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