Camino de Santiago Day Three

It was another predominantly road-based start today with a ride around the outskirts of Ponferrada before a short stop in the town itself next to another castle. Then on along smaller roads and tracks to Villafranca, with its great views over green valleys and wooded mountains, and a bustling market in the town square.


The afternoon was surprisingly energetic with a long ride along the old road to Herrerias, twisting and turning below the new A6 dual carriageway as it crossed between the hills above. I found myself pushing hard ahead of most of the group, with John, one of our older group members, for company. One of the reasons for cycling this week was that I was unfit after little exercise for several months following an ankle injury. It was slightly disconcerting to find it hard to keep up with someone over thirty years older than me, but I think John did a lot of cycling, and besides, the exercise was what I needed. The muscles were aching that evening though, as we stayed in a beautiful stone build hotel between the mountains.

Camino de Santiago Day Two

Today started with buying picnic food – empanadas (the local version of a pasty, with either meat or tuna), bread, cheese, and of course olive oil and wine! The cycling was notable for a long late morning ascent to the Monte de la Cruz de Ferro – at 1505m, the highest point of our ride. I’d stayed at the back for the first part of the morning, so by the time we started climbing I wasn’t near the head of the group. However this gave me the opportunity to branch off onto the off-road track rather than following the road up the mountain. Slightly more challenging ups and downs, and a good excuse for not being first to the top of the hill!


After a long rest and a prolonged picnic, the way down the other side was long and steep on roads that weren’t great. Still a good journey though, and fun around all the tight twists and bends. Pretty much the whole afternoon was downhill, ending in Molanaseca with a delightful hotel situated next to another pilgrim bridge. We were early enough to enjoy a walk around the village, followed by well earned beers outside in the shade before the sun went down. So many of the villages we passed through or stayed in had narrow streets with very few cars. They were quite delightful and picturesque, although also seeming slightly backward. It did make for a peaceful and bicycle-friendly route.

Camino de Santiago Day One

After an early breakfast we were away on the bikes soon after nine am. Our luggage would be taken by minivan between hotels on the route, so we travel light with, for me, a small rucksack containing water, first aid kit, small toolkit, and a lightweight rain jacket. It was surprisingly cold in the early morning shade of Leon, and our first stop was in the centre with a visit to the Cathedral. This was huge and fairly spectacular, but I did hope that this wasn’t to be the pattern for the whole week. I mean cathedrals are all very well, but I was there for the cycling!


There was quite a long stint alongside the roads on the way out of Leon, but the countryside soon appeared and it turned into a beautiful day of rural cycling along small roads and farm tracks. The group seemed to keep together fairly well, with no major problems with fast cyclists and slow ones. The most spectacular part of the journey was the entry to Orbigo over a long stone bridge of Roman origin, following which we lunched. Most of the restaurants along the way did “Pilgrim” menus which were three course meals with wine/water for a fixed price. It was much needed on this first day after cycling 35km, but I was slightly concerned that I might go home having put on weight should this pattern be repeated each day!


After lunch was a leisurely (thankfully, given my full stomach) ride to Astorga. Along the way was a drinks stop in the middle of nowhere at a building which turned out to be a bit of a commune. I found myself quite challenged by one young English girl there, who had been walking the Camino but had stopped there for three weeks – when I wasn’t particularly interested in seeing round the living quarters in this commune she had a bit of a go at me for not embracing the pilgrimage and seeing “the simple life”. Obviously at her age, she was on a significant personal journey, but she walked off before I could challenge her assumptions... I mean, I’ve done the whole long journey alone thing (climbing Kilimanjaro), and I’ve done the whole living simply thing (in rural Uganda), so it would be entirely appropriate at my age to enjoy a simple cycling holiday without being judged for it! However, the brief conversation did stay with me for several days, so I guess she was successful in making me think about what I was up to!


In Astorga we settled into another hotel before exploring the old town. The main architectural feature was a very Disney-esque palace designed by Gaudi from the 19th Century. If I’m not mistaken, the castles in Disneyland/world/etc were based on this design! Dinner, after evening drinks, was in a local restaurant notable for a delightful young waitress who had the biggest smile I’ve seen outside of Uganda, even if she spoke no English!

Camino de Santiago October 2011

Finding myself with a week of holiday in October, and with the Scottish weather rapidly turning Autumnal, I managed to be book a cycling holiday in Spain at relatively short notice. Cycling the Camino de Santiago from Leon to Santiago sounded worthwhile. The route would be on and off road along the pilgrim’s trail which has been followed for many hundred years. I actually hadn’t heard of it before, but it’s apparently one of the three great European Christian pilgrimages, along with the journey to Rome and the journey to Jerusalem. Some people would tell you that cycling rather than walking is cheating, but hey, I wanted some exercise and a cycling holiday – the fact that it’s along a pilgrim trail isn’t really important to me...

From the trip notes: “The Camino de Santiago de Compostela across northern Spain is one of the world’s oldest pilgrimage routes. For more than 1000 years pilgrims have made their way to Santiago and in 1987 it was declared the first European Culture Route. Also known as ‘The Way of St James’, it originated in the region of Galicia where the tomb of the Apostle James the Great was discovered in the 9th Century. The way is marked by the symbol of the Scallop Shell, typically found on the Galician shores, and the grooves in the shell that join together are said to represent the many different ways pilgrims travelled from to reach the tomb of Saint James....”

Easyjet actually did pretty well at getting me to Northern Spain via Stansted, along with my bag and my bicycle (considering the last Easyjet flight I went on lost my bag for five days on the way to a skiing holiday, this was great news). I even managed to watch most of the rugby world cup match with England losing to France in the quarter final while waiting between flights in Stansted. There turned out to be fifteen cyclists in our group – a good combination of single travellers and couples/friends. Unexpectedly, I appeared to be the youngest in the group – with a number of people in their forties, fifties and even sixties.

Saturday evening was a chance to get to know folks over a drink, and an evening meal of Tapas, in Leon. Bikes had been sorted out, and my bicycle put back together. With no idea of the likely fitness levels or cycling experience of my companions, the first day’s cycling was a little into the unknown, but the weather forecast suggested blue skies, sun and heat which boded well for a good trip.

Here I go again...

...looking forward to heading back to Uganda again in May. It was too long between my last visits, so I've managed to sort things out to head back only seven months after I was last there. Of course most of my time will be spent at Kiwoko Hospital, and I've already been asked to cover the surgical workload while one of the local surgeons has a holiday!

It'll be great to see friends again too - both those in Kiwoko, and an increasing number in Kampala and surrounds, ex-pat and Ugandan. I also have lots and lots of supplies to take out - its amazing how much gets thrown out from hospitals in the UK because it can't be used, yet its perfectly good stuff and can be so useful in Uganda. This time I have boxes and boxes of sutures, plus some more endoscopy equipment and attachments for patient-monitors. Fortunately KLM allow 2 large bags in the hold of the plane!

Less than three months to go!!!

Steve

Steve In Fife...

...should really become the new title for this blog. As of 1st November I have been a Consultant General Surgeon in the Kingdom. It’s been an interesting few months settling in and seeing how things work. I feel I’m starting to get a handle on some of the issues and difficulties that reaching Consultanthood brings, particularly in my new hospital. Although the good people of Fife might object, sometimes it does feel that I’ve swapped one Third World Hospital for another in terms of some of the pathology!

My new hospital covers a population about the same size as my Ugandan hospital – about 500,000. However, where in Uganda there are on average seven doctors to run the place, in Fife we have many, many more. In Uganda there were two of us surgeons – I am now part of a team of Eleven Consultants, Fourteen Middle-graders and Sixteen House Officers. And thats just in General Surgery – there are a whole lot of other surgeons looking after Vascular Surgery, Urology, Orthopaedics, ENT, Maxillo-Facial Surgery, Breast Surgery, and Plastic Surgery. And all of us are working full time for more than 48hrs a week...

I’ve been finding my niche within the unit too. I was appointed on the basis of being a very General Surgeon with a special interest in Laparoscopic (Keyhole) Surgery and plans to take on Thyroid Surgery too. While on call I’ll therefore take almost any emergency/urgent patient, but my non-emergency workload has been predominantly hernias, gallbladders, bottoms and bowel problems. I’ve managed to do some advanced laparoscopic work – doing clever things with stones in bile ducts, and I’ve finally found a patient to do some anti-reflux surgery on, an operation I trained hard to learn last year, and which I’ve not had the chance to perform in the last six months! As I’ve not done thyroid surgery for a few years, I’ve been getting some refresher training from the other Thyroid Surgeon in the hospital – It’ll need a few more cases before I’ll feel confident to get on by myself, but I’m slowly getting there.

On the non-surgical side of things, I’ve started to take on some of the role of looking after our juniors. This is mostly rota and admin stuff, but it’s important to look after the doctors of the future, and ensure they’re getting reasonable training. I’m also starting to get involved with some of the Endoscopy administration, which is perhaps unsurprising considering my involvement setting up the unit in Kiwoko Hospital, Uganda.

My endoscopy and theatre staff have been fantastic in collecting old equipment and supplies for Kiwoko. I have boxes and boxes of sutures, suction tubes, gloves and dressings that would all otherwise have been thrown out. They’re now at home filling a corner of my study until I can take them out to Africa with me. I’m planning to go back during some leave at the beginning of May – I think I’m being lined up to help out with the surgical work load at Kiwoko while another surgeon is away! Nothing like a good holiday for relaxation!

So it’ll be back to Steve In Africa soon! I just can’t stay away from my other home, and I’m looking forward to meeting all of my Ugandan family again. Come and visit me soon, either in Fife or Kiwoko – although preferably not on a professional basis!

Steve

I've got those post-African blues...

...now that I’m back again from Uganda after my all too brief visit over the last couple of weeks. As usual, I’m missing Kiwoko Hospital and all my Friends in Uganda greatly, and the grey, cold, damp Edinburgh autumn hasn’t been helping either. It took quite an effort to say goodbye to everyone again this time - almost a year since my last visit, and I hope it’ll not be quite so long next time before my next trip.

The Kiwoko Chase was the first highlight of my stay – the day after I arrived at Kiwoko. About 50 walkers and 80 runners took to the dirt roads around the hospital for a 16.5km race, for which I was Guest of Honour. As someone who doesn’t usually run (hill-walking and cycling are my usual activities) this was only the second time I’d run over 10km, and the heat of the morning, the sun beating down, and the altitude all combined to make it as touch a run as I remembered from my last “Chase” in 2007. I remember running up the kilometre long hill back into Kiwoko Town looking forward to turning right at the roundabout with only 500yds then left to run, and then finding out with disappointment that the route continued straight on through the town and back to the hospital by another route adding a km to the distance I was expecting! At least I was able to reach the end with enough energy left to deliver a speech and give out prizes later in the day. Many thanks to the many people who sponsored me to run – I’ve raised over £1500 for the work of Kiwoko Hospital – and there’s a link on this site if you’d still like to donate!

My busy weekend continued on the Sunday with a party and Official Opening for a Bakery which one of my friends had built. I’d helped support this venture financially, so again I was Guest of Honour! This event included a full Ugandan meal, various party games, and the obligatory speeches. Bosco John is an unusual Ugandan who manages to look forward beyond his next meal, and has provided for his family by building six rooms to rent on his property so he can get school fees for each of his six children. He currently bakes buns in a charcoal oven, but his new bakery will employ some local people as he trains them and then sends them out to sell the products. There’ll also be a small cafe which I suspect might get decent use from some of the many visitors to Kiwoko, hopefully as well as some of the locals!


Once the working week got started, it became apparent that I’d arrived in the middle of a hernia camp! Worldvision Uganda had arranged for about ninety of their children to get hernias and other minor surgical conditions fixed, and about fifteen children were arriving daily and getting operated on. We got a second operating table into the main theatre, and this allowed three of us to work on different kids simultaneously, with two of us together in the main room and a third in the minor theatre. I’d brought some oxygen sats probes with me which came in handy as it allowed us to monitor all three kids safely.


By the end of the week all the children had had their surgery and things quietened a bit. A friend from the UK is spending a year working as an anaesthetist in Kampala, and I was pleased to welcome her for a day to Kiwoko and show her round a rural mission hospital – I think it was an interesting and eye-opening experience for her, and fun for me to show-off my hospital! Lots of people visit Kiwoko for short periods of time, and get a variety of experiences, but its only by staying in one place for a number of months that you can really start to understand why things work the way they do in Uganda. There was a decent bunch of foreign students and other volunteers at Kiwoko while I was there, and I hope they got to experience some of the spirit of the place and the people who live and work there. I think many of them realised why I go back again and again...

My second weekend was spent visiting friends in Kampala. I took Mark and Helen out for dinner in a local Thai restaurant which was a novel experience for them. We were able to join up with my anaesthetist friend and her housemates to make it a very Western experience! I’d managed to plan meetings with Zai, Maureen and Christine on the Sunday, which although logistically complicated worked well, and I was taken to visit Maureen’s new hospital in Kampala. I sponsored her through her nursing training, and it’s really good to see her using the skills and qualifications she’s gained, and be so proud of what she’s accomplished. Emma, the other student I sponsored has also qualified, but is looking for work at the moment – she stayed on at Kiwoko to see me before heading back to her home in Kenya, hopefully to return soon when a job becomes available.

In so many ways I’m envious of my ex-pat friends at Kiwoko. Ken & Judith kindly let me stay in their spare room, and Rory, Denise & Gideon fed me well throughout my visit. It was so good to see them all again too. They get to stay in Kiwoko, and a large part of me would love to be back there more permanently. It seems that God currently wants me to stay in Scotland, however, as shortly before my holiday I had an interview for a job as Consultant Surgeon in Dunfermline, near Edinburgh, and was successful in getting what was my first choice of jobs in the UK. I complete my training at the end of this month, and it seems that I’ve been working towards this new job for the last thirteen years.


So I’ll be staying in central Scotland for the foreseeable future, although I’ll hopefully be able to visit my other home in Uganda frequently. Either way, I hope to see you soon...

Steve