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From the 4 months I'll have spent in Uganda, I have never experienced anything like the last week. There's no adequate means of describing it, the only way would be for anyone reading this to come and see it, or to have been a part of everything I've seen and done in the past week. I'll write what I can, in the hope that no one will ask me about it again.
The slums of Kyebando, Kisenyi zone
The areas just outside Kampala seem fairly stable in comparison to the situations you reach on venturing further away. This is what I thought, having passed these roads hundreds on times on the way to Kampala, but what I've seen on the roadside has been so misleading. Just down the side streets you come into miles of swampland, which for some hideous reason the government has allowed to be built on. This area of swamp is inhabited by thousands of people who have fled their villages, where the extremity of their poverty due to the dryness of the land has driven them to Kampala. Kampala in their eyes defined wealth and success, job opportunities and food for their families. Yet where they are forced to live, on the cheapest land available (20-50,000 shillings a month rent, the cheapest being less than a fiver), their lives are in the furthest possible situation from this vision.
Walking through was actually the most difficult thing I've ever had to do in my life, which sounds so hyperbolic, but it really was. The entire place has an atmosphere of social deprivation, as if this was a dumping ground for the outcasts in society. Yet the people dumped here are those that need help the most, the population being disabled, elderly or sick in its majority. I can list what we saw but it already sounds so inadequate in my mind and so stereotyped as a picture of Africa, but these are real people living like this. The dirty drinking water; this was brown water from a dug-up hole in the mud. Mud and rainwater mixed together was what people were crowding around to collect in broken jerry cans, fully planning on using it to drink and wash themselves with. I tried to imagine having to drink that everyday, please actually imagine that. The flooding. When it rains in Uganda it full on rains and rains, and everything stops when it does - the roads and streets become empty because it is too heavy to be out in. The inhabitants of the slums are already in marshland, which receives the heaviest downpour. They cannot move away from it. The floods reach levels as high as a man's waist or a front door, this front door being so badly protected from the water that it just enters the house. These houses are mud, or corregated iron, or in the 'richer' parts, you might see some poorly put together brick. There are constant streams running outside people's homes. People are always trying to brush away the water, clear walkways in the mud and survive with the constant damp that so violently invades their homes. Everyone lives on top of each other with absolutely no privacy or trust. Everyone is faced with the possibility of theft, rape, and more than anythnig, sickness. This last one is incredibly important, with only 2% of people who live in this area maintaining their health.
There was one man in particular, Fred. When we first saw Fred, which was only for a minute or so, we were told he was TB positive with HIV. He could not breathe, or walk, and his body had no flesh but just bone. I have never seen a human so completely frail. At this point we did not know the seriousness of his case, the 2 of us were just affected by him so strongly due to a reminder of our Grandad's, who had both been victims of TB before they died. We just wanted to take him to be checked up and attain his medicine for him, just as something to relieve his situation slightly. Out of the hundreds of people we saw who so desperately needed help, Fred was our focus. The next 3 days proved our decision had been so necessary as a matter of his life.
We took him to a local clinic where he had 2 tests for TB and HIV as well as an x-ray. He could barely walk and every single breath was such a struggle. He was taken home while we waited for his results, when we were to find out that as well as having TB and HIV, he was severly anemic and had also contracted pneumonia. His blood count was so dangerously weak that he required an immedate blood transfusion. Upon seeing his results the doctor told us that if he fell down he would die, or could pass out to death at any point from now. We had to get him to the hospital immediately as an emergency patient. It was 6pm at this point and the rain had started, meaning the roads were jammed, but more importantly that Fred was back in the slums with the immediate risk of falling over in the rain.
Thankfully one of CALM Africa's wonderful team lives so close to the slums that he was able to pick Fred up and bring him straight to the clinic. One of the doctors there had seen our panic and upset, and offered to come with us to the hospital as one of his close colleagues works in the blood transfusion department and he wanted to ensure that Fred would be seen straight away. We got him there, absolutely terrified, and he was seen quickly enough. When we left him, having had to purchase the needle kit necessary for his transfusion, as well as his sheets and bed for the night, he was already breathing so much better due to the saline drip he'd been given. He thanked God and thanked us profusely. We left him overnight to have his transfusion. By this point we'd realised too late that we have not been inoculated against TB.
Unfortuntely, when we arrived the next day, we found that Fred had escaped from the hostpial that morning, with the help of his ex-wife and daughter who had come to visit him there (we realise now that they would have pushed him to leave due to the incoming costs). We found him back at the slums with the needle from his transfusion still in his arm, and the documentation from the hostpial. The list of necessary care and medication he would have received there was extensive, which would have kept him there for a week's rehabilitation. Instead he had fled. At this point we felt that this had reached a level completely beyond what we could do, 2 mzungus without a shred of medical experience or knowledge, with only one member of CALM Africa aware of what we were doing, this being outside their usual service as we had not made an official assessment of Fred's situation, as intervention had been so immediately necessary. We were at a loss. It seemed that Fred just wanted to die and didn't want any help. But we couldn't leave him now.
We took his documentation back to the clinic, discovering he'd needed 5 follow-up injections and a month's worth of TB medicine (which would have been free from the hospital). Without any assurance that this aid would be appreciated, or even that he'd want to take this medication, we paid a nurse who would be doing his injections, got the equipment for that, and bought the TB medication. So close to giving up, and just abandoning this task which was too much for us and too expensive.
When we got back to Fred with all this as well as some immedate nourishment, we knew that what we'd done was all for some purpose. He was so grateful, so overwhelmed and more than anything so apologetic, that we could see he'd only fled from the hospital because he'd been so terrified of being there (which I cannot blame him for cos seriously the state of that place was horrifying). He promised us he'd take his medication appropriately and make sure he ate and rested well. His breathing was so much better, I felt like I could see the blood pumping through him and strengthening him. We'd spent so many hours in clinics and the hostpial and of course at the slums themselves, but after those 3 days we can look back and actually realise that if we hadn't have found Fred when we did, and felt the need to go back to him, he would have been found dead by now. Upon our last visit to him his neighbour told us how glad she was that we'd come, because every morning she'd been checking to see if he had fallen dead.
Today I've been back to see a completely new life in him. Just a week after we found him. He is laughing, moving around, talking and actually breathing without pain. He can really breathe now. He has become a completely different person. But he can't stay there. If he stays in his mud house, with a stream of contaminated water outside his home, he will fall ill again so quickly that everything of the last week will become void. We plan to get him out. But more on that when I'm home. For now, he is going to be okay, and that's become such an indispensable part of me now.
There has been a lot of positives amongst the extremity of Fred's case. Of course I feel like I've been here forever and cannot imagine not living my Ugandan way of life. We made a jingle for Radio Simba, one of Uganda's most popular stations, which will be played to millions of listeners over the next few years (so cringe). We were amongst the 12 closest people to Joseph Luganda to accompany him to his first official introduction to his fiance's family, which was absolutely amazing and we were so lucky to be a part of that. Although I had to stop breathing so many times to keep myself from actually pissing myself laughing. Latrine 5 has been completed and has ensured the immediate sanitation of a poverty-strikken family as well as providing the essential sanitation levels necesssary for CALM Africa to open their Kira office of that area.
CALM Africa, I found out last week, have been struggling a lot more than I realised. As the staff rely on their income from UK donations, through their partner charity in the UK, their income can often be sporadic and a lot of the time, non-existant. I found out that for the last 4 months not a single member has been paid. 10 of them haven't received anything. The morale of the entire organisation has been noticeably low and there has had to be talk of cuttnig back vital staff and vital hours. The lack of pay was seriously hindering the work of CALM and everything that they do. Amazingly, CALM have today received a donation of a thousand pounds to cover these staff allowences. You know who you are and I'll never be able to thank you enough for that. CALM can push on with strength and continue the absolutely incredible work they do, which I am absolutely not ready to leave.
Home on Sunday, so speak to you guys then. I know this has been so long and detailed, but I'll never be able to describe this past week out loud, or really talk about it, so if you've read it til now then you'll at least have a chance of understanding. I've done more here this time than ever before and will find it impossible coming home. Luckily I'll be back in December and this time with the fam too.
Big love
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