Irene Nabukeera has worked as a midwife nurse for the last 15 years. And she is very good. If your wife was giving birth at Mulago Hospital in Kampala, you would want Irene to help her deliver. Yet even Irene was not good enough to avoid an accident that strikes healthcare workers every day across the world.

In September 2001, Nabukeera accidentally pierced herself with a needle as she was drawing blood from an expectant mother for an STD test. Holding the needle in her right hand, she had reached across with her left to catch three blood-collection tubes as they rolled toward the edge of a counter. As she did so, the needle, filled with the patient’s blood, pierced her left index finger.

“I felt scared and stressed,’’ Nabukeera says. “But at the same time, there was a voice inside my head calming me down, saying, ‘No, it’s not going to happen to me. I’m not going to get HIV.’” Happily, an HIV test proved negative. But today, she has learned to be extra careful when drawing blood from patients.

Nabukeera’s alarm clock rings at 5am. She dashes to the washroom for a quick bath, before preparing tea for her two primary school-age daughters. By 8am, she has arrived at the hospital to begin her duties.

At Mulago, the picture is one of unending queues and a sea of doctors, nurses and patients flowing in and out of the dilapidated hospital. These incessant movements are compounded by the yells and screams of the sick brought into the hospital and those lying on the slanting beds. A smell of pollution and decay assaults the nostrils. Nabukeera has to pass through this chaos on her way to the labour ward, where she confronts the wails of women in labour pains.

Yet Nabukeera, who has worked at Mulago for the last ten years, says she enjoys her work. By working abroad she could receive better pay and more pleasant working conditions, but she would not get the satisfaction that comes from treating fellow Ugandans.

Nabukeera’s shifts alternate between day and night. She does not like night shifts because they mean her children are left alone - her husband works in the upcountry district of Mbale and so is often absent. But nightshifts are part of the job.

She explains her routine. “My shift usually starts with a little history. The nurse who supervised the patients during the previous shift briefs me. This is how I find out what to expect for the next eight hours. I have to learn each patient’s diagnosis, what medications each needs, what special care each requires, and who might come or go during my shift. I will also go over the doctor’s reports for each patient.”

Nabukeera has more to do before she can see the patients. “I set up treatment sheets for my patients. I record the history the nurse has told me, and include any other important information picked up from the charts. This is a good time to look at the laboratory tests that have and will be run. You want to be prepared so when the unexpected happens, you won’t get completely sidetracked.” In the course of each nurse’s shift, the needs of the patients are constantly re-evaluated as their health changes.

Nursing can be very stressful. But professional nurses find that saving lives makes up for the stress. Nabukeera says: “With people living longer than ever before and new technology and medications found every day to treat diseases, you have the opportunity to touch many lives. Once you learn how to balance the paperwork and schedules, as well as the emotions from patients, doctors and families, you can handle almost anything.”

In Uganda, a comprehensive nurse earns at least Shs 300,000 per month; some have moved abroad, seeking better pay. And like Nabukeera, many nurses stand a risk of contracting diseases through contact with the patients they look after. In November 2007, for example, five nurses lost their lives as they fought the dread Ebola fever that had struck the southwestern district of Bundibugyo.

The willingness of people like Irene Nabukeera to face up to such risks is testament to their steadfast commitment to serve Ugandans.

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