Time Flies

February 15th, 2019 by ashleylutrick
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I cannot believe I have been here for three weeks already. It’s even harder to believe I only have one week left. The last 10 days or so has gone so incredibly fast. I have seen some quite interesting cases at The Surgery over the days, including a case of suspected pneumocystis jiroveci pneumonia in an untreated HIV positive patient and a case large bowel volvulus likely secondary to parasitic infection. I’ve been able to get my hands working with various procedures, which I have found extremely helpful in keeping up my skills. And although I can’t provide details, I even had a patient who works for one of the most iconic musicians of all time (at least in my mind). My patients have come from all over the world. It has taught me a lot about medicine in general, but also about culture.

Last weekend we took a little adventure to Jinja, about 2 hours east of Kampala. Jinja was much different than Kampala, being much smaller, with less people and beautiful nature. Our first day there, we rafted the Nile River, which was one of the most amazing experiences. I have to admit, there were areas that ramped up the adrenaline and I did feel what I can only describe as fear. Despite the anxiety, it was so worth it.

Our lodge while in Jinja was directly on the Nile, with a view that pictures just don’t do justice to. The camp was full of monkeys, and I mean full! From what I could tell there were 2-3 different species of monkeys, and approximately 30 spread all over camp.

Day two we started with a two-hour ATV tour of various villages in the Jinja area. As we drove through, you would see children running from their mud huts to the dirt pathway waving frantically and yelling, “Hello, Muzungu!” Muzungu translates to “white man,” though they seem to use it for any person who is not native to Uganda. They would reach out their fists for a “pound” with the largest smiles on their faces. Our tour also went along the Nile, where we saw various groups of fishermen, women washing their clothing, and children splashing along the riverbank.

The ATV ride left us covered and dirt. And what’s the best way to wash off dirt? Jump in the river of course! But what’s better than that? Rope swinging into the river. So that’s exactly what we did, and it was exhilarating. After rafting and swimming in the Nile, I most certainly have Bilharzia (discussed in a previous post). Good new is treatment is easy. šŸ˜‰

Before heading back to Kampala, we shopped at the local craft stores where we saw some amazing art, craft and clothing made by the locals. Part of me wishes I wasn’t traveling after my time here in Uganda so I could take back paintings – they really are gorgeous and capture Uganda perfectly in so many ways. I guess that just means I’ll have to come back someday.

The One That Keeps You Up

February 5th, 2019 by ashleylutrick
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When most people are asked why they decided to be a doctor, the answer almost always includes something along the lines of wanting to help people. And it’s true. At least it is for a majority of us, including me. As a doctor, patients come to you for solutions. They come to you to fix them. Well despite your best efforts, there are times you feel like your hands are tied.

I have been involved in a case over the last few days that has very much troubled me. A young village girl was involved in a terrible accident, secondary to a chronic medical issue, and suffered debilitating injury. As explained in my previous post, significant appearance differences can lead to banning from a village. This is exactly what happened in this young girl’s case, as her disfigurement was not socially accepted.

From her orphanage she received a sponsor, whom has been attempting to aid her in receiving treatment to correct her physical deformities. Unfortunately, she has been denied by the best surgeons in Uganda. Their only recommendation they can offer is a psychiatrist, ultimately to counsel her on acceptance of her appearance.

It breaks my heart to see such a young girl, scarred from a tragic accident due to a medical condition she couldn’t control. Words cannot describe the pain that was so evident in this girl’s eyes when we told her the surgeons denied her case. And what’s worse is it isn’t the physical pain that bothers her most, but instead is the social outcast she will inevitably face for the rest of her life.

I have been troubled for several days, racking my brain and consulting with more experienced mentors. In the end, we do have options, and I intend to carry through with doing whatever I can to help this patient. It will be a lengthy process, but I have hope and I have determination. Sometimes that’s all you need.

Beauty or Beast?

February 4th, 2019 by ashleylutrick
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Today, I saw what is possibly the most beautiful little boy I have ever seen. He was a young Ugandan boy with the purest blue eyes. They were a shade I’ve never seen, so light they were almost approaching white. I looked at him and said without thinking, “You have beautiful eyes.” He smiled, looked down and said, “Thank you.”

 

When he left I told the doctor they were the most beautiful eyes I’ve ever seen. His response was, “Are you sure?” When I said yes, again I was asked, “Do you think so?” I paused for a second, wondering if this was a trick question. Eventually, I answered and said yes.

 

I was then told a story of a young Ugandan girl from a village not far. A couple years ago she was to be sacrificed, as she had similar eyes to the beautiful boy I had seen today. The eyes were described as eyes of “devil speakers,” as they seemed to glow in the dark. They were thought to bring evil to the village, and therefore, not accepted. This girl was not sacrificed, though she was banned and sent to an orphanage where she was later adopted.

 

It is interesting, the two thought processes. Here I am admiring this boy for his rare genetics, while in the presence of a different culture he is feared for his beaming eyes. Is he a beauty, or is he a beast?

The Surgery

January 30th, 2019 by ashleylutrick
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Day 1 at The Surgery was busy. Walking into my first patient, I was handed a needle and asked to drain the patient’s left knee. Ten minutes, 50 cc’s of yellow fluid, and 40 mg of triamcinalone later, the patient was up and about his day. Patient number two: I was again handed a needle and ask to do a paracentesis for comfort of a man traveling to another country. Thirty minutes and 7.5 liters later, he too was up and on his way.

The rest of the day was sprinkled with a vast range of pathology. There were many patients with histories or active infection of bilharzia, a blood fluke I honestly had never heard of, until I looked it up and realized the name I learned it as was schistosomiasis. This particular parasite lives up to 15 years, some saying even longer, causing primarily non-specific fatigue, but can sometimes be more troublesome in unlucky patients. One couple, who were told they were both infertile, were seen at The Surgery and both treated for bilharzia after positive tests. Three months later, they return, and report they are 2 months pregnant. You have to wonder if bilharzia may have been the culprit to their unsuccessful attempts of pregnancy in the past. I find this parasite incredibly fascinating, and will definitely be researching it extensively this month.

The entire afternoon of my first day was spent doing medical examinations on Ugandans looking to contract with the United States Army. This was a very unique experience for many reasons that I won’t list here – mostly because I’m too lazy to type it out. I’ll discuss it with those who ask. šŸ˜‰

Overall, my first day was great. The hospital is very nice, having 7 consultation rooms, phlebotomy, nursing consultation, midwives, x-ray, ultrasound, pharmacy, an immunization clinic, and a small emergency department that includes a resuscitation room as well as a critical care room. They use part of the emergency department as a short stay unit, for patients requiring a few days of extended care, such as malaria treatment. Though malaria isn’t common in Kampala, it is in other parts of Uganda, and we did have one patient discharged today with a positive malaria test.


There isn’t air conditioning, but open windows and fans provide for some relief from the heat. It’s been about 70-80 degrees every day with a great amount of humidity.

At the hospital there are Ugandan ladies who make lunch for the hospital every day. This was my first experience having Ugandan food. I already forgot what they called each component, but it consisted of one of their most popular dishes that is made from plantains with a purple peanut sauce covering it. This was served with rice with beef and thin sauce, along with potato. I enjoyed experiencing a traditional meal.

Day 2 at The Surgery was very different than Day 1. The day was much slower, with fewer patients to see. I worked with a pediatrician so most of my patients were children. Thankfully, none were overly ill. Most patients had common illnesses I see commonly back in the States, but there was one particular patient with suspected glucose 6 phosphate deficiency, which I have only read about with books.

We left work around 4:00 and stopped by Acacia mall. The mall is very nice, with multiple stores, restaurants and a Cinemax. This is a higher end mall in Kampala, very different from the area we are staying in, so it was interesting to see the contrasting environments.

Once home, we made dinner and ate together with the other residents at Claire’s. It’s so amazing to be able to spend time with people from all over the world, discussing their reasons for travel, and hearing the stories they have to offer. Dessert was half a mango I bought from Jessica down the road. She is a lovely Ugandan with supposedly the best fruits around. I have been eating her baby bananas every morning for breakfast, and after this mango, I have to agree with the rumors. šŸ™‚

Makindye House

January 27th, 2019 by ashleylutrick
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Today is our first full day in Uganda. The journey here was taxing and stressful, particularly in Dubai, where my plane from NYC was delayed and I arrived at 9:07am when the doors to my plane to Entebbe were supposed to close at 9:05am. Luckily, they waited, and I made it just in time! Dani (my classmate) and I arrived yesterday afternoon around 2:00pm. It took some time to get our luggage, buy a SIM card and exchange money, but we eventually made it to Claire’s around 4:00pm. Claire is the owner of the Makindye House, which is an AirBnb. Claire has been the most welcoming of hosts. Her home is comfortable, with plenty of space and amenities, though some people may call it basic. She houses travelers from around the world, making this experience even more exciting. Everyone has amazing stories, and I could sit and talk with them for hours.

After getting settled, Dani and I walked down the hill to the market. It was about a 20 minute walk. Along the way we encountered a bull on the side of the road, grazing on the grasses, many Ugandan runners getting their daily exercise, and multiple ladies selling fruits and vegetables.

Although I was incredibly exhausted, I didn’t sleep the greatest last night. There are so many new sounds here. Many times I woke up to a barking dog, roosters crowing, birds calling, or the occasional footsteps of our night guard, Bosco. I ended up waking at 5:00am, laying in bed for hours until I decided to rise at 8:00am. It’s Sunday morning, so there are churches in session and I can hear their choirs singing from many directions.

I came to the back patio, and oh my goodness – it is so beautiful. The weather is perfect, approximately 65 degrees with the slightest of breezes. The back yard is so peaceful – green, with shading trees, a hammock, and flowers sprinkled everywhere. There are even fruit trees, including avocado and mango, and a garden that provides fresh salad for the house. There are even two sweet pups, Poppy and Kira, who (or is it whom?) are great company on this lovely morning.

The view is gorgeous. Through the trees you can see Entebbe upon a hill in the distance. Sitting on the back porch puts me in a peaceful state. Despite being in a foreign country, disconnected from friends and family, and without my luxuries of an American life, I feel calm.

Throughout the morning Claire, Josh, and a friend of Josh’s, Sarah, all joined me on the patio. They have been so welcoming and willing to help us adjust to our new environment. They’ve given us so many tips on how to acclimate including places to eat, shop, and how to get around. Boda Bodas are the easiest and most commonly used form of transportation here in Uganda. They are essentially motorcycles that weave in and out of traffic. To be honest, they scare me. Everyone seems to take them though, and their piece of advice is, “just wear a helmet.” We’ll see if a get the courage to take one eventually. I’ve heard with the traffic in Kampala it can take nearly 2 hours to get to the hospital via uber, while it’s only 20 minutes with a Boda. For now, we plan to use uber, but we’ll see how long it takes before we get sick of the traffic and face our fears on the Bodas.

I could go on and on. I cannot put into words how wonderful my first impression has been. We start working at The Surgery tomorrow, and I’m very much looking forward it.

The Start of a New Adventure

January 24th, 2019 by ashleylutrick
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Today is the day I embark on my international medicine experience in Uganda. The journey to Uganda is a long one…1 day, 5 hours, and 1 minute to be exact. I’m not entirely sure what to expect from this experience, but I plan on keeping an open mind, learning as much as I can, and take all the opportunities I can to experience the culture of the Ugandan natives. I will be working at The Surgery, located in the capital city of Kampala. I have reached out to my preceptor, and was granted permission to work within the emergency department during my rotation. For those who know me well, you can imagine how much I will be looking forward to this!

Though I am very much looking forward to my adventure, it’s been difficult to part with my life here in Phoenix. Not only will I miss my family, friends, and loving boyfriend, but saying goodbye to the fur babies, Mara and Pepper has been difficult as well. They haven’t left my side over the last couple days, especially Mara. It’s crazy how they somehow know I am leaving for a long period of time.

I’ll be honest, I’ve never started a blog before, so we’ll see how this transforms the more I post. I’m not sure what kind of connection I’ll have when I get there, but hopefully I’ll be able to keep up with regular posts, and can hopefully sneak a few pictures in here as well.

Thank you for those who follow along. It shall be a great adventure.

Introducing Myself

January 10th, 2019 by INMED
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Hello! My name is Ashley Lutrick. I am a student at A.T. Still University-KCOM, and Iā€™m starting my INMED service-learning experience at The Surgery in Uganda beginning in January ā€“ February 2019.