June 12, 2020 • 43 mins
When Renee’s story hit the airwaves, a Ugandan official decides to look into her alleged crimes. He’s shocked by what he finds: nothing.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
What you hear in this podcast does not implicate any
individual or entity in any criminal activity. The views and
opinions are solely those of the individuals participating in the podcast.
Previously on the missionary, they're providing nutrition services to combat
a crisis that literally the hospitals and others were unable
to handle just due to the volume. When I moved there,
(00:22):
there was a mentality of you have two patients, which
one has a better chance of life this one than
this one? You pick in this one you leave. It's
like you were color coding people on a war field.
I was fit to like provide medical care and whatever
were over my head, like this is serious, serious, make
(00:43):
you take you care. So, based on the allegations you
have heard that she was an unlicensed medical facility, that
she was providing medical care without having medical qualifications, do
these allegations surprise you, given you what you know about
how and geos operated here, Of course they don't surprise me.
(01:14):
Jim mc graham was twenty two years old when he
found a pamphlet recruiting young healthy men to serve their country.
It was November nineteen and millions of American men were
going abroad to fight in World War Two, but Jim
was a conscientious objector. Instead of taking up arms, he
(01:34):
found other ways to help by planting trees fighting forest fires.
But he wanted to do more. This call for volunteers
sounded like an opportunity to provide a worthwhile service, not
just to our country, but to all humanity. Jim volunteer
to be a guinea pig in a study called the
Minnesota Starvation Experiment run by Dr Ansel Keys of the
(01:58):
University of Minnesota, DA. He was featured in a documentary
by Colorado State University. We knew fairly well what a
star of person looked like and what starvation did to
the human body, but until this time, there had never
been an opportunity to measure exactly what changes take place
in the body under starvation conditions, Nor had there ever
(02:19):
been any scientific tests to determine what best to feed
a star of person to bring him or her back
to health. The project's goal to learn how to treat
starvation after the war ended. The experiment was fairly simple.
Thirty six men were semi starved for six months. Their
diet was modeled after famine diets of bread, potatoes, porridge,
(02:43):
and turn ups. They continued walking at least twenty two
miles a week, taking classes in the university and working
at the lab. Jim was six ft two and he
began the study at one hundred seventy five pounds, but
it wasn't long before the famine diet took a toll.
Most of us suffered from edema, the collecting of liquid
(03:05):
in the body, some more than others. I always woke
up in the morning with my face puffy on the
side I was lying on. Sometimes my ankles and knees
were puffy. I look in the mirror and see that
my eyes looked hollow, my cheeks were only a thin
covering for the bones in my face, and my hair
was getting thinner. If I tried to smile, it was
(03:26):
just a grimace, and I never laughed. As Jim and
the other participants rapidly lost weight, some dropped to a
mirror one hundred pounds, and the psychological changes mounted, fatigue, depression, paranoia,
(03:46):
symptoms that previously hadn't been attributed to starvation. We became
very irritable and intolerant. Little things seemed to annoyance. We
were no longer polite with each other or with ssitors.
It seemed as if the veneer of civilization had been removed,
leaving bear the animal underneath. Years later, researchers would publish
(04:10):
one thousand, three hundred pages on the scientific effects of starvation.
The research remains key to a lot of what we
know and still don't know about malnutrition. I have experienced
hunger and the apathy and depression that goes with it,
but we lived in sanitary quarters under the constant care
(04:31):
of doctors. Furthermore, we knew that it would all be
over on a certain date. I often think how horrible
it would be to be starving and never know when
it would end, if ever. In association with I Heart Media,
I'm Halema ge Condy, Malcolm Burnley, I'm Roger Gola and
(04:53):
this is the missionary episode six, one hundred five children.
There are a few basic facts that everyone agrees on.
Renee had run a health facility for malnourished children, It
(05:15):
was unlicensed for years, and at least one hundred five
children died, But those facts alone didn't support the worst
of the allegations that Renee was a baby killer. We've
passed through years worth of Renee's blogs, social media posts,
talked to missionaries and activists, but there hasn't been much
(05:39):
else to support these accusations and allegations. It was obvious
to me that there were more perspectives out there, more
people we needed to speak with, a completely different world
that we hadn't tapped into yet. That was Uganda's health
care system and the near dozen medical staff who worked
with RENEE for years. I knew that I had to
(06:01):
get into that world. The first time I traveled throughout
eastern Uganda, passing by farms huge plantain and cassava plants,
pineapples and sugarcane fields, I thought, how could there be
severe malnutrition in a place like this? Um Dr Esther
(06:26):
I am a pediatrician. I also have a PhD in
a clean connutrition and I am the head of Manama
Jimon Nutrician Unit, Malago National Referra Hospital. Dr Barby Rickare
has been working on malnutrition for more than twenty years
and then one of the GYMO Nutrition Unit is the
top children's nutrition unit in the country. About one percent
(06:49):
to two percent of children, especially in the five years
of age, severely malnourished, so it is that big. On average,
we admit about one hundred children per month with severe
acute malnutrition just on one world that nutrition or unit,
so that's is quite a big number. Malnutrition remains a complex,
(07:17):
mysterious problem, especially for children in Uganda. They're quite a
number of causes or predisposing factors to malnutrition. People are
surprised why we have a lot of food and yet
we have malnurised children. But these children may not be
taken in adequate amounts. And also the quality of the
(07:38):
food and how is this food prepared. In Uganda, the
main stables of today are mostly starchry foods like cassava
and maize that lack a lot of vitamins that babies need.
A lot of other countries have addressed this by fortifying
or enriching their stable foods. In the US, wheat flour
is often enriched with iron and folic acid. Table salt
(08:02):
has iodine, but that hasn't happened much in Uganda. Food
isn't the only factor either. Also diseases. We find some
chronic diseases like tibi or v or diarrhea, diseases predisposed
that children getting malnutrition. These combined factors were deadly for
(08:24):
malnourished children There's another oddity to malnutrition too. Instead of
becoming skin and bones, some children's bodies swelled, especially around
their stomachs. It's an image that many Americans are likely
familiar with seeing on the news starving children with bloated bellies.
The swelling is called edema, and it's similar to what
(08:46):
happened to the adults under the Minnesota experiment. With some children,
their faces can become so swollen as if they're having
an allergic reaction, their eyes get puffy. In Ghana, this
is called quash or car, meaning the disease of the
displaced child. It mostly refers to when a baby is
(09:07):
weaned prematurely after their mothers become pregnant again. Quash your
car also has local names in Uganda of Bosi and
Luganda and Lose and Lugisu. Experts like Dr Esther Barbera
Care are still trying to research why certain children develop
it and why others simply become incredibly skinny. Around the
(09:30):
time that Renee had established serving his children, malnutrition was
the direct cause of more than a third of deaths
for children under five years old in Uganda, and malnourished
children or nine times more likely to die than healthy ones.
Even when children were able to get to hospitals like
i Mlago and be seen by experts, there were still
(09:53):
a high chance they would die. They'll take an example
of ard that is them Lego and a demnutrition or
unit they come verily to when they are critically ill
with these complications and you try your best, but still
about ten to may day. This is unacceptable and acceptably high.
(10:20):
As grim as those numbers are, it's actually an improvement.
Ten years ago, the mortality rate for children with severe
malnourishment in Uganda was even higher. Sometimes between twenty and
of severely malnourished children died in hospitals. That was the
scale of the problem and that's why Uganda created a
(10:43):
new system to build more health centers and clinics in
hard hit areas. Testing testing, Okay, so could you just
say your name, um and your profession. Okay. My name
is r Dr Honey Forbach. I'm a retired medical practitioner
and a nutritionist. I worked in the National Hospital Hospital
(11:08):
from nine and then moved on to the National Nutrition
Unit where I worked until two thousand and nine. Then
I moved into programming and have recently retired Dr Hannover
Pacho is another top child nutrition expert in Uganda. In
(11:30):
two thousand nine, the year when they moved back to Uganda,
Dr Pacho had turned her sights on working with the
Ugandan Health Ministry to create policies to address the child
malnutrition problem. She was instrumental in developing Uganda's new national
guidelines on managing these cases, a step by step manual.
(11:52):
Up until then, treatment of severe malnutrition had mostly been
centered around hospitals. What was wrong with that approach? The
approach was not wrong, except that there were challenges. One
is that the care give us would stay for very
long and in five distance away from their families because
(12:14):
those facilities were few. And also in the course of
staying in hospitals, they would get cross infections. Yes, the
plan Doctor but Show helped create was to decentralize the
care of severe and moderately malnourished children. The goal was
to reach children who weren't accessing hospitals and to stop
(12:36):
children from becoming severely malnourished in the first place. The
community specifically is supposed to have a structure that identifies
children with manetrition and refer them ali to the health facility.
This model has been shown to reduce the mortality of
(12:59):
child malned Chrisian. The idea was to move them up
the pyramid of care as the cases got more complex.
Children with moderate malnutrition could be treated out patient, as
in they go to rural health clinics for checkups and
get nutritional formulas, but they stay at home. On the
other end were severe cases of malnutrition, especially those with complications.
(13:24):
These children were supposed to be enrolled in full time
in patient care, but this was also a last resort
for only the most intractable cases. Once a child's health
was stabilized, they could be transferred back home for the
rest of their treatment. If this sounds familiar, it's because
these are the guidelines. Renee says. She modeled serving his
(13:46):
children after sending out social workers to teach about nutrition
and screen for children with severe malnutrition in the villages,
and then taking those sickest children back to their facility
in Jina. I asked Dr Bachou which region was the
worst in two thousand nine, the year Renee sat up
serving his children. I it was an eastern region, Eastan
(14:10):
region Lamutumba. It was a real case of severeli Malarui.
It was really an emergency that the country had to
move in to ensure that a nutrition in it was established.
The name Nama Tumba sounded familiar. Later I went through
my notes again and there it was. One of the
(14:32):
children in the court case against Renee. His name Tolala Kifabi,
his village Namatumba. We began this podcast and reporting this
(14:56):
story with the court case against Renee. The fact that
two Ugandan women were suing an American missionary over the
deaths of their children. That to me was the most
important part of this story because it seemed like this
was a rare opportunity for Ugandan's to get justice. We
(15:17):
had heard so many allegations, but these were the actual victims.
Their stories were essential and piecing together what went wrong.
Starting with the court documents that Renee submitted, I thought
I could find material evidence that Renee was running this
quack facility. Now to Lale is one of two children
(15:40):
whose mothers are suing Renee Bach. He died after being
treated at serving his children for seven days. His mother, Gimbo,
was given fifty thousand Ugandan shillings less than fifteen dollars
for her loss and a bag of beans. We mentioned
his story in episode one. In the court documents, Kimbo says, quote,
(16:03):
the women from Serving his children were not doctors and
may have done something unprofessional that led to the death
of my child. Essentially, she thinks something went wrong, but
doesn't know exactly what now. The lawyers say Serving his
children violated to Lally's right to life because the facility
(16:24):
wasn't licensed at the time. The case also states that
they violated his right to privacy because to Lali's photo
was posted on Serving his Children's social media account. I
managed to track down the health workers who oversaw Tolali's case.
(16:46):
It was early two thousand thirteen when to Lali first
became sick in his village of Namutumba. Namatumba is about
an hour away from two major hospitals. The local health
center diagnosed to Alale with malnutrition and directed Gimbo to
buy nutrition supplements. This should have been a sign that
(17:08):
the system was working, but according to Gimbo, she couldn't
afford the medicine, so she returned to the village empty handed.
Sophie said, those are the children. Renee and her employees
were trying to help. She didn't get children who were
fine from the villages. She was getting children from the
(17:28):
ridges who are desperate to bring them and how at
least for them to reford Esmail. That's Sophie Mutessi, a
midwife who worked at serving his children from around two
thousand twelve to two thousand fifteen. She has a lot
of experience bridging the gap between villages and hospitals. To
(17:49):
Lally was a prime example of those gaps. Even when
services are nearby, many Ugandans, especially the poor, faced too
many barriers to accessing them. Patients have to pay for
basic supplies like gloves, gaus, bedsheets, medicines, even mats to
sleep on, and they have to pay for that upfront.
(18:11):
Those who can visit the hospital can't always stay long.
That's what made serving his children different. They paid for
everything by time they reached hospital. Then need is not
only treatment. The mother is stressed, that's taken three days
without eating, no, so not everything blessed sickness. Don't you
(18:32):
reach at Rene's place, the treat her psychological and give
her class time for resting. In July two thou thirteen,
Gimbo was pregnant with another child by now months had
passed since they visited the health center, so to a,
Lali's condition had likely gotten worse. Serving his children passed
(18:56):
by Gimbo's village during one of their outreaches, the staff
asked her to take to Lale to the facility in Ginger,
So Gimbo sent her mother to go with tolal A.
But this didn't seem to be the same serving his
children that Jackie Kramlck, the American nurse and volunteer, had criticized.
By now, the organization had heated her warnings and hired
(19:20):
trained nurses to join the staff. When Tolally arrived at
serving his children, he was in really bad shape. He
was severely dehydrated, his body was swollen, his skin was peeling,
and his condition would only continue to worsen. Sophie Mutessi
(19:41):
took care of tolal A on at least two shifts.
According to her notes, Tolally was no longer able to
eat the special formulas made for severely malnourished children, which
is a bad sign. He also had diarrhea and was vomiting.
Looking at her own notes, Sophie said that there was
no difference between the food they were feeding him and
(20:02):
what was coming out of Tol's body. That was a comment,
why is that serious for the rest of us. They
weren't medical like you are putting milk here. It was
the milk coming down, which means no digestion was taking place.
Does that mean the digestive system just isn't working down?
(20:24):
Not working hm, urinating one or four times, dehydrated, Continue
with plants, rehydrate your got you chosen. He spent, So
that was the end of your shift. One of the
early lessons of the Minnesota starvation experiment was that you
(20:48):
have to be very careful about how you refeed or
rehabilitate patients. Dr Barbara Carey told me about something called
refeeding syndrome. Refitting syndrome is a phenomenon or a condition
that occurs to manorite children when you're beginning to feed them.
They have had electrolytes that imbalanced, that are not in
(21:12):
right order, so when you begin to feed them, then
that may worsen the condition. This causes a rapid crossing
of some electrolytes into the cells, others out of the cells,
and then that causes derangement in the body function and
then they may Die. Here's Dr Barbara carry talking about
(21:32):
the therapeutic milk products they use that Lago and how
they monitor at the way we manage this or we
prevent it is we use a feed usually we call
it therapeutic feed, or it is like a medicine, but
in form of food. It has the right balance of
these nutrients and we give it cautiously slowly until the
(21:55):
body is learning or beginning to learn to use these nutrients.
Then always tip up the nutrient of value, especially the
protein and the energy, so that now this baby or
this toad begins to gain weight again. So it is
actually a serious killer if you're not using the rate
feeds in the beginning before the body function returns to them.
(22:20):
The special formula she's talking about our f SEM five
and F one two powders you can mix with water,
developed in the nineties as an emergency treatment for child malnutrition.
Refeeding syndrome is something that critics like Jackie said Renee
was clueless about. But if you feed a child too
much or the wrong type of substance too early, it
(22:43):
can kill them. Even though Renee had access to these
feeding formulas, which are normally distributed by units f or
the Ministry of Health. If a child is in danger
of refeeding syndrome, they should be around specialists who can
recognize it. In that case, I thought maybe Renee had
failed to refer to Lally to a hospital when he
(23:04):
should have been, which would have been a clear sign
of negligence. But in the court case, Renee says she
left the country the day to Lally arrived at the facility,
and she submitted her passport pages as proof, which means
in theory, she wasn't there to make the hour. By
our calls about to Lally, that decision would have fallen
(23:27):
on the most senior person there. Mudasi causa as first
professionalism msconsin she was employing professionals, qualified people. That's what
I knew. Oh, I know she was employing professionally. They
didn't have quacks there, okay. Mudosie is a clinical officer
who works at the now Lifenia Children's Hospital in Ginger.
(23:49):
They're kind of in between nurses and doctors. They play
a big role in filling the healthcare gaps because they
can practice medicine, diagnosed cases, performed surgeries, but they don't
spend as many years studying medicine as doctors. We Darcie
would come into serving his children a few times a
week to check on the children, write prescriptions and sometimes
(24:13):
refer them to the hospital. Actually, when I found him,
he was working at the hospital. As these are doctors notes.
Do you recognize these? Yeah, I suppose my handwriting. I
had him read over the notes on Tolally's case. Then
I asked him if there was any sign that he
had requested that Tolally be referred to the children's hospital.
(24:38):
He didn't. He thought serving his children was managing the case. Fine,
this one, this one was it was story. But you
would do, you'd manage. That's why when you look at
to these records, I was saying, well, there's some improvement.
The new complaints were not there. Yeah, so cooking and stable.
(25:03):
Days later, on July sixteen, two thousand thirteen, Totally died
of severe malnutrition. I asked Dr Patow to read over
Tollly's medical documents as a second opinion, to see if
there were any irregularities, any sign of misconduct, anything that
(25:25):
went wrong reading water, you know, how He examined the patient,
came up with the tentative diagnosis, and then returned that
the treatment protocol, I think he must have had some
you know background, yeah, or for managing this kiss? Is
there any point so far where this child should have
(25:45):
been in a hospital? Do you think? I don't know,
I don't know to commit. But then it's this jealous
put on oxygen, this child was put on ivy. This
child was you know, put on antibiotics, the antibiotics and
was being monitored. So not knowing this situation A then
(26:09):
I would assume that this is a health facility with
the trained health focus. What if it's me She has
all this sophisticated a medical equipment and she is not trained.
Who who decides to when to take action or not action?
(26:32):
I was just as baffled as Dr Pato. Initially, I
thought by tracking down for Lolly's journey, I would find
the prime example of Renee's medical misconduct, whether she had
done medicine herself or made decisions that had led to
to Allalay's death, But to Alway's case, hadn't done that.
(26:53):
In fact, it showed the opposite that Renee had hired
qualified Uganda ners in medical professionals at least by two
thousand thirteen. It showed that they were the ones who
had treated to Lala and didn't bring him to the
local hospital. Ultimately, it showed that Tolally had died despite
(27:16):
their best efforts because severe malnutrition is so hard to
treat at that stage. That makes Tolal a one about
least one hundred five children who died at Serving His Children,
And I keep thinking back to that number. We've talked
about it throughout this podcast. One hundred five children died.
(27:41):
I mean, it's shocking every time I hear it. And
remember those are just the numbers that Serving his Children
admits to, and they provided them a couple of years ago,
and given the inaccuracies in their documentation, that number could
be way higher. We don't have the medical docum mints
of the other children who died at Serving His Children.
(28:03):
That said, the number one hundred five still seems like
a lot to me. Here's the math. Between two thousand
and ten and two thousand fifteen, one hundred five children
out of nine hundred forty who were treated in patient
at Serving His Children died. That's a mortality rate of
(28:24):
eleven percent. But that's nearly half the mortality rate in
Uganda's top hospital after learning about how hard it is
to treat severe child malnutrition. That number doesn't look as
bad as it did in the beginning. Based on that
number alone, it could be tempting to say that serving
(28:47):
his children helped save more children from malnutrition than had died.
But there's one obvious caveat that we can't forget. Even
though to Lolly had gotten quality care from quality Ugandan
medical professionals when he died, serving his children was still
(29:09):
an unlicensed facility. Wake up, Africa, you're trying to come
open up your pie gone Helen. Welcome to Africa. Watch
(29:36):
on the Dr Mombi Show. My name is Dr mombys Iraki.
How you're doing. How's everything going? I pray you well
in everything earthing. I just hope everything is going absolutely
fantastically for you and you're living your best life. Now.
I've got a story that got me just I even
wanted to just throw this at someone for real. It
got me so emotional. And it's all about this a
fake ass, you know, white supremacist. You ain't even a doctor.
(30:02):
This YouTube show aired on February five, two nineteen, when
the news of renee Bach and serving his children was
just starting to spread online. She wasn't deported, she wasn't charged,
The health ministry in Uganda didn't belaunch any kind of
investigation against and she's still in Uganda till this day.
(30:23):
It's crazy. So what they're doing now is their demanding
that this question has nagged me throughout this story. In
the past year, I learned Uganda does have a lot
of rules and regulations that are sometimes complex and bureaucratic,
but they're there. So how had Renee been able to
buy and procure medicine for years, to coordinate blood transfusions,
(30:47):
get lab tests, order specialized nutritional formulas, and eventually higher
legitimate staff, all without a license. We couldn't both say
that you gone that had laws and regulations that Renee
hadn't followed without recognizing that someone was responsible for enforcing them.
(31:08):
Could you introduce yourself. I'm doctor Cartoon by Cento executive
or you're gonna Medican Dental Console. It's a government which
is in charge of regulity in the practice of doctors
and their facilities. I'm in doctor Saintongo's office in Kampala.
It's not too far from the country's biggest hospital and Lago.
(31:29):
Doctor sin Tongo is one of those matter of fact
expert types. He just doesn't beat around the bush. He
told me he hadn't heard about these latest accusations that
Dr Mumby was talking about against renee Bach or serving
his children until he got a call from the Minister
of Health saw that the video running. I don't seen it,
(31:53):
so she wanted it to know. Are the issues to
do that fast? So it today and the producer a
primary portion. So now he had to get to the
bottom of it fast. Doctor sin Tongo assembled a three
person team to go out and investigate the claims against
serving his children. Dr Katumba tried to find other people
(32:18):
who had worked at serving his children in Ginger or
the mothers in the court case, but they didn't find
them and they had limited funds to continue investigating, so
we didn't get to the opportunity. I tried to get
to details at what happened Deforma clinics because unfortunate today
put in a good doctor. We also didn't have contact
(32:42):
of the people had to complain. I had some better
luck and more time to track down some of these folks.
I knew that there were plenty of nurses and doctors
involved with serving his children over the last ten years,
but only a handful were part of the actual court case.
They would have seen firsthand how things had worked there,
(33:04):
and it seemed like no one else was talking to them,
not the lawyers, not the media, and not the government investigators.
After months of pouring over court documents and medical databases
and criss crossing the country on buses and motorcycles, I
managed to track down eight nurses, three doctors, a nutritionist,
(33:25):
and a medical officer who at one point or another
had worked at Serving his Children, but only a few
were willing to go on the record about their time there.
It was easy to see why they wouldn't want to
get involved in this mess. After all, if something wrong
had happened at Serving his Children and they didn't report it,
(33:46):
they could lose their licenses. But one of them, a
nurse named Violet, was willing to go on the record.
So I'm on the way to Kagadi, which is a
town that's in western Uganda, close to order with the DRC,
and I'm searching for a nurse named Violet. So I
called her a few days ago and explained what we're
(34:07):
trying to do. Um it's a Sunday, so I'll probably
have to wait for her to get out of church.
Violent Auto Beatrix had worked at Serving His Children in
two thousand twelve for about six months. She's now a
government nurse and the opposite side of the country, about
eight hours away from Ginger. When we met at a hotel,
(34:28):
I realized she hadn't heard anything about the case. She
was exactly the kind of source I wanted to speak
with when I just got there. Nothing much was told
to me about how the organization started, but being someone
who's looking for a job, someone who is jobless, I
just took on. They didn't tell me that we have
(34:50):
a opened that organization wasn't experienced medically. Violet told me
she had her reservations about serving his children. She had
a lot lot of experience working at big NGOs like
Doctors without Borders, but she didn't think she and her
fellow nurses were equipped to deal with extreme cases of malnutrition.
(35:12):
And she was a trained midwife, but also didn't think
they were equipped to have women giving birth there. Violet
knew her own limits, but didn't think Renee knew hers.
I would see how read she would read through books,
and then she would apply, let's see her reading medical books.
Would see how read medical books and an apply and
(35:32):
and she would she would do the medical, the nothing,
the treatment, all that. Yeah, Violet agreed line by line
with what Jackie Kramlick, the American nurse, had said. Renee
did blood transfusions, I v s, intramuscular injections, spinal taps,
femeral artery punctures. So here was someone who categorically thought
(35:57):
Renee had done wrong. This is the type of person
who could have said something at the time. I asked
her if she did, there's no I would say, but please,
I want to see your papas, but please wise your
certificate displayed here. There was no way I would ask that.
Why not, Well, it would look like I'm attacking her.
(36:18):
When I entered there, I saw her actions. She acted
a medical person. She introduced everything to me and we
started practicing together with her. So I kept it to myself,
and I'm like, after all, I won't work here for long.
Violet told me that government nurses like her make about
one hundred dollars a month. She needed the job at
(36:41):
serving his children. This was something I had heard from
other former employees too. They said the nurses were too
subordinate to say anything, So I wondered, what about the doctors.
We need a doctor, plain and simple, a doctor who
can be there in emergencies, give your action to our
nursing staff, and provide an in house diagnosis for the
(37:04):
many complications that come with severe malnutrition. In May two
thousand twelve, a year before Tolali's case, Renee put out
a blog post asking for donations twenty two thousand dollars
so she could hire a doctor and a nutritionist. A
doctor who can come alongside us as we strive to
(37:24):
save the lives of children that faced the horrible reality
of malnutrition. A doctor who shares our passion for serving
the Lord. Until she hired that full time doctor, she
had other doctors coming in periodically. One was Dr Alex Wassamoka,
who came in a few times a week. He worked
at serving his children for about six or seven months
(37:46):
in two thousand twelve. Now he's a doctor at Ginger
Hospital and when he looked back at serving his children,
he saw nothing but things to be proud of. So
there was no time, not even a single time, when
there was no nurse to attend to the children. These
(38:07):
children were actually treated in the best way I could say,
the best way possible. In his view, sometimes kids were
better off at serving his children than the hospital. It
was well equipped and had to study supply of oxygen,
which many hospitals often run out of, and it was small,
(38:27):
so it had a good nurse to patient ratio. When
I compared that with what was in the hospital, you know,
the hospital, the numbers were so enormous. The nurses in
the hospital are a few story could not attend to
all the children in time and as required. You know,
when the nurse patient ratio is not a proper then
(38:52):
even the quality of care drops because then the children
were too many compared to the staff available. Dr Wassamocha
wasn't the only one who thought this. I spoke with
at least two other doctors who had worked part time
at serving his children who thought the facility overall had
(39:12):
done a good job. So did nurses like Sophie Mutessi,
who you heard from earlier. It was exactly these sorts
of competing narratives that had stumped Dr Katumba's investigation. He
had heard news about RENEE killing hundreds of kids performing
medicine trampling on Uganda's rules. But then when he managed
(39:34):
to visit Serving his Children's brand new facility less than
two hours outside of Ginger, he found staff who were
properly licensed, a facility with all of the right paperwork
and an administration that was going by the book. Where
were all of the dead kids? The main component was
in India District unaffortunated. So we wrote a report and
(39:58):
it had administer that that was our immutation, that we
couldn't find a compliment for the Gingha site. The issue
was that all of the accusations against Renee were made
about work she had done at an old facility in Ginger.
The team didn't have the time or resources to investigate
(40:19):
claims at a facility that no longer existed, and even
if they did, they would have probably heard the same
conflicting things that I did. The report they submitted concludes
this that they are unable to support allegations that children
died in large numbers due to serving his children, and
that they found no evidence that Renee Boch was treating children.
(40:44):
The report was released, but the case was kept open
in case any additional evidence or sources ever came forward.
The experience that Dr sin Tanko had, I think speaks
to how the whole story has unfolded. We had entered
the story with huge, big, scary, outrageous testimonies about Renee
(41:08):
and what she had done, the number of children that
had died, the court case, but so far a lot
of that evidence wasn't actually supporting the worst of the allegations.
In fact, if anything, it suggested that it wasn't as
bad as we thought. But what had become crystal clear
(41:31):
to me was that there had been a bigger structural
failure that goes well beyond Renee. And this mattered to
me as somebody who has covered health and human rights
in the region, because at the end of the day,
Renee's only one person and Geo's like serving his children,
had been encouraged allowed to operate in Jinja for years.
(41:55):
They were able to interact with other hospitals and facilities
and pharmacy ease. And despite the fact that yes, Uganda
is a country with laws and regulations, those same laws
and regulations hadn't managed to regulate her, and staff who
were licensed, who were credible hadn't stopped it either. Next
(42:24):
time on the missionary, I just couldn't understand how people
could look at the same evidence we were looking at
and come to such different conclusions. And I said, but sir,
these kids will die if we send them home. And
he said, you're right, they will die, but it's no
longer your problem, So get them out of here at
before five o'clock before I'm taking you to jail. I
remember I would walk into like cafes and people would
(42:46):
leave when they saw me, Like I went to like
missionary events, and people would like refuse to speak to me.
And this was my sort of ah ha moment. This
was my wake up call that I had been lied
to directly to my race. The Missionaries produced an association
(43:18):
with iHeart Media. It's written and reported by Roger Gola,
Helene mcgegandhi, and Malcolm Burnley. It's produced by Michelle Lands
and Ryan Murdoch. Mark Lotto is our story editor. Our
executive producer is Mongiter. Our fact checker is Austin Thompson.
Mixing by Josh Rogison and voice acting by Taylor Kaufman.
What you hear in this podcast does not implicate any
individual or entity in any criminal activity. The views and
opinions are solely those of the individuals participating in the podcast.
Previously on the missionary, they're providing nutrition services to combat
a crisis that literally the hospitals and others were unable
to handle just due to the volume. When I moved there,
(00:22):
there was a mentality of you have two patients, which
one has a better chance of life this one than
this one? You pick in this one you leave. It's
like you were color coding people on a war field.
I was fit to like provide medical care and whatever
were over my head, like this is serious, serious, make
(00:43):
you take you care. So, based on the allegations you
have heard that she was an unlicensed medical facility, that
she was providing medical care without having medical qualifications, do
these allegations surprise you, given you what you know about
how and geos operated here, Of course they don't surprise me.
(01:14):
Jim mc graham was twenty two years old when he
found a pamphlet recruiting young healthy men to serve their country.
It was November nineteen and millions of American men were
going abroad to fight in World War Two, but Jim
was a conscientious objector. Instead of taking up arms, he
(01:34):
found other ways to help by planting trees fighting forest fires.
But he wanted to do more. This call for volunteers
sounded like an opportunity to provide a worthwhile service, not
just to our country, but to all humanity. Jim volunteer
to be a guinea pig in a study called the
Minnesota Starvation Experiment run by Dr Ansel Keys of the
(01:58):
University of Minnesota, DA. He was featured in a documentary
by Colorado State University. We knew fairly well what a
star of person looked like and what starvation did to
the human body, but until this time, there had never
been an opportunity to measure exactly what changes take place
in the body under starvation conditions, Nor had there ever
(02:19):
been any scientific tests to determine what best to feed
a star of person to bring him or her back
to health. The project's goal to learn how to treat
starvation after the war ended. The experiment was fairly simple.
Thirty six men were semi starved for six months. Their
diet was modeled after famine diets of bread, potatoes, porridge,
(02:43):
and turn ups. They continued walking at least twenty two
miles a week, taking classes in the university and working
at the lab. Jim was six ft two and he
began the study at one hundred seventy five pounds, but
it wasn't long before the famine diet took a toll.
Most of us suffered from edema, the collecting of liquid
(03:05):
in the body, some more than others. I always woke
up in the morning with my face puffy on the
side I was lying on. Sometimes my ankles and knees
were puffy. I look in the mirror and see that
my eyes looked hollow, my cheeks were only a thin
covering for the bones in my face, and my hair
was getting thinner. If I tried to smile, it was
(03:26):
just a grimace, and I never laughed. As Jim and
the other participants rapidly lost weight, some dropped to a
mirror one hundred pounds, and the psychological changes mounted, fatigue, depression, paranoia,
(03:46):
symptoms that previously hadn't been attributed to starvation. We became
very irritable and intolerant. Little things seemed to annoyance. We
were no longer polite with each other or with ssitors.
It seemed as if the veneer of civilization had been removed,
leaving bear the animal underneath. Years later, researchers would publish
(04:10):
one thousand, three hundred pages on the scientific effects of starvation.
The research remains key to a lot of what we
know and still don't know about malnutrition. I have experienced
hunger and the apathy and depression that goes with it,
but we lived in sanitary quarters under the constant care
(04:31):
of doctors. Furthermore, we knew that it would all be
over on a certain date. I often think how horrible
it would be to be starving and never know when
it would end, if ever. In association with I Heart Media,
I'm Halema ge Condy, Malcolm Burnley, I'm Roger Gola and
(04:53):
this is the missionary episode six, one hundred five children.
There are a few basic facts that everyone agrees on.
Renee had run a health facility for malnourished children, It
(05:15):
was unlicensed for years, and at least one hundred five
children died, But those facts alone didn't support the worst
of the allegations that Renee was a baby killer. We've
passed through years worth of Renee's blogs, social media posts,
talked to missionaries and activists, but there hasn't been much
(05:39):
else to support these accusations and allegations. It was obvious
to me that there were more perspectives out there, more
people we needed to speak with, a completely different world
that we hadn't tapped into yet. That was Uganda's health
care system and the near dozen medical staff who worked
with RENEE for years. I knew that I had to
(06:01):
get into that world. The first time I traveled throughout
eastern Uganda, passing by farms huge plantain and cassava plants,
pineapples and sugarcane fields, I thought, how could there be
severe malnutrition in a place like this? Um Dr Esther
(06:26):
I am a pediatrician. I also have a PhD in
a clean connutrition and I am the head of Manama
Jimon Nutrician Unit, Malago National Referra Hospital. Dr Barby Rickare
has been working on malnutrition for more than twenty years
and then one of the GYMO Nutrition Unit is the
top children's nutrition unit in the country. About one percent
(06:49):
to two percent of children, especially in the five years
of age, severely malnourished, so it is that big. On average,
we admit about one hundred children per month with severe
acute malnutrition just on one world that nutrition or unit,
so that's is quite a big number. Malnutrition remains a complex,
(07:17):
mysterious problem, especially for children in Uganda. They're quite a
number of causes or predisposing factors to malnutrition. People are
surprised why we have a lot of food and yet
we have malnurised children. But these children may not be
taken in adequate amounts. And also the quality of the
(07:38):
food and how is this food prepared. In Uganda, the
main stables of today are mostly starchry foods like cassava
and maize that lack a lot of vitamins that babies need.
A lot of other countries have addressed this by fortifying
or enriching their stable foods. In the US, wheat flour
is often enriched with iron and folic acid. Table salt
(08:02):
has iodine, but that hasn't happened much in Uganda. Food
isn't the only factor either. Also diseases. We find some
chronic diseases like tibi or v or diarrhea, diseases predisposed
that children getting malnutrition. These combined factors were deadly for
(08:24):
malnourished children There's another oddity to malnutrition too. Instead of
becoming skin and bones, some children's bodies swelled, especially around
their stomachs. It's an image that many Americans are likely
familiar with seeing on the news starving children with bloated bellies.
The swelling is called edema, and it's similar to what
(08:46):
happened to the adults under the Minnesota experiment. With some children,
their faces can become so swollen as if they're having
an allergic reaction, their eyes get puffy. In Ghana, this
is called quash or car, meaning the disease of the
displaced child. It mostly refers to when a baby is
(09:07):
weaned prematurely after their mothers become pregnant again. Quash your
car also has local names in Uganda of Bosi and
Luganda and Lose and Lugisu. Experts like Dr Esther Barbera
Care are still trying to research why certain children develop
it and why others simply become incredibly skinny. Around the
(09:30):
time that Renee had established serving his children, malnutrition was
the direct cause of more than a third of deaths
for children under five years old in Uganda, and malnourished
children or nine times more likely to die than healthy ones.
Even when children were able to get to hospitals like
i Mlago and be seen by experts, there were still
(09:53):
a high chance they would die. They'll take an example
of ard that is them Lego and a demnutrition or
unit they come verily to when they are critically ill
with these complications and you try your best, but still
about ten to may day. This is unacceptable and acceptably high.
(10:20):
As grim as those numbers are, it's actually an improvement.
Ten years ago, the mortality rate for children with severe
malnourishment in Uganda was even higher. Sometimes between twenty and
of severely malnourished children died in hospitals. That was the
scale of the problem and that's why Uganda created a
(10:43):
new system to build more health centers and clinics in
hard hit areas. Testing testing, Okay, so could you just
say your name, um and your profession. Okay. My name
is r Dr Honey Forbach. I'm a retired medical practitioner
and a nutritionist. I worked in the National Hospital Hospital
(11:08):
from nine and then moved on to the National Nutrition
Unit where I worked until two thousand and nine. Then
I moved into programming and have recently retired Dr Hannover
Pacho is another top child nutrition expert in Uganda. In
(11:30):
two thousand nine, the year when they moved back to Uganda,
Dr Pacho had turned her sights on working with the
Ugandan Health Ministry to create policies to address the child
malnutrition problem. She was instrumental in developing Uganda's new national
guidelines on managing these cases, a step by step manual.
(11:52):
Up until then, treatment of severe malnutrition had mostly been
centered around hospitals. What was wrong with that approach? The
approach was not wrong, except that there were challenges. One
is that the care give us would stay for very
long and in five distance away from their families because
(12:14):
those facilities were few. And also in the course of
staying in hospitals, they would get cross infections. Yes, the
plan Doctor but Show helped create was to decentralize the
care of severe and moderately malnourished children. The goal was
to reach children who weren't accessing hospitals and to stop
(12:36):
children from becoming severely malnourished in the first place. The
community specifically is supposed to have a structure that identifies
children with manetrition and refer them ali to the health facility.
This model has been shown to reduce the mortality of
(12:59):
child malned Chrisian. The idea was to move them up
the pyramid of care as the cases got more complex.
Children with moderate malnutrition could be treated out patient, as
in they go to rural health clinics for checkups and
get nutritional formulas, but they stay at home. On the
other end were severe cases of malnutrition, especially those with complications.
(13:24):
These children were supposed to be enrolled in full time
in patient care, but this was also a last resort
for only the most intractable cases. Once a child's health
was stabilized, they could be transferred back home for the
rest of their treatment. If this sounds familiar, it's because
these are the guidelines. Renee says. She modeled serving his
(13:46):
children after sending out social workers to teach about nutrition
and screen for children with severe malnutrition in the villages,
and then taking those sickest children back to their facility
in Jina. I asked Dr Bachou which region was the
worst in two thousand nine, the year Renee sat up
serving his children. I it was an eastern region, Eastan
(14:10):
region Lamutumba. It was a real case of severeli Malarui.
It was really an emergency that the country had to
move in to ensure that a nutrition in it was established.
The name Nama Tumba sounded familiar. Later I went through
my notes again and there it was. One of the
(14:32):
children in the court case against Renee. His name Tolala Kifabi,
his village Namatumba. We began this podcast and reporting this
(14:56):
story with the court case against Renee. The fact that
two Ugandan women were suing an American missionary over the
deaths of their children. That to me was the most
important part of this story because it seemed like this
was a rare opportunity for Ugandan's to get justice. We
(15:17):
had heard so many allegations, but these were the actual victims.
Their stories were essential and piecing together what went wrong.
Starting with the court documents that Renee submitted, I thought
I could find material evidence that Renee was running this
quack facility. Now to Lale is one of two children
(15:40):
whose mothers are suing Renee Bach. He died after being
treated at serving his children for seven days. His mother, Gimbo,
was given fifty thousand Ugandan shillings less than fifteen dollars
for her loss and a bag of beans. We mentioned
his story in episode one. In the court documents, Kimbo says, quote,
(16:03):
the women from Serving his children were not doctors and
may have done something unprofessional that led to the death
of my child. Essentially, she thinks something went wrong, but
doesn't know exactly what now. The lawyers say Serving his
children violated to Lally's right to life because the facility
(16:24):
wasn't licensed at the time. The case also states that
they violated his right to privacy because to Lali's photo
was posted on Serving his Children's social media account. I
managed to track down the health workers who oversaw Tolali's case.
(16:46):
It was early two thousand thirteen when to Lali first
became sick in his village of Namutumba. Namatumba is about
an hour away from two major hospitals. The local health
center diagnosed to Alale with malnutrition and directed Gimbo to
buy nutrition supplements. This should have been a sign that
(17:08):
the system was working, but according to Gimbo, she couldn't
afford the medicine, so she returned to the village empty handed.
Sophie said, those are the children. Renee and her employees
were trying to help. She didn't get children who were
fine from the villages. She was getting children from the
(17:28):
ridges who are desperate to bring them and how at
least for them to reford Esmail. That's Sophie Mutessi, a
midwife who worked at serving his children from around two
thousand twelve to two thousand fifteen. She has a lot
of experience bridging the gap between villages and hospitals. To
(17:49):
Lally was a prime example of those gaps. Even when
services are nearby, many Ugandans, especially the poor, faced too
many barriers to accessing them. Patients have to pay for
basic supplies like gloves, gaus, bedsheets, medicines, even mats to
sleep on, and they have to pay for that upfront.
(18:11):
Those who can visit the hospital can't always stay long.
That's what made serving his children different. They paid for
everything by time they reached hospital. Then need is not
only treatment. The mother is stressed, that's taken three days
without eating, no, so not everything blessed sickness. Don't you
(18:32):
reach at Rene's place, the treat her psychological and give
her class time for resting. In July two thou thirteen,
Gimbo was pregnant with another child by now months had
passed since they visited the health center, so to a,
Lali's condition had likely gotten worse. Serving his children passed
(18:56):
by Gimbo's village during one of their outreaches, the staff
asked her to take to Lale to the facility in Ginger,
So Gimbo sent her mother to go with tolal A.
But this didn't seem to be the same serving his
children that Jackie Kramlck, the American nurse and volunteer, had criticized.
By now, the organization had heated her warnings and hired
(19:20):
trained nurses to join the staff. When Tolally arrived at
serving his children, he was in really bad shape. He
was severely dehydrated, his body was swollen, his skin was peeling,
and his condition would only continue to worsen. Sophie Mutessi
(19:41):
took care of tolal A on at least two shifts.
According to her notes, Tolally was no longer able to
eat the special formulas made for severely malnourished children, which
is a bad sign. He also had diarrhea and was vomiting.
Looking at her own notes, Sophie said that there was
no difference between the food they were feeding him and
(20:02):
what was coming out of Tol's body. That was a comment,
why is that serious for the rest of us. They
weren't medical like you are putting milk here. It was
the milk coming down, which means no digestion was taking place.
Does that mean the digestive system just isn't working down?
(20:24):
Not working hm, urinating one or four times, dehydrated, Continue
with plants, rehydrate your got you chosen. He spent, So
that was the end of your shift. One of the
early lessons of the Minnesota starvation experiment was that you
(20:48):
have to be very careful about how you refeed or
rehabilitate patients. Dr Barbara Carey told me about something called
refeeding syndrome. Refitting syndrome is a phenomenon or a condition
that occurs to manorite children when you're beginning to feed them.
They have had electrolytes that imbalanced, that are not in
(21:12):
right order, so when you begin to feed them, then
that may worsen the condition. This causes a rapid crossing
of some electrolytes into the cells, others out of the cells,
and then that causes derangement in the body function and
then they may Die. Here's Dr Barbara carry talking about
(21:32):
the therapeutic milk products they use that Lago and how
they monitor at the way we manage this or we
prevent it is we use a feed usually we call
it therapeutic feed, or it is like a medicine, but
in form of food. It has the right balance of
these nutrients and we give it cautiously slowly until the
(21:55):
body is learning or beginning to learn to use these nutrients.
Then always tip up the nutrient of value, especially the
protein and the energy, so that now this baby or
this toad begins to gain weight again. So it is
actually a serious killer if you're not using the rate
feeds in the beginning before the body function returns to them.
(22:20):
The special formula she's talking about our f SEM five
and F one two powders you can mix with water,
developed in the nineties as an emergency treatment for child malnutrition.
Refeeding syndrome is something that critics like Jackie said Renee
was clueless about. But if you feed a child too
much or the wrong type of substance too early, it
(22:43):
can kill them. Even though Renee had access to these
feeding formulas, which are normally distributed by units f or
the Ministry of Health. If a child is in danger
of refeeding syndrome, they should be around specialists who can
recognize it. In that case, I thought maybe Renee had
failed to refer to Lally to a hospital when he
(23:04):
should have been, which would have been a clear sign
of negligence. But in the court case, Renee says she
left the country the day to Lally arrived at the facility,
and she submitted her passport pages as proof, which means
in theory, she wasn't there to make the hour. By
our calls about to Lally, that decision would have fallen
(23:27):
on the most senior person there. Mudasi causa as first
professionalism msconsin she was employing professionals, qualified people. That's what
I knew. Oh, I know she was employing professionally. They
didn't have quacks there, okay. Mudosie is a clinical officer
who works at the now Lifenia Children's Hospital in Ginger.
(23:49):
They're kind of in between nurses and doctors. They play
a big role in filling the healthcare gaps because they
can practice medicine, diagnosed cases, performed surgeries, but they don't
spend as many years studying medicine as doctors. We Darcie
would come into serving his children a few times a
week to check on the children, write prescriptions and sometimes
(24:13):
refer them to the hospital. Actually, when I found him,
he was working at the hospital. As these are doctors notes.
Do you recognize these? Yeah, I suppose my handwriting. I
had him read over the notes on Tolally's case. Then
I asked him if there was any sign that he
had requested that Tolally be referred to the children's hospital.
(24:38):
He didn't. He thought serving his children was managing the case. Fine,
this one, this one was it was story. But you
would do, you'd manage. That's why when you look at
to these records, I was saying, well, there's some improvement.
The new complaints were not there. Yeah, so cooking and stable.
(25:03):
Days later, on July sixteen, two thousand thirteen, Totally died
of severe malnutrition. I asked Dr Patow to read over
Tollly's medical documents as a second opinion, to see if
there were any irregularities, any sign of misconduct, anything that
(25:25):
went wrong reading water, you know, how He examined the patient,
came up with the tentative diagnosis, and then returned that
the treatment protocol, I think he must have had some
you know background, yeah, or for managing this kiss? Is
there any point so far where this child should have
(25:45):
been in a hospital? Do you think? I don't know,
I don't know to commit. But then it's this jealous
put on oxygen, this child was put on ivy. This
child was you know, put on antibiotics, the antibiotics and
was being monitored. So not knowing this situation A then
(26:09):
I would assume that this is a health facility with
the trained health focus. What if it's me She has
all this sophisticated a medical equipment and she is not trained.
Who who decides to when to take action or not action?
(26:32):
I was just as baffled as Dr Pato. Initially, I
thought by tracking down for Lolly's journey, I would find
the prime example of Renee's medical misconduct, whether she had
done medicine herself or made decisions that had led to
to Allalay's death, But to Alway's case, hadn't done that.
(26:53):
In fact, it showed the opposite that Renee had hired
qualified Uganda ners in medical professionals at least by two
thousand thirteen. It showed that they were the ones who
had treated to Lala and didn't bring him to the
local hospital. Ultimately, it showed that Tolally had died despite
(27:16):
their best efforts because severe malnutrition is so hard to
treat at that stage. That makes Tolal a one about
least one hundred five children who died at Serving His Children,
And I keep thinking back to that number. We've talked
about it throughout this podcast. One hundred five children died.
(27:41):
I mean, it's shocking every time I hear it. And
remember those are just the numbers that Serving his Children
admits to, and they provided them a couple of years ago,
and given the inaccuracies in their documentation, that number could
be way higher. We don't have the medical docum mints
of the other children who died at Serving His Children.
(28:03):
That said, the number one hundred five still seems like
a lot to me. Here's the math. Between two thousand
and ten and two thousand fifteen, one hundred five children
out of nine hundred forty who were treated in patient
at Serving His Children died. That's a mortality rate of
(28:24):
eleven percent. But that's nearly half the mortality rate in
Uganda's top hospital after learning about how hard it is
to treat severe child malnutrition. That number doesn't look as
bad as it did in the beginning. Based on that
number alone, it could be tempting to say that serving
(28:47):
his children helped save more children from malnutrition than had died.
But there's one obvious caveat that we can't forget. Even
though to Lolly had gotten quality care from quality Ugandan
medical professionals when he died, serving his children was still
(29:09):
an unlicensed facility. Wake up, Africa, you're trying to come
open up your pie gone Helen. Welcome to Africa. Watch
(29:36):
on the Dr Mombi Show. My name is Dr mombys Iraki.
How you're doing. How's everything going? I pray you well
in everything earthing. I just hope everything is going absolutely
fantastically for you and you're living your best life. Now.
I've got a story that got me just I even
wanted to just throw this at someone for real. It
got me so emotional. And it's all about this a
fake ass, you know, white supremacist. You ain't even a doctor.
(30:02):
This YouTube show aired on February five, two nineteen, when
the news of renee Bach and serving his children was
just starting to spread online. She wasn't deported, she wasn't charged,
The health ministry in Uganda didn't belaunch any kind of
investigation against and she's still in Uganda till this day.
(30:23):
It's crazy. So what they're doing now is their demanding
that this question has nagged me throughout this story. In
the past year, I learned Uganda does have a lot
of rules and regulations that are sometimes complex and bureaucratic,
but they're there. So how had Renee been able to
buy and procure medicine for years, to coordinate blood transfusions,
(30:47):
get lab tests, order specialized nutritional formulas, and eventually higher
legitimate staff, all without a license. We couldn't both say
that you gone that had laws and regulations that Renee
hadn't followed without recognizing that someone was responsible for enforcing them.
(31:08):
Could you introduce yourself. I'm doctor Cartoon by Cento executive
or you're gonna Medican Dental Console. It's a government which
is in charge of regulity in the practice of doctors
and their facilities. I'm in doctor Saintongo's office in Kampala.
It's not too far from the country's biggest hospital and Lago.
(31:29):
Doctor sin Tongo is one of those matter of fact
expert types. He just doesn't beat around the bush. He
told me he hadn't heard about these latest accusations that
Dr Mumby was talking about against renee Bach or serving
his children until he got a call from the Minister
of Health saw that the video running. I don't seen it,
(31:53):
so she wanted it to know. Are the issues to
do that fast? So it today and the producer a
primary portion. So now he had to get to the
bottom of it fast. Doctor sin Tongo assembled a three
person team to go out and investigate the claims against
serving his children. Dr Katumba tried to find other people
(32:18):
who had worked at serving his children in Ginger or
the mothers in the court case, but they didn't find
them and they had limited funds to continue investigating, so
we didn't get to the opportunity. I tried to get
to details at what happened Deforma clinics because unfortunate today
put in a good doctor. We also didn't have contact
(32:42):
of the people had to complain. I had some better
luck and more time to track down some of these folks.
I knew that there were plenty of nurses and doctors
involved with serving his children over the last ten years,
but only a handful were part of the actual court case.
They would have seen firsthand how things had worked there,
(33:04):
and it seemed like no one else was talking to them,
not the lawyers, not the media, and not the government investigators.
After months of pouring over court documents and medical databases
and criss crossing the country on buses and motorcycles, I
managed to track down eight nurses, three doctors, a nutritionist,
(33:25):
and a medical officer who at one point or another
had worked at Serving his Children, but only a few
were willing to go on the record about their time there.
It was easy to see why they wouldn't want to
get involved in this mess. After all, if something wrong
had happened at Serving his Children and they didn't report it,
(33:46):
they could lose their licenses. But one of them, a
nurse named Violet, was willing to go on the record.
So I'm on the way to Kagadi, which is a
town that's in western Uganda, close to order with the DRC,
and I'm searching for a nurse named Violet. So I
called her a few days ago and explained what we're
(34:07):
trying to do. Um it's a Sunday, so I'll probably
have to wait for her to get out of church.
Violent Auto Beatrix had worked at Serving His Children in
two thousand twelve for about six months. She's now a
government nurse and the opposite side of the country, about
eight hours away from Ginger. When we met at a hotel,
(34:28):
I realized she hadn't heard anything about the case. She
was exactly the kind of source I wanted to speak
with when I just got there. Nothing much was told
to me about how the organization started, but being someone
who's looking for a job, someone who is jobless, I
just took on. They didn't tell me that we have
(34:50):
a opened that organization wasn't experienced medically. Violet told me
she had her reservations about serving his children. She had
a lot lot of experience working at big NGOs like
Doctors without Borders, but she didn't think she and her
fellow nurses were equipped to deal with extreme cases of malnutrition.
(35:12):
And she was a trained midwife, but also didn't think
they were equipped to have women giving birth there. Violet
knew her own limits, but didn't think Renee knew hers.
I would see how read she would read through books,
and then she would apply, let's see her reading medical books.
Would see how read medical books and an apply and
(35:32):
and she would she would do the medical, the nothing,
the treatment, all that. Yeah, Violet agreed line by line
with what Jackie Kramlick, the American nurse, had said. Renee
did blood transfusions, I v s, intramuscular injections, spinal taps,
femeral artery punctures. So here was someone who categorically thought
(35:57):
Renee had done wrong. This is the type of person
who could have said something at the time. I asked
her if she did, there's no I would say, but please,
I want to see your papas, but please wise your
certificate displayed here. There was no way I would ask that.
Why not, Well, it would look like I'm attacking her.
(36:18):
When I entered there, I saw her actions. She acted
a medical person. She introduced everything to me and we
started practicing together with her. So I kept it to myself,
and I'm like, after all, I won't work here for long.
Violet told me that government nurses like her make about
one hundred dollars a month. She needed the job at
(36:41):
serving his children. This was something I had heard from
other former employees too. They said the nurses were too
subordinate to say anything, So I wondered, what about the doctors.
We need a doctor, plain and simple, a doctor who
can be there in emergencies, give your action to our
nursing staff, and provide an in house diagnosis for the
(37:04):
many complications that come with severe malnutrition. In May two
thousand twelve, a year before Tolali's case, Renee put out
a blog post asking for donations twenty two thousand dollars
so she could hire a doctor and a nutritionist. A
doctor who can come alongside us as we strive to
(37:24):
save the lives of children that faced the horrible reality
of malnutrition. A doctor who shares our passion for serving
the Lord. Until she hired that full time doctor, she
had other doctors coming in periodically. One was Dr Alex Wassamoka,
who came in a few times a week. He worked
at serving his children for about six or seven months
(37:46):
in two thousand twelve. Now he's a doctor at Ginger
Hospital and when he looked back at serving his children,
he saw nothing but things to be proud of. So
there was no time, not even a single time, when
there was no nurse to attend to the children. These
(38:07):
children were actually treated in the best way I could say,
the best way possible. In his view, sometimes kids were
better off at serving his children than the hospital. It
was well equipped and had to study supply of oxygen,
which many hospitals often run out of, and it was small,
(38:27):
so it had a good nurse to patient ratio. When
I compared that with what was in the hospital, you know,
the hospital, the numbers were so enormous. The nurses in
the hospital are a few story could not attend to
all the children in time and as required. You know,
when the nurse patient ratio is not a proper then
(38:52):
even the quality of care drops because then the children
were too many compared to the staff available. Dr Wassamocha
wasn't the only one who thought this. I spoke with
at least two other doctors who had worked part time
at serving his children who thought the facility overall had
(39:12):
done a good job. So did nurses like Sophie Mutessi,
who you heard from earlier. It was exactly these sorts
of competing narratives that had stumped Dr Katumba's investigation. He
had heard news about RENEE killing hundreds of kids performing
medicine trampling on Uganda's rules. But then when he managed
(39:34):
to visit Serving his Children's brand new facility less than
two hours outside of Ginger, he found staff who were
properly licensed, a facility with all of the right paperwork
and an administration that was going by the book. Where
were all of the dead kids? The main component was
in India District unaffortunated. So we wrote a report and
(39:58):
it had administer that that was our immutation, that we
couldn't find a compliment for the Gingha site. The issue
was that all of the accusations against Renee were made
about work she had done at an old facility in Ginger.
The team didn't have the time or resources to investigate
(40:19):
claims at a facility that no longer existed, and even
if they did, they would have probably heard the same
conflicting things that I did. The report they submitted concludes
this that they are unable to support allegations that children
died in large numbers due to serving his children, and
that they found no evidence that Renee Boch was treating children.
(40:44):
The report was released, but the case was kept open
in case any additional evidence or sources ever came forward.
The experience that Dr sin Tanko had, I think speaks
to how the whole story has unfolded. We had entered
the story with huge, big, scary, outrageous testimonies about Renee
(41:08):
and what she had done, the number of children that
had died, the court case, but so far a lot
of that evidence wasn't actually supporting the worst of the allegations.
In fact, if anything, it suggested that it wasn't as
bad as we thought. But what had become crystal clear
(41:31):
to me was that there had been a bigger structural
failure that goes well beyond Renee. And this mattered to
me as somebody who has covered health and human rights
in the region, because at the end of the day,
Renee's only one person and Geo's like serving his children,
had been encouraged allowed to operate in Jinja for years.
(41:55):
They were able to interact with other hospitals and facilities
and pharmacy ease. And despite the fact that yes, Uganda
is a country with laws and regulations, those same laws
and regulations hadn't managed to regulate her, and staff who
were licensed, who were credible hadn't stopped it either. Next
(42:24):
time on the missionary, I just couldn't understand how people
could look at the same evidence we were looking at
and come to such different conclusions. And I said, but sir,
these kids will die if we send them home. And
he said, you're right, they will die, but it's no
longer your problem, So get them out of here at
before five o'clock before I'm taking you to jail. I
remember I would walk into like cafes and people would
(42:46):
leave when they saw me, Like I went to like
missionary events, and people would like refuse to speak to me.
And this was my sort of ah ha moment. This
was my wake up call that I had been lied
to directly to my race. The Missionaries produced an association
(43:18):
with iHeart Media. It's written and reported by Roger Gola,
Helene mcgegandhi, and Malcolm Burnley. It's produced by Michelle Lands
and Ryan Murdoch. Mark Lotto is our story editor. Our
executive producer is Mongiter. Our fact checker is Austin Thompson.
Mixing by Josh Rogison and voice acting by Taylor Kaufman.
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