Thursday 5^th November

Ann arrived safely in Mityana around lunchtime on Monday and has been fairly fully occupied since spending the first two days at the school and today at the café. There is much to be discussed and updated about. The water tanks on the houses are now in place and harvesting rain effectively form the house rooves and from some of the other buildings. This will certainly be a great help once the dry season starts at the beginning of next year.

Water tank alongside Jonno House

There have been a couple of new arrivals who seem to be settling in well. Thye are 4 legged- two kittens recruited to try to keep the site free from rats as much as possible!. There are also some new teachers who seem to have integrated well into the teaching team.

One of the new kittens settling in well!

The lighting to the various children’s houses is gradually making progress with 3 houses now linked up. There has also been a hedge planted to try to give a definite boundary to the site as a whole so it is a busy time at Ekiwulumo.

I have been fairly well occupied on the medical wards. Laurence, a new medical officer, arrived yesterday to replace Basil who has left. He seems very thorough and should be a good addition to the medical team. One patient I met today was very happy to have his photograph taken.  For the eagle eyed you will notice his jacket with its very shiny buttons is courtesy of the West Midlands Ambulance Service!

A satisfied customer!

For the medically inclined, the following 3 chest x-rays illustrate the complexity of some of the people on the ward.

First is a 46 year old man who was diagnosed with HIV and started on anti-retroviral drugs for this 7 months ago. He has now turned up extremely ill, jaundiced and in renal failure with a creatinine of around 700. If that wasn’t enough he had 500ml fluid drained from the right side of his chest and almost certainly has Tuberculosis. The challenge is to know how best to manage his anti-retroviral drugs as well as treat his TB!

Second is a 40 year old man with newly diagnosed HIV who presented with a cough and also a a positive test for Malaria. He was in quite a bad state initially but he has considerably improved on treatment for suspected Pneumocystis pneumonia and commencing his anti-retroviral drugs. He should hopefully do well.

Finally there is a 30 year old man who presented with a painful left ankle and a cough. The next day he had a painful right knee and right elbow. At first we thought he might have an infection in his ankle but it subsequently looks as if he has joint inflammation related to his left lower lobe pneumonia (a reactive arthritis) so I am hopeful as his pneumonia improves his joints will settle down. Time will tell!