Jawed ’17 ‘Final Pills, Final Thoughts’

Bilal Jawed ’17 – When I woke up that very first morning in Uganda, I had 87 pills of doxycycline packed away for malaria prophylaxis –one for each day in Uganda. It’s been a pure, raw, and emotional journey watching those pills disappear, day by day, pill by pill. As I swallow #87 today, I would be lying if I said I was the same person at #1. Each pill has its own taste, some sweet, others sour. It’s difficult not to reflect while holding an empty prescription bottle for the first time. A few come to mind. #2: my first day on the ward. Words and pictures will never represent the suffering and sadness adequately. #15: discovering that Mulago has a private ward for paying patients. I remember the frustration of learning how much of a difference a few dollars a day can make. #30: visiting the ward after dark to finish up some work from the day. I will never forget the overwhelming experience of swarms of people coming up to me, requesting medication and medical attention. Sick people remain sick even when the doctors go home. #73: sitting down to discuss a patient only to realize that there is almost nothing we could do to treat his disease (at the time he was thought to have a condition called ICL).

Spending a holiday in the home of a good friend.

Spending a holiday in the home of a good friend.

While it is so very easy to reflect on the bad, discuss the bad, and even blog about the bad, the bad will not be what I take away from Uganda and will certainly not be what I will remember in the years to come. I will remember the people. I will remember the doctors who don’t bat an eye when work and life begin to blend. I will remember the nurse, who despite being pulled out of retirement may be one of the hardest working people I know. I will remember the lab phlebotomist who spends his day running back and forth from lab to lab to give the most up to date results, and possibly save a life. I will remember the HIV counselor who fearlessly combats years of dense misconceptions and stigma day after day without falter. I will remember the friendly Ugandans –I never once regretted starting a conversation with a stranger.

I’ll end by being honest. I am not sure how the average American can help the sick people of Uganda or if they even need our help in the first place. The issues there are infinitely more complex than just sickness. Ellen Einterz summarizes it best, “It is probably possible to fill a well by pouring water from above, but better in the long run to dig deeper and let water rise from below.” Education, stronger structures, cheaper drugs, and sanitation will always be the answers. While Africa and Uganda may be a long plane ride away (I can attest to this), we as Americans in a shrinking world are not so far away. While the majority of the world will never see the poverty in those wards first hand, the poverty is certainly there and it is very close to us. This experience has absolutely shrunk my view of the world. It has distorted and altered my view of what health is, and what it means to be a health care provider. For the rest of my life, I will always carry a slight tinge of responsibility to share the stories found in Uganda –to serve as a reminder to the other 99% of the world that will never see a Ugandan ward.

Finally, no story is complete without its thank-yous. I would like to extend an extremely deep thank you to Dr. David Boulware for opening up his project and world to me. I am always astounded by all of his work. I would also like to thank Dr. Wetzel, Mrs. Rogers, and the Global Health Initiative for making this all possible. Lastly, I would like to thank Dr. Rhein, Ms. Williams, and the entire ASTRO team for being so welcoming to their work, their lives, and for some, their country.