Greetings from Uganda where the weather is hot and dry (a relief from an extraordinary rainy season and all the mud it presented).
Today I was able to help another patient at our local St. Joseph's Hospital. The orthopedic surgeon who visits us regularly on behalf of poor patients told me about a 48 year old man with epilepsy who was just admitted. He fell from a mango tree breaking both forearms and a hip. The hospital agreed to waive the fee for his operations this week. Our funds will support the multiple implants and braces and walker as well as food for him and his attendant caregiver. Just when you think you've seen the worst case come through the door a new person in need appears.
Last year we were able to help many poor people and refugees pay their out-patient and in-patient medical bills with almost $67,000 from Maryknoll donors to my Mission Account. Add to that the people we cared for with eye problems (cataracts) who were treated in screening programs, the total exceeded $100,000.
Village and small town life during the pandemic in central Africa goes on sometimes as if there was no pandemic at all. In the cities there is more attention to social distancing and mask wearing, probably because the people are better informed and have heard of people dying of Covid 19 at the government referral hospitals (which are full of Covid patients). Early in the pandemic central Africans generally took the pandemic warning seriously since they have been through earlier "drills" with Ebola and HIV and know how dangerous some viruses can be.
There still is a 9 PM curfew nationwide. The schools are slowly reopening since closure many months ago. No virtual learning here to speak of. We still get our temperature checked with the "gun" and have to wash our hands before entering a public place. There is less and less compliance as times goes on, enforcers just look the other way not really taking it seriously.
Several priest friends of mine have tested positive and fortunately they all recovered without any serious effect. Not so for several local religious and clergy, many of whom struggled with blood pressure and diabetes (common here).
At Mass some people are faithful to mask wearing, others carry it in their pocket until told to put it on.
At the beginning of every Mass in the refugee settlement I spend 10 minutes going through the “Standard Operation Procedures” list. The first thing I do is tell the unaccompanied children, 10 years and under, to go outside the church. Then I tell the young people to distance themselves, using the space created by the exit of the youngsters. Finally I have to tell many to go home and get a mask.
Two weeks ago I used the first reading from Isaiah, about Yahweh calling to Samuel who woke during the night and went to Eli who said "go back to sleep Samuel" until he (Eli) finally said listen to the voice and respond. I told them every Sunday I feel like the voice of God calling each of them over and over to wear their masks, only for them to forget to do so week after week. When will they finally listen?
For many reasons the Covid 19 virus has not been the huge crisis it is in the northern hemisphere. The short explanation is that life is spent outside. In addition, we have far fewer international airports and thus fewer travelers from infected countries (thanks to early travel bans from China). Rural people don't travel far from home, few have cars or even motorcycles. The weather is warm year-round so windows (if a house or school even has windows) remain open all the time which avoids indoor spread of the virus. Early on last year all bus and motorcycle-taxi traffic was stopped. Crossing the borders with our six neighboring countries requires all drivers and passengers to first produce a Covid 19 NEG Certificate. Sounds reasonable but for the fact that there are only a handful of hospitals in the country offering the expensive test.
When I send two rented trucks of food and fuel to South Sudan each month the driver and his ton-man have to take the Covid test upon returning to Uganda. They have to wait up to 5-6 days for the results to come back to the border from a lab at the other end of the country. This of course makes it difficult to find truck drivers willing to endure the wait. I sweeten the deal by giving them money to buy food while they wait at the border and I pay the 240,000 Ugandan Shillings ($65) charge for the Covid test.
Underlying all these obvious inconveniences is the true and often hidden impact of the pandemic. Hunger is everywhere because prices have gone up, the economy is in recession here too. People have lost work (like school teachers, etc. etc.) there is no job security here like in the US, and even less in the way of government subsidies or safety nets. I can't tell you how many people, of all ages, come to me for help with their family's food needs. So many families are single parent households already. Most people here in the rural areas eat once or twice a day if lucky. Yes, many cultivate small parcels of land growing staples like maize, sweet potatoes, ground nuts (peanuts), and cassava. This helps initially, if the heavy rains didn't damage their crops last year. They're lucky if the food stretches long enough until the next harvest in the fall. There are already reports of famine in some remote areas of South Sudan.
Many people suffer from stomach ulcers due to the lack of an adequate diet. If they don't fill their stomach on a regular schedule the stomach acid has nothing else to digest and starts working on the stomach lining. Unclean drinking water also contributes to a bacteria that can cause stomach ulcers.
Finally, reports are coming out that the knock-on effect of the pandemic will be more costly in lives lost than the virus itself! NGOs and governments have had to ration resources for other ongoing public health programs (malaria control, Polio and Measles vaccinations, Maternal and Child Health, etc.) and then of course the malnutrition, all add up to higher morbidity and mortality, especially among the very young and old.
We'll never know the true number of Covid fatalities here because most Africans can't afford to go to the hospital. Many self-medicate themselves incorrectly. Government hospitals don't have the PPE they need (some places nurses go on strike). There are reports this week in the NY Times that well-to-do people in Zimbabwe are importing PPE and ventilators, etc for their personal use realizing that the hospitals can't cope with the rising demand. There is a variant of the virus coming out of South Africa which is more aggressive and has caused many countries (including the US) to ban travelers from So. Africa who are not US citizens. We continue to pray that the spread of the virus and new variants will not accelerate here. If the USA won't be able to vaccinate everyone by later this year, think when that vaccine will finally reach inland Africa (if ever).
All in all, when the dust settles months/years from now, these poor countries will have wiped out much of the progress gained in public health programs of the last few years.
Peace,
John Barth, MM
Kitgum, Uganda