Internet problems

Thursday 30^th June

Apologies for all those eager to look at xrays! The internet is so slow at times it’s difficult at present to download pictures. Whenever the mains power goes off which is several times a day at present then the internet seizes up. Also when the power is down the xray machine can’t function. There is one you man who has been waiting for 3 days to get an xray done because of this.

The typhoid protocol has been looked at by everyone and suitably tweaked so hopefully we are nearing the finished article.

Ann did a revision class for P7 who she taught back in February. The school was shut today because of a teacher’s conference but the P7 form are boarders so were free all day. They were very pleased to see her and the lesson was much appreciated by those who stayed awake!

David and Goliath

Wednesday 29^th June

Today has been a busy one at the hospital with many sick patients on male ward. In particular there are a number of patients with cardiac failure and a boy in his teen who is failing to respond to his TB treatment and on whom we haven’t been able to get a CXR done because of difficulties over the power supply which has been very erratic. I’ll post some xrays I’ve copied for the interest of the medically inclined!

Ive had an opportunity to discuss the guideline for abdominal pain with fever which needs tweaking but everyone seems very enthusiastic.

Ann taught about David and Goliath. She used a long stick with a balloon on to represent Goliath and the children were highly amused when he fell down and the balloon burst! This afternoon she went to another nearby school where she heard a recorder recital including Joy to the World and the local Bokonzo anthem.

Another wet day

Tuesday 28^th June

When Ann arrived at school this morning there weren’t many children around She wasn’t sure if it was because they hadn’t paid their school fees or just because it was too wet! Its certainly been very wet here today so quite envious of the UK heat wave. It was difficult at times teaching over the heat of the roof.

The medical students seem to be gradually finding their feet but we now have 3 from Makere University who have just appeared in addition to the Ugandan students from Mbarara university and the UK students.

We have been writing and typing up a guideline for treating abdominal pain with fever which I am going to get the other doctors to sruitanise to try to make sure that any early typhoid cases presenting to the hospital are promptly treated.

Marching round the walls of Jericho

Some of the children in Ann's class trying to keep warm

Shades of The Constant Gardener

Monday 27^th June

At school Ann lost her red pen. Absolutely essential for marking as no other colour will do! After looking for it for some minutes one of the children offered to lend her her pen which Ann found very touching. The children thoroughly enjoyed acting out the story of the Israelites leaving Egypt particularly the ten plagues of Egypt.

One of the issues regarding the Typhoid epidemic here is whether the ciprofloxacin we have is of adequate quality. So one of today’s missions was to the pharmacy to get samples of the ciprofloxacin (the main antibiotic being used to treat typhoid) being dispensed. One of the brands is rather discouragingly named Ificipro which doesn’t fill you with confidence!! Reminds one a little of The Constant Gardener for those who have seen the film.

On the ward round this morning I had no less than 6 medical students in tow which I think I would find very frustrating but Im doing my best to stimulate their interest and get them motivated to do some learning Today I also did a session for them on typhoid and dysentery.

Getting wet!!

Sunday 26^th June

The sermon in church today was about having a good marriage using the text of Samson and Delilah! Also apparently marriage is like an orange! I’ll leave you to work that one out!

I did say to Ann thus morning that I wasn’t going to the hospital today but a couple of phone calls later and I was needed by some of the medical students!

This afternoon involved much wetness. We set out for the waterfall and after walking for 15 minutes we were stranded in a downpour fortunately sheltering under a tin roof of a nearby shop. The walk to the waterfall proved challenging for the 7 of us (including Rachel and 4 of her friends from UK). We walked through the river for around 20 minutes lead by Rachel with the river  in full flow because of all the recent rain and some strong currents needing to be negotiated. Once at the waterfall we had a very welcome swim in some freezing water. We are still trying to warm up 2 hours later.

With another snake seen today the snake score so far stands at 4! Fortunately only one alive-a green tree snake seen yesterday!

Had to shelter from this downpour!

Swimming under the waterfall

Our first sunny day

Saturday 25^th June

The morning started with a further discussion about tackling Typhoid here. I may be able to help by constructing an acute management pathway for the staff in out patients to use. Also it can come down to money. There is a hope to obtain 30000 water filters at a cost of £500000 so its an ambitious target. I then went to the hospital for “5 minutes” and ended up tied up for 2 hours!

This afternoon has been hot and sunny for the first time since we have been here and we enjoyed an outing to the nearby orphanage to see further developments there and on to Queen Elizabeth pavilion near the entrance to the park for a soda. We had hoped to see some of the nearby craters but they were inside the park and didn’t really justify the $30 each entrance fee to the park.

The boy with the psoas abscess is making good progress but he has to have the gentamicin (an antibiotic) he needs purchased from the nearby shops as the hospital is out of stock!

Im sure theres a lion out there somewhere.....

Ann keeping in touch with the world on facebook!!

Typhoid is a big problem

Friday 24^th June

Today has been focused on typhoid. Dave Lyth one of the surgeons here is starting a coordinated campaign to tackle the typhoid epidemic there is here. Last month there were 32 patients requiring surgery for gut perforation which is a staggeringly large number.  There needs to be a coordinated and multifaceted campaign to tackle the problem involving clean water supply better education alleviating poverty as well as striving to achieve the best possible management when patients arrive at hospital.

The hospital has a substantial number of medical students who seem to have been very much left to get on with things. I took pity on them today and ran a session on malaria for them which seemed to go down OK and I’ve promised to do something around lunchtime each day next week so hopefully by the end of it all they may have some grasp of what is going on in the medical and paediatric wards

Ann managed to teach the remainder of lesson 1 this morning and this afternoon had a very successful trip to Kazinga market. There is certainly a lot more fruit available at present. Pity I don’t like mangoes!

A big avocado pear 4p!

large finger bananas cost about 15p - delicious!

Children children and children!

Thursday June 23rd

Ann has been busy this morning teaching 2/3 of lesson 1 to P6  a class of 62. There are some colouful names such as Muhindo Happy Edwin, Capacity Scovia, and Simple Baby!! She is having to go slowly beacause the childrens english isnt quite so good

Todays event at the hospital was Elijah aged 8 who was brought to outpatients where I was helping out this afternoon. For the medically minded he had a psoas abscess which needs surgery this eveing. This is something I have never actually seen before and would be rare in such a young person. It was confirmed within about 15 minutes by ultrasound which is rather quicker than it would be in the UK

.                                                Elijah with left sided psoas abscess

This evening we had an interesting walk accompanied by a young man with learning difficluties named Samuel who seemed to enjoy wandering along with us. There was so much to see with pineapples mangoes avocadoes millet bananas maize casava sweet potatoes all growing in profusion following the rain of the last couple of months.

If you are interested in Ann's alternative blog then email her and she will send you a copy!

We have arrived.

Wednesday June 22^nd

Today was a day of travelling with a 6 hour journey from Mityana to Kagando.  All went smoothly thanks to a lift from a kind friend. We travelled with a couple one of whom works for send a cow so we had some interesting discussions about cows and how to look after them!!

Everywhere is incredibly green and its obviously been raining a lot so we look forward to a downpour tonight!

The internet is quiker here in Kagando so here are a couple of photos from yesterday.

The deserted railway station

No risk of being run down by the Kampala express!!

The last train from Mityana-missed!!

Tuesday June 21^st

This morning we headed off to Ebenezer secondary school where there are quite a large number of Esuubi sponsored pupils studying. We arrived during a mid-term exam so all was quiet. The head teacher Richard was once again stressing the need for a good attitude to work, a goal to strive for and to believe in themselves. During the interval between exams Ann and I gave short speeches exhorting them to use the opportunity they have. I almost sounded like a teacher!!(Ann did!!)

A lengthy 4 hour delay followed while we waited to have an important Esuubi meeting but it was worth the wait with a very useful discussion ensuing.

Then we had an exciting cultural expedition into the African bush to discover the whereabouts of Mityana Railway Station. Alas no trains just a scene of dereliction but still very recognisable after over 30 years of disuse. Only the Maribou storks and a cow seemed to be patiently waiting for the next train!

Ekiwumulo is growing

One of the houses with the glass in place

Monday June 20th
Today we have had a long visit to Ekiwumulo where much has changed since we were last here 4 months ago. The windows are in the classrooms and glass now in the windows of 2   of the houses. The water tank for the site is in position with the piping being laid from the bore hole and the vocational training block is nearing completion. The foundations of a 4^th house are nearly complete and this house should be completed in the next 2 weeks. It really is remarkable how the site has developed since the first group visited in 2007

 The children as always were very welcoming to the “visitoors” with many songs and specially written poems being performed. There are now 203 children in the school.

Football was a great diversion for the older boys thanks to the kind donation of footballs from a company in Eastbourne.

Footbal match in progress with the vocational training block in the background nearing completion

John Bosco who is doing alot to coordinate Esuubi's work

A wet start

Sunday June 19th

The warm heart of Africa turned into a very wet one for our arrival! It was so wet the plane had to circle Entebbe for 20 minutes before attempting a landing which is unprecedented!

Yesterday was spent meeting up with people in Mityana. We spent some of the afternoon visiting Bob who we have sponsored for a number of years.

 It was the first time Ann had visited the place where he lives It was very humbling to see him living in a room shared with 4 others and all his possessions in a small tin trunk. The pastor’s pigs are growing and there were rabbits wandering freely around the compound!

One small boy found texting home very interesting as he has to sit at Kolping all day while his mother works here.