KAMPALA, Uganda (BP)–“Beware of the sweetness and splendour of sex,” the poster warned. “It could prove hazardous to your health and life.”
A lot of people have paid little attention to the message that hangs on an office door at Makerere University Medical School in Kampala. Uganda has one of the highest AIDS rates in the world.
Mark Pierce, a Southern Baptist missionary who is an infectious diseases specialist at the 1,700-bed hospital, said more than half his patients have AIDS. Since the hospital’s AIDS clinic began in 1987, more than 13,500 patients have registered.
The story is about the same 200 miles away at Mbarara University Hospital, where Larry Pepper, another Southern Baptist missionary, works. More than half his patients also have AIDS.
The hospitals are crowded, and there is a shortage of doctors and other medical personnel. Sometimes the hospital runs out of medicines, and patients can’t afford to buy it from a pharmacy. Diagnostic tests and medical equipment commonplace in the United States are not available. What is available is too costly for most Ugandans.
“I feel frustrated because they can’t get the medication or treatment and frustrated that there’s nothing I can do about it,” said Pierce, 42. “You can’t just stomp your foot and get what you want.”
Before he came to Uganda last summer, Pierce was director of the Infectious Disease Clinic and assistant professor of medicine at Vanderbilt University, Nashville, Tenn.
Pepper, 37, cared for astronauts and their families at NASA’s Johnson Space Center in Houston before going to Mbarara in September.
“I think it’s something all of us face, not only as missionaries, but as Americans in a country like this,” Pepper said. “People come to your door every day with needs that can’t be met.”
The doctors don’t have much privacy with their patients. That lack of privacy is evident at Makerere AIDS clinic, where Pierce and two other physicians were seeing patients on a recent morning.
The three doctors saw three patients simultaneously in a room about the size of a walk-in closet. Those waiting to be seen sit on the floor or on wooden benches in a poorly lighted hall.
Pierce left the clinic and walked through an open ward. Beds, many with chipped paint, were close together. Unscreened windows were open.
He stopped at the bed of a 30-year-old man who was comatose. The patient was suffering from cryptococcal meningitis, an illness most people could fight off, but not someone weakened by AIDS.
The man had been in the hospital several days but had received no therapy because his family can’t pay for it.
“It’s not all gloom and doom, but this is fairly common,” Pierce said.
Because the hospital has few nurses, the man’s mother and sister stayed there, sleeping on a mat on the floor beside his bed, to care for him. The mother mixed porridge and milk to feed her son through a tube.
“The hospital serves some food, but when it’s gone, it’s gone,” Pierce said.
Families not only furnish food, they also bring sheets and blankets or the patient has none. Several patients lay on bare mattresses. Outside, family members washed patients’ clothes in bright red, blue or orange plastic pans, spreading the wet things on the grass to dry.
Mbarara Hospital has a few rooms for one or two patients, Pepper said. The cost is $10 U.S. per day. If two people share the room, they split the cost.
At Makerere Hospital, chest X-rays are $1.50. The hospital has a CT scanner, but it’s seldom used because the cost is $80 and few Ugandans can afford that.
Ugandans accept AIDS and death as a matter of fact. “You see so much of it,” Pierce said. “It’s not ever routine, but you do become somewhat dull to it after a while. The people here are so different in their relationship to illness. They seem to maintain their spirits better. Their family does, too.”
Pepper is surprised at the attitude medical students have toward AIDS patients.
“I want to help students understand there is something we can do for AIDS patients,” Pepper said. “There are plenty of treatments for secondary complications, such as pneumonia and diarrhea. The thing here is: ‘They are going to die anyway, so why bother?’ I’m trying to get them to realize they can touch patients — not just touch with a stethoscope — and talk with them.”
In addition to caring for their patients’ illnesses, the two missionary doctors try to save their souls. Pepper leads a Bible study on Friday nights for medical students at Mbarara Hospital. And sometimes he tells his patients about God and gives them Bible leaflets.
He gave a leaflet to Anthony Kamuntu, 37, who had been hospitalized three days because of stomach pain. The cause of his pain hasn’t been diagnosed. Holding his Bible, Kamuntu said, “I am so happy to find out there are other people who love God.”
Pepper said, “I’m not a Billy Graham, so I’m not out there holding preaching crusades. But God has allowed me to lead a few people to Christ and that is a great reward.”
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