Today I’m sitting in an internet café in Kampala, having left the hospital by matatu at 7.30 this morning. The matatu is the basic form of transport in Uganda – basically a 14 seater small minibus that stops and picks people up along the way. This morning’s was full – 22 people at one point, but also fast, and I arrived here in under 2 hours.
Its fairly surreal sitting here, having had a full English breakfast for brunch (in order to take advantage of the free wireless internet), in the middle of Kampla, in a café full of other ex-pats all sitting in front of laptops. I’ve just managed a fairly long conversation to the UK as mobile phone reception here is much more reliable than in Kiwoko. I think this country is full of contrasts, but there is certainly a big rich-poor divide, especially between the wealthy of Kampala and the rural poor of Kiwoko area.
Since I last updated, I’ve been fairly thrown into work in the hospital. Its been a bit like a constant week of emergency take back home – starting at 7.30am with a ward round, spending most of the day operating, and often not finishing until late evening. We don’t admit many patients to surgery – perhaps 5 per day – but most of them have such big pathology that we need to operate!
The theatre suite here is surprisingly well equipped – one major and one minor theatre, and there are anaesthetic technicians who look after that side of things (nominally overseen by the surgeon). A lot of stuff is under Local Anaesthetic, but we’ve used a lot of ketamine/diazepam (used for vetinary practice in the UK), and ether anaesthesia which appears to be very safe, even if it is flammable! The range of operations is huge too – most stuff this week has been hernias, large abdominal bowel tumours, and gynae ops, but we’ve also done a femoral nailing for a fracture that was sustained ten months ago. A couple of the big tumours were in 5 year olds – which is a little scary: fortunately I’m not the lead surgeon for those! Both have made good recoveries!
Last night I was on-call for the first time: basically the only doctor on for the whole hospital which involved paediatric admissions, neonatal ICU admissions, medical admissions, an obstetric emergency and one surgical patient! Its surprising how much stuff I can remember in order to cover this without too many problems, and the nursing staff are quite proactive. I think I’ll basically be on a one-in-three rota with the other two surgeons to cover a week of night-time surgical cover at a time, including one night on for the whole hospital during the week and the whole weekend including one night for everything. Then hopefully a couple of weeks without being disturbed overnight. The other medics cover the other nights, but need help for anything surgical – not reciprocated on the nights I’m on for the hospital, but I think they’ll help if I need them!
Its good to be off for the weekend. Tomorrow will be church in the morning (an English service), followed by relaxation – perhaps a bike ride in the local area. The local kids love seeing us “Muzungus” out on our bikes around their villages! They all come out and shout and wave. I don’t think they know how to say anything more in English than “Hey Muzungu, how are you? How are you?”.
I’ll also need to do some laundry – I haven’t yet got myself a housekeeper, but hopefully that will come soon. It seems strange to employ someone to do the washing-up, cleaning and laundry, but it provides valuable income for one of the locals – hopefully a win-win situation. The locals hold all doctors in quite high respect here too, so a doctor doing laundry isn’t really expected, and is thought to be very strange!
So after ten days here, so far so good! My house is comfortable, the locals friendly, the work busy but fun…. It should be a good year!
Steve
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