Hospice Foundation

Through their relationships with various organizations at the University of Notre Dame, including the Kellogg Institute for International Studies and the Ford Family Program, Center for Hospice Care and Hospice Foundation have arranged for three students to intern in Uganda this summer. Interns were matched by PCAU with a member organization most suited to their internship goals. Throughout their time in Uganda, these three students will be blogging about their experiences.

Gaby Austgen is a MS in Global Health from the University of Notre Dame's Eck Institute for Global Health. While in Uganda, she will help in structuring a national palliative care audit (framework for monitoring and evaluation); identify methodology; research tools, work plans and establishing possible prompt updating of palliative care data. She will be placed at the Mulago Palliative Care Unit that offers palliative care to patients and families in a national referral hospital and national cancer center. She will be in Uganda from May 21st until July 6th.


Anna Heffron is an honor's student with majors in biochemistry and philosophy. She has a minor in Glynn Family Honors program of University of Notre Dame. While in Uganda, Anna will be undertaking a research project - comparing the practice of palliative care delivery in Uganda to the practices in the United States. PCAU identified Hospice Jinja as a suitable member organization that would benefit Anna. Hospice Jinja coordinates its services around Busoga region and its team visits and networks wit the five hospitals in the region. It also has out-reach clinic programs near remote villages. She will be in Uganda from June 4th until July 30th.

Emmie Mediate is a sophomore minor in International Development Studies student with Africana Studies and Pre-Medicine majors from University of Notre Dame's Kellogg Institute for International Studies. Emmie will be visiting Uganda for the second time; having spent some time last summer in Hoima and Gulu doing research work, she fell in love with the country and says returning to Uganda and doing an internship will revive all the beautiful memories of the country. While in Uganda she will be furthering her understanding of the Ugandan healthcare. Her interests are in, but not limited to, maternal health, establishing how poverty affects health care in Uganda and would like to be engaged in awareness programs. She will be placed at Kawempe Home Care, a PCAU community based member organization that provides holistic home care to people living with TB, HIV/AIDS and or cancer. She will be in Uganda from June 2nd until August 4th.

Anna - 7/27/13
Anna - 7/27/13

Emmie and I set out for Mulago, Uganda’s national referral hospital. As we sat in the usual traffic jam, I found a few new favorite signs: Curious Funeral Services, Cinderella Supermarket, and the Molly Drug Shop.

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July 24, 2013
Emmie - 7/24/13
Emmie - 7/24/13

There is a man named Nathan. You’ll probably never meet him, but if you did, you would probably become friends quickly. He’s the kind of person who lets you into himself with his smile and his calm demeanor.

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July 22, 2013
Anna - 7/22/13
Anna - 7/22/13

I forgot to mention a few things in my last post (ironic, considering how beastly long it was). First, I have finally gone running here! I had planned to go numerous times before, but plans are hard things to stick to in Uganda. So now I’ve been twice.

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July 21, 2013
Anna - 7/21/13
Anna - 7/21/13

And from my longest period yet without posting anything—I’m back! Sorry it took me so long; I thought things would get less busy as I neared the end of my time here but of course just the opposite has happened.

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July 18, 2013
Emmie - 7/18/13
Emmie - 7/18/13

I can’t help but think that this post is sardonic, as I am writing it while the power has gone out (a frequent occurrence) at my house in Kajjansi. Nevertheless, I hope that this ironic moment simply helps to further bring to light (pun intended) my point.

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July 17, 2013
Gaby - 7/17/13
Gaby - 7/17/13

In the week and a half I’ve been back, I have:

  • Chowed down on American food
  • Attended class and meetings
  • Visited two of my best friends in Chicago
  • Successfully defended my thesis, and 
  • Jammed everything I own into my car to get ready to move home.
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July 16, 2013
Emmie - 7/16/13
Emmie - 7/16/13

A popular facet of the fight against HIV/AIDS is focused on the Prevention of Mother to Child Transmission (PMTCT) to avoid the spread of the disease from one generation to the next.

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July 14, 2013
Anna - 7/14/13
Anna - 7/14/13

I’m back in the land of electricity! Although that should have an asterisk by it, considering that I got back to my apartment yesterday afternoon but didn’t have power until earlier today. Nonetheless, for the moment the electricity is working just fine.

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July 11, 2013
Emmie - 7/11/13
Emmie - 7/11/13

Today, instead of reflecting, I want to simply present a number of patient cases that I have encountered and allow the situations of each person to speak for themselves as examples of what I am seeing every day.

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July 10, 2013
Anna - 7/10/13
Anna - 7/10/13

This is going to have to be a bit of a brief update, since I’m currently out in very rural Bulindi in Hoima and the place I’m staying has no electricity, and unless I can find somewhere to charge my computer this might be my last post until Saturday.

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July 8, 2013
Emmie - 7/8/13
Emmie - 7/8/13

In Uganda, people are big fans of palliative care. PCAU is a well-respected organization and healthcare workers around the country are enthusiastic about ending suffering and relieving pain in their facility.

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July 7, 2013
emmie - 7/7/13
emmie - 7/7/13

Jinja is probably the epicenter of tourism in Uganda: it offers bungee jumping, safaris, rafting, ATVing, biking and any other adventure sport that you could probably imagine. After visiting this weekend, though, it’s clear why foreigners flock to Jinja for a vacation or a venture.

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July 7, 2013
Anna - 7/3/13
Anna - 7/3/13

Wednesday was a VERY interesting day. Rose took Emmie, Gaby, and I (and also a pharmacist and a fellow from the Ministry of Health) into the forest (no, I can’t remember its name) to see the traditional healers. It was really pretty cool.

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July 3, 2013
Gaby - 7/3/13
Gaby - 7/3/13

There’s still a pretty high demand for traditional medicine in Uganda, so Rose maintains a relationship with Dr. S’s (not even going to attempt spelling it) school of traditional medicine in the Buyijja Forest (about 1.5 hours southwest of Kampala). So today, we got to go on a little field trip into the forest with Rose, PCAU’s new pharmacist, Chris, and a Ministry of Health official.

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July 3, 2013
Emmie - 7/3/13
Emmie - 7/3/13

The wet ground is matted with leaves and pieces of wood. Trees and vines surround the entire space, save for a narrow dirt pathway leading into the depths of the woods. The fresh smell of various plants and herbs fill the air. An occasional chirp or click suggests that the biosphere is rich with diversity. We are in the depths of the Ugandan forest.

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Anna - 6/30/13
Anna - 6/30/13

This being late with posting thing is becoming a habit. On the other hand, maybe means I’m getting a grasp on Ugandan culture.

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June 26, 2013
Emmie - 6/26/13
Emmie - 6/26/13

Week 1-A female patient with an extremely distended stomach and lower abdominal pain is given treatment for ulcers by the Kawempe clinician.

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June 25, 2013
Anna - 6/25/13
Anna - 6/25/13

Today, I am happy to report that the power is back on! We were approaching the 24-hour mark and I was beginning to worry we were headed into a 3-day no-power stretch (this apparently has happened before), and then you all would be bereft of my lab report-style writing for a few days.

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June 23, 2013
Anna - 6/23/13
Anna - 6/23/13

The visit to Soroti Hospital last week hit me pretty hard. The hospital was overcrowded and understaffed, as I get the impression most Ugandan hospitals are. I’ve pretty much gotten used to the African way of doing things—very laid back, not really ever on time—and it generally doesn’t bother me, but this wasn’t the case in the hospital.

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June 20, 2013
Emmie - 6/20/13
Emmie - 6/20/13

This experience comes in the midst of our week in Soroti (East Uganda), during which PCAU has been evaluating the Soroti Regional Referral Hospital in terms of its palliative care capacity. We have been visiting the hospital, meeting various healthcare workers, seeing patients and visiting partners in the community.

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June 20, 2013
Gaby - 6/20/13
Gaby - 6/20/13

Today was great. We started the day off at the hospital, where we did some networking at different offices.

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June 19, 2013
Anna - 6/19/13
Anna - 6/19/13

I was at a hospital earlier today, supporting the scaling-up of palliative care in Soroti Regional Referral Hospital. Currently, I’m back in my hotel room listening to the rain.

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June 15, 2013
Anna - 6/15/13
Anna - 6/15/13

Thursday was a pretty long day (not meant in a negative way; we just spent a really long time out in the field). One of the home visits we made was to the most remote area I’ve seen yet: towards the end of the journey the car was just bouncing along a footpath.

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June 14, 2013
Emmie - 6/14/13
Emmie - 6/14/13

About three days ago we made a home visit to a 25-year-old female patient who was very sick – Stage 4 HIV+, TB, Kaposi’s sarcoma (a kind of cancer), herpes zooster and a hemoglobin of about 4 (way too low). The clinician and I prescribed her with a myriad of drugs to combat her various issues and then expected to see her the following week.

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June 13, 2013
Anna - 6/13/13
Anna - 6/13/13

To start with a short story: Sunday evening I took a nap (read as: laid on my bed and stared at my ceiling) for a while, and I happened to notice a large oddly shaped crack in the corner of the room. The next evening I was napping again (perhaps I should call it “contemplating the universe”) and noticed that the crack had moved! Putting my glasses on, I realized this was not a crack at all but was in fact a lizard (a gecko, I think).

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June 13, 2013
Gaby - 6/13/13
Gaby - 6/13/13

On Monday of this week, I joined Harriet (in charge of training and advocacy at PCAU), Irene from APCA (African Palliative Care Association) and Sam (who drives for PCAU but has a degree in Business Administration and Political Science and wants to go into politics) on a trip to Gulu to follow up on palliative care trainees at two different hospitals.

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Emmie - 6/11/13
Emmie - 6/11/13

I learned that pre- and post-natal care in Uganda is lacking, and may not even be present. I saw a 28-week premature baby who had just been born and was very sick.

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June 10, 2013
Emmie - 6/10/13
Emmie - 6/10/13

Today was difficult. I made my first home visit to a client who had AIDS and Kaposi’s sarcoma (cancer) in the outskirts of Kawempe. We drove to the man’s house along narrow, bumpy, dusty roads and pulled up into a muddy, dilapidated community.

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June 8, 2013
Anna - 6/8/13
Anna - 6/8/13

Since I last posted, I traveled to Jinja through one of Uganda’s huge forests, saw the Nile River and Lake Victoria, met the Hospice Jinja team, moved into where I’ll be staying while here, and spent my first day out in the field.

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June 7, 2013
Emmie - 6/7/13
Emmie - 6/7/13

6:30 am: Wakeup (usually because it starts getting light around this time and my alarm goes off).
6:30 am-7:30 am: Get ready for the day (take pills and vitamins, eat breakfast- usually a mango, yogurt or a granola bar, get dressed, check emails, etc.).

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June 6, 2013
Anna - 6/6/13
Anna - 6/6/13

Greetings from Uganda! Sorry it took me so long to actually get this blog thing started; getting the Internet to work here has been a hassle. Anyway, the flights were uneventful — although the 14-hour layover in Amsterdam was fun — and I’m happy to say I’ve now seen three continents!

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Emmie - 6/6/13
Emmie - 6/6/13

In a world where there are no HIPAA regulations, a shortage of trained medical personnel and a high prevalence of diseases to treat, volunteers/interns such as myself are highly utilized in clinics in a way that they probably would not be in the U.S.

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June 6, 2013
Gaby - 6/6/13
Gaby - 6/6/13

I visited Masaka Regional Referral Hospital this afternoon. The wards were even more crowded than at Mulago. Patients were on flimsy mattresses on the floor, their IVs hanging on the frames of the beds above them.

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June 5, 2013
Emmie - 6/5/13
Emmie - 6/5/13

Imagine a city, a bit smaller than Denver, but with roads only one or two lanes wide everywhere you go…. welcome to Kampala. With little guidance, adherence to traffic laws or any order at all, transportation in Kampala is, I have come to realize, chaotic.

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June 5, 2013
Gaby - 6/5/13
Gaby - 6/5/13

Uganda is a paradox. The land is rich and fertile. The sun shines brightly every day, and yet it rains often enough to keep things growing. Family and community are highly valued, and people are generous with their time. Yet there is so much unnecessary suffering.

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Gaby - 6/2/13
Gaby - 6/2/13

Friday was PCAU’s “update meeting,” where members are invited for a talk and discussion about a specific topic related to palliative care. This meeting’s topic was spirituality.

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June 2, 2013
Emmie - 6/2/13
Emmie - 6/2/13

Collaboration. That is the word that I would use to describe the Palliative Care Association of Uganda (PCAU). I began my first day of “work” today (it consisted of visiting PCAU’s office, meeting everyone and then running a few errands in town…the real work starts tomorrow when I begin at Kawempe Home Care, my PCAU site for the summer) and this theme of working together in palliative care seemed ever present.

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May 30, 2013
Gaby - 5/30/13
Gaby - 5/30/13

My experience at Mulago National Referral Hospital has come to an end! Today was my last day with the team. While we spent Monday and Wednesday on rounds, today we broke into smaller groups to “clerk” new patients – to take their histories, assess their pain, and create a list of problems to be presented to the team to be further discussed

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May 27, 2013
Gaby - 5/27/13
Gaby - 5/27/13

I should probably explain what exactly I’m doing in Uganda. One of the major requirements for my MS in Global Health program is to complete a “field experience,” which entails fieldwork (usually in a developing country) and a specific project. For my field experience, I am working with PCAU, the Palliative Care Association of Uganda.

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May 26, 2013
Gaby - 5/26/13
Gaby - 5/26/13
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