Kisiizi Hospital is 66 years old!

In 1958 a large crowd came here  to commit to God the building of the Hospital in this remote, mountainous part of south west Uganda. The basic facilities with just a few staff that existed then have grown to the substantial hospital that is here today.

Each year, to celebrate its founding and to thank God for what He has done through the Hospital and its staff  there is a week of special clinics where patients attend for free because normal consultation fees (of  less than £1 or almost a day’s minimum pay) are waived. This attracts a large number of people with health concerns who would normally be put off because of the cost. On ’Kisiizi Day’, the official birthday of the Hospital, staff gather for a short service, entertainment and cake,

For the celebration students from the Hospital’s School of Nursing performed a traditional dance. Malcolm would love to explain what it was about but his knowledge of the local tribal language, Rukiga (pronounced Roo- chig-a), isn’t good enough!

Staff each month vote for the ‘Employee of the Month’ and this was an opportunity to honour  this year’s 12  winners. Staff also voted for the ‘Employee of the Year’ which was won by Dr. Paul Matovu. Because he was working his wife, Becky, accepted the reward for him. This was presented by Dr Henry, the Medical Superintendent .

Malcolm is getting ready to return home and to hand over his work to the other staff in the Accounts department. The Accountant, Lynn has returned from maternity leave with a baby boy and is back  at work.

One of the main functions of the office is the cashier service which receives the income from patients and others  manages the payments to staff and suppliers etc and calculates the bills for in-patients. , The service is open 7 days a week, 12 hours a day and is provided  by 3 accountancy assistants,  Esther, Lean and Sabiiti,  To help Malcolm with some of the work, the Deputy Principal Nursing Officer, Sister Agnes spends half her time in the office helping to prepare payment vouchers, checking that claims for payment are legitimate and chasing people for signatures.

Peter is currently a ‘volunteer’ on a small allowance who provides back-office support.

Berlina manages the finances of the HIV /AIDS project funded by USAID, the USA Government’s International Aid agency.

One of Malcolm’s last jobs is to update his wardrobe of African style shirts. The Hospital’s tailor, Sam, (who is also pastor of a local Assemblies of God church), was able to make one to measure. Just right for a celebration event!

"…but you can call me Stu."

 

Malcolm has been meeting a lot of new friends this week.

Easter is a traditional time for Christenings in Uganda. On Easter Sunday Sasha,the granddaughter of Medius, a Theatre Assistant, was Christened at the Hospital chapel.

Malcolm met another 6 day old baby, Faith, daughter of Abraham and Prima who are a Radiology Assistant and a nurse at the Hospital. The delivery was by Caesarean Section the previous Monday and Prima invited Malcolm for Sunday lunch just 6 days later! Amazing. Many women whose family depend on food grown on their small plot of land to survive will return to work on the land soon after having a baby. (Nothing like a bit of digging to get those stomach muscles back into condition!)

At the start of his morning walk Malcolm passes the girl’s hostel of the hospital’s School of Nursing. A routine is that every morning some of the students are tasked with sweeping the dust off the ‘pavement’ outside the hostel –a challenging job as with mud roads and paths there is dust everywhere.

This week on his walk Malcolm got into discussion with a group of children about what they eat for Easter (vegetables as their families can’t afford meat), Continents and how far the UK is from Uganda. The ambition of many children is to travel to countries such as England even though their parents usually struggle to pay their school fees of a couple of hundred pounds a year.

 

You don’t see people taking dogs for a walk here – but you do see them walking with goats and cows. Malcolm decided this one was called Stewart (Stu for short) brother of Cassie, Meatloaf, Wellington and Lunch.

Traditional butchers here do not have the hygiene standards expected in England. Cows may be butchered on a bench by the road and joints carried off strapped to the back of motorbikes or bicycles to various small shops or kiosks. Unlike the UK where meat is ‘hung’ in a cold room for several days to soften, here meat is sold and cooked the same day – absolutely necessary in a warm country where people do not own fridges, but it results in a lot tougher meat to eat.

 

Easter – from death to life

As well as treating the sick, Kisiizi Hospital also has a tourist attraction. One of the reasons the hospital was built here was the availability of water, and in particular for the hydro-electric system serviced by the local river and waterfall.

 

For the local tribe (the Bakiga - pronounced Baa-chiga) the waterfall has cultural significance, with a sad background. Daughters were valued in part because of the custom that still exists that a suitor has to pay her family if he wants to marry  – this custom, the bride price, still exists though the price of several cows has been largely replaced by cash equivalent. 

 

However, in Uganda if a daughter became pregnant before marriage and before a bride-price had been agreed then this not only brought great shame on the family, but meant that her value as a potential bride was shattered.

Different family groups had different practices. In the neighbouring town of Kabale the practice was to abandon a pregnant daughter on a small island at the centre of a lake to either die, or be claimed by any man who wanted her, who might not normally be able to afford a bride price.

In Kisiizi the custom was that the family would take the daughter to the top of the waterfall, and push her over to her death.

The task of execution was given to the eldest brother, because he would have expected the bride-price received for his sister to be used to pay for his own bride, and her pregnancy had denied him of that money / herd of cows.

Fortunately the custom of executing pregnant daughters no longer happens, in part due to the teaching of missionaries who first came to the region about 100 years ago, though the custom of bride-price continues.

A few years ago a sculpture was erected showing the change to Kisiizi. 

Once this was a place of death and grief for unmarried pregnant women and their families;

 now it's a hospital sharing the good news of Easter, and a place of joy and new life.

 

To celebrate Christian new spiritual life, on Good Friday services are held to remember Jesus’s sacrifice so that we might live. One of the local catholic churches held a walk of witness which passed the hospital, which was one of the places where they stopped and prayed for the area.

Footnote:

If you are shocked by Bakiga culture,the local young women here are shocked by how little value Britsh culture places on our daughters. Our custom was that the bride's family had to pay a dowry to the groom's family before the marriage. It is still common for the bride's family to pay for the wedding.

Ho, Ho, Hoe!

 In an attempt to keep fit (and to try and not put on too much weight) Malcolm goes for a 3 mile walk every morning, usually before breakfast. Because the hospital is  at the bottom of a valley this is 1 ½ miles, and 1 ½ miles back along the same road. As the sun rises between 6.30 and 7am this means  he  starts out in the dark.

 

Most of the people he meets are school children. Schools start very early here, with many children getting to school by 7am. The school day is much longer then in the UK with lessons ending about 5pm, just in time for the children to walk home before it gets dark

As  Malcolm walks the same route at the same time every day he has become a familiar sight, greeting the children in English and sharing ‘high fives’.

Last Thursday most of the children were carting gardening tools, presumably so that they could do  some digging to help tidy up the school  grounds. Some of the children were carrying traditional hoes. Others were carrying large machetes; knifes over 40cm long used for cutting grass, and which would be regarded as a dangerous weapon if carried in the UK.

 

Today is Palm Sunday. Here palm trees are plentiful so members of the Hospital chapel brought them to the service.

 

When Malcolm arrived he at first wondered if all branches had to be left outside.

 

He needn’t have worried. The branches were outside so that those who forgot to bring their own could pick off a few leaves to wave during the hymns

“Charity Begins at Home” – or maybe not

 When working abroad you need to be careful what you say. George Bernard Shaw called Britain and America two countries divided by a common language. Sometimes  Malcolm hears a  Ugandan say something in English which has a completely different meaning to the one he knows.

An example: ‘Charity begins at home’.

 Last week he attended a two day training course with the Board of Governors of the hospital. This was held in one of Uganda’s most recently declared cities , Mbarara. (pronounced ‘Oom  -bar – rara’.)

 

The training was attended by almost all the Board members, including the Chairman of the Board, Bishop Onesimus. Most of the Board members have been recently appointed so the training concerned the powers and responsibilities of the Board and its members in Ugandan law.

The training organisation,(the Ugandan Protestant Medical Board) was recently involved in producing a Policy document for the Church of Uganda on Health Ministry, and copies were presented to the Bishop for the Diocese.

During the training the phrase ‘Charity begins at home’ was used, which to Malcolm meant that we should take care of our own family (or country) before helping those outside our family (or country) which is sometimes an excuse not to help others. In Uganda it means don’t criticise or try to sort out other people’s problems or faults until you have sorted out your own. i.e. take the plank out of your own eye before taking the speck out of your neighbour’s eye.

(The most terrifying / exciting part of the training was Malcolm driving the 100 miles back to  Kisiizi in one of the Hospital’s large, 4 wheel drive Toyota Landcruisers, much of it in the dark on the local rough mud roads. The passengers commented that he seemed to be trying to hit all the holes in the road!). Despite not driving a car with a manual gearbox for a long time he only stalled once!

Concerning charity, there is not a large range of new clothes available to buy in Uganda, partly because there is little manufactured here, and partly because people don’t have the money. There are many tailors who will make a dress for a couple of pounds for labour. The most common source of clothing is second hand, often from surplus items sold in bulk for import to developing countries by Charity shops or collectors of recycled textiles in the UK and other countries.

Traders selling second hand clothes can be found everywhere including outside the hospital.

 

Closer to home, Malcolm's house has a garden complete with bar-b-que and shelter. 'Private' land is not so private in Uganda and someone saw an opportunity while Malcolm was away to bring their goats to feed on the grass. Still, it saved looking for a lawn mower!

Earth to earth

 When Malcolm takes a morning walk along the main road from the Hospital to the neighbouring village there are often interesting things to see. Main road? Heavy lorries use the road but it is made of earth and stones (murran) which dries to a rough, hard surface. However, when it gets very wet it turns to mud.

Just by the Hospital a heavy lorry  got stuck in a muddy patch of road and almost toppled over. The only 'rescue services' are anyone who happens to be nearby. In this case another lorry offered to tow the trapped lorry out of the hole.

 

As for the road, don’t expect the Highways department to repair the potholes. Either traffic will smooth out the ruts, or it will gradually dry out and become a series of road humps to slow down the traffic.

The road may have been made wet by the water from a stream which runs near the road. The water is relatively clean - the spring that feeds the stream further up the hill also provides water for the hospital – boiled before drunk! The stream is also useful for washing clothes – and your children!

One of the shops nearby is a coffin makers. Death is much more common here (the life expectancy is mid 40's) and there is less taboo about coffins than in the UK. Coffin manufacturers display their products openly and you often see them transported on the back of a motorbike or a car – possibly not empty! (Photo taken in Kampala a few years ago)

Along the local road you often see piles of bricks. The soil here is ideal for making mud bricks. There are no big brick companies. It’s a cottage industry and owners of several houses cut into the hillside to quarry the soil and cut it into brick shaped lumps. (This process has the added benefit of converting the slope into a building plot.)

The bricks are then allowed to dry in the sun.

For a longer lasting brick huge pyramid kilns of dried bricks are built with a space for a wood fire in the centre. When the pyramid is complete the fire is allowed to burn for several days in order to bake the bricks. When cooled down, the pile then become a stock of bricks ready to be sold or built into a house by the owner