This week was another intense one at work. We visited government HIV clinics throughout Kampala to interview health workers about their training needs. The first day we worked from a highly overburdened clinic next to one of the city’s largest slums. When we arrived around 10am, the small clinic was already bursting at the seams – and the people just kept pouring in. The clinic was divided into an outpatient room, maternity ward, HIV clinic, adult male circumcision center, and an area just for HIV positive boda boda (motorcycle) drivers. In each of these areas hundreds of patients crammed onto long hard wooden benches waiting most of the day to see a nurse or doctor. The HIV clinic waiting area was actually a tent so full that patients started crowding into any available shade under trees and around buildings in the compound.
Through all of this madness, we interviewed clinic staff. I attempted to slip through the press of people – tripping over crutches and people lying on the floor, moving past mothers with screaming babies, and stepping around construction workers who were laying a sidewalk in the middle of everything. I silently cursed myself for decided to bring along an unwieldy laptop and purse, wondering how each was steadily growing heavier as the sun climbed higher. I also marveled at my choice in attire – really Faith, a polyester suit jacket?! What was I thinking?!
My day ended in the only available shade, next to the adult male circumcision tent where I waited for my colleagues and listened to a doctor explain the circumcision process to groups of young men. Fortunately for me, the explanation and accompanying video were mostly in Luganda, minimizing my psychological discomfort. Unfortunately for me, the flaps on the tent kept blowing open revealing a doctor demonstrating the circumcision motion on a fully-clad patient lying on an exam table. And that, is where I waited for three hours.
I was hot, sunburnt, dehydrated (the clinic ran out of water), and very hungry (no lunch beside a small cake). I tried valiantly to continue making charts on my laptop, but after a while I seriously began to wonder if (a) my laptop would burn a hole through my skirt, and (b) if my feet could literally cook in my shoes. Needless to say, my efficiency and analytic ability definitely suffered.
During the wait, my brain cleared just enough for me to wonder if I was experiencing the ‘real’ Kampala? I began to suspect that this crowded place full of HIV patients was closer to the public health reality than my cool, second-story office building complete with a generator and Wi-Fi. While IDI calls upon me to complete tasks for which I am trained and able, the overworked data managers at this clinic often find themselves left with the tough task of providing HIV counseling to patients.
My realization that the battle for public health in Uganda is normally a lot more hot, crowded, and messy than my experience at IDI has given me a lot to think about. In the end, I don’t think I’m cut out for work on the ‘front lines’ – I sunburn too easily and the circumcision motion alone makes me a bit queasy. But, I am happy to make my small contribution to the fight for global health equity – from a cool office with working internet.