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!!