I'm trying to think what I should write as an update in the short amount of time that I have to use the internet this morning. I'm borrowing someone's modem but the connection is really slow right now.
This past week has been a fairly good week for me. It's had its ups and downs but I have been feeling a little more settled as far as work and am starting to sense a bit more clarity concerning some potential areas I can focus on while I am here. I am thinking of spending more time in the nutrition unit where there are obviously children who are developmentally lagging and also kids with C.P. etc. I need to observe and find out more information related to needs around dysphagia and management of feeding. I think there is potential to have some useful input in this area. Tuesdays are almost totally consumed, at least the last couple weeks, with the C.P. clinic. It is rather exhausting, but good to have a lot of patients turning up. I may try to reserve Thursdays for going out in the field to assist with clinics.
We run clinics in surrounding villages/subcounties to assess the patients and refer either to Kumi hospital or other health clinics and hospitals for their various conditions. We typically end up bringing a Landcruiser full of patients back to the hospital with us. These clinics can be really interesting and useful as we are able to connect people to health services they need. However, often they are very long and draining days as well. This last Thursday we left around 9:00 and after we had dropped patients off and made a couple other stops it had been close to 3 hrs on the road---much of which are dirt roads with potholes. The clinic was only about 2 hrs itself but then we had to wait about 2 more hours for the eye Dr. to get through his patients before we could leave. We ended up getting home around 7:00pm. This past clinic though was a sad ending as we brought back a 12 year old girl who had been severely burned 3 yrs ago. I had never seen anything like what she had as her one arm had virtually 'grown'(you couldn't really even see much of her arm anymore) into the side of her body and she really only had function of her hand. Because of how the contractures were attaching her arm to her body her hand was restricted to about her chest level for use. Her other hand was also burned and basically just a stump. Her neck and ear were also burned. We were so hopeful that the plastic surgeon team currently working at the hospital (for a few more days) would be able to do something for her. We stopped by to see the surgeons that evening and unfortunately they said they wouldn't even attempt operating on her as it could likely make her have less functional use of her arm. She is such a lively and beautiful girl it was rather devestating to think she would have to continue life with this disfigurement. I don't think the Dr's had ever seen anything like this situation before. So... this girl and her father were sent back to their village the next morning, obviously very disappointed. Thankfully the other 3 plastics patients were good candidates for surgery.
Anyhow, I overall am feeling more settled and was also invited to the German nurse's home this past week and had a good visit with her and the 2 other German girls who are volunteering at the hospital for another 9 months or so. I have also been warmly welcomed by a couple of the younger local Dr's who also live here at the hospital, so its nice to have some friends already:) Speaking of which, one of the Dr's connected me with his IT friend on Thursday night (he came up from Kampala) to check out my computer. Unfortunately, it was not a straightforward process and he was up almost all night working on it...and still was not able to sort out the problem. He took it back to Kampala and I will try to go to Kampala early this week to pick it up. Apparently though it sounds like he has found the problem and fixed it so I'm praying that what he has done has resolved the issues. I'm hoping to buy a modem in Kampala when I pick up the computer and will then be able to access internet from home:) This has been an answer to prayer so thanks for praying!
I better sign off for now as someone else is wanting to take advantage of the internet before I have to give back the modem.
Will try to update again in a week or so!
Friday 23 October 2009
Friday 16 October 2009
Survived 7 Days!!
Today marks the completion of one week in Kumi Hospital. It feels like it has been closer to 2 weeks! I will try to summarize some of the highlights or at least my activities this past week, although, I am rather exhausted so I hope it is coherent. I finally got access to internet tonight around 10:00pm so figured I should take advantage of it and at least give a brief update. I'll start with technology or lack thereof.
The guesthouse where I am living does not have internet, so we mainly rely on borrowing a modem from one of the Dr's when we are able to, which so far seems to be for one evening a week. My computer has been acting up since England and also is not accepting the modem, so I have to wait until my housemate is done with her internet tasks so I can borrow her computer. On top of that we only have electricity from about 8;00 pm till 8;00 am, so the window of access for internet is rather brief.
Living- I am staying at a guesthouse on the hospital property (although it is about a 7 min walk to the hospital compound itself)--the grounds are quite large with a significant number of staff houses on it. I likely will stay at the guesthouse for the year. Food-One of the benefits is that we have our meals made for us--at least our dinners and on weekends lunch if we request it. The down side is that we don't have a stove so it's a bit difficult for me to cook for myself if I wanted to! The food has been good so far. I was especially relieved to discover that one of my current housemates is a vegetarian so we are enjoying a no meat, fish, or chicken diet. The ladies who cook are happy as it is less work for them. The first few days I was here we had a rather consistent diet of french fries, jipaties (?sp),rice, cooked cabbage, and some type of beans. For breakfast it's white bread and margarine/P.B. and maybe a boiled egg. I've managed to break my coffee addiction and now usually drink tea with sugar and milk in the mornings:) We recently requested more of an African diet and so yesterday we were pleased to find a local greens dish with rice on the menu. I am daily faced with the temptation to drink sodas as they are in constant supply in the guesthouse fridge for us to drink as well as very accessible and cheap at the little stores on the hospital site itself! Transportation- I am already missing have my independence with a set of wheels. For trips into Kumi town (about 15 min) depending how fast the driver is, we just take 'boda boda's' which are small motorbikes. We are picky with the drivers we go with though:) The dirt road is rather tretcherous (due to the number of pedestrians, cyclists, cars/trucks, and motorcycles all having to share space) and I hope I don't have to take the boda boda's in the dark too often. Showers- I'm getting used to cold showers again, often in candlelight. It's not too bad with the weather fairly warm out here but I still would rather have hot water if there was an option! Sleeping- I actually don't mind using a mosquito net as it does provide some sense of protection from whatever critters are sharing my room at night. Weather- so far it has been fairly mild in my opinion compared to what I'm used to in Ghana and the humidity is way less. However, apparently the hot season is still to come so I'll see how that is. We've had one really good rain storm which provided the best shower I've had since I arrived--great water pressure coming off the roof! Laundry- I have washed a few of my clothes but have a large laundry load to wash by hand and hang on the line this weekend. The ladies who work at the guesthouse will probably laugh at my weak attempt at scrubbing clothes if they see me!
Work- my hope of fitting in better with the culture here as far as my difficulty with punctuality was quickly dashed as the morning devotions at the hospital had already started when I arrived on Monday and it was not yet 8;00! However, I think other aspects of life here still are condusive to time challenged people like me;) I recieved a warm greeting.
Monday I spent a good part of the day with the physio from Holland who was just here for a few more days. He toured me around the hospital and we worked with some kids with CP, particpated in part of ward rounds-I had to excuse myself as I almost passed out for some reason!, we saw two patients who had had strokes, and did exercises with kids who have gluteal fibrosis. Gluteal fibrosis is very common here in children and is so sad. It is caused by quinine injections given for malaria that then affect the gluteal muscles. It is easily identified by asking a kid to squat and if they squat with their knees turned outward instead of the typical knees forward when squatting you know they have it. They end up having to do surgery on their bottoms to cut the muscle and it is really painful for the kids during recovery.
Tuesday I spent a good bit of the day with the local physio here working in the CP clinic. Saw some interesting patients and I realize I have to become more tough. I found it so hard to see the physios working on a girl's contractures while she cried in pain that I had to step out. So many kids' contractures are so severe because they haven't been managed properly for so long that it is incredibly painful for them at this stage to have therapy.
Wednesday I went out into the field with a CBR worker (community based rehabilitation worker) and a former physio from England (she is here till end of Nov but is not really doing physio work anymore) to follow up with some people in different villages. We picked up a goat to deliver to 2 sisters who are physically disabled (however, they are incredibly able!), and also assessed some more patients for coming to the hospital. We had a full truck of patients on the way back. This made for a rather long trip back as we had to stop to pick up food for them to take to the hospital etc. It was a long day with a lot of driving. I think we left around 10:00 am and got back after 7:00! We probably spent at least a good 4 hrs or more of that time driving.
Thursday we went to another town that again was a long way away -about 3 hrs to get there but that was with dropping off patients at various locations enroute. We were overwhelmed when we arrived in the village to see the number of people waiting outside.There were probably around 500 people gathered. We weren't sure how many were there for our clinic. Thankfully not all of them were there to see us but we did manage to screen 100 people who had various disabilities or health issues (mostly children) and referred a good number of them to health clinics or hospitals and then others were referred to come to Kumi hospital and some we took back with us to the hospital. It is quite the system. I had joined the outreach trip at the last minute and they were glad I had as we were able to form 3 separate stations to see the patients more efficiently. I was impressed with how well i.e. the physio and physio assistant can diagnose and identify various conditions. It was a good learning experience but I didn't feel too useful except for my writing ability! It was exciting though to be able to take some people back, especially those who require plastic surgery since there is a team of plastic surgeons coming on Friday. It was another long day as we got back after 6:00.
Friday I spent some time working with kids at the nutrition clinic trying to see where they were at as far as developmental milestones and trying to facilitate standing, rolling, more typical movements etc. I then joined the team that had arrived (15 people) in total from the UK to do plastic surgeries. There are 3 plastic surgeons as well as other medical professionals and a BBC photographer,journalist etc. It was interesting but sad to see all the horrific injuries, deformities, and various conditions that people have been living and suffering with. It was rather heartbreaking to see so many children in such challenging situations. The team will be here for 2 weeks doing surgeries and I am getting nervous about what this might mean for me as far as following these patients after skin grafts etc.
Anyhow, I know this is longwinded but seeing as I can't use internet too frequently you shouldn't get post every day at least:) I hope this gives those of you interested a bit more of an idea of life here. I still am trying to figure out how to structure my time and what my priorities are going to be as far as patient caseloads. There is a local OT who will be returning from vacation but I am unsure of how much teamwork there is going to be?
Prayer: please pray....
- for wisdom as I try to discern where my focus should be and plan how to use my time most effectively.
- development of good relationships with the other staff especially the rehab staff. It would be so beneficial if we could function as a cohesive team.
-for emotional and physical strength as I see a lot of suffering and pain in a very different context than I am used to
- for an ability to expand my knowledge and the skill base necessary to provide the needed interventions, and for confidence during this steep learning curve
-for people I can share with spiritually to encourage, challenge and support each other
-safety especially on the roads as apparently about 50% of patients seen are due to road related accidents!
-for someone who can help me with learning Ateso (one of the main local languages here)
-for direction in where to take my computer to get fixed! Likely will have to go to Kampala which is a 4 hr drive
Thank you for your support and I really value your prayers especially during this time of adjustment. I would love to post pics but have to wait until my computer problems are sorted out. The pictures will explain more than the above words can:)
More to follow....
The guesthouse where I am living does not have internet, so we mainly rely on borrowing a modem from one of the Dr's when we are able to, which so far seems to be for one evening a week. My computer has been acting up since England and also is not accepting the modem, so I have to wait until my housemate is done with her internet tasks so I can borrow her computer. On top of that we only have electricity from about 8;00 pm till 8;00 am, so the window of access for internet is rather brief.
Living- I am staying at a guesthouse on the hospital property (although it is about a 7 min walk to the hospital compound itself)--the grounds are quite large with a significant number of staff houses on it. I likely will stay at the guesthouse for the year. Food-One of the benefits is that we have our meals made for us--at least our dinners and on weekends lunch if we request it. The down side is that we don't have a stove so it's a bit difficult for me to cook for myself if I wanted to! The food has been good so far. I was especially relieved to discover that one of my current housemates is a vegetarian so we are enjoying a no meat, fish, or chicken diet. The ladies who cook are happy as it is less work for them. The first few days I was here we had a rather consistent diet of french fries, jipaties (?sp),rice, cooked cabbage, and some type of beans. For breakfast it's white bread and margarine/P.B. and maybe a boiled egg. I've managed to break my coffee addiction and now usually drink tea with sugar and milk in the mornings:) We recently requested more of an African diet and so yesterday we were pleased to find a local greens dish with rice on the menu. I am daily faced with the temptation to drink sodas as they are in constant supply in the guesthouse fridge for us to drink as well as very accessible and cheap at the little stores on the hospital site itself! Transportation- I am already missing have my independence with a set of wheels. For trips into Kumi town (about 15 min) depending how fast the driver is, we just take 'boda boda's' which are small motorbikes. We are picky with the drivers we go with though:) The dirt road is rather tretcherous (due to the number of pedestrians, cyclists, cars/trucks, and motorcycles all having to share space) and I hope I don't have to take the boda boda's in the dark too often. Showers- I'm getting used to cold showers again, often in candlelight. It's not too bad with the weather fairly warm out here but I still would rather have hot water if there was an option! Sleeping- I actually don't mind using a mosquito net as it does provide some sense of protection from whatever critters are sharing my room at night. Weather- so far it has been fairly mild in my opinion compared to what I'm used to in Ghana and the humidity is way less. However, apparently the hot season is still to come so I'll see how that is. We've had one really good rain storm which provided the best shower I've had since I arrived--great water pressure coming off the roof! Laundry- I have washed a few of my clothes but have a large laundry load to wash by hand and hang on the line this weekend. The ladies who work at the guesthouse will probably laugh at my weak attempt at scrubbing clothes if they see me!
Work- my hope of fitting in better with the culture here as far as my difficulty with punctuality was quickly dashed as the morning devotions at the hospital had already started when I arrived on Monday and it was not yet 8;00! However, I think other aspects of life here still are condusive to time challenged people like me;) I recieved a warm greeting.
Monday I spent a good part of the day with the physio from Holland who was just here for a few more days. He toured me around the hospital and we worked with some kids with CP, particpated in part of ward rounds-I had to excuse myself as I almost passed out for some reason!, we saw two patients who had had strokes, and did exercises with kids who have gluteal fibrosis. Gluteal fibrosis is very common here in children and is so sad. It is caused by quinine injections given for malaria that then affect the gluteal muscles. It is easily identified by asking a kid to squat and if they squat with their knees turned outward instead of the typical knees forward when squatting you know they have it. They end up having to do surgery on their bottoms to cut the muscle and it is really painful for the kids during recovery.
Tuesday I spent a good bit of the day with the local physio here working in the CP clinic. Saw some interesting patients and I realize I have to become more tough. I found it so hard to see the physios working on a girl's contractures while she cried in pain that I had to step out. So many kids' contractures are so severe because they haven't been managed properly for so long that it is incredibly painful for them at this stage to have therapy.
Wednesday I went out into the field with a CBR worker (community based rehabilitation worker) and a former physio from England (she is here till end of Nov but is not really doing physio work anymore) to follow up with some people in different villages. We picked up a goat to deliver to 2 sisters who are physically disabled (however, they are incredibly able!), and also assessed some more patients for coming to the hospital. We had a full truck of patients on the way back. This made for a rather long trip back as we had to stop to pick up food for them to take to the hospital etc. It was a long day with a lot of driving. I think we left around 10:00 am and got back after 7:00! We probably spent at least a good 4 hrs or more of that time driving.
Thursday we went to another town that again was a long way away -about 3 hrs to get there but that was with dropping off patients at various locations enroute. We were overwhelmed when we arrived in the village to see the number of people waiting outside.There were probably around 500 people gathered. We weren't sure how many were there for our clinic. Thankfully not all of them were there to see us but we did manage to screen 100 people who had various disabilities or health issues (mostly children) and referred a good number of them to health clinics or hospitals and then others were referred to come to Kumi hospital and some we took back with us to the hospital. It is quite the system. I had joined the outreach trip at the last minute and they were glad I had as we were able to form 3 separate stations to see the patients more efficiently. I was impressed with how well i.e. the physio and physio assistant can diagnose and identify various conditions. It was a good learning experience but I didn't feel too useful except for my writing ability! It was exciting though to be able to take some people back, especially those who require plastic surgery since there is a team of plastic surgeons coming on Friday. It was another long day as we got back after 6:00.
Friday I spent some time working with kids at the nutrition clinic trying to see where they were at as far as developmental milestones and trying to facilitate standing, rolling, more typical movements etc. I then joined the team that had arrived (15 people) in total from the UK to do plastic surgeries. There are 3 plastic surgeons as well as other medical professionals and a BBC photographer,journalist etc. It was interesting but sad to see all the horrific injuries, deformities, and various conditions that people have been living and suffering with. It was rather heartbreaking to see so many children in such challenging situations. The team will be here for 2 weeks doing surgeries and I am getting nervous about what this might mean for me as far as following these patients after skin grafts etc.
Anyhow, I know this is longwinded but seeing as I can't use internet too frequently you shouldn't get post every day at least:) I hope this gives those of you interested a bit more of an idea of life here. I still am trying to figure out how to structure my time and what my priorities are going to be as far as patient caseloads. There is a local OT who will be returning from vacation but I am unsure of how much teamwork there is going to be?
Prayer: please pray....
- for wisdom as I try to discern where my focus should be and plan how to use my time most effectively.
- development of good relationships with the other staff especially the rehab staff. It would be so beneficial if we could function as a cohesive team.
-for emotional and physical strength as I see a lot of suffering and pain in a very different context than I am used to
- for an ability to expand my knowledge and the skill base necessary to provide the needed interventions, and for confidence during this steep learning curve
-for people I can share with spiritually to encourage, challenge and support each other
-safety especially on the roads as apparently about 50% of patients seen are due to road related accidents!
-for someone who can help me with learning Ateso (one of the main local languages here)
-for direction in where to take my computer to get fixed! Likely will have to go to Kampala which is a 4 hr drive
Thank you for your support and I really value your prayers especially during this time of adjustment. I would love to post pics but have to wait until my computer problems are sorted out. The pictures will explain more than the above words can:)
More to follow....
Wednesday 7 October 2009
Getting over Jetlag!
I have started my journey towards Uganda. I arrived in England on Sunday and despite a rather challenging trip (trying to manage my 3 large suitcases) from Heathrow airport to my friend's place in Croydon, I did eventually arrive. I have been able to lay low and relax for a few days and am trying to get over jetlag. Thankfully, there is only a 2 hr time difference btw London and Uganda so I shouldn't have too much jetlag to fight!
I will be boarding my flight to Entebbe Uganda on Thursday evening and will arrive at 7:45 am in Entebbe. I have confirmation now that there will be someone to meet me at the airport:)
I will update you all when I am able to, but don't know how soon that will be...
I will be boarding my flight to Entebbe Uganda on Thursday evening and will arrive at 7:45 am in Entebbe. I have confirmation now that there will be someone to meet me at the airport:)
I will update you all when I am able to, but don't know how soon that will be...
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