Michael, my husband, injured his hand about a month ago, and it was still hurting quite a bit, 4 weeks on. He was concerned that it wasn’t healing, and we wanted to get an x-ray to check that it wasn’t fractured and didn’t need a cast (something we were both dreading!! ).
Of course, there is nowhere to get an x-ray in Kamwenge.
So we begrudgingly piled into the car to set out on our fortnightly trip to Fort Portal, the nearest big town to Kamwenge. Fort Portal is a big town (maybe 80,000 people? I really have no idea!) about 70 km’s away, and it normally takes about 1 to 1 and a half hours on a windy dirt road, surrounded by beautiful scenery – hills cultivated with maize, millet and matooke banana trees, a section of tropical rainforest with baboons along the way, and then rolling expanses of neatly ordered tea plantations, sprinkled with old houses left over from the colonial era. A beautiful drive.
But now that the wet season has well and truly come, the road is terrible. We crawled along for most of the journey, trying to avoid the gazillion pot holes and deep rivets in the road, all the time shaking our heads at the poor state of the roads. It took us over 2 very bumpy hours to reach Fort Portal for our day trip.
After getting all our other jobs done – recharging the internet modem, going to the bank, printing, getting stuff for MH ticked off the list – we looked around for a place to get an x-ray. First we tried a private clinic in town recommended by someone on the main street. We were told they are a clinic used by one of the main insurance companies in Uganda, and would definitely have an x-ray.
What I found was a small dingy room full of bored patients, with no staff in site. A woman who was waiting pointed towards the next room, where I found what looked like some makeshift outpatient rooms. It was only when I poked my head around the corner into a small store that I found a nurse. When I asked what I needed she was quick to tell me they had no equipment for x-ray here, but told me to try Kabarole Hospital – the Anglican church hospital round the corner.
Arriving at Kabarole, we struggled to find anyone to help us, just crumbling buildings and a freshly painted one labelled ‘private ward’. We approached the dispensary and after getting over his surprise that a white person would be there, the man shook his head as he told us the X-ray machine had been broken for some time. Instead, we should try another private clinic in town.
The next clinic wasn’t much different. Here, they were known for x-rays (it was even written on the sign outside) but unfortunately, the films were over and they didn’t know when they would next come. With a resigned sigh that conveyed almost no confidence, the women told us to try Buhinga.
Buhinga is the main regional referral hospital for this part of western Uganda. It is a government hospital. We have heard many stories of patients coming there to find doctors who will not see them without bribes, a lack of equipment and medications, and overcrowded rooms of very sick patients. Currently, this is where most people in Kamwenge get referred onto.
We were very lucky though. Or perhaps, more accurately, we were white. We found a nurse along the maze of undercover pathways that linked the hospital buildings, and she was friendly and happy to help us. She led us to the x-ray department, where we wove through dozens of patients sitting (or lying down), waiting for their x-ray or ultrasound. The doctor was pleasant and happy to do the x-ray for us immediately (and free), and although Michael’s hand was slightly fractured it was small and almost healed, so there was no need for a cast.
But as we were waiting for the film to develop, there was a little girl in line, needing to have her face x-rayed as she had a severe head injury. It was not possible. They were only stocking the half size x-ray films, which meant there was no way to get a full x-ray of her head. Her father, who looked poor and out of his depth in the situation, listened intensely as they told him he would have to take her somewhere else for an x-ray. I already knew from my experience that day that there were no other places in Fort Portal to get an x-ray and he would not be able to afford the transport to somewhere far.
Michael and I lived in Mannum a few years ago. In the small town of maybe 5000, they had a good x-ray machine. Compare this to Kamwenge, who in the town itself has about 20,000, but services a district of 350,000 people, with no x-ray machine.
It sounds clichéd but again it made me realise how lucky Australian’s are to have the health care system we have. As for me? I am not used to driving 2 hours on a muddy, potholed road just for a simple x-ray. I am not used to driving around to 4 different clinics in one big town just to find a working x-ray machine.
One day I hope and pray that this will be as strange to Ugandans as it is to me.