Meet The Nurse Who Wheeled her Patient for 5km to A Hospital

Dorris wheels her patient to the Hospital in Arua District accompanied by a care taker

For a long time now, Nurses and Midwives in Uganda have worked in low resource health facilities, and done so fairly well. Part of their success in these settings & key determinant is their willingness and ability to quickly adapt, innovate and recover. It is an admirable on-to the next one attitude. They have learned to use meager resources wisely, save essential medicines, care for and save as many lives as possible, even under tasking conditions such as, low pay, long work hours, lack of adequate Personal Protective Equipment, and lack of advanced technology. Uganda's  Nurses and Midwives make up 70% of the health work force, each and every one of those has done something sacrificial that only they or their patients know.  We are lucky in a way to be able to share in Dorris’ sacrifice, because it reminds us of those Nurses and Midwives that have gone above & beyond their duty, whose story we shall never know.

Dorris Okundinia has been a Nurse for five years, and serves at a Health Centre III in Arua District. It was a seemingly normal day for her, she reported to her Health Centre at 7am and found a patient with her care takers on the floor. Curious and concerned, she asked them what the problem was. She found out they were there for consultation and made sure they saw the Clinical Officer immediately upon his arrival at 8am. There were many laboratory tests to be done but most were unavailable at her Health Centre, the best option for the patient was a referral to a higher level facilitywhere more tests could be run and her condition managed. The District was informed and a request for an ambulance to transfer the patient was made. However 2-4hours later, there was no ambulance. 

    

“I saw the patient’s condition worsening and the ambulance from the District was not arriving” explains Dorris. Fearing for her patient, and with no other viable alternatives (due to the public transport ban) Dorris decided to transfer the patient using a wheel chair for a distance of five kilometers, on a rough terrain under the scorching sun.  The Nurses & Midwives in Uganda & all over the world have applauded her passion and resolve;

 "True, this lady deserves a meritorious award, this is the true meaning of chosen to love and serve. She is called to be a Nurse indeed." Scovia, Nurse in Kampala

“We all know that wheeling someone in the village infrastructure even if it's half a kilometer is a sacrifice, we are not drivers neither are we conductors, she is a hero, a capable medalist.” Sarah Musomesa, Ugandan Nurse in the Diaspora

The Minister of Health for Uganda, Dr. Jane Ruth Acheng praised the Nurse on her official twitter account:  

"A true hero she is. True definition of service before self. I celebrate Sr. Doris and all our Health Workers who sacrifice their lives to save thousands of lives daily” 

How sustainable is this?

We hail Dorris’ act because she risked her well being to get her patient the right help. But how sustainable is it, for Dorris and other Nurses & Midwives facing the same challenges in both the rural and urban setting to wheel their patients in case of referrals when ambulances are unavailable? When I shared the story with a Ugandan Nurse, she exclaimed saying; “She is even lucky to have had a wheel chair!” It just shows just how much we have learned to expect so little from our own Health Facilities.

The Government of Uganda, together with the Ministry Of Health and District Health Offices must do a better job of creating a healthy work environment for all Health Workers to enable them effectively serve their communities better. After an exhausting ten kilometer to & fro walk on a sunny afternoon, Dorris probably deserved a few hours rest, but that would mean that other patients are denied care. Chances are high she did not take that well deserved rest for the sake of her other patients. Which is what we want to hear! But what will happen if carers keep making such sacrifices? One wonders who will then be left to care for them.

Nurses and Midwives should not be placed in a position where they must make multiple personal sacrifices or acts that endanger their long term health and well being. The profession is not one meant to put out fires caused by a poor health infrastructure. According to the Uganda Nurses and Midwives Council, the Nursing profession encompasses:- treating the sick, conducting health research, advocacy, shaping health policy & in patient health systems management, education.

For Uganda it would seem that we have abandoned all the other key components of Nursing and are now just satisfied with our Health Workers over compensating for an inadequate health system. The failure to provide appropriate tools and equipment to Health Workers is a costly weakness long term. If indeed the bulk strength of any health system lies in it’s labor force, then now is a good time for Uganda to invest in her own, as well as the Health Facilities where they work.

 If Government  prioritized the revival of the ambulance system nationwide through provision of ambulances, setup transfer teams at both District & Facility Level across the country, this would mean that Dorris & other Nurses & Midwives would never have to wheel a patient for five kilometers again. An investment in more Personal Protective Equipment would provide adequate protection for our workforce so that they can live longer & serve more people. Revision of Nurses' & Midwives' salaries, the roll out of an annual CME strategy for all Health Facility levels to streamline on job training and the provision of more scholarships for students of  Nursing and Midwifery should also be prioritised. These are all worthy investments that are a 'win-win' for us all.

Health Workers must be given all tools and facilitated in all ways to be more efficient, more effective and less strained in their work.

Written with Input from The Nurses & Midwives in Kampala Group