Birth of a hospital
Working among the Batwa people of Uganda, a California doctor discovered the power of collaboration, the joy of service, and a slice of heaven
In the late 1970s, my wife, Carol, and I spent two and a half years working at a mission hospital in Nepal. When we returned to the United States, I established a medical practice, but we decided that every year we would volunteer as a family in a needy part of the world.
In the summer of 1987, we assisted in starting a youth baseball program at an orphanage in Cochabamba, Bolivia. It was a perfect fit for my two young sons. While they were building a baseball field and instructing the children in the art of throwing, batting, and fielding, I assisted with Rotary International’s polio eradication efforts in remote villages of the Andes.
This time when we returned to the U.S., I discovered that several of my friends were members of Rotary. They talked to me about Service Above Self and encouraged me to join. This was the beginning of a wonderful partnership that would sustain me during my many ventures in the years to come.
In the summer of 2000, we were asked to perform a medical survey of people from the Batwa Pygmy group of the Bwindi Impenetrable Forest in southwestern Uganda. Initially, Carol was unsure about working there, but her hesitancy was trumped by the desire to get to know the people who lived in that part of Africa.
Illustrations by Daniella Ferretti
The Batwa were the ancient inhabitants of the Bwindi Impenetrable Forest. But in the early 1990s, the forest was designated a national park and a UNESCO World Heritage Site to protect mountain gorillas and other endangered species. As a result, the Batwa were evicted from their homeland, and, as our survey revealed, their lives had grown exceedingly dire. They had an estimated life expectancy of 28 years and an annual income of $25.
Despite the desperate circumstances and harsh conditions, Carol felt like she had come home. The Batwa people’s survival was in jeopardy, and she was moved by their plight. She shocked me by suggesting that, this time when we returned to the U.S., we sell our possessions and relocate to Uganda to assist them.
There was no denying that, in all of our travels, the Batwa were the neediest people we had encountered. Without interventions, we believed, they would cease to exist. I asked myself, “If not us, then who?” After careful consideration and much prayer, it was obvious to us that we should serve.
It required a massive effort to downsize. We sold two homes and a part interest in a hospital, and I turned my California medical practice over to two other doctors. A year later, in 2001, unburdened by possessions, we returned to Uganda.
Delivering medical services was a challenge as there were no hospitals or clinics in the region. The only option for treatment was to bring services to people through mobile medical clinics. We drove as far as the road allowed and then carried our medical supplies to villages at the edge of the forest. While I unpacked medicines and unfolded mats for examinations, Carol pitched our tent, where we would spend the night.
Vigorous drumming by the Batwa spread the message that health care was available. Typically, our clinics attracted 300 to 500 patients per day. Our intensive care unit was established under the shade of a tree. Children, semicomatose from the ravages of malaria, lay on mats while IVs, hung from the tree’s branches, dripped lifesaving quinine into their veins.
The work was exhilarating; this was medical practice in its purest form. The vast majority of diseases we encountered were infectious and, with simple regimens, they were treatable. Being surrounded by daily miracles and grateful patients was a true gift.
In the process of living among the Batwa, we came to learn their language, culture, and traditions. Another benefit of our new lifestyle surprised us. When we lived in California, Carol continued to further her education, while I had a busy medical practice, ran an indigent care center, and engaged with the Rotary Club of Nevada City 49er Breakfast. Exchanging that hectic lifestyle for the simplicity of life in a tent was a gift to us. We talked long into the night regarding how, as a couple, we could deal with the travails we faced. In the process we learned to love each other in ways we never thought possible.
I was exceedingly grateful to be loved by, accepted, and integrated into the Batwa community. In the United States, we tend to be goal oriented. This is in contrast to life in that part of Africa, where it’s all about relationships.
After we’d spent a few years providing mobile clinics, the village elders became convinced that we needed to establish a permanent clinic. They approached us and asked, “Can we work together to prevent the deaths of our pregnant mothers and our children?” From this collaboration was born Bwindi Community Hospital. With the community’s support and the generosity of several donors, we were able to construct an outpatient unit and a maternity unit.
Once the hospital’s initial structures had been completed, along came our many Rotarian friends. Through a grant from The Rotary Foundation, District 5190 (parts of California and Nevada) sent a container outfitted with the first X-ray unit in our region. Best of all, a Rotary team came to assist with the installation. Another Foundation grant was secured to facilitate rainwater collection, protect springs, and provide sanitation to prevent diarrheal diseases. After seven years, when the grant was finally closed, diarrhea rates had dropped more than 50 percent.
"We drove as far as the road allowed and then carried our medical supplies to villages at the edge of the forest."
Rotary Foundation grants provided equipment for surgical, pediatric, and medical units, as well as neonatal and adult intensive care units, at the Bwindi Community Hospital. But as the hospital grew, so did the headaches for Carol and me. We were ill-equipped for the challenges of administration, logistics, accounting, and human resources.
Once again, help came from Rotary, in particular, from Jerry Hall, a past governor of District 5190 and, at the time, the vice president of Rotary International. What’s more, Jerry, who came to the Bwindi to help with the installation of medical equipment, was a strategic planning consultant.
In learning about our administrative dilemmas, the very first question that Jerry asked was, “What are the factors that would end this hospital immediately?” The most obvious one was a rebel incursion from the nearby Democratic Republic of Congo. Another was the loss of the hospital’s two main champions: Carol and me.
Jerry’s next words to us markedly shifted the trajectory of our work. “You have given much to the Batwa and to this hospital,” he said. “Perhaps it’s time for you to relinquish the responsibilities, to relax, and enjoy your time at the Bwindi. I’ll help you.”
Carol and I wept. Not only was Jerry’s advice impeccable, we realized that we had a friend who would assist in bringing this transition to fruition.
We developed a strategic plan for the hospital and began transferring responsibility to the Ugandans. Over the next year, we hired additional staff. The transition took time, but our efforts paid off with the establishment of a sustainable medical facility. Today, Ugandans lead and manage an award-winning 155-bed institution — and in 2013, the hospital started the Uganda Nursing School Bwindi, which is now rated as one of the country’s finest nursing schools. As an added bonus, Carol and I discovered that our smiles had returned.
I currently spend five to six months a year in Uganda. I remain on the hospital board, I’m still engaged with fundraising, and, when I am in Uganda, I consult on difficult hospital cases. The Bwindi Community Hospital was chosen as a site for viral research through a National Institutes of Health-funded program called EpiCenter for Emerging Infectious Disease Intelligence, where I am a senior consultant. In collaboration with the University of California, Davis, the program is searching for novel viruses that may spill over from animals to humans, with one goal being to prevent future pandemics.
Over the years, hundreds of Rotarians have visited Bwindi Community Hospital, bringing everything from administrative talent to medical expertise to information technology. Our projects have received much support from Rotary International; from Past District Governor Rick Benson, of the Rotary Club of Westport, Connecticut; from the Rotary clubs of District 5190 and other California Rotary clubs, as well as the Rotary clubs of Kihihi, Kabale, and Mbarara in Uganda, and from many generous donors. With Rotary’s help, the Batwa are freeing themselves from their cycle of poverty.
My time in Africa has been the best of my life. I gained a true understanding of the gift of relationships and the joy derived from service. All this was done in collaboration with committed members of Rotary. I encourage them all to come to the Bwindi, where they will touch a slice of heaven.
A physician specializing in tropical medicine, Scott Kellermann is a proud member of the Rotary Club of Nevada City 49er Breakfast in California.
This story originally appeared in the January 2024 issue of Rotary magazine.