Kisiizi Hospital – “Capilla” by Cecilia Guridi
A book from rural hospital into the Light
Article and images by Cecilia Guridi (Documentary Photographer)
We arrived in Uganda during a hot and dusty December 2015 and very quickly left the bustle of the capital, driving for several hours to a very small community located in the mountains of north Kigezi, in the Rukungiri region of south-western Uganda. There, in what it was an old flax factory, is nestled a rural hospital, originally founded in 1958 and which grows larger with each passing year. Kisiizi Hospital is a private, non-profit, healthcare provider, run by the Church of Uganda, which serves a very poor community with healthcare, hydro-electricity, primary school education and a community health insurance scheme. For over fifty years, Kisiizi has continued to develop and now has a School of Nursing, which trains two hundred nursing students and midwives every year.
My husband, a consultant psychiatrist, had received an invitation to help at the mental health ward while I, as a Documentary Photographer, was going to document images in the life in this hospital along with the surrounding community, through the daily activities of the people who live and work in the area. We were kindly offered a cute, round house in which to stay, overlooking astonishing green grasslands and views of the famous Kisiizi waterfalls. On the first morning, when everything still looked very strange and new and I was consumed by the challenges ahead, two of the most beautiful birds I have ever seen – grey-crowned cranes – flew over these plains, which I saw as a sign of good luck for the coming two months.
The culmination of my work is this book, where images and quotes are compiled to show the hard work of every person in the hospital, that celebrates the splendour of the people and shows how they help each other, embracing the true concept of community. The challenge, however, was to simultaneously capture the harsh reality of the sick. The Superintendent of the hospital, Dr Ian Spillman, named the book: “A World of Difference, Portraits of Kisiizi” which is now available via the Internet and can be seen and purchased from anywhere in the world.
For a photographer, to be given such an opportunity is, simultaneously, a dream and a genuine challenge. However, I had the good fortune of being supported by many people in the making of this book.
A loud drum in the early morning wakes us all up and moulds our days into regular routine. The rhythms of Africa are alive and well in Kisiizi, expressed each morning with clapping and singing, which invites all staff to again attend to their ceaseless work.
The constantly changing skies, filled by the most colourful of birds, distracts the artist from unglamorous corridors and hospital beds, but my focus was to get accustomed to the conversations about health and to give a voice to those in pain. I made an initial decision not to intrude immediately with my presence, so for the first two weeks I barely took a photograph. Instead, I simply visited every ward, familiarizing myself with the people, the patients, the rhythms and schedules of activities, then slowly I took out my camera and just started walking around. Initially, people looked at me curiously, asking many questions. Of course, I wanted my photographic gear to be a natural extension of me and not to be invasive. Slowly, the patients, their relatives and the hospital staff became accustomed to my equipment and, when I finally gained their trust, I started taking photos in earnest.
It was all an extraordinary experience, in part due to all the new people I met but also because of the extraordinary African landscapes I encountered. The shared goal and common purpose with others allowed me to forge and establish life-long relationships. Due to the almost total lack of electronic distractions, we shared intense, human experiences and, due to a common bond, we all welcomed every birthday and shared arrivals and farewells, in a mutual celebration of life. This quickly made me feel like I was amongst my own family. The Superintendent had already warned me: “You will not be the same person when you leave Kisiizi, as when you arrived”. He was right!
Learning a bit of the local language also helped me to communicate and connect further with the individuals I was photographing, usually provoking lots of laughter due to my wayward pronunciation, limited vocabulary and hence the inevitable, resulting miscommunications! All that camaraderie though, helped me become more accepted and very soon I was following some cases in the hospital, which I visited almost everyday. The neo-natal unit, particularly, caught my attention, with all the tiny babies struggling to survive and remain in this world. This unit, small in size but supported by so many, ended up being one of the places I could be regularly found, for sure. You can find there seriousness and sweet smiles, and modern techniques such as kangaroo care, where a mother holds her tiny baby against her chest for the baby to feel the heartbeat, which today is believed to be of great help to the development of the baby. Such a treatment attracted my attention for the pureness and simplicity of the scene and hence I followed the specific cases of two mothers with premature babies. Sadly, the images of one of them could not be used for the book because, after many, long months of fighting for life, that small soul chose to depart. The other mother asked me to name her baby and there now exists in Kisiizi, a baby Santino, which comes from the Latin word meaning “saint”.
Yes, I am scared of seeing blood and serious injuries, which delayed my photographic approach towards the more extreme cases. Whilst sitting around the table with visiting doctors, medical students, midwives and nurses – all volunteers – I rarely got accustomed to the topics of discussion. But the day came when a strange sense of curiosity came over me and I found the courage to deal with my personal phobias and I finally went to visit the surgical ward. I found, to my surprise, a very welcoming environment, where serious operations take place accompanied by the beautiful notes of classical music and where miracles seemingly do take place. This is where brilliant brains and skilled hands combine, identifying crucial solutions, keeping people alive and cheating the cruel hand of death. The big challenge for me though, was how to make art out of an operating theatre? Whilst I was exploring their concerned faces, often contorted into quirky angles through deep thought and concern, Dr Gabriel Okumu, a Consultant Surgeon and his surgical team, seemingly forgot about my presence and once again I became invisible with my camera.
Odd though this may sound, I usually found some degree of relief from the stress of theatre in the Rehab Centre as, when visiting it, I could always find a smile from the staff and the patients. There was an extraordinary sense of life there, watching all the courageous battles to overcome physical and other impediments. You could see the stamina and endless resilience of the kids and adults alike, trying everyday to work harder and do their exercises better. The beautiful and energetic physiotherapist, who was named Night, was full of energy. She attracted staff and residents, not only to purchase souvenirs made by the patients, but also encouraged others to attend the Keep Fit – a combination of aerobics combined with yoga – to lift up our spirits. Alternatively, every evening when the heat of the day dissipated, the local staff played sports like badminton, football, and volleyball or touch rugby. Most of us at some point joined in with these activities, distracting us from the stress and distress we encountered during the long days.
Not all the photo shooting took place in the hospital. A fashion shoot opportunity came along one day after talking with local staff and when learning about their traditions, including ways to celebrate weddings and other occasions. I ended up in the house of Night, who was modelling traditional party dresses. Life was never dull in this beautiful place.
Some one hundred and eighty three images express some of what takes place in Kisiizi and these have been combined with meaningful quotes written by visitors and local staff about their own experiences. This book is not only a representation of the reality of being part of this particular hospital but is also an attempt to raise the profile of all the small hospitals doing similar work throughout Africa. It is a description of human existence and the power to rise above adversity, as well as a memoire for all the fortunate visitors who have come to help, and who end up treasuring their own, very powerful experiences.
As Rebecca Newell, a medical student from Bristol, England expressed: “By not shying away from the tragedy of the world, Kisiizi allows for the exploration of profound suffering and injustice, whilst the beauty of the location, the local people and the constant flow of interesting and dynamic visitors drawn to the hospital, allows for consideration of these often-paralyzing truths, in a refreshing, real and potentially life changing way. My highlights were meal times, just chatting away and being able to talk about real things, and sometimes really personal things but still being able to laugh and have a great time. The relationships formed were often intense and it was lovely to spend time in an amazing place, with people you really felt had become like family. Uganda is a beautiful country”
My initial dilemma was, how to capture, dignify and express the suffering rather than simply creating another medical journal? My sincere hope is that this book has – in some small way – come close to achieving this ambitious goal.