Big challenges at Amuria Health Centre

Yesterday proved to be another eye opening and pretty overwhelming day, both emotionally and physically draining. It was a bizarre day of contrasts and mixed emotions as we got an insight into the shocking conditions at a local Ugandan health centre in the morning, and then celebrated World Toilet Day at a huge national event in the afternoon.

The most shocking and eye opening part of my trip so far was visiting Amuria Health Centre. I've visited several developing countries before and have seen real poverty but nothing could have prepared me for the sights at the health centre.

Although positive in that people do have somewhere to go for treatment when they are sick, ill or pregnant, the conditions at the hospital were truly awful. The health centre manager, doctor and midwife, Claudia, are very strong, positive people to be admired for the incredible work which they do with very little resources. It is great that the health centre helped fund medical training for their one doctor, however he, one midwife and a few nurses and support staff have to deal with the 24,000 patients who visit the health centre each year! These wonderful hard working people are very proud of their health centre, despite its problems.

We walked (accompanied by a stray chicken) through the crowded maternity ward where sick and recovering mothers lay. There were only 14 beds so many mothers lay on thin mattresses or simple mats on the floor. They all shared their beds with their tiny new babies as there were no cots. I felt overcome with sadness for these poor ladies who were feeling exhausted and ill after recovering from a Caesarian or suffering from malaria. All us supporters were fighting tears back.

The midwife explained that they have on average 160 births at the hospital a month, despite the maximum capacity being 130 a month. This means that they are often sent home early before they are fully recovered. There is one old ambulance but most heavily pregnant women have to walk or cycle to the hospital to give birth from their remote rural locations up to 30 kilometres away. Then back home again after. The only available painkillers whilst they give birth are paracetamol.



There is no incinerator at the health centre, no laundry and no kitchen. We were shown the placenta pit - this was a rancid concrete deep pit which the placentas are thrown into. It's assumed that they just degrade and seep into the soil in there.

Patients wash and dry their clothes outside. I assume with no laundry the same happens with the sheets. I can only imagine what bugs are lurking on the bed clothes ready to spread disease and cause infections. I will look with new eyes at UK hospitals with their comfy beds, nice clean sheets, plentiful toilets, sinks and hand sanitiser stations when I return.

I went to see the latrines and was horrified to see that many of them are filling up. As they are old style latrines which cannot be emptied the health centre will have to try to find the money to build new ones. Us volunteers all helped to scrub the exterior floors of the centre with disinfectant but it felt futile when there are so many other problems there.

WaterAid are planning on working with Amuria health centre and partners to improve the water, sanitation and hygiene there. They hope to then use the health centre as a good practice model to improve other health facilities. This is really encouraging news and accentuates the importance of the work of WaterAid in improving water, sanitation not only for homes and schools, but also health facilities.

I left the health centre feeling very sad and incredibly humbled by these wonderful people who work so hard with huge effort and a kind heart to help those in such need. I also felt so impressed by the positive uncomplaining attitude of the patients who are so grateful for what they've got. It's going to make me much less tolerant of British people complaining about the NHS. We should appreciate what we've got, and realise we're extremely lucky.