...which fortunately coincides with a period of less-intense activity for Kiwoko Hospital. Over the last week or so, the rainy season has begun – meaning that most days there has been a significant downpour. I’m not sure you could really count it as comparable to Scottish rain (although I believe April back home has been hot and dry!) because when it rains it really is a tropical deluge, but it seldom lasts longer than an hour, and the rest of the time its still pretty warm and sunny. The season is really good news for Uganda – it tops up water levels in our rain-water collectors, and allows the crops that have been planted over the last few weeks to start growing with a vengeance. For this Muzungu, it means slightly cooler nights allowing better sleep! All activity seems to stop during the rains, so it also means fewer patients…
Work has settled down into a fairly happy 7.30am-5.00pm routine, with enough time to take a lunch break. I’m still operating almost every day, but that’s shared with Dr Peter, and there aren’t lots of patients to see and sort out every morning. As a result of half-empty wards, we’re currently managing to redecorate each ward in turn by moving patients around. The old dirty walls and peeling paintwork are looking much fresher, cleaner and more hygienic, which has got to be good news for preventing post-op infections. I seem to be doing a steady stream of hernias and hydroceles at present, which is fairly relaxing as it’s within my normal range of operations. I’ve also had several Ugandan staff members approaching me surreptitiously to ask me to circumcise them. I think the main idea is that circumcision has been shown to dramatically reduce the incidence of HIV transmission, and so this has to be a good idea, even if as Christian staff members they are unlikely to be sleeping around anyway!
It has meant that I’ve had time to put together detailed plans for several of the activities that I want to do over the next few months. I’ve got a couple of research/audit studies sorted out, which hopefully I’ll be able to complete fairly easily. I’ve developed plans for introducing reflective learning through looking at our complications and deaths and discussing possible alternative management. I’ve also put together a fairly comprehensive trauma management course loosely based on the ATLS course that many UK doctors complete. The final stage of that may be introducing a “Resus” room for immediate care of critically ill or injured patients, but that will have to wait some further redevelopment of our buildings… although it is a definite possibility.
I’m also starting to get some thoughts together for some travelling – I’ve now been here three and a half months, so its about time I got to see some of the country. My current immediate plan is to get some white-water kayaking on the Nile in the next few weekends, and then I’ve thought about climbing Mount Elgon, abseiling the Sipi Falls, and chilling on the Ssese Islands. I will also hopefully have some visitors before too long, and will plan some safari trips and some white-water rafting with them! So if anyone wants to come and join me for a holiday…
However, the hospital will become busier soon, and unfortunately that’s likely to coincide with a period when we’ll be short of doctors. Our two Ugandan juniors are likely to move on in June – although the basic pay is slightly better here, there’s more opportunity for financial reward in Kampala medical practice. We’ll try to recruit some replacements, but its not easy to attract doctors into a rural area, once they’re used to the facilities available in the big city. I was updating my surgical logbook today, and reflecting on some of the stuff I was doing at the beginning of February when it was busy and I was on my own. I think all of the patients I agonised over and was scared to operate on did very well. There was my six-month old with bowel necrosis from an intussusception, who survived against most odds. There was a man who was very unwell with intestinal fistula who I was forced to operate on twice and who lost most of his weight, but recovered, healed and went home. There was another man with major intra-abdominal sepsis and likely fistula following someone else’s hernia repair who again I had to operate on, and who took some time to recover, but went home smiling!
It’s amazing to be privileged enough to be so involved with these patients lives, and to know that in some way I’ve been part of helping them get from near death to recovered – and humbling to realise that I’m sure I’ve only been a small part of that process. One of my wise friends from home related a story to me recently of how he’d advised a midwife friend at some point in the past that rather than delivering babies herself, she was really a trained assistant to Jesus! Looking back, I can very much empathise with this view of God-given work.
Its been great to get lots of news from home in the UK recently, although given the number of engagements among friends that have suddenly occurred, I think there must be something in the water… I’ll stick to my boiled and filtered bore-hole water here, thanks very much. But all stories of what folk are up to are most appreciated – do consider dropping me a letter or email! Steve Bennett, Kiwoko Hospital, PO Box 149, Luwero, Uganda!
One further point for prayer – in addition to losing some of our doctors, several of our nurses have recently departed for government jobs too. Please pray that we would be able to recruit more staff quickly, and also that more donors may be found to help provide finance for the hospital to be able to pay its staff a little more, which may aid in retention of current staff. And of course if you were willing to donate a little yourself, please visit www.fokh.org.uk to see how easiest to give.
God bless,
Steve
Friday 27 April 2007
Monday 16 April 2007
Working where the sun don't shine...
I’m on-call tonight for the hospital, and its not been outrageously busy so far – a young child with cerebral malaria causing fits and needing a blood transfusion, a fifteen year old with EMF (EndoMyocardial Fibrosis – an extremely rare condition in which children develop severe heart failure, and are admitted every few weeks to drain fluid which accumulates in their abdomens!), a young woman with pneumonia who is likely to also have HIV, an older child with diarrhoea, vomiting, cough and fever who is likely to also have cerebral malaria… Not too bad so far, but unfortunately I’m likely to be up through the night doing caesarean sections. There are two women in our labour ward who have been in labour for some time, but are not progressing. We’ll reassess both at 1am, but I suspect it may be a busy night in theatre! Well, I did warn you at the end of the last blog that I’d probably be a bit more medical this time!
The title refers to one aspect of my work here that is part of my normal repertoire! Yep, colorectal surgery! Our clinical officers (A&E doc or GP equivalent) don’t seem to be particularly good at diagnosing anal conditions, and I keep getting referred patients “Admit for Haemorrhoidectomy”, who actually have no such thing. In fact in the UK, we rarely operate on piles, as there are other less invasive treatments that usually work. However, I actually have yet to see a patient with decent piles here! The ones who are referred are suffering from a simple bit of excess skin (no treatment required), a small bruise or perianal haematoma (settles by itself), or an anal fissure (incredibly painful and usually treated with a special cream in the UK, but here requires a bit of a stretch!!!).
The difficulty I have is that I want to properly examine the patients, but it is difficult to see the lining of the tail end without the correct equipment. So, I have ordered a special tube and light called a sigmoidoscope, over the Internet that will hopefully be brought out to Uganda from the UK by one of our next visitors. I’m looking forward (perhaps that’s not quite what I mean) to being able to better diagnose and treat patients, and then also to educate the other docs and clinical officers on common colorectal conditions. I have some tutorials that I can use, and it’s good to have identified a simple difficulty/problem that I can easily sort out and train others in. After all, that’s a large part of why I’m here.
Can you tell I’m feeling well rested and cheerful after a good weekend off? Actually Saturday afternoon was quite exciting. I’d been in Kampala in the morning shopping for food, which was a surprisingly successful trip and I had a pretty full rucksack! On the way back in the matatu (share taxi-minibus) the heavens opened and we were completely deluged. Unfortunately I was sitting in the wrong seat and at one point had to get out into the rain to let someone else out, and boy was it wet rain! On this occasion I had to change at Luwero, the town on the main road after which its dirt road for 16km to Kiwoko. The next transport along was actually a car-taxi rather than a minibus matatu, so seven adults and four kids plus my rucksac piled into this rather small saloon car for the journey! I wouldn’t really have believed it possible to get so many people so far in so small a space! The exciting part of the journey was that every so often we would pull into the side of the road – to let a speeding rally car fly past! The “Pearl of Africa” Rally is on at the moment, and the stage for Saturday afternoon included the main road to Kiwoko. Of course, this being Africa, they didn’t close the road to traffic at all – that would spoil the fun of dodging other road users and pedestrians! However, for all those who have commented on my driving in the UK, I have now actually been on a rally drive course during a race…..and lived to tell the tale.
Anyway, I hope life is bright wherever you are reading this, and that you are enjoying what I’m told is unseasonably good weather in the UK. Apologies for any errors here – my mother had the kindness to write this week and tell me off for several spelling and grammatical mistakes in my writings…. And I can’t even use the excuse of typing in the dark any more!
Please keep Kiwoko hospital, its staff and patients in your prayers.
Steve
The title refers to one aspect of my work here that is part of my normal repertoire! Yep, colorectal surgery! Our clinical officers (A&E doc or GP equivalent) don’t seem to be particularly good at diagnosing anal conditions, and I keep getting referred patients “Admit for Haemorrhoidectomy”, who actually have no such thing. In fact in the UK, we rarely operate on piles, as there are other less invasive treatments that usually work. However, I actually have yet to see a patient with decent piles here! The ones who are referred are suffering from a simple bit of excess skin (no treatment required), a small bruise or perianal haematoma (settles by itself), or an anal fissure (incredibly painful and usually treated with a special cream in the UK, but here requires a bit of a stretch!!!).
The difficulty I have is that I want to properly examine the patients, but it is difficult to see the lining of the tail end without the correct equipment. So, I have ordered a special tube and light called a sigmoidoscope, over the Internet that will hopefully be brought out to Uganda from the UK by one of our next visitors. I’m looking forward (perhaps that’s not quite what I mean) to being able to better diagnose and treat patients, and then also to educate the other docs and clinical officers on common colorectal conditions. I have some tutorials that I can use, and it’s good to have identified a simple difficulty/problem that I can easily sort out and train others in. After all, that’s a large part of why I’m here.
Can you tell I’m feeling well rested and cheerful after a good weekend off? Actually Saturday afternoon was quite exciting. I’d been in Kampala in the morning shopping for food, which was a surprisingly successful trip and I had a pretty full rucksack! On the way back in the matatu (share taxi-minibus) the heavens opened and we were completely deluged. Unfortunately I was sitting in the wrong seat and at one point had to get out into the rain to let someone else out, and boy was it wet rain! On this occasion I had to change at Luwero, the town on the main road after which its dirt road for 16km to Kiwoko. The next transport along was actually a car-taxi rather than a minibus matatu, so seven adults and four kids plus my rucksac piled into this rather small saloon car for the journey! I wouldn’t really have believed it possible to get so many people so far in so small a space! The exciting part of the journey was that every so often we would pull into the side of the road – to let a speeding rally car fly past! The “Pearl of Africa” Rally is on at the moment, and the stage for Saturday afternoon included the main road to Kiwoko. Of course, this being Africa, they didn’t close the road to traffic at all – that would spoil the fun of dodging other road users and pedestrians! However, for all those who have commented on my driving in the UK, I have now actually been on a rally drive course during a race…..and lived to tell the tale.
Anyway, I hope life is bright wherever you are reading this, and that you are enjoying what I’m told is unseasonably good weather in the UK. Apologies for any errors here – my mother had the kindness to write this week and tell me off for several spelling and grammatical mistakes in my writings…. And I can’t even use the excuse of typing in the dark any more!
Please keep Kiwoko hospital, its staff and patients in your prayers.
Steve
Wednesday 11 April 2007
Frustrated...
It was going to happen sooner or later… At some point I was always going to get a bit frustrated at life in Uganda, compared with back home. This weekend was it, possibly the first time that I’ve felt a bit fed up! Fortunately it didn’t last long, and had an underlying cause. The couple of weeks since I last posted a blog have been very busy – apologies if you’ve been waiting for an update – and this combined with several poor nights of sleep managed to turn me grumpy!
So yesterday I was feeling a bit fed up. A bit isolated, miles from anywhere, with no personal means of transport; A little annoyed that I’d have to spend most of another Saturday travelling into Kampala to do some food shopping, carrying everything back in a matatu afterwards; Definitely annoyed at the kids who run around noisily outside all the time with no concept of allowing any privacy or any sense of what may be someone else’s garden; Very tired due to two hot nights with restless sleep and one night where the village disco was blaring music until 4am; Frustrated that all the things I’m planning to do and develop here at the hospital are taking a long time to sort out; Arrgghh – as you can probably see, I got a little overtired!
Fortuntately I was able to finish work on time yesterday, and got out on my bike for a ride around the local area. I can really recommend exercise as a good way of letting off steam, but riding around the local dirt roads and tracks, seeing the houses and the way people live, and being greeted by the children and adults alike, all brought home to me in so many ways just how much I have here compared with the rural population, and also reminding me why it is that I’m here, and who I’m here to help. The alteration in perspective was very welcome, and I arrived back after an hour very hot, tired and dusty, but also happier and more fulfilled. I just need to try and prevent it happening again now, or at least recognise it sooner.
There have been many good times here that I now remember fondly! The weekend before Easter was especially busy. I got to Kampala on Saturday morning to get a large car battery for emergency power, and had a particularly successful shopping trip – just because something is there one week is no guarantee that you’ll see it again for months! Then Saturday evening was party time at the Nurse training school. You may remember that the prize for the winning “house” at the sports day was a bull – well Saturday was the bull-party (nothing to do with a stag party in case you’re confused!). Being a Muzungu, I was of course one of the guests of honour (they are really into respect here – it goes both ways) and the party was fairly long and involved. We had games, dances, speeches, more dances, amazing barbequed bits of bull with roast potatoes, and a great time! I think the cultural thing here is to perform by putting on a tape/CD of some music you like, while singing/dancing along to it (a bit like Karaoke). For encouragement, other people then dance up to you from the audience, join you for a couple of minutes and then press a gift into your hand – a sweet, a coin or even a flower. One apparently popular girl had about ten different people giving her gifts all at the same time, or perhaps she was just so bad they wanted to make her feel better by encouraging her! After several hours of this I was ready to leave, but then they got on with the less formal part of the evening, and I was dragged up to dance for a while… I really wish I had more natural dance rhythm! The students all thought it was great of course (or perhaps they too were being polite!).
Then Palm Sunday was spent in one of the local churches, which was fairly lively and good fun, and humorous at the end when they had an auction of local market produce to raise funds – quite a surreal way of ending a church service! Then the afternoon and early evening was spent at the Training School “Easter Carol Service”. This turned out not to be half a dozen Easter songs, but in fact was a three hour Passion play put on by the students, interspersed by a dozen different Easter hymns. After the initial shock when (as of course a guest of honour) I was given the programme, it actually turned out to be a really good spectacle, with only a couple of dodgy theological moments! One memorable bit was after the crucifixion scene – cue darkness, thunder and lightning, with the devil running around going mad and celebrating. Of course we call it Good Friday because through that crucifixion, the devil didn’t gain a great victory but was in fact defeated….
I’ve then been on-call for surgery all week and weekend, hence the slightly run-down state by Easter Monday. I have at least found time to connect up my new emergency power supply to the house lighting system, so I now have electric light whenever the mains is off. I’ve also been getting a bit more involved with the musical side of our morning hospital meetings. Every morning we have fifteen minutes of sung praise and worship before a talk and prayers, which is a fantastic way of starting each day, recognising who ultimately is responsible for the work that will be done that day, and entrusting it all into God’s hands. I’ve been helping lead some of the singing, and have been slowly introducing a couple of newer songs. Everyone seems very enthusiastic, and this morning’s praise was especially good.
Next week I’m doing the talk on Friday morning. I’ve not been given a topic, so I’ll have to put something together myself. I’m actually a little apprehensive, as although I’m sure I’ll be able to stand up and say something, I think that the Ugandans working here perhaps have as much knowledge of God as I do, and put their faith into action much more readily, so I feel a little under-qualified to preach to them! I think some prayer of my own is required!
So no medical stuff to describe this week! Those of a squeamish nature will be grateful – those who love the gory detail will have to be patient until next time. Happy Easter, and God bless you.
Steve
So yesterday I was feeling a bit fed up. A bit isolated, miles from anywhere, with no personal means of transport; A little annoyed that I’d have to spend most of another Saturday travelling into Kampala to do some food shopping, carrying everything back in a matatu afterwards; Definitely annoyed at the kids who run around noisily outside all the time with no concept of allowing any privacy or any sense of what may be someone else’s garden; Very tired due to two hot nights with restless sleep and one night where the village disco was blaring music until 4am; Frustrated that all the things I’m planning to do and develop here at the hospital are taking a long time to sort out; Arrgghh – as you can probably see, I got a little overtired!
Fortuntately I was able to finish work on time yesterday, and got out on my bike for a ride around the local area. I can really recommend exercise as a good way of letting off steam, but riding around the local dirt roads and tracks, seeing the houses and the way people live, and being greeted by the children and adults alike, all brought home to me in so many ways just how much I have here compared with the rural population, and also reminding me why it is that I’m here, and who I’m here to help. The alteration in perspective was very welcome, and I arrived back after an hour very hot, tired and dusty, but also happier and more fulfilled. I just need to try and prevent it happening again now, or at least recognise it sooner.
There have been many good times here that I now remember fondly! The weekend before Easter was especially busy. I got to Kampala on Saturday morning to get a large car battery for emergency power, and had a particularly successful shopping trip – just because something is there one week is no guarantee that you’ll see it again for months! Then Saturday evening was party time at the Nurse training school. You may remember that the prize for the winning “house” at the sports day was a bull – well Saturday was the bull-party (nothing to do with a stag party in case you’re confused!). Being a Muzungu, I was of course one of the guests of honour (they are really into respect here – it goes both ways) and the party was fairly long and involved. We had games, dances, speeches, more dances, amazing barbequed bits of bull with roast potatoes, and a great time! I think the cultural thing here is to perform by putting on a tape/CD of some music you like, while singing/dancing along to it (a bit like Karaoke). For encouragement, other people then dance up to you from the audience, join you for a couple of minutes and then press a gift into your hand – a sweet, a coin or even a flower. One apparently popular girl had about ten different people giving her gifts all at the same time, or perhaps she was just so bad they wanted to make her feel better by encouraging her! After several hours of this I was ready to leave, but then they got on with the less formal part of the evening, and I was dragged up to dance for a while… I really wish I had more natural dance rhythm! The students all thought it was great of course (or perhaps they too were being polite!).
Then Palm Sunday was spent in one of the local churches, which was fairly lively and good fun, and humorous at the end when they had an auction of local market produce to raise funds – quite a surreal way of ending a church service! Then the afternoon and early evening was spent at the Training School “Easter Carol Service”. This turned out not to be half a dozen Easter songs, but in fact was a three hour Passion play put on by the students, interspersed by a dozen different Easter hymns. After the initial shock when (as of course a guest of honour) I was given the programme, it actually turned out to be a really good spectacle, with only a couple of dodgy theological moments! One memorable bit was after the crucifixion scene – cue darkness, thunder and lightning, with the devil running around going mad and celebrating. Of course we call it Good Friday because through that crucifixion, the devil didn’t gain a great victory but was in fact defeated….
I’ve then been on-call for surgery all week and weekend, hence the slightly run-down state by Easter Monday. I have at least found time to connect up my new emergency power supply to the house lighting system, so I now have electric light whenever the mains is off. I’ve also been getting a bit more involved with the musical side of our morning hospital meetings. Every morning we have fifteen minutes of sung praise and worship before a talk and prayers, which is a fantastic way of starting each day, recognising who ultimately is responsible for the work that will be done that day, and entrusting it all into God’s hands. I’ve been helping lead some of the singing, and have been slowly introducing a couple of newer songs. Everyone seems very enthusiastic, and this morning’s praise was especially good.
Next week I’m doing the talk on Friday morning. I’ve not been given a topic, so I’ll have to put something together myself. I’m actually a little apprehensive, as although I’m sure I’ll be able to stand up and say something, I think that the Ugandans working here perhaps have as much knowledge of God as I do, and put their faith into action much more readily, so I feel a little under-qualified to preach to them! I think some prayer of my own is required!
So no medical stuff to describe this week! Those of a squeamish nature will be grateful – those who love the gory detail will have to be patient until next time. Happy Easter, and God bless you.
Steve
Subscribe to:
Posts (Atom)