A matter of life and death for one nurse in Uganda

Gerieke Zandberg, a paediatric nurse from the Netherlands, is working to save babies’ lives at Gulu Hospital in Uganda.


Volunteer nurse Gerieke Zandberg is stationed in the neonatal intensive care unit of the hospital. Here, she is training nurses and saving the lives of tiny newborns. It’s no surprise Gerieke is run off her feet at a hospital that serves 1.5 million people across seven districts.

“Mondays are chaotic. I won’t have been in over the weekend, so I‘ll come back and the unit will be a mess. There are no doctors, and the staff that are in will be busy with other wards. No one really gets the proper attention they need.

“Sometimes I’ll work a day and an evening shift in the same day. The nurses miss crucial things, as they don't have the knowledge – recently we had a baby with a spine that hadn’t developed properly, and nobody noticed.”

Gulu is an incredibly busy hospital, seeing on average 89 births a week, and 101 newborns returning for urgent medical care. Some days, it’s just about making it through to the next:

“In the beginning, I was just leaving a shift, crying, like ‘oh my god, what happened here?’ I’ve learned how to cope with it now. In the afternoons, if I’m sad I will read a book, watch a movie, go to the pool or just hang out with other people. Then you are refreshed.”

“Who am I going to save?”

“I remember one particular day, the night nurse reported on the status of the babies. She told me everything was fine. ‘They're all breathing,’ she said. And then the very first baby I attend to, I said, ‘Hey, this baby is not breathing anymore. Have you not seen this?’

“She said the baby had been fine when she checked an hour ago. I started resuscitating, and then noticed two more really poorly babies, also in need of resuscitation. Sometimes you do have to make a choice. I think to myself, who am I going to save?

“When these nurses don’t give the proper care to babies, it’s not because they don’t want to. It’s because they haven’t had the training, and nurses are rotating between different wards all the time.”

What’s important is not just supplying all this equipment, but really working together with the local staff and transferring knowledge.

Impossible decisions

 “I’ve been given a lot of responsibility as there’s no one here who's skilled enough. There's one paediatric doctor, but she’s got so many babies and children to attend to that I end up making treatment plans and making decisions, like whether to discharge babies or admit them.

“The nurses here don’t have the skills and knowledge to recognise when there’s a problem. In the Netherlands, when there's something wrong with a baby, you run. You treat it as an emergency. Here, when there’s a baby that’s doing really badly, the nurses don’t recognise the problem in time. They recognise the problem when the baby is almost not breathing anymore and then it’s too late.

“I’m privileged to have received training in neonatal care. Here in Uganda there’s no special education, no training in how to care for these babies. The neonatal unit should have specialised nurses, who can give specialised care.

“In my first weeks, I tried to focus on calculating the proper dose of medicine to give a patient. I then discovered that while the nurses can read and write they can't do calculations.

"We need skills, knowledge and training - that's the biggest problem here."

Life-saving work

“The mothers and babies here are really resilient. It’s tough because there isn’t the training that’s needed, and often the babies die because of that. But I know I’ve made a difference. I can say that I have saved babies while I’ve been here.

“I've got new mums calling me every week still, giving me updates on how their babies are doing and sending pictures. They’re very proud. Sometimes they name their babies after me.

“What’s really frustrating is that had these babies been born in the UK or the Netherlands, they might not have even become sick to begin with, as they’d have had the right care and the right equipment to treat them.

“What’s important is not just supplying all this equipment, but really working together with the local staff and transferring knowledge.”

Nurses like Gerieke are pushed to the limit – it shouldn’t be like this. It shouldn’t always be a matter of life and death, but to do this we need more volunteers. You can read more about the important work our volunteers do for mothers and babies here:

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Amazing moment volunteer brings a baby back to life

Newborn deaths and infection rates have plummeted since VSO opened this intensive care unit in northern Uganda three months ago.

Going above and beyond to save lives

Andrew Sesay is a Community Health Officer at Binkolo clinic, Sierra Leone. He’s often the first point of call for the thousands of people living in the community.