Welcome!

This blog originally started life on another website, but has been transferred here in its entirity. It charts my experiences during a year of working as a surgeon in Kiwoko Hospital, Uganda - a rural mission hospital in the middle of the infamous Luwero Triangle, devastated during the civil war of the 1980s.

You might need to read the blog entries from the beginning of 2007 to get a full understanding of life as a Developing World Surgeon. The more recent posts are some more infrequent reflections! Enjoy, Steve

Wednesday 18 July 2007

Surreal transportation...


I’ve just started back doing surgery at Kiwoko Hospital today, after having a fantastic holiday for the last couple of weeks. It was really great to take some time off and rest, but I also managed an amazing trip around the Ugandan countryside! I could probably write a novel about all the different experiences, but I’ll try and sort out a few thoughts into more manageable chunks of blog! My first thought is to try and explain some of the many ways I’ve found of getting around Uganda!

First off must come what Ugandans call a taxi (Kenyans call it a Matatu – it is probably best described as a share-taxi/minibus). I’ve mentioned a few of my taxi journeys in previous blogs, and after six months in Uganda I’m getting fairly used to the joys of this particular form of public transport. The taxi-parks in Uganda look like complete chaos at first glance, but there’s always a helpful Ugandan to point you in the direction of the minibus going to where you want to go. Then it’s a simple matter of squeezing in with whatever bags you have, and waiting until it’s full. Of course full is a relative term, but in Uganda it’s actually supposed to be illegal to have more than people on board than there are seats! A lot of the time, this is a fairly loose concept, and especially in rural areas where there are no police checks its really a factor of how many can possibly fit. I’ve had 27 people including the driver in one minibus with seats for 14 before!

However, we actually hired a small 4x4 for our week of travelling around the country, and this proved to be a very sensible idea. It meant we could go where we wanted, when we wanted, and therefore enabled quite a creative tour to be created. The 4x4 was very necessary after it had rained almost non-stop for two days, as the dirt road between Murchison Falls National Park resembled a mud-wrestling pit for much of its length. In fact, the most extreme driving conditions were actually found in Kampala at the start and end of our journeys! Driving in Kampala is really just a giant game of chicken… The person with right of way at any junction or roundabout (or even just pulling off from the side of the road) is the person who looks least likely to stop for anything! After carefully negotiating a couple of roundabouts at the start of my driving experience, I must have started getting a slightly crazed look about me – very few other vehicles got in my way, and we were able to get about in a reasonably civilised manner!

I’m sure I’ve mentioned the state of the roads in Uganda before. The main road to the North of the country is supposedly surfaced, but is covered in some of the deepest potholes I’ve seen. I think some of them would swallow a whole lorry if they got the chance. Driving is therefore a case of finding the safest route through/around/over them, usually by weaving all over the road and the verges, while simultaneously watching for on-coming traffic doing the same and keeping out of the way of the taxis or buses coming from behind on either side (I think taxis are much like company cars in the UK – able to drive through potholes/up kerbs without any apparent modification!). The road to Kiwoko Hospital has become very potholed itself, and could do with a re-grading of the murram surface, but is negotiable at a slow speed. The World Bank is financing a resurfacing of the Luwero-Gulu road which made our journey north a little slow as they seem to just plough whole of the previous surface up before attempting any levelling or tarmac, but I was surprised to find the main road to Masindi was mostly newly surfaced.

The most dramatic part of our drive occurred on the very good dirt road into Murchison Falls National park – 20 minutes in and I suddenly lost control of the car, swerving violently into the ditch on the left, then the ditch on the right before managing to come to a stop in the middle of the road. It’s only by the grace of God that the car didn’t overturn, and other than a small bruise on an elbow, nobody was injured! Imagine my surprise when I went to check on the car and found that one of the rear wheels was missing! The nuts securing the brake drum to the axel must have been loose, and had shaken off during the bumpy journey. The wheel was attached to the drum, and was fortunately retrieved from the middle of a field of maize by a couple of helpful locals. I managed to get everything back together as by taking the nuts attaching the spare wheel to the back of the vehicle we had almost enough to secure both brake drum and wheel to the axel! Fortunately the brakes themselves were undamaged.

In the same week we had a superb boat trip up the Nile to view lots of wildlife and the amazing Murchison Falls waterfall, and then at the end of the trip we went white water rafting near the source of the Nile, which turned out to be exhilarating, great fun, and not particularly scary at all! Its just as well that there are no crocs in that part of the Nile, as our guide took great pleasure in allowing us to tip upside down in several of the rapids!

No tour around Uganda would be complete without a game drive – and we managed a sunset trip around the new Kabwoya Wildlife Reserve in the company of the owner of the Lake Albert Safari Lodge who also runs the reserve itself. To complete our set of motorised transport in one week, there was the obligatory Boda-boda ride between the Bujugali Falls on the Nile and The Source of the Nile at Jinja. This is basically a back-seat ride on a 50cc motorbike, often reaching terrifying speeds and winding in and out of traffic and potholes with abandon!

Our list of crazy transport isn’t quite finished, as in the second week of holiday we managed a couple of bike rides in the area around Kiwoko Hospital. A trip to the local town and back was a bit of a warm up for the hot weather and dusty road conditions, and getting three pineapples at the market for the equivalent of 30p was a definite bonus! We also managed a two-hour ride into the unknown to visit some of our students who were on community placement. This involved mostly recently graded dirt roads, but included a couple of sections where the roads were being improved by having mounds of clay dumped on them randomly. I hope they’ll be graded at some point, but it was great fun hurtling downhill at high speed over the bumps!

The most surreal (although seemingly completely safe) journey was also by bike. We visited our friendly Ugandan family at their homestead and after much fun, hot tea and games, ended up cycling back to Kiwoko in the dark. It was interesting to be cycling along pitch-black roads, passing people and other bikes without any lights, and being overtaken by a couple of vehicles and boda-bodas, especially when we had only two lights among three of us! It was completely crazy really, but at the same time actually surprisingly straightforward.

Who would think so much fun could be have just by travelling?!!

Steve

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