God is always in time!

This week has been a very busy one, apologies for not writing an update for a while. I’ve been on female ward which is divided into medical and surgical, although the majority of the patients are on the medical side. I’ve been left in charge of the ward for a good portion of the week, while the doctor overseeing me has either been in theatre, off the ward discussing patients with other doctors or away visiting relatives, occasionally popping in to do a quick ward round or see patients for review. I am rising to the responsibility, something I found terrifying to start with but am now getting used to. I think female ward is my favourite – the nurses are great fun and the ward rounds are usually punctuated with howls of laughter. The ‘in charge’, Sister Grace, is a total legend, a cuddly mother figure who always has a smile on her face and repeatedly tells me ‘EH! Why are you still here? It is past even African lunchtime (2pm – our lunch is ready at 1) – you must be so hungry! This patient can wait, go and eat something!’

There have been some challenging cases on the ward, in particular an elderly woman who came in yesterday morning following a fall at home. She was fairly drowsy, confused and disorientated, and very difficult to take a history from (made even more difficult by me not speaking Luganda), let alone examine. Trying to do a neurological exam through a translator on a drowsy, uncooperative patient is challenging to say the least. We got there in the end – it seems that she has suffered a fairly severe stroke, so we started treatment but I remained guarded about the outcome. Early this morning before chapel (or even breakfast!) I was called by the ward because the patient’s condition had changed. She had slipped into a coma, her BPs had soared and unfortunately despite our attention she died shortly afterwards. Even with fancy tests like CT scans I’m not sure the outcome would be any different. Having said that, in the UK she would have had her blood pressure checked decades ago by a friendly GP and antihypertensives started, potentially preventing the stroke. Only yesterday I was thinking that I hadn’t had a death in a while, and as it happened my morning bible study was about attitudes to death and conquering death, looking at Revelation 20:11-15. In fact I was reading the bible study when Daniel the nursing student came to get me. At least for the patient’s sake she slipped away quickly and painlessly, something that I had prayed would happen if that were to be the outcome.

Last week I joined the community team who run the HIV clinics, the Youth Friendly Centre in Kiwoko town and do community visits for immunisation clinics. The YFC is a drop in centre for young people, where health promotion videos aimed at this age group are shown, games are available and there are clinical officers, counsellors and a small laboratory to run HIV, STI and pregnancy tests. I found it encouraging how clued up the young people were about the importance of getting tested and the implications of contracting HIV. There was even a group of them who had written a song in 3 part harmony about how abstinence is best and that they should be protecting their health! Brilliant!

Despite there being lots of positive work in the community there are still areas of frustration. On one day we went out to a village deep in the bush to run an immunisation clinic for local mothers with young babies. All immunisations are free, and the mothers are given plenty of notice in advance before the clinic. However still only 5 mothers turned up in the 4 hours we were there – apparently there is still doubt in the local people about the effectiveness of immunisation, and many prefer to stick with traditional healers instead. Each baby is weighed using a sling with scales hooked onto a tree branch and the immunisations delivered on a bench under the tree. Details are entered into a book and the mother goes on her way, walking barefoot along the dusty dirt track further into the bush with her baby slung on her back.

Last weekend was my first full weekend in Kiwoko, and for the first time there were just two of us in the Guest House, as we said goodbye to Sian, Carolyn and Abi last Friday. But we have certainly not been lonely - on Saturday we opened our doors to a collection of nursing students, doctors, families and other acquaintances for a party to celebrate Rhea’s birthday. Fuelled by fizzy pop and mandazis (like doughnuts but more stodgy!) we had a lot of fun, particularly playing musical chairs and blind man’s bluff – these went down very well with the nursing students in particular! Getting to know some of the students has been a real highlight of my time here, through nurses fellowship (praise and bible study every Wednesday evening until the electricity goes off), working together on the wards and now even playing party games together!

I was pleased to be able to join Mark for the morning service at Voice of Truth church on Sunday morning. There was much clapping, dancing, arm waving, whooping and disco beats from the keyboard. And apparently this was relatively reserved for an African church service! I was made to stand up and introduce myself into the booming microphone, I’m just glad I wasn’t asked to sing (a tradition in some churches to welcome newcomers!). A handwritten poster on the wall read ‘God is always in time’ which made me chuckle – Ugandan timing is very approximate – for example the service started at 8am so Mark picked us up at what time? 8am! When we arrived around 20 past we were the only ones there, by 8.45 the church had begun to fill and the service started properly. At least by Ugandan standards I am usually early!

An entertaining evening’s activity here in Kiwoko is to go for a bike ride. Last week Sian, Mark and I borrowed some fairly ancient bikes to cycle to the nearby orphanage, New Hope. The journey was…interesting! On the first downhill I realised that the luxury of brakes does not extend to Uganda, at least not on the bike I had been given. I gritted my teeth and hoped for the best as I started to pick up speed along the dusty road, trying to avoid potholes, bodabodas, heavy laden trucks, goats, pedestrians and other cyclists. There was only one slightly hairy moment when a charcoal truck piled high with sacks of coal came thundering along the road, with a matatu coming the other way while I was squeezing my non-existent brakes in a vain attempt to stop and get off the road. In the end I stuck both feet down and eventually shuddered to a standstill, dragging my bike out of the oncoming path of the unforgiving truck, much to the amusement of its passengers who were perched high up on top of the sacks. If I borrow a bike again I will definitely make sure it has functioning brakes! Mukama yebazibwe (praise the Lord) we all made it to New Hope and back in one piece!

Mmm...fish heads. The stench of these is overwhelming. I think it is a sack of these delightful subjects that we once shared a hot matatu with for a several hour journey.

With only a week and a half to go here at Kiwoko I’m trying to make the most of my remaining time here, but having to strike a balance with studying for finals. It’s been great to hear from everyone back home – keep the emails/facebook messages coming. Looking forward to seeing you all again in the not so distant future. Email is brown_chicken@hotmail.com if you hadn’t worked that out already!