February 7, 2012
David Robinson (Engeye Scholars Fellow)
I returned to Ddegeya a week ago today and, although there is much I want to write about – part of my role here is to share updates of the work I'm doing for the Engeye Scholars program – tonight the only thing on my mind is water, and I cannot sleep. We ran out of it this morning. Or, more specifically and perhaps less dramatically, our rain collection tanks ran dry. Now, and until the next rains come (and we're just halfway through the historical dry season), we must head down the hill to fetch water at the bore hole or pond. Please understand that this is not our drinking water (we purchase 5-gallon canisters of drinking water in Masaka) but the water with which we are to cook and bathe, the water needed for everything from washing hands after using the latrine or seeing patients to water boiled for a cup of tea. Suddenly these things, and all activities and “necessities” in between, require work and planning. In this, the clinic is suddenly no different than the dozens of families in Ddegeya, who begin each day down at the well, pumping water into five gallon jerry cans to lug back to their homes. I watch children, probably age six and up, men and women haul water all day – balanced on heads, strapped four-deep to bikes, or grasped in each palm. (I witness this scene most often as I sit on the bunkhouse porch, sipping my morning coffee, made from water from our rain collection tanks that Prossey, our cook, has boiled.)
 Five days ago, when water seemed plentiful and I was still sleepwalking through the latter stages of jet lag, I was reminded sharply of how precious water is here. Or anywhere. I'd stopped to wash my hands at the smaller of the two catchment tanks, where I twirled the handle thoughtlessly so as to provide a good and respectable flow. Richard, a local who currently works with Engeye, stood quietly beside me while I washed all the red dirt from my hands. When it was his turn to wash, I noticed that he opened the spigot just enough to allow a thin thread of water to stream into his hands. At first I thought the scene was a bit ridiculous or that he didn't understand and then I was slapped by understanding. In that moment I was reminded that I must pay attention to my use – and misuse – of water. Embarrassment aside, it was a good and early lesson, and one I cannot forget. Not now, after today's two trips to the well with Mbaziira Edie to fetch water for the clinic compound.
Standing in line with the half dozen or so kids and teens waiting to fill their cans, I realized how little I think about water even now after three previous trips to this area. Every single day, from the beginning until today and into tomorrow, these kids, their parents and grandparents, what they know about water is that it is precious and it is hard work. Though I've never heard complaint -- far from it: rural Ugandans are not prone to complaining. (I hear that there's even something like a "teen hour" at the pump around dusk, when teens gather and do as teens the world over do, give or take a gadget or three.) The clinic is fortunate to have two tanks that catch rainwater from the guttered tin roof of the laboratory building. It is a grand luxury, one paid for by donors and visiting doctors and volunteers. But it is not enough. As the clinic continues to grow and to expand its services, and as more volunteers and staff move into the bunkhouse, the demand for water increases exponentially. In two weeks a medical mission from Providence Health in Portland will arrive, increasing our numbers by seven. We will then need to hire a villager to fetch our water (and lots of it) for clinic and staff use.
 I can't say that I dislike my trips to the well, although I imagine it will get old. And water is heavy. A better plan is in the works, however. This year's Minerva Fellows from Union College in Schenectady, New York, Mark O'Shea and Brendan Kinnane, have proposed to increase our rain collection system by 50,000 liters and to gutter the main clinic buildings and bunkhouses. I encourage you to read about their water project at http://engeye.org/aboutus/history/95-engeyewater.html and to share it with those whom you feel would be interested. I want to be clear: this is no Sally Struthers infomercial, asking you or anyone to cry or to feel guilty or to give to the neglected children of Africa. No one needs or wants that; not them, especially, and not us. (And the kids I know here are far from neglected!) But I think it's interesting and informative, a useful assessment of how we live on this planet and what we can do. If you know of someone who would like to help make this happen, send me a message. And I know that we will do this, that the water project will receive the funds it needs to move forward. It will be another grand and simple step in the continued growth of the Engeye, Inc and in the services it provides to the local community.
Images courtesy of David Robinson. |
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January 24, 2012
Update (February 1, 2012): Thank you everyone for helping us reach our goal. Noeline is beginning chemotherapy thanks to your generous support. We reduced our ChipIn goal, because some donors elected to donate via check, but we did reach $3,000. We will keep you updated on Noeline's progress. Thank you so much for helping Noeline fight cancer.
Occasionally in life, especially when advocating for a fellow human being, we must go to the extreme. In such cases, as medical practitioners, we often wonder if we are too entrenched or intertwined in our patients’ suffering and health. The lines become blurred. Where does the patient-provider relationship end? Where does the boundary lie in our intervention with the well-being of others? Defining the limits for when to ‘hold on’ and when to ‘let go’ can be a challenge. Noeline, a shy, barefoot, soft-spoken eight-year-old girl, entered our lives last year, and has pushed us to this edge.
As many of you know, Noeline came to the Engeye Health Clinic on July 12, 2011, feverish and clearly ill. We came to understand that over the preceding several months she had been developing a large, fungating growth that protruded from her vagina. Based on a subsequent biopsy, it was determined to be rhabdomyosarcoma, a soft tissue tumor, growing from her vaginal wall. By the time she reached us, the mass was painful, pushing on her other organs, and it was infected. Simply put, eight-year old Noeline had cancer, in the worst possible way.
But thanks to your generous donations, we were able to raise the necessary $2,000 USD, allowing Noeline to receive chemotherapy critical to treating her tumor.
 After six rounds of chemotherapy and months of emotional and physical exhaustion, we thought we had Noeline’s cancer beat. Her mass had shrunk significantly and for the first time in years, she had the energy to consider school, to haul water from the well like other little girls her age, and to laugh and smile – in short, she was able to live the life of a healthy little girl.
But last week, Noeline returned to Engeye Clinic fatigued. Her nasty mass has returned . . . and it is enlarging. A CT scan confirmed that her tumor has returned.
If future care were utterly futile, we would offer our condolences with lumps in our throats, and advocate for comfort care during her final days. But a final, second round of dual chemotherapy with immediate subsequent surgical resection is not a pipedream. In fact, this is often how this particular cancer is treated in the U.S.
We want to offer Noeline one last shot at life. If we do nothing, she will undoubtedly die. On the other hand, with this second treatment attempt, there is a chance that she will live a long, productive life. But we need your help. No doubt this will be another uphill battle, but it is one worth fighting. If Noeline were one of our daughters, nieces, cousins or next door neighbors, we would not give up. Especially for only $3,000 USD.
Putting in such an effort to save just one life doesn’t always make sense. The rational mind would suggest that Noeline’s care is “ill-advised”, that such funds “would be far better spent in any number of ways that would benefit so many more people.” This may be true.
We are ever conscious of the need to focus on the majority of the population; public health efforts geared toward basic vaccinations, primary care and clean water, and therefore, this is exactly where our principal efforts are currently centered. But sometimes we become intertwined in one patient’s care as we are working on the larger goals, and it doesn’t feel right to give up on that individual. To us, it doesn’t feel right to give up on Noeline. We must realize the sea of need and focus our efforts there, but we cannot forget that the sea is comprised of individual drops of water.
Please help The Engeye Team raise $3,000 USD as soon as possible to help secure emergency treatment for Noeline. Her Ugandan oncologists and surgeons are on board and she and her mother are currently in Kampala awaiting her final attempt at life-saving treatment. This is a very time-sensitive plea and we need to act swiftly. If treatment does not work, we will utilize any remaining funds to ensure that Noeline's final days are comfortable. To donate, please use the ChipIn button above. You may also send a check to Engeye, Inc, 1500 SW 11th Avenue, Suite 2304, Portland, OR 97201, marked for Noeline's treatment. We also welcome any phone calls to further discuss Noeline's treatment course. E-mail
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to set up a phone call meeting.
Thank you for stepping forward and giving Noeline another chance for life.
We realize this is an outlying project that does not follow our regular allocation of funds, which generally benefit large groups of people and the clinic as a whole. Because this is a unique project, in that it only benefits one person, similar to the Save Susan project, we do not feel it is ethical to use general donor or general clinic funds. The Save Noeline project will only use funds that are specifically earmarked for Noeline's care.
(Updated January 26, 2011) |
January 7, 2012
UPDATE (February 3, 2012): The water project reached its initial goal of $5,500! This will help build the initial infrastructure, but your contributions are still needed for plumbing, drainage, and other infrastructure costs. Thank you everyone who made this project possible! To contribute to this important project, follow the link below.
Minerva Fellows Brendan Kinnane and Mark O'Shea are embarking on a project to help address water needs at the clinic and around the community. The pair has carefully worked with peer health clinics, engineers from Uganda and the United States, the Engeye Board of Directors, and the clinic staff to come up with a plan to help update Engeye's water infrastructure. Now we need your help to make all of their hard work become a reality (click below to donate)!
Ddegeya Village, like almost all villages in rural Uganda, operates without the basic resource of running water. Yet everyone – men and women, young and old, Muslims, Christians, the rich, and the poor – shares a common reliance on water, each and every day. The Engeye Health Clinic is no exception. The clinic and its residents and staff currently draw from two plastic cisterns that store domestically collected rainwater for cooking, bathing, cleaning, etc. – the vitals of daily life and operation. Although the current tanks help supply the clinic, they struggle to meet the demands of water usage throughout the year. During the height of the dry seasons, staff members must fetch water from the local borehole or the clinic must pay for such a service. For this initial reason, the call for a larger tank that could provide water for all present and future needs was heard.
The call for a greater and more sophisticated water supply was echoed loudly as future needs and goals for the clinic were considered. Aspirations to board patients, perform surgery, offer dental care, and build a maternity ward (for deliveries and emergency caesarean sections) all depend on a reliable source of running water. By introducing running water to Engeye Health Clinic, such never-before-offered medical services can be provided to the people in this region. Thus, the Engeye Water Project took form, its aim being to benefit both the health clinic and thousands of patients it serves annually by providing an abundant supply of clean, running water.
The project includes the following components: a rainwater harvesting system, a 50,000 liter belowground water tank, a foot pump and a gravity pressure plumbing system. The tank design and project logistics have been reviewed and approved by several sources and professionals, including the Engineers Without Borders team from MIT and an experienced local builder-engineer (who built the nearly identical system after which the Engeye Water Project is modeled). A 2012 fundraising effort has been launched to make the water project a reality this spring. The goal is to raise $3500 in the next month and half and begin construction by the end of February ($2,000 has already been contributed by private donors). Please help us to reach this goal and to bring running water to Engeye Health Clinic and the broader community it serves by donating below.
Thank you again for your time and support!
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Donate directly to the water project via credit card, e-check, or PayPal account! |
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December 18, 2011
Happy Holidays from Engeye!
It is incredible how fast this year has gone and how much Engeye has accomplished. In the past few months Engeye has:
- This year, we have seen more than 12,000 patients at just $3.60 per patient - this makes health care affordable and accessible to a region that never had access to quality health care before
- Installed an electronic medical records system
- Increased the capacity of our laboratory
- United with Kinoni's Health Office to begin providing vaccinations at Engeye Clinic (thanks to MIT EWB for making this possible by updating the clinic's photovoltaic system)
- Continued a partnership with Uganda Cares to provide HIV testing and counseling to patients in and around Ddegeya
- Engeye Scholars is now supporting 22 students
- Union College has sent us a pair of Minerva Fellows for the fourth consecutive year
- Three medical missions saw over one thousand patients
- MIT Engineers Without Borders helped us expand our photovoltaic capacity and is investigating improving water resources in the village
- Helped a 12 year old girl, Noeline, receive cancer treatment at Mulago Cancer Institute
- Welcomed Joe Freeman, PharmD, and Dr. Kathy Chang Freeman as our resident pharmacist and physician
Every bit makes a difference and there are many ways you can help!
- Consider making a monthly donation to Engeye this holiday season. Monthly donations support our long-term costs so that we can continue to improve and expand Engeye's core services.
- A one-time donation can make a great gift for friends and family, too!
- Do your holiday shopping through GoodShop. Just type Engeye and use GoodSearch for your holiday shopping - this saves you money and results in donations to Engeye Health.
Happy Holidays and thanks for thinking of us this holiday season!
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December 1, 2011
 The month of November was an exciting one for the Engeye Scholars Program. We were thrilled to welcome Engeye Health Clinic Co-founder and Manager, Mr. John Kalule, for a two week visit to New York. John’s schedule was packed with meetings, lectures, events and presentations. This visit allowed John and Engeye to strengthen existing collaborations with current partners such as Union College and Albany Medical College, while developing new relationships with several additional organizations. John was also welcomed as the guest speaker at the 18th Annual Alice E. Fruehan Lecture at Albany Medical College where he and a physician panel spoke about “Sustaining Global Healthcare Through Community Collaborations: Experiences at Engeye Health Clinic, Uganda.” His two week visit ended with a Craft Fair in support of the Scholars educational programs and a cocktail party fundraiser where current donors had the opportunity to personally meet John, ask questions, and learn more about the program. It was a very successful two weeks and we are excited to begin work on many of the ideas developed during his visit. |
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