Tuesday, January 28, 2014

Videos

Maundo kids



Our welcome in Apigakwee



Teaching kids how to play frisbee in Maundo



We think this girl had sleeping sickness



More pictures

Typical lunch provided by the villagers

A beautiful mamma and her boy

Kids posing for pictures

Lunch break

Ridiculously cute baby


Line of patients waiting to be seen

These kids had never seen bubbles before and weren't sure what to do
Maternity Ward at Alanyi Health Center in Apigakwee

Maundo kids.  I recognize some of them from last year.

It is typical for girls to wear very fancy dresses

A home 

Kids playing a game

Grain storage



A lot of girls have their ears pierced, but do not have earrings.  They place small sticks in the holes to keep them open

We found a lady wearing an Oregon shirt.  I think she was quite confused about why we wanted to take her picture

Apigakwee pictures

I tried balancing the pot on my head.  It is not easy!

It is typical for kids to be the caretakers for young children

Baboons run fast and like to steal things

Nile Safari Lodge.  Best place I have ever stayed!

Hungry hungry hippo

This family of elephants was grazing along the Nile

Kingfisher

Watch out hippos, here comes the elephant




The Nile

Vervet monkeys are the cutest!

Friday, January 24, 2014

Safari Pictures

Kingfisher

Elephants holding tusks

 The giraffe is my favorite

 African Beecatcher

 The warthog family outside my room

 Brown eagle

 Oribi.  The second smallest antelope in Africa

Savannah sunrise


Wednesday, January 22, 2014

Apigakwee photos

 Our typical meals included rice, beans, potatoes, pumpkins, chicken, beef, goat, and cabbage. 

 One of the many roosters who woke us up at 4am.  Behind him is the kitchen.





Massive splenomegaly in  30 year old.  It made her look like she was pregnant.

Apigakwee



What a couple of days!  We have been in a village called Apigakwee for the last three days.  This village is about a 2.5 hour drive from the town of Lira in Northern Uganda.  It feels like the middle of nowhere!  Alanhyi Health Center is located in Apigakwee and is staffed by a few nurses and a local physician Dr. Martin Otine.  Dr. Otine grew up nearby and spent time training and practicing medicine in both Europe and the US.  He has decided to come back to serve his people for the remainder of his career. 
Our first day was spent traveling to the village and having a welcome ceremony.  The people here are very welcoming and grateful for our presence.  Some of the other work that has been done here has been to assist in vocational training and the   This was to be our first medical camp for these people.  We met with the local staff and made determinations about the flow of work for the next few days.  1500 people were registered to see us over the next 2.5 days.  To give some perspective to that, we typically see around 400 patients per day so 1500 was more than we were expecting!  Day one was challenging from a process flow standpoint, but eventually got moving.  It is a great opportunity for me to practice focusing on the patient in front of me and trying to let all of my frustrations with the system go.  Similar to the practice of medicine in the US!  I had a man who had a horrible finger infection that needed debriding so I was able to do a digital block and clean that up.  That was one of many moments when I wished I had Trent around to walk me through it.  There were a lot of women with back pain which is very common here.  It only takes a drive around the village to realize why: they do a lot of manual labor.  They work in the fields digging and stoop over to do all of their chores including cooking, cleaning, and tending to children.  My back would hurt too if I did that all day! 
On the second day I woke up not feeling too great, but went to work anyway.  By noon, I was out of commission.  I was sick for about 24 hours, but seem to be on the mend now.  I now fully appreciate the makers of sublingual zofran!  We are staying at a convent which is next to the clinic.  The head Sister took care of me through the night and this morning she told me how afraid she was to see me sick.  Apparently some time ago she had a woman visiting from Germany.  She fell ill for an entire week with malaria and Sister was afraid she was going to die here.  Luckily she survived with IV quinine.  I don’t have malaria and am not nearly as sick, but I appreciated Sister’s vigil and prayers on my behalf. 

My original plan had been to stay here for a few more days while the rest of the group goes on Safari, but after this illness and the challenges of the last few days, I have decided to let myself rest and recover.  I will going along with the group and am most looking forward to a hot shower!
 



 Little man had on a three piece suit in 90 degree weather!

 Donna showing kids how to High Five

 Cindy with a child sharing her name.


Dr. Andy and Nurse Donna consulting.





Saturday, January 18, 2014

Maundo Village

For the past three days we have been in Maundo village which is about a 40 minute drive from Torroro and near the Kenyan border.  Maundo village is where our medical camps began some years ago and where we have the most connection to the community.  We were able to see close to 750 people over the course of two full days of camp.  The most striking thing I noticed was that the children of Maundo are healthier appearing than the children in Aburi.  This is surprising because their villages are only about an hour away from each other, but distances in Uganda are very different from what we are used to.  My guess is though it takes an hour to drive between them, they are only around 20-30 miles apart.  In Aburi, the children has much more fungal skin infections and more overt bacterial infections.  They also wore clothes that were in horrible shape and most children did not have shoes.  In Maundo, the children just had an appearance of being healthier (with the exception of Malaria) and their clothes were in better condition.  Of course, these differences are small in comparison to children in the US, but it was noticeable.
Because we were in Maundo last year, I was able to see a few of the same patients I saw last year.  It was a fun experience recognizing them and having them recognize me as well.  I definitely feel a connection to that village and a genuine love for their people.
Languages in Uganda are fascinating.  The official language is English and most people understand Swahili and Luganda, but each area has it's own tribal language as well.  The people in Aburi and Maundo speak Japadola which is completely different from the language spoke where we will go to next in Northern Uganda.  I was able to pick up and practice a few Japadola words which the people get a kick out of.  They giggle everytime I speak their language which is a great way to connect with them.  Some words I have picked up:

  • One/Atchel
  • Two/Arrio
  • Three/Adek
  • How are you/Entenne De
  • I am fine/Entenne Ber
  • You are fine/Iber
  • He/she is fine/Gober
  • Cough/Wallow
  • Headache/Wishafuda
  • Fever/Lietho
  • Pain/Litho

Today I spent the morning visiting with Samson (the nurse for the clinic in Maundo) and his wife Martha and young son Jonathon.  It was enjoyable hearing about their families and struggles.  They are both in their late 20s and both grew up in families with 9 children.  They dated for 4 years before getting married and currently live about 6 hours from each other while Samson is assigned by the government to work in Maundo.  They see each other about once a month when they are able to afford the cost of travel.  In the meantime, Martha lives in their home village at Samson's family home and helps take care of his siblings and aging mother.  It fascinates me how much hardship these two face, yet their optimism and sense of commitment.  It also amazes me how committed they are to taking care of their families and serving their people in Uganda.  

After my visit, our group left Maundo and drove to Lira where we are now.  What a drive!  It took about 7 hours to drive about 200 kilometers.  The ride was filled with potholes and huge dust clouds that forced us to constantly close the windows.  This is miserable when you are riding in a van in 90 degree heat without air conditioning and the sun beating through the windows.  When we finally arrived in Lira it was 730pm and we had to sit through  a typical Ugandan welcome meeting.  Oh man, was I frustrated!  It is customary here for many speeches to be had that last for quite some time.  Their sense of urgency is no where near ours!  We will recover here tonight and then head to the villages of Apigakwee and Okwallogabo tomorrow to plan out our medical camps for the next few days.  

More Pictures

 Young kid with a growth on his neck.  It had been present for years and getting bigger, but not painful.  It was soft and mobile.  Thoughts?

 A girl with a bizarre fusing of her back upper molars.

 Our exam room.  Chickens, turkeys, and dogs made their way in there throughout the day.

 A Ugandan village home.