We made up for our lack of community service yesterday on Thursday. First stop was the Soroti Secondary School, a boarding school which Pilgrim founded in the early 2000s to provide for children who had been kidnapped by the Lord’s Revolutionary Army, many of whom were forced to be child soldiers. Those children have since moved on, but the school continues to serve the indigent: its students have all lost at least one of their parents and they are from extremely poor backgrounds.

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The school children sang us some songs and performed a well-executed skit about malaria. After we were invited to go into the classrooms and meet some of the kids. Jason (of RC Queen Anne, and a fellow Young Rotarian Grant recipient) and I had a ball interacting with the students in the classroom we chose. They were interested in our daily lives in Seattle (this is when Jason told them about his kid/dog, to rousing laughter), the curriculums we studied and what languages we speak. I mentioned I had a degree in Spanish, so they asked me to say a few words – when I did, they were completely tickled. Then they tried to repeat everything I said. It was very cool. We would have loved to have stayed longer but it was time to head to our next stop.

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We were off for a tour of the hospital in Katakwi, where Pilgrim Africa implemented their malaria pilot project years ago. Most of our time was spent in the diminutive children’s ward: two shared hospital rooms with maybe 10 beds in each, a treatment room and a hallway used for emergencies and administration. One nurse serves every patient, which is why mothers are there to actually care for their children, with the nurse’s guidance. This ward often gets as many as 80 child patients, so once the few beds (which do not have bed nets, despite the fact that their occupants are usually there for malaria diagnosis and treatment) are taken, the overflow lays on mats on the floor. Mothers must feed their children and there are no kitchen facilities. They also do the wash, and dry their clothing and linens by laying them on the ground or the few wash lines present, as well as the branches of a large dead tree left on the grounds.

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The overseeing doctor/medic told us that while they frequently see malaria, they do not see Burkitt’s. We were encouraged to hear this, until we saw a little girl in front of the ward who clearly had a Burkitt’s-like growth protruding from her abdomen. When we voiced our concerns to the (locally) well-respected gentleman who was with us, he said it wasn’t Burkitt’s “and some children are just fat”. This was discouraging to hear, since last I checked, baby fat didn’t tend to make 4 year-olds look like they were near the end of a full-term pregnancy.

The winds slightly out of our sails, next we headed to work at a malaria intervention farther into “the bush”. Folks came from as far as seven kilometers away, mostly on foot and with small children and elderly in tow, to be tested for malaria. I was asked to help at the table where all the prescribed medicines were distributed. The action was non-stop, as over 1,000 people showed up (we registered 1,135, to be exact) and a significant number of these required treatment in some form. 599 people were tested that day, with 217 diagnosed with malaria – the majority of which were children. A lot of Coartem – which is used in Uganda to treat malaria in kids – went out, as well as de-worming medicine. In fact, I’d bet 85% of prescriptions filled were for de-worming. The lifestyle in this part of the country – playing outside in mud puddles, drinking tainted water, eating tainted meat, etc., etc., results in very high risk of worms in children.

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I was pleased to see the difference in this medical outreach vs. our Ssese island experience: a nurse/pharmacist explained dosage, et al, to every single patient – a very rare occurrence the other day. They left the majority of the medication gathering and dosage (once I was taught) to me, and once I had completed this they would take over, which was great. Again, somewhat the opposite was true at Ssese.

My partner in medicine distribution - she was very diligent in instructing patients on their medications, et al image

Despite the hectic pace I loved this experience. It was extremely fulfilling as I knew I was making a positive impact – and I was very appreciative to 1) be in the shade and 2) have seating this time around. And once someone even thought to bring us a bottle of water (ah, the little things)! We went as long and hard as we could, wrapping up before dusk (and therefore the mosquito-biting hour); the camp went on the following day without us to ensure that everyone was tested and treated. I can’t recall the stats from the second day but I remember that the incidence of malaria was actually materially higher. This is likely due to the fact that it took those in greater need/poorer health longer to get to the site.

image A small portion of the line of locals waiting for testing and treatment image My aperture was too open but I still really like this photo of a boy by the medical tent (ditto)

That evening wrapped with a dinner at Dorothy (Seattle #4 and an executive director for Pilgrim Africa) and her (Ugandan) husband Calvin’s house in Soroti. The camaraderie was great as always and it was nice to debrief a bit about the action-packed week, which was quickly coming to an end.

image School masters' residences near the malaria outreach location, which was on the grounds of a primary school.

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