Five University of Lethbridge nursing students who completed their final preceptorship in Uganda this past summer got an experience that opened their eyes, tugged at their hearts, and gave them a foundation to inform their nursing practice in the years ahead.
As recipients of the President’s Grant for International Community Engagement, Tracey Christoffersen, Melissa Collins, Danielle Clearwater, Zoe Sultani and Renae Nedza, spent May, June and July in Kampala working at Mulago Hospital, a teaching hospital associated with Makerere University.
“It was definitely very intense,” says Collins. “We were exposed to some pretty harsh conditions but it was a great learning experience.”
With information and insight provided by their nursing professor Dr. Jean Harrowing, who did her doctoral research at Mulago, they prepared as best they could. Even though they knew what to expect on an intellectual level, they couldn’t prepare for the sights, sounds and smells they’d encounter.
“They go expecting to help others and to sharpen their nursing skills and knowledge, which they do, but it’s all the things between the lines and in the margins that they are startled to learn,” says Harrowing.
Mulago is a referral hospital operated by the government of Uganda. Patients are often very sick and travel long distances to reach the hospital. Nurses typically have 40 or more patients to care for with limited amounts of medications and medical supplies.
“We all became very resourceful,” says Christoffersen. “The way they were able to use other materials to replace those they had run out of was just phenomenal.”
The students worked on several units in the hospital during their preceptorship and Collins and Sultani also spent a week working in a hospital in a remote village.
“One of the heartbreaking things is they had no resources and even the pharmacy is not equipped with all of the medications or enough of them,” says Sultani.
Uganda is one of the poorest countries in the world and the majority of people live in rural areas. Daily, the students confronted the health consequences that resulted from living in poverty.
They often cared for diabetic patients whose conditions had deteriorated because they lacked the necessary supplies and knowledge to manage their disease.
“They’ve never seen a glucometer because they’re expensive and they can’t afford to buy one. They only get a certain amount of syringes and needles to do their insulin. They come to the hospital a few months later with infections all over their body because they’ve been using the same syringe and needle for the last month. Now they have ulcers and sometimes these infections have reached to their bones so now we have to amputate,” says Sultani.
The students soon realized they didn’t have the power to change the whole health system in Uganda but they tried to effect as many improvements as they could while they were there. One patient at a time, they did what they could to ease pain, offer encouragement, provide therapeutic interventions and educate patients about how to care for themselves.
Before they left Canada, the students secured thousands of dollars worth of donations and medical supplies. They used some of the funds to buy a supply of antibiotics for the rural hospital and left it with a local nurse to dispense to the patients in greatest need. They bought 15 glucometers, which they left with a doctor to distribute to young people diagnosed with Type 1 diabetes.
Nedza was also able to help out the eye unit at Mulago Hospital, thanks to a donation from the Lethbridge West Lions Club. In addition to essential tools like ophthalmoscopes to perform eye exams, the unit needed an autoclave and a refrigerator.
While they may have initially felt overwhelmed by the conditions they witnessed, they soon came to understand that medical professionals in Uganda did what they could with what they had. They saw the gratitude in the eyes of their patients and family members for the extra care they provided.
“I’m so glad I went and I wouldn’t have changed that experience for anything. You were kind of thrown into it and you had to just be confident with your abilities and yourself and do a lot of reflection, where staying in Canada I don’t think I would have gotten that,” says Clearwater.
The President’s Grant for International Community Engagement awards were first distributed this year. They were established by an anonymous donor to encourage and support U of L students who want to participate in international development work. The grant will provide up to $5,000 for students to spend an extended period of time working in a paid or volunteer role in a developing country. Three grants will be awarded annually. Applications must be submitted by 4 p.m. Jan. 30, 2015. Application details.
Danielle Clearwater
"My experience in Uganda helped me gain confidence, increased my critical thinking skills, taught me how to prioritize care, and helped me gain an understanding of healthcare within a different culture. I hope that while I was there I was able to help spread some of my knowledge to healthcare professionals and clients and their families. I learned a lot just working side by side with different healthcare professionals in the hospital and I hope that them seeing me do things the right way will spread to other people and make small changes."
Melissa Collins
"Completing my final nursing practicum in Uganda was a very rich experience, which provided learning in a professional, as well as personal manner. Professionally, I was able to work on many different units, allowing me to further develop my spectrum and skills as a nurse. There were many situations that challenged my knowledge, skills and critical thinking abilities, which I feel has now enhanced my understanding for the profession of nursing, as well as my confidence and independence level. On a personal basis, this experience has given me the exposure and chance to embrace a new culture, and develop great friendships and professional relationships around the world. However, most importantly this experience highlighted how fortunate we are to live in Canada. Although I gained a lot while working in Uganda, it was equally important that I gave back, if even on a small scale, something for the people of Uganda. I made sure that each day I gave back to at least one patient, beyond regular required care as a nurse, by further assisting them with daily needs, or necessities they could not otherwise afford. I feel that although my measures may have been small, I knew they would have a great impact on the patients I provided care for, and that they could carry on making the small changes for themselves, or their community. I hope that one day, these small changes can account for a greater difference for the people of Uganda."
Renae Nedza
"While in Uganda I gained the nursing experience of a lifetime. I was able to interact with a diverse population both culturally and medically. As my nursing skills developed and my confidence grew, I was able to provide more effective and holistic care after overcoming barriers like lack of resources, limited co-nurses, and a large number of patients. I believe I was able to leave a positive impact on my patients and fellow colleagues by bringing my skills and knowledge, but also through my caring attitude and presence in difficult times. I also was given the unique opportunity to purchase and distribute needed supplies and equipment to the eye unit at Mulago due to a generous donation from the West Lethbridge Lions Club."
Tracey Christoffersen
"Uganda, Mulago Hospital and the amazing people I met during my three-month preceptorship gave me more than I could have ever asked for. I went to Uganda with the intention to learn as much about nursing and the local culture as I could. I had the opportunity to work with a knowledgeable and passionate medical team and learned very quickly how to practice resourcefulness, think critically and cope with the unpredictable and, at times, traumatizing environment. I took it upon myself to learn as much of the local language as I could and found that it really helped with communicating with hesitant patients and also calmed some, and lightened the mood as patients giggled at my attempts to speak their language. I feel that each individual that comes into this hospital and environment leaves behind their own individual footprint. I worked very hard to prove that I deserved to work next to these phenomenal medical professionals and made lasting impressions through my care and compassion with the patients I worked with and the staff I collaborated with. I am truly grateful and humbled that I got to be part of such an amazing learning experience."
Zoe Sultani
"My experience in Uganda has been one of deep and powerful understanding as to why I chose this rewarding career. Through the exchange and sharing of current and new knowledge, therapeutic care, and advocacy with local clients and health care professionals, we have contributed to an ever-growing importance of optimal health for all, regardless of borders. The world is our community and our positive experiences will continue to reach out to those who also wish to contribute in some ways and make changes to current conditions, in the hopes of keeping this chain reaction strong and lasting."