Eight years ago, I made my first journey to the tiny village of Nansana, in Uganda, a country where an estimated 7 million children are orphans. My adventure began after my then 13-year-old daughter saw a television special on orphans in Africa and decided that she needed to change the world. Through the Internet, she found and contacted Segawa Ephraim, director of an orphanage in Uganda for about 600 children. He astutely discovered that I am a medical doctor and promised my daughter a teaching post if I would run the town clinic for one month.
Five months later, Segawa, along with six children, met my daughter, Julia, and me at Entebbe Airport. We packed into an old truck and bumped our way along heavily potholed dirt roads to the combined school and orphanage. So began a journey to a place where the needs of the orphans are so great, and the people so destitute, that I would feel compelled to return year after year.
When we arrived in Nansana, we were shocked by our first sight. The children were barefoot and dressed in rags. There was no water or electricity, and there were two “dorms” where the orphans slept head to toe on thin mats on the ground. Four unpaid teachers taught 600 children, and everyone looked hungry. The orphanage was on the brink of closure.
We hung mosquito netting in our tiny, windowless room, and the next day, awoke to the sound of children singing religious songs before they cleaned the outhouse, collected water from the local dirty river and performed other chores. Breakfast (and dinner) was posha: boiled water mixed with white flour, cooked on a huge outdoor fire, their daily menu.
My daughter taught from 7 a.m. to 5 p.m. and spent her evenings assisting with homework. I walked every day to the town clinic, about a mile from the orphanage. It consisted of a room furnished with only a table and chair and a bare light bulb that frequently lost power; it had no medical equipment at all. Fortunately, I brought basic medical tools. I treated every manner of infectious disease: worms, parasites, tertiary syphilis and many diseases I had never seen in any medical book. Malaria is the plague of the country, killing people all the time, because they cannot afford $12 for lifesaving medication; I treated about 40 cases a day. Diagnosis is based only on clinical exam, not on blood tests and X-ray imaging—presenting a daily challenge.
Three weeks into our stay, Segawa took Julia and me to Kiboga, where Rwandan refugees settled after the genocide. We drove deep into the backcountry, through reputed cannibal villages, to a village of mud huts. The people work as farmhands for about $4 per week. There is no school for the children, and no doctor ever visits. In Kampala I stocked up on enough medications to fill large suitcases. I set up a clinic under a tree, with two benches where people waited. The only doctors are witch doctors, evidenced by healed scars in parallel on patients’ bodies. From sunrise to sunset for eight days I treated patients.
Much has changed in the seven years I’ve been going to Uganda. I have my own tiny foundation, the Nansana Kiboga Fund, to improve the school in Nansana, hire more teachers and improve medical care for the village and children.
We are building a high school on land we bought locally, in Namayumba. About 5 percent of Ugandans have high-school degrees; if the children of our orphanage complete high school, they will have a dependable future. I dream of completing this, and also of building a school and clinic in Kiboga.
My work in Uganda has changed my life in so many ways. Often, as I sit on the public bus—packed with dogs, chickens, people and an occasional goat—I wonder why I feel so happy. I have come to understand that my work keeps me grounded, connected with the struggles of most people of the world, and reminds me in a very tangible way of why I became a doctor.
I watch Segawa, the orphanage director, smile at the children, and I am moved sometimes to tears. People ask me, “Why do you keep going back?” Because if I don’t, no one will. I will keep returning as long as I am physically able.
SAQ Summer ’13