Tororo District Hospital is missing a lot of things. I can't hire more staff or create a reliable supply of medicine, but I can try to help by purchasing essential, lifesaving equipment.
Blair Thedinger, a family medicine resident from Oakland, CA, spent a month here. Blair and I decided to link up with a non-profit organization called World Altering Medicine that raises money for hospitals in developing countries to buy lifesaving equipment for hospitals.
Michelle Montandon, another family medicine resident from the same program, used our site to raise money before her recent trip to Tororo. Through generous donations, Michelle was able to bring $3000 when she came here.
Michelle bought some of the supplies when she first arrived in Uganda, but the oxygen concentrator wasn't available then. So Michelle and I took a trip to Kampala recently to buy the supplies.
First, we went whitewater rafting in Jinja. This was taken just after we survived the final rapid, appropriately named The Bad Place. We are exhausted and glad to be alive.
Then we headed to Joint Medical Store in Kampala to buy supplies. Supplies are subsidized there, and are often cheaper than bringing them all the way from the US.
Michelle is receiving the box of small supplies we bought, marked for Tororo.
I am waiting in the "Picking Area" - the man behind me is carrying our oxygen concentrator.
In order to get these 2 boxes to Tororo, we brought everything with us on a matatu. We had to pay for extra seats in order to fit the boxes. It was a ridiculously long and occasionally harrowing journey, and we were happy to get to Tororo safely and with all items intact.
We were able to buy a lot of great supplies with the money.
The midwives don't have adequate protective equipment for when they deliver patients. We bought gumboots and aprons.
The midwives modeled their aprons:
Hadija is demonstrating proper use of the gumboots while taking blood pressure:
Here, midwives don't have an electronic fetal monitor to listen to the fetus' heartbeat. They use a fetoscope, which is a cone-shaped metal instrument. It's quite hard to use and took me a few months to really learn. We didn't buy any fetoscopes, but Hadija really wanted me to take a photo of her using one:
We also didn't buy the weighing scale either, but Hadija was getting really into the photo shoot, and we were having fun:
The one blood pressure cuff on maternity ward was broken - the velcro is weak and so the cuff always falls off the arm while you are taking the blood pressure, and the patient has to hold it on. The accuracy of the readins is questionable. So we bought a new blood pressure cuff, which is more portable than the old one (the one Hadija was using) and doesn't have mercury.
Patricia was very happy with the blood pressure cuff.
We also bought some operating theatre equipment. Some of it seems small, but it can lead to a big improvement in efficiency.
Previously, instruments would be sterilized in one big tray, left inside the autoclave all the time, and pulled out one by one for any surgery when they are needed.
We bought autoclave cloths and autoclave tape. The instruments can then be wrapped and autoclaved, and then stored inside the cloth to maintain sterility until needed. The tape has temperature-sensitive stripes that turn black when autoclaved.
The instruments can be packaged together in sets for a particular surgery, like a D&C or a cesarean section. This allows the theatre staff to pull out an entire set all at once, which means it is much faster to get a patient to surgery. Below is a laparotomy set.
The sets or individually wrapped instruments can be placed in metal autoclave containers and sterilized within the container and left there until needed.
The operating theatre staff started using the autoclave almost immediately after we brought it. Wesonga, the anesthetist, demonstrates some autoclaved sets within a container.
Lastly, we unveiled the oxygen concentrator we had dragged all the way from Kampala. Wesonga (the anesthetist) and I were excited to open up the box with the oxygen concentrator.
Dr. Wabomba, one of the hospital doctors (left), turned up and was also excited about the oxygen concentrator.
Michelle and I were thrilled that we were able to buy it.
The hospital, prior to this, had only two oxygen concentrators. One was in maternity, and the other was in the operating theatre. Both are very old, and often broken. We brought this one to theatre, and are hoping to fix the old one and bring it to Pediatric ward, which currently has no oxygen at all. When a child in Pediatric ward needs oxygen, the nurses need to schlep the concentrator over from maternity. It is bulky and heavy, and by the time they actually get it moved, sometimes it is no longer needed.
There are more things I would like to buy for the hospital:
1. More oxygen concentrators
Optimally, I would like each ward to have an oxygen concentrator - there is plenty of need for it, and it is absurd for someone to die of respiratory distress for lack of oxygen.
2. More protective equipment for the midwives
We were only able to buy a few aprons and gumboots for the midwives, and I would like to buy more, especially so that they are protected when they deliver HIV-infected patients. They do so many deliveries every day that the few we bought will be destroyed quickly.
3. Autoclave containers
Especially one for the labor ward, where they have a very small autoclave but never bother to use it, so there are never any sterile instruments. When a woman needs a vaginal tear sewn, the midwives hold the needle in their gloved hands without an instrument. If I can buy a small container that would fit in the autoclave, they could sterilize instruments in advance and store them in the containers.
When a woman has vaginal bleeding, she can't be examined because there are no speculums. So I would also like to buy some speculums that can be wrapped up, autoclaved and stored for use when needed.
5. Poor patient fund
I would like to have a flexible fund to pay for necessary tests and/or medicines for patients who absolutely can't afford it. I have been doing that casually at the moment, and it would be great to have a system in place.
As I come back and forth over the next couple of years, I hope to buy more supplies on each trip. I prefer not to buy anything that will be used up, like medicine or disposable things, but more permanent and reusable equipment that can have a big impact for a lot of patients.
I will be reporting on our future purchases here on my blog, and if you let me know that you donated, I will email you individually and let you know exactly what your donation paid for.
So, therefore, dear readers, friends, family and compassionate strangers, I ask for your donations in order to help me help TDH. You would be surprised how far a small amount of money goes - even $5 would buy an apron for a midwife.
The link to our Tororo page through WAM is here.
The donation page of the website is here.
I will also put a link on the sidebar of my blog so you can donate any time you feel so moved.
There are 3 ways to donate:
1. Paypal - This will deduct 3% from the total donation for Paypal fees. You can't specify which program you want to donate to, so if you use Paypal, you should email both me and to WAM to let us know that you want to donate to the Tororo project.
2. Network for Good - This will also deduct 3%, but you have the option of adding the 3% to your total so that the full amount will go to the project. You can designate the Tororo project. Network for Good also accepts credit cards.
3. Personal check - You can mail a personal check to the address on the website. The total amount will then go toward the project.