By Dr. Hannah Coulter, Lukwiya Fellowship Recipient 

“We chose it at some point in our lives, maybe for the prestige it gives us, or because we want to save lives. Now I under­stand more deeply that it is a call from God. This service cannot be sep­ar­ated from the will­ing­ness to give one’s life.” — Dr Matthew Lukwiya.

Dr Matthew Lukwiya, the name­sake for the fel­low­ship I have been blessed to be first to receive, was the head of the largest hos­pital in North­ern Uganda and the last health­care pro­fes­sional to die of Ebola haem­or­rhagic fever in the dis­astrous year 2000 out­break here, which des­troyed more than 200 pre­cious lives. Dr Lukwiya worked at St Mary’s Lacor Hos­pital in Gulu, the city where I am living, and spent his final years here. While this year’s out­break has not had much impact on Gulu city and for me the risk of Ebola has been minimal, it prompts us to reflect on the con­sequences health pro­fes­sion­als suffer.

Matthew 12:49–50 (NIV) says: ‘Point­ing to his dis­ciples, he said, “Here are my mother and my broth­ers. For whoever does the will of my Father in heaven is my brother and sister and mother.”’

“It is a privilege and an honour to look after my brothers and sisters in Christ. Uganda has just been declared Ebola-free, while the outbreak continues to affect thousands in the Democratic Republic of Congo.”

NZCMS has kindly granted me this oppor­tun­ity to volun­teer as a doctor under the super­vi­sion of Dr Nick Laing at St Philips Health Centre, a clinic and small inpa­tient unit run by the Anglican Diocese in Gulu. St Philips’ ethos is to provide the best quality health­care at the lowest pos­sible price, making high-quality care afford­able for poor fam­il­ies. My col­leagues are incred­ible, and I really admire their com­pet­ence, patience and com­pos­ure in their work.

Dr. Nick and his wife Tessa have been working tire­lessly in North­ern Uganda for the last decade and a half, ful­filling the calling that God has placed on their lives.

The group of volun­teer and paid staff members has a huge variety of skills that cannot be under­val­ued in terms of people man­age­ment, medical know­ledge, social com­pet­ence, faith/​theology, astute­ness, hard work, and patience under extreme tempta­tion to act frus­trated. Many also have poten­tial to grow if given the oppor­tun­ity, and I have enjoyed hearing about their aspir­a­tions to achieve higher medical and nursing qualifications.

“Having an educational role here has been an unexpected source of joy and fun. I have been producing learning resources and tutorials to keep my colleagues up to date and promote continuing medical education.”

Whilst I am no expert, I can encour­age enthu­si­asm for learn­ing, espe­cially with the gradual intro­duc­tion of more advanced tech­no­logy. For example, Dr Nick and I ran a tutorial on the full blood count, a very basic test that almost every­one has had in New Zealand. While my col­leagues learn about inter­pret­ing red and white blood cells, I am learn­ing more about teach­ing to this target audience.

Our edu­ca­tion is obvi­ously dif­fer­ent; mine has focused on an ana­lyt­ical mindset, curi­os­ity and casting a wide net for pos­sible dia­gnoses and treat­ment options. However, in a resource-poor envir­on­ment, neces­sity dic­tates that the staff must focus on treat­ing what is in front of them quickly. Bring­ing down fevers and giving anti­bi­ot­ics are done lib­er­ally, usually fol­low­ing very basic guidelines, and deep thought about the “but why” ques­tion does not happen. To balance this in the future, we will need to take a grass­roots approach and value curi­os­ity while main­tain­ing pragmatism.

Gradu­ally, I am learn­ing to speak enough Acholi (the local Ugandan lan­guage) to hold brief func­tional con­ver­sa­tions. Listen­ing to real-time trans­lated church ser­vices, Acholi lessons and doing my best to under­stand con­ver­sa­tions that happen around me have been the best ways to learn, and slowly I am coming to under­stand more. It is a beau­ti­ful tongue and strangely similar to Te Reo Māori.

People go by at least two names, usually one English and one Acholi. It has been inter­est­ing to learn the back­ground of Acholi names, which are often based on whether they were born breech, if they fol­lowed twins, what tree their pla­centa was buried beneath, or another aspect of their birth. Having many sib­lings is common, so indi­vidu­al­ising the story of their birth helps to bring out their identity.

Many Ugandan patients are very dif­fer­ent to what I see in New Zealand, yet sim­il­ar­it­ies remain. How many 10-year-olds do you know who would treas­ure a pair of sparkly plastic high heels? Prob­ably quite a few.

“How many 10-year-olds do you know who would suffer through agonising peeling off of sticky gauze from recent burns without pain relief, fully naked except the said high heels? Soon realisation hits that this is her attempt to clutch on to dignity and individuality in a time of terror and loss of bodily control.”

A stark reminder of how unique and special each and every one of God’s chil­dren is, no matter their age, eco­nomic status, or phys­ical place in the world.

Per­son­ally, I have found the social back­ground behind the dis­eases that I am seeing thought-pro­vok­ing and chal­len­ging. One example would be pelvic inflam­mat­ory disease, an infec­tion of the inside of the pelvis that most com­monly happens to women after they have a sexu­ally trans­mit­ted infection.

Under­ly­ing many of these present­a­tions is undis­closed domestic and sexual viol­ence, and this, along with its impact on highly valued fer­til­ity, is sober­ing. My heart also aches when sick babies cannot access care through no fault of their own and don’t have input on decision-making.

“Despite the hard things, there are joyful aspects to work here. Having people come back smiling, their problem solved with simple interventions and a bit of time spent with them, has been amazing for my soul too. Prayer for, and with, our patients also forms a central part of the way we operate; something that places like New Zealand are sadly deficient in.”

In the next half of my time here, I look forward to con­tinu­ing to grow in my faith, know­ledge and support for those around me. We may not be able to change the world, but perhaps each little impact can have some ripple effect for God’s kingdom. Forget the menu, live with the resources you have today, and be glad in your cir­cum­stances. If God can clothe the flowers in outfits more stun­ning than ballgowns, how much more is your pre­cious soul worth to Him?

NZCMS sup­ports the Lukwiya Fel­low­ship run by Dr. Nick Laign in St. Philips Health Centre in Uganda. Learn more here — https://​www​.nzcms​.org​.nz/​g​e​t​-​i​n​v​o​l​v​e​d​/​l​u​k​w​i​y​a​-​h​e​a​l​t​h​-​f​e​l​l​o​w​s​h​ip/