On my final day of work at Save the Mothers, I left the office feeling not great and woke up the next morning in a state of semi-delirium with a dangerously high fever, extreme weakness, difficulty breathing, and a severe migraine.
This was far worse than any of the numerous parasites, amoebas, or other unpleasantries my body had endured over the course of the year. In my cloudy-minded state, I was picked up by a driver and taken to one of Uganda’s best hospitals in the capital city, Kampala.
Alone and hardly able to hold myself up long enough to walk through the emergency department doors, I was greeted with an empty reception desk. When the receptionist finally returned, I told her I needed to see an ER doctor immediately. She asked me if I had insurance. I told her, between labored breaths, that I didn’t have my card on me. She told me I’d have to go pay at the cashier before I could see the doctor. I told her I needed to lay down immediately and that I couldn’t breathe. Reluctantly, she walked me to an empty ER bed and told me to stay there until the doctor came.
Two hours later, I still hadn’t received any meds to reduce the fever, my body burned, my head pounded, and I struggled to breathe against the weight of my lungs. I lay in my bed, the sound of another patient moaning in pain behind the curtain next to me.
At this point, I was terrified I might die alone in a Ugandan hospital.
After a year working on maternal and child health issues in a country where one in 1,000 births in a health facility results in the death of a mother, I’m ashamed to admit that I’d become a bit numb to the whole experience. I got bogged down in proposal writing, stuck in front of my computer screen, and started to lose my heart connection to this work. Bad news when you’re toiling away in a field where that vital connection is sometimes the only thing that keeps you going.
About 6 hours after arriving, I was still in the ER, and finally getting some IV meds (antibiotics, I guess, though I wasn’t told by the nurse who administered them) and oxygen. I had also been joined by some Global Health Corps friends who sprung into action the moment they arrived, grilling the health workers about my condition, calling their contacts at home for clinical advice, ensuring my health insurance situation was straightened out, and making sure I was drinking plenty of fluids.
At some point, I overheard one of the nurses saying “septicemia,” and if I hadn’t been utterly exhausted and delirious, I probably would have completely freaked out.
After a blood test, chest x-ray, urinalysis, vaginal swab, and some other exams, it was decided that I should stay in the ICU for the night. I have no idea how long I’d been in the ER when I was finally wheeled upstairs to the ICU. All I know is, I was relieved to see a familiar face among the doctors stationed in the ICU for the night—a friend’s fiancé, who immediately put me more at ease.
I spent the entire sleepless night vacillating between teeth-chattering, body-quaking chills and sheet-soaking, feverish sweats. Nurses came by every now and then to feed me various pills or change my IV bag or check my oxygen consumption. In the morning, three nurses and a doctor attempted to draw blood from four different veins. Despite my being totally dehydrated, one of them eventually succeeded, and since my fever appeared to have stabilized, I was transferred to the general ward.
Once settled in my room in the general ward, I was given the results of my chest x-ray—pneumonia. I asked how in the world I could have gotten pneumonia and what the other tests had shown. The doctor said it was difficult to know how the pneumonia developed, and that I wouldn’t know the results of my blood, urine, or swab tests for another couple of days. Understandable, but frustrating, confusing, and scary nonetheless.
I spent the next few days in a private suite (big shout-out to my dear, Lena, who went out of her way to arrange this with my insurance company, which is the only reason I ended up in such nice quarters) hooked up to a constant flow of IV antibiotics, oxygen, and fluids, and surrounded by my surrogate family—friends from GHC, Save the Mothers, and various other spheres of my life in Uganda. I had visitors from sunrise to sundown, who brought me food, clean clothes, entertainment, and lots of hugs.
As soon as she heard I was in the hospital—and despite having a brand new baby at home—the unshakeable force that is Dr. Eve Nakabembe called every doctor she knew at the hospital where I was admitted and made sure I was assigned one of the best in the ward. She called me—and my doctor—every day to check in. Quraish, one of my best friends here in Uganda, stayed with me at the hospital, sleeping in the spare bed in my room, and comforting me every time I had to endure another needle stick or I woke up soaked in sweat.
Even with all of this support, advocacy and care, I was really scared.
I’d never been hospitalized before—let alone in a foreign country, far away from my family. I’d also spent the better part of this past year assessing the quality of care in hospitals throughout Uganda and speaking with health workers about the resources and supplies they lacked to do their jobs. And now, here I was, a patient in the same struggling health care system.
As I lay in my hospital bed on the fourth day, in a brief moment of solitude between the constant flow of friends and nurses, I imagined this whole scenario happening with no one there to advocate for me, no financial resources to pay for the services, and no access to a functioning, well-equipped health facility. I imagined it happening to people I love and care about. Or to the many beautiful faces I saw in crowded hospital waiting rooms, labor suites, and postpartum wards over this past year.
Because that’s the reality. Daily life for so many people in this country, in this world. And it’s completely unacceptable.
In that moment, I felt my privilege—and accountability—so viscerally, my eyes filled with tears and my heart burned. I finally reconnected to that vital heart space that provides me with the energy and passion to continue this work.
Speaking from experience, I can tell you that health care systems are flawed everywhere, from Uganda to the US and beyond. Siloed financing and service delivery, insufficient resources, and systems that ultimately exclude the most vulnerable are not unique to this part of the world. However, what is unique to this region is the convergence of complicated political histories and contemporary economic and social forces that amplify and perpetuate health system failures. Flows of donor money tagged to specific conditions – HIV/AIDS, malaria, ebola – ignore the more insidious issues like nonexistent primary care or an inadequate, de-motivated, and underfunded health workforce—prerequisites for functioning health systems. The vast landscape of health-related NGOs provide services in parallel to public systems, which fills an important gap, but fails to address the root causes validating their very existence. And yes – corruption, extreme poverty, and poor management of resources – also contribute to these problems. It’s complex.
Your eyes may have glazed over at this point, and I wouldn’t blame you. This stuff can get overly-intellectual, hyper-wonky, and downright overwhelming. That’s why I find the heart connection so critical. It’s what drives me when the problems seem so vast and entrenched. And it’s why ultimately, I’m so grateful for my experience in the hospital.
I’m still exploring next steps for my life and career, but one thing I know for sure is that I’ll go where my heart takes me. And for now, that means I’ll continue working to ensure that safe, high-quality, affordable health care is accessible to the poorest and most vulnerable communities in our world.