Tired but still standing!

Written 02/03/07

I haven’t managed to update this for a while – sorry if you’ve been waiting! What started off as a busy surgical workload has turned even busier over the last couple of weeks. I have been on-call for surgical emergencies for the last two weeks 24/7, and have been the only surgeon here for day-to-day work for the same time! Dr Raul is on holiday, and Dr Peter, our Ugandan Surgeon, has been away in Kampala while unwell. That has left me doing everything on my own!

I’ve been able to control the workload somewhat – getting started early in the morning is a good idea, and I’ve been trying to avoid operating too late into the evening. Fortunately the overnights have been alright (except for last Sunday night when I was on for the whole hospital and spent most of the night operating – three caesarean sections and an abdominal operation for obstructed bowel).

Dr Peter was supposed to be back yesterday, and I was expecting him to be able to work today, allowing me to get to Kampala for the day. I need more supplies, and am missing two weeks’ worth of emails! Unfortunately he didn’t make it back yesterday, so here I am, stuck in the hospital. I also didn’t sleep well last night – a combination of heat, thoughts about all the things I’ll not now get done today, the possible beginnings of a cold, and perhaps the Larium, which I’m taking for malaria prophylaxis.

I’ve had Larium twice before over the last ten years and not experienced any problems – there are reports of potential psychotic side effects. However, since being here, various people have said that they’ve had difficulty with insomnia because of Larium. I hope that’s not something that’s going to be a problem for me. Malaria prophylaxis is essential here given the high level of malaria-carrying mosquitoes, and Larium is certainly one of the best in terms of a once-weekly tablet with a good level of protection. If my blogs start showing signs of psychiatric tendencies (at least more than usual), please somebody let me know!

I’ve been managing a vast range of different types of surgery this week. In terms of UK specialities, I’ve been a General Surgeon, an Orthopaedic Surgeon, a Plastic Surgeon, a Urologist, an Ophthalmic Surgeon, a Vascular Surgeon and a Gynaecologist! Operations have ranged from hernias to burns to external fracture fixation, exenteration of an eye, several gynae abscesses and even repair of a major vein! Yesterday was a little disheartening – a 13 yr old with a large muscle tumour of her abdominal wall that was too big to remove and I could only biopsy. She is likely not to survive many months. There was also a man who had refused to seek treatment for an eye infection that had subsequently spread to his sinuses and into his brain. Although I drained the eye, he is unlikely to regain consciousness, and will die soon, I think.

On a lighter note, I now have a housekeeper – a girl who has just finished school and will be starting nursing college in September. My house is now very clean, and I no longer have to worry about hand washing of laundry (except for unmentionables which she won’t have to wash!). I’ll be teaching her how to cook some western-style dishes too, so I should get some decent food when I get back from the wards each evening. Its quite an odd concept, employing someone in this way, but for here its quite normal, doesn’t cost me very much, but gives someone a good paid job with a reasonable wage and is therefore supporting the local economy. I guess for us in the UK such a set-up has concerns about the abuses seen in for example America or South Africa in the past, but here things seem to work very amicably.

I think I’ll leave this blog entry here (and post it on the net when I can – hopefully I’ll get a day off during the week once Dr Peter’s back). I hope my frustration about being so busy the last couple of weeks doesn’t show too much! All-in-all, I’m really enjoying what I’m up to, and after all, the work is the reason I’m here! Many greetings to all back home… I hope February isn’t too cold!!!

Steve