KS (patient’s initial) is a 20 year old woman admitted at Mulago Hospital Diabetic unit. She left her parents’ home in Sembabule district 6 years ago to go to Kampala (about 132 Km) in search of employment. This followed her failure to complete primary education due to lack of school fees. Being the eldest of seven siblings, KS had the task to support both her siblings and parents. In her opinion, leaving home then for employment was the best solution to the challenges the family had. She thought she would make enough money not only to cater for her needs, but also support her family.
Unfortunately, with her education status, KS could not get better jobs. She could only be employed as casual laborer and she worked as a house helper in several homesteads with luck to save money as she was often fired and hired after short periods of employment. Her misery got worse in January 2017 when she was diagnosed with chronic and non-curable illness; type 1 diabetes mellitus, a condition that results from body’s failure to produce insulin to metabolize blood sugar. KS got fired from her job and had nowhere to stay. She sought shelter from a nearby Pentecostal Church that run daily prayers campaign and willing to accommodate homeless persons. Although she got accommodation, overcrowding, poor hygiene, and lack of food were other challenges she was confronted with.
Consequently, due to the new challenges, she found herself in and out of hospital more frequently due to infections low and sometimes high sugar levels. She often acquired drugs at discharge, but adherence to treatment was a big challenge as she lacked both financial and social support. She lacked financial support in a sense that she could not afford drugs whenever they ran out and lacked transport to go back to the hospital for review and refills. Socially, she lacked support in a sense that she neither had a family members nor friends to confide in her fears. She was afraid of daily injections and what her colleagues would perceive of them not mention the absence of somebody to administer treatment to her. Most times she ran out of medications yet she had no money to afford a refill or travel and see a physician for a review.
At the beginning of December 2017, KS was readmitted with complications resulting from poor diabetic control. She had high glucose level, urinary tract infection and peripheral neuropathy. She had no one to provide and care for her, had no money to buy drugs and do investigations because they were not offered at Mulago hospital. It’s at this time that KS’s primary care team called Caring Hands International Medical Missions and Ministries (CHIMMAM). CHIMMAM was able provide drugs, food and paid for all investigations.
Two weeks later, KS had greatly improved and was ready for discharge. However a number of questions arose. Where would she go? How will she get drugs? Will she be able to self-administer daily injections? How will she be able to monitor her sugar levels? What would she eat? Could she be re-united with her parents and re-integrated back into her a community? There were more questions than answers.
CHIMMAM a charitable non-government organization through its multidisciplinary team discussed the possibility of returning home, getting re-integrated back in the community and as well a possibility of further training to equip her with skills that she would in future use to earn a living. The team was able to counsel her in regard to her fears; however, on visiting the hospital to engage her in implementation of the plan, she was already gone. We strongly believe that she will be back as her challenges were not fully addressed.
As mentioned above, KS’s challenge of having a chronic condition that not only requires critical monitoring with specialist care, but also finances to buy medications, glucometers for continuous monitoring and routine tests. This might not be achievable as longer as KS remains unemployed. As CHIMMAM, we would like to help and ensure that she obtains education and employable skills.
KS’s story is not unique and many Ugandans go through similar situations. We hope with the Grace of God, and the support from every willing individual, we shall be able to reach out to many more Ugandans who share similar stories.
Kiggundu John B
Doctor