Apologies for the delay in another post - I did write it in full but lost everything in another powercut; a daily occurrence here!
Here is our latest update:
Kitovu Hospital
On Thursday I went to Kitovu Hospital (approx 15km away) where my friend Sarah from England is working. She is a GP who has been in Uganda for approximately 2 years, and has just recently returned having had a baby in England. It was really interesting to see this hospital and compare it to Villa Maria. It is approximately twice the size and has a specialist vesico-vaginal fistula (VVF) unit. I sat in on one of Sarah's teaching sessions with the nurses and spent some time on the new baby unit which is fantastic. She then took me round Masaka in the afternoon and we had lasagne for dinner which provided a welcome change from rice and beans!
The Ssese Islands
On Friday morning, we left for the Ssese Islands in Lake Victoria. We arrived on time ready to get the 2pm ferry, only to find that it did not leave until 5pm! We are getting used to Uganda time... We had a lovely relaxing weekend by the beach. I even had a warm shower on one of the evenings which was real luxury! Yesterday, we came back to Villa Maria via Masaka, and had lunch in a lovely cafe run by a Belgian HIV charity. We then had a wander round town, and I did some successful bartering (much to my surprise!) in some fabric shops.
The Ssese Islands:
The paediatric ward round
This morning, Felix, Emma, Rachel and I did the paediatrics ward round with Dr Alfred. There were many children with malaria and respiratory tract infections. The child with the wound on her head following a road accident had gone home which I was very pleased to see! Sadly, the little boy with tetanus has yet to receive any antitoxin, nearly 2 weeks later... It seems unlikely that the hospital will be able to source it, and even if they do the family are very poor and would not be able to afford the costs.
Another sad story is of the 2.5 year old girl I mentioned in a previous post who was originally diagnosed with croup. She was later found to have TB and was started on quadruple therapy. She has now developed frequent partial seizures, and was found to be HIV positive over the weekend. She has been started on carbemazepine (an anticonvulsant) and her CD4 count is awaited. Dr Alfred has suggested that she may have cerebral toxoplasmosis or cryptococcal meningitis. Neither of her parents were known to have HIV, and have not yet been informed of her diagnosis...
Emma, Rachel and I on the children's ward:
The adult male ward
Rachel and I then went on the male ward round. There were only 5 patients on the ward. The medical and surgical patients are all together on one ward. The first patient we saw was admitted with suspected colitis, although they do not have access to endoscopy at Villa Maria. We then saw another gentleman who had undergone a laparotomy a week ago and was found to have a sigmoid volvulus (twisted bowel). One week is approximately the amount of time patients here will remain in hospital after an operation.
We then saw a patient admitted with jaundice.He did not want to stay in the hospital for investigation and treatment, so self-discharged against medical advice. The next patient had initially been admitted with abdominal pain, but then developed a flaccid paralysis. Dr Alfred suspected Guillain-Barre syndrome, however the treatments (immunoglobulin and plasma exchange) are not available here. The personal tragedy of illness and disability is compounded by the social and economic implications - there is no welfare system here, no state pension, and family members are usually called upon to care for their relatives. The final patient was a 62 year old gentleman diagnosed with TB. He had an HIV test on admission which was negative, but was found on subsequent testing to be HIV positive. Here, he will be treated for his TB first before starting anti-retroviral therapy, to avoid the risk of immune reconstitution inflammatory syndrome.
Rachel and Dr Alfred on the ward round:
St Cecilia's Primary School
This afternoon we went to St Cecilia's primary school just up the road from the hospital.
From left to right - myself, Felix, Rachel, Cate, Flo and Gemma:
We had been invited by some of the teachers we met locally, and they were very pleased to see us! There were approximately 200 children (all girls) in a barn with all the school teachers, and the children put on a range of traditional tribal dances and songs for us which were wonderful. At this school there are 52 pupils per teacher! They had all gone to so much effort and were so welcoming:
The headteacher then give a speech, and then turned to me and asked me to do the same! I didn't really know what to say and was pretty embarrassed...! I just explained who were were, where we were from and what we were doing at Villa Maria. I wanted to emphasise that we are keen to build a sustainable long-term link here. We then had a 'Q&A' session where the children asked us lots of questions including whether we had children(!), who was the country's leader and what we like to eat in England.
We then had a tour, and watched the girls playing netball. We have managed to talk ourselves into playing a match against the children on Thursday! I will let you know the outcome...!
Another update to follow soon,
Amy
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