Today has been exhausting but good! We said goodbye to Amy, who has a couple of kids and a job and everything back in L.A. and so had to get back to her real life, and then went over to Ali's host house to pick her up and help her move into our house. Ali has had a bit of a rough experience with ELI so far. She arrived in Entebbe at 1am and wasn't collected by the ELI representative, so she just caught a matatu out to Iganga with the help of a friendly fellow traveler. Within a couple of days, another problem came up: $100 was stolen from her wallet while she was bathing, and the host family ended up accusing another ELI volunteer of taking it. Happily, we love Ali and have another room in our house for her, so our host family ok'd it and we moved her over here with us.
We also had to do laundry today, which would be really nice if there were a spot of shade to do it in, but as it is we have to sit in a concrete courtyard in sun, which has been pretty hot recently. Connor is the laundry-doing master- he has the physical strength and patience for it which I lack, so all I have to do is organize all of our clothes to be washed in order of whiteness to less-whiteness (because the water gets dirty pretty fast) and rinse them and hang them up to dry. Really, Connor has been so helpful on this trip- he's genuinely cheerful and selfless so much of the time- he's just a joy to travel with. I would go on, but everyone except for Connor's parents would probably find it irritating.
Wednesday, July 20, 2011
7/18/11
Four of us decided to spend our last morning in Sipi Falls on a coffee tour. Most of the coffee tours I've heard about from working at Lamill in L.A. involve tours of some major plantations, huge farms with a lot of equipment. In Sipi, which is on the Eastern side of Uganda, next to Kenya and Mount Elgon, the tours are pretty much given by individual families, who show you how they make coffee for themselves. The whole process was delightfully simple. I won't go into all the details, but the most interesting part for me was the end of the process- instead of selling the raw beans to a cooperative, they roast them and then grind them in to a fine powder themselves. This powder is what they consume as instant coffee- it's pretty good when it's fresh of the fire, but not as much when I have to drink it out of a tin weeks after it's been ground. This is why Ugandan coffee does quite well outside of the country, where it is properly roasted and brewed the way I like it, but Ugandan coffee in Uganda is a bit disappointing.
After the coffee tour, we all headed back to Iganga for another week of work. Connor and Ali and I will all try to work nights in maternity- we'll see how that goes!
After the coffee tour, we all headed back to Iganga for another week of work. Connor and Ali and I will all try to work nights in maternity- we'll see how that goes!
7/17/11
We went on another fantastic hike today, Sunday. We hired the same guide who took us last time, but Connor also wanted to abseil...
Digression: I have become so used to looking everything up on Wikipedia! None of us knew what abseiling was, and I actually assumed it must be spelled absailing- a quick search just now revealed that it's a German word. Anyway- it's just rappelling.
...so we left him on top of the 100 meter waterfall and then hustled down to watch him rappel off of it. I had initially been pretty excited about doing this also, but when they showed me the point from which the rappelling actually takes place, I again confronted my aversion to risk-taking. Also, I've always been pretty afraid of heights, and 100 meters is high enough that when we were standing at the bottom, Connor was a tiny little speck. He admitted to a little apprehension as he leaned back over the edge of the cliff, but he was rewarded by a really spectacular view of this waterfall, only twenty feet or so away, as he descended. From the bottom at least, the scale of his tiny human body against the cliff and the waterfall was pretty spectacular.
Conversations with our friends Anna, Ali, and Amy were really the highlight of the weekend for me. I feel very lucky to have met such wonderful people when I've moved around over the last few years, and have spent a lot of time recently thinking about all the people I love who live scattered far and wide. So it's almost bittersweet to make such good friends and then lose them immediately to distance. I know that I'm not the best at keeping in touch with people, but I hope that everyone I've neglected over the last few years knows that I don't forget friends, and that I'm thankful for them.
Digression: I have become so used to looking everything up on Wikipedia! None of us knew what abseiling was, and I actually assumed it must be spelled absailing- a quick search just now revealed that it's a German word. Anyway- it's just rappelling.
...so we left him on top of the 100 meter waterfall and then hustled down to watch him rappel off of it. I had initially been pretty excited about doing this also, but when they showed me the point from which the rappelling actually takes place, I again confronted my aversion to risk-taking. Also, I've always been pretty afraid of heights, and 100 meters is high enough that when we were standing at the bottom, Connor was a tiny little speck. He admitted to a little apprehension as he leaned back over the edge of the cliff, but he was rewarded by a really spectacular view of this waterfall, only twenty feet or so away, as he descended. From the bottom at least, the scale of his tiny human body against the cliff and the waterfall was pretty spectacular.
Conversations with our friends Anna, Ali, and Amy were really the highlight of the weekend for me. I feel very lucky to have met such wonderful people when I've moved around over the last few years, and have spent a lot of time recently thinking about all the people I love who live scattered far and wide. So it's almost bittersweet to make such good friends and then lose them immediately to distance. I know that I'm not the best at keeping in touch with people, but I hope that everyone I've neglected over the last few years knows that I don't forget friends, and that I'm thankful for them.
7/16/11
We headed out on Saturday morning to Sipi Falls with a few of our fellow volunteers and pretty much relived the weekend we had a couple of weekends before. We traveled by matatu to Mbale where we caught another one up to Sipi Falls. Happily, this time we didn't need to take a boda (motorcycle) up the mountain. I'm starting to appreciate that I really don't have very much of a thrill-seeking personality, but Connor does. I blame Dad's many hours in the trauma ward working on motorcycle crash victims and others, and then his dinner stories, through which I was convinced at a very young age that it's perfectly possible to be maimed or killed by doing stupid things. Happily, Connor doesn't do stupid things...but my tolerance is probably a bit lower than I would wish, and so there remains some small difference between his comfort with sky diving and motorcycle riding and such, and my desire to ride horses and rock climb. More on this in tomorrow's post, I'm sure.
Anyway! We made it to Sipi Falls and settled in at the Crow's Nest, a really rustic but comfortable group of cabins perched on some cliffs overlooking the falls. Our weekends have been more important to me than I could have guessed. At the more touristy places, kids are so much more accustomed to seeing white people that I can get away with waving and shouting "Hi!" to their calls of "Mzungu!!!"...walking anywhere in Iganga really does mean being tugged on and held onto by a number of four year olds and laughed at by the adults. It doesn't bother me nearly as much as some of the other volunteers, but it's enough that I'm kind of glad to get away for a day or two every week.
Anyway! We made it to Sipi Falls and settled in at the Crow's Nest, a really rustic but comfortable group of cabins perched on some cliffs overlooking the falls. Our weekends have been more important to me than I could have guessed. At the more touristy places, kids are so much more accustomed to seeing white people that I can get away with waving and shouting "Hi!" to their calls of "Mzungu!!!"...walking anywhere in Iganga really does mean being tugged on and held onto by a number of four year olds and laughed at by the adults. It doesn't bother me nearly as much as some of the other volunteers, but it's enough that I'm kind of glad to get away for a day or two every week.
Tuesday, July 19, 2011
7/11/11 - 7/15/11
Back to work in the hospital, it was a bit of a stressful week. We spent most of our time in the male ward learning more about tropical diseases, but the week just seemed harder than most for some reason.
Monday was very exciting, as they often are here- the surgeries that have kind of piled up over the weekend all got done, so I saw several C-sections, got to really assist one, we saw the craziest appendectomy ever (the appendix had grown to be literally about 8 or 10 inches long!), but none compared to this guy with horrible peritonitis. Peritonitis is basically when you have a generalized puss-y infection of your abdominal cavity. They cut him open and this incredibly foul smelling liquid puss just squirted out, having been building up pressure for who knows how long. They took out his guts, which were all lined in this yellow, bacteria-laden puss stuff, and basically just had to scrub his intestines clean bit by bit. They then, and this is absolutely terrible and tragic, washed his whole abdominal cavity out with tap water. Tap water which we don't even drink, it's so incredibly not sterile. I suppose they had no choice- they certainly don't have gallons of sterile saline sitting around- but it was tough to watch. He died on Tuesday.
We also met Johnny, another new volunteer (there have been quite a few recently!). He too is a med student, and will also be helping out at the hospital. We got to see Amy (the respiratory therapist) at work too, especially because the hospital got an oxygen tank over the weekend (WOOOO!)!! She really has saved some lives this week, it's been great to see.
In addition to all this, on Monday Anne Marie was patient advocate extraordinaire. Apparently exploding out of "getting acquainted with the hospital" mode and kicking into "get stuff done" mode, she got a found a patient with appendicitis who had been here for 2 days and got him actually scheduled for surgery (this was the crazy one you've just read about, in fact!); she found a little kid who had re-broken his leg which had been in traction for a month, and got an ortho consult, Xray, and got it re-set for him in three hours; in short, she made things happen. The patients really need someone who cares to come around, basically just doing rounds, and pushing things through hat have fallen through the cracks. It was great.
Wednesday, dear readers, your hero's health took a turn for the worse. As I lay in bed, all achy and sad, making the most of being sick and getting a day off to read, I realized that this could be Malaria - after all, two of our roommates had already contracted the super-easy-to-cure-but-only-if-you-get-treated disease. I got tested, but no, I was only milking a cold or something, so I happily went back to reading. Anne Marie stayed home to take care of me. Frankly, I kind of think we both just needed a day off.
Thursday and Friday I threw myself into a project - getting two oxygen concentrators they apparently have in a back corner of the maternity ward to work. Oxygen concentrators, as I'm sure my worthy readers have pieced together, are amazing machines that concentrate oxygen out of the air in real time, as a patient breathes- to about 95%, even, which would be outrageously useful for babies who've been in fetal distress. I was told that the machines, which were donated by the US, work but require a transformer to get the 240V here down to 120V (plus an adapter to get the plug to fit). In the operating theater, I found an old voltage stabilizer that did both of these things! But no fuse. So I began an epic search, all around Iganga, for a 10 amp fuse- a nothing part. But here in Uganda, there are no Home Depots or Lowes. There are tons of shacks, however, with "technicians" who have taken apart every piece of broken consumer electronics they can find and sell the working parts. Sadly, 10 amp fuses are pretty heavy duty, and are not found in VCRs.
But on Friday, after scouring for a few hours, I found a bona-fide electronics parts shop on the other end of town, run by this awesome Indian dude. He gave us some free 5 and 6 amp fuses to try, but we ended up just buying another voltage stabilizer from him. It was amazing how refreshing it was to feel like he wasn't a pushy salesman or trying to take advantage of us. It's definitely why we decided to buy this pretty expensive machine from him. That, plus the hospital does have two concentrators, so two voltage stabilizers makes sense.
But alas, it wasn't meant to be. The concentrators powered up but didn't work, and when I took them apart to see why, I found that both were missing the circuit board that controls them. I can only guess why this would be, but probably someone had plugged them directly into the 240V power here and they'd fried, and when a technician saw this took out the boards but couldn't replace them, as the manufacturer is somewhere in Idaho or something. I was very disheartened by this, but don't really know what I can do about it in the remaining two weeks we're working in the hospital.
Jenny also left Friday- sad.
We're going back to Sipi Falls this weekend, and are all super excited!
Monday was very exciting, as they often are here- the surgeries that have kind of piled up over the weekend all got done, so I saw several C-sections, got to really assist one, we saw the craziest appendectomy ever (the appendix had grown to be literally about 8 or 10 inches long!), but none compared to this guy with horrible peritonitis. Peritonitis is basically when you have a generalized puss-y infection of your abdominal cavity. They cut him open and this incredibly foul smelling liquid puss just squirted out, having been building up pressure for who knows how long. They took out his guts, which were all lined in this yellow, bacteria-laden puss stuff, and basically just had to scrub his intestines clean bit by bit. They then, and this is absolutely terrible and tragic, washed his whole abdominal cavity out with tap water. Tap water which we don't even drink, it's so incredibly not sterile. I suppose they had no choice- they certainly don't have gallons of sterile saline sitting around- but it was tough to watch. He died on Tuesday.
We also met Johnny, another new volunteer (there have been quite a few recently!). He too is a med student, and will also be helping out at the hospital. We got to see Amy (the respiratory therapist) at work too, especially because the hospital got an oxygen tank over the weekend (WOOOO!)!! She really has saved some lives this week, it's been great to see.
In addition to all this, on Monday Anne Marie was patient advocate extraordinaire. Apparently exploding out of "getting acquainted with the hospital" mode and kicking into "get stuff done" mode, she got a found a patient with appendicitis who had been here for 2 days and got him actually scheduled for surgery (this was the crazy one you've just read about, in fact!); she found a little kid who had re-broken his leg which had been in traction for a month, and got an ortho consult, Xray, and got it re-set for him in three hours; in short, she made things happen. The patients really need someone who cares to come around, basically just doing rounds, and pushing things through hat have fallen through the cracks. It was great.
Wednesday, dear readers, your hero's health took a turn for the worse. As I lay in bed, all achy and sad, making the most of being sick and getting a day off to read, I realized that this could be Malaria - after all, two of our roommates had already contracted the super-easy-to-cure-but-only-if-you-get-treated disease. I got tested, but no, I was only milking a cold or something, so I happily went back to reading. Anne Marie stayed home to take care of me. Frankly, I kind of think we both just needed a day off.
Thursday and Friday I threw myself into a project - getting two oxygen concentrators they apparently have in a back corner of the maternity ward to work. Oxygen concentrators, as I'm sure my worthy readers have pieced together, are amazing machines that concentrate oxygen out of the air in real time, as a patient breathes- to about 95%, even, which would be outrageously useful for babies who've been in fetal distress. I was told that the machines, which were donated by the US, work but require a transformer to get the 240V here down to 120V (plus an adapter to get the plug to fit). In the operating theater, I found an old voltage stabilizer that did both of these things! But no fuse. So I began an epic search, all around Iganga, for a 10 amp fuse- a nothing part. But here in Uganda, there are no Home Depots or Lowes. There are tons of shacks, however, with "technicians" who have taken apart every piece of broken consumer electronics they can find and sell the working parts. Sadly, 10 amp fuses are pretty heavy duty, and are not found in VCRs.
But on Friday, after scouring for a few hours, I found a bona-fide electronics parts shop on the other end of town, run by this awesome Indian dude. He gave us some free 5 and 6 amp fuses to try, but we ended up just buying another voltage stabilizer from him. It was amazing how refreshing it was to feel like he wasn't a pushy salesman or trying to take advantage of us. It's definitely why we decided to buy this pretty expensive machine from him. That, plus the hospital does have two concentrators, so two voltage stabilizers makes sense.
But alas, it wasn't meant to be. The concentrators powered up but didn't work, and when I took them apart to see why, I found that both were missing the circuit board that controls them. I can only guess why this would be, but probably someone had plugged them directly into the 240V power here and they'd fried, and when a technician saw this took out the boards but couldn't replace them, as the manufacturer is somewhere in Idaho or something. I was very disheartened by this, but don't really know what I can do about it in the remaining two weeks we're working in the hospital.
Jenny also left Friday- sad.
We're going back to Sipi Falls this weekend, and are all super excited!
7/10/11
I had a bad day on Sunday. One of the guys we know in Jinja, Chris, is a pretty cool English guy who's living here indefinitely to help start and run an orphanage. He's pretty tech savvy too, and offered for me to come over in the morning for an hour or so, so he could help me jailbreak and unlock my iPhone. I wanted to do this because then it could work on MTN's local network here, so we could make calls on it and stuff, which sounded cool. Plus, data usage through MTN is very cheap, and we'd then. Be able to check our email and the news from home- very convenient, right? It was the perfect plan.
But alas, four hours later, my hoped had gone from "turn my iPhone into something better than it is" to "get my iPhone working again" to "get the hell out of here, bricked iPhone be damned, I am so frustrated right now." So without going into the boring technical reasons it didn't work, alas, my beloved iPhone now doesn't turn on. I'll be able to fix it when I get back to the US, but for now it is dead. RIP for now, beloved friend.
My mood further deteriorated when I learned that bungee jumping over the Nile costed $95, not $60, because they'd raised the price 5 days ago and no, they couldn't give a discount because I'd heard the old price... so no bungee jump. Sigh.
However, Anne Marie and the girls had a great morning shopping and seeing the sights of Jinja-town, and after a tasty lunch together we headed back to Iganga, spirits high again and enjoying the company of our new friends!
But alas, four hours later, my hoped had gone from "turn my iPhone into something better than it is" to "get my iPhone working again" to "get the hell out of here, bricked iPhone be damned, I am so frustrated right now." So without going into the boring technical reasons it didn't work, alas, my beloved iPhone now doesn't turn on. I'll be able to fix it when I get back to the US, but for now it is dead. RIP for now, beloved friend.
My mood further deteriorated when I learned that bungee jumping over the Nile costed $95, not $60, because they'd raised the price 5 days ago and no, they couldn't give a discount because I'd heard the old price... so no bungee jump. Sigh.
However, Anne Marie and the girls had a great morning shopping and seeing the sights of Jinja-town, and after a tasty lunch together we headed back to Iganga, spirits high again and enjoying the company of our new friends!
7/9/11
We all woke up pretty early Saturday morning to go off to Jinja, for our luxurious Jinja vacation. It's a short hour or so away, and as soon as we arrived we checked in to our hotel, Paradise on the Nile. This place was sweet. A pool, a gym, a spa, air conditioned rooms, poolside bar and restaurant, amazing view of the Nile... all for 100,000 shillings, or about 40-45 bucks (split two ways to $20 each). Amazing. We relaxed hard.
After a few hours of this, Amy, Anne Marie and I decided to go on a booze-cruise of the Nile, where for $15 we got a two hour cruise of Lake Victoria and the head of the Nile river, all food and drink included. Good times, here too, were had by all.
Well fed, watered, and beered we fell asleep in our incredibly comfortable beds perfectly content.
After a few hours of this, Amy, Anne Marie and I decided to go on a booze-cruise of the Nile, where for $15 we got a two hour cruise of Lake Victoria and the head of the Nile river, all food and drink included. Good times, here too, were had by all.
Well fed, watered, and beered we fell asleep in our incredibly comfortable beds perfectly content.
7/8/11
Today in the hospital, we got to see the X-Ray equipment- which was really cool. It was actually really nice compared to most of the hospital. The machine was in great order, and the room was very swanky. The technician taught us all about how it all worked, and showed us how to develop the films. Pretty cool! Though Anne Marie wasn't very impressed, as her dad is an orthopedic surgeon and she's pretty much grown up with them.
We then were introduced to Ali, a nice new volunteer from New Orleans and a nursing student. As we were giving her the whorl-wind tour of the hospital, we saw a woman being carted from Maternity to surgery for a C-section (a pretty common occurrence). Excitedly, we encouraged Ali to come in and watch, and through her reaction were reminded of the fact that though we've really gotten used to them, surgeries at the hospital are totally crazy.
Feeling a bit bad that we'd totally overwhelmed Ali, we came home for lunch and met Amy, yet another new volunteer! She's a respiratory therapist from California, which is very exciting because it means that the hospital is finally getting a qualified volunteer instead of just students! There was a bit of a mix up about whether or not she was here to teach English at a nearby village, but once all was cleared up she moved in and started getting excited for the hospital (where she's totally helped to save a few newborn lives with her mad resuscitation skillz).
We all went out to dinner that night and got to know one another at the wonderful Sol Cafe- one of our two delicious salvations from boring Ugandan food. Jinja tomorrow!
We then were introduced to Ali, a nice new volunteer from New Orleans and a nursing student. As we were giving her the whorl-wind tour of the hospital, we saw a woman being carted from Maternity to surgery for a C-section (a pretty common occurrence). Excitedly, we encouraged Ali to come in and watch, and through her reaction were reminded of the fact that though we've really gotten used to them, surgeries at the hospital are totally crazy.
Feeling a bit bad that we'd totally overwhelmed Ali, we came home for lunch and met Amy, yet another new volunteer! She's a respiratory therapist from California, which is very exciting because it means that the hospital is finally getting a qualified volunteer instead of just students! There was a bit of a mix up about whether or not she was here to teach English at a nearby village, but once all was cleared up she moved in and started getting excited for the hospital (where she's totally helped to save a few newborn lives with her mad resuscitation skillz).
We all went out to dinner that night and got to know one another at the wonderful Sol Cafe- one of our two delicious salvations from boring Ugandan food. Jinja tomorrow!
Thursday, July 7, 2011
7/7/11
Connor just observed that it's seven-seven-eleven. We don't know what that means, but it sure sounds exciting.
Anyway, just so no one actually worries, I'm totally fine. I just had this weird dizziness yesterday and a really glamorous UTI which antibiotics have happily helped with greatly.
I want to second what Connor said about the masala chips, sipi falls, and Ugandan men. They are, respectively: delicious, beautiful, and extremely forward. I also want to emphasize the extreme joy that we both felt when Ben K texted us to let us know about the birth of Brugh, which was the real highlight of our weekend. Ben also deserves a shout-out for most encouraging big-brotherly phone call ever. Many of our medical experiences here have been overwhelming to me- the difficulties are so much more systemic than just resource management. For example, today in the male ward, Connor and I were making rounds with the head nurse and visited an elderly man who has a seriously obstructed bowel, a life-threatening condition should it rupture and spill it's bacteria-laden contents into his abdomen. When the surgeon stopped by to obtain consent to operate on him, the patient was extremely confused and unable to speak clearly, but his many sons were there adamantly refusing consent for the surgery. When we were making rounds, the patient could speak, was lucid, and clearly wanted the surgery, but there were no doctors of any kind around, and the sons still didn't want their father to have the surgery. The head nurse talked at length with the family, who seemed pretty well-off and relatively urbane for Iganga, but who then launched into a full-on tirade about their father being bewitched, being poisoned (possibly by the hospital?) and that what he needed was a witch doctor. Their father, it seemed to me, was probably just having difficulty with his lucidity as a result of his medical condition, a common, reversible, and in fact already reversing condition. Instead of listening to the nurse's explanation of this, they loaded him onto a gurney and took him out of the hospital, probably sensing that Connor and I were planning to run down to the operating theater and grab a surgeon to obtain consent and book the surgery, which we damned well were about to do, in accordance with the ethical principle of patient autonomy. They took him away.
This all goes to say that the problems with healthcare here, as in the united states, are systemic and confusing. They are cultural, financial, organizational...and they make the scale of suffering almost unbearable to imagine. When Connor and I went out into the village Tuesday, we drove out of Iganga, across an hour of countryside, then through a very small town called Namatumba, where we turned off onto a little dirt road that journeyed on further through miles of cornfields, and scattered through these cornfields was hut after hut occupied by people living as subsistence farmers in a country with no infrastructure to help them have safe, happy births, lives or deaths. I like Uganda a great deal, and I'm not saying any of this to imply that people here and elsewhere aren't trying to improve these problems- it's actually the opposite. It's disheartening that even with so much goodwill and so much money being poured into NGOs and government efforts here, we still arrived Tuesday afternoon, three med students expecting to see twenty or so kids with some gnarly wounds, and instead we sat in those rooms Connor talked about and each saw student after student, about seventy or eighty each. The teachers there made lunch for us but didn't bring it out because we were working so hard, and they wanted so much for the kids to get some kind of medical attention. And so did we. But we're not doctors yet, and we were in a school with dirt floors in the middle of miles of fields full of corn, sugar cane, bananas, coffee, tea, where people live without much that we take for granted every minute of every day.
I don't really remember what Ben said to me in response to some of my more hopeless thoughts about all of this, but it really did encourage me to learn as much as I can from this journey.
Also, we could really use some assistance with web-based research about basic preventative/maintenance healthcare recommendations for kids. Are there any good protocols for schools in underserved parts of the world that address how to instate cost-effective programs to promote general health? We're especially interested in nutrition, tooth hygiene, vision correction, de-worming, wound care, hand-washing...really basic things like this. If you are looking for a time-killer at work, give this a quick google or pub med or whatever else for us. Thanks so much! Please email one of us with whatever you find.
Anyway, just so no one actually worries, I'm totally fine. I just had this weird dizziness yesterday and a really glamorous UTI which antibiotics have happily helped with greatly.
I want to second what Connor said about the masala chips, sipi falls, and Ugandan men. They are, respectively: delicious, beautiful, and extremely forward. I also want to emphasize the extreme joy that we both felt when Ben K texted us to let us know about the birth of Brugh, which was the real highlight of our weekend. Ben also deserves a shout-out for most encouraging big-brotherly phone call ever. Many of our medical experiences here have been overwhelming to me- the difficulties are so much more systemic than just resource management. For example, today in the male ward, Connor and I were making rounds with the head nurse and visited an elderly man who has a seriously obstructed bowel, a life-threatening condition should it rupture and spill it's bacteria-laden contents into his abdomen. When the surgeon stopped by to obtain consent to operate on him, the patient was extremely confused and unable to speak clearly, but his many sons were there adamantly refusing consent for the surgery. When we were making rounds, the patient could speak, was lucid, and clearly wanted the surgery, but there were no doctors of any kind around, and the sons still didn't want their father to have the surgery. The head nurse talked at length with the family, who seemed pretty well-off and relatively urbane for Iganga, but who then launched into a full-on tirade about their father being bewitched, being poisoned (possibly by the hospital?) and that what he needed was a witch doctor. Their father, it seemed to me, was probably just having difficulty with his lucidity as a result of his medical condition, a common, reversible, and in fact already reversing condition. Instead of listening to the nurse's explanation of this, they loaded him onto a gurney and took him out of the hospital, probably sensing that Connor and I were planning to run down to the operating theater and grab a surgeon to obtain consent and book the surgery, which we damned well were about to do, in accordance with the ethical principle of patient autonomy. They took him away.
This all goes to say that the problems with healthcare here, as in the united states, are systemic and confusing. They are cultural, financial, organizational...and they make the scale of suffering almost unbearable to imagine. When Connor and I went out into the village Tuesday, we drove out of Iganga, across an hour of countryside, then through a very small town called Namatumba, where we turned off onto a little dirt road that journeyed on further through miles of cornfields, and scattered through these cornfields was hut after hut occupied by people living as subsistence farmers in a country with no infrastructure to help them have safe, happy births, lives or deaths. I like Uganda a great deal, and I'm not saying any of this to imply that people here and elsewhere aren't trying to improve these problems- it's actually the opposite. It's disheartening that even with so much goodwill and so much money being poured into NGOs and government efforts here, we still arrived Tuesday afternoon, three med students expecting to see twenty or so kids with some gnarly wounds, and instead we sat in those rooms Connor talked about and each saw student after student, about seventy or eighty each. The teachers there made lunch for us but didn't bring it out because we were working so hard, and they wanted so much for the kids to get some kind of medical attention. And so did we. But we're not doctors yet, and we were in a school with dirt floors in the middle of miles of fields full of corn, sugar cane, bananas, coffee, tea, where people live without much that we take for granted every minute of every day.
I don't really remember what Ben said to me in response to some of my more hopeless thoughts about all of this, but it really did encourage me to learn as much as I can from this journey.
Also, we could really use some assistance with web-based research about basic preventative/maintenance healthcare recommendations for kids. Are there any good protocols for schools in underserved parts of the world that address how to instate cost-effective programs to promote general health? We're especially interested in nutrition, tooth hygiene, vision correction, de-worming, wound care, hand-washing...really basic things like this. If you are looking for a time-killer at work, give this a quick google or pub med or whatever else for us. Thanks so much! Please email one of us with whatever you find.
Wednesday, July 6, 2011
7/6/11
Which brings us to today!
Not much happened today. We fully intended on going to the hospital, but Anne Marie fell ill, and I wanted to stay home with her to help out as long as I thought she might need something. We did laundry, I got a whole slew of prescription-grade medicines at the local pharmacy for a smile, and we're hopeful she'll live. It doesn't seem like Malaria, for those that are worried about that (though even if it somehow were, Malaria is very readily diagnosed and easily treated over here, so no big deal).
Shout out to Ben and Julie Kessler, incidentally, for having a stout young baby boy on July 1st! Anderson Brugh. May he be as awesome as his name is.
Not much happened today. We fully intended on going to the hospital, but Anne Marie fell ill, and I wanted to stay home with her to help out as long as I thought she might need something. We did laundry, I got a whole slew of prescription-grade medicines at the local pharmacy for a smile, and we're hopeful she'll live. It doesn't seem like Malaria, for those that are worried about that (though even if it somehow were, Malaria is very readily diagnosed and easily treated over here, so no big deal).
Shout out to Ben and Julie Kessler, incidentally, for having a stout young baby boy on July 1st! Anderson Brugh. May he be as awesome as his name is.
7/5/11
Back in Iganga. We had arranged last week to spend today in a little village about an hour outside of town at a small orphanage / boarding school that was set up by another ELI volunteer. We grabbed some chippotti (our new favorite!) and set out.
The village was pretty crazy. At perhaps 9:30 we were seated in two small rooms in this tiny little school/orphanage, with 200 kids waiting in lines outside to be examined. There were no doctors there, or nurses... only Anne Marie, Jenny and me. None of us had more than 1 year of med school under our belts. And yet, here we were, looking one after one at kids (orphans, no less) that have almost certainly literally never been examined by anyone with any medical training EVER. Anne Marie and Jenny sat in one room, looking at the girls. I sat in another room, looking at the boys. And they filed in, one after another, unendingly, with all kinds of big, crazy open wounds; almost all with malnutrition and distended abdomens, stomach and head pains; almost all with GI worms; in they came with ringworm, eye problems, tooth problems, infected wounds and almost all other kinds of infection. In short, it was unbelievable. I spent the first two hours there pretty unhappy - it was a pain to consult Anne Marie and Jenny in the other room, our supplies were split, and I seriously did not know what I was doing for most of it. But as I fell into it, I realized that what little we could do was better than nothing. We wrote down what we thought all the kids had, and most of it - the infections, the worms, the fungus - will be treated later by people with money that can get the appropriate tablets. But we cleaned dozens of wounds, many obviously infected, and frankly, by the end I was focused more on what we could do than what we couldn't. It was good to actually be helping... we were so much less helpful than if we were qualified doctors with all the drugs we needed, but so much more helpful than no-one, which is who would have seen them if we hadn't come out.
By the time it was all over 8 absolutely unbroken hours later, we were hungry and tired, but happy to have helped. We went to our favorite restaurant in Iganga and got beers and Indian food and even some little cheeseburger sliders, and by the time we got home we were very happy with a hard day's work.
The restaurant reminds me of one last small digression I'd like to make about the food here - it's really, really bland. Almost no flavor. I say this not because I'm picky or unadventurous about my cuisine - in fact, I feel the opposite. My tastes are far too adventurous for Uganda. So when we discovered some time last week that you could get Masala Chips at a restaurant here, we were thrilled. Delicious english potato wedges, smothered in spicy indian masala sauce??? Awesome! Then, once we'd gotten into the tasty food scene in Iganga, we heard about the Sol Cafe, where we went in the evening of this blog post. It offers burgers. They're little, kind of white castle-y, but By God, they're burgers! It's very exciting. Though I realize it's a pretty strange digression from our epic day of healing sick orphans. I guess I'm hungry.
The village was pretty crazy. At perhaps 9:30 we were seated in two small rooms in this tiny little school/orphanage, with 200 kids waiting in lines outside to be examined. There were no doctors there, or nurses... only Anne Marie, Jenny and me. None of us had more than 1 year of med school under our belts. And yet, here we were, looking one after one at kids (orphans, no less) that have almost certainly literally never been examined by anyone with any medical training EVER. Anne Marie and Jenny sat in one room, looking at the girls. I sat in another room, looking at the boys. And they filed in, one after another, unendingly, with all kinds of big, crazy open wounds; almost all with malnutrition and distended abdomens, stomach and head pains; almost all with GI worms; in they came with ringworm, eye problems, tooth problems, infected wounds and almost all other kinds of infection. In short, it was unbelievable. I spent the first two hours there pretty unhappy - it was a pain to consult Anne Marie and Jenny in the other room, our supplies were split, and I seriously did not know what I was doing for most of it. But as I fell into it, I realized that what little we could do was better than nothing. We wrote down what we thought all the kids had, and most of it - the infections, the worms, the fungus - will be treated later by people with money that can get the appropriate tablets. But we cleaned dozens of wounds, many obviously infected, and frankly, by the end I was focused more on what we could do than what we couldn't. It was good to actually be helping... we were so much less helpful than if we were qualified doctors with all the drugs we needed, but so much more helpful than no-one, which is who would have seen them if we hadn't come out.
By the time it was all over 8 absolutely unbroken hours later, we were hungry and tired, but happy to have helped. We went to our favorite restaurant in Iganga and got beers and Indian food and even some little cheeseburger sliders, and by the time we got home we were very happy with a hard day's work.
The restaurant reminds me of one last small digression I'd like to make about the food here - it's really, really bland. Almost no flavor. I say this not because I'm picky or unadventurous about my cuisine - in fact, I feel the opposite. My tastes are far too adventurous for Uganda. So when we discovered some time last week that you could get Masala Chips at a restaurant here, we were thrilled. Delicious english potato wedges, smothered in spicy indian masala sauce??? Awesome! Then, once we'd gotten into the tasty food scene in Iganga, we heard about the Sol Cafe, where we went in the evening of this blog post. It offers burgers. They're little, kind of white castle-y, but By God, they're burgers! It's very exciting. Though I realize it's a pretty strange digression from our epic day of healing sick orphans. I guess I'm hungry.
7/2/11 - 7/4/11
Saturday at last! We stopped by the hospital to give one the patient's some medicines he needed and were off to Sipi Falls - super beautiful and awesome Sipi Falls. Oh, how we love Sipi Falls.
But first things first, we went with Jenny (another med student who lives with us) and this other kid named Johann from Switzerland, who's also volunteering with ELI but in a different house. Jenny and Johann were hilarious all weekend. They're both at least slightly crazy - Jenny in a super med-studenty way, and Johann in a super crazy European way. Inevitably, the whole weekend was a bizarre and amusing romantic tension... ah, l'amour.
We took a matatu to Mbale (perhaps a 2.5 hour ride) and then another to Sipi Falls, another hour in a matatu and perhaps half an hour in a boda boda. It was the longest boda ride we've yet taken, and it was fairly terrifying... no helmet, 15 year old driver going breakneck speeds on a crappy little motorcycle with broken mirrors. And yet, we arrived safely, and found ourselves at the Crow's Nest.
The Crow's Nest was absolutely beautiful. For only $13 per night (for both of us), Anne Marie and I got a private little cabin on a hillside that overlooked the three GORGEOUS waterfalls that comprise Sipi Falls. I've never in my life seen such awesome waterfalls, and the rest of the scenery was equally amazing.
Being a tourist destination, it was pretty full of white people - sort of weird after being used to never seeing other mzungus - but we had a great time. Saturday night we stayed up late drinking at the bar and playing card games. Sunday was the big nature hike - for pretty cheap we all got a guided tour around all three waterfalls (one 100m, one 67m, one 78m). The hike lasted about six hours, and was pretty tiring... so when we came back, we were ready to eat and drink and nap, all in the fabulously cool temperature that high elevations in mountainous Uganda provided for us. It was magnificent.
Sunday night, we walked next door to eat an incredible, four course meal at a neighboring place for 18,000 shillings each - about 7 bucks. I'm sorry if I keep talking about how cheap everything is here, but it's just so crazy to me. We slept like kings on our huge double mattress, and spent all morning on Monday, July 4th reading, enjoying the views, eating big meals, doing crosswords, and otherwise relaxing hard.
We loved Sipi Falls.
But first things first, we went with Jenny (another med student who lives with us) and this other kid named Johann from Switzerland, who's also volunteering with ELI but in a different house. Jenny and Johann were hilarious all weekend. They're both at least slightly crazy - Jenny in a super med-studenty way, and Johann in a super crazy European way. Inevitably, the whole weekend was a bizarre and amusing romantic tension... ah, l'amour.
We took a matatu to Mbale (perhaps a 2.5 hour ride) and then another to Sipi Falls, another hour in a matatu and perhaps half an hour in a boda boda. It was the longest boda ride we've yet taken, and it was fairly terrifying... no helmet, 15 year old driver going breakneck speeds on a crappy little motorcycle with broken mirrors. And yet, we arrived safely, and found ourselves at the Crow's Nest.
The Crow's Nest was absolutely beautiful. For only $13 per night (for both of us), Anne Marie and I got a private little cabin on a hillside that overlooked the three GORGEOUS waterfalls that comprise Sipi Falls. I've never in my life seen such awesome waterfalls, and the rest of the scenery was equally amazing.
Being a tourist destination, it was pretty full of white people - sort of weird after being used to never seeing other mzungus - but we had a great time. Saturday night we stayed up late drinking at the bar and playing card games. Sunday was the big nature hike - for pretty cheap we all got a guided tour around all three waterfalls (one 100m, one 67m, one 78m). The hike lasted about six hours, and was pretty tiring... so when we came back, we were ready to eat and drink and nap, all in the fabulously cool temperature that high elevations in mountainous Uganda provided for us. It was magnificent.
Sunday night, we walked next door to eat an incredible, four course meal at a neighboring place for 18,000 shillings each - about 7 bucks. I'm sorry if I keep talking about how cheap everything is here, but it's just so crazy to me. We slept like kings on our huge double mattress, and spent all morning on Monday, July 4th reading, enjoying the views, eating big meals, doing crosswords, and otherwise relaxing hard.
We loved Sipi Falls.
6/29/11 - 7/1/11
Greetings, avid fans and loyal bloggees!
Anne Marie is feeling ill today (the real today, Wed 7/6) so here I sit at the internet cafe all on my lonesome, with only some very slow internet to keep me occupied. As such, dear readers, I might get bored and not type in quite as much detail as I've done in the past. I know that you all normally cherish my long-windedness, so I apologize in advance if I'm more succinct. Indeed, I'll begin by compressing last Wednesday through Friday all into one concise and easy-to-read bundle.
After such an exciting day in maternity on Tuesday, we decided to spend our time the rest of the week exploring what else the hospital had to offer. We saw many more circumcisions in the minor operating theater, spent lots of time in the major operating theater watching C-sections and a few other surgeries, spent a bit more time in maternity and mapped out a plan for what we were going to do with our time at the hospital, specifically, for the remainder of our time here. Unfortunately, there isn't much to say about these days. Ugandans didn't seem to be very sick for most of them, and mom's weren't pushing out babies as we've been used to seeing. It was really nice getting some more time to get to know the folks at the hospital though, so we were very happy overall!
On the getting-to-know-Ugandans-better note: Ugandan men are super funny. It's a culture in which homosexuality is, as I've mentioned, so illegal as to have just avoided being punishable by an automatic death penalty. It's a culture where I just saw a Ugandan paper in which the president supports his policy of throwing the gays in jail because God created Adam and Eve, not Adam and Adam. Uganda is even a place where PDA between men and women is considered very inappropriate, including holding hands. But men here hold hands all the time (which takes a bit of getting used to), but more importantly the relatively small number of Ugandans working at the hospital to whom I've given our cell phone number are CONSTANTLY calling and texting me. Now I'm certainly not saying they're all secretly gay for me (flattering as it would be) but from my cultural perspective, it is pretty funny watching all of these men calling me all the time, texting me in the middle of the night, and trying to hold my hand. If Ugandans weren't outrageously homophobic, I'd think they were pretty flamboyant!
I'm finding that I really like a lot about Uganda, actually. As alluded to, the people are extremely friendly. The cell phone service is great - it's cheap (international calls are well under a dime per minute), and offers cool services like money transfer between phones (for cash withdrawal, even) and texts when the number you've tried calling that was busy becomes available. The weather is a bit hot during the day, but is lovely at night. It's super easy to get around, and the transportation is really cheap (if also terrifying and uncomfortable). I'm increasingly thinking I'd like to come back here, for at least a little while, once I'm actually a doctor and could actually help people.
Anne Marie is feeling ill today (the real today, Wed 7/6) so here I sit at the internet cafe all on my lonesome, with only some very slow internet to keep me occupied. As such, dear readers, I might get bored and not type in quite as much detail as I've done in the past. I know that you all normally cherish my long-windedness, so I apologize in advance if I'm more succinct. Indeed, I'll begin by compressing last Wednesday through Friday all into one concise and easy-to-read bundle.
After such an exciting day in maternity on Tuesday, we decided to spend our time the rest of the week exploring what else the hospital had to offer. We saw many more circumcisions in the minor operating theater, spent lots of time in the major operating theater watching C-sections and a few other surgeries, spent a bit more time in maternity and mapped out a plan for what we were going to do with our time at the hospital, specifically, for the remainder of our time here. Unfortunately, there isn't much to say about these days. Ugandans didn't seem to be very sick for most of them, and mom's weren't pushing out babies as we've been used to seeing. It was really nice getting some more time to get to know the folks at the hospital though, so we were very happy overall!
On the getting-to-know-Ugandans-better note: Ugandan men are super funny. It's a culture in which homosexuality is, as I've mentioned, so illegal as to have just avoided being punishable by an automatic death penalty. It's a culture where I just saw a Ugandan paper in which the president supports his policy of throwing the gays in jail because God created Adam and Eve, not Adam and Adam. Uganda is even a place where PDA between men and women is considered very inappropriate, including holding hands. But men here hold hands all the time (which takes a bit of getting used to), but more importantly the relatively small number of Ugandans working at the hospital to whom I've given our cell phone number are CONSTANTLY calling and texting me. Now I'm certainly not saying they're all secretly gay for me (flattering as it would be) but from my cultural perspective, it is pretty funny watching all of these men calling me all the time, texting me in the middle of the night, and trying to hold my hand. If Ugandans weren't outrageously homophobic, I'd think they were pretty flamboyant!
I'm finding that I really like a lot about Uganda, actually. As alluded to, the people are extremely friendly. The cell phone service is great - it's cheap (international calls are well under a dime per minute), and offers cool services like money transfer between phones (for cash withdrawal, even) and texts when the number you've tried calling that was busy becomes available. The weather is a bit hot during the day, but is lovely at night. It's super easy to get around, and the transportation is really cheap (if also terrifying and uncomfortable). I'm increasingly thinking I'd like to come back here, for at least a little while, once I'm actually a doctor and could actually help people.
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