. Her pregnancy test was also positive. She informed the nurses that she had been giving herself to wealthier men in her village, by orders from her father, in exchange for food for her family. Even the thought of abortion in this community is an abomination, and so is adoption. This girl, a child herself, will have another life to care for and raise in less than six months. Ontop of this, that newborn has a ~40% chance of having HIV, vertically transferred from his/her mother.  

The mobile health team, nurse Dennis, and nurse Lucy
A diagnostician and I running patient tests

 

I want to help. Whether it be people or animals, I have now amassed nearly 8 years of post-secondary education. I want it to be worth something, and I want to make a difference in the world, no matter how small the contribution is in the scheme of things. The thought of becoming a professor frightens me, because, I am sad to say, I have noticed that much of the work professors do is glorified paper pushing. I once asked my professor about whether he thought that any of his research had really contributed meaningfully to anything other than scientific knowledge. He answered honestly: he wasn’t sure, but likely not. However, his years of research in Kibale have now done something more profound. He and his wife have gained respect in the community, they have made connections. They have given back tremendously by creating the health clinic, a place where villagers can access the medical care they need, a place that offers them a better chance of simply surviving. Of course there will still be suffering and unnecessary loss of life in the area, such as the boy in the purple shirt. But now choices can be informed. The HIV positive girl is now aware of her disposition, when otherwise she would have been ignorant. She can take steps to ensure her child does not contract her disease.

For many scientists, whether they be cancer researchers, infectious diseases experts, or conservation biologists, the prognosis of our field is bleak. However, we can to do far more than simply contribute to the body of scientific knowledge that exists, and perhaps it is our responsibility to use the resources and clout that we wield to make a measurable change in our realm of study. I am fortunate to have a supervisor that has set such a powerful example.

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