Walking in Pain with Cancer Patients

“Yes, I knew they were supposed to die but I made sure they would die in comfort.”

Dr Ddungu affirms in a soft voice but the conviction with which he says it, makes it loud enough for me to notice even as we drive through the streets of Kampala from Mulago Hospital.

  • Henry Ddungu, before becoming Dr Ddungu, while pursuing his first degree in Medicine and Surgery at Makerere University during clinical rounds met many distressed cancer patients – dying in pain.
  • As a young boy, he helplessly watched his own father being eaten up by cancer. He could do nothing to lessen his father’s pain till his death.

Yet Ddungu’s intention as he started studying medicine at Makerere University was to be a general physician but in his fourth year when a doctor from Hospice talked of palliative care and offered him an introductory course, his interest was stirred.  His sub specialty would be blood cancers like leukemia, lymphomas, bone marrow and failure syndrome among others.

“Understanding all aspects of blood would help me understand cancers better,” he said.

  • To ensure that his plan went through, Dr Ddungu joined Hospice Africa Uganda for further training in palliative care where at the end he would offer end of life care to patients in their homes.
  • Two years later, he decided to do a masters degree specializing in internal medicine at Makerere University and after 3 years his passion for palliative care drove him back to Hospice.
  • While working at Mulago hospital, he got an opportunity to study hematology at McMaster University in Canada.

He came back and helped push for the training of two clinicians at the same university as he advocated for hematology oncology for students studying medicine—a rare speciality in Uganda. In fact Dr Ddungu says there are only four hematology oncologists working in the government sector. Equipped with all the knowledge there is to know about blood cancers, he is now a consultant with the Uganda Cancer Institute at Mulago.

“The fact is that blood cancer is a killer but I give my patients hope of death with minimal suffering,” he explains.

He has fond memories of some of his patients. A case in point is a 13-year old girl with leukemia who told him to allow her go back to the village and die. “It was painful to hear her say that, but I gave her medicine and a year later she came back to thank me, I have never been happier,” he says. But his job comes with challenges.

For instance one has to always know the exact extent of the disease or exact cells. “Working blindly is not the best. I know what to do but I can’t do it,”he notes.

Dr Ddungu says that the Uganda Cancer Institute has most of the needed medicine to treat cancer but the novel targeted treatment is too expensive for even the more developed countries. The sadness he always lives with is knowing that his patients will sooner than later die because of lack of better medicine.

“Every doctor would love to catch a patient’s disease in its earliest stages but unfortunately patients present late. It’s often not their fault, they are not aware of little lumps.”

This, he notes requires creating more awareness, the reason he has been hosted on several radio talk shows to talk about the disease.

Dr Ddungu is however perturbed by the fact that for a long time, cancer has not been given precedence especially in terms of supportive care. “The need for blood is so high in this country but cancer patients are not prioritized for blood transfusion. More doctors, at least specialists are needed. Some doctors don’t have lunch and work nonstop on patients who sit from morning till late and even some go home without treatment,” he reveals. But even with these challenges, Dr Ddungu appreciates government’s effort to construct a new cancer building, making available free cancer medicines to patients and setting up diagnostic laboratory services.

Away from work, the 40-year-old doctor loves music. He plays a trumpet and is aspiring to master a saxophone, an instrument lying in wait in his house. Music he says gives his patients hope and spiritual healing.

“When a patient tells me, doctor I slept peacefully, that makes my heart smile,” he says with a grin.


PS: This article appeared on pg.32 of the Health Digest, an initiative by the Health Journalists Network in Uganda – HEJNU. Health Digest

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Girl Please! You got me so emotional!

She wasn’t a mean female when I joined the station in November 2010, fresh from training/working at NMG in Nairobi. We sorta hit it off, with her serenity and my sorta wildness.

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Health oyeeee! Keep smiling!

I remember my 2nd or 3rd feature on health focus scared her pant less, I was gonna report on menstruation, a topic she had never reported about and for which she said to me, “you girl, you’re dry.”

I loved her fussiness on the subject so much so that my excitement at her agony came through in my story. The Kawungezi desk (non-English bulletin) didn’t run with it, boss wasn’t that ready for menstruation and they all wondered at the words we would use in Luganda, “kibada”, “kutonya”, kukulukuta”, kukona kagere” etc, heavy words, as heavy as the menstrual flow of some females when said in Luganda.

Anyway, years later, bitch has been reporting about menstruation like she was born for it, surpassed my ‘dryness’.  Yayyyy!

Great lady who understood my moody self especially when it was bleeding time. And yeah, I did give her some headaches, she gave me some too but we worked through it all and understood each other. Helped me fetch food from Dewinton too, I detested walking ‘down there especially if food turned out to be arrrgh! I always gave her excuses as to why I couldn’t go and she bought them, hahahaha…lovely girl, glad Faddy and Patricia didn’t poison you on that front.

Anyway, thank you for helping me be a great health reporter, improving my Luganda PTCs while in the field and being a great camera girl and mic holder when it was your turn. Masaka was great, so was Karamoja and the Kampala slums!   You, very energetic and diligent woman; fast at video editing (got some shortcuts from you too); do rock!

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I however introduced you to social media, yayyy.

Nam

I am happy you’ve broken free into a new field after years of holding the mic,  thanks to NTV Uganda.   I’m happy that you’re happy, though it’s a loss to health reporting in Uganda. All you girls have quit TV health, Annah-Nat, Leah-B, you. I’m still in, so is the on and off Karungi & Uwit is catching up.

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2011, we’ve come from farrr

When I come back, let’s do the short numbers and celebrate us. Some work colleagues don’t like each other or they just tolerate each other, so I’m glad we’ve managed to stomach each other throughout the years and become more than colleagues.

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This Little Numbers Night has to be re-DONE

I call you friend and I would invite you to my wedding if I were to ever get married but you know my thoughts on the subject. Bitch you’ve managed to make me teary…lucky you and yeah I’ve sacrificed sleep to write this!

However, Irene Namyalo of https://twitter.com/irynamyalo you get extra candy for resurrecting my blog but health reporting is gonna miss your passion.  What a BlooDy loss!

Namyalo

Good luck in your new post. #ForgetNotHealth

The Cost of a Bleeding Female in Uganda

Menstruation is a natural biological process for females but it comes with tangible and intangible costs. But what role can government play in lessening the burden of menstruation through policy?

Watch the story here;

If you’ve tried to follow my life, you know I love talking about menstruation and anything female boldly!

A Win for #MaternalHealth Rights! Yay!

Press release via #CEHURD

High Court declares the right to health Justiciable in Uganda

Kampala –Uganda –

The High Court of Uganda has today declared that the right to health can be justiciable in Uganda. While delivering a judgment in which The Center for Health, Human Rights and Development (CEHURD) and others sued Nakaseke District Local Administration (Civil Suit No.111 of 2012), Justice Kabiito declared that the deceased Irene Nanteza’s rights to access emergency Obstetric care, life, health, freedom from cruel, inhuman and degrading treatment and equality and those of her children were violated.

This case was initiated after CEHURD was notified of the death of Irene Nanteza at Nakaseke district Hospital on the 5th day of May 2011. Ms. Irene Nanteza (RIP) had gone to deliver her baby like all mothers when in Labour. While at Nakaseke Hospital however, she was left to suffer an entire day without the help of a medical officer that would offer her a C-section since the nurses on duty had found her suffering an obstructed labour. She bled to death.

CEHURD decided to challenge the deliberate denial of the deceased Irene Nanteza’s access to emergence obstetric care for approximately 10 (ten) hours prior to her death and denial of access to the hospital ambulance to transfer the deceased to another health facility.

“Every woman in Uganda has a right to access emergence obstetric care. In Article 33(3) of the Constitution, the government of Uganda has committed to protect women and their rights, taking into account their unique status and natural maternal functions in society.” Mulumba, Moses, Executive Director of CEHURD noted.

Today’s judgement lays a very important precedent to Ugandans that have lost their mothers, wives, sisters and daughters due to preventable maternal deaths. We now have a platform for advocacy to ensure that expectant mothers have access to emergency obstetric care, access to quality antenatal care, access to maternal health commodities and to ensure that health workers that attend to them are well motivated.

For more information contact info@cehurd.org, nserekoibrahim@gmail.com, mugisamartha@gmail.com  kwagalap@gmail.com vivian4cehurd@gmail.com or call 0414 532283               

Womb To Tomb – Life Cycle Approach to Reproductive Health

The routine care girls get as infants determines their whole future, according to the United Nations Population Fund (UNFPA).

That’s a simple concept, but one that often gets lost in a sea of overlapping policies and our zeal to treat specific diseases when they strike, according to many public health experts.

We need planning for global health not to be driven by disease [but], rather, by a well-being perspective,” asserts Dr Babatunde Oso- timehin, the UNFPA executive director.

At a MNCH conference in South Africa

With Dr Babatunde at a 2014 MNCH conference in South Africa

Wellbeing, he says, is a life-long concern.

“How do we ensure that a pregnancy is safe? That giving birth is safe? That a baby starts life on a strong footing with good nutrition, education, [and] exercise? That children consume less sugar and fat?”

The flood of questions continues as he labours to explain the “life cycle approach” to health.

“How do you make sure that the average adolescent girl gets good comprehensive sexuality education that en- ables her to make choices like when she wants to have a baby, know how she can have a good life after babies, check for cervical cancer, and know when menopause starts?”

Dr Olive Sentumbwe, a reproductive health expert working with the World Health Organisation in Uganda, has an answer to all these questions.

Womb to Tomb

Interview with WHO Uganda’s Dr Olive

“I’ll summarize it for you: from the womb to the tomb it should be,” she says.

“The life cycle approach recognizes that what you are, you’ll become; and what your reproductive health will be like all starts when you are being formed as a baby inside your mother’s womb.” It then looks at what issues will affect the health of a person at different ages throughout her life.

For children, the approach includes good nutrition and exercise, vaccinations and good education on healthy behaviours. And by the time a woman gets pregnant, it means she should know that she needs to follow health workers’ advice and eat foods rich in folic acid and proteins.

“If a pregnant woman receives no food or little food, if she gets malaria, her baby is likely to come small, and this has implications on the child’s own ‘reproductive health career’,” she notes.

Michel Sidibé, the executive director of UNAIDS, says it is especially important to reach girls at an early age.

“We [shouldn’t] talk to women in frag- mented ways,” he says, adding: “We need to think about a life-long process.” That means reaching girls well before they become pregnant. “That will help us address issues before girls conceive, and give them skills so they can negotiate their sexuality.”

With ED UNAIDS in South Africa #IMNCH 2013

With Michel Sidibé ED UNAIDS in South Africa #IMNCH 2013

Dr Sentumbwe says children can grasp health messages from birth. “The newborn should be able to bond with both parents, hear the positive messages, and be in a good environment because everything will influence her future.” School health also is very important, she says. “If you lose them in their teens, then you are done for because this is the critical stage when they develop mentally and physically,” she ar- gues.

The teen years are when many things go wrong for girls, with unwanted pregnancies, abortions, and HIV and other sexually-transmitted diseases”, Sentumbwe notes.

UNFPA’s Dr Babatunde agrees, arguing that this is one reason why gender equality in access to education is crucial.

“Unfortunately,” says Dr Zainabu Akol, the head of Reproductive Health in the ministry of Health, “there’s no such thing as a specific policy for the life cycle approach in Uganda. It seems to be missing or unclear.”

In contrast to the scattered and rarely-discussed approach in Uganda, she cites developed countries like Japan and Korea. There, girls get passports at birth, which track their immunisations. Their mothers record any illnesses or disabilities that could affect their reproductive lives.

At menarche, girls are given their passports.  Dr Akol faults other sector players like education, which she calls ‘pretentious’ for not allowing any expansive talk about reproductive health in schools.

“We haven’t sat down and said this is a package of information we give women. You should not wake up and find that you are pregnant and [only] then wonder what you should do next.

Dr Sentumbwe maintains that the lack of open discussion has bad consequences. “That’s why people are afraid to even say, ‘I’m pregnant’ or ‘I’ve missed a period.’ Yet we know the first three months are really vital for foetus formation … we need to check a woman for everything.”

Sadly, many women don’t get the services they need during this crucial period. Uganda’s Antenatal Care policy says pregnant women should make four visits to health facilities. But according to the 2011 Uganda Demographic and Health Survey, only 48 per cent of women make all four recommended antenatal visits.

That is particularly unfortunate since these visits are designed to give women education on what foods to eat during pregnancy, preparations for birth, advice on breastfeeding, HIV testing and prevention of mother-to-child transmission of HIV, and they get to go home with insecticide-treated bed nets to protect against malaria, which disproportionately strikes pregnant women.

Most importantly, as emphasized by Dr Myres Lugemwa at the ministry’s National Malaria Control Programme, “Uganda’s policy on prevention of malaria in pregnancy recommends two doses of sulfadoxine-pyrimethamine as intermittent preventive treatment in the second and third trimester of pregnancy for all women.”

Dr Sentumbwe insists the way a pregnant woman is treated will have a huge impact on what sexual and reproductive health of the nation will look like in the future.

“They need health to enable them take care of younger nieces, daughters, nephews and sons. This is the womb-to-the-tomb issue,” Dr Sentumbwe concludes.

Dr Jessica Nsungwa, the Child Health head in the ministry of Health, acknowledges that Uganda’s policy is “a little scattered.” The country does have a reproductive health policy that covers adolescent health, family planning issues, cancer, and gynaecological problems.

“Then we have the Maternal Health policy where we have the antenatal care, childbirth and after-delivery care. Then you have a policy on newborn care, a child survival policy and a school health policy. And since some adolescents are not in school, we have the Adolescent Sexual and Repro- ductive Health policy.”

With arms moving from place to place but landing nowhere in particular, Dr Nsungwa recites these pol- icies almost in an endless singsong … not narrowing down to a particular angle at all.

That’s the problem: there are many policies, but one has to dig through them to get a complete picture. And there are gaps too.

Dr Akol says the policies haven’t been tied together in a comprehensive way that people can understand.

We haven’t sat down and said this is a package of information we give women. We don’t have human resources and a package, for example, to teach a uni- versity girl about her health.

We don’t deal with human beings … we leave people to gamble.”

Hope My girl Lynette gets it..she's growing fast!

Hope My girl Lynette gets the Womb to Tomb Approch..she’s growing fast!

PS: This was published in Health Digest http://www.hejnu.ug/ and is amongst numerous articles that won an award by the the Population Reference Bureau prb.org

Indonesian Hymen Police – 2-Finger Thrust Virginity Test & You Join

Two fingers!  I wonder if they’re gloved fingers!  Is it the thumb and the index?  The index and its neighbor?   Away from the thumb?   Or do they borrow a finger from each hand?

Which fingers are being used to dig their way into women’s vaginas in search of unbroken hymens amongst the Indonesian women so that they qualify to serve the public on the police force?

Filthy smarmy germ filled fingers, *me sums it up*!

When did humans stoop so low?  Silly question!  They stooped so low as far as the earth was created.  Where a woman is concerned it’s been a low after low ridiculous demeanor.

The sad part being the woman getting made a part of the lowness, accepting the vile afflictions bestowed on her kind!

What’s in a hymen?

My very intelligent friend from Indonesia says this, “…a top cop argued the “two-finger” virginity test is needed to find female cadets with good morals because apparently intact hymen is crucial to maintain public security.”

Dessy Sagita whom I somehow expect to confirm all this to me as untrue actually says she has testimonies. It’s bad! Real bad!

“…you should hear what I’ve heard from cousins and friends who have endured this humiliation just to score a job as underpaid cops.

How much?  A paltry $500!  Of course it could be a fortune to many!   God knows some people in my country don’t earn that in a year or even 2.

No amount can however justify this misogynistic debasing act.

Sagita refers to it as repulsive, I concur because each time I imagine those 2 fingers finding their way in there to find an intact hymen, I cringe in fear and I immediately reach to protect my own member.  I do get the shivers!  I wear my “disgust face”

The #2fingerHymencheck is just  as bad as a rapist’s dirty invasive thrust, pounding his way into the  delicate female member.  You can never get over that.

Why do we as women put up with this?  What if we all rose against such overrated stupidity in the name of virginity?

And who breaks the hymen to begin with?

Lord what’s in a hymen that makes some stupid men rape babies in the hope of curing HIV?   

What makes a man shove his disgusting finger right through your panties as he carries you – and a few meters away, your father sits oblivious to what the shithead of a friend is doing to his daughter? 

An innocent child who doesn’t even know what the hell is going on, but notices something is wrong and gets away somehow?  She later chooses to block that memory out for years and always shivers when she thinks of the idea of that finger!

I just recently told my girlfriend to break her hymen already.  She’s waiting for marriage, but she is gonna get a man who has already broken other hymens.  Let’s not forget his own virginity (which is hard to prove btw) but it’s expected of her to be pure – to bleed on the wedding night white sheets – to prove she listened to what culture and religion demanded of her since she was little.

You lose it, you’re a whore!  You’re tainted!   You’re against culture!  No man will want you for marriage!  You’re a curse to society?   

And in Indonesia, its absence will make you a bad cop.   #IndonesianHymenPolice is recruiting and little girls are gonna be told to close those legs (not that this will keep the rapists away) if they wanna get into the force.

The force’ll need proof.  How to get it?  #2fingerdisgustingthrusts in their kept virginity – in a place we’ve been taught to call private and even fear to utter its name.

Why did we get a vagina that has become a basis upon which we are judged as women?

Further reading from Sagita Dessy’s paper.

http://thejakartaglobe.beritasatu.com/news/human-rights-watch-slams-virginity-test-female-police-cadets/

I LOVE BEING LOVED – THANKS FANS

Timothy Karyegira of the Kampala Express took this.

Timothy Karyegira of the Kampala Express took this.

A lazy way to revitalise my sleeping blog.   I will post what https://www.facebook.com/pages/Kampala-Express/517413465055638?sk=photos_stream# posted about me and what some of my viewers said, those who follow KE anyway.

NTV health news reporter Florence Naluyimba (known on Facebook as Flory Mujaasi) reads through a script she’s working on at a computer, Nov. 2, 2014. With nearly 4,000 followers on the micro-blogging platform Twitter,
Naluyimba is one of many journalists whom the public seems to look up to,
and therefore the Kampala Express is increasingly focusing on, in its countrywide photo research. Journalists working in the print, and especially the broadcast news media, are among the best-known and most keenly-followed public personalities in Uganda. (PHOTO: Timothy Kalyegira)