It’s in the final week that you realise just how much you have left to try and cram in before you have to leave!
This week saw Dave and I do many of the usual things we’ve got used to over the past three weeks. Morning briefs, case reviews, home visits (including Dave’s observation!) as well as a few added extras.
Wednesday we visited Malago hospital, this time it was not a new patient we were going to see but one that we had been following since week one. The young girl in the wheelchair had developed an infection, which due to the paralysis in her legs had gone unnoticed until now. She was weak dehydrated and suffering from anemia. It wasn’t just us who were keen to see her either, five members of hospice, including part of the finance team came with us – this just showed how important her ( i keep saying little girl but she’s an adult!) health was to the hospice.
Although not the most shocking place we’d visited, with regards to level of cleanliness, there was something about being there that was unsettling. The lack of nurses, beds, equipment and privacy was shocking .The rooms could hold three people but on top of that family members stayed, sleeping on the floor on mats, or in the ‘waiting area’. Ugandan hospitals provide nothing for free, all health care, medication, x-rays and treatment have to be paid for by the individual. Forget turning up to hospital and expecting to be provided with food, bedding and all necessary essentials, here is it all done by the family, not the hospital. They hadn’t even cleaned her bed sores until we arrived.
The evident lack of care in the place just shocked and humbled me somewhat – the NHS is something to be grateful for, regardless of the waiting time, they still see and care for you without asking you for anything, and it’s available to all.
The evenings were a little more lighthearted;
We were lucky enough to have dinner with Dr. Anne and Miriam at their home. Dr Anne the founder of hospice told about how she came to be in Uganda – by fluke which seems to be the case in most cases (including mine).The care and compassion Dr. Anne has for the patients, the hospice, and the people of Uganda is inspiring, and just goes to show that anyone can help people, you definitely don’t need lots of money to do it.
Our favourites VIcky and Maureen cooked us up a feast, which we enjoyed with them on our final night.
I tried to each as much pineapple and mango as I could without making myself sick, and then it was Friday, and time to say good bye to everyone.
They celebrated our leaving with cake (!) and we were able to thank them for the amazing experience we’ve had over the past four weeks. It’s something that I know (and I’m sure Dave), will never forget. The generosity, hospitality and love the people of Hospice and Uganda have for each other is something that I am definitely taking home with me – never again will i point a lost tourist in the right direction, but will walk them to wherever they need to be!
Hopefully these blogs will have given you a little insight into what we’ve experienced, but words can’t really describe all the things we’ve seen, heard, smelt (!) and eaten (!). Hopefully one day you’ll all get to go to Uganda, we definitely would again. !
Was probably the busiest day we’ve had, with three home visits to three very different patients. From hospital, to a shack next to the railway, to a middle class family compound. They each had their own concerns and were equally challenging both visually and emotionally.
I think we’re building (I mean I’m) our emotional resilience on this trip.
Managed to get back in time for lunch: rice matoke and beans (our standard favourite!)
They dropped another public holiday in the week – International women’s day deserves its own holiday in Uganda ! Woop!
Two more home visits for us we returned to a patient from last week; the distressing situation we’d found the week before felt completely different. Hope was back in the families life as their mother had begun to regain some strength the children and grandchildren were happy and laughing, which was a joy to see.
Took us to Mild May, one of the hospitals in Kampala. As Daves says ‘It was probably one of the most enjoyable and frustrating days all in one!’. We shadowed a social worker and legal aid as they tried to manage the legal quagmire that surrounds HIV tansmission and underage sexual relationships (Too many details to write!). They also hold a legal clinic once a month; individuals (adults and children) can come and ask for advice on any legal issue they have (usually about land or child custody). We did spend a lot of time trying to pick up he jist of the English conversation that intermingled the lugandan!
The services they provide at mild may are amazing, with clinics for babies and new mothers, children and adolescents. The hospital is built of the side of a hill and had the most beautiful grounds…. Nothing depression about this health care facility with the sunshine shining overhead!
Wad presentation day (!!!). Save and I were asked to prepare a presentation on an article related to palliative care. We’d spent a few evenings getting ready but we were both fairly nervous!
No need to worry – it all went smoothly and by 9am we were free to prepare for the rest of the day!
After meeting another patient (and having my direct observation!) we were free to go and spend all out money in he local craft market! Needless to say Dave and I spent far too much and will be returning home with more gifts than we know what to do with !!
The weathers improved! After two days of rain and feeling like a chicken in a hen hut, we’ve been able to catch some rays!
Photos to follow.
It was time to some quiet time. Jinja, the source of the Nile. Bliss.
Was a fairly busy week.
Took us to visit our first patient (17yr old female, in a wheelchair). This was an eye opening experience, and our first to one of the poorer areas in Kampala (of which there are many). The local area was made up of small stone houses, dirt tracks (potholes), rubbish and stagnant water, as awful as it sounds, this is the reality for many Ugandans. There was no running water, inside bathroom or electricity in their property, which consisted of two very small rooms, one for sleeping (3 of them), the other a sitting room. They cooked and cleaned outside. The most astonishing thing about their house was the five steep steps that led to it, which Vicky evidently could not use by herself.
She was wheeled by a doting friend (who travelled a mile by foot to see her almost daily) to the internet café that we’re hoping to use for I.T qualifications. Kids here have to travel to school, usually by foot, and often for more than an hour. We don’t realise how lucky we are simply to have roads that we can walk on safely, that disable people can use without needing someone to help them. The infrastructure here restricts people on every level.
Dave got sick.
It was inpatient day so I spent the morning handing out tea, bread and boiled eggs (a staple here!) to the patients and their carers, with some of the other volunteers. I learnt how to make doughnuts on the coal burners they use here with Carol* (the inpatient day organiser), and had a reflexology lesson with Madge* (she even did my feet!).
The afternoon was taken up with two young girls discussing their carer prospects, which was a fairlyy frustrating process. They both want to continue with their education (at 17, they’ve only completed Primary 6), but they’re being encouraged to pursue vocational rather than further educational training. My western brain said – but why! They should be allowed to pursue the education they want! but in reality, vocational training would give them skills that would prove financially beneficial in their current circumstances. As much as education is valued here, there comes a point at which it is more sensible to take the opportunities that are being offered to you, than to pursue education further. Free education is a privilege that we in the UK take far too much for granted.
Dave had recovered and we were off to spend the day with the TASO group based at Malago hospital. TASO (The Aids Support Organisation); Living positively with Aids. TASO was set up to engage more men in dealing with HIV, education communities on how and where to get treated, how to live with aids, taking medication and protecting themselves and others, and the other social issues that can come with HIV. They travel to communities, engaging people through dance and drama. We went with JD* to a gathering which had been prearranged – the drama was very entertaining (going from the crowds response as it was in Lugandan!). It was really interesting to see how they engaged people, dispelling myths and educating them at the same time. It’s something we could apply far more in our primary and secondary schools for sex education and alcohol/drug awareness.
Turned out to be a shorter day than usual but then we spent three hours getting home….
Turned out to be an emotional day. After case conference in the morning, we went with Harriet and a medical team to visit a patient. It was the first time I had seen someone so ill and living in conditions that you would just not find in the UK. It was touching to see the way Harriet worked with the patient and her family, supporting the patient to sit, and then talking to the family, carefully trying to prepare them for what was likely to come soon.
There’s nothing that prepare or comfort you in those circumstances other than experience and kind words.
On a lighter note – I TOTALLY forgot that it was Maureens birthday !! So we took her and Vicky put for dinner :) They deserve it after looking after Dave and I for two weeks already!
Was fairly relaxed. Dr Anne (the hospice founder) presented a final lecture on elderly patient care… Dave and I were given articles to present on next week (!!!)
I got sick. It was not nice and not something that I wish to do again. Dave will tell you. Luckily we were on the way to drop off Marilyn and Rachel at the airport and had time to come back to the hospice (ruined our plan of visiting Entebbe together, but never mind).
Spent the rest of the day in bed.
Stated off fairly docile, then Maureen (our Ugandan Mum), took us on a mini tour of Kampala to visit some of the sites (there aren’t that many).
The Kings tombs were quite interesting – fun facts;
- The first king buried there had 84 (!!!) wives and he had to build houses for all of them
- The first born son is not allowed to be king…
- Twins are considered very special in Ugandan culture (they even bury their umbilical cords – the royal ones).
The houses/toumbs are these beautiful thatched ‘huts’ and they bury the king in half the hut, which no one is allowed to enter – I think the rest is left as a shrine (should have listened properly to our guide, Annitoli).
There are 56 (don’t quote me) Ugandan tribes, of which everyone in Uganda is born into and they’re all names after plants, fruits and animals. You’re not allowed to eat whatever tribe you come from – luckily no one is names after a mango!
Then we went to the Ugandan national museum; both Dave and I were expecting to learn about the development of Uganda as a nation, how it developed post colonialism etc, we were sorely disappointed. It was a bizarre mix of the national history museum (bones of dead animals) and the science museum (some bits of technology, including an old Ford car…).
Never mind, we enjoyed getting out of the compound and seeing a bit more of Kampala, to be honest we just like spending time with Maureen. After driving round Kampala, it becomes apparent that they pave the rich roads and leave the poor ones…the gap in infrastructure between the rich and poor areas is shocking. And pot holes… HA – You think we’ve got problems!
Fed ourselves at the American colonial club opposite the hostel (very expensive by Ugandan standards £6-8 per meal). It’s a world away from the reality of Ugandan life. We’ve been using it for wifi over the past few days and as nice as it is, I find myself feeling uncomfortable just being there – I suppose I don’t want to feel like there’s an exclusive, rich hub into which we fit – but the reality is, we do.