It was an unlikely relationship that would develop between two distant communities.
Known for its political diversity, Nevada County is home to recreation enthusiasts and retirees.
In contrast, the Bwindi Impenetrable Forest, in southwestern Uganda, is known for its plant and animal biodiversity and has served as home to some of the world’s most marginalized people; the Batwa pygmies, as well as half of the world’s remaining population of endangered mountain gorillas.
Unlikely as it has been, the relationship between Nevada County and Bwindi has been considerable and so, too, the mutual benefits. In a world filled with seemingly unsolvable problems, this story reminds us that hope is alive and well in 2014.
Until recent times, the Batwa lived as nomadic hunter-gatherers within the forest. In 1992, the Bwindi Forest was made a World Heritage Site in an effort to preserve the mountain gorillas. This left the Batwa as landless conservation refugees, forced to carve out their existence as squatters along the edges of the forest boundaries.
In 2000, local doctor Scott Kellermann and his wife Carol performed a medical needs survey of the Batwa that revealed an under-age-5 mortality of 38 percent and an estimated life expectancy of only 28. It was obvious that if an intervention was not instituted, the very survival of the Batwa would be imperiled.
Moved by the great poverty they witnessed, Scott turned his medical practice over to a colleague, and the Kellermanns sold their possessions and moved to Uganda. The demands were daunting.
The Kellermanns’ outdoor mobile medical outreaches would treat 200-500 patients each day, often with IVs hanging from branches and secured with vines.
The needs were great and the workers few.
Nevada County answered the call and stepped up on numerous occasions to support the Batwa and their neighbors. One of the first volunteers was Bethany Norman (now Gregory), whose journal excerpts were published by The Union and who encouraged others to travel to Uganda.
Nevada County resident Simi Lyss designed the Bwindi hospital and provided sage advice regarding hospital management. (See sidebar for the Nevada County honor roll of volunteers who have visited).
Over the years, countless Nevada County residents have undertaken the long journey to this remote southwestern corner of Uganda, stepping out of their comfort zones with the intention of helping those in need. Witnessing firsthand the challenges faced by the Batwa and their neighbors, these volunteers have contributed on multiple levels in delivering hope and health.
Upon returning, many report feeling that they have gained more than they have given. The strides that have been made toward improving the health of the Batwa and their neighbors over the last 13 years have been tremendous.
These accomplishments would surely not have been achieved so quickly without the contributions and generosity of Nevada County residents.
In 2005, Don Fultz galvanized several local Rotary clubs for the provision of an X-ray machine, a dental unit, generators, motorcycles and much-needed medical equipment, all tightly packed into a shipping container.
Barry Turner, DDS, then led a 17-member Rotary team to Bwindi to install the equipment. When an operating room was built, Fultz and Harry Auld organized yet another team bound for Uganda with operating room equipment.
Diarrheal diseases are a large contributor to the under-age-5 death rate in sub-Saharan Africa. Despite living adjacent to a rain forest, only 35 percent of the population had access to clean water or adequate sanitation.
Nevada County residents Chuck Elizondo and Fultz teamed up to secure a Rotary 3H (Health, Hunger and Humanities) grant for water and sanitation improvement. Nancy Kemp and Wyn Spiller oversaw the grant, while Sol Henson, a hydrologist, and Tor Erickson spent several years in Uganda assuring the successful construction of rain-water catchment and protected springs.
The result has been a dramatic decrease in the prevalence of diarrheal diseases, which had been afflicting the population.
Malaria, one of the most devastating parasitic diseases in the world, sadly remains poorly understood. The World Health Organization estimates that there are 350 million-500 million clinical cases annually, resulting in approximately 1.2 million deaths, and there is no vaccine.
It is so common in our area that the local word for fever, “omuswiija,” is synonymous with the word for malaria. A malaria-related death occurs every 30 seconds, so by the time you have read the first part of this paragraph, another child has died from malaria. Working with the Abafumu (traditional healers) and generous Nevada County residents, an anti-malaria bed net campaign was initiated.
The Abafumu informed us that if the nets were just given freely, they would not be appreciated. As one Abafumu stated, “Bed nets make a fine fishing net or a stylish woman’s wrap.”
The Abafumu suggested that a price of $1 or the payment of a bow, arrow or basket would be acceptable for payment. The campaign was launched, and the response was surprising. Sales began with 100 nets selling during the first month but quickly grew to a rate of 1,000 nets per month.
Subsequently, the Bwindi hospital noted a substantial drop in the admission rates for malaria. Records indicate that in 2006 one to two children were dying of malaria every week at the Bwindi Hospital.
After 18,000 mosquito nets had been distributed to the children, over the next 12 months not one child admitted to the hospital died from malaria.
A statistical analysis indicated that the prevalence of malaria had been reduced by more than 80 percent. Malaria has not been completely eradicated, but many children now survive into adulthood because of the use of mosquito nets supported by Nevada County residents in innovative collaboration with the Abafumu.
Financial stability is one of biggest challenges faced by the Bwindi Hospital. The Kellermann Foundation, a US 501(c)(3), http://kellermannfoundation.org, the brainchild of Dick Panzica, was established in 2004 to support the vision and sustainability of the hospital.
Many Nevada County residents have given generously of their time, talent and treasure through the Kellermann Foundation in support of the good work occurring there. Additionally, several years ago an insurance plan was launched, in which patients contribute $3 per person per year for complete basic healthcare coverage.
Now 40,000 patients have joined, allowing them access to Bwindi Community Hospital services without the fear of economic deprivation due to a medical crisis.
In the U.S., there are 874 registered nurses for every 100,000 persons, whereas in Uganda, that ratio is only 28 per 100,000 with most of these nurses residing in the urban areas, not rural villages where care is most desperately needed.
A chance meeting at a Bwindi tourist lodge between Dr. Kellermann and two tourists, who were there in 2011 to trek the mountain gorillas, may be changing that equation for southwestern Uganda. Inspired by the work at the Bwindi, the donors committed to funding the construction of the first registered nurse-level nursing school in the region.
In Africa, highly trained registered nurses are the core of community care and can oversee a 10- to 30-bed clinic while supervising admissions, deliveries and surgeries.
The new nursing school building is well appreciated, but similar to transforming a house into a home, the completed school and dormitories required furnishings, appliances and love. Rotary International has stepped in with the cooperation of local Rotary clubs, providing for desks, chairs, beds, kitchen supplies, books and an instructional laboratory.
A portion of the funds is allocated to bringing nursing instructors from the U.S,, including Alexa Curtis, FNP, Ph.D., who will be training the instructors at Uganda Nursing School, Bwindi, in the art of teaching.
The results of these interventions have been striking. Instead of IVs hanging from trees, there is now the 112-bed Bwindi Community Hospital, widely regarded as the best hospital in Uganda. Through the provision of high-quality maternal health, maternal death rates have been reduced by more than 60 percent.
Bed nets have reduced malaria rates by 80 percent. Cases of diarrhea have plummeted, as have the rates for HIV transmission from mother to child. Local Rotary club involvement has insured that a high-quality nursing school will now educate 24 outstanding, compassionate nurses annually — assuring that health care delivery will continue to improve.
The upshot of these efforts is that Batwa mortality has improved from 38 percent of the children dying before age 5 to now only 6 percent. Previously, only six in 10 would see their fifth birthday; now more than nine in 10 will celebrate a fifth birthday.
“Agari hamwe nigo gate eigufa” is a Batwa pygmy expression meaning “it takes all the teeth to break the bone” or “united we stand.” This expression is exemplified by Nevada County’s involvement and support of the Batwa pygmies and other tribal groups living along the edge of the Bwindi Impenetrable Forest.
Nevada County has greatly contributed to a better life for the Batwa and their children, one of hope and health.
Jean Creasey and Scott Kellermann are members of the Kellermann Foundation.