Nurses worldwide are engaged in innovative activities every day, resulting in significant improvements in the health of patients and communities. Their contributions are fundamental for progress in the provision of health care around the world. Nurses continue to make a difference; working in all types of settings with diverse populations and communities. As part of the first ever global Year of the Nurse and Midwife, I spoke to Emmanuel Ochola (known as Emma), a Ugandan registered nurse and midwife, at the Northern Uganda Diocese for the Church of Uganda Health Centres where he has worked for four-and-a-half years and whom I know through the partnership with Nurses Reaching Out, a UK charity that has a community project in the Northern Uganda Diocese.
Where was your first nursing post?
After training at Lacor Nursing School, Gulu [in Uganda], I moved to South Sudan and worked in a hospital before moving to a rural health centre. I learnt Arabic so I could communicate better with patients and families. The time there became the foundation for working with the Church of Uganda Health Centres.
What are the Church of Uganda Health Centres?
The mission is to demonstrate Christ's love through the provision of health care. There are about 256 health centres and 13 hospitals throughout Uganda, over 37 dioceses. Each diocese has a headquarters.
Did you move back to Uganda and start working for the Church of Uganda?
Yes, I started working at St Philip's Health Centre (HC) in Gulu, Northern Uganda.
In Uganda, an HC II is an outpatient facility run by a nurse; an HC III has maternity services above that of an HC II, along with some diagnostics, and is run by a clinical officer; and an HC IV is run by a doctor. St Philip's is an HC II, but it is unique in that it also provides maternal health care.
What did you do there?
Prescribing, family planning, HIV and AIDs counselling and testing, and infection control, as well as treating patients in the outpatients room. In 2016, I received training by Marie Stopes International to provide family planning for St Philip's HC. I was counselling mothers, young girls and couples for family planning.
Did your training include midwifery?
Yes, I was trained to conduct normal deliveries. I was expected to complete 50 antenatal checks, at least 15 deliveries and 10 postnatal checks. After nursing school I honestly didn't practise midwifery that much. In terms of midwifery now, I assist with deliveries and supervise both nurses and midwives.
You are not at St Phillips now, though?
No. I moved to the diocese headquarters, working as the nurse manager overseeing its eight health centres and I'm the health educator. I supervise the nurses and midwives and carry out staff training. On a Wednesday and Saturday morning, I worked at a remand home for young offenders. A UK nurse, Shirley Crawford, set up the clinic in 2017 and we'd see and treat the young people here. The clinic expanded to reach the local community a year later, which was good as it gave them access to healthcare. I mentored a nurse to take over from me last year.
Nurses across the globe have faced many challenges in the face of the COVID-19 pandemic. A strict lockdown in Uganda began on 30 March 2020. How has this affected your work?
Staff have been scared. The community is scared. We haven't had any cases in Gulu. My major target is infection control to protect staff and patients. I've learnt about COVID-19. Staff have been briefed to remain at home and report in sick if they have any cough or fever.
Across the health centres we have created ‘cough corners’. Anyone coming in with a cough waits in this area. Because malaria also presents with a fever, this needs to be ruled out. We have protective wear and masks, and handwashing has increased. We bought more soap. Staff have to bring their own packed lunch, there is no cooking at the centres at this time.
We've implemented social distancing among patients and bleach the patient areas frequently. Only one attendant per patient is allowed. We have introduced a health questionnaire and checks to make sure patients and their attendant are free of the virus. We show them how to do handwashing and they need to do this regularly.
Public transport has stopped, which brings many challenges. I am challenged to see situations where I can't help, where someone in need of hospital care dies waiting for an ambulance. Women in labour walk to the health centre and arrive so tired. It is hard for nurses to see these kind of things.
What are your hopes for your future?
I love the job of health education. I mean, I love the clinical work, but I'm passionate about the educational side of nursing. I'd like to be in a better position to help prevent disease, to spread important facts about disease to both nurses and the community, so I'd like to do more studies to progress further in this important area.