BY JK FALLIN, MD
I had the opportunity to travel an extraordinarily long distance to Uganda last year on a mission with One World Heath, a nonprofit that aims to provide affordable health care to communities in need. The trip had a rather disjointed start because Delta forgot that they needed a computer to fly their airplane. After this minor hiccup, we embarked on our journey across the Atlantic, then Europe and Africa before landing in Entebbe, Uganda.
Entebbe is about 20 miles southwest of Kampala, the capital city of Uganda, but there is in reality little demarcation between the two towns. It's located along beautiful Lake Victoria, the largest lake in Africa, which is bordered by Uganda, Kenya, and Tanzania. The city is extremely energetic with surprising signs of modernization but a prevailing sense of a developing world culture still trying to find its identity.
Our travels were not yet finished. After landing, we met a representative of One World Health at the airport, who chauffeured us to our hotel for the evening. Our first night was spent coming to terms with how air conditioning was a privilege not experienced by the majority of the planet. After several cold showers and a wonderful breakfast, we loaded onto a mission van to go on the last leg of our journey.
After driving five hours north, up through the heart of the country, we made it to our destination of Masindi. This is a smaller town where One World Health has established a permanent clinic. The organization has designed a self-sustaining health care model that can staff and train its own workers, creating more efficiently run clinics compared with the local government-run facilities.
They require cash payments, but the rates are unbelievably cheap, and they work with patients who absolutely cannot afford their services. They have actually been able to expand to several other clinics in nearby villages, and the goal is for these clinics all to be financially viable in the near future so they do not have to rely on donations permanently. They have an x-ray machine, a new ultrasound unit, primary care, and OB-GYN services in addition to general surgery. They also have rooms and lodging for overnight and long-term care.
One World Health has an excellent relationship with a local inn, which is quite an anomaly for the region. Masindi itself is not a tourist destination, but several hours north of town is the famed Murchison Falls National Park, and the inn is a convenient pit stop for tourist groups traveling north. More recently, it's become the brief home of many mission groups in the area, including the United Nations and Doctors Without Borders. They provide excellent local dishes (i.e., carbs) and wonderfully cold showers at the end of long days in the heat.
During our stay in Masindi, we would travel to local villages by van every morning to provide health screenings and medicine to villagers where they lived. They would wait for hours, marinating in the hot sun without food or much water, just for a chance to be seen. They had many of the same health complaints we deal with on a regular basis in the United States, like heart burn and osteoarthritis. The main difference, however, was the numerous parasitic diseases that we don't have here, such as malaria, ringworm, and filarial disease.
I was impressed by the influence the mission had in the area. Many patients were already on prescription medications, had received vaccinations, or had been diagnosed with some ailment. Unfortunately, much of the morbidity present in the area is due to poverty, lack of access to clean water, and general lack of knowledge of personal health and hygiene. Many of the patients' lives were greatly improved just by getting sunglasses to help with the long-term degeneration of their eyes due to a life spent toiling under the sun.
Most of our days were spent in patient care, but we did take the time to enjoy the stereotypical mission trip activities of taking pictures with adorable local children, comparing music and lifestyles with particularly fluent translators, and struggling to learn bits and pieces of the local dialects.
Each day we would climb reluctantly back on the vans, slightly more enlightened but much grungier, more odorous, and more exhausted for the trip home. Luckily, several in our group were blessed with unending enthusiasm and energy, and despite the somewhat cramped conditions, they were still able to make glib conversation during the commute, which would otherwise have been filled with silent pondering of what we had just experienced. Each night I would peel out of scrubs caked in a strong concoction of clay dust and sweat, clamber into the shower, and turn on the wonderfully cold water that erased my grimy farmer's tan. Afterward, we would have dinner and a moment of reflection and prayer prior to heading to our beds.
The last two days of the trip were spent on an excursion to the Murchison Falls National Park for a taste of what this area of Africa looked like prior to modern human influence. We got to spend the night at a resort in the park that had a pool!
It was the greatest thing I had ever seen at that point in my life. We all impatiently waited for niceties to be exchanged between the resort staff and our group leaders before rushing off to don swimwear and plunge into the pool. After spending a relaxing afternoon floating, we prepared for our activities the next day, which would include a true African safari in the game reserve of the park. The safari was exactly what you'd expect and well worth the expense. We got to see the entire cast of the Lion King (except, of course, the lions, which decided to lay low) in their actual element. My only regret was not bringing a better camera; my phone camera just could not do the scenery justice.
After playing British explorers in the game lands, we traveled back to Masindi before heading back to Entebbe for our red-eye flight to Europe. I know it sounds cliché, but the trip was over way too soon. Friendships are best forged in such environments, and the sheer number of memories that develop from these types of trips makes me wonder why more of us go on them. It may be much easier, cheaper, and safer to avoid such undertakings, but by doing so we miss out on experiences that truly sculpt our worldviews and life stories.
The burden that the mission has undertaken is humbling in scale when you consider the number of villages that are still unreachable in this one region in this one country on this one continent. Money donated to the mission, unlike many other organizations, is not just going into a bottomless pit. The self-sustaining model that they have developed will likely be reproducible in many other underserved areas. This enables the reach of the mission to expand while still receiving the same financial backing. The trip was a great opportunity to experience and be a part of the mission and a culture that is so foreign to us.
Dr. Fallin is a graduate of the West Virginia University School of Medicine and a member of the Palmetto Health EM class of 2017.