Roads are an underestimated necessity of health and development. Getting from Point A to Point B in most of the developed world is rarely a matter of concern. Of course, we all know how annoying it is when a road is closed, when a pothole blows out a tire, or when general traffic tacks on another hour to our journey. Here in Atiak roads are far less reliable, blown tires are a common occurrence, and it takes 2-3 hours to travel 50km. Bad roads leave people stranded and on more than one occasion I have been touched by just how dangerous that is for rural communities.
Last week a woman had to be transferred from the clinic to the health center in Atiak. With low fetal heart tones and a labor that had stagnated, greater intervention had been deemed necessary by the midwives. In an ideal situation the woman would have been transferred to a well-staffed, equipped hospital. I’m not sure one of those exists in Uganda, but Lacor Hospital in Gulu is fairly reliable and the best option in Northern Uganda. Unfortunately, the three roads that lead from Atiak to Gulu were washed out by heavy rains and closed. Hundreds of trucks lined the roads waiting for the rains to stop and the roads to be prepared. Gulu was not an option for this woman or anyone else that week. Fortunately, this woman was able to deliver her baby and Oliva and Racel successfully resuscitated the infant and repaired the woman’s episiotomy. But not every woman has been lucky in the end.
When the roads to Gulu are passable other issues remain. Atiak and Gulu are separated by a mere 56 kilometers, but the horrible road makes the trek anywhere from 2 hours to 8 hours during the rainy season. Transferring a laboring mama to the hopistal in Gulu can pose as many risks as not transferring her. On more than one occasion, women have given birth in the Earth Birth ambulance after hours on a bumpy road forced the baby out. With a birth attendant in the vehicle as well, most of these women and their newborns have been ok, but there is always the risk that they won’t be. There is always the risk that a 2-3 hour drive is nowhere near close enough for women and infants to be safe.
Last week, I went to Gulu with Rachel to get some supplies for one of the projects I have been working on. It took 4 hours to travel the 56km and there were several instances in which I thought I was going to crack my head on the ceiling of the car as the potholes and mud pits tossed our bodies around. 3 days later, the road was closed to cars and trucks after more torrential downpour washed out the roads. This presented a small problem as I needed to take a bus back to Atiak for a meeting while Rachel stayed a few more days in Gulu. With no other option, I hopped on the back of a moped with my duffle bag strapped to the back. It was actually an incredibly fun ride, late in the afternoon as the sun started to set across gorgeous green landscape. But my point is that the road was so awful only tiny mopeds could get by. It was so dusty and muddy that by the time I got home I was the filthiest I had ever been. My legs were caked in mud and I drew pictures in the dirt on my face. We had to walk around enormous holes and puddles that few vehicles could have navigated. Rachel remained stranded in Gulu for several more days and the ride home took her 7 hours and several bribes.
Bad roads quarantine communities and jeopardize individuals. I happen to find my most personal encounter with these awful roads a bit amusing (see above paragraph), but there is nothing amusing about people being unable to reach a hospital, unable to transfer their goods so that they can sell them in the market and earn a living to pay for their families’ food and school fees. Roads are essential. They are life-altering and life-saving. They connect people to opportunity and in turn have a significant impact on levels of development and health.