Bethlehem was over 150 or so kilometres from the city of Nazareth, let us start there: About the same distance east of Kampala is Bugiri Hospital in Bugiri district. What if Mary and Joseph had somehow stumbled upon it? Would Jesus have made it? First of all, for a hospital meant to serve 50,000 people within the district, it is serving 100,000 people. Well, that is according to a petition to Parliament by an organisation called Busoga Yaiffe.
“Joseph, the baby is coming?” Mary would have shouted in a crowded hospital. “Wait my love, we have got to wait for the 50 mothers in the queue!” A frustrated Joseph would then respond.
As Mary crawls on the floor in pain, a rat fleeing the crowded scene in the dilapidated structure built back in 1969 would then startle her to an upright position.
“Joseph, take me out of here, before I die. I hear the mortuary does not even have a refrigerator!” She would have cried out loud.
So they would then decide to go back to Mayuge district, over 100km east of Kampala. And that would have been a mistake! Only last year, the media was awash with reports that Mayuge had one doctor. Yes, a one Dr. Charles Nabangi! With this on-and-off phone network we have today, assuming his phone was off at that time… hmmm.
Make no mistake; some of the 167,087 women of the district’s 326,567 people will be in labour that night. No, not a lie folks, not a lie! Remember, the 2013 World Population Prospects report by the United Nations Social and Economic Affairs Division in New York puts the country’s total fertility rate at 5.9%. So would multiplication be going on; not with a vibrant fishing community only a whisker away!
On their way back from Mayuge, they would not have dared to pass Jinja Hospital. Not after it was alleged that an expectant mother died back in 2012 because of failure to raise money for a bribe.
“Do you remember the story of Shanita Namubiri, who died after her operation, had reportedly been delayed by a doctor seeking a sh700,000 bribe. Mary, you know I am a struggling carpenter, right?” Joseph would have reminded Mary.
Had Mary wondered if they should go to Teso region, Joseph would have barked out a laugh and said: “Do you know that Soroti Hospital has a capacity of 263 beds, but receives patients almost triple that number?” He would have paused, then said: “Oh, and then there is that hospital called Princess Diana Memorial Health Centre IV, where patients were reportedly using polythene bags to dispose-off their feaces after the latrines filled up. Hahhaha!”
The land of oil maybe?
How about if they dared to reach the land of oil, Hoima district? Trouble folks, more trouble! Wasn’t it in Hoima that a report by The Uganda Safe Birth Organisation revealed that the district hospital’s maternity section had only 15 beds, yet it had over 30 daily admissions?
As if that is not bad enough, there was only one senior midwife running the entire ward, a real case of falling out of the frying pan to the fire, right?
Also, it is not news that some of the district’s men have taken on more wives of reproductive age after they got a few million shillings as compensation for the sale of their land.
“Eh, but these Ugandans can also over produce! We should have checked Kamuli Hospital as we were in the east,” Joseph might say as he prepares a place on the floor for Mary to have baby Jesus.
“No, not Kamuli Hospital Joseph, not that one where they say 101 children of every 1,000 live births die every year. And, 10% Joseph, 10% die!” Mary would say.
“I will sleep under the bed darling and pray that the mother on top does not break it when I am deep asleep!”
Mary is kind of right. About a year or two ago, Blandina Nakiganda, the Kamuli district health officer, told media that in 2012, of every 1,000 births, they lost 101 children.
“Nope, my baby Jesus will not be another statistic. And neither will he be among the 131 children the United Nation’s Children Fund (UNICEF) said died per 1,000 live births in Uganda. He is the messiah you know,” Mary would have lamented.
“But Mary, you said that about Nakaseke Hospital when we reached Luwero and I asked that we branch off,” Joseph would shoot back only to receive a piercing stare from Mary.
“I did not say that. I said I read in the papers that Nakaseke Hospital had a toilet crisis two years ago. Do you want Jesus to be born in such a situation Joseph, do you?”
What if they had not branched off and just gone all the way to Gulu Hospital. Well, someone should have told them how the 2012 Ministry of Health Report, exposed a shortage of nurses in Gulu Hospital.
It revealed that Gulu Hospital had slightly over 100 nurses instead of the 200 required for general hospital service delivery.
“You know Mary; I read in the Sunday Vision of April 13, that only 10% of the nurses here are midwives and that close to 289 mothers of every 100,000 who give birth here, die!”
Hours after they try to get attended to, Joseph would have come back panting breathlessly to Mary.
“Mary, I think you will have to scream louder if that midwife attending to those five mothers is to notice you,” Joseph might advise.
So together they start: “Help! The baby is coming, help!” A midwife would then rush to them and apologise for the delay.
“I am very busy, but it is obvious your situation is not urgent, let me work on the other mothers first. I am also waiting for my colleague who stays very far because of shortage of staff houses. When she comes, this work-load will reduce a little,” she might explain.
Joseph and Mary are extremely humbled by her kindness, because the impression they had of most of the Ugandan midwives was completely different from that.
What if they had just branched off to West Nile, and found a less crowded health centre? Maybe, they would have arrived at Ewanga Health Center III in Arua district.
“Joseph, this is not as big or more equipped as Gulu Hospital but at least I am sure I will have a midwife to myself,” a hopeful Mary could have said.
That night however, they notice that the only source of power in the whole health centre is a phone torch. Mary sees midwives running up and down because a mother is about to have a baby.
“Joseph, are they going to deliver that mother with light from that tiny torch?” Mary asks and before Joseph responds they hear cries of a newborn, yet the health centre still sits in pitch darkness. “Joseph, get me out of here, the Messiah is a child of light not darkness, no!”
The Western route
Let us assume that Joseph was from Lyatonde instead, how about that? Straight away, Mary would have refused to stop at Lyatonde Hospital after it was investigated for using unqualified staff.
“Joseph, for me to go to that hospital where officials from the Allied Health Professionals Council ordered a special inquiry into reports that unqualified staff were treating patients, no way!” She would begin. “The king should be born by qualified staff only!”
Well, Joseph would have no option but carry on. However, what they would find in Kabale Hospital is equally alarming.
“Mary, will Jesus make it? Do you know that I have seen only two midwives attending to 13 mothers and the rest are running back and forth from theatre? Some woman has just torn off her dress to make a point. I give up!” Joseph would have told a puzzled Mary.
“But Joseph, I remember reading the Word Development report by a researcher called Berry Baker that said; 70% of Ugandan doctors and 40% of nurses and midwives are based in urban areas, serving only 14% of the country’s population. Isn’t this what today’s youth call, a missed call?” Mary would offer.
Immediately, Joseph would then decide that they come back to Kampala and pitch camp at Mulago Hospital, but a stubborn Mary would refuse.
“Joseph, I heard that earlier this year, that big hospital had a water crisis, on top of its overcrowding. Any way, you will be the one looking for water in the neighbouring slums because I am not about to put a jerry can of water on my head.”
But before Joseph can respond, Mary might grip his hand tight and the neighbour in the taxi would notice “Is the baby about to come?” she might ask and Mary nods. “I know an old woman in the next village who can help deliver your child safely. But you will have to take a motorcycle, if you are to reach safely.”
In comes the traditional birth attendant
Mary and Joseph then have to hop onto a motorcycle (bodaboda) through a bumpy path.
“Joseph, I think by the time I get to that old woman’s house, baby Jesus would have FEATUREjumped out of my belly, eh!” Mary cried out to Joseph, who is seated next to her on the bodaboda.
“Well, I think my foot might be crashed by the metal on this motorcycle,” Joseph might respond and they both burst out laughing.
Suddenly, the bodaboda cyclist might stop the motorcycle and say he is not continuing if they do not add him a little more money.
“Ah, you are heavy, and Jajja’s place is far. I might have to go to a garage tomorrow,” he laments and they have no option; lest baby Jesus gets born in a dark bush somewhere.
Upon arrival at the tiny dark compound, an old woman would usher them into a dark hut and order Mary not make a sound.
“Hhhu… it hurts. Joseph, it hurts hhuuuu,” Mary might scream only to have her mouth covered by the old woman’s hand.
“Young woman, do you want the Police to come and arrest me?” the old woman might roar.
“If you cry again, you will have to walk 60km to the next hospital, have you heard?” Meanwhile, as she threatens them, Joseph sees her mixing various herbs and he freaks out.
It then hits Joseph that traditional birth attendants were abolished in the country back in 2010 and they should not be risking baby Jesus’ life with one.
He would drag Mary and flee the tiny compound with a promise to explain later.
“Joseph, why didn’t that woman, want me to make a sound?” Mary might have wondered and Joseph’s response would leave her speechless.
“Mary, forgive me. I had forgotten. Do you remember the story of a traditional birth attendants called Jovia Tumusiime who was arrested in Kanungu after a mother and child allegedly died in her care? I think this lady did not want anyone to know you were here just in case you died,” Joseph would have said.
As they leave the traditional birth attendant’s place, and pause next to a kraal, Mary might realise that baby Jesus cannot wait.
“Joseph, did I just sit on cow dung? What just bit me? This place stinks, Joseph!” a restless Mary would cry out.
“These people let the animals sleep in dung! Joseph, did a flea just bite me again?” Oh poor Mary, she does not know that the world is in the heart of global warming and the sun is not for light anymore but rather for baking us folks and breeding enough dust to entice fleas.
She cannot help but regret why she just did not tough it out in the hospitals.
“You know Joseph, at least in the hospital, baby Jesus might not have arrived in a flea-infested kraal. I would not have you my unskilled husband delivering our son. Baby Jesus would have gotten immunised. What happens if I over bleed from here covered in dung?”
Before Joseph can respond, Mary might scream out loud, “Ouch, it bit me again. Joseph, where is the hay in the kraal?”
To that, Joseph would laugh and say: “Sorry my dear, but these animals have foot and mouth disease and they are going to be sold on the black market tomorrow night. Trust me, they can sleep in their own dung if they like, just as long as they make it to the black market in time!”
A restless Mary then tries to stand up with the support of the tiny kraal fence and it all crushes to pieces.
“Sorry Mary, the traditional cows here are tied on a tree, this kraal is just for show!” Joseph would provide as he picks Mary, now covered in dung off the ground.
“You know what; I think I have had enough! We have to return to Bethlehem and have the Saviour there, just as was written in the scripture,” Mary would say.
“Come on Prince, let us go back to Bethlehem just as the scripture said and have you born in a manger!”
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