Ms. Rose Nakame’s story as a nurse, a storyteller and an advocate for remote health workers and immunization in Uganda comes from her experience as a seven-year-old child battling a benign brain tumor. Due to the family’s poverty, she remembers the difficulty for her mother in accessing proper care and treatment.
“I realized I had to do something at a young age. In school, I took up science courses and moved into health to become a nurse,” she says.
Her experience as a child motivated Ms. Nakame to do better for other patients in the same situation. As a nursing student in Uganda, and on her own initiative, she learned how to perform incisions and drainages on patients who had waited a month without being admitted to a doctor, often dressing wounds for 30 patients in an eight-hour shift, on top of her routine nursing activities.
Through her work, it became clear to Ms. Nakame that the difficulties health workers were experiencing were a result of lack of staff and impossible working conditions for the majority women workforce. It motivated her to set up Responsive Mental Health Sustainability Initiative (REMI), a health equity organization working to improve the lives of the poorest by influencing policy. REMI East Africa also serves as a platform to profile and document the stories of women rural health workers delivering care in Uganda, many of whom are also battling their own poverty.
“Health workers didn’t have a voice. Decisions were made for them without consideration of their experiences, or the challenges of their circumstances and context.”
“Women can’t take up career growth opportunities because of the additional burdens they already have as care-givers in the home. Many at the lowest cadres of nursing, who serve the poorest, don’t have the resources to pay for childcare.”
Her advocacy on immunization during the COVID-19 pandemic was noticed by health authorities in Uganda, who recturited Ms. Nakame to work with rural health workers in several districts to increase uptake of vaccines and understand vaccine acceptance and demand in the district. As leader of a group of early career nurses and midwives, she spearheaded initiatives to train and support women in advocacy and storytelling, serving as a Sabin Immunization Advocacy Champion.
Ms. Nakame is clear about her demands of the international community – the burden must be alleviated on the majority women health workforce. Meanwhile, she is continuing to confront the inherent weaknesses in the health and care workforce that are holding women back and causing more to leave.
“Most of the nurses that I studied with are leaving because of the low pay brought about by the lack of implementation of the scope of practice, which would ensure that advancement in their nursing education is matched with increased pay. There is no incentive for nurses to advance their career. It demotivates them, especially those in rural areas.”
The problem of mental health among health workers has become an increasing focus of her demands, particularly in the context of the COVID-19 response. Ms. Nakame is grateful that her advocacy work enables her to mobilize funds for educational initiatives like digital literacy programs and mental health support.
“This would not have been possible if it was not for the work we are doing now. We can engage with those in power and in positions of authority to act on these issues.”
