Naggalama hospital is basically a compound of one story plastered brick buildings with corrugated roofs connected by covered sidewalks. Walking around the grounds, it has a very open airiness, families sitting on the grass preparing meals or doing laundry in the troughs provided. Children run everywhere, both pediatric patients and their supportive services of brothers, sisters, and cousins. Patients languish in beds if they are too sick, but you may find them sitting on the curb outside their ward, heplock IV in place, as if this were a fresh air sanitarium from the early 20th century America.
Observing the care at Naggalama is feels very much like going back in time. Limited technology, patchy knowledge, multi-bedded wards, and nurses in caps, it all seems so sepia toned.
In 1965, we drove our charcoal gray 1962 Rambler station wagon to “The World’s Fair” in New York City. While I don’t remember much about the fair itself, except a telephone with a television screen and some giant plaster green dinosaurs courtesy of Sinclair Oil, I remember staying at the Ambassador Hotel [1] and not sleeping due to the noise of the street below. But the highlight of the trip to me was a visit to “The Automat” where I put a nickel in the windowed wall and took out a slice of lemon meringue pie. This was my first experience of the concept of “self-serve” and I thought it was just swell.
In Uganda they still may not have self-serve frozen yogurt stores, or self-serve Korean grocers’ salad bars, or do it yourself Kinkos office machines, but in Uganda they have something we don’t have in the West. They have self-serve hospitals.
Controlled by the consumer, Ugandan hospitals have all the amenities of a US hospital without those bothersome labor costs. Most hospitals in the U.S. don’t have 24 hour dining services. Uganda does. In order to understand this concept, you first have to know that hospitals in Uganda require that every patient must have an “attendant” that stays with them at all times. In fact a patient will be refused admission if they can’t guarantee there will be someone to stay with them 24 hours a day during their hospitalization, not that there is a bed provided for your sitter. Nor a recliner, not even a plastic chair, but the concrete floor next to the sick person’s bed will be your lodging for the duration.
So you want your dinner at 2 a.m.? No problem. Your spouse or sister or auntie will prepare all your meals for you whenever you want, prepared on the floor just below the edge your bed so you can guarantee freshness. What American hospital can advertise that I ask you? Familiar foods served on your familiar plates from home, how comforting that must be.
Or sleeping on your own bed linens, changed whenever your relative is available, the epitome of “home away from home.” No need for a hospital laundry, or a costly hospital employee to make your bed. Your attendant will change your linens when you soil them at any time without having to find the call bell no matter how critically ill you are.
And medical care? No problem. Phototherapy is just a few steps away from your bed onto the lawn. And it can be combined with respiratory therapy; nothing beats some fresh air for those nasty HIV lung infections than sitting on a bench watching the other patients cough and sputter.
There’s even self-serve hygiene, with your very own wash basin brought from home from which to bathe, and a toilet only 65 feet down the hall. For the less ambulatory, a bucket brought from home stashed under the bed to spare the walk to the WC, though no curtains for privacy.
Need an x-ray? Just walk yourself over to the cashier, plunk down some Ugandan shillings and then walk over to radiology and get your x-ray handed to you in just a few minutes, after it has been hung out to dry in the sun first, of course.
Medications? No problem. Ugandan hospitals have figured that out as well. The nurse just leaves your medications at the bedside in little manila envelopes, with handwritten instructions on the envelope such as 1 x 3, or as we so cryptically would write in the US, one tab TID. And this includes pain pills for the patient to administer themselves prn, what we call Ugandan PCA. No need for those expensive pumps.
And let’s not forget your wake up call, the rooster standing next to your bed at 4:30 each morning.
Remember that the average hospitalization in the US is about $12,600, where the average bill, payable on receipt before they let you out the iron gate at Naggalama Hospital is about $16. Next time you feel your blood pressure spike when you open your bill from your local hospital, remember that Uganda is only an airplane trip away and Naggalama Hospital is there for you.
[1] The Ambassador Hotel was deservedly demolished the following year.
Observing the care at Naggalama is feels very much like going back in time. Limited technology, patchy knowledge, multi-bedded wards, and nurses in caps, it all seems so sepia toned.
In 1965, we drove our charcoal gray 1962 Rambler station wagon to “The World’s Fair” in New York City. While I don’t remember much about the fair itself, except a telephone with a television screen and some giant plaster green dinosaurs courtesy of Sinclair Oil, I remember staying at the Ambassador Hotel [1] and not sleeping due to the noise of the street below. But the highlight of the trip to me was a visit to “The Automat” where I put a nickel in the windowed wall and took out a slice of lemon meringue pie. This was my first experience of the concept of “self-serve” and I thought it was just swell.
In Uganda they still may not have self-serve frozen yogurt stores, or self-serve Korean grocers’ salad bars, or do it yourself Kinkos office machines, but in Uganda they have something we don’t have in the West. They have self-serve hospitals.
Controlled by the consumer, Ugandan hospitals have all the amenities of a US hospital without those bothersome labor costs. Most hospitals in the U.S. don’t have 24 hour dining services. Uganda does. In order to understand this concept, you first have to know that hospitals in Uganda require that every patient must have an “attendant” that stays with them at all times. In fact a patient will be refused admission if they can’t guarantee there will be someone to stay with them 24 hours a day during their hospitalization, not that there is a bed provided for your sitter. Nor a recliner, not even a plastic chair, but the concrete floor next to the sick person’s bed will be your lodging for the duration.
So you want your dinner at 2 a.m.? No problem. Your spouse or sister or auntie will prepare all your meals for you whenever you want, prepared on the floor just below the edge your bed so you can guarantee freshness. What American hospital can advertise that I ask you? Familiar foods served on your familiar plates from home, how comforting that must be.
Or sleeping on your own bed linens, changed whenever your relative is available, the epitome of “home away from home.” No need for a hospital laundry, or a costly hospital employee to make your bed. Your attendant will change your linens when you soil them at any time without having to find the call bell no matter how critically ill you are.
And medical care? No problem. Phototherapy is just a few steps away from your bed onto the lawn. And it can be combined with respiratory therapy; nothing beats some fresh air for those nasty HIV lung infections than sitting on a bench watching the other patients cough and sputter.
There’s even self-serve hygiene, with your very own wash basin brought from home from which to bathe, and a toilet only 65 feet down the hall. For the less ambulatory, a bucket brought from home stashed under the bed to spare the walk to the WC, though no curtains for privacy.
Need an x-ray? Just walk yourself over to the cashier, plunk down some Ugandan shillings and then walk over to radiology and get your x-ray handed to you in just a few minutes, after it has been hung out to dry in the sun first, of course.
Medications? No problem. Ugandan hospitals have figured that out as well. The nurse just leaves your medications at the bedside in little manila envelopes, with handwritten instructions on the envelope such as 1 x 3, or as we so cryptically would write in the US, one tab TID. And this includes pain pills for the patient to administer themselves prn, what we call Ugandan PCA. No need for those expensive pumps.
And let’s not forget your wake up call, the rooster standing next to your bed at 4:30 each morning.
Remember that the average hospitalization in the US is about $12,600, where the average bill, payable on receipt before they let you out the iron gate at Naggalama Hospital is about $16. Next time you feel your blood pressure spike when you open your bill from your local hospital, remember that Uganda is only an airplane trip away and Naggalama Hospital is there for you.
[1] The Ambassador Hotel was deservedly demolished the following year.
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