There is one doctor at Amuria health centre. That is one doctor to serve a population of 55, 000 people. 24,000 visits a year. To oversee 160 births a month with the help of one midwife. And to be the surgeon, the gynaecologist, the paediatrician, obstetrician, you name it he did it, whatever the time day or night.
I met him and he was a lovely man. Grateful that the health centre had funded his studies and were pushing to be upgraded to district hospital status. But the conditions the man had to work in, and the conditions for the patients, they had to be seen to be believed.
I have two children. When I was pregnant the midwife told me to pack a bag to take to the hospital with some clothes for me and the baby, wash bag, nappies, snacks that type of thing. In Uganda you have to take your whole life. Nothing is provided, no food, no bedding. There is no kitchen, so relatives go and prepare food on open fires outside the wards. They do laundry outside and spread it on the grass to dry. The latrines were disgusting and to get to them you had to navigate a filthy wasteland of rubbish. Not forgetting the placenta pit and the 'incinerator', an open hearth littered with needles. I was dispirited to say the least.
Women arrive in labour on the back of bicycles. There are just 14 beds in the maternity ward. No cots. Lots of mats on the floor to cope with the extra mothers. The strongest drug is paracetamol. I dread to think what would happen with a birth like my eldest daughter's.
I needed to remind myself, through talking to the women, that they are grateful to have the facility. But I cannot get past the stench of the toilets, the all-pervading dust, the rubbish strewn compound and the odd hen wandering through the wards waiting to be made into a patients lunch.
WaterAid are hoping to assist in making this health centre a model for good water, sanitation and hygiene practices. It cannot come soon enough for the patients.