Category Archives: Faculty of Public Health, Nursing and Midwifery

Butabika National Referral Hospital, in Kampala, Uganda, is the country’s only mental health facility.

UCU nursing graduates seek to fill gap in Ugandan mental health care

Faculty of Public Health, Nursing and Midwifery, UCU School of Medicine, , , ,


 

By Douglas Olum

When Conrad Ochola suffered depression in 2017, he heard a voice in his head.

He walked before his elder sister with whom he lived and threw off some of his clothes. The abnormal action shocked not only the sister but also the rest of the family. They were not aware that Ochola, then a new graduate of Uganda Christian University (UCU), had battled his mental state for some time. He hadn’t slept for months, with strange voices constantly screaming in his head. One of the voices persuaded him to throw himself in a pit latrine. He survived because the hole leading into the pit was too small to swallow him.

Through those months, Ochola, suffering in part due to the loss of his mother, lived in fear of death, saw things in twos and dodged meals because every time he ate, he would feel pain as though he was eating his own body parts. He never told anybody.

Butabika National Referral Hospital, in Kampala, Uganda, is the country’s only mental health facility.
Butabika National Referral Hospital, in Kampala, Uganda, is the country’s only mental health facility.

It was when the 24-year-old stripped naked that the family came to realize that he indeed needed mental health care. They rushed him to Butabika National Referral Mental Hospital, where he was diagnosed with depression. After months of medication in this only such facility in Uganda, Ochola recovered.

Ochola, a marketing executive at a Uganda investment company called Xeno, is an example of how proper mental health assistance can make a positive difference.

Daniel Ojok, a high school graduate, wasn’t so fortunate. He crashed himself onto a speeding truck in December 2018 along the Gulu-Juba highway, days after dropping suicide hints that nobody got. The late Ojok is like millions of Ugandans who need mental healthcare but do not get it.

One mass example is in northern Uganda where thousands still suffer the traumatic consequences of the two-decade Lord’s Resistance Army (LRA) insurgency, hundreds have committed suicide and more still continue to do.

A recent World Health Organisation (WHO) report indicates that at least 1.7 million Ugandans (about 4.6% of the total population) suffer from depressive disorders and another 3% suffer from anxiety. Depressive disorder is a condition characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness and poor concentration. Two years ago, the WHO ranked Uganda among the top six African countries heavily affected by mental health issues.

The Uganda Protestant Medical Bureau (UPMB), a charitable and technical national umbrella organization, reports that 98% of people with mental health issues in the country do not have access to care.

The problem is attributed to lack of community-based psychiatric care facilities, poverty that incapacitates many families from taking their mentally ill members for medication and the misconception that mentally ill people are connected to witchcraft, the latter often subjecting victims to rituals that, unfortunately,cause further harm to their mental states.

Butabika Hospital currently has up to 900 patients – double its capacity. A Butabika nurse who spoke on condition of anonymity said most times the extra patients are admitted because they have no where else to go.

Often, those afflicted with mental health issues roam the streets. Men and women dressed in rags, with dirty, twisted hair and many times carrying sacks of rubbish, stroll along streets of urban places across the country or seated in isolated places, mumbling junks of sentences.

Training institutions such as the Uganda Christian University aim to lessen the Butabika overload and the number of victims on the streets.  The department of Nursing, for instance, is equipping student nurses with psychiatric nursing skills. Throughout their final semester of studies, students pursuing the Bachelor of Nursing Science, spend at least a day every week serving and learning at the Butabika Mental Hospital.

Mrs. Jemimah Mary Mutabazi, the head of the Department of Nursing at UCU, said as a department, they have been teaching mental health since the approval of their curriculum in 2006.

“It is part of curriculum because we want to equip our nurses with skills that enable them provide holistic care to their clients. Nurses work with people of different kinds including mentally ill patients and we want them to be able to handle all cases professionally,” Mutabazi said.

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For more of these stories and experiences by and about Uganda Christian University (UCU) programs, students and graduates, visit https://www.ugandapartners.org. If you would like to support UCU, contact Mark Bartels, Executive Director, UCU Partners, at m.t.bartels@ugandapartners.org or go to https://www.ugandapartners.org/donate/

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Counselors Irene Ojiambo and Joseph Musaalo at the UCU-Mukono campus (UCU Partners photo)

Erasing mental health stigma – one person at a time

Faculty of Public Health, Nursing and Midwifery, , ,


Counselors Irene Ojiambo and Joseph Musaalo at the UCU-Mukono campus (UCU Partners photo)
Counselors Irene Ojiambo and Joseph Musaalo at the UCU-Mukono campus (UCU Partners photo)

Note:  This is the first of a two-part series focusing on mental illness in Uganda.  Part I demonstrates how Uganda Christian University (UCU) deals with the problem.  Part II will provide an example of a program making a difference outside of the UCU campuses.

By Patty Huston-Holm

For Irene Ojiambo, the desire to be a counselor came before she could speak the word. As a little girl, she saw people come into her house, crying and looking for her father, a priest. Instead, the distressed men and women got her mother who had them laughing on the way out. That, the young Irene knew, was the job she wanted.

For Joseph Musaalo, the call to counseling was progressive. The students he taught and the steady flow of needy children that his wife, Sarah, brought home found him increasingly wanting to do more. It was an 11-year-old female HIV/AIDS victim who showed up at his job with Compassion International who propelled him to action.

“We were shedding tears together,” Joseph recalled of that day and the pain that he and the girl both felt about the naming-calling she endured as well, for him, feelings of inadequacy to help. “I knew I didn’t want to feel that helpless again.”

So it was that Irene, who aspired to “make people laugh” and Joseph, who sought to stop the tears, became counselors.  Their offices slope down among the trees between the Uganda Christian University (UCU) medical building and the Noll classrooms on the Mukono/main campus. UCU has counselors at all five of its locations.

The first UCU counseling office opened in 2005 – eight years after the university was founded. A pastor was hired to do the job. In 2008, Joseph came on board, seeing UCU students and staff in a small room that was part of the Allan Galpin Medical Center.

“I immediately started making a case for locating the counselor services in a place that would provide more respect,” Joseph, now head of UCU counseling services, said. “There was – still is – a stigma about people seeking help for emotional problems. Some people say they are ‘mad’.”

Today, Irene, who came to UCU four years ago, and Joseph, at UCU more than a decade, offer counseling services in a building that was once a family home. They each see about five people a day or 50 total a week – usually by appointment and most often young females. They hold large meetings in a structure that used to house a resident’s car. A white tent for the twice-a-year para-counseling workshops is nearby.

“Counseling is about empowerment and not advice,” according to Joseph, known as “Uncle Joe” for his regular column in the university’s student newspaper, The Standard. “We listen, give coping solutions and empower people to make decisions, hopefully beyond a one-time crisis.”

Friends and family members give advice that may or may not be the best and could resolve a short-term problem related to bullying, abuse, diet, study habits, drugs and money. Counselors strive to enable individuals to not only resolve a single issue but to have to have the tools to avoid re-occurrence.

Mental health is less understood in developing countries like Uganda, according to Joseph.  Butabika Hospital, founded in 1955 in Uganda’s capital, Kampala, is the mental health national referral hospital for the entire country’s population of more than 40 million. One source notes that 98% of Ugandans with mental health issues have no place to receive services.

The UCU counselors are doing their best to fill that void for students and staff. The overriding issues of fear, anxiety, self esteem and depression are connected to such conditions as drug and alcohol use and abuse, HIV/AIDS and financial deficiency and pressure toward extra-marital and pre-marital sex and academic cheating.

The counselors, along with Richard Bwire, their administrative assistant, know the clients they see barely touch the surface of the campus need. In addition to the negative stigma with asking for help is the requirement that students and staff come to the counselors and not the other way around.

“They have to come to us,” Joseph said. “We know there are many out there who feel isolated with a problem, but they need to take the first step and ask for help.”

One way to help meet the need that is too large for counselors is staff and student training.  Since 2008, there have been 2,073 students and 396 faculty and staff receiving UCU para-counseling training to help themselves and others around them. Topics include self-awareness, and anger, stress and financial management as well as basic information about frequent mental and physical topics that a trained counselor addresses.  There are some conditions – such as Post Traumatic Stress Disorder common to those coming from war-torn areas – that only a certified counselor should handle.

“We are a Christian university and we are Christians, but we always follow the path of the client first; we unwrap the problem,” Irene said. “Some people we see have been hurt by people professing to be Christians.”

One client, one workshop at a time, Uganda’s trained counselors “must change the way of thinking that somehow mental illnesses are less serious than physical ones,” according to Joseph. “And we need to realize that we all have some level and some moments of mental incapacity, but when they become large, we need help.”

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To learn more about the UCU, go to http://ucu.ac.ug/. To support UCU, go to www.ugandapartners.org and click on the “donate” button. or contact UCU Partners Executive Director, Mark Bartels, at mtbartels@gmail.com.

UCU nursing students are blessing to government hospitals

Faculty of Public Health, Nursing and Midwifery, UCU School of Medicine, , , ,


UCU student mixes drugs before administering it to a patient at Naguru Hospital while students, nurses and lecturers look on.
UCU student mixes drugs before administering it to a patient at Naguru Hospital while students, nurses and lecturers look on.

By Douglas Olum

When Ruth Nakanwagi woke up the morning of Wednesday, March 13, her two-year-old son, Rogers, was shaking with fever at a very high temperature and vomiting. She knew that the child needed emergency healthcare. But she did not have enough money to rush him to a private clinic where she expected faster treatment.

Nakanwagi, a fruit vendor in Nakawa, a Kampala city suburb, painfully took her child to Naguru Referral Hospital, a government facility located about six kilometers (3.7 miles) east of the city centre, with little hope that the child would get medication in time.

A UCU student administers medicine to a patient in the Medical Ward at Naguru Hospital while a Senior Nurse looks on.

“I tried to borrow money from my neighbors and friends so that I could take the child to a clinic but I failed. I didn’t want to bring him here because I thought I would find a long line and reluctant workers who would not quickly attend to the child but I was surprised by how they attended to him so fast,” Nakanwagi said, smiling vaguely.

The hospital, housed in two, long, double-stair buildings, indeed had patients lined up on benches, both at the children’s and adult sides of the Outpatient Department (OPD), waiting to be served. Others were at various locations, awaiting other medical procedures such as X-rays, CT scans or antenatal check-ups.

Those already served were either exiting the gate or seeking refuge from the scorching sunshine under trees in the hospital compound. And Nakanwagi and her son were part of those leaving, just about two hours after their arrival time.

Rogers was diagnosed with malaria, one of the leading killer diseases in Uganda. And their shocking good experience was because that morning, second-year Bachelor of Nursing Science students from Uganda Christian University (UCU) were at the same hospital for their practical training. The students had quickly assessed the child’s condition and facilitated the treatment processes.

Across the OPD, Children’s, Medical, Antenatal and Surgical Wards, the students, donned in white coats with the UCU logo printed on the upper left, were taking history, counseling and administering drugs to patients. Others were in the theatre, helping with surgical processes.

Human resource shortage remains a huge challenge in Uganda’s government hospitals. With a nurse-to-patient ratio of 1:11,000 (International Council of Nurses, 2013 report), the situation is further worsened by absenteeism and negative attitude towards work among the personnel who are poorly paid. Consequently, Ugandans who can afford it, turn to private healthcare service providers who charge them exorbitantly.

But with the interventions by trainees from UCU, the story is changing in some government hospitals like Naguru.

Aidah Balamaga Nabiryo, a Senior Nursing Officer in charge of the Medical Ward at Naguru Hospital, said while the number of patients often overwhelms them, the learning visits by the UCU nursing students come as a blessing to them because they not only reduce their workloads but also speed up their service delivery.

“We have a big human resource gap here.” Nabiryo said. “For instance, in the whole of this Medical Ward, we are only two established staff members and we get overwhelmed by the tasks. But when these students come, they relieve us because they are very hardworking and also very good in nursing processes like injections, psycho-social support, cleaning of patients and identifying those in need.”

She said unlike students from other universities and nursing schools that go for similar trainings when they don’t know what to do, UCU students are very well prepared and they know exactly what to do under nearly every circumstance.

“When they don’t know something, they inquire and shortly afterwards, you find them doing it very well. Apart from their medical skills, we even tap into their computer skills that help us in report writing and presentations,” Nabiryo added.

Every week, different groups of the students are taken for practical trainings for at least four out of the five working days in various government hospitals including Naguru, Kawolo and Butabika Mental Hospital. They participate in collaborative health care service provision with the hospital personnel and their lecturers.

During those processes, they are exposed to medical, surgical and child health care procedures.

Irene Nagadya, one of their lecturers, said such exposures help the students integrate the theories they learn in class with practical application in the field.

“We show them how to do and also allow them practice investigations, insertion of tubes and other basic and specific nursing care skills. Through these, we are build professionalism that will result into competent health workers,” Nagadya said.

While such hospitals are just training grounds for the students, their services cannot be taken for granted considering the huge gaps that they fill. It is therefore, no doubt that their release into the health sector will not only save many lives like Rogers’, but also speed-up and improve the quality of service delivery in Uganda’s hospitals.

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If you are interested in supporting UCU school of nursing students and their training or other programs and services at UCU, contact UCU Partners’ Executive Director Mark Bartels at  mtbartels@gmail.com, or click on the Donate button on the Partners Web site.

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UCU Partners nursing program scholarship recipients 

Faculty of Public Health, Nursing and Midwifery, Scholarship, , , ,

(NOTE: In the fall of 2018, Brendah Ndagire, UCU Partners’ Communications Associate, came on the Uganda Christian University Mukono campus to interview some UCU Partners scholarship recipients.  For a 10-day period, UCU Partners features a summary of their feedback. To support students like these, contact Mark Bartels, executive director, UCU Partners, at m.t.bartels@ugandapartners.org  or donate directly at: https://www.ugandapartners.org/donate/)

Name: Uwimbabazi Sarah

Program: Bachelor of Nursing Science

How has the scholarship helped you in your course of study?
The scholarship covers my fees, and I attend classes with no worries. This has helped me to perform better in classes.

How would do you want to use your degree and why?
I will go back to my hospital  and deliver holistic nursing care to the people within and outside the hospital with interest in maternal and child health for the betterment of our community and nation.

What do you want to say to your sponsor?
I want to express to her how much I am grateful. Thank you for making me who I am today.

Name: Murezi Mereth

Program: Master of Nursing Science

How has the scholarship helped you in your course of study?
I have had timely access to university services including lecture rooms and library. And I have been able to focus on my academic work without interruptions.

How would do you want to use your degree and why?
I want to engage in teaching activities so as to strengthen the nursing profession further. Secondly, I want to become an education specialist and largely engage in policy formulation.

What do you want to say to your sponsor?
I am very thankful for his/her support and devotion in seeing  progress in the academic arena in Uganda.

Name: Monday Edson

Program: Master of Nursing Science

How has the scholarship helped you in your course of study?
It has relieved me a lot. I have been able to attend all my classes without worries, and this has improved my concentration in class. I love my program and I have been able to take of my family alongside studying.

 

How would do you want to use your degree and why?
I want to be a university lecturer and a researcher in the nursing field.

What do you want to say to your sponsor?
Thank you so much!

Robert Kamugisha, center, with two staff members at the Uganda Nursing School (UCU Partners photo)

Alum Success: Fulfilling medical needs in tourist gorilla trekking area

Faculty of Public Health, Nursing and Midwifery, Scholarship, UCU Alumni, , , , , ,
Robert Kamugisha, center, with two staff members at the Uganda Nursing School (UCU Partners photo)
Robert Kamugisha, center, with two staff members at the Uganda Nursing School (UCU Partners photo)

By Patty Huston-Holm

“This will hurt,” the nurse said, preparing to inject a vaccination into the arm of the six-year-old boy. “But it will help you be protected for the rest of your life.”

That boy was Robert Kamugisha, now age 37 and one of the leaders of a nursing school located 100 kilometers (62 miles) from the western Uganda area where he grew up and received that immunization. He has a small injection scar with a memory of how that experience propelled him to his career in medicine.

 “Her words made me feel like a part of this at that very young age,” he recalled.

Signage of nursing school in the western Uganda area of Bwindi (UCU Partners Photo)
Signage of nursing school in the western Uganda area of Bwindi (UCU Partners Photo)

 Robert is the academic registrar at the Uganda Nursing School (Bwindi), where students can get a certificate after about 2.5 years and a diploma in about 3 years. Uganda Christian University (UCU) provides the accreditation for the school. UCU’s School of Nursing relationship with the new school in Bwindi is one example of how the university reaches under-served areas.

While westerners know Bwindi best for gorilla trekking in the Impenetrable Forest, East Africans recognize the area’s rural poverty. Behind what most tourists see is the economically and educationally poor Batwa (pigmy) tribe. The Kellerman Foundation, based in Texas, has been instrumental in serving needs of this population.

“Infant mortality is a problem here,” Robert said. That’s the topic of his soon-to-be finished master’s dissertation with UCU, where he received his Bachelor of Science in Nursing in 2013. He got that degree with the assistance of a scholarship from the Uganda Christian University Partners organization.

From practicing nurse to oversight for nurses at Bwindi Community Hospital, Robert’s career climb accelerated to a leadership position for a new school when two gorilla trekkers from the United States agreed to fund the building construction in 2013. Rotary International, through the Rotary Club of Reno, Nevada (USA), and the Rotary Club of Kihihi, Uganda, furnished the school.

The first class of 36 graduated in March of 2017. Today, there are nearly 300 Uganda, Kenya and Rwanda students studying at the Bwindi facility. 

Taking care of people, including nursing students, is second nature to Robert. As the first born of five children, he grew up with the family responsibility for his younger brother and three younger sisters with little financial support for himself.

 Robert and his wife, Uwimbabazi Sarah, have two children.  A woman from Israel sponsors Sarah’s studies at UCU through UCU Partners.

 “At some point, I want to be in a position where I can support someone other than my own family,” Robert said. “Ugandans can and should give back that way.” 

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If you are interested in supporting students who are making a difference in Uganda such as UCU Partners Scholarship Recipient Robert Kamugisha is, contact Uganda Partners’ Executive Director Mark Bartels at mtbartels@gmail.com. 

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Two Ugandan nurses gear up for expanded UCU leadership roles

Faculty of Public Health, Nursing and Midwifery, , , , ,


Elizabeth Ekong and Faith Sebuliba at Uganda Christian University (UgandaPartners Photo)

By Brendah Ndagire

In 2006, Elizabeth Ekong and Faith Sebuliba were part of the pioneer group of students enrolled in the Nursing Program at Uganda Christian University (UCU).  A dozen years later, they are close to leading it.

When they began, they did not think about the prospect of being considered the future leaders of UCU’s Nursing Program. Once they graduated with bachelor degrees in 2008, they got employed and started working as tutorial assistants for new students. As teaching assistants, they were intentionally mentored by the current founders and heads of UCU’s Nursing Department, Mrs. Jemimah Mutabaazi; and Dr. Karen Drake of Bethel University in Minnesota, USA. The mentorship process is geared towards sustaining the program leadership by putting it in the hands of Ugandans.

UCU nursing program growth
UCU nursing has deepened from certificates, diplomas and bachelor degrees to offerings at the post-graduate (PG) level. The first PG program leads to a Master of Nursing Science. Other graduate degree programs are planned in midwifery, women’s health, and psychiatry as these relate to nursing.

As trailblazers, Faith and Elizabeth graduated with their Master’s in Nursing Science in 2011. They were appointed lecturers, teaching undergraduate students in nursing classes such as foundations of nursing, medical surgical, anatomy, physiology, research, and midwifery. With Mrs. Mutabaazi, they were among only four full-time lecturers in all nursing classes for a long time. In their full-time lecturer roles, “we were expected to be an all-round teachers,” Elizabeth said. Today, they still work as lecturers as well as being online PhD students of nursing through Texila American University.

Faith with some of her students, Magdalene Kokor (right) and Kemigisha Misk (left)  –  (Uganda Partners Photo)

What makes UCU’s Nursing Program different from other programs in other universities in Uganda is that the Bachelor of Nursing curricula at UCU includes foundation courses like world views, Christian living (New and Old Testament), Christian ethics and others that ground students in reflecting and managing their future clients as individuals that deserve the best of care.

“To me, as a nurse, it is really important to strengthen my professional as well as my Christian ethics,” Elizabeth said. “As a Christian it is important to know what kind of professional ethics I am going to portray as I practice nursing.”

“All we are and what we do is the result of our faith. It is not all about being like any other nurse or teacher, but being a Christian nurse and teacher begins with serving the Author and Giver of this life we have, and inviting others to be part of that service in our communities.” Faith Sebuliba

Passion to serve
Reflecting on lessons learned as lecturers, Elizabeth and Faith both remember how they started their passion and inspiration for teaching and becoming nurses.

  • Faith remembers the time when she was a 6-year-old child and damaged her eardrum. She had accidentally put a stick in her ear. While she was at the hospital, she loved the nurses who took care of her in the entire healing process.
  • In earlier years, teaching wasn’t Elizabeth’s passion. “I had been a student and saw how teachers treated students, and I remembered that when I finished my first diploma in midwifery, I never wanted to be a teacher. Over time, I learned that I can be a teacher with a difference. This means valuing students and the work we are doing. And that’s what I wanted to do as a nursing teacher.”

Speaking about the challenges facing UCU’s Nursing Program, they have seen the main obstacles of being under-staffed due to limited funding and lower student enrolment. The program currently has some part-time staff and “the challenge with that is we are unable to stretch part-time staff. They only give you the time they have available. Our hope is that we are able to hire and have full-time lecturers in the future,” Faith said.

Regarding low student enrolment, since the program is full-time, many prospective candidates are not able to apply for full-time classes. “Many of them are already working and cannot afford to hold their work and study full-time. The enrolment numbers have been going down over the years, so our responsibility is to make sure that these number start increasing,” added Faith.

Elizabeth in class with her student Esther Gidongo.  (UgandaPartners Photo)

The main question they ask themselves is how they can keep providing good quality education and also attract a good number of students in the nursing program. In future, they are looking at revising the nursing curriculum, modifying their teaching methods to include more dialogue, and the possibility of having both online and classes on campus for undergraduate students.

“We (also) intend to increase work-based learning so as to create an impact on the employability of our graduates, and strengthen employability skills for professional nurses,” Elizabeth said.

Partnerships are key
Partnerships are one way of increasing the number of students coming through the bachelor and master degree pipeline. Two years ago, partnerships were forged with Bwindi and Kagando Schools of Nursing, which both offer Diplomas in Nursing. The two women intend to maintain this partnership, with the hope that if diploma graduates are interested in getting their BA in nursing, they would come to UCU.

They also hope to continue the tradition of grooming other students. And part of doing this is having an inclusive education. According to Faith, “students have different learning needs. Our responsibility is to come down to the level of students, and make sure that every student is included in the conversation we are having on a particular subject.” Being humble as a teacher also is important.  Teachers can learn from students.

Success viewpoints
What does success look from the two mentored nurse perspectives?

For Elizabeth, success is “when students graduate and excel in every sphere of their lives. I understand that teaching is not about me, but about what kind of graduates we put out in our communities. What makes me happy is when I see a nursing graduate having a job… [and] when our graduates are confident in what they are doing in the field.”

For Faith: “We want to see as many people come to the program and when they go out there, they are relevant to the communities they are serving.”

They are excited about the future of nursing in Uganda. According to Faith, nursing in Uganda was previously the career for someone who couldn’t qualify for university learning.

“People have looked at nursing as some kind of diversion in career,” Elizabeth said. “If you failed in this field, you can be a nurse. This led to so many people in Uganda to disrespect the field and the nurses themselves.”

Having PhD graduates within Uganda’s nursing field would enhance the profession’s credibility.  “The more qualified nursing graduates are, the more chances there are that Uganda’s healthcare system is going to improve,” Faith said.

This is pertinent to their responsibility as nurses and lecturers themselves, to change the perception of nursing and nurses at UCU and in Uganda.

“We want to let people know that the nursing field is for academicians and professionals who want to give quality nursing services to the communities in Uganda,”  said Elizabeth.

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The Nursing Department at UCU is grateful for the special partnership they have with Bethel University. And  these two women are specifically  thankful to God, Uganda Partners’ support,  and UCU leadership for investing in their growth as lecturers. If you are interested in supporting UCU’s Nursing Department or its students, contact the Uganda Partners’ Executive Director, Mark Bartels, at  mtbartels@gmail.com.

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