Well it has rained and rained since the weekend, some say they haven't seen rain like if for some time.  Unfortunately around some parts of Mount Elgon the rain has had disasterous effects.


view from indoors!

 A mudslide has occurred in the Bulambuli district, at least 26 people have been killed and 22 houses are buried.  There was a terrible picture in the paper of a woman up to her knees in mud trying to dig with her bare hands as her children had been buried by the slide.  Earlier this year there was a similar event but killing 350 people.   Much of this is believed to be due to deforestation and encroachment, the chopping down of trees has left land subject to landslides and people are setting up home on high slopes.  Apparently the government was warned of a looming landslide and failed to act until after the event.  But not to worry, Cabinet has approved a policy on 'disaster' which is awaiting implementation (!!)


I suspect that there has also been floods in some areas and that many roads have become impassable as they've turned to mud. Maybe this is covered by the disaster policy too.......

Many crops are also being destroyed by the rains - this will have a big impact on those who rely on crops for their livelihoods and will also mean that there is less food available in local markets.

I ran the gauntlet of the local market today.  It's a pubic holiday today to celebrate the end of Ramadan; there were many people dressed up in their finery all around the town, the women were very colourful and the men were mostly dressed in white (I wish I knew their secret for bright whites - mine are all turning brown).  The market was fairly busy - loads of chickens which are fairly docile (which is why I always think they are dead)- I'm not sure why they don't run around causing havoc, some were in cages but most were just dumped in the car parking area.  Will need to try to find out.  I also realised at one point that I had a load of street kids tailing me - I felt like the Pied Piper!

A number of people have asked me about food.  I think it's quite well established by now that I mostly eat rice and beans.  However it is possible to buy most things in the shops so I tend to eat similar sorts of things that I might have at home.  There's a smaller range of fruit and veg because everything is seasonal - the quality is also variable so it pays to shop around a bit.  But I've discovered a Cadbury's coconut and cashew choc bar is very tasty!!

Unusual article in the newspaer today - Zimbabwe has done a lot to reduce HIV transmission rates and has seen some good results.  It seems a South African study has shown that circumcision reduces the risk of transmitting HIV by 60% - so the Cabinet Ministers in Zimbabwe have decided all men should be circumcised and that they will lead the way setting an example!!  Mind you I think this could be counter productive as people may think it's safer and take less precautions....

Well it is supposed to be rainy season.....it started raining about 2.30 yesterday and is still going strong with a short respite this morning timed nicely for the 5 min walk to work.  It was raining so hard at one point yesterday it felt as if a river was pouring out of the sky. It seemed to bring the insects out last night - I had to turn the light off in the end as it sounded as if a swarm of insects were trying to break in through the mesh.  I hope the lizard that lives in the window had a good feed!



spotted this morning - chilling out on the
window pane

 A grasshopper managed to get into the house - think he was sheltering out of the rain.  These particular grasshoppers are a delicacy here - they are deepfried and eaten.  Not much meat on one but I bet it tastes like chicken!  Being a veggie I'm not inclined to seek these out to try... they are bright green and about 3 inches long.  I haven't seen one jump....yet.....


last night - newly arrived






Went for a swim on the weekend up to the Mount Elgon Hotel.  There was a great view down into the low land and of Mount Elgon itself.  Saturday was a much warmer and sunnier day than yesterday so it was nice to get into the outdoor pool. I also had it all to myself too.  By the time I'd come back to the pool area after a massage (v nice) the pool had filled up with kids - so I think I timed it well!

Just found out we have a public holiday this week to celebrate the end of Ramadan.  That makes up for working on Bank Holiday Monday!  Even though Uganda isn't an Islamic country it is one of the most popular religions here.  In Uganda most people are Christian and keenly practice their religion - however other key religions are recognised hence the day off for Eid ul Fitr.  There are quite a few Muslims in Mbale - there is an Islamic University here and a few mosques.

Fairly quiet this week - maybe life is slipping into a routine - not sure this is good.

It's been mostly business as usual around the hospital this week.  Last night was a bit noisy - they are building a new store room behind the guest house and plan to put a huge water tank on top.  I was a bit worried as the store room has a few openings at the front and is made mud bricks...the water tank will be v heavy.  A collapse and it would be heading straight for my room.  However reinforcement is underway - work with heavy machinery went on until about 9:00pm.  The sun set at 7.00pm and out came the odd lampbulb - I was quite impressed there were no accidents. Spot the hazards......



water tank on the right



It was the physiotherapists last day today, she's got  new job in a government hospital.  It was also the birthday of one of the lab techicians.  We had a little party at the end of the day for them.  Everyone had a soda (bottle of pop) and small cake (bit like sponge/brioche). Happy birthday was sung for Davis and he was made to do a dance.  Then there was a prayer, followed by people standing up and giving messages to the person who was leaving - what they'd liked about working with her and so on.  This was very nice.  The speeches were also quite short so it was lively.  She was also given a small present and did a short thank you speech.



Giving thaks



chilling out in the canteen

There has been some talk of the events in Libya. Uganda is one of the countries that still recognises Gaddafi as leader.  When I saw the news earlier there was a bit about France, Britain, Brazil, China, Russia etc meeting to discuss the situation. No mention of any African leaders nor the fact that African leaders are also meeting to discuss - they would still like to resolve matters using diplomatic means fearing a civil war.  It is interesting to see how the news is reported and plays out in different countries; also interesting is the apparent lack of engagment of African leaders - Gaddafi is after all one of the African elders.

Another week has flown by; need to get some plans sorted for the weekend - they've been on hold as I thought I may have had some time free next week for a bigger trip.  Working on a business case instead.
Halfway through now......at this rate I'll be back before I know it!

Quiet one this weekend.  Did boring but necessary chores like washing and ironing. Can't believe how stubborn some of the dirt is....it's red and gets everywhere.

Forgot to mention last week that I have been given an African name - Akot - it means comes with the rains.  This is quite appropriate as my arrival co-incided with the start of the rainy season, also I come from somewhere where it rains quite lot.  A name that fits me well I think. Most of the names I have come across have been names that are not unusual and many are biblical names.  One that threw me was Emma.  I was looking for a female doctor instead of a male doctor.  Here Emma is a common name for men as it is short for Emmauel and not used at all as a name for females.  I won't be making that mistake again.

One of things that has surprised me since I've been here is how strong the sense of tribe is.  It is something that seems to define everyday life for Ugandans.  You can often tell from people's names which tribe they come from. My African name above is from the local tribe. People often define themselves by their tribe.  The languges are also different - which is why people from different areas sometimes can't communicate if they don't speak English.  Apparently there are also physical characteristics that typify some tribes.  I've been told that there is a hierarchy of tribes, those belonging to the tribe that is in power thinking that they are better than other tribes.  Also the cabinet tends to be made up of those from the same tribe as their leader; and apparently more spending/ contracts etc go to those of the tribe of the ruling party.   So it seems that even if there is a change in goverment unless there is some sort of equality of tribes there can never really be democracy. And of course, tribes also span across national borders.

As it's been a quiet weekend this is a much shorter update....until the next time

Ah, another day at the office.  That's another week gone by in a flash.  Super focused today; we're going to have a staff meeting next Friday for me to go through my findings, observations and suggested actions.  This is positive.

Someone has also offered to take me out on a home visit.  If the patients don't turn up for their follow up appointments then the social worker may undertake a home visit.  We're going to do a local one - this is good as some of the journeys sound like intrepid treks. The social worker didn't get home unto 1.30am this week after getting soaked (rain) and having to hitch a lift back on a cart as there was no transport at all.  Although there are big buses connecting the major towns and taxi-buses connecting other main routes outside this, it's boda bodas (motor bikes), then bicycles and then ? whatever comes along - if anything.

There was a parents support group meeting here today.  About 50-odd parents who have been through the hopsital came along, with their children.  They have education classes, the children get to play with each other and associate with others who may have similar disabilities.  It also shows mothers who have children admitted in the hospital that their child can survive and can live a normal life.  Well, I walked past on the way to lunch - I couldn't believe how much mess the kids could make in so little time. There was one little boy who had spina bifida and who was a  bit knock-kneed who was racing about the place.  fter lunch I joined him and his friend (below) for a game of catch - I had to throw the ball very precisely as their balance wasn't the best - they however liked to give me a bit of a runaround now and again!  There was a child with hydrocephalus watching - he was funny as he screamed and laughed hysterically everytime I had to stretch out for the ball!

Have learnt today about a rather random bug.  I have no idea what it is called and wouldn't have known it was even a bug if someone hadn't told me.  Here it is

It looks like a bit of paper; but apparently creates mould - particularly on walls.  It also jumps about 6 inches when it's dark.  Wierd.

Happy birthday Jem

Time for the weekend....



Internet has been running slower than a slow thing lately.  Patience......Talking of slow things here is a snail I spotted the other day when I was walking to work in the rain, it's about 4 inches long

Forgot to mention the fashions in my last update.  The ladies, mostly outside the town, wear very colourful outfits with very pointy shoulders - sometimes rising quite a few inches above shoulder height. They look very graceful as they are walking along.  The shoulder designs look like a feat of engineering.

Had some drama last night.  Got back from town (I'd ventured into the fruit and veg part of the market this time) and it suddendly sounded as if it was pouring down with rain.  If only.....a water pipe had burst in Dr Shabani's bedroom and water was flooding out - by the time the head of maintenance had been tracked down and the stop cock had been located (noted for future reference) 3 bedrooms had been flooded and most of the main sitting room.  Shabani had created a bit of  damn to try to stop the water flooding out of his room.  Much of the evening was spent on clean up - dustpan was v effective in scooping up water!  Some of the guest house is now without water - I'm lucky - I had water and didn't get flooded.  Who knows what will be available later...

Bit of controversy here at the moment over a local forest.  There are government proposals to give some of the land to a private company to grow sugar cane.  It said that the land was deforested however when MPs went on a fact finding mission they discovered the land was still forested!  There are acres and acres of sugar cane grown here - plans to chop down an important forest to grow sugar cane seem like madness - particuarly when there is uncultivated land elsewhere.  They've been experiencing land slides near here and people have been killed  these are likely to have been exacerbated by deforestation.

There was a (peaceful) protest in Kampala against the government yesterday.  Protesters were soaked with pink water and dispersed......

Was on the ward this morning finding out a bit more about the work of the nurses.  There was a boy who had come back after surgery.  He was given morphine because he was in such pain.  He had a very big brain tumour which should have been operated on years ago.  After surgery all the side of his head was swollen - he couldn't really open his eye, he was in a right state poor thing.  He was with his grandmother who was very worried about him, however people all over Uganda speak different languages and so can't always converse with each other unless they can speak English.  It must be quite frightening being so worried and not knowing what exactly is happening because you cannot communicate.

I also saw Dick being brought back from surgery. I think he suffers a lot with fits.  Here's a photo of Dick I took earlier in the week.  He was eating a lolly and didn't know his tongue had gone blue so I took a photo to show him.  He was quite weak when he came back to the ward as he'd up most of the night vomitting - he still managed to raise me a little smile though.

Nearly finished my initial report - I've a meeting  (hopefully) with the Medical Director tomorrow so should hopefully be able to finalise it and work out what I'm going to do next. I've been looking at information flows within the hospital, working out the high level process - from the time a patient registers to when they go out the other end and have follow up appointments - and mapping what happens in terms of information during this process.  It seems a patients name and no is recorded at least 30 times during a stay.....The report identifies potential issues and improvement actions.  I'm also producing a framework in terms of how the information could be logically stored which they can use if they implement an electronic system..

Jinja town, lake Victoria in the background



Nile at Bujagali Falls




More of the powerful Nile




Me, Dr Sam and Dr Shabani on an island in the middle of the Nile reached by a small wooden boat..



It has been a long, fun weekend begining with an invite to dinner on Friday night. One of the intensive care nurses, Benina, generously invited those of us staying in the guest house to dinner.  A bit of a panic Friday morning as I'd not met her and so she didn't know I'm a vegetarian (note - many take vegetarian to be someone who doesn't eat red meat only).  She has a big house with huge gardens set on the outskirts of Mbale.  The sun was setting as we arrived, and with the luxury of back-up power in the guest house, I'd forgotten how dark it can be.  There were two candles lighting up the room.  The room reminded me of home.  It must have been the old British colonial influence as the ceilings were high, with picture rails and wooden panelled doors with old fashioned door handles & locks.  Benina also invited her son, Giddeon, to join us - he's a guide in the local national park Mount Elgon.  During the evening we also met other members of her family - 3 generations live in the house.  Everyone is exceedingly polite - with lots of how are yous, pleased to meet yous, thank yous and you're welcomes. We  ate off our knees with a small table in front and had some small (salted I think) nuts and pastry like things (made with maize flour and eggs) to start; tasty.  This was followed by rice, some bitter tomatoes in a thick paste-like sauce made with finely ground (soya?) flour - it was described as food for people with no teeth - that's all I can say is that it was delicious.  There were also some peas and bitter tomatoes in another sauce and some meat (beef probably).  This was followed by a veg which grows like spinach but has the texture of cabbage and some rice. All finished up with fresh pineapple, watermelon and bananas.  V filling.  This was accompanied, and followed by, a lot of talk on politics.  One of the guests is Tanzanian so there was a lot of discussion about what goes on in the respective countries and also about Kenya which is the other large country that forms part of the East African Community.  It was interesting because I don't think I've ever heard people speak so postively about another nation's people before - v complementary about the Kenyan work ethic (compared to that in Uganda) for example.  Much talk of the president and the economy too and how Uganda could catch up with it's neighbours.  From what I've seen so far this seems impossible given the general culture and decision making by the President (for example he's just spent trillions buying 3 old jet fighters from the Russians - why? will he have trained pilots to fly them, weapons to put in them or a reason to use them?).

Went to Jinja on Saturday morning - this is a town located, not very far away looking on a map, but a few hours on the road.  Jinja sits on the source of the river Nile.  We took a taxi bus as all the proper buses had left.  Not my ideal form of transport as they tend to be overloaded and the drivers drive as fast as they can.  The taxibuses are like small minibuses and are supposed to carry up to 14 passengers.  Our driver trawled about town for an hour (groan) until he'd managed to cram in 19 people.  I passed over the dam at Jinja when I came from the airport but the taxi bus took a different route so I got to see different things.  Just after we left Mbale we passed lots and lots of wooden stalls at the side of the road - selling bedsteads, mattresses, garden gates and..coffins.  This gave way to fields and small villages.  There were lots of small round (mud?) huts with thatched roofs. In many places there are half built brick houses - some with crops growing inside - I can't work out whether they are half built or just abadonned. The women had obviously been doing their washing as it was laid out on the grass to dry.  Some of the huts had small hedges around them - like a garden.  There were often lots of children running around playing.  We passed quite a few schools but it made me think of the Friday night discussion on the economy and how could Uganda develop when there were no learning opportunities (apart from water collecting and similar chores) for children outside school and potentially no jobs after they had finished their schooling.  Most jobs being in the towns/city mean that people flock there with no money, end up in (or creating) slum areas and so not creating the progression and economic prosperity that people are talking about.  In fact, being a boda boda (motorbike) driver seems to be what many men do- hanging around all day in packs, on their motorbikes, giving lifts (for a fee).  At one point we pulled into a district hospital to let some people off, next to the bus inside the hospital grounds was a woman lying on the ground with someone feeding her a bit of food,.  Elsewhere people had set up camp with blankets and small fires for cooking.  People have told me that in public hospitals one doctor often has 200 patients, and that nurses often come and go as they please.  Care is very minimal and drugs are limited.  In the Cure hospital where I work food is provided to patients to ensure that they don't set up camps and cause H&S risks and so that they are also well nourished - helping recovery. We pulled into a town (Iganga) at lunchtime to offload a few people (and cram in some more) and were swamped by people waving sticks of corn on the cob, chapattis and meat (or lumps of gristle) on a stick through the windows.  After about 3 hours we arrived in Jinja.  It was good to restore feeling to bits of my body that had gone numb! 

In Jinja we met up with 2 Ugandans (1 had worked in the hopsital in June and was friends with Dr Shabani that I travelled with).   This was good as Dr Sam knew the place and we also generally paid Ugandan prices rather than muzungu prices.  After having a refreshing beer in a cafe (a Club beer, v nice, approx 65p) we rattled (literally, due to the state of the roads)to Bujagali falls.  Here you could do white water rafting and bungji jumping.  However we went a bit further along the Nile where there are lots of small falls.  The water powers along at tremendous speed and force.  There are locals that seek payment for throwing themselves into the water, coming out amongst a load of white froth a bit further on - so dangerous and life threatening for very small sums of money.....  We took a small wooden boat (with motor and 'life jackets') a bit further along the river to see Jackson falls and to reach a small island in the middle of the Nile.  For those who know what I think about being in a small boat - I tried not to be too scared!  After getting back on dry land we went to the source of the Nile next to Victoria lake, here the river is much wider and free flowing (a bit more like it is in Egypt). Had some fresh tilapia fish and chips overlooking the Nile.  Yum yum.

Went to a bar in the night 'Babez' - v loud music, pool playing, dancing and football.  It was mostly men dancing (with rythym!!) - in fact it is mostly men out and about even in the day time.  Most of the time I forget I'm a different colour to everyone else around me but it's quite diffcult to get used to being surrounded by so many men.  Chilled out on Sunday until the return journey. We had the same mode of transport on the way back, although with only 15 people (and a couple of kids) crammed in.  I think people must go to Jinja for their 'big shop' to stock up on things as the taxi bus was full of stuff. Again we spent about an hour or so waiting for the bus to fill - this was an opportunity to develop my patience - I'm not usually very patient at the best at times - I really wanted to offer the driver some money just to get going but I knew this wouldn't be the thing to do so I just sat and waited...and waited. I wonder if I will be able to maintain this level of patience when I get back home.......  I don't know how many times I had the same torch waved in my face by the hawkers during this time - I lost count.  Eventually we got going - pretty much the same as the journey down to Jinja- I was mentally blaming the woman next to me for the odour of fish that started pervading the van (it was getting quite warm in there!). However, after a couple of hours we stopped to let someone off (along with his 2 live chickens that unbeknown to me had been in the boot the whole time) when he left so did the fishy smell.  phew.  Was glad to get off after 3 and a half hours, get home and have a shower.  Had a great time in Jinja and a very interesting weekend.

Picked up the Sunday papers on the way back; there was a full page spread in one of them 'an insiders view of why England's children are rioting an looting'.  The article blames moral collapse for the riots, particularly blaming the Labour goverment for moral degredation and destroying the traditional nuclear family and identifying Harriet Harman as a 'ultra-feminist wrecker'.  Interesting reading!  I couldn't find the particular article on line but are there are others here if you're interested
http://www.monitor.co.ug/OpEd/Commentary/-/689364/689364/-/bk3620z/-/index.html

Right, time to go, will upload some photos of Jinja tomorrow

It rained all night and most of the day - it feels like home! 

Spent some time this morning talking to the physiotherapist and to a social worker this afternoon.  The hospital tries to provide a rounded package of care including medical, social and spiritual.

Walking back from town this evening (trying to dodge the numerous muddy puddles) a man rode past me with a few chickens (dead) hanging off his handle bars - think I know what he'll be having for dinner.

There are quite a few articles in the newspapers about civil servants at the moment. The general feeling seems to be that they are overpaid, lazy, underachievers.....there are talks of plans to give them all 1 year contracts which only get renewed if they do a good job.  They also introduced performance plans last year - good performers could get paid trips to professional meetings, higher budgets, trophies, parties and paid vacation - poor performers could be disciplined, demoted or have their salary cut........I'm not sure what people think when I tell them I'm a civil servant, they don't look too impressed if I tell them I work for the government either!

Also an interesting comment on the English riots in the 'my observation is' column in the newpaper this evening.....'the UN should declare a no-fly zone over London to prevent the British Prime Minister from brutalising his own unarmed civilians'...! saw something similar to this in another paper earlier in the week. A different take on the UK government!

Went into town after work last night to buy a paper and look for the market.  The market was off one of the main streets and consisted of lots of small wooden stalls tightly packed together. There are narrow alleys that run between the stalls - the alleys are about 1 - 1.5 persons width wide so it is quite a bit darker than on the main street. The stalls are built on bare ground so the alleyways are partly washed away/bit craggy/with puddles etc.  It's a bit like a maze.  I didn't see it all and apparently the veg stalls I was looking for are quite close to the top of the road - the other end from where I was.  I did find the fish alleys unfortunately - had to hold my breath and walk v quick.  I'm not a fan of fish, including fish with flies.  Mostly it was piles of very small fish - probably dried - I didn't stop to ask!  A couple of people in work expressed surprise that I went there by myself - bt I didn't have any bags and walked quite fast so I was fine.  In fact it was in the street outside that I was greeted by calls of 'hey muzungu!' (white person) and got asked lots of questions.

Woke up to lots of birds in the garden, about knee high with v long beaks,it had been raining so I think that they were snuffling for insects. Someone walked past and scared them off, what a racket!!

Had a v interesting start to the day, I was shown around the lab by uncle Z.  He is retiring at the end of this year, has worked in his field a long time and is extremely knowledgable. It was also interesting because he has memories of the colonial influence pre-Amin.  All his school teachers were British and one was 'Mr Jones' from Wales.  He had taught his pupils a few words of Welsh; we had an interesting discussion about the Welsh language and I taught him a few words.  The lab is used to run all sorts of blood and body sample tests - it was like chemistry in school (my fave subject).  I also saw the bacterial cultures that were growing and the tests where antibiotics are applied to the cultures to see which are effective so the doctor knows which to prescribe. 

Pictures of the London riots over the front pages of one of the papers today, with the headline 'London's burning'...people are questionning me as to why the riots are happening

First day without beans for lunch, what a good combination rice and coleslaw is - with 'Irish' potatoes.

Today there was the first death since I've been here.  A baby with spina bifida died this morning.  The mother was waiting quietly in the spritual centre, next to where I work, for her family to come and collect her and the baby. V sad.

Rained a bit over night and this morning so the temperature dropped - I wasn't expecting to have to wear my cardigan over here!

Found out a bit more about the little boy with the tumour who featured in yesterdays update.  He's 7, I'd been told he'd had surgery to remove the tumour but it turns out this isn't the case, he's had some surgery previously and is in for another op today, they will be unlikely to remove the tumour due to it's location.  Also bumped into Olivia again today as I walked around the hospital - still all smiles - she's having her op later.

Spent some time in the intensive care unit eariler this is where patients come after surgery.  Then went to see the CT scanner in action - there was a bit of a drama as a private adult patient had had a scan and apparently paid the money (approx US$100) to some random person,  some consternation arose - was it a trick - had they been duped- what would happen - should they have the copy of the scan without having paid for it.......it was the talk of the canteen and most people had a view.  This would be a sizable sum of money and not something that someone could likely afford to pay twice.  General consensus was that this was a scam but of course no one knows the truth of the matter.  It seems the patient would not have been able to get a scan in the public hospital so had to go private if it was to be done.  It was interesting to see the CT scanner in action, particularly the brain scans as they came up on the screen - it was possible to see the different hydrocephalus cases, the size of the problem and so on.

UK riots have been a topic of discussion at tea break - some surprise and questionning to understand why they have started.  Wondering how this will end...



Corner of the garden aka rest home for wheelchairs

 I've been told that my blog is boring.  That no one wants to hear about the intricisies of water supplies but more of daily life and the work of the hospital (although dodgy water supplies (along with power supplies) are of course, part of daily life (and sometimes feel like the final straw)). 

Electricity (or lack of it) is a topic of discussion at the moment, power supplies are being rationed impacting not only on individuals but also on business and therefore potentially on the economy.  As you may expect, people in general are not happy about the situation - there is power but apparently the government are currently refusing to pay their arreas to the power company, who in turn are rationing the supply...when (and how) will it end, who knows.....As you may expect the hospital here has back up power supplies and a diesel generator for emergencies. Fuel is very expensive here, similar to UK prices but with petrol being more expensive than diesel.
Chilled out in the guest house garden on Saturday.  Think I may have mentioned in an earlier blog that there are some great birds here (not that I'm particularly a fan of birds) with amazing colours that you can't fail to like (Mrs Meekley you'd be in bird heaven), check this one out
http://www.africa-uganda-business-travel-guide.com/Uganda-Birding-Safari_-.html

Did a bit of exploring of the town yesterday, it was a bit quieter so I could see more. There are quite a few colonial looking buildings and a large clock tower in the centre of town.  Most of the buildings are fairly run down, the banks however were quite smart.  The banks and some of the shops had armed guards out front - very chilled out and relaxed though, don't think they were expecting much activity. Football is very popular amongst the men -I think the betting shop was the busiest shop I passed, everyone jostling to make their bets. You could bet on 'Money City v Man U'. Many Man U fans here - not sure 'money city' would have been a good bet as it turns out!  Am glad I am a vegetarian - the butchers shops have great big hunks of raw meat on the counters in the street - it was quite hot yesterday so they must have been maturing nicely...

Spent some time on the ward earlier with Collin who captures the stories of the mothers and before and after photos of the children, some of which are then selected and used for publicity in the US.  Most of the spina bifida children are very young, babies some just a few days old,  Charles we saw this morning is one that I checked in at outpatients last week and is now just a week old - tiny.  My favourite patient that we saw was Olivia (possibly 11 months old) - she was all smiles - although got serious when the big camera came out - she has hydrocephalus and is being operated on v soon. You can see in the photo that her head is enlarged, although hers was quite small compared to some others who often needed their mothers to support the weight of their heads. These children are often unable to walk or even sit.  One of the mothers that we spoke to was HIV+ and was being advised on what to do in order to protect her baby who is HIV-.

The little boy in the photo had had a brain tumor, he wanted to have his photo taken, he was a little bit shy.



Olivia and mama



Can't get used to people wearing quilted jackets and thick shawls. As it's been raining a bit for the last two days the temperature has cooled a bit - but is still fairly warm!

There is a (British) film crew here at the moment filming the work of the hospital, they've bought some biscuits for the team for the last 2 days.  I have never seen a big box of biscuits disappear so quickly - blink and they are gone; they are a real treat for people so there's a lot of excitement.  Me, I'm quite happy with the home made chapattis which are a bit like pancakes- delicious.

Am discovering the tempramental water supply.  Got woken up at 5.30 yesterday to the sound of V loud dripping - the shower had spontanaeously spurred into action.  No amount of knob twiddling would stop it. So I got back into bed, re-tucked in the mossie net and tried to stuff my head under a rather small pillow.  Got back after work last night to discover water gushing out full force - assumed the cleaner must have left it on.  Went to have a shower last night as ususal but could only get water out of the tap and not the shower head -think pressure was too low.  Just finished soaping up and the water decided to dry up.  You can imagine I was in a good mood at this point (no sleep - mosque praying 3.30 am,shower dripping 5.30 am, not so good progress in work...etc etc).  Eventually managed to squeeze enough water out of the various taps to rinse off and then cracked open this weeks pack of Percy Pigs (thank you Menna). aaaahhhhhh :-)

Never realised until this morning how sweet bananas actually are.  Ventured out to do a bit of shopping last night - bit scary to begin with but soon got into the swing of things. Got 2 red onions, a green pepper and the biggest avocado I've ever seen (and it was the smallest one there) for the grand total of 25p - and that was probably at muzungu prices!

Think they have dressed down Fridays here - the people I've seen so far are looking a bit casual in their jeans and t-shirts; I probably look the smartest I've looked all week today  I've acutally tucked in my shirt - oh well.....here's to the weekend...

Well there's nothing like making things happen, within a minute of talking about where I could work a desk and chair appeared.  Brilliant! I share the office with Brian the IT manager, with Colin the 'blogger' who logs the stories of the patients, and with the IT server and switch.

Everyone downs tools at 10ish for 'break tea' or tea break, brilliant way of knowledge sharing and finding out what's going on, I also got to meet people I didn't meet yesterday which was great.
Everyone also comes together for lunch too, it's a really sociable place.  There isn't really much of a hierarchy (v interesting comparison to usual way of working!) with everyone working as a team - it also means it's really clear for everyone to see how they contribute to the mission statement of the organisation.

Been having quite a lot of power cuts - there are lots of problems with electricity; however we're very lucky at the hosptial as there is some back up power available.  In the guest house this powers the lights and wireless router but not the fridge or cooker!

Spent some time in outpatients and also with Colin who captures the stories of each of the patients - some are here just by chance, hearing about the hospital through knowing someone who knows it exists.  Without the chance encounters the patients would die. Others are luckier because the mothers gave birth in hospital so were referred to the specialist unit here.

Have finally arrived, sun is setting and birds are tweeting.  The journey from the airport although long was quite eventful.  Kampala is a bit manic cars everywhere and no apparent rules of the road (the driver laughed when I asked him about this) only saw one crash though - not bad considering!  Saw some great scenery on the way over, luscious green valleys and hills, there were lots of towns along the roadside and the odd escapee cow (one nearly had a bloody end). The hills gave way to flatter plateau further east with lots of sugar cane, some tea plantations, rice paddies, papyrus fields and more -such a variety.  We apparently had a near miss with a crocodile at one point (i'm reading lizard rather than croc), unfortunately I'd snoozed off behind my sunglasses - whilst trying to appear alert - and missed this.  Bit of a shame.  Had a bit of a treat when we passed over the source of the Nile at Jinja, I knew the journey was nearly at an end when we turned a corner on the plataeau and suddenly Mount Elgon loomed up in the distance- beautiful. 
Arrived at the hospital to find that Channel 4 are here filming for a few days as part of their Unreported World series. 
Have had a whistle stop tour - loads of really friendly people and loads of names to remember.
Had a quick whizz around Mbale town and am now ready for a snooze......
Over &out



me travelling light........