When it comes to rural medical practice in Uganda, one of the things that fascinates me is the alarming teenage pregnancies. This leads me to a story of one of my patients who came to the health facility I work in (Kapelebyong health center 4, located eastern rural part of Uganda), a 16 year old girl with her mother in law. (Yes her mother in law, its crazy!!) They came to the facility with the complaint of failure to carry pregnancy, ever since she got married 2 years ago (It means she got married when she was 14 years!!). It had been her 3rd time miscarrying her pregnancy. And this time they decided to come to the hospital for guidance.
When I first saw them I thought it was a mother who had escorted their daughter to hospital for a consultation. But she spoke out and said this girl is failing to conceive. I was very disturbed, It was already running in my mind that this is a child and marital issues should not be in her mind. In fact by what I could see she needed to go to school or she needed to be in school. Her family had already handed her over as a wife to her boyfriend who is also 16 years but he was in school at the moment. (In this rural area boys are usually favoured to continue with their education because in their understanding when a girl marries she joins the other family leaving her old family behind, so any investment in her would be a waste of time!!) This angered me more because I knew the parents probably made her marry earlier so as to secure a bride price mainly because of the financial situation they have at home.(Poor families are more likely to marry off their daughters earlier to get bride price and this is just so sad!!)
But given the situation it is a rural area in Africa where the community still thinks educating a girl child is useless because she anyway leaves the home and gets married into another home. And marriage comes with a bride price.
Of course I advised them to come back to the facility the next time they get pregnant. Starting a battle with them and nullifying the marriage was out of my jurisdiction as a medical doctor in a rural area guided by cultural norms.
But this comes to the main issue, many children in the rural area I work in are raising other children. It is sad but I have seen girls as young as 14 years of age getting pregnant. Sometimes the mother and child come to hospital to give birth at the same time. And it becomes worse because by 20 years, most of these girls have given birth to at least 2 children. So you can imagine when they are 30 years of age? In fact by 30 most of the women have at least an average of 8 children!! This is really sad.
Of course as a rural doctor we have started outreach programs to schools encouraging children to remain in school especially girls. But it has come under a lot of pressure and still many girls are also being put under pressure by other girls (their own peers) who already have children of their own. They usually ask questions like, “why are you wasting time? Do you want to spend all your time in school?”
It is a sad situation but the trend is now showing that a young mother is more like to bring the sick child to hospital more often than an older mother.
It is a battle we are fighting quietly. I am really interested to know if this happens in other countries. Any one who can share with me what they are doing to save their rural girls???
Me with some of the rural children of the young mothers on an outreach!
SOME OF THE OUTREACHES ENCOURAGING CHILDREN TO REMAIN IN SCHOOL. ESPECIALLY THE GIRLS..
I am Dr. Etonu Joseph, Junior medical doctor from Uganda 29 years of age, I've been practicing for 2 years in a rural area in Uganda in a county called Kapelebyong county. I Started my work when I was 26 years old in the facility. Iam the only doctor there covering the health of 89,000 people. Being a very rural area very few doctors attempted to work there but so far i am the one who has lasted the longest in the facility..The people I serve are the humble indigenous rural people of Karamoja and also Kapelebyong county..I graduated in 2012 at the University of St. Petersburg Pavlov,the Russian Federation. But i started working in this rural area in late 2014. I ride a motorcycle to work because the roads are soo bad in the rains that sometimes it rains on me! BUT I LOVE MY WORK and I have learnt a lot from the people I serve.