A laast visit to Ekiwumulo

Saturday July 9^th

Our last day in Uganda which was spent travelling from Mityana to Entebbe but with a stop off at Ekiwulumo to see what further progress there had been

The 4^th house seems to be progressing well and only one of the rooms in the vocational training block still needs finishing although that will take some major earth moving to get the floor level right

It’s been much more like Africa temperatures the last couple of days so hope its warm when we get to Heathrow tomorrow afternoon. It should be pretty hot and dry for the team coming out to Mityana in just 3 weeks.

Thanks for following the blog which I hope has both informed and amused you through the last 3 weeks.

The 4th house now waiting for its roof

Some of the children with a new water filter waitng to be assembled next week

3 of the new solar lights which are proving very useful already

Netball and football

Friday July 8^th

We had an uneventful journey from Kagando to Mityana apart from some baboons drifting across the road at one point! After some refreshments and a chat with Pastor and John Bosco we headed off on boda bodas for a school football and netball competition in which the school at Ekiwumulo were competing. The girls were runners up after a couple of exciting matches and we left the boys football at half time with the score at 2-1. It was about 6.45 by then with the sun just about to set. The children all played brilliantly and it was great to see how much pleasure they got from the semi-final netball win

The Ekiwumulo netball squad

Much rejoicing after the semi-final victory

Goodbye to Kagando

Thursday July 7^th

Today was a last working day. The morning continued until 1.45pm but this afternoon Ive done a case based discussion with Rachel for her GP training so this afternoon wasn’t quite so intense. Ann spent some of the morning doing a rerun of Jonah and the Big Fish to 600 children at Kasinga Primary School about a mile away. This afternoon we were able to enjoy a last walk along one of the local tracks though banana and millet plantations.

Reflecting on our time what have we achieved? I hope we have been able to contribute something to the life of the local school and hospital. It’s certainly been a very intense 2 weeks but we are pleased to have been here and certainly we have learnt a lot about appreciating what we have in the UK and take so much for granted. Particularly the locals are always so grateful for the rain so we need to make sure we don’t grumble on a cold wet day in the UK! We are looking forward to apples, a long hot bath and some clean towels!!

Fortunately there hasnt been any Ebola virus otherwise we might have been stuck here for several weeks as all movemnts are stopped!

 

And goodbye to Bertie who lives in the corridor of the guesthouse

The mission begins

Wednesday July 6^th

Today started with an amazing time in the chapel. A mission is just starting with a choir from Congo, preachers from Congo and Zanzibar and 5 friends form Dave and Helens church in Scotland who arrived last night. The choir was amazing singing in Swahili which most of the locals can’t understand but they were excellent. The missioner from Zanzibar spoke as well. He is from a Muslim background very well versed in the Koran and spoke about its legality and that in Islam there is no provision of forgiveness. I have rarely heard anyone speaking with such clarity and authority about the contrasts between Islam and Christianity

Jonah in the boat soon to be swallowed by the big fish!

Ann has been busy at the school helping with some parachute games and the story of Jonah and the Big Fish which they thought was great!

A parachute game under way

I lead a CME session this morning looking at malaria treatment It is such a challenge to get people to accept change particularly trusting the rapid diagnostic tests when they are already not trusting the malaria blood slides the lab is producing So often malaria treatment is started or continued in the face of a negative malaria slide whereas the RDT kits could produce a more reliable answer more swiftly. I shall battle on!

Today has been anaemia day on the wards with a boy of 14 arriving with a haemoglobin level of 1.8 (instead of 12) and another aged 6 with a haemoglobin of 3.4. One of the things the lab is good at here keeping a ready supply of blood for cross matching which is so important in these cases.

The famous international speaker

Tuesday July 5^th

Ann became a famous international speaker today giving a short message on Psalm 121 a the start of the mission that is taking plce in the village over the next few days There were several hundred listeners who gave her warm applause at the end! She also taught a physics practical lesson on the refraction of light and the pinhole camera. She hadn’t taught many physics lessons before and the last would have been over 30 years ago The only slight problem was, to her horror the prism was knocked off the table so it produces rather more refraction than it did before!

This is the stage Ann spoke from It visibly rocks when the group are singing!

The hospital was down to 4 qualified Doctors today as Rachel was ill and wasn’t working. Somehow everything seemed to get done largely thanks to some final year Ugandan medical students who are on attachment here before starting work in various places in August. One of them called Simon is from a village only a few miles away and his parent still live very near so hopefully in time he will come back to work at the hospital which will be a real bonus as he seems very willing and competent.

I spent some time with Benson the project director discussing a number of issues I’ve picked up on since I’ve been here and spent an hour typing a detailed report of our discussions so I do hope that that will be help in the months ahead.

A tragic accident

Monday July 4^th

Tragically one of the junior doctors here Marvin was involved in a road traffic accident at the weekend which has left him with a fracture of one of the bones in his neck (odontoid peg) and has been transferred to the neurosurgical unit in Kampala. That’s a significant blow personally to him and his family but also has an impact on the manpower situation here. We are hoping there may be some better news later today after he has had a CT scan. For the moment Im running the male and female wards which are both pretty full with patients on the floor.

The hospital has been very busy today with much to do. The 28year old woman from Saturday died last night which was so sad. There is another young man who has been admitted with TB and HIV who is having pus drained from his chest each day at present so I hope and pray we will be able to do more for him over the next few days and weeks. Another young woman of 16 has developed a widespread cancer of her abdomen (juvenile granulosa tumour) which might be amenable to chemotherapy but when I discussed this with the father there was utter dismay in his face at the impossibility of being able to take her to Kampala for the chemotherapy she would require.

Ralph Settatree, a retired gynaecologist left today-he was the person who had given us a lift on our way up here. He has worked tirelessly to talk to so many people about the situation here. For a whole host of reasons there is a large financial deficit which somehow will need dealing with but I think it’s a huge challenge to everyone here in much the same way people are finding the financial difficulties at home so difficult to deal with. We were sorry to see him go as he had been a very cheery person to have around. We now are the sole residents at the guest house at least for a night or two.

Exciting Elusive Elephants

Sunday July 3^rd

Today was our first full day off so we took a trip to Queen Elizabeth National Park. We had a superb day despite the 5.45am start.

These hippos were only about 10 yards from the shore-you can just see the bow of a fishing boat in the foreground

There was much to see but the one of the two major highlights of the day was watching a huge group of 42 elephants across the Kazinga Channel from Mweya lodge. We weren’t able to take the boat trip we intended until 16.15 as the 14.00 boat wasn’t going to go so we were able to watch the herd move around over a 3 hour period which was truly amazing. The boat trip that followed was equally stunning. We took a small boat carrying 8 passengers including ourselves which was able to get in extremely close to the bank of the channel with some spectacular views of the birds and animals. Unfortunately the herd of elephants had moved on by that stage but there were still a couple who remained behind

All in all it was an amazing day and one we were very grateful to have experienced but it is such a contrast to the environment we are currently living and working in.  

This elephant looked as if he had had a problem with toothache!

Trip to the river

Saturday July 2^nd

A sight which really moved me this morning was the last patient I had to see on a ward round I was keen to get away for lunch but was confronted by a very wasted young woman of 28 with HIV. I doubt she weighs more than 30Kgs and had several features of very advanced disease including obvious Kaposi’s sarcoma. It saddened me so much to see such a young life being slowly destroyed and made my hurry to get to lunch seem rather inconsequential.

At lunch we broke into our fruit which in Lukonzo is named Echamba. An interesting blend of flavours which we are glad weve experienced but we probably won’t look too hard for it again!

This afternoon we took a walk to a river nearby which amused the locals no end. At the river people were washing clothes and bathing at the river edges but drinking and collecting water from the middle of the river. Given the colour of the water its easy to understand that typhoid could affect so many here. We did pass one smallholding where the owner was growing vanilla pods. Apparently a German exporter pays them UgSh9000 per kilo which I should imagine leaves the exporter with a handsome profit judging by the cost of vanilla in the UK but the grower obviously felt this was a fair price

Down by the river

Guess the name of the fruit

Friday July 1^st

Trying to set up a chest drain for a patient today was an interesting challenge. The ward felt the equipment was in theatres and the theatre staff thought it was in the ward. Feeling I was not getting anywhere fast I compromised on doing a chest aspiration to draw fluid off the man’s chest. Back to theatre to ask for the 3 way tap I needed to be told it was locked in a cupboard and yet again “The man with the key has gone”!! Indeed he had because when I phoned I discovered he was in Kasese about 40 Kms away with the key!! Such is life in this part of the world….

Ann had a visit to the market and purchased an interesting specimen which we have christened a Tortoise Fruit. She did ask someone when she was buying it what it was but the person didn’t know the name only that it is sweet.

Managed to plough through my NHS emails this afternoon as the internet has recovered for the time being. No thunderstorms or powercuts so long may that continue!!

This 10 year old arrived in out patients today Any offers from the medics?

Guess the name of the fruit. A Tortoise fruit??

Xrays to look at

At long last some xrays to see!

Any guesses??!!