Thoughts from Sharon

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Leaving at 6 am this morning, we were picked up by Bosco (one of the GRI drivers) to go out to Imvepi Clinic, a 2-hour drive. For the first hour we traveled rocky roads in the dark…lit by our vehicle and a sliver of new moon. As dawn arrived, we were met by more and more students walking along the road to local schools, by early morning fires near homes preparing morning tea, by packed trucks with people headed off to Arua. The daylight revealed dusty land with sparse trees and farmers in their fields preparing to plant as the rains draw near. Two hours later --- we had arrived!

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Clinic staff welcomed us as they prepared to see the patients coming with their health needs. Today a total of 75 patients were seen – an average day for the staff. The medicsa gathered slowly as we anticipated walking out to some of the homes where they had seen sick children over recent weeks.

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Initially the medics were trained to go door-to-door in their villages and raise awareness of healthy practices and disease prevention. Later the FMRs were trained to test children with fevers for malaria, the most common and often deadly illness in children under 5 years of age. The medics perform a Rapid Diagnostic Test (RDT) with a small drop of blood. And then they treat those who are positive for malaria with a combination of Artemether and Lumefantrine for 3 days. Poni Margaret, one of the medics from a nearby village, (and her 7 month-old daughter Gloria) proudly shared about 2 children she had tested and treated the previous week. Both children had improved and were back in school!

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Early testing and treatment reduces the likelihood of serious illness in these children and builds confidence among the families that the GRI Imvepi Clinic truly cares for them. If the malaria test is negative, the sick child is referred to the clinic for medical staff to review. The medics assist intermittently with the clinic activities and are supervised well by Biira, the clinical officer in charge. The hot sun and rocky paths are daily challenges for these refugees as they serve their communities …but the commitment, joy, and love of God expressed by the medics really impressed us!

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As the medics left and returned to their homes, we were served a delicious lunch of cassava ugali, rice, meat and beans. The medical staff welcomed further discussion about another common illness -- typhoid, or enteric fever. With no tests to confirm typhoid infection, the patients are sometimes treated empirically for this serious illness which is caused by contaminated water and food.

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Thankfully the staff reported few cases recently, but with limited safe water and the close living conditions, an outbreak is always possible. Careful medical exams and proper treatment with antibiotics is essential and life-saving!

Dr. Sharon Fogleman, GRI Board member

4 March 2019

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