Thursday 6^th October

Yesterday I spent the morning in the HIV clinic. Managing HIV patients poses particular problems for Doctors coming here from outside Uganda. 

Board outside the hospital advertising HIV services. Spot the deliberate spelling mistake!

HIV is a complex disease and often one which is relatively unfamiliar to Doctors in the UK. The complications of advanced disease are rare in the UK while the treatment regimens available are designed for conditions locally providing drugs that both affordable and effective. To make matters more complicated the Ugandan medical authorities have a huge liking for abbreviations. For instance TR means Tested and Received by patient negative result while TRR means the patient has a result that is reactive ie they have HIV. There are numerous others relating to testing for HOV and the treatment regimens so it does take time to really assimilate the local systems. However the clinic time yesterday proved very useful and I think for the first time I really have got to grips with the local systems!

There is a huge poster campaign at present encouraging people to take steps to avoid catching HIV. It is hard to know what impact they are having but at least it is a real effort to stem the resurgence of HIV here after a number of years of decline in new HIV cases.

One of many different posters on display at present

For the medically minded some fascinating and relatively unusual things crop up. One girl presented with Nephrotic syndrome, a situation where the kidneys become very leaky to protein but she also had a rash. This has proved to be due to an unusual condition called Henoch Schoenlein Pupura. She is rapidly improving which is an encouragement when there have been a number of patient deaths during the week largely due to their very late presentation at hospital.

Young girl with Nephrotic Syndrome and rash on her legs and arms

The Bishop is here today which mean I get the added bonus of being invited to lunch so I shall be having more than chapattis today. One good thing I have discovered this week is that one of the local shops can do Rolex (Chappati with omelette) which is a real bonus!

While writing this there has been a sound like a heavy lorry passing by and the furniture is shaking- a not inconsiderable earth tremor which has occurred on a couple of occasions since I’ve been here. It lasted around 15 seconds. This is a potential earthquake area although nothing substantial has happened for many years!