Thursday September 29^th

I have just been stranded in out-patients for an hour waiting for the rain to stop. When it rains it really rains! 

This blog is a little delayed because I have been laid low with what the locals would call “really serious flu”! In reality a heavy head cold!

The prison visit on Sunday proved extremely interesting. The prison at Naburongo is about 3km from Kagando. It houses 82 prisoners at present, 47 of whom are on remand. That is fairly typical with many spending months before a magistrate hears their case. Most are there because of petty theft. The prison has no perimeter fence and there are in total only ten prison warder so the men are often locked up for up to 16 hours a day. All the men are housed in a single large room with two toilets but sleeping almost touching each other. The women have a small room but there are usually no more than two female prisoners. Each month there is an outreach for some basic medical checks. I had expected to be a spectator on this occasion but eventually asked to see some men including 3 with hernias, one with probable chlamydia and another with nasty infected scabies. As a result of the visit arrangements are being made to screen the rooms with mosquito netting and also provide a 100 litre water tank to allow access to drinking water. Up to now there has been no drinking water available for the men between 6 pm when they are locked up for the night and 6.30 am in the morning. No photos allowed but I am sure you can imagine the conditions but the staff there do their best to provide care to the men in their charge.

Smoking remains a major challenge here with many with lung conditions including a man seen this week with an advanced lung cancer.

70 year old man with an advanced carcinoma of his right lung

Others present with other types of malignancy including a man just yesterday with lymphoma and a teenager with probable Acute Myeloid Leukaemia. Also there have been several cases still with late stage problems from HIV. Unfortunately for many there is little that can be done. It can mean a referral to Kampala for treatment with uncertain prospects of receiving treatment. The only radiotherapy machine in the oncology department in Kampala has currently broken down.

On a more positive note and Intensive Care Unit has been established since I was last here. In reality it is more like a high dependency unit but allows some of the sickest patients to be cared for in one place and provide a high standard of nursing care that can be modeled on the other wards.

Chapel this morning included an interesting and rather telling announcement. Each of the wards had bottles of alcohol liquid for cleaning hands between patients. Apparently some students have been tempted to try drinking it! They were warned today that there are other components including hydrogen peroxide which might leave anyone drinking it rather worse for wear!!

Sunday 25^th September

I feel I am gradually settling in after a few days. I have spent much of the week on the medical wards mainly working with some junior doctors from the UK. Andrew has been here for several weeks and will be here until November. Neil and Jenny were due to go to work at Yeo in South Sudan but have been diverted here because of the fighting in that area. They may be here for up to a year. I hope they have appreciated the opportunity to discuss some of the quite complex medical cases that we have here at present.

I am currently staying in a smallish room in the guesthouse It is rather undecided whether I would be moving to a small house which is currently being refurbished before Ann arrives or whether I might move into one of the other houses when one of the nurses, Rita who frequently comes here, goes back home in mid-October for 3 months. The house being refurbished looks rather like a building site at present and I suspect the completion date of next Wednesday is a little optimistic!

House which may become home in due course

Kitchen diner

The entrance hall!

Yesterday morning was Jha Jha’s day which is a monthly event where local children who are HIV +ve can come to play, do crafts, attend a short service and get a good meal. It is a popular event and supported by some very dedicated mothers who do the cooking and also by the daughter of one of the Clinical Officers who seems to have boundless enthusiasm.

I am going with some of the nurses this afternoon to the local prison where they hold an outreach once a month to check on the health needs of the prisoners. I have never set foot inside a Ugandan Prison so that should prove and interesting and educational expedition.

Lots of young children come to Jha Jha's day

One of the HIV+ve children Some of the local women busy doing the cooking in the background.

 Went to church this morning wearing my Ugandan outfit which was made for us last time we were here. Only problem was I realised half way through the service that I had it on the wrong way round with the pockets at the back!!

Wednesday 21^st September

I am gradually settling back here at Kagando after an eventful flight. I arrived at the check in at Gatwick and was asked to have my hand luggage weighed. This has only happened once but this time I weighed in at 18kg against an allowance of 7kg. The air hostess after reprimanding me was understanding enough to let me through which I was extremely relieved about!

At Dubai security decided my 4 way plug was too dangerous and confiscated it. I think they were worried I might strangle the pilot! Eventually arrived at Entebbe at around 2 pm on Monday Unfortunately everyone was there to meet their relatives returning from celebrating Eade so it took over an hour to clear the airport car p[ark. Fortunately things went rather more easily from then and I had a pleasant stay with our friend Simonpeter in Kampala before travelling on to Kagando with 2 other people who have come out to do work in prisons, work with the physio department and other things.

Today has been spent greeting many people and spending time on the medical wards. The hospital is fairly busy at present and the doctor numbers lower than on some occasions with a number of junior doctors from the UK filling in.

I am currently living in the rather cramped conditions in the guest house but hopefully moving to a small house that is being made ready in a week or so. A welcome find amongst things we left here nearly a year ago was another 4 way plug so I can have the computer, a bedside light and a kettle all going at once!