Lugazi Week 8

Our final week! On Monday, we revisited the nearby city of Jinja with some of the Okadi family and Pastor Tom. Our main goals: visiting the ‘source’ of the river Nile and some shopping… African crafts can make for good presents and we wanted to pick up a few Ugandan woven baskets before leaving. Gorreti was a valuable asset in bargaining! On visiting the source we were horrified (but not surprised) at the difference between the Ugandan and ‘Other’ entrance fees. Despite being tempted to turn around, Sam came to the rescue with some expert haggling. After a short, hot walk, we found a pretty, clear view towards the ‘source’ and a few small islands where fishermen base themselves in straw huts when not in their boats -not a bad office apart from the threat of African river life…

Despite appearances, the orb spider is probably one of the more friendly river creatures…

We finished off the trip with some coffee, cake and card games. Later that evening we were party to another spontaneous ‘Okadi choir’ singing sesh. Just love the rich voices and effortless harmonies they can produce!

On Tuesday morning we had a meeting with Sister Mable who is the Kawolo nurse lead for outreach. We really wanted to increase communication between Kawolo and Living Water staff and also, clear up some issues to improve the service- hopefully this will be a positive step forward for the programme.

Bright and early on Wednesday morning we -along with David our clinical officer- were picked up by Zuzana and Barbora to go to their clinic in Buikwe. We were keen to have as many of the Living Water staff as possible visit the clinic to see how well our service could run in the future. Hopefully, it will provide some motivation for our staff and valuable links to other health centres. On arrival, we had time for tea and were treated to homemade pancakes with nutella -yum! Zuzana (not a morning person) had dragged herself out of bed at 6am to prepare these for us… We then went through to hear the morning education talk that the clinical officer was leading for the patients. We left David with the other clinical officer to go over day to day life at the clinic and Barbora took us to visit Buikwe hospital. It is a private set up but offers treatment for very reasonable rates and facilities are much of an improvement from the government-run Kawolo. The Slovakian nun, Sister Lowra, welcomed us for a tour around the hospital.

Despite limited resources, it was clean and well organised. Fortunately, we were able to re-donate some intensive care airway equipment that we couldn’t use at the clinic and the hospital staff were delighted to receive it.

Slovakian Sister Lowra (right) and Dr Katherine (centre) were very chuffed to receive the supplies on behalf of the hospital staff.

We then went back to the clinic to rescue David from the enthusiastic clinical officer amidst a heap of paperwork, said our goodbyes and boarded a bumpy taxi back to Lugazi.

David (centre) at the Buikwe clinic

On Thursday we worked desperately to try and wrap everything up -including a final crochet class with Edith. We were also invited to visit Milly, the clinic cook, at her house and had the opportunity to purchase some beautiful mats she had woven herself. We were humbled to see that her house was made up of one small general room with a tiny sleeping area attached.

Getting ready for a photo at home. Mama Milly and one of her grandson’s Juram.

There she looks after her three grandchildren by herself: two of whom are orphaned, while the other is also from a very difficult background. Despite having very little, she insisted on buying us a soda because in Uganda if you have visitors you must give them something to eat or drink. We had no choice but to graciously accept…

Friday came round too quickly and we spent the morning shopping at the market for lunch ingredients -a goodbye ‘British’ meal of pasta, vegetables and sauce. We were slightly concerned about cooking enough to satiate the Ugandan posho-primed bellies and happened to mention this to Sam. He was slightly alarmed that our offerings should constitute the whole lunch and quickly pointed out that Milly should most definitely cook something also. Ha –he was so right!

Lunch time!

We spent a couple of hours preparing and gathered everyone (and a few randoms) for the meal. It was well received and luckily the clinic was quiet so we could proceed with education session afterwards. Our admin lady Robinah managed to present this week, with some persuasion, and everyone discussed the topic well.

We further primed the staff for a ‘general goodbye’ meeting with pineapple and cakes but unfortunately, there was a delay as Pastor Sam was held up with other business. Time for some improvised Ceilidh dancing –which everyone found hilarious!

Time to Ceilidh!

After all the exertion, some staff members just couldn’t keep awake during the meeting… We had a quick round up of the past 2 months; comments on positive aspects of the clinic work; recapped future aims; and discussed areas that need more focus. Altogether it was a good meeting. After our goodbyes, we had to rush to Annette’s house as she insisted we come for dinner. What a spread she laid on for us!

Saturday was spent hand washing clothes, popping down to the clinic to finish off some work and make sure weekend staff were ok.

Robert ‘Keddy’ and his family who live in a room at the clinic. Saying goodbye is hard!

We also said our sad goodbyes to staff at Hallelujah supermarket. In the afternoon we managed do most of our packing and had the evening to enjoy the family’s company.

Raz finally finished her mat with Gorreti.

After lunch on Sunday there was quite a downcast atmosphere before we left and it really felt as though the family were sad to see us go. We were sad to leave -there is so much more to do! But perhaps we would have felt like that no matter how long we were there.

Saying goodbye. Most of the Okadi family & co (left to right): Pastor Sam, Hannah, Mama Gorreti, Benja, Dan, John, Pastor Tom, Paul & David.

Poor Gordon chose the very last day of our trip to succumb to Africa-belly. It was a bit touch and go but we made it to the airport with only one stop required!

Maybe two stops… We had to take a picture of this menu on the main road: Rolex in this instance is not a high quality timepiece but a chapati and egg (roll-eggs)!

When we finally stepped onto the British Airways flight it was like entering into a completely different world –almost like boarding a spaceship! Soon, we were zipping our way through the dark night under the stars, towards home and a land very different to the one we had just left. The flight probably wasn’t Gordon’s best ever but he made it back in one piece (albeit 5kg lighter than when he left two months ago)…

Finally, we have been back a few days now and it’s already been busy. Both of us have felt a strange mixture of feelings: cold; slightly unnerved by the lack of orange dust; pleased to be reunited with milk, Special-K, raw vegetables and our families; disgruntled with resuming UK life and the pace that western life demands; and a desire to maintain contact with Living Water and all the great people we met. What the future holds in store for us we cannot know but hopefully it includes the opportunity to visit Lugazi again one day!

Thank you to all those who have supported us on our trip and also to those who continue to support the Capstone program out in Uganda. Without regular UK funding, the projects in Lugazi would grind to a halt. The aim to achieve a self-sustaining future for the local people of Lugazi is more than admirable and having witnessed it first hand, we believe it cannot be allowed to fail.

If you like to find out more about our trip, ways in which you can help or simply to say hello and welcome back, we would love to hear from you.

For more details about the charity please visit: capstoneprojects.org.uk

Until next time…

Lots of love,

 

Gordon & Raz xx

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Lugazi week 7

Wow, only one week left! Another quick week has elapsed. Following our trip to Chilly Willy on Saturday, we had a busy day on Sunday.

In the morning Sam took us to church in the remote village of Busiba. The journey was a bit of an adventure as it had been raining all night and the hill up to the village had become a mud slide. We waited in trepidation at the bottom and watched as a truck became stuck several times before battling gravity and mud to reach the summit.

After a quick prayer at the bottom and some excellent rally driving skills from Sam, we also made it! We were welcomed to a lively gathering with good ole African drums and dancing.

‘Dancing’…

In the afternoon we made our last visit to the children’s home with boxes of shoes in tow. We had to give rounders a miss due to another downpour but it was just as well really as shoe fitting took quite some time! Turns out measuring feet with a ruler combined with buying shoes made in China, makes for some pretty inaccurate sizing. Despite being labelled with European sizes, the shoes were around 2 sizes smaller than size stated. Luckily we had bought extras! Everyone’s feet were suitably clad after a couple of chaotic hours –the kids and leaders were very chuffed.

Thank you so much for the donation we received to help with this! We had time for a couple of songs, soda and then home to collapse on the sofa.

Good to see that the Cub Scout poster is already looking well examined.

On Monday we had our last outreach clinic. We spent part of the morning making up medication prescribing cards for the staff to help with prescribing –especially for children.

It is quite difficult to make sure children receive the right doses of medication as currently only adult preparations are available for outreach. At the very least paracetamol needs to be available for children –we hope to ensure regular funding for this.

Tuesday was a computer day for Gordon and the secretary Robinah -they battled on despite power cuts what seemed like every five minutes! Raz spent the most part of the day organising the treatment room and drug cupboard with Mama Monika.

No steel trolley though. They are using a plastic chair for a sterile field area!

Fred had also finished the consultation room and we admired the new sink, tiled floor and fresh lick of paint -very satisfying to see!

On Wednesday morning we visited Kawolo to meet with the heads of the lab service to talk about issues surrounding processing of samples for an important HIV test (CD4 test). Some of our samples have either gone missing or not been processed over the past few months and we needed to get to the bottom of it. We talked over some issues and hopefully it will help to resolve the situation. The afternoon was spent tackling spreadsheets/doing some more filing education with the staff (alphabetical order is proving unexpectedly difficult to master) and making some more jewellery with Annette.

Fred -our builder friend.

After the paint dried, David moved to the new consultation room with a big grin on his face and all in all he is settling in well.

Generally, we have been trying to tie up loose ends and think about some last minute things we can do. Raz had another knitting session with Edith (Pastor Tom’s wife). We also had a surprise delivery. The lovely Slovaks, Zuzana and Barbora, dropped in a precious bunch of grapes for us. Sam had mentioned a longing to taste them again as the last time was 10 years ago in Scotland. We were asking the ladies if they knew where we could find them and lo and behold they surprised us by sourcing some from Kampala. You should have seen Sam’s face! He was like a 5 year old at Christmas. Although, somehow, we don’t think our UK kids would be quite so impressed by a bunch of grapes these days…

Other news from this week: Gordon tried his hand at milking one of the family cows!

He was successful but Raz found it amusing to see the thin stream of milk he coaxed out compared with the powerful jets the boys can manage. Raz continues to crochet and weave, going down a storm with the boys by making bible covers for them. Yesterday we were keen for a relaxing day and went to play some pool with the boys, followed by a jaunt up to the golf course with Zuzana and Barbora.

Couldn’t resist a tourist photo on the way to play pool…

We explored the beautiful gardens, an exotic Indian paradise and in complete contrast to Lugazi town –the Mehta family own the Sugar Corporation of Uganda for which Lugazi is famous.

Not quite sure if it’s friendly…

Today was a busy day with Easter celebrations –it’s almost a bigger deal here than Christmas and they have never heard of Easter eggs! A turkey was purchased in honour of the occasion. No popping down to Tesco for a chilled, prepared bird here. It was clucking around the yard last night awaiting its fate this morning….

Gordon was keen to learn the skill and was up at 6am to check out how it was done. Raz stayed in bed- she was already quite attached and had been making friends with it yesterday. Next stop was church and we went in style: dressed in traditional Ugandan dress. Gordon looked rather sharp in his ‘Kanzu’ (a long white man-dress) with suit jacket but Raz was rather less impressed with the sack like ‘Gomazi’ complete with peaked shoulders to rival any 80’s shoulder pads. Flattering -not.

Pastor Sam -looking good as always. Not so sure about the other two…

However, everyone was very impressed -so it was all good. After a huge lunch we rounded up everyone for the Easter egg hunt we had secretly prepared using imported mini eggs (via Drew). After a brief explanation of the relevance of eggs to Easter, a frantic search of the house ensued! Everyone seemed to really enjoy it and all the mini-egg packages were found successfully – even the one in the washing machine… Afterwards, Paul (one of Sam’s sons) took us on a long walk after the heat of the day had passed. We walked up to our golf club haunt but then he took us right round ‘Mehta-ville’: long lines of greenhouses where Mehta grows flowers for export –including tulips for the Netherlands; a staff village; lots of sugar plantations and the sugar factory itself. A good two hour leg stretch! The rest of the evening was spent playing some games and chilling with the family. The place is happily full with everyone back from school/uni for the holidays…

On that note it’s getting late and we had better sign off -early start tomorrow!

Happy Easter to you all.

Lots of love,

 

Gordon & Raz xx

Lugazi Week 6

What a busy week it was too. Our days at the clinic are now frequently stretching later and later in an effort to make the most of our time left in Uganda.

Monday saw the launch of our new records system. We explained the process of how the system should work to each member of staff and made posters which explained the rationale of filing in alphabetical order! We really take some things for granted at home. The staff have just about got to grips with filing, but it was a challenge trying to convince them that a year of birth (date of birth largely unknown amongst patients) instead of just writing the age on the front of the notes is a must!

New note system on the left, old on the right…

That said, some are very enthusiastic about it, which is encouraging. Fingers crossed the system will work after teething problems ironed out over the next couple of weeks.

In the afternoon we travelled a short distance from Lugazi to the village Nanyongo. It was a good team this week and we had clinical officer in training Dan Okadi (Pastor Sam’s son) to help us out. The heavy rains made uphill driving pretty interesting and we were glad to be under the shelter of the local church.

Wondering about the journey home in the rain…

It was from there that we treated all the people gathered inside whilst the storm began around us. Thankfully, after we had finished there was a brief pause in the weather to allow us to slip and slide back down to our vehicle (no Land Cruiser that day!).

Back to Lugazi

The next day we set off for Kampala with a mission to pick up our first free HIV order and new shoes for the Children’s Home. First stop though was the Ministry of Health compound to source some education material for the clinic. Situated in a relatively affluent part of the capital (we passed by many expensive SUVs and international associated agencies), we did our best to look purposeful as we passed through security at the main entrance –we had no idea where we were going! Once successfully inside we realised that there was no floor plan, instead, each part of the building was labelled A,B or C with corresponding floor numbers. A real rabbit warren. Keeping up our confidence we asked for a contact that Drew had thankfully emailed us. This allowed us to start 2 hours of running backwards and forwards, here, there, up and down… with some limited success. Finally, we were given contact details for the HIV administration/education department –outside the compound and about 200 metres down the road! It in itself was a mission to find as no sign nor plot number guided us but eventually we found it behind a big brown security gate. Our luck then improved as the people inside were very friendly and we left with a boot full of educational materials and promises to contact us for further staff training. With nowhere in sight for lunch we then went off to look at shoes in the city centre markets. After a nightmare of weaving through the traffic, ages of waiting behind badly parked trucks and taking the opportunity to buy some sugar cane out of the car window (for 25p!), we eventually found a parking space. On our way to Williams street we met a friend of Pastor Sam who quickly assured as that he knew the best placed to buy some shoes (we were after some strong sandals for the kids). What followed was a crazy chase through the winding, narrow streets, taking care to avoid the boda boda motorcycles and the mass of people carrying all sorts: big bags of sugar, telegraph long poles, furniture, boxes and more boxes… All the bustle, noise and smells were a real assault on the senses –it felt like a scene James Bond film as we hurried to keep up. Naturally, we did not find what we were looking for until we eventually made it back to Williams street –where we had originally been going! In an almost desperate state by this time we were so relieved to find a Chinese wholesaler and another lady who sold good quality individual shoes for a very reasonable price. On leaving we realised it was quarter past four and the medical warehouse closed at five! Another mad dash across the city and we eventually found the supply depot with a few minutes to spare –yet again without a signpost or even a sign on the building. Talk about a covert operation… There we met the interestingly named Polycarp who was in charge of issuing our HIV order. Two and a half hours later we were sitting in a roadside café finally eating lunch –it was getting dark! Tired and weary, we finally arrived back late to Lugazi but that fact couldn’t hide our delight at having had a very productive day. We all had smiles on our faces carrying the boxes into the clinic. Just about time to try some sugar cane and relax before bed.

Chilling with the boys after a long day in Kampala.

The next day everyone was pretty excited about our successful trip to Kampala. While we did not get all the laboratory supplies on our order, we now have 500 HIV testing kits to last for the next month and a half!

Finally we can begin offering free tests to everyone who comes to the clinic. It was so satisfying to place up our posters on the front door advertising free HIV services! There is so much still to do –this is only the beginning really.

We decided there was too much to do at the clinic this week and did not go up to the hospital. Most of the week was spent ironing out issues in the new filing system. Fred our handyman is back and making a great job of the new consultation room. The floor tiling is almost complete and we hope it will be ready by the middle of next week.

Fred (striped shirt) is really doing great work for us at the clinic.

The records room is finally pretty finished and has been kitted out in fancy purple (Raz’s favourite colour!) curtains to protect the files from dust.

We’ve also been running around doing various bits of clinic shopping. The challenges of Africa still amaze us though! We ordered an ink stamp for our new patient notebooks but, typically even this was not simple. Firstly, the man made an error in the first one, so had to remake it. Then on day 2 after it was made the wooden handle came off as he had only attached it with a nail. After subsequent trips backwards and forwards with it to him for the next 3 days, he finally told us that he needed to go to Kampala for a screw for it! Africa.

Raz also found some time for more clinic crafts! On Wednesday afternoon, she was furthering her paper bead education and had fun making some necklaces with Annette.

On Thursday, Pastor Tom’s wife, Edith, came for her first knitting lesson. We hope that she will soon start up a ladies church craft group.

Gordon had some further cooking experience on Thursday and pretty much made 20 odd chapatis himself -yum!

On Friday, the education afternoon was reasonably well attended. We even had a wee girl there who was a daughter of one of the nurses! She pottered over to see what was going on and was right into school mode. She found herself some paper and a pencil and diligently sat at the front to make notes on David’s presentation on ‘the sick child’. Too cute!

Today we were supposed to venture out with the Slovak ladies but exhaustion has caught up with us and instead we decided rest: do some simple chores, pop into the clinic to check the weekend staff were ok with filing and otherwise do nothing. Still, hopefully we will have time to meet the Slovak’s at the local restaurant Chilly Willy for some food and, of course, Ligretto!

Another week past and the count down has begun in earnest. Tomorrow we are due to make our last visit to the Children’s home and hope it is not too sad saying goodbye.

Until next time,

Lots of love,

 

Gordon & Raz xx

Lugazi Week 5

Glad to hear that Drew made it back ok, if only to start work on Monday morning –on a 9 day stretch in A&E, Manchester!

Monday and Tuesday passed pretty quickly this week. The plumber came to install a sink in the new consultation room, which involved digging an impressive trench in the clinic with a pick axe to lay new pipes –and he worked alone! He even found time to be involved in our animated discussion about translating the new HIV poster we had designed.

We made an English version too! Basically invites people to come for free HIV screening & care.

Gordon also had a bit of ‘Africa tummy’ over the two days but thankfully it didn’t amount to much – nothing that was beyond Raz’s excellent nursing skills!

After persistent nagging with many phone calls and emails between us, UPHSP/USAID and our clinic supply store –we finally have a real breakthrough. Following the official visit last week and all our communications, Living Water has finally been authorised to receive free HIV testing strips, laboratory/clinic supplies and staff training –hooray! Given the level of corruption in the supply chain, we are not sure how much we will receive but nevertheless, we placed a preliminary order and have been told that it can be picked up on Tuesday 8^th April. Moreover, our Midwife Dorothy has been able to go to Kampala for a five day HIV service update! Now that is FAST for Uganda and a real answer to prayer. Over the few weeks and months to come, we hope that the HIV service will grow significantly and even after we have left, that the staff can continue to push for what they are entitled too. It can be a really great service to the people of Lugazi, particularly as the only other service at Kawolo hospital is swamped with patients.

Speaking of Kowolo… we again made our visit to their HIV service for the Wednesday paediatric and parents day. Overwhelming is one word you could use, frustrating another. Patients often cannot afford follow up investigations that the Clinical Officers want to make. Imagine in Scotland being told that you were being referred, for example, for an ultrasound scan but that you would only be going if you could pay for it! Otherwise, it’s just tough luck and we will see you back at the clinic again in one month’s time with the same problem…

We also ‘met’ an interesting customer that day. Hearing a commotion outside a consultation room is never a good thing, particularly in Uganda, and when Gordon offered to help, the clinical officer said we had better wait in the room while he found out what was going on. After a few minutes of shuffling footsteps, the odd shout in Lugandan and the sound of furniture being dragged across the floor, it went quiet and we cautiously opened the door –a mistake. Immediately outside the door, a sweaty, crazed looking local was bouncing up and down on his backside. We had a fraction of a second to wonder what on earth was wrong with him, when he saw Gordon peering out and bizarrely shouted “White man! CHIPS!”. Although for some reason he couldn’t stand, the man promptly tried to push his way into our consultation room by thrusting his feet through the door and clawing at the door frame. We didn’t like that very much. Gordon and the nurses promptly disengaged his hands and feet before shutting the door firmly with their shoulders. After what seemed like a long time but can only have been less than a minute, the battering subsided. Had he gone –nope. Another minute, then silence. He was gone. We cautiously crept outside but now the atmosphere was much improved –the other nurses and patients had started about their business again. It wasn’t long before we saw the man lying semi-conscious on the floor just inside the hospital main entrance. What on earth had happened? The staff informed us that the man had been drinking the night before and had just gone out for a cross country running race, subsequently collapsing. He was being treated nearby for severe low blood sugar but rapidly became aggressive and combative –demanding chips! After visiting us, he had been dragged away by the psychiatric nurse and promptly beaten into submission. Incredible. His friends were now stuffing glucose powder into his mouth and we had to keep our distance to avoid ‘the Muzungus’ setting him off again. Only in Africa! Although the staff were soon laughing about the absurdity of the situation, we would lying if we said that our pulse rates had remained completely steady throughout. Despite how crazy it sounds, we were sadly reminded of scenes, especially in the UK, where alcohol and drug fuelled Friday and Saturday nights can often resemble a war zone in A&E –without the beatings from the staff though…

On Thursday we had a busy day procuring things for the clinic. After much debate we have decided on a records system and decided to take the plunge and buy what we need to start it up. Basically, every patient who attends the clinic will receive a small exercise book which will act as their medical records. The book will contain all their notes/results and details. However, this system will depend entirely on the efforts of the staff in keeping the records in alphabetical order to make sure they are found easily and used instead of being left to gather dust. Fingers crossed…

On Friday, Gordon turned 28! We arrived to the clinic at 8am sharp to take the first teaching session after our meeting last week. Disappointingly only one member of staff was there –we should have known. Africa time strikes again!

We decided to postpone teaching until 3pm when more people would be around and we left for a few hours some birthday celebrating. After an enjoyable walk up to the Mehta golf course, we had some sodas and Gordon played 9 holes –the green fee was only £2.50! Our caddy was helpful and Gordon managed not to lose too many balls despite not having played for a few years! The course was beautiful to walk round and we enjoyed relaxing with our books for a while afterwards.

Missing the ball in style…

Raz was pleased to see chickens clucking around on the course too! We returned and were pleased to see a few more staff around for teaching. It went down well and it was agreed that Friday afternoon was best. We have made a teaching rota with the staff so that everyone will take a turn to present a topic each week. Hopefully this will continue!

That afternoon, Raz also spent some time with Annette who manages the ladies microfinance scheme. To date the scheme has supported hundreds of ladies and provided loans to help them start small businesses. It has been successful despite a few who have not been able to pay the loan back but these are usually due to extreme circumstances. Otherwise Annette marches them down to the local police station! She also makes jewellery and tries to sell her colourful, hand made, paper bead creations when she can. It’s hard in Uganda though as people often don’t have the money to buy these things. Another group of women in the town have been successful with their jewellery company and using good management skills have established regular exports to the US. It would be great if a small opportunity could present itself for Annette. Raz had fun learning how to make paper beads too! All in all it’s been a crafty week with Pastor Sam’s wife teaching Raz how to weave a mat from dried palm leaves. It’s a work in progress!

Pastor’s family really pushed the boat out for a special birthday dinner for Gordon – 6 different items including both beans and meat (normally it’s one or the other). We were also really really touched when the boys got together to sing happy birthday and Gordon was presented with a heavy box containing a huge birthday cake! Needless to say, we have all ensured that none of it is wasted.

Saturday was a working day and we planned to see all of the children from the children’s home for basic health screening. The plan was that the younger ones were to arrive at 10am and the older kids at 2pm after school to avoid a bottle neck. Of course this did not happen and they all turned up en masse at 10.30. Apparently, they heard we were measuring for shoes and they didn’t want to risk missing out…… groan. So it was complete pandemonium for the whole day trying to shepherd excitable kids from one room to the next: they were tested for HIV/malaria; seen by one of us for a basic MOT; had their feet measured; and also received medications that they needed for free.

Captsone kids new records on the new records room shelves. How could that little pile cause so much chaos on Saturday?!

However, apparently this screening is not currently in the clinic’s budget! Many of them took it upon themselves to head back to the home before everything was completed. This meant that some of them had to come back again in the afternoon…. We eventually managed to shovel some rice down our throats about half past three. Poor Joshua the lab tech was completely snowed under, but he worked steadily and got through everyone – what a dude! “When are you taking me out for some chocolate?!” -he demanded at the end of the day.

We were tired but can’t complain, it’s still nowhere near a day in the NHS! We had a quick rest and then were welcomed at Pastor Tom and his wife Edith’s house for dinner. Raz really wanted to just go round and take Edith all the kindly donated needles and wool to set up a knitting group but of course they wanted to welcome us with a meal. There was a great spread and after there was just enough time to show Edith the goods before Sam started falling asleep. We have arranged another knitting time! Edith was really chuffed with everything, so thank you again ladies of Troon for your kind donations.

Today, we were taken out by one of our Slovak friends, Zuzana, and her visiting friend to Ssezebwe Falls. It’s so close to Lugazi yet most people we spoke to haven’t been there!

Tea!

Zuzana, expert haggler, got us through for ‘resident rates’ and we had a great hike past the gushing falls, through a huge tea plantation and up to a ruin of a house. The shell of the house had the most amazing views across the tea plantations and rolling green hills surrounding Lugazi. We explored the inside and found quite a European style of house complete with indoor bathroom and large fireplace. It must have been quite something when in use -quite sad it’s been left to languish, covered in graffiti.

We thought it would make quite a spectacular holiday home -people would snap up the opportunity to stay in a house with such a view! Zuzana had prepared a great picnic using some Slovakian supplies for our break at the top of the hill: crisps, oreos!!, pears and our first sandwich in 5 weeks! Afterwards, we enjoyed some fast paced Ligretto (see the entry from last week) before heading back. Happily tired, we are now enjoying a chilled evening and turning our thoughts to what will most likely be another very busy week…

Only three weeks to go –so much still to do!

Until next time,

Lots of love,

 

Gordon & Raz xx

 

Week 4 Lugazi

On Saturday we journeyed to Entebbe to collect Drew from the airport. On route, we stopped by the beachy shores of Lake Victoria to have a stroll and in the evening we found ourselves at a Chinese restaurant of all places for dinner. Never thought we’d be eating Chinese food in Uganda! We also were given our Ugandan names after 3 weeks of being here. Raz is Nambi and Gordon is Chinto. The story goes that Chinto was a village man with only one cow to his name. He admired Princess Nambi from afar and asked for her hand from the king. The king set him some tasks to face before he would hand over his daughter and clever Chinto succeeded. Apparently they were the Adam and Eve of the region and had many children…

The best taxi motto seen to date! A way of life for the Ugandans…

We were very happy to see Drew and despite his lack of sleep the poor guy was up and raring to go on Sunday morning. We really appreciated the chance to explore some new areas we had not yet had time for. First up was a trip to Lugazi’s very own golf course (owned by the very wealthy sugar entrepreneur Mr Mehta)! He has a huge estate with school, hospital, housing and golf course. It was good to stretch the legs and sit in the beautiful grounds with a cold soda –quite unlike anything we had experience so far. In the afternoon we went back to at the children’s home for a slightly less chaotic game of rounders!

Mr Mehta’s private viewing platform for the 1st hole tee!

T-shirts from Drew for the kids at the children’s home.

Monday looked to be a busy day with the USAID officials due to visit our clinic and go on the outreach. Of course things did not go quite to plan but worked out well in the end. We phoned to make sure they were on their way and received a text saying ‘today?’ So that was a good start haha! Luckily we persuaded them that indeed they should come as arranged. Meanwhile, we did a bit of cleaning and headed across the road for lunch. Before our food arrived we unexpectedly heard a crash from outside and people started screaming. The three of us rushed out to find that one of the wooden electricity pillars had fallen over onto the road with a heavily pregnant woman sprawled alongside. Some locals were already helping her up and into the clinic –only metres away. She had taken quite a knock to the head and there was already a rapidly swelling egg on her forehead. She was incredibly lucky not to have been killed outright. Fortunately, after we complete an initial assessment we found her to have little other injury. However, we were really concerned about her head injury. Again, sooo different to home where she would have been taken straight for a CT scan –our nearest one is in the capital city about 3 hours away! Moreover, our local hospital could offer no real benefit over our clinic. Instead we waited for her husband to arrive on motorcycle from her village ~20mins away. If she stayed with us there was a real risk she might die if there was any deterioration. We had no option but to refer her to the capital city, easier said than done when there is no ambulance or helicopter! We could only stress the importance of this to her family and hope that they were able to afford private transport. Thankfully, they were able to take her to Kampala for observation so least she would be near better resources in case of any problem. After that brief drama, the outreach ambulance arrived and also the USAID visitors – we still had to have lunch! We managed to whizz them round the clinic and address key issues of obtaining free HIV testing kits and some HIV training for the staff. Hopefully this will lead somewhere.

The fallen pole after being moved from the road -the base had rotted away!

We were quite late for outreach but in a way this was good as there was a crowd of patients waiting on arrival which demonstrated to our visitors the demand for our outreach program.

Outreach: week 4

We also encountered a bizarre case of an arrogant husband when faced with another pregnant patient –a 19 year old girl. Gordon was in with the nurse at the time doing antenatal checks when the patient removed a scarf from her left ankle revealing a hand sized full thickness burn. It was two months old and surrounded by infected, necrotic tissue –a horrible injury! She had received no medical attention for it. Nearly ready for delivery, she had been having fevers and showed signs of serious widespread infection. Incredibly her husband point blank refused to let us take her to hospital -despite explaining she could lose her leg, her life and possibly the baby! Our midwife finally persuaded/told him outright that we should take her. “He (the husband) probably won’t even visit her in hospital”, our midwife said sadly.

On our bumpy 40 minute ride home in the back of the Landcruiser, there were 12 people in total including: the patient, a stretcher and all our equipment …. Oh and the pastor who decided to jump in at the last minute to hitch a lift to Lugazi. As the thunder and lightening approached, poor Gordon was trying his best to keep his feet from landing in the sharps bin (unsealed of course), stop his head from banging off the roof and to not squish the life out of Raz who was jammed beside him. Altogether a pretty unique experience! Needless to say we were pretty pooped on Monday night.

On Tuesday we bashed out a few more issues at the clinic and Drew caught up with some of the staff on how they felt the clinic was running. Our new storeroom was completed and ready for the records thanks to Fred -the lovely reliable joiner. In the afternoon Drew took us for a little surprise trip. Our first outside Lugazi other than Kampala! We hitched in a crowded ‘taxi’ (9 seater minivan) to a nearby village and walked for 2km up into the Mereba rainforest. It was dense, lush and full of butterflies and as e arrived to the ‘Rainforest Lodge’ we were greeted by some red-tailed monkeys! After a delicious lunch in the peaceful yet deserted lodge, we explored the area before heading back. It was great to relax!

On Wednesday we visited the Slovak ladies’ HIV clinic in Buikwe. We were very impressed at what they have managed to do with the small space they have. It is so well organised and they do a lot for the community. The day we went they were holding an education day for new mothers. It was very inspiring and we saw how well a clinic could run with dedicated staff. The ladies told us it is still very hard work to keep motivation levels high and keep everything running smoothly.

Barbora and the kids!

We met some twins who were just a couple of months old. One was HIV+ve and one –ve. The difference in appearance was quite shocking. The little one with HIV had such a sunken, gaunt face with the tiniest frame in comparison to the healthy sibling. Apparently she had been close to death before the clinic saw her and now she is on correct treatment and improving. It just shows how ghastly the outcome is for HIV+ve babies if they are not cared for and given correct treatment. So many mothers are still in total denial of their condition, but it’s when their kids suffer for it that it really hurts. In the afternoon we visited Jinja with them (a main tourist destination and source of the river Nile).

Bungy jumping over the Nile with crocodiles -nah…

It’s an interesting old colonial city: some of the buildings have been renovated whilst others have become overgrown and lie in ruins. We were amazed at the number of resorts in town- we walked through one and it felt like ghost town invaded by incredibly cheeky monkeys. The Slovaks took us to their favourite view points, a restaurant and coffee stop! They also introduced us to a new and quite addictive card game called Ligretto –definitely an Ebay purchase when we return.

Ligretto.

Thursday and Friday were spent at clinic. The heat got to us a bit and we were reliant on many sodas to get us through our lethargy! Our first staff meeting on Friday afternoon was really good as there were lots of issues to discuss –it was also hilarious. It was due to start at 4pm so naturally that meant 5pm. It was all very formal and first everyone had to introduce themselves (even though we already knew each other), then there was a blessing, followed by an introduction, followed by a welcome for Drew, followed by a request for a greeting from Drew and finally an estimated end time had to be agreed. It was decided that the meeting should end in 35 mins (there were 7 objectives to cover on the board)….. we wrapped up three hours later at 7pm! Nevertheless, it was really useful and we managed to discuss some key areas of improvement for the clinic.

Finally, we drove to Kampala yesterday and Sam dropped the 3 of us off for a bit while he went to a wedding. The life of a pastor: about 5 wedding invitations a month and every time he goes he is expected to speak at some point in the proceedings! Again we were spoiled by Drew and had lunch at ‘The Lawns’ http://www.thelawns.co.ug. An interesting menu including ostrich meatballs and crocodile!

The Lawns menu (last page) -we could not resist a touristy photo!

Then it was time to drop Drew off at the airport, very sad to see him go but we had a great week and it was really lovely to see a bit more of the country.

Drew’s chance to catch up with friends ‘on both sides’ as they say in Uganda.

Our time is flying by and we are now over halfway.

Until next week,

Lots of love,

 

Gordon & Raz xx

Ps. Disaster has befallen the chickens. NO chicks left! Hole in wall discovered…. Local wild cat is prime chick murderer suspect! Raz is very sad.

 

Week 3 Lugazi

This week we have had the pleasure of meeting more of the Okadi family who had come home from various workplaces/school at the weekend. A very talented bunch, thankfully they were on hand to help us out with a Sunday afternoon visit to the children’s home. Sadly there is no green space so we all went on a short trip to the local school field to play various games including football, netball and rounders. Not surprisingly, all the children were super excited to be out of the home and keeping a game of rounders going was initially quite a challenge. Especially when everyone wanted to be in the batting team… Hats off to teachers! It was really good fun though and we enjoyed the opportunity to run off some of the excessive carb-loading. Even Pastor Sam joined in to try for a home run. Afterwards, it was back to the home for some more singing and crazy dancing -Uganda is not a place where you can be shy!

On Monday the outreach was based at the village of Kikuta. This time, we attempted to diplomatically tackle several issues: over-prescribing of medications (especially antibiotics); ensuring everyone is verbally offered HIV testing; drug dosing for children (they have no liquid medication which makes dosing for tiny children often not very accurate!); and time keeping. Africa time ensures that instead of leaving at 1pm for outreach, we end up leaving at 2.30pm but still finishing up at the same time which means a rush to see all the patients. There was some progress made but we get the feeling that it will take a looooonng time and a lot of patience to fully sort things out.

Wednesday was our first day at the HIV clinic at Kawolo hospital. For some reason we turned up at 8am sharp, as directed, only for the clinic to predictably start late -at 10am. Despite this being a week where they were running a special program of multiple, daily meetings on quality improvement, the usual weekly 500 odd patients were still scheduled for appointments…  The clinical officers (COs) shared a cramped room to see the 100+ patients in less than 5 hours. At times, this resulted in several consultations happening together in the same room.  There was hardly enough time to ask all the relevant routine questions, never mind deal with some of the serious medical issues these patients presented with. At one point, one of the COs disappeared to make his apologies for not attending a meeting and told us to carry on seeing patients. Ten minutes later we were faced with the issue of a patient needing to start on some pretty serious medication for HIV and we wondered where the CO had gone- he was having a speedy lunch! The staff did exceptionally well under dire circumstance. What could we do when faced with a possible febrile child but to laugh with disbelief when asked if we had brought a thermometer as the clinic did not have one. Further still, it wasn’t long before the CO was complaining that he was about to run out of patient note paper!  Not all doom and gloom, we saw some interesting clinical signs and made some really worthwhile contacts, particularly when it comes to further supporting our staff at Living Water clinic. Dorothy, our midwife, had some valuable experience in HIV counselling, which is done well at Kawolo and we hope that she will continue to be mentored by some staff there even when we are gone.

In other clinic work this week:  we have battled with a filing system that would strike fear into the hardiest NHS clerkess –who would have thought there could be so many surnames beginning with ‘N’; we began to think about compiling some community health education leaflets; prepared for our HIV service visit on Monday; started an audit; studied malaria through a microscope (we actually might have seen more than just a few coloured blobs!); and saw some general medical patients.

Outside of medicine, Sam’s daughter Irene, had us both on our feet in the living room one evening for Ugandan dancing (Maganda) and a drum lesson using an empty water container.  The hip-shake-ometer didn’t quite reach the colossal level of the Ugandans- we just don’t know how they do it! You-tube ‘Maganda dancing’ and see for yourself…

Last night we were honing our chapatti making skills, perhaps we can impress Drew with some Ugandan cooking. Talking of Ugandan cooking- we thought po-sho was bad but that was nothing compared to the sight that met us one day after work. We entered the yard to find a tray full of huge, dead, white ants. Gordon joked, ‘Ha, Raz, there’s our dinner’…. yep, so it was bound to happen at some point, but think this is the first time for both of us we have encountered insect delicacies on our travels. The locals lure the ants out of anthills at night with bright lights, catch them, dry them, fry them and then munch by the handful. We can eat almost anything but really can’t stomach the thought of a handful of bugs. Raz politely declined that one even before being offered to try!

Drew arrives in Entebbe late tomorrow night and we are really excited about going to meet him at the airport. It’s going to be a really busy week while he is here and hopefully we can make some real progress with a few things –particularly the HIV service. All being well, we will also find some time in the week to relax!

Until next week,

Lots of love,

Gordon & Raz xx

Ps. Chicken family update: after losing another two over last weekend, four chicks remain and are growing bigger by the day.

Week 2.5 Lugazi

Just a wee note to say that over the last two weeks, we have identified a few simple building/renovation projects that need funds to go ahead. These include shelving for a new medical records room (already 8 months overdue!); repainting and flooring of a second store room with lockable storage space for medical donations; and floor tiling for the new HIV consultation room. High quality durable tiling is especially important in the consultation room as standard concrete flooring has a very limited lifespan before cracking in the harsh African environment.

We now have a reliable, hard working builder but no capital with which to start building. ~1.9M Ugandan Shillings = £475 (including labour costs at fractional £60!)

In Uganda this means a long process before anything can be done and therefore will outside the time frame of our visit.

However, if you have been reading our blog and would like to help by making a one off donation, please contact us directly via email (g.smith.04@aberdeen.ac.uk); leaving a comment below; or by sending a private message to Gordon on Facebook.

Any help would be very much appreciated,

Love Gordon & Raz xx