By Caleb Bamwesiga
Magdalene Nayonjo is one of 653 residents of Nakkoba Village, located in rural Dundu Parish, Kyampisi Sub County – about a 45-minute mostly bumpy bus ride from the Uganda Christian University (UCU) main campus. At age 89, she’s the one I remember most during a February 2020 trip with UCU Nursing students and their head of department, Elizabeth Nagudi Situma.
Openly in her Luganda language and while plucking tiny stems from the bitter miniature apple fruit called katunkuma, she says she is barren. She admits that over the years she has been shunned for her inability to have children. Now approaching 90 years, however, she is an accepted part of her community. With her husband who has had other wives with children, she is content.
Segayi Dessan Salongo, a village council member and the student nurse contact for the day, agrees. Magdalene is a respected and valued member of this poverty-stricken village. He supports the student visits not just for their ability to apply learning but also for what they teach residents about health care. In this village, safe drinking water is not abundant. There is no health care facility or pharmacy. Knowledge of the importance of cleanliness is sparse.
Elizabeth Nagudi Situma, who sits next to me enroute to and from the village and remains with me as I meet residents, explains that these visits are part of the year four learning for students working toward a UCU Bachelors of Nursing Science degree within the School of Medicine and give opportunity to students get exposed to health care at the grass roots level.
While healthy for an elderly person, Magdalene struggles more than younger residents who spend hours in farming or brick laying and ride motorcycles called bodabodas into towns with stores and clinics.
In order to address rural and urban health care disparities, Elizabeth says that the university joins forces with the Mukono district health service.
“We signed a memorandum of understanding with the Mukono district health service,” she said. “We carry out community health nursing outreach, educating people about the health preventative measure. This program is just one aspect of the university’s efforts to improve health care in rural communities around the university.”
The UCU Head of Nursing notes that the community nursing program’s strategic initiative is emphasizing preventive measures that not only have direct impact on rural areas, but also cultivate learning opportunities for students.
“With preventive measures at finger tips, this places people in the community at a privileged position of not suffering from communicable diseases, and other diseases resulting from poor sanitation are minimized,” she said. “Students are able to address critical issues encountered by health care professionals every day, from the prevention of disease to the delivery of care.”
She also noted that public awareness of symptoms of conditions and diseases (such as strokes) can help improve the speed of receiving medical help and increase the chances of a better recovery.
“On some occasions we encounter people who are sick with diabetes or blood pressure and live without knowing they are sick,” the head of nursing said. “This delays the chances of one seeking diagnosis from medical professionals. The untreated condition can advance and get worse. In these cases, the benefit of treating the disease promptly can greatly exceed the potential harm from unnecessary treatment.”
Residents are encouraged to go to government hospitals where they can access free medical services. Mulago hospital, for example, has free diabetic clinics.
John Bosco Ntambara, one nursing student, noted long-held cultural beliefs and practices keep people from seeking health care facilities. Often, they prefer traditional healers because they are better known and live nearby.
“That’s why they go for medical treatment late,” John said. “They first believe that they will get better. Some traditional healers will tell them that the payment arrangements will be made when they heal.”
However, the university head of nursing notes that one aspect of quality nurse service delivery is understanding culture and also getting to know what traditional healers offer to clients for easy clarification to community members.
“We don’t just talk,” she said. “We listen.”
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