Uganda

African Adventure

A year studying contagious diseases at Lacor Hospital, a few months after the end of the Ebola epidemic. Work lived as mission. Because “our vocation is to try to save lives,” as Dr Matthew used to say

BY CHIARA PIEROTTI

I have been in Uganda for five months, working in the general medicine and tuberculosis wards at St Mary’s Hospital, better known as Lacor Hospital, which has been directed since 1961 by Dr Piero Corti, an Italian physician, and until five years ago by his wife Dr Lucille Teasdale, a Canadian surgeon, who died in 1996 of AIDS, contracted during her surgical work. Lacor Hospital has about five hundred beds and is located in Gulu district, in northern Uganda. This is the land of the Acholi, the rebels, and now famous also because of Ebola.

What am I doing here? I have a medical degree and this year I am finishing my third year of specialization in contagious diseases at the new university called Vita e Salute (Life and Health), attached to San Raffaele Hospital in Milan. My African adventure all started because, in a discussion with my graduate advisor about the possibility of spending a training period abroad during my specialization (whoever would have thought of Uganda?), I had dared to mention my passion for Africa and my desire to work there both as a doctor and in order to further my studies on AIDS, which is widespread in developing countries. In those very days, all the San Raffaele employees had received an e-mail from AISPO (the Italian Association for Solidarity Among Peoples, active within the sphere of San Raffaele), requesting a doctor to do clinical work at Lacor Hospital in Uganda. And so, two months after the end of the epidemic of hemorrhagic fever due to the Ebola virus (usually with a very high mortality rate, but this time it was “only” 53%), I decided to leave for Uganda with a year’s plan to study opportunistic infections affecting the central nervous system in AIDS patients and to help the two local doctors left to run the general medicine and tuberculosis wards and the outpatient clinic of the hospital, sorely tried during the Ebola epidemic.

The Ebola experience remains vivid in the minds of the staff and has profoundly affected the future of Lacor Hospital, especially after the death of Dr Matthew Lukwiya, the Medical Superintendent.

Passion and dedication
The Ebola epidemic has left behind it the fear of new epidemics of other viruses unknown to us but hidden somewhere in darkest Africa, but it has not been able to eradicate the will to start working again, as before, in the hospital. Above all, it has not diminished the passion and dedication that the entire Lacor staff puts into their work as service to their patients. This is what enabled the staff to go on facing the terrible virus even though it was extremely dangerous, to the point of claiming the lives of twelve of them, including Dr Matthew.

When you arrive at Lacor Hospital, you wouldn’t think you were entering an African hospital, because the wards are clean and functional (obviously in the African manner, but they do work), but what is especially striking is to see how the work of all the staff, from the manual workers to the physicians, is lived as a mission. It seems that the saying Dr Matthew repeated often during the hard work to contain the Ebola epidemic, “our vocation is to try to save lives,” has deeply penetrated all of them and become part of their make-up. And this, as the head nurse of the general medicine ward told me with deep emotion, originates from an education given by the example that persons like Lucille and Matthew always demonstrated in their work as service to others, to the point of death. When I asked my nurses to tell me about that time, their faces would grow somber, but as soon as they remembered the work of Matthew and others on the staff, a smile full of hope would reappear. When I arrived, the memory of those terrible moments was so vivid that during Mass we were not allowed to shake hands when we exchanged a sign of peace; on the wards, two pairs of gloves and a mask were worn while washing the floors, and the number of patients was very low, because Lacor was a synonym for Ebola, and every suspicious death set off an alarm and spread panic (once this even happened to me).

In the beginning, during my entire first month, work on the wards was very hard, partly because of language problems (communication with the majority of the patients is impossible without a nurse as intermediary, because only a few speak English), and above all because of the pace and the different approach to patients from what I had learned in Italy. Here one acquires what is called a “clinical eye,” since there are very few diagnostic instruments available (even though Lacor is one of the best hospitals in East Africa) and a great many patients to be attended to. In the mornings, I do rounds with a local doctor, Dr Henry, on the general medicine wards, where there are about ninety patients, at least half of them HIV-positive, and then, when I can, I go help Dr Yoti in the outpatient clinic, which has about 200 patients every day. I spend the entire afternoon supervising the tuberculosis ward, which “only” has thirty beds, since it has been left with no doctor in charge. I was very frightened and did not think I could handle it; I was also left alone from the start during holiday and night duty. I had been warned that the doctors and nurses watch you in the beginning, and if they don’t like you they continue to ignore you, but if they accept you, they let you know. And that is just the way it was.

Exhausting shifts
Despite the toil of exhausting shifts, a warm friendship was born with all the staff. One day I had to do the outpatient clinic for Ebola survivors (they have a check-up and laboratory analyses every two weeks) and because of a technical mix-up I was left without a nurse, which meant that I could not go on examining the patients. I ran to the general medicine ward, and none of the nurses wanted to help me because it wasn’t their job, but finally the nurse on duty, Paska, came grumblingly along, saying that if she did it, it was only for me! Often I feel inadequate because, faced with certain patients, especially those with pathologies connected with HIV infection, nothing can be done for them except to stand by them in their suffering and call Fr Vittorio for the Anointing of the Sick.

A very great help in facing these moments has come from the welcome I received from Dr Corti, Dr Bruno Corrado and his wife Valeria, members of the group of Italians who work as collaborators or volunteers at Lacor Hospital, and, unexpectedly, from the small but very lively CL community of Gulu: Brother Elio Croce, Fr Patrick, Gustavo, Rose, Proscovia, Charles, Mariano, Martin, Veronica, Ronald, and all the others. Their companionship and School of Community on Thursdays have been fundamental for facing the hard daily labor, which can be faced only by entrusting oneself to Our Lady through the Act of Consecration to Mary (written right here in Uganda). At the beginning of July we came together from all over Uganda to meet in Kampala for the Retreat of the Fraternity, in which participation was intense, despite the difficulties in following the lessons translated into English while watching videocassettes.

Unity of experience
A particularly touching moment came during Fr Giussani’s talk, because we felt the unity of the experience of the Movement which could enable all these people, Africans and Italians, to watch with attention and emotion a man miles away from Africa but who was the origin of that friendship. Not the least of my support has come, and still comes, through e-mails and telephone calls from my friends in the Fraternity of Milan and my parents in Italy. The other Italians, too (Antonella, Andrea, Eliseo, Paolo F, Paolo G, Graziano, Romano, Adriano, Davide, and all the others who are just passing through), who even though they are not a part of the experience of the Movement and might even have opposing views, have accompanied me as I faced the toil of every day, simply by living together moments outside of work, such as eating, having a beer in the bar, playing cards, or watching movies. Heated but stimulating discussions with them on the themes of life have served as a touchstone and verification of what I am and to whom I belong. Also, as Fr Giussani wrote in the Corriere della Sera, “we do not feel ourselves to be different from others; indeed, we feel more and more distinctly just like everyone else, but we have something different inside us that has impact on our life”–as Eliseo said to me right before leaving, “I do not share your certainties, but you are really a fine person;” or Andrea, “I beg you, pray for us too.”

Weighing my first months in Africa, I can say that even though they have been very hard and tiring, they have been helpful both professionally and even more so personally, as an opportunity for growth and experience of life.