Wednesday 7^th December

This will be the last blog entry for this trip. It has been an amazing 12 weeks. I have spent much of today saying goodbyes as well as showing a nurse from New Zealand around She arrived last night to stay for 3 months and will be living in the house we have been using once I leave.

I particularly wanted to say goodbye to Julius who is in charge at the farm. He had been very kind to us with our milk supplies and had been particularly grateful when I went for milk 2 days after the shootings when few people had wanted milk. I had looked after his sister on our Intensive Care Unit about 10 days ago but she had died very swiftly from cancer at the early age of 29.

They had just killed a pig and there was along queue to buy pork which is a local favourite!

I am returning back to Kampala tomorrow and hopefully will have an opportunity to stop at the café and also a craft shop in Fort Portal on the way back.

My grateful thanks to all of you who have been reading this over the weeks, for your support love and prayers for us both.

Sunday 4^th December

A week has now passed since the events of last weekend. The story of what happened is well documented on the Africa page of the BBC although there was little mention of the events here at Kagando which left 10 people dead. All now seems peaceful and people seem much more relaxed again. The evidence of what happened is fast disappearing as bullet holes are filled in and repairs undertaken.

Bullet damage to the gates of the compound

A window in the chapel damaged by a stray bullet

The honey store peppered with small bullet marks

A larger clibre shell penetrated the guards hut

The last few days has definitely seen an increase in activity in the hospital with all the wards seeing activity at a level comparable to 2 weeks ago. One lady was admitted vomiting blood with a haemaglobin of only 2.9. Shen needed blood but was group O rhesus negative but no compatible blood was available. The decision had to be made to give her O Rhesus positive blood as a life saving measure and worry about the consequences for any future pregnancies she may have for the time when she has recovered. A man was admitted on Friday who had not been able to walk for 2 months because of weakness in the legs. It strongly looks as if he has syphilis affecting his nervous system so hopefully some prolonged treatment with penicillin may restore his ability to walk. The medical work here is full of challenges, not least making the best of the limited resources available.

This afternoon a number of us had a trip out to somewhere about 30kms away for lunch. It was a very relaxing time and a great antidote to everything that we have experienced in the last 8 days.

The current expatriate staff together with Gloria (physiotherapist) and Mary (Paediatrician and Medical Director)

The obligatory stop at the Equator

I am due to leave Kagando on Thursday morning and I am getting a lift from Jonny Rowland who is running the local coffee project. This is a day earlier than I had planned but the opportunity to travel down with Jonny was too good to miss. It is hard to believe that the 12 weeks in Uganda are drawing to a close. So much has happened during the time and I am so grateful to have had the opportunity to be here to share in all the experiences both good and difficult and to have remained well and safe throughout. Coming home again to all the pre-Christmas build up may be rather hard not to mention the freezing temperatures after getting used to an ambient temperature of 25 to 30 degrees and night time temperatures always over 20.

Thursday 1^st December

After the events of the weekend a slightly uneasy peace has again descended onto Kagando with the shops all now open again and people going about their daily lives with a semblance of normality. The events made it to the Africa page of the BBC website but were eclipsed by the death of Castro and an article about Donald Trump!

On Sunday and Monday many patients wanted understandably to be discharged and particularly the medical and surgical wards were quiet for a couple of days. However admissions seem to be picking up again. But throughout the paediatric ward has remained busy with some quite complex situations to be dealing with. A ward round yesterday included a 10 year old with HIV and an extremely low white cell count (CD4 level was only 3), a girl with sickle cell disease with an apparently very high white cell count (which on review of a blood film proved to be a false count contributed too by many red cells emerging from the bone marrow rapidly in response to her sickle cell crisis) and a 4 month old baby with severe fluid accumulation in the abdomen the cause of which we have yet to establish. Today in outpatients I admitted a very ill woman who has HIV and malnourished twins aged 8 months. So there is much to do in the midst of an uncertain situation for many.

It is hard to believe in a week I will be leaving here for the relative security of the UK. To be honest it will be hard leaving behind many to whom I have become close in the last few weeks.

I am so grateful to the many people who have been praying for Kagando and for me in particular over the last few days.