Welaba Kiwoko!

This is the last update I will write from Uganda, as I leave Kiwoko tomorrow, heading to Nairobi for a couple of days to visit Kieren from P’s and G’s, arriving back in the UK on Monday evening all being well. I am a little worried about the ominous ash clouds that still seem to be causing a bit of disruption in air space and would appreciate your prayers for a safe and speedy homeward journey.

I spent last week with Dr Peter on surgery again, although with less theatre time this week – instead I took to covering the ward while he was operating, clerking new patients and reviewing others, and getting some studying done if it was quiet. I really like the continuity of care here – patients being looked after by one doctor for the majority of the time, occasionally being seen by the on-call doctor if new issues arise - by the end of the week I knew all of the patients on the ward, what operation they had already had or were waiting for, what their current issues were and when they were likely to be discharged. When coming to write discharge summaries it is so much easier to actually know the patient, rather than trawling through pages of notes to work out what has happened while they’ve been in hospital. Plus it means that ward rounds are actually interesting because I want to know how the patients are recovering/responding to treatment and it’s so encouraging to see them improve and be discharged back to health.

A couple of patients spring to mind from this week. One guy in his 30s sent to the ward from outpatients with a ‘7 year history of scrotal swelling’. Scrotal swelling was an understatement – he had a hernia the size of a basketball which was now affecting his work as a cattle herder because it was so heavy. The previous evening I’d been practicing my slick finals-style hernia exam on the long suffering Dr Carolyn who had obligingly agreed to perch a banana and two oranges in the correct anatomical position for such an exam. I was pleased to have an opportunity to practice on a real patient (not pleased for him, of course, I pitied his 7 years of giant herniation) and to have my diagnosis of massive right inguinoscrotal hernia confirmed by Dr Peter when he reduced it in theatre the next day. The patient was pleased to be relieved of his swelling and was discharged a couple of days later, fit and well.

On Sunday afternoon Carolyn and I went on a little revision-break visit to the hospital farm which supplies milk to staff and patients. We took a bodaboda from outside the hospital which, after much skirt rearrangement to cover up our exposed ‘genitals’ (knees), was actually reasonably enjoyable compared to bodas in Kampala. After navigating our way around the potholes and even doing a little off-roading to avoid a cow we arrived bang on milking time. We were given our own cow and bucket and proceeded to milk it with surprising success - we reckon we got about 2 1/2 litres out of her (admittedly in the time it took the milkmen to fill several buckets) and were very pleased with ourselves. We had a nice walk back to Kiwoko in the warm afternoon sun and when the milkman arrived this evening we were very pleased to ask for 2 cups please, feeling proud that we'd personally milked this milk with our own bare hands. We set the milk on the stove to boil and settled down to play Settlers of Catan (addictive board game). About half an hour later when an interesting smell started to waft through from the kitchen we suddenly realised we’d completely forgotten about the milk. NOOOOOOOOO! It was absolutely burnt solid, completely dry and blackened in a thick layer onto the bottom of the big pan. The pan was so big it hadn't even boiled over. It then took another half hour of scraping with knives and wire wool to get it clean again. We laughed. A lot. Neither of us have ever worked so hard to not get any milk!

This week I’ve been in outpatients department – the equivalent of a GPs surgery combined with A+E. I was expecting to sit in with one of the clinical officers but when I pitched up on Tuesday morning I was told they were short of staff so I would run my own clinic, and was given a room, a translator and a steady stream of patients with all sorts of weird and wonderful complaints. The Oxford Handbook of Tropical Medicine has come in very handy! There seemed to be a lot of mzungu-fearing children this morning – there’s a familiar look that passes across their faces when they come into the room, see white skin, grab mama’s leg for reassurance and then burst into fervent screams if you dare approach them, no matter how much cooing or distraction is used!

I have thoroughly enjoyed my time here in Uganda; there have been tears, laughter (a lot of that!) and daily challenges. Kiwoko has earned a very special place in my heart – after my gap year in Nepal I thought there couldn’t possibly be a cooler country in the world, but you know what, I think Uganda might just be that place. I have been so lucky with the people I’ve met and the friendships I’ve made. I will be back….! If anyone reading this blog has ever considered taking some time out to go abroad I would highly recommend Uganda as a welcoming, exciting and very beautiful country. I’m looking forward to catching up with you all back in the UK very soon.