Extend! Extend!

The story of a journey from Kampala to Kiwoko, Ugandan style.

The main public transport here are little 9 seater minibuses called matatus, painted white with a blue pattern and adorned with varying encouraging messages on the front such as 'Jesus Saves' and 'John 3:16'. After spending the weekend in Kampala the other students and I headed to the main bus park in Kampala to catch the bus back to Kiwoko. It was absolute mayhem, similar to the bus park in Kathmandu - buses everywhere in a muddy, dusty, potholey park, with no indication either on the ground or on the buses which ones are going where. We asked someone for help, and he waved vaguely to the other side of the park; we then weaved in and out of these buses until we found someone who said 'follow me' and took us to a bus. We piled in, already pretty sweaty because of the humid African heat, and waited for the bus to fill up. Meanwhile sellers came to the windows offering all sorts from cold drinks, sunglasses, fake watches and food to posters of the recent riots in Kampala.

After lots of horn tooting, manouvering and loud shouts to the other buses from our driver we set off towards Kiwoko. The first part of the journey was pretty uneventful and an hour and a bit later we rolled into Luweero bus station, 14km from Kiwoko. We were turfed off this bus and onto another, very old and battered looking one, whose windscreen had an ominous looking crack down the middle, that looked like it would struggle to make it out of the bus park, let alone along the potholed dirt track to the hospital. With about 11 people in we pulled off, but it seemed we were just going to the garage to inflate the tyres and fill up with petrol, then drive back to the bus park and wait for more passengers. A lady with 4 children piled in. Great, we thought, bus definitely full now - lets go. Not so fast! Another lap of the bus park to pick up some potatoes to put in the boot, and tie some luggage onto the roof and then off goes the engine again. Cries of 'extend! extend!', which interprets as 'budge up, this bus can take plenty more passengers yet' and we all squished up to allow another passenger to join the overloaded bus, and then another 3 children.

Now it's getting really very full, we're squished into the back seats all v. sweaty and dusty by this point. But then shock horror...another passenger turned up, but not just anyone - one of the Sisters from the hospital. She is some lady. A formidable size, with what can only be described as a 'shelf bottom', something so big it almost eclipses the sun. There was no way she was going to fit in this tiny minbus - there were already 18 people in a bus designed for 9, but this didn't to pose any problem to the driver. He turfed a couple of passengers out of the front seat, who joined the sweaty mob in the back (more cries of 'extend!') and Sister squeezed into the front. Finally it appeared we were going to leave, about an hour after changing buses. We pulled off and drove a little further along the road through Luweero, only to stop AGAIN and pick up not one but TWO more passengers. There wasn't a whole lot of extending we could do - the middle of the minibus was full to bursting, so as a solution a couple of children were passed backwards to join the sweaty, cramped muzungus on the back row, making use of the vertical space by sitting on our knees so the extra passengers could fit in; they didn't bat an eyelid, despite the common rumour here that white people eat children. Final tally: 22 passengers in a 9 seater bus. Oh yes.

Made it back to Kiwoko in one piece, very dusty, VERY sweaty and very glad to get home for a much needed shower.

Starting hospital placement proper tomorrow - medical stories to follow!

Oli otya from Uganda

Technically the title of this post is grammatically incorrect, since 'oli otya' means 'how are you', but as it is the standard greeting it seems a shame not to share it.

I arrived here at Kiwoko Hospital yesterday lunchtime, after a night in Utrecht, near Amsterdam with my good friend Aukje, and a night in Entebbe and have been made to feel thoroughly welcome by everyone I've met - Ugandans are very friendly. I already feel very at home in the small house I'm sharing with three others - a paediactric reg (also from Edinburgh), a nursing student and another medical student. My bed is comfy, the company is good and the food is excellent! The amazing quantity of fresh fruit and veg is a particular bonus - pineapples like I've never tasted, bananas, passionfruit, avocados grown just down the road...unfortunately it isn't mango season at the moment but with the variety of the available selection I think I'll cope.

I was shown around the hospital yesterday afternoon (in the baking Ugandan sun, such a nice change!) and was quite surprised at how big it is - there's been a fair bit of development since Dr Ian Clarke who started the hospital wrote the book 'The Man With The Key Has Gone', which is pretty much what my mental pictures were based on. I am still slightly disorientated when walking around the hospital, but its main components are: outpatients department where new arrivals are seen, male and female wards which each have a medical and surgical area, children's ward (for children under the age of 5 - any bigger and they won't fit in the cots!), recently completed maternity unit with neonatal ICU, theatres, TB ward, nutrition ward, administration block and multipurpose hall used for morning chapel/staff meals/lectures.

I spent the morning on the paeds ward with Carolyn the paeds reg and saw my first cases of malaria (lots of them), sickle cell crisis, osteomyelitis...oh and a case of bronchiolitis that made me feel at home. There are a lot of differences between the practice of medicine here and in the UK, the most striking being the limitations to investigation and treatment due to financial shortages of the patient and their family. Blood tests are carefully justified, not fired off as fast as the admitting doctor can think of them, and if the treatment needed is too expensive it simply cannot be carried out. There are also far more deaths here than I have ever seen in the UK, already four patients, two of which were children, since I arrived. I wasn't involved with their care on the wards but two of my housemates were and understandably found it quite difficult emotionally. I am not looking forward to the time when I will experience it for myself.

On a lighter note I met my first cockroach yesterday on the way to the outdoor long drop toilet. Wasn't as unpleasant as I'd expected! (The cockroach, not the toilet - although actually the same could be said for that).

The electricity has just gone off again and my battery is running low so I'll sign off.

Sending lots of happy thoughts from Uganda

Charlotte

10 days to go...

In just over a week I'll be flying from Manchester to Entebbe airport, Uganda, with a quick stop in Amsterdam to visit a gap year friend. I am due to arrive on 23rd March, and will head out of Kampala to Kiwoko Hospital the next day.

My room here in Edinburgh is currently strewn with clothes, textbooks and medical equipment (including 50 catheters, 100 infant nasogastric feeding tubes, several boxes of sterile gloves, scalpel blades and sutures and one lonely chest drain). My task now is to somehow squeeze all this stuff into my rucksack...easier said than done.

I will hopefully be able to update this blog every once in a while, and will try and put some photos up once I've worked out how to use my fancy new camera. I am very excited about this trip - it will be so good to experience everything of Kiwoko and Uganda as a country that I've heard so many good things about.

That's my side of the bargain - yours is to keep in touch with me by email/facebook/Ugandan mobile - I have been given a sim card but not sure of the number yet, I should find out once I get there.

Looking forward to updating you once I get to Uganda!

Charlotte