'My contribution made a difference': retiree, 77 years old, serves volunteer placement at Ugandan hospital.

HILDA SHILLIDAY IS no typical overseas volunteer; she is 77 years old, but like many others she has always wanted to help people abroad.

"When I was 16, I wanted to be either a medical missionary or a Shakespearean actress. Now I am wondering how old Lady Macbeth was," said Ms. Shilliday, a retired public health nurse.

After being told she was too old to work in Africa, Ms. Shilliday met a Friends of Mengo Hospital (FOMH) volunteer who had just returned from Uganda. The people behind this Victoria-based, non-profit organization had just the place for the upbeat and energetic Ms. Shilliday: the Mengo Hospital HIV/AIDS clinic.

The clinic, referred to as the counselling department, is one of the programs supported by FOMH donations and volunteers.

On Sept. 28, Ms. Shilliday arrived for a two-month stint in Kampala, and got down to work, easing pressure on the overworked staff. On busy days, the clinic can see over 125 patients, with only three clinicians, six nurses, and five counsellors.

"The numbers of patients is increasing, but the number of staff isn't increasing," said Dr. Edith Namulema, the program manager. "The more volunteers we have, the less the burden to us, the staff, and to the patients [as] their waiting time is shortened."

Each day Ms. Shilliday arrived at the clinic and worked in whatever capacity was required.

"I function as a nurse, sometimes that nurse means being a pharmacist, sometimes it's interviewing patients, and I really enjoy that," Ms. Shilliday said.

As clients arrive at the clinic they discuss with a counsellor the issues of HIV transmission and living positively. People who are being tested for HIV can receive results within 10 minutes of their blood being drawn.

Ms. Shilliday spent much of her time split between triage and pharmacy. In triage HIV-positive patients are asked questions to rule out tuberculosis, and their weight, temperature and blood pressure are recorded. TB, a dangerous co-infection to HIV, affects nearly half of the HIV-positive patients.

In the pharmacy Ms. Shilliday counted antibiotics, anti-retrovirals (ARVs), vitamins, painkillers, and anti-malaria medication, packaging them into small plastic bags and writing dosage instructions.

ARVs are provided by the Ministry of Health and the Inter-Religious Council of Uganda, but everything else is donated by drug companies or purchased with financial donations. If the clinic pharmacy has the medications in stock, patients receive them free.

However, the pharmacy can only supply about 60 per cent of the medications they need, as the rest are too expensive. Dr. Namulema says that if the clinic cannot afford the medications, most of the patients cannot afford them either.

Another requirement not being met is adequate nutrition; many of the patients on ARVs are too weak to work and cannot afford food.

"They say forget your drugs, we are hungry," said Dr. Namulema.

Aline Mujawamariya, a counsellor at Mengo hospital, says the most difficult part of her job is explaining the importance of a balanced diet to an HIV-positive client, only to realize they are unable to buy food.

"They feel if they cannot follow the doctor's instructions, they will die," she said.

Ms. Shilliday, a clergy widow from Victoria, says seeing the people who are so hungry, and the HIV-positive children were the most difficult aspects of her work. She says her faith helped her continue volunteering.

"I felt really guided and led by God to do this, and I knew that the everlasting arms had never let me down and wouldn't let me down this time," she said.

A key moment for her occurred on a normal Monday when she donated the funds for Sharif, a severely malnourished child, to be admitted to the pediatric ward. Sharif's mother was unable to pay the fees, and had just learned her child was HIV-positive: Ms. Shilliday said she believes her being at clinic that day was the difference between life and death for Sharif.

The incident reminded Ms. Shilliday of a sermon delivered by her late husband Errol; it was about a boy who was on a seashore throwing starfish into the water.

The tide had gone out and the starfish were dying. A man came along and asked the boy what he was doing. The boy said he was saving the starfish. The man said, "That's nonsense. There are thousands of starfish, what difference is it going to make?

"And the little boy said, 'it makes a difference to this one,'" Ms. Shilliday said. "Now I know Monday morning thousands of babies in Africa were dying of malnutrition, but [my contribution] made a difference to Sharif."

Angela Hill is a Canadian freelance journalist and photographer, currently based in Kampala.

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