ProgrammeUpdateBrenda

UMECS Nursing Student Brenda Ataro

Interns at Gulu Regional Referral Hospital

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September 15th 2014. Brenda Ataro performing her practicum as a student nurse at Gulu Regional Referral Hospital

This month, UMECS student Brenda Ataro, 19, is treating and counseling patients at Gulu Regional Referral Hospital in Gulu, Northern Uganda as part of her practicum at Gulu School of Nursing. In August 2016, Brenda will complete her nursing programme and enter the nursing profession, bringing sorely needed nursing services to communities and medical facilities in Northern Uganda.

Becoming a nurse was Brenda’s childhood dream, but there was little about her childhood that suggested she would become formally educated, let alone become a nurse. “My childhood has not been smooth,” notes Brenda, 19, as she reflects on her journey from a difficult war-affected childhood to the vitality of nursing school.

War-affected childhoods were suffered by more than a million children in Northern Uganda and continue to be endured by millions of children throughout the world. Brenda’s story is typical of millions of children whose families have been displaced by war to refugee settlements and internally displaced persons camps and also, as in the case of Brenda’s family, to urban slums.

We have often shared the stories of displacement to internally displaced persons camps in Northern and Northeast Uganda through the stories of our students and communities we serve. In Brenda’s story, we focus on the conditions children endure when their families have been displaced by war from their traditional ancestral villages to urban slums. This is another face of war – with scant discussion.

Brenda’s story is one of an uneasy childhood in which children ordinarily do not turn out well, winding up uneducated and exploited. Her story is also about the resilience of children when given a chance – that chance being the intervention of long-term education. Moreover, it is a story about the power of indigenous culture and the strength and resolve of women, in this case, Brenda’s mother, who under the most harsh and dangerous situations, do their utmost to carry on and care for their families.

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2013. Brenda and her UMECS sponsored colleague Atimango
Patience in their S4 year at Sacred Heart Secondary School

Brenda grew up in an urban slum known as Vanguard in the Pece division of Gulu town. Her parents had been displaced before she and her younger siblings were born. Then, Northern Uganda was called “the breadbasket of the country” and village life was agriculturally prosperous. Her father’s ancestral village is Lukome, a picturesque rural community in Gulu district, an area then rich in livestock production and agricultural produce including maize, beans, garden vegetables, drought resistant crops such as cassava and sweet potato and simsim, an oil rich seed with high-profit market value. In addition to the prosperity of rural Northern Uganda, Brenda’s parents grew up with traditional culture, solid work ethics and strong family and community support systems.

The war in Northern Uganda with its massive violence of killings, rapes and mutilations, and later abductions of children, displaced her parents and their extended families to an urban slum in Vanguard which is where Brenda and her three younger siblings were born and raised.

The conditions of Vanguard were similar to urban slums throughout Uganda, and throughout much of the world. Tin roofed houses fallen into disarray and small metal and wood shacks served as overcrowded dwelling units for large extended families. There was no electricity and the small windows provided little ventilation. There were no plumbing or sewerage facilities. Outside latrines were seldom serviced and in appalling conditions. Drainage was poor, with diseases incubating in stagnant pools of water. There were no water points. Family members walked long distances with jerry cans to boreholes. Due to the unsanitary conditions, disease was rife.

Vanguard residents were largely unemployed or underemployed while some worked for low wages as domestics or as seasonal labour. Some women started small businesses such as small produce stands in the markets or brewed local beer which spread alcoholism in the Vanguard community. Many people became alcoholic and idle and were drunk throughout much of the day and night.  Crime was rampant, from petty thievery to violent street-wise criminal gangs. It was said security avoided Vanguard due to the gangs. It was unsafe for girls or women to go out at night and during the day, children sent to the market to buy a bag of beans would often be robbed of their few coins.  In short, the conditions of Vanguard made life unbearable for women and children, both inside and outside their overcrowded dwellings.

It was into these conditions, in addition to the camps, that many families in Northern Uganda were displaced by the war. Vanguard was the polar opposite of the stability, culture, peace and prosperity of rural village life but it was the only place urban displaced families in Gulu could afford, having fled their villages because of the spreading mass violence, leaving their land, property and farms behind. Now, without livelihood, income or community support systems, Vanguard’s cheap rent attracted hundreds, then thousands of war-displaced persons to its dangerous, unsanitary surroundings.

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Brenda taking medical history from a new patient in the Outpatient Department

Many families fell apart from alcoholism, unemployment and depression which led to household hunger, lack of basic amenities, the spread of HIV/AIDS and domestic violence.  Her father had been trained as a fine artist and painter but was unable to find work. Her mother, however, started a small produce stand in the markets although she made little money and often, there was not enough food to eat or funds to purchase medicines or household basics.

Her mother’s work was dangerous. In order to supply their market stands with fresh produce purchased cheaply enough to make a profit, Brenda’s mother and other women would venture into nearby rural areas where people had not been displaced to purchase fresh produce. Twice Brenda’s mother escaped near-abduction from the Lord’s Resistance Army (LRA) rebels. Most women abducted by the rebels were forced to perform hard labour, then were tortured and killed. Three times she and her colleagues were nearly killed by landmine explosions.

The constant danger her mother faced and her many near-death experiences kept Brenda and her siblings in a state of trauma, which was compounded by their own danger. During much of her childhood, the LRA was regularly abducting children from Gulu town and Brenda and her younger sister and two younger brothers were terrified of being abducted. Abducted girls were forced into sex slavery and hard labour while abducted boys were forced into child soldiering, forced to kill and conduct atrocities. Many abducted children were brutally killed by their captors for falling sick, becoming weak, disobeying orders or attempting to run away.

Says Brenda: “Vanguard was not an easy place growing up. We lived in constant fear. There were many displaced persons, street crime, and we lived in overcrowded conditions. My parents struggled to provide us with food and shelter. I was constantly terrified of being attacked by the LRA.”

Yet it was the strength and determination of Brenda’s mother that inspired her to stay strong and do her best:   “My mother was a strong woman with a strong personality. She worked very hard. She inspired me a lot.”

Throughout the trauma and difficulties of her childhood, Brenda was grateful that her parents believed in education. She and her siblings attended nearby Vanguard Primary School where Brenda did well. Like most older siblings in these circumstances, however, Brenda was burdened with household chores – childcare, housecleaning, washing clothes, and cooking – while her mother was away for long hours in the market. Despite these burdens, Brenda applied herself in primary school, became a proficient reader and scored high grades.

Brenda4When she finished Primary 7 in November 2009 at the age of 14 and it was time to continue in secondary school, her father informed her there were no funds available for secondary school fees, scholastic materials and personal requirements. She could work with her mother in the market or find some other work. As with most of her peers in Vanguard living under similar circumstances, Brenda accepted her fate. She would not become formally educated.  Her lifelong dream of becoming a nurse had come to an end.

“Once my father informed me he could not afford my secondary education, I just resigned myself to my fate. From then, it never crossed my mind that I would ever be enrolled in secondary school. Never!”

Three months later, UMECS changed her life. Through a community process that identifies vulnerable war-affected children and youth who need educational and mentorship support, UMECS Northern Uganda Education Programme had identified Brenda as a child whose household was too vulnerable to afford the high costs of secondary school and higher education, and as a child committed to hard work and education. In February 2010, UMECS informed Brenda and her family that she had been selected to be sponsored at Sacred Heart Secondary School in Gulu, and thereafter, to a higher education programme through its completion. Brenda was ecstatic. Her dream might still come true.

We enrolled Brenda in Senior 1 at Sacred Heart Secondary School, a longtime UMECS school partner, with a cohort of other UMECS sponsored girls for their four-year O-level programme. For the first time in her life, Brenda was now in boarding school, a 24/7 safe, wholesome educative environment with colleague students determined to make something of their lives. Sacred Heart also fosters community-mindedness, one of the reasons we choose Sacred Heart for our sponsored students, fitting in with our community development approach to educational sponsorship. In addition to the need for war affected children and youth to become fully educated, their war-affected communities also need development through the contribution of their professional services. In this way, they help to develop their communities while they lift their families out of poverty and serve as critical role models to children and youth.

Brenda excelled at Sacred Heart, performing well academically, personally and socially developing and participating in co-curricular activities. She completed her Senior 4 year in November 2013 and when her O-level results came out in early 2014, she had performed well, qualifying her to proceed into A-level on track for a university education. Proud of her accomplishments, Brenda nevertheless informed us she preferred to proceed directly to nursing school and pursue advanced degrees after she started her nursing career.

Knowing Brenda’s determination to achieve her goals, we supported her decision. Earlier this year, we enrolled Brenda at Gulu School of Nursing where she joined four other UMECS sponsored students there: Jenifer Rose Idilet, Kevin Aujo, Annet Addie and Vivian Agik. Gulu School of Nursing recently changed its name to Gulu School of Comprehensive Nursing and Midwifery.

My early influences to become a nurse

“From childhood, nursing has been my dream. For me, the nursing profession is a calling. I like to help people and nurse patients. Our healthcare system needs nurses and I want to promote primary healthcare, immunization against the killer diseases, and healthcare sensitization of my community through participatory hygiene and sanitation transformation.

“My early influences that led to my dream to become a nurse were the unsanitary conditions in which I grew up.  My younger siblings were always falling sick due to the poor and unhygienic environment we lived in. They were frequently infected by bacteria.

“I was also appalled by the conditions I witnessed in the IDP camps when I went there to visit relatives. There were complete breakdowns of social systems. No healthcare services, high rates of infections and illness.

“There are also many opportunities for a nurse in Uganda. I plan to work as a nurse and fund my siblings through school. Then, I will pursue advanced degrees in nursing.

“I chose the nursing profession over other professions so that I can play my part in promoting healthy living in my communities, treating and preventing illnesses. Nursing goes beyond the hospital or clinical setting. It is a service anywhere at any time.”

How I see the role of a nurse

Brenda5“The role of the nurse is not limited to the clinical setting. The role of the nurse in the community is just as important. There is a need to involve the community in promoting healthy living through forums, seminars and workshops. There is a need to make healthcare services reach every part of the community by having mobile clinics. There is a need for all healthcare centers to have antenatal services since a lot of pregnant mothers still die during child birth. There is need for proper storage of medical equipment and drugs to avoid damage and spoilage. There is need for community mindsets to change: Alcohol and drug use must be avoided. In terms of preventing disease, communities need sensitizing and educating about keeping their environments clean and about basic hygiene.

“The nurse, especially nurses living in the community, plays a large role in providing this sensitization and education, in changing mindsets.

“To be a nurse is to be a bridge between life and death.”

What it takes to be an ideal nurse

 “You must understand the basics of all the scientific disciplines. Just like there are many organs of the body with interrelated functions so is the nursing profession. You must know basic pharmacology, microbiology, chemistry, human anatomy, physiology, enzymology, and psychology.

“To be a professional and qualified nurse you must be patient and a good listener. Good listening is the first step of clinical assessments and diagnosis.

 “You must be honest, hardworking, dedicated and a self-motivated person. Nursing needs someone with a kind heart who is willing to work with difficult patients.

“Nursing is a calling. It is a choice. You have to be prepared physically and mentally and you must be prepared to make quick and sound decisions. Nursing starts with me, my thinking and my environment. You must be ethical at all times in what you say and what you do.”

My Nursing School Programme

“Our course is a complete package. I am in my first semester so there is no specialization at this stage. We will qualify as both a nurse and midwife. In this semester, my course units are Introduction to Nursing, Microbiology, and Pharmacology, Nursing and Medical Ethics, Communication Skills, Legal and Medical Statutes and my practicum which I am now doing at Gulu Regional Referral Hospital. Our semesters are a full six months with intensive coursework and assignments. Each semester, we are required to do a practicum.”

My Practicum at Gulu Regional Referral Hospital

“We will be doing our practicum for two months, which we started in early September. We perform our duties Monday – Friday, 8 a.m. through 6 p.m.  I am attached to various departments and assigned to senior nurses and clinical officers who are our workplace supervisors. Currently, I am placed at the outpatient department.  I meet patients and in the case of new patients, record their histories, symptoms and complaints. I immunize babies and dispense drugs based on doctor’s prescriptions. I treat wounds and assist doctors and clinical officers during minor surgeries. I counsel patients according to their needs. I also do clerical work including record keeping.

“I am enjoying the interaction with patients, working in the hospital setting and the opportunity to apply what we learn in our course units and build practical nursing skills.”

How my role as a nurse will benefit my community

“In addition to the sensitization and education I will provide to my community, I am a role model in the making. I think other girls who might find themselves in similar situations like I was can borrow a leaf from me and be inspired to join the nursing profession. In fact, I will help to mobilize the youth in my community to consider nursing as a noble profession.”

How UMECS has changed my life

Brenda5“UMECS has made my career dream come true. I am grateful to UMECS for all the support rendered to me. The school fees, tuitions, counseling and mentorship. I think I am a better person with the heart to help. UMECS has made me into a responsible citizen. I am peaceful with myself and my environment and family. I have respect for my teachers and colleagues. I am looking forward to a better future, something I had never dreamt would come my way before UMECS.

“My parents’ lives have also changed thanks to UMECS. They respect me so much for becoming educated and it has improved all our relationships. My siblings will become educated because I will have the ability to educate them.”

Anthony Ojok, UMECS Education Field Coordinator, a former secondary school head teacher and one of Brenda’s mentors since 2010 notes: “Our intervention immediately transformed Brenda’s life. She was always a hard worker and took her work ethic and applied it to her academic life at Sacred Heart. We were not surprised she chose nursing school over university. She is dedicated to the nursing profession and is eager to send her siblings to school. As with our other students, Brenda sees that with education comes responsibility. We believe that as a nurse, Brenda will have a great impact on the health of her community and inspire others to enter the nursing profession.”

Throughout Northern Uganda and all of Uganda, children endure childhoods like what Brenda experienced. Children are also resilient – they bounce back when given a chance and that chance is long-term educational opportunities and support services.

Children like Brenda bounce back through their resilience and become nurses, doctors, teachers, engineers and entrepreneurs. Then they help to transform their communities as they lift their families out of poverty. All children can be like Brenda – if given a chance.

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