Louisville Medicine Volume 67, Issue 8 | Page 22

STUDENT INTERNSHIP & EXTERNSHIP REFLECTIONS (continued from page 19) that access to food, water, and shelter is never a certainty. With the standard of living so heartbreakingly poor, sickness is inevitable. Learning about, and assisting with, public health concerns was a large part of our trip. For every day we spent in the clinics, we spent another day doing some kind of public health outreach. Truth be told, at first many of us, myself included, were pretty disappointed. After all, we’re medical students. We should be spending our time in the clinic learning about the presentation and treatment of a variety of tropical diseases, right? Instead, we taught a remote village an easy way to make a bulk supply of porridge, taught families how to attend to sustainable agriculture, educated families on the utility of raising rabbits, and so on. The most impactful thing we did for the long-term health of many members of the Kabale community came as a result of one of our public health outreaches. Access to clean water is likely the biggest barrier to health in Kabale. Most of the families live in one- room huts high in the hills where they care for their small plot of land. In terms of accessing clean water, the best-case scenario for these families is to send someone down the mountain with a couple large jugs. This person would then have to wait in line with everyone and eventually fill up the heavy water jugs at a well before making the grueling climb back up the mountain. One older man showed us an open gash he suffered three years prior after getting hit by a motorcycle as he made the climb up the mountain after collecting water. The wells would often run down to a trickle during the dry season. Many kids were often sent at dawn on this tiring and dangerous trek. Unable to make it back in time, kids got behind in school. Other families didn’t live close to any well and collected water instead from highly contaminated ponds. In order to combat this problem, KIHEFO began building huge rain water harvesting tanks. Built for the communities struggling to access enough clean water, these tanks were built into the ground, walled off and supplied by a series of gutters that would direct water from roofs of huts down into the tank. They had several simple and innovative ways to filter the water before it entered the tank. Inspired by what we saw, we raised $600 of our own money to sponsor and build a new tank. Construction began the next week. We dug a 6-by-9-by-5-foot hole, built walls out of eucalyptus and papyrus, and sealed it shut with a tin roof. The tank would hold over 5,000 liters of clean water. Although we had to leave before the final product was complete, our contribution would give an entire community in the mountain access to clean water for the next decade. While we were initially a little upset about the trip’s emphasis on public health, as I reflect on my experience, I am thankful. We have our whole careers to learn about recognizing and treating a variety of disease processes. Helping with the various public health projects gave us insight into the trials and tribulations the people of Uganda must overcome for basic necessities. Watching this community suffer such depths of poverty was humbling. The clinical officers, despite being some of the most 20 LOUISVILLE MEDICINE educated people in Kabale and often working upwards of 12 hours a day, made only the equivalent of $82 a month. They could save every cent they made for 30 years and not afford a house. They lived in one-room apartments with communal bathrooms. Running water and electricity were luxuries reserved for the few. Dishwashers and washing machines were non-existent. Despite the financial short- comings, all the clinical officers were incredibly happy people. They are called to medicine for the same basic reasons we are. Most are not as fortunate as the clinical officers. One Sunday morning we delivered a few dozen kilograms of food we bought for children in the local orphanage. Even though it was a weekend, the children at Little Angels Orphanage were in the midst of a social studies lesson in school. (I was taken aback by the strange irony that the 320 children packed into the handful of small classrooms were learning about population density.) The children and teachers could not have been more grateful. After their lesson, they sang, danced and played with us before wishing us goodbye. Every one of them was smiling. The children undoubtedly knew all too well that when they turn 18, they must leave this home to fend for them- selves. Almost all of the KIHEFO workers at our apartments were once orphans. Dr. Geofrey sponsored their continued education. Now they either work on the various projects in the community or as maids or chefs for students like us in the KIHEFO program. They are the lucky ones, and they will be the first to tell you such. One thing that I will never forget about Uganda is that over the course of the month we spent there, I did not hear one man, woman or child complain about one thing, ever. Not one person ever complained in our hearing. In fact, I met some of the happiest and most carefree people in my life during my time in Uganda. On the contrary, I became increasingly aware of how ingrained com- plaining is in our communication. One day we were complaining about having to go to yet another public health outreach. Another day we complained about how few patients we saw in the clinic that morning. The glaring differences in our upbringing compared to so many of the people in Kabale was literally right in front of us, and too often we turned a blind eye to it. Access to medicine, food, water and shelter are all scarce. That is the hand that the people of Kabale have been dealt. They are taught at a young age that com- plaining about their scarcities will not solve anything. Instead, they accept their situation and work hard to improve it so that the next generation can be a little better off than the last. This relentless pursuit of positivity in the face of adversity left me humbled, and inspired to do better. Carter Richardson is a second-year medical student at the University of Louisville School of Medicine.