...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
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