Holiday clubs or Hospital?

Saturday January 21^st

This morning was busy at the hospital. In the last week we have gone from 9 patients on the medical ward to around 20 with some very sick people with malaria. One man unfortunately developed acute renal failure and died this evening. It was fortunate that the relatives hadn’t taken him to Kampala that morning as he wouldn’t have survived the journey

                                                    Exhausting Parachute games

                                                             Roaring lions!

This evening we played Settlers of Cattan which seems popular in these parts Suffice to say I came in a dismal last place. Definitely more practice needed!

IT problems

Friday January 20^th

IT is definitely not one of Kagando’s strong points! This morning in Out Patients a long queue of patients rapidly accumulated. A new computer system has been introduced just a month ago with linked computers in the cashier’s office and the registration desk in Out Patients. Fine in principal but in fact the computer in Out Patients doesn’t work while the Cashiers office computer is being used! Hopefully a solution can be worked out soon.

I feel like I have been yo-yoing between the medical wards and outpatients today which I hope has been of some value to the more junior staff.Last night we had a bible study meeting with many of the expatriate and local medical staff. The meeting was very helpful and encouraging. One of the things I have been impressed with on this visit is the improving working relationship between local and expatriate staff.

For the medically minded I know you love a little quiz! This small boy had been coughing for a week. What is the diagnosis?

Oh Rats!

Thursday 19^th January

Today rats have been the cause of some trauma in the hospital.

The main x-ray machine has been inactivated for the time being because of a rat getting in amongst the works again. The last time this happened the machine was out of action for several weeks and the subsequent repair cost £2500! I’m assured the damage is not as substantial this time.

Also I went to the hospital lab to check up on some missing blood results. However the blood samples couldn’t be found even though the request slips were there. “We have a problem with rats drinking the blood samples” I was told!

In part the solution may lie with 3 relatively new residents at Kagando.

Fortunately chest x-rays are still possible using a portable machine. This has certainly proved useful for a couple of patients today.

               This man has a pleural effusion the cause of which has yet to be determined

Unfortunately this 55 year old mans problem is all too evident with a secondary in the lung from a    probable sarcoma from his arm

Add caption

The problem with goats

Wednesday 18^th January

This afternoon has in part been frustratingly trying to get the email account for Dave Lyth, one of the surgeons, working. It was rather like the blind leading the blind as I’m certainly no expert on IT matters! Our endeavours were interrupted by 2 small goats that wandered into the room where we were working! They were shown the exit just as they were threatening to eat our washing that I had just retrieved from the line!

Some of the frustration of working in an environment like this was typified by the last woman I saw today.  She had had blood stained sputum for the last 1 week but on closer questioning she had in fact been diagnosed as having Tuberculosis a year ago but had never taken her treatment as she was worried about the cost. In fact TB treatment is entirely free!! Hopefully she will come back tomorrow for some further tests and a chest x-ray.

Meanwhile Ann was out again at the holiday club at a church in a village where even more children appeared than yesterday. Ann, with Jethro a children’s evangelist translating, used drama to tell the  story of Meshach Shadrack and Abenego and the fiery furnace. The photo shows King Nebuchaneezer’s men enthusiastically throwing them into the fire!

                                       Sainsbury's bags make a very good fiery furnace

The holiday club begins

Tuesday 17^th January

Today has been quite a busy day on the wards. One poor young man of 22 was admitted overnight very distressed after his wife committed suicide by taking rat poison. He was still very upset today but wanted to be discharged to be at his wife’s funeral tomorrow. I found it so hard to comprehend how this man was trying to cope with his whole world being turned upside down.

There are also some definite encouragements around the hospital. There is now a machine for ding blood counts for haemoglobin and white cell counts which is transforming some of the decision making on the wards. The only unfortunate thing was that today the calibration of the machine went astray with haemoglobins being reported as 6 instead of 16!! It also is encouraging to start to see a more coherent approach to the treatment of patients with potential typhoid but there is still a long way to go.

Ann has had the first day of the holiday club this afternoon after planning this morning-not what she is used to doing at home. There was some dispute amongst the locals as to who was leading the event but this was eventually amicably sorted out by everyone doing their own thing! Around 250 children turned up today.

  

Children at the holiday club playing the flip flop game.

Au Revoir to Janet and Clem

Monday 16^th January

Clem and Janet left us today. White Crest Safaris turned up promptly with a vehicle that actually had decent tread on its tyres! Simon Peter their guide for the next 5 days seemed very amenable. He was in fact born at Kisiizi hospital delivered by our good friend Bill Cave when he was working there around 30 years ago! It has been great to have Janet and Clem with us over the last week.

 

Janet and Clem about to set off

Ann spent his afternoon with Helen Lyth doing the very unglamorous job of trying to sort medical records sat on the floor amidst piles of unsorted papers, small ants and rat droppings!! But Ann was glad to be occupied ahead of the holiday club she is helping with which kicks off tomorrow.

I spent much of the day in Out Patients which was instructive. Normally there are no doctors there just clinical officers and medical students. I think I will probably be spending more time there during this visit than I previously have. This evening there is a medical education evening so maybe I have in some small way managed to encouraged this to happen.

A quiet Sunday at Kagando

Sunday 15^th January

This morning was chapel at the hospital featuring the launch of the campaign by the Echoes of Victory choir promoting their CD. This included an auction including cockerels, bunches of bananas and eggs. Needless to say we didn’t stay for all the proceedings which lasted most of the morning!

                                                          Kagando Chapel
This afternoon we had a leisurely walk along some local paths. We very soon picked up a gaggle of small children who followed us for ages. To liven up proceedings I tried giving them an impromptu English lesson!

                                                   An improptu English lesson