Wednesday 28^th October

Sunday afternoon saw us caught out in a torrential thunderstorm. We spent around an hour sheltering under the edge of a house roof until the rain eased up. Everything here seems to grind to a halt when it rains and people just seem to wait until it is finished however urgent the need for them to move which can sometimes lead to some frustrating delays in people getting treatment they need!

Waiting for the rain to stop

Rather muddy aftermath of the rain

This week the puppets have been given a rest and Ann has been getting children on the ward to act out some bible stories. Today it was the Good Samaritan with a guest appearance by me as the pig!

The Prodigal Son just before the guest appearance of the pig!

 

One of the major events today was the diagnosis of a man with Cholera. They haven’t had any cases here for a number of months but there has been a cholera outbreak at Hoima which is about 150 miles away.

This afternoon we moved yet again but hopefully for the final time to a house which has given us much more space to relax in. This is the 4^th bed we will have slept in since we arrived here 3 weeks ago.

We are very much looking forward to our weekend away at Fort Portal from Saturday to Monday which will give us an opportunity to see Andrew who is a friend from Mityana who has recently qualified asa doctor and is currently working at Fort Portal hospital

 

Sunday 25^th October

After an active Saturday morning, we have had a reasonably rested weekend for which we have both been grateful. Ann helped with Jha Jha’s day yesterday morning which is a club organised to meet monthly for children with HIV and their carers.

The start of Jha Jha's day

 

 It is a huge success with around 30-40 children attending. It gives the opportunity for the children to play games and enjoy a cooked lunch. It is an attempt to normalise life for these children as much as possible.

Children enjoying a craft activity

The volunteer cooks were delighted to receive a gift of a bra each for their efforts! Bras are a much appreciated commodity here!

The volunteer cooks

 

I spent the morning on the wards. Unfortunately the woman who was admitted so unwell on friday died overnight from ongoing bleeding. Blood is available for transfusion but it is a very scarce commodity. However others are improving and recovering including an 18 year old girl who had become paralysed from the waist down but seems to be responding to high doses of steroids.

An 18 year old. One of many patients presenting with pneumonia

 

During the afternoon Ann made a birthday cake for one of the other people staying here at present. Jane, whose birthday it was, was delighted and it was a good time in the evening when the cake was shared around amongst all those staying here. There have been a lot of Mzungus here during the weeks we have been here but many will be leaving in the next few days.

The cake!

Much appreciated!

 

We had a walk down to the nearby river yesterday afternoon. All the vegetation is starting to look quite lush due to the rain which is now getting very heavy. It certainly kept us awake last night for a while!

A very green landscape at present

 And a very full river

Friday 23^rd October

This week has been a very full one. The hospital has remained full of very many challenging situations. One man in his early 40s presented with difficulty swallowing. He almost certainly has Cancer of the oesophagus with little prospect of being able to access any suitable intervention to help him.

Barium Swallow of man with Cancer of Oesophagus

Another lady of 36 was admitted unconscious with a Haemoglobin of 37 needing an urgent transfusion We had 3 drips up and blood going within half an hour which I thought was a very impressive response by the staff. Unfortunately it looks as if she may have a cancer of the vagina so her prognosis isn’t good.

Ann has been beavering away trying to help the pharmacy staff get to grips with the computer system to improve recording of drug movements between the pharmacy and the wards I think it has proved rather an uphill struggle!

Two "tins" of honey we purchased earlier in the week!

 

Today is World Nurses Day so this has been celebrated in fine style first with a church service including remembering Florence Nightingale’s lamp and a march through the village by the nursing students followed by much eating!

The lamp being passed round during the service

 

The march through the village complete with brass band!

One of the highlights of our week has been a daily puppet show we have done on the children’s ward at 4pm. Having seen so much malaria and so many burns we thought it would be good to try to do some health promotion amongst the Mums. We have covered sleeping under mosquito nets, importance of drinking clean water, preventing burns, worms(!) and finally today at the mothers request family planning which proved challenging as a puppet production!. It all seemed very much appreciated and prompted a lot of questions from the mothers. We will probably repeat the exercise next week by which time most of the children on the ward will be newly admitted

A very receptive audience on children's ward

The rainy season has begun and it is pretty hard at times but fortunately not continuous. It made for rather a wet transition from our accommodation to the hospital!

When it rains it rains!

Rather damp getting to the hospital!

Sunday 18^th October

We have had quite a relaxing day today. This morning we went to the local primary school where they have started having a Sunday morning service over the last 4-5 months. We sat down and after 2 minutes it was apparent that the person leading the service was not going to turn up so we were asked if we would preach! We shared the story of Shadrach, Meshach and Abednego and the fiery furnace which Ann got them to act out including a tree trunk carried in to be the statue of Nebuchadnezzar! Afterwards I said a few words about the story afterwards and it all seemed to be appreciated.

After church Ann spent some time helping Rita, a nurse from York who is working here, with some computer work. We are fast becoming regarded as computer experts which will cause considerable entertainment to our family!

This afternoon we went off for a walk locally timing our return perfectly to avoid the rain!!

A new school being built by the road we were walking on. Storm clouds gathering!

 

The local children never ceased to be amused by us!

 

Time to head for home Ann!!!

 

We are currently in the process of trying to devise a puppet play which we can use on the paediatric ward to help educate the Mums about the importance of using mosquito nets.

Mama Betty has got the message to always use a mosquito net to protect her baby!!

Saturday 17^th October

This week has proved a varied one for us both. Ann has been spending some of the mornings helping at Kagando School and in the afternoons praying with some patients on the wards.  She has also been trying to compile a list of drugs in preparation for producing a proper formulary for Kagando. Often important drugs are running out leading to difficult decisions on how to best treat patient s and it is hoped that having a formulary may help prevent this happening.

Ann had a successful shopping trip for lemons-only 10p!

 

 One morning was also spent distributing some knitted baby clothes and hats to some new born children on the Maternity ward.

One very happy Mum with new knitted jumper and hat

 

On Thursday Ann went out to a local centre about 8 Kilometres from the hospital to see a number of children get fitted up with suitable wheelchairs that had been donated by a UK based charity. It proved a very moving experience.

Loading up the wheelchairs for the visit to Kyrumba

 

The boy in the picture is aged 12 years and suffering from Cerebral Palsy. He has always had to be carried by his parents and his mother had carried him down from a village in the mountains on the morning of the visit so the provision of a wheelchair for that family will make a huge difference.

He was very happy with his new wheelchair

I spent a busy Monday and Tuesday on the wards in an effort to release some of the Junior Doctors to attend a course being run by PRIME, a Christian medical organisation seeking to teach whole person care to include the Mental and Spiritual needs of patients as well as their physical needs. The course also ran on Wednesday for a group of 35 Church leaders to consider the Health Care being provided in their churches and on Thursday to a mixed group of 30 Clinical Officers, Nurses and Doctors in Kasese 45 minutes’ drive away. The course seemed well received and I felt very privileged to be able to help with the teaching on the 3^rd and 4^th days.

Getting the generator going before the conference on Wednesday

 

One of the sessions at the Pastors Prime conference

 

One evening during this week we discovered a snake which was living between the door post and wall of one of the outside toilets! This was a toilet we had been frequenting during the night and I had been walking there barefoot earlier in the week! He was rather dark, thin and about 10 inches long. Boiling water was subsequently poured into his hole which will either have dealt with him or left him with a very damp home! Many of the snakes in this area are poisonous so they need to be treated carefully. This incident persuaded us that perhaps a move to a room with an en suite toilet might be better and we moved there this morning.

Another encounter with the local wildlife occurred while examining a patient this morning when all of a sudden a rat appeared from underneath the blanket covering the patient! I am pleased to say he made a hasty exit!

This afternoon we had a long walk exploring about 3 to 4 kilometres from the hospital but some of the paths were not too well marked. At one point 3 small children aged about 8, 6 and 4 were assigned to show us the way when we were getting a little off course! They proceeded to take us on a very zig zag route before re-joining the path we wanted to be on.

We have certainly felt much better this week having fully recovered from the rather difficult journey out. We are looking forward to Ann being able to go to Mityana perhaps in 2 weeks after a weekend away in Fort Portal staying at Ruwenzori View Guest House.

Kagando on a particularly clear morning earlier in the week

Sunday 11^th October

This blog has been somewhat delayed. The last few days have probably proved to have been some of the most difficult for us in all our Uganda visits.

We had a difficult flight out via Brussels as British Airways have now ceased direct flights to Uganda. A melt down in their security meant a long queue at Brussels security and we only just made our connection.  Unfortunately Ann was very travel sick on the subsequent journey via Kigali to Entebbe. We were glad we had made arrangements for a 2 night stay in Entebbe which allowed us to enjoy a complete day recovery time before the journey on to Kagando on Wednesday. Unfortunately Ann was again ill on the journey and we arrived to find instead of our expected accommodation in our own house we were in a single room about 8 feet by 10 feet next to the dining room which proved very noisy and allowed us no opportunity to unpack so our morale was very low on Wednesday evening! We have subsequently moved to a better room for which we have been grateful. We have found Kagando also quite crowded with Mzungus which left us for a while wondering why we were here but that has perhaps become clearer as the week has gone on.

Exhausted after arriving at Kagando!

 

The week ahead sees a course being run by PRIME a medical education organisation teaching good consulting techniques and patient centred whole person care. I shall be pretty busy Monday and Tuesday covering the wards to allow as many of the Ugandan doctors as possible to attend while on Wednesday I will be helping on the course for a day aimed at local pastors exploring how they deal with health needs in their parishes. On Thursday there will be a day spent with local health leaders in Kasesse to try to encourage better integrated working by the different health providers in the area.

                                   
                 Rob and Clare the 2 PRIME tutors discussing the course with some local help!

I am pleased to report that Ann has gradually recovered from the traumas of the journey and we have been able to enjoy a more relaxed weekend. Ann has been busy cooking today so we will be offering lemon drizzle cake to all who are here to supplement their evening meal!

It has been a challenging time but sometimes it is during times like this that you grow stronger and you faith deepens at it has certainly felt like that as the week has progressed.

Feeling somewhat better today!