When Dr. Anna Chollet traveled from her home in Sonoma to one of the poorest countries in the world, it wasn’t the poverty that struck her the most. It was the rural villagers of Uganda who left a lasting impression.
“To me the poverty wasn’t as shocking as the resiliency or resourcefulness of these people,” said Chollet, who spent two weeks in the African nation as part of her residency with Sutter Health’s Santa Rosa Family Medicine department. In addition to the normal three-year residency program, Sutter residents develop a broad range of special interests and proficiencies during 18 weeks of elective time spent at home and abroad.
Chollet, who holds a master’s degree in public health and a medical degree from Tulane University in New Orleans, chose global medicine after reading about a maternal health proposal compiled by a Santa Rosa grant writer. She visited Uganda as a collaborator with Uganda Rural Information and Communication Technology, a charitable nongovernmental grassroots organization that provides community resources within the Busoga region in eastern Uganda. She interviewed practitioners and expectant mothers through the agency’s Safe Motherhood Initiative, which trains local women to become birth attendants.
The initiative also supplies sanitary and hygiene kits to pregnant women, providing such basics as a clean razor blade and clamp for the umbilical cord, soap, bleach and a plastic sheet for deliveries, “basically the bare minimum to have a clean delivery,” Chollet, 30, said.
The majority of the village women in the remote Kamuli district give birth at home, often unable to reach the closest hospital, about 15 miles away. Few living in the “basic” homes with dirt floors and thatched roofs can afford or obtain transportation to the 100-bed facility in the town of Kamuli, accessible by dirt roads riddled with potholes.
In emergencies, Chollet said, “All of these delays can add up to a very ill or dead mother and child.”
She interviewed numerous doctors, nurses, midwives, birth attendants and expectant mothers about their concerns and ideas, and discovered a “stark difference in empowerment” between villages with and without birth attendants.
“It gave me a lot of hope for communities with birth attendants,” she said. “The education and training is probably what’s going to make the difference.”
The government-run hospital “was running on a short staff and short on supplies most of the time,” Chollet said. She said power outages and generator failures aren’t uncommon, yet the staff is undaunted.
Chollet used her medical skills to help with a Cesarean section delivery of twin girls at the hospital, each healthy and weighing 7 pounds. Fathers wait outside during deliveries, the labor area and operating theaters accommodating several women within the shared spaces.
Even without Doppler fetal monitors, fetoscopes and other equipment considered standard in the U.S., the hospital can be a lifesaver for village women with high-risk pregnancies and those who develop complications during labor and delivery, many of whom receive little prenatal care.
Intervention is critical, said Chollet.
She traveled to Uganda with her brother Peter Chollet, 27, who works in health information technology in Kansas City, Mo. Initially he was asked about developing an app that could help the hospital reach women with critical deliveries.
The siblings determined that something far more basic — an on-call taxi system of motorcycles and bicycles with attached gurneys — could better serve the villagers. The concept is among the observations and suggestions they provided to officials.