Benjamin’s Blog

Watotos

February 21, 2011

Apparently the city is still in holiday mode, because the city was still quiet and The Surgery was very slow again. Museveni officially won by the way with close to 70% of the vote. The stories are still flying about how improperly managed the elections were and Museveni’s opponent apparently says he will not go the legal route this time to appeal but instead call on the people to start demonstrations much like other African and Middle Eastern countries currently and in Egypt this past month. The problem a lot of people are saying is that unlike some of those other places, Ugandans are generally less educated and less connected into social media and other mediums that will allow them to join together. Basically, there is no real way to unify enough people together to make a difference. You show up with 20 friends and you’ll probably get killed or beaten but you show up with 50,000 friends and then you’re on the front page of CNN and while people still die, the whole world is watching. We don’t even have any idea of what it would be like to speak up in the remote villages where you can easily be harmed without anybody knowing. And the military is everywhere! Museveni is making sure that nothing is allowed to even begin to build. So being uneducated and without unity, it looks as if the Ugandan people will not say much and go about life as usual. They are too afraid of reliving the past and unwilling to speak out against the government. It is still early though and maybe something will still happen.

As I said, The Surgery was slow so at half day I went over to the Watoto baby’s home (www.watato.com) which is just down the street from the clinic. This is a very cool organization that basically accepts abandoned and orphaned children and attempts to correct malnutrition and any other health problems before returning them back to a stable situation. This can either be temporary care with return back to the mom, or to 1 of their multiple Watoto villages, which are essentially completely self contained villages full of these kids. They can typically leave the baby home and go to the village at 2 years of age and a family typically consists of 1 female mother figure with 6-8 children and they try to keep families together. There is a clinic, school, and market in each village and they focus on providing children education including college.

There I saw multiple kids, ranging from a newborn who had been brought by the police after having been abandoned and surviving for 9 days on her own to a 12-14 month old girl who was born without arms and legs. A lot of these children are fairly healthy but also many are abandoned due to birth defects as they are usually not understood and seen as curses. The girl without arms and legs in fact was supposedly never taken outside and she and her mother were left by the father I was told because of her condition. It is actually remarkable how ignorant many of these rural villages are and how they rely on witch doctors for care. Many kids here walk around with tubes coming out of their noses, which is the route for correcting their malnutrition. But somehow I wasn’t ever really depressed about this place like I thought I could be. Kids are so young and innocent that they usually don’t know how to do anything else but be a happy kid. I felt like they were getting a good chance to live a better life so I left not feeling bad for them or myself.

Jimmy got a new car also and I feel like I must have pretty much paid for it with all the money I’m spending each day on him as a taxi. The truth is I could fairly easily take way way cheaper forms of transportation but I like to think I’m helping Jimmy out by using him and giving him some steady business. Claire saw him with his new car today was so happy, telling me how he has been talking about saving up to get a new car. I think he’s really happy about it which makes me feel good. I know that I will never miss this money and I hope that it is actually making a difference to him. After all, yearly salaries in this country can be as little as a few hundred dollars.   

Voting aftermath

February 20, 2011

It’s Sunday and the election results are still being tallied up, with Museveni in a pretty commanding lead. I was reading one of the local newspapers in the house and it was completely filled with stories of inefficiencies, bribery, and rigging throughout the country. While I was not seeing any signs of anything other than peace on Friday in Kampala, there were arrests made and some small sorts of riots in other villages outside the city. There were numerous stories about people waiting in line for hours to vote and of voting materials arriving hours late to the polling stations. People who had been sure they were registered were told their names were not on the list and therefore not allowed to vote. Ballot boxes were showing up with ballots already in them and I read a funny blurb about ballots blowing away in the wind in one area and people having to pick them out of the bushes. There were other stories about polling agents being untrained and biased and others of people being given pre-ticked ballots in favor of Museveni. The opponent having already planned on extensive rigging, planned on setting up his own independent tally based on messaging but found out quickly most of the cell phone providers in the area were blocking messages with specific content. Another independent European organization was having the same problem not being able to receive messages. Hardly a coincidence I think! The whole election just stinks so badly of poor and unfair practices it is impossible to realistically think the whole thing is not compromised. All the talk from the Electoral Commission about “free and fair” elections is complete BS. After almost 5 years of being able to prepare for an election, this is as good as could be done? Late arrival of materials and turning people away from voting or confusing them so much that they give up. This is why all of the people I talked to said they weren’t voting. It is a shame however because they obviously would’ve voted for the opponent, theoretically tightening the race. But again, Museveni was never going to lose.

I ended up heading back to the American Club today and played another few rounds of tennis in what is basically perfect summer weather. This trip would’ve been much different without the ability to work out, play tennis, and enjoy some American style food at the club. Much more boring in fact.

Election day

February 18, 2011

Today were the presidential elections and although it was a national holiday, The Surgery was open for business as usual. I went to work at the normal time and it was very quiet in the city. Normally, by the time there is daylight, there are hundreds of people on the streets as well as taxis and bodas but today not so much. Many of the smaller shops were closed and it felt like strange to see so few people out. We did however see an increased military and police presence and we couldn’t take our normal route because the military closed the road. This rerouted us through downtown Kampala where it was also eerily quiet. On the way to work, I saw people waiting in line at several polling stations.

Work was very slow and since it was Friday anyway and I had mostly just been sitting around, I ended up leaving at around 1 and headed back home. More of the same on the drive home with a few chances to see some more people waiting to vote. Apparently the results will take about 48 hours to come in at which time, things may or may not get interesting.

The sort of back story is that President Museveni (current president) is running for another 5 year term after serving as president since 1986. Once hailed for bringing stability to a country which has a notorious history of violent rule, his popularity has supposedly been declining due to a lack of any real advancement in any part of daily Ugandan life. His major opponent, which is his former doctor, lost to him in both 2001 and 2006 and also lost appeals that he filed claiming (undoubtedly valid claims) the elections were unfair and rigged. 

I’m interested to see how the election turns out, results and logistically speaking. For now though, everything seems to be calm and peaceful, at least within Kampala and Makindye, where I stay at. Multiple Ugandans I’ve talked to actually aren’t even going to vote because they believe it is useless to vote when in their minds the election has already been decided in favor of Museveni.

Election eve

February 17, 2011

Just got out of the shower! Usually nothing to be excited about except for the fact that we have had running water maybe only 3 or 4 days since I’ve been here. You have to enjoy it while it lasts because it may be gone tomorrow. Even the power too for that matter.

Today was pretty slow with more of the usual patient complaints: abdominal pain with diarrhea (which means lots of stool samples for the guys in the lab), medical exams for people trying to claim disability, and other typical aches and pains. Sadly with the exception of the occasional malaria or tuberculosis patient, working here at The Surgery isn’t a far cry from working back home. There are definitely more outdated and less supplies and options for specialists to send to but still similar problems. The good thing is that The Surgery has competent doctors and takes good care of people in Kampala. The bad thing is that it is located in a wealthier area of Kampala so we more or less get only the people who can afford to pay their bills. This translates into not a lot of times feeling like I’m really working in Africa, which is the point of this whole experience. I’m sure I would be appalled to work in other clinics and villages (which absolutely still have witch doctors) but I think that’s what I came to experience. Next week I’ll get a taste of the other side of things when I take a field trip to Mulago, the government run hospital down the street. I’ve heard so many horror stories and rumors about the place that I’m banking on being shocked. I’ve been told people can sit there for days or weeks without any treatment and then if they’re lucky and don’t die make it out of there alive (most likely worse than when they got there). I want to see it but at the same time don’t want to see how bad it really is.

Along the same lines, one of the Ugandan doctors was telling me today how surgeons in this country can put you out and cut you open to give you a scar and the impression that you had an operation you never in fact had. Somebody can think they have had their appendix removed and have the scar and then magically still get appendicitis because it was never taken out when they believed it to be. He also told me during his intern year after 3 weeks, he would do surgeries unsupervised based hopefully on what he had watched somebody else do or by looking at a surgery book. If the power went out they had to use the light on a laryngoscope blade (used for intubating patients) or wait for somebody to run out and but a flashlight. Really scary stuff. I think I’d rather try operating on myself with a dirty butter knife than go to most of the hospitals around here. The point is that this is a developing country with serious medical system issues, I just hear about it instead of seeing it.

Yesterday was fun though because I rode on one of our ambulances for a few transports. We first took a young girl who fractured her femur Tuesday night riding a boda-boda (imagine that) to basically the only trusted orthopedic surgeon around only to sit there for over 2 hours before getting a bed for her on the ward. There really wasn’t any eagerness to help her from the staff at this hospital and they refused to let her in until 60,000 schillings were paid (about 25 dollars). They didn’t have any money so I put up the 60,000 to get things moving and get her a bed. They don’t do any emergency surgery there so basically there was no urgency to do anything for her. Her sister was with her and wanted me to have her information so we could be friends and keep in touch so I took it down and actually called her tonight to check on the progress having believed she would get the operation today. I talked to her and her sister and was told she actually would have to wait until Monday before she would get her operation. I know they don’t do emergencies but we’re still talking about the best orthopedic hospital around and that’s the best that they can do. Imagine if she had gone to Mulago where Jimmy told me there is actually a ward called “boda-boda ward” because of how many boda accident victims go there. If she’s waiting a week at this place I can only imagine she could wait 3 there. Another reminder for me to stay off bodas and to stay 100% healthy while I’m here.

We took another “call” this time to pick up a lady who had just been at The Surgery with malaria but who was now dehydrated and having diarrhea profusely. So we hopped in the ambulance and after about 25 minutes and getting lost we finally made it to the right place. We went to her house with lights and sirens (which I obviously love to do) and had to get directions over the phone. “Turn left after the supermarket and right by the church, and then where the paved road turns into dirt it’s 3 more houses down.” That was the rough rundown of the directions we got and a big part of us getting lost. Ambulance service is vastly different here and also scary. We got a little better than OK respect from drivers on the streets when it came to trying to get through traffic. There were times though when people really were working to get out of the way and let us through. And sometimes we would make a turn only to find the traffic in gridlock to where we had to back up and try to find another route. There is not really such a thing as prehospital care here so basically we stuck in an IV, loaded her onto a scoop which in itself is a mess, and put her in the back of the ambulance for the trip back. We then put an oxygen mask on her which I believed didn’t even have any oxygen flowing (the nurse assured me it was on and working) and when we got back I put it on myself to confirm what I thought all along which was there was no oxygen flowing the whole time. It turns out the tank was actually empty. So even at The Surgery there are slip ups and some disconcerting ones. This same lady was believed by the nurses to not be making urine once she got to an inpatient bed only to find out sometime later that the catheter was not even in the bladder (only 1 guess as to where it actually was). Of course she actually was making urine and once the catheter was in the right place, it started flowing. These things are kind of embarrassing and Dr. Stockley gets rather annoyed by them. This is the level of care that is considered some of the best around so again just imagine life in the rural clinics. It’s no wonder the life expectancy is only around 50 years old here.

Elections are tomorrow so it’s finally time to see what happens. Most people think tomorrow will be really quiet and if anything happens it won’t be until after the results come out and people decide how to react from there. It’s sort of sad because I’ve talked to numerous Ugandans who are not going to vote because they believe it is already rigged and that their votes are useless. Most sad of all is that they are probably right. I tried to tell them if they don’t vote, there is absolutely no chance of changing things but in their minds they really believe that the results have already been decided. One of the lab technicians believes the only way it can change is for demonstrations to take place like those that just happened in Egypt. I really doubt anything like that will happen and I’m predicting the current president will remain in power without much resistance. If I’m wrong things could get very interesting. With all the political turmoil that is going on throughout Africa and Middle East at the moment though, anything can happen I guess. We shall see…  

Murchison Falls

February 15, 2011

Just got back from a long weekend at Murchison Falls National Park which is about 4-5 hours northwest of Kampala. I was dropped off at the tour company (Red Chili) in Kampala Saturday morning by Jimmy and it was about 9 by time we got on the road to the park. We took an 8 seat safari van and there were 5 of us to start: me, a younger Dutch girl who had just recently graduated and was volunteering in Nairobi, 2 other girls from Washington D.C. who work for American Red Cross and were here for 2 weeks volunteering to build secondary schools, and an older guy from the UK who was pretty much a professional traveler and claimed to have been to over 125 countries. As we got out of Kampala and headed toward Masindi (the town where we were to stop for lunch) we started to see more of rural Uganda. Although I’ll have to say it wasn’t too different than what I see everyday. Tons of people walking to and from home, young children playing and walking down the street, people biking or pushing their bikes with water jugs, charcoal, and furniture on them, boda-bodas and farm animals. Basically there’s never a time while driving down the road when you can’t people-watch. At the same time, you can watch out the window for a mile and then the next 100 miles are like a repeat of everything you just saw so it still ends up being kind of a boring car ride. When we got to Masindi we stopped to eat lunch and it took well over an hour to order and get our food. The power had been out for 3 days so they couldn’t offer us 75% of their menu and their drinks were nice and warm. We ate and shortly thereafter entered the park and within another 2 hours total we were at the Red Chili camp ground.

We finally arrived around 5 or 6 at the camp on Saturday night and had nothing planned except to see the camp and get situated in our tents. The tents were pretty good size and each had 2 small beds in them. There were 2 bathroom and shower facilities with running water and a bar/restaurant area that served food and drinks. There were a decent amount of other people staying at the campsite but we mostly hung out with the people in our group. We also had another couple from Northern California join our group. The weekend trip was near the end of their 40+ day biking trip around Uganda so they had a lot of interesting stories to tell. They own a bike shop back home and spend time each year biking around different countries in the world. They had only what they can bring on their bikes and they figured out where to eat/stay each day. Between them and the world traveler, I didn’t think talking about my Carnival cruises was very riveting so I mostly listened to their stories and asked questions. We all ended up getting dinner from the restaurant which was delicious and having drinks while talking most of the evening. I took a shower at the end of the night and went to sleep at around midnight so I could wake up at 6 for the safari.

We started off early Sunday morning for the safari and first had to take a ferry across the Nile. We took the same van and popped open the roof so we could stand up and look out. Our tour guide, apparently the first and only woman Uganda National Parks ranger (with an AK-47) jumped in the van with us and we started the game drive. It didn’t take long before we started seeing some animals. Hundreds of different antelope, some elephants and giraffe, warthogs, water buffalo, birds and eventually 2 lions! Quite obviously Christopher Johnson’s distant relatives. We saw a male and a female but they didn’t stick around too long and didn’t really give anybody any good pictures. Still an awesome sight and a highlight of the whole trip. It’s somewhat of a rarity to see any cats so I felt pretty lucky and fortunate that we got to see the lions. No leopards though. We drove through the park and ended up at another part of the Nile where we stopped to stretch and see all of the hippos that were sleeping in the river. They mostly sleep during the day and then leave the water to eat at night so it was hard to catch any on the land. The one Californian lady we were with actually was woken up by a hippo outside her tent the night before the rest of us got there. After our break we headed all the way back to the ferry, giving us another 2 hours of driving through the park and seeing tons more animals. It was very refreshing to see the animals in the wild and not behind bars at the zoo. I really can’t describe what a great experience it was so I won’t try. Hopefully when I can upload some pictures they will speak for themselves.

While waiting for the ferry back we watched a baboon raid the trashcan and eat a sandwich (no crust) and whatever else was edible in the trashcan. He was literally eating only a few feet away from us. We went back to the campground and had a short lunch break before our 3 hour boat ride down the Nile toward the base of Murchison Falls. I sat on the second level of the boat and worked on my nicely developing tan. The boat ride was also amazing and offered us the chance to see tons more birds, elephants, hippos, warthogs and crocodiles. I mean all in one snapshot you can see hippos and crocodiles side by side in the water while warthogs and water buffalo are drinking water from the river, and in the distance watch elephants chasing birds. If you saw that and aren’t blown away you have no soul…We got to the base of the falls (about 700 meters away) which was of course beautiful and which only pictures can explain. We headed back for the evening after that and had another night as a group sitting around the table talking.

I walked up to the bar for a drink and an off duty worker from Red Chili offered to buy me a Coke and talk. I of course accepted and we spend the next 2 hours or so talking about life in Uganda and America. He is 24 going on 25 and a semester into school where he studies business. He was a very well spoken and intelligent Ugandan and very interesting to talk to. He supports 2 of his sisters and nephew as well as pays for school with the money he makes from working at the tour company. I’m slightly ashamed to admit I thought for a while he may end up taking an angle for donations or something after telling me that but he never came close. He is just a really friendly guy trying to get an education to get out of poverty and make his own career where most people get married early and immediately start farming without any hope of anymore more. And maybe they are fine with that, I don’t know. I ended up exchanging contact info with him so I could keep in touch and see what he ultimately ends up doing. I would be happy to host him if he ever comes to the U.S. One of the things I’m enjoying most about this country is the simplicity and happiness here. The Ugandans (with exceptions of course) are always smiling and usually thank you for thanking them. They seem incredibly resilient and happy with whatever they have. It makes me think of all the opportunities I’ve had in life and how spoiled I am. I have to use my privilege in the future to do things for other people whether in other countries or back home in America.

The last day of the trip (Monday) we stopped at the top of the falls on our way out of the park. It was even more amazing…blah blah blah…pictures to follow at some point. We stopped again in Masindi for lunch followed again by never ending people watching on the roads back. We did however come across a couple of presidential rallies for the current president which was quite interesting to see.

Which brings me to the last thing for this blog, the elections! So presidential and parliamentary elections will be held this Friday, the 18th for Uganda. I somehow planned this trip perfectly (or imperfectly) considering elections are only held once every 5 years in February. There have been multiple State Department briefings cautioning Americans and other Westerners to be more aware this month and there is increased military and police presence all over Kampala. In fact, seeing guys with guns all over the streets isn’t even exciting anymore (except that I’m lying and it is still cool). Nevertheless, this week is leading up to the elections Friday and I’m waiting to see what happens. I’ve heard different opinions and literally have no idea of what to expect when it comes to reactions to whoever becomes president. I just know I’m not planning on strolling around town this weekend, but instead watching from a distance. With the rest of the political climate as it is in Africa, I think it’s a toss up.

Fun day on the roads

February 9, 2011

A few things to update…the wild European man with malaria woke up very pleasantly with no recollection of trying to run out of the hospital naked or punch nurses so he went home. Secondly, Dr. Stockley said I could print out the chest x-ray of that TB patient that came to the clinic so now I have a copy.

Now on to today. Nothing too exciting happened at work. Dr. Stockley is out at the moment though so things are a little disorganized as far as I’m concerned. I ended up catching a ride back today with the business manager of The Surgery at around 3 and we had quite an interesting ride home. First we were made to pull over by the traffic police for “running a red light” and while we were stopped I witnessed my 2^nd boda boda (motorcycle) accident when this guy got squished in between two cars he was trying to weave through. I couldn’t really see through all the other boda drivers that started gathering but apparently he wasn’t too badly hurt and was up walking around pretty quickly. As for our citation, the police tried to bribe the woman who was taking me but she said instead she would pay the ticket at the police station. She told me she didn’t approve of allowing them to bribe her and would rather pay the fine and go get her license back than to pay straight into the pocket of the cop. I asked Jimmy about this later and he told me he just makes photocopies of his license and when he gets pulled over (like he did yesterday) he lets them take his photocopy and then just makes more copies of the original so he never has to go to the police station. He told me he got stopped yesterday for some reason and the traffic police told him just to give them 50,000 schillings (about 20). He said he tried to offer 10,000 and instead they just took the photocopy of his license. He even told me sometimes if there is open road and they try to flag him to the side of the road, as long as they don’t have their car or motorcycle he won’t even stop. We both started laughing really hard when he told me that. Also, there’s a billboard on the route home that says “May 21, 2011” and then “Have you answered the trumpet?” which is all apparently a reference to May 21^st being “Judgment Day”. Needless to say, if people start disappearing at our wedding we’ll all know what happened and I even suggested to Kristen we move the wedding up to Friday so that we all have one more day together before we’re sorted into heaven and hell. I think it would be a nightmare to do that so I think we’ll take our chances still with the 21^st. Don’t let that stop you from making it to the wedding though!

When I got dropped off from work down at the bottom of the hill Jimmy happened to be parked right there so I went ahead and hopped in his car with him and had him take me to the craft mall for some souvenir shopping for the misses and family. I guess most of it is junk but you have to bring back something when you go on a trip. So I walked around a few little shacks which of course all have the exact same thing and spent an unknown amount of money on things people probably won’t even want. Haha oh well there will be no fault for not trying. I also have planned to go on the 3 day safari trip to Murchison Falls starting Saturday so I’m pretty excited about that. Everybody I’ve talked to said its great and I will see a lot of animals and wildlife. Jimmy has never been but he said he’s seen some animals at the zoo near the airport. I don’t understand why you would go to the zoo when you live in Africa! Haha maybe they have raccoons, squirrels, and opossum in the zoo here. Personally, I think elephants, lions, hippos, and crocodiles are more fun.

Tennis and fajitas take 2

February 7, 2011

Interesting start to the day today. Dr. Stockley told me to go see a European guy who was admitted as an inpatient over the weekend for malaria. I went upstairs and looked at his chart and all the nursing notes since he was admitted kept saying how he was combative and pulling out his IV lines and catheters. He was sleeping so I didn’t bother with him but as I was leaving Dr. Stockley was walking up so I went back into the room with him. Right about then this wild animal got up out of bed butt naked and made a run for the door ripping his IV line out. The only thing that stopped him from running down the street or around the rest of the hospital was a Dr. Stockley tackle and the fact that his catheter bag was attached to the side of the bed…yeeeoooowwww. Anyway this guy was strong, delirious, and naked so it was hard (and weird) to wrestle him down to the bed. We needed a good amount of Valium and Haldol to put him back to sleep. Anyway I’m not sure his whole story but it was definitely interesting. It also got me thinking that he is the sort of guy I will probably see many times during my time in the emergency room. I better work on my tackling skills and start taking some punches to harden my jaw a bit if I’m going to be wrestling these drugged up animals. I also saw a chest x-ray and a positive sputum sample of a patient with tuberculosis which may be the first case of real active TB I have seen before.

Traffic home was terrible and it took at least an hour to get back. Probably had something to do with the fact everybody was stopping and lining the streets to listen to an election candidate give some sort of speech. Of course I couldn’t understand what he was saying but I’m betting it had to do with serving pizza during lunch everyday and making recess twice as long as normal. People always vote for strong platforms like that. By the way I didn’t mention there is an election on Friday the 18^th while I’m here. The president and the whole deal. Out of all the times I could be here somehow it turned out to be during February in an election year! As if there wasn’t enough excitement already, I may end up stuck in the middle of a political mess depending on what happens that day. I’ll talk more about it as it gets closer and I start to understand more of what is going on. Given what has been going on in Egypt and Sudan, I’d say there’s definitely more than a 0% chance of at least some tension no matter what happens in the presidential elections. I may have to stay home from work that day so I don’t have to drive around the city though.

I went back for Monday night tennis and played some more doubles before eating fajitas again. I knew I’d be back for them and it only took a day. I got a shower at the club also which is nice because we are still without running water. I heard that tomorrow we may finally have some so that we can actually take showers. Not having a shower is probably the worst part of this whole trip so far. That and trying to sleep in the heat which is what I’m going to attempt to do now…

By the way, loading pictures takes forever so I may have to just wait until I get home to post some. If I have some free time I will try to add some more to Facebook.

Super Bowl Sunday

February 6, 2011

I woke up today and went with Claire and some of the other housemates around 10 to the American Recreation Association (American Club) just down the hill from the house. This place is exactly where I need to be hanging out! There are 2 tennis courts, a weight room, swimming pool, restaurant, etc. We played tennis on the clay courts for a few hours and it was awesome. It’s been winter for a while now in Ohio so I haven’t played in a few months. Here it was 80 something degrees and sunny so it was perfect weather. So perfect that I burnt myself…my signature move. Not to worry though the progression goes from red to tan in no time. We played doubles which I don’t really like but we did have ball boys so that was cool. I still gathered a lot of my own balls though because I don’t really like to be waited on by other people. I guess I did pay him 2 dollars though so he was well compensated. Haha. I had a quick workout in the gym after that and then ate chicken fajitas from the restaurant. They were so delicious that I’m considering giving up cooking at the house and eating at the club every day. I’ve come a long way from my first day eating a borrowed sandwich that I had to put in the toaster to kill the ants that were crawling all over it to the fajita and bottled coke life. Why else would I leave the U.S. to come to another country if it wasn’t to hang out at a place called the American Club? Anyway it costs like 4 dollars to get in and with all that stuff I should probably go back more often. I got invited by another American from D.C. to come back tomorrow night for night tennis so we’ll see. I guess the only crazy thing about the American Club is that with the terrorist bombings last July in Kampala targeting Westerners, hanging out at a place with a giant sign outside that says American Recreation Association on it and filled with white people probably isn’t the best idea in the world. It has a pretty strong security force and is walled off though so I guess the risk is pretty low. And plus they have chicken fajitas! Risk vs. reward people!

I stopped at the store for bottled water after that and then walked home back up the hill to my place. There are always tons of people and motorcycles going up and down the street and I like to say hi to them. The African kids wave at me and call me Mzungu, which basically means “hey white person” and they get a big kick out of that. They are really cute. At the top of the hill I was met by a heard of about 30 cattle walking down the road. I was a little worried they were going to gore me with their huge horns until I realized a 7 year old was walking them down the hill alone. Haha. I wish I would’ve had the camera…maybe next time.

Yesterday (Saturday) I worked at the surgery from 8-6 and as it was the weekend and with less doctors on duty, I had a room to see my own patients. I basically saw them, ran them by Dr. Stockley and then proceeded to order labs or give them medications depending on what we talked about. If I’m right about what to do it’s basically like I do everything on my own and if I’m not quite right we talk about it and edit my plans accordingly. I’m not 100% right hardly ever though considering almost never do I have a potential list of diagnoses that includes schistosomiasis, amoeba, malaria, typhoid, Dengue fever, tuberculosis etc. With that being said, we still see people with strep throat, regular viruses, high blood pressure, diabetes, and other (to me) more common things. But I’m working on learning some of the tropical stuff and asking everybody if they’ve been spending time in Lake Victoria or rafting in the Nile lately. There was also a police officer in the waiting room holding his assault rifle and I was like please let me have this guy as a patient so I can see this gun more closely. Haha no dice!

I signed up for a 3-day safari for next weekend at one of the national parks but I haven’t gotten confirmation as to whether or not there is availability yet. I’ll go one way or another though because I’m not planning on coming here without seeing wild animals I can only see in the zoo back home or on Planet Earth. I’m going to try to also stream the Super Bowl tonight so I can watch but it starts at 2 a.m. local time so I may have to take a nap first in the evening in order to survive tomorrow at work.  

The Surgery

­­February 4, 2011

Looks like I’m a day behind already. Oops. I finally got a USB internet card for my computer though so I can finally use it where I’m staying. Makes life 100% better although the power is currently out again and the water tank is not yet fixed so we have no running water. I’ve had 1 shower out of a bucket of water thus far so I’m probably overdue at this point but with no power or running water at the moment, it makes things a little difficult. So anyway what I’ve been doing the past couple of days here…

Wednesday I didn’t do much but hang around the property and meet everybody who’s staying here which is something like 10 people total. They are all working on interesting projects, mostly for school. There’s one guy from Texas but most everybody else is European. They offer me to do different things with them but they all take the “boda bodas” or motorcycle taxis and I’m not so sure I’m up for that. Before I left the person in charge of my elective from OSU told me a University of Michigan student died here on the back of one a few months before I was to come. If I didn’t have a wedding to star in soon I may live a little more dangerously! Haha Kristen told me if I got hurt here and didn’t die she would finish me off when I get back so I’m trying to stay safe. Also, I actually saw one crash out the window on Wednesday while I was at The Surgery. 

Since that’s what I’m here for I should probably talk a little about it… It’s called The Surgery which for a while made no sense to me until I was reading this book on health care in which this man goes to a “surgery” in Britain. So it’s basically just the term the British use for a doctor’s office. Dr. Stockley, who started the place, is in fact British so it all makes sense now. Claire was also telling me he was in the Last King of Scotland also but I haven’t seen it so I can’t comment. Of course now I’ll watch it and see if I can find him when I get home.

Back to the hospital…It’s a fairly small place and everyday Jimmy takes me there he says, “Ah The Surgery, very small but very busy.” I got a tour on Wednesday (my first day) from one of the nurses. It’s mostly an outpatient clinic and is set up as a tri-level. The first floor is the reception desk and waiting area, the middle floor has a station for blood draws and other labs as well as the “ER” which is 2 beds in a room, and 3 inpatient beds. The bottom floor contains the exam rooms which are fairly spacious as well as the onsite laboratory. If you walk a few feet outside the ER there is a fairly state of the art x-ray machine and down the hill there is a café where I get to eat lunch for free. Boom! It has a lot of open doors and windows so I constantly enjoy the nice weather outside. I will post some pictures eventually or if I can’t I will bring them home so this all makes sense.

Anyway, Wednesday was my first day and I worked from 8-8. From 8-1 I tagged along with Dr. Conrad, one of the Ugandan doctors. He seemed rather young and is very nice. He’s a general practitioner so he doesn’t especially see the tropical medicine cases. We saw a girl with strep throat and did a decent amount of simple work and school physicals where they basically have no show they don’t have malaria, syphilis, or parasites. Of course just like anywhere else there is a form to fill out so in the end they were routine and not particularly exciting. Between patients we talked about medical school and the differences in the path to becoming a doctor in Uganda vs. the states.

After his meetings, Dr. Stockely started at 1 and I followed him for the rest of the day from 1-8. He’s the tropical medicine specialist so patients are specifically scheduled to see him vs. one of the general practitioners. Of course there is a decent amount of overlap between who sees who so we still saw general cases mixed in with tropical cases. Also like any doctor, if the person doesn’t have a complaint that specifically addresses their area of expertise, they get a little annoyed i.e. when Dr. Stockely sees a person who wants to talk about diabetes. Haha he still sees them though and has a pretty broad knowledge base. With him I saw a lot of cases of people with Bilharzia which is a parasite that enters the body as larvae through the skin when people go in the water and then becomes worms. Pretty much nearly everybody who lives here has that and amoeba in their poop. Not like they feel worms crawling around in their body or anything but it still creeps me out. Who knows, I probably already have it somehow! I may have to just flush the system out when I get back.

We saw a particularly interesting guy with charcot marie tooth, a nervous system disease that causes nerve damage and loss of sensation (maybe motor too, I have to look it up) that was affecting his legs. Bottom line, similar to diabetics, is that you lose feeling in your feet and then you get some sort of trauma that you never feel, which becomes infected all the while the person never knowing. So he literally had a whole the diameter of a pencil on the bottom of his foot which I put a probe in straight to the bone. Of course he doesn’t feel that either so he didn’t care. If nothing else, I guess it’s the best anesthesia. We did an x-ray to see if he had a bone infection on top of the soft tissue infection and Dr. Stockley pointed out all the previous fractures this guy had. Apparently back in the day, he broke all of his metatarsals on that same foot and had no idea. Theoretically though, unlike diabetics he shouldn’t have a difficulty with the actual process of healing so we packed the wound and he will be on antibiotics now. An interesting disease I may have seen a few times before at the OSU neurology clinic but I can’t remember for sure.

Anyway, that was roughly my first day and I can never write enough about what I am doing or seeing. Hopefully this gives you some idea and pictures will help it make sense once I take some. (I mean seriously, who wants to be the pale white guy walking around here with a camera?)

If anybody has any particular questions you can post comments or something and I can try to answer them further. Hopefully this isn’t too boring!  

Welcome to Uganda suckas

­­February 2, 2011

Nearly 19 hours, 3 planes, and multiple time zone changes later, I finally arrived in Entebbe, Uganda last night around 8 o’clock local time (noon back home). It was already dark so I didn’t get a great view of the country or Lake Victoria from the air but I was just happy to be out of the air and on firm ground. 

Getting my Visa was painless and once I sorted through tons of drivers at the airport I found Jimmy (my driver) holding a little sign that said “benjamin”. We loaded my bags and headed toward Kampala and my house for the next month. The drive took about 45 minutes and was stressful. People walking and biking, motorcycles, and cars all trying to share the mostly 2 lane streets and shoulders. Add in cars and motorcycles passing each other and people crossing the road whenever they want with poor visibility and you feel like you’re going to hit somebody or something any minute. It’s similar to how I feel when I’m driving around campus and it’s full of students. Not a relaxing drive. 

The drive felt more rural than city but there were stretches of small stores and markets still with a lot of people shopping. It was pretty humid and the whole drive smelled like a wet bonfire. It reminded me of working for the fire department and what a house that’s on fire smells like and the smell of my fire gear. What a sweet scent!

After getting my Visa and driving from the airport, it was close to 10 o’clock by time we actually got to the house. The power was out in the area so it was very dark and it was hard to get a feel for where we were or what the house looked like but it was off a bumpy dirt road and behind a locked gate. Henry, one of the security guards, opened the gate and showed me to my room once Jimmy left. 

My room is 1 of 4 individual rooms in a building separate from the main house. It’s about a 9’ x 9’ square with a door with padlock, window, bookshelf, desk, and twin bed with mosquito net. The bathroom and shower are in their own rooms at the end of the building. I did talk to Claire (the host) briefly before bed and she said there was no running water currently because the water tank was just repaired. The power also generously decided to come back on but I decided just to go to bed since I had been traveling so long. Claire and I also decided I would not go to the hospital until Thursday so I could spend Wednesday figuring things out around here.

I was a little worried about sleeping because of the 8 hour time difference and what was essentially trying to make my body go to sleep at 3 in the afternoon. Luckily one of my greatest skills is the ability to sleep and I had no problem falling asleep once I crawled under the mosquito net. However, between animal barking and howling, thunder and lighting (no rain), and eventually roosters and some other strange noises, it wasn’t the greatest sleep and I was looking forward to sunrise so I could wake up. I’m sure I will get used to all the noise and will sleep more soundly in the days to come. If I had a fan I would surely be in sleeping heaven!

Now that there’s daylight, it’s time to figure this place out a bit. I’m glad that I can still text and keep in touch with everybody although I think I may have to actually go somewhere to use the internet. Therefore, instead of not writing about what is going on I figured I would just write on my computer daily and post chunks whenever I have the internet.

I look forward to starting work at the hospital tomorrow and will hopefully have more interesting and exciting things to talk about! As a friend of mine always says, smell ya later!