Howard Eison MD
I’m in Uganda today. Surrounded by friends, colleagues, and so many patients. Sitting in my chair, at my desk. The light shifts, I look out the window and it’s snowing. Really coming down. Those big flakes, sticking to the railing of the fence surrounding the deck. How much snow has fallen, 5 inches, maybe 6? I redirect my gaze back inside and look again at my laptop. The picture of 4-year-old Willie high-fiving me, his big belly stretched tight with fluid and tumor, a momentary smile caught by the camera, in the blinding equatorial sun.
I spend every day in Uganda. Even though it is 7000 miles away. Because anyone who has been there, anyone who has done the type of work we do, knows that Uganda gets inside of you and you can never be away from it. Whether it is with little Willie and his shy smile, or old Suleiman, lying on a woven mat, reaching his hand up to shake mine, because that’s the only part of his body he can still lift on his own due to the ravages of disease and hunger. Mustering the strength to say thank you. For what little we can do for him.
Uganda sits on the equator in East Africa, a country about the size of Oregon (but with 10 times the population), once called the Pearl of Africa by Winston Churchill. * It’s indeed a beautiful country, not so much by the landscape, but by the people we have met there. No matter what worries they have, what troubles they carry, the Ugandan greeting is always, “You are welcome.” Hospitality, in the Ugandan style, is a fresh clean mat laid out onto the floor on which to sit, always brought for a visitor even if the family must sit on the dirt floor.
People who know us know we carry Uganda with us. Many don’t know why. Many don’t know much about Uganda and what draws us there. I can tell them facts, like, “You know, if you were born a Ugandan instead of in the US, your lifespan would be 25 years shorter.” Or “You’d make 97% less money if you worked in Uganda”, or “Your children would be 10 times more likely to die in infancy.” Harsh statistics that make us all very uncomfortable. Certain to cut conversations short. And we don’t want people to back away when we tell them about why we go to Uganda, so we don’t tell them these things, certainly not at the beginning of the dinner party. Maybe after a couple of drinks.
But it’s not the differences between countries that draw me to do the work we do, rather it’s the similarities between us that absorb me. A cough, a pain, or breathlessness are all blind to where we live, and who we are. Worries that the headache or dizziness might be a sign of something serious. Something all people experience no matter where we were born, what we do to survive. That we fear that an illness will debilitate us, perhaps make us unable to earn a living, care for our families, is the same in Uganda as it is here in the US. Weakness, nausea, and worry know no culture or government. And above all, pain. Pain ignores geopolitical borders or socioeconomic status, we all experience and fear it the same.
But the main difference between “us” and “them” is access to relief. The ailments and the misery are something we all share. To be free of symptoms is something we all strive for. To gain comfort; that is the great divide. There is the inequality born of chance.
I look out the window again and the snow has now stopped. It’s really pretty, all clean, but the afternoon sun hurts my eyes with its silent glare. I turn toward Uganda.
*Winston Churchill, 1908 “For magnificence, for variety of form and color, for profusion of brilliant life — bird, insect, reptile, beast — for vast scale — Uganda is truly “the Pearl of Africa.”