A challenging day

Wednesday January 25^th

Every morning during the week there is chapel at 8am. This does vary hugely but this week it has been exceptional with Canon Benson talking from Isaiah 49. He has been reminding us of how much God cares for us and is aware of the details of our lives Verse 16 talks about us being engraved on God’s hands reminding us how he is always aware of our lives and his constant compassion for us. I’ve found that a great encouragement and comfort both for myself but also as I consider the plight of the patients I am seeing.

This morning I was helping out with the HIV clinic. HIV patients are a constant challenge both in the complexity and also the potential severity of their illness. Each patient here has about 5 minutes with a doctor while I’m sure at home they would have up to half an hour to be reviewed. Today’s clinic included a 12 year old who had defaulted from treatment for 6 months because the aunt she was living with had moved and not taken her for treatment. Also there was a woman of 53 who had had a cough for 1 week but on listening to her chest almost certainly has TB but can’t afford the UgSh18000 (about £5) for the chest x-ray. This really is a lot of money for these people.

This afternoon I was in out patients with one of the clinical officers and patients ranged from a woman with advanced carcinoma of the cervix, a one year old with pneumonia and a man with abdominal pain who has a gut perforation. My aim in being there has been to encourage where necessary guide decision making and prescribing but my respect for the clinical officers has grown enormously as I watch the range of situations they are having to deal with with very little medical support with their initial assessment of patients.

Unexpected events!

Tuesday January 24^th

The Guest house nearly suffered a catastrophe today. At breakfast one of the American students Heidi decided to make sugar and cinnamon toast by heating the bread resting it on top of the toaster. Result a fairly substantial fire which only died down after about 30 seconds of strong blowing from the 3 of us. Fortunately no damage done we hope but I look forward to doing the toast tomorrow with some trepidation!

A remarkable incident occurred over the last 24 hours. Last night our good friend Bill Cave emailed for up to date news regarding the defunct hydroelectric scheme here as he had a friend staying who had been involved in the refurbishment of the system a few years ago. Amazingly this morning the director here Canon Benson stood up to announce that funds were being made available for a new turbine and cable to connect it to the hospital to restore the system to use. After chapel I talked to Benson and he was desperate to make contact with the very person who is staying with Bill at present. Was this simply a coincidence or Gods way of intervening in the situation? Whatever you may think it was a most remarkable chain of events which has allowed me to email the proposals for the new scheme to Bill within 24 hours of his original email.

Ann happened to be in medical records again trying to establish some degree of order. While she was filing a nurse came in to request a set of notes Obadiah the man in charge of records was delighted and suprised that he could find the notes now in "less than one minute!". So progress is being made.

                The kittens are growing up fast oblivious to their future rat catching career!

Lets hope the wind doesnt blow

Monday January 23^rd

Today has been a busy day again in the hospital. Today has highlighted the organisational issues which impede the function of the wards with results not available or drugs out of stock. I think we may having a discussion with the ward staff to try to determine how we could do things better. Change is difficult in any organisation but certainly there is much that could be done differently to improve patient care at no additional expense.

Ann spent this morning working away at note sorting in the medical records department. Some head way has been made but there remains a lot to sort out.

                                  It could be catastrophic if the wind decied to blow hard!

This afternoon I spent a couple of hours with the Ugandan Students discussing Diabetes which was very interesting and instructive for me. The students we have here at the moment are very bright but as I explained it’s very important that they learn to realise what they don’t know about as much as display their knowledge to the other members of the group

Elephants come for tea

Sunday January 22^nd

Today has been a complete day off and Dave and Helen very kindly offered us the use of their vehicle. We set off at 6.30am with Fern, a 19 year old gap student, and visited some of the game park areas which are free to enter.

At one site near Katwe we decided to stop for a very welcome cup of tea which was cut short by Ann calmly saying “I think we need to get back in the vehicle” Just behind us were a group of 5 elephants about 30 yards away! We nearly had a further recurrence when after the elephants had passed and we were resuming our tea 2 buffalo suddenly appeared. It was great for Fern as she had never seen any of the large animals in the wild before

We stopped at a couple of the local game lodges, Jacana lodge and Kyambura, where for the price of some sodas we were able to relax and enjoy the facilities. Ann was very impressed by the towel rail in the ladies at Jacana!

                                      Tasteful towel rail in the ladies at Jacana Lodge!

We saw a large group of Black and White Colobus in the trees around the lodge which was wonderful and took us back to the days when we used to see these in the forest on the road to Kapsowar over 25 years ago. It has certainly been a very enjoyable and relaxing day.

                                    Black and White Colobus monkies lying in the trees

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!