Thursday 27th June. Day 4. In theatre

A very exciting, though slightly nerve-racking day for me today. 

It started in a lovely way, with Christine discharging home a lovely 16 year old boy who had never previously walked, having fixed flexion deformities of his knees.  He used to crawl around, but with help from Christine (gradually splinting his legs into a more extended position) and the people in the workshop at CoRSU, he is now able to walk with crutches.  How fulfilling Christine's job is!  His mother calls her a miracle worker - I agree.  He was wearing a brilliant t-shirt, saying 'Parents for sale. Buy one get one free'!  Made me laugh.

Then I was off to theatre to splint the little 22 month old boy with burns.  It didn't go quite to plan, and lots of improvisation was needed in theatre.  Luckily I had Stanley (another physio from CoRSU), who helped a lot, along with Alex Devaraj, helping to keep the child's head still while we were trying to get the material around the back of his head.  It's something I have never done before, and I think it turned out well.  Dr Andrew Hodges was happy with it.

I felt very important as I was called to the other theatre to splint another little boy!!!  He had burn scar releases on his hand by Vikram, Woan-Yi and Martin.  

Lunch consisted of rice, peas and matoke - I'm going to try and write this in a different order each day I think.

Then it was back to help Stanley in the physio department.  I treated a little girl with a stiff elbow following an arm fracture.  Then I watched Stanley treat a 17 month old with cerebral palsy.  The physios here are amazing - there are only 5 of them, compared with about 70 at the RD&E, so they all have to know a lot about many different conditions.  They are extremely skilled, and take on anything that is thrown at them, however complex (which it very often is)!

Lastly we saw a 28 year old man with cerebral palsy who had fallen and broken his leg, which was in plaster.  We tried to get him to walk in the parallel bars, but he was having none of it!  I had to take a picture of the most ingenious bit of recycling I have ever seen!  

... It's a plaster shoe made out of an old bicycle tyre - brilliant!!!!

Bex has been interviewing the 2 trainee surgeons today for the Interface Uganda video, about how the charity has helped them over the past few years.  They were really good sports for doing it, as they had been operating in theatre all day before Bex collared them at 5pm to be interviewed!

Vikram and Woan-Yi were involved in quite a dramatic case where a young boy had his arm amputated due to a tumour.  

Karen spent some time in theatre and had fantastic time watching all the trainees in action.  She also got a chance to talk to some patients and relatives, finding out exactly how the charity has helped them and made a difference to their lives. 

Wednesday 26th June. Day 3 - Another busy day at CoRSU

After a sleepless night (for me) chasing a cockroach the size of a mouse in my room, Andrew drove us all to CoRSU hospital at 7.15am.  I met Christine, and we got to work immediately to take a pattern for a splint that will be made tomorrow in theatre for a 22 month old child who has had burn contracture releases around his neck and arms.  I had contacted David Burdon (occupational therapist at the RD&E), as it looked quite complicated, and he has kindly emailed me the instructions of how to make it.  Here are the bits I made today!

I also watched Christine treat a little 2 year old boy with spina bifida, who has no sensation and little muscle activity below waist level.  Then we assessed and treated a patient with a radial nerve palsy (limited movement in her wrist and hand) from a traffic accident.  We also saw a little boy of around 8 years with a brachial plexus lesion (many muscles in the arm not working - from birth) who Vikram had asked us to assess for possible tendon transfer surgery next week - we came up with a plan to splint him today and do some stretches, then he will have surgery next week.

Woan-Yi was teaching her very own 'round -the-clock' suturing technique all morning to the trainees, Martin and Darius, a possible future trainee, Linda, and to Alex (medical student).

Vikram Devaraj was assessing the trainees, and has reported that they have improved since their previous assessment.  Vikram then spent time in theatre.

Lunch consisted of rice, beans and posho (something carbohydrate-y made with maize flour).  

Some pictures of the important ones, doing their important stuff:

Bex has had a productive day and started filming, and taking photos for the website.  Karen has also been taking some photos, and finding out about how Interface Uganda can be involved at CoRSU hospital in the future.

Back at the Hodges' house now, and the pizza is cooking in the outdoor pizza oven - looks and smells amazing. Meanwhile, Vikram has been horse-riding!

Tuesday 25th June. Day 2 - Namawongo slum and Hands for Hope charity

An emotional and incredibly interesting day for myself, Bex and Karen.  We visited 'Hands for Hope' charity.  I found this charity when they contacted the Interface Uganda facebook page, asking for surgical and medical help for one of the children they have helped to educate.  When I looked at their website, I was motivated to sponsor a child to attend the school.  So being in Kampala, I could not resist visiting!  So this is me meeting Catherine and giving her the cards that my children made for her (plus a very small gift).

This is meeting Ryan - a child sponsored by another physio friend, Ann.  Her little boy (Jack) wrote him a lovely letter with a photo.

One of the classrooms.

Drumming and singing.

Catherine dancing!

Some of the donations for the school from our friends in the UK - they really appreciated it!  Their website is worth looking at:

www.ugandahandsforhope.org

They sponsor around 300 children from namawongo slum to go to school.  The staff there were brilliant.  

After showing us around the small school, we were taken into the slum for a walk around.  Whilst there, 

we met a mum with a small baby who had had a cleft lip and palate repair at CoRSU hospital last week -

by the surgeons who had been helped in their training by Interface!  We also saw where Catherine lived,

the indescribable poverty - a lot to take in and think about.  All quite overwhelming.

Crazy roads!  No rules at all.

Annette making juice from passion fruit.

Meanwhile, back at CoRSU, 5 surgeons (of which 2 were from Interface) and 3 medical students were in theatre doing 13 cases.  They had 3 theatres on the go all day.  This included several very complex cases.  Vikram also performed some hand anomaly surgery.

Vikram describes today as challenging, but marvellous.  Woan-Yi's description: 'It's so weird to be confronted with things in the developing world. There's some stuff you'd never see in the UK.  Some of the patients were so stoical.'  

Monday 24th June. Day 1. Arrived!

So we're here!  It's been a whirlwind of experience so far.  The plane took off from Heathrow at 9.30pm Sunday evening, shortly after which  Vikram Devaraj was already saving a life on the plane after a call from the pilot for a doctor!  After little / no sleep, we arrived at Entebbe airport at 7.30am, and were met by Andrew Hodges.  We came with 12 suitcases and 8 items of hand luggage - we just about managed to squeeze it all into his car (plus ourselves).  We were all extremely surprised to see it was raining - not just raining either - chucking it down!  Must have brought it with us.



Andrew drove us straight to CoRSU hospital, where we were given an extremely warm welcome from all the staff.  We met Malcolm Simpson (the CEO of CoRSU), who seems incredibly motivated to make great changes there to enable even more patients to be treated.
We were then shown around the hospital.  My first impressions were that it is larger than I thought it would be, in beautiful grounds.  The rooms are spacious, and all the staff that I met seemed well motivated and all so friendly and welcoming.
I personally spent a lot of time with Christine Tusiime, head of physiotherapy and occupational therapy (OT) at CoRSU.  It was so lovely to see her again - she came out to spend time at the RD&E for 3 weeks in August 2005, and stayed with us.  I did some teaching on hand therapy to all the physio and OT team, which I think went well.



Then we opened the suitcase of goodies - new splinting equipment personally donated by David Burdon and myself, along with loads of splints from reps that had not been used, and some second hand splints which could not be re-used at the RD&E.  I think they were happy!



After teaching, I was almost immediately put to use to make a splint!  It was a very different experience from making a splint at the RD&E, where all the equipment is set up to use so easily.  Lots of improvisation was needed.

  

Lunch was provided by the hospital - it is all cooked over a log stove in huge pots for all the patients and staff.  We had rice, peas and matoke (a kind of plantain / banana) - it was really good, and I went back for more!  More splinting was required after lunch on a small child with cerebral palsy.  As there was no sewing machine in the therapy department, we tried to adjust a fabric splint in the workshop with an amazingly patient man called George on the sewing machine!  Poor chap - he had to make around 5 different adjustments for us, never complaining once.  I could not have used his machine - it had some sort of device for making it 'go' which he used his foot for (not a normal pedal)!



So that pretty much made up my first day at CoRSU.

Meanwhile, Vikram Devaraj, Woan-Yi Chan and medical student Alex Devaraj were seeing a huge amount of patients in clinic with George Galliwango (Ugandan plastic and reconstructive surgeon), Darius and Martin (who are training to be plastic and reconstructive surgeons).  Malcolm Simpson (CEO at CoRSU) had advertised that specialist hand and reconstructive surgeons were coming from England with Interface Uganda, and many people had turned up with all sorts of complex conditions, some of which could be helped, and others which sadly they may not be able to help.

Karen and Bex Devaraj were busy taking photos, speaking to staff and generally finding out what Interface can do to help in the future.

We left the hospital at around 5pm, and went back to Hodges' house, where we are staying.  What amazing hosts!  We have a room each, some with a bathroom!  We are being extremely well fed with delicious food, and watered with passion juice, wine and beer!

Altogether an extremely productive and incredibly tiring day!

It's imminent!

So, after many years of hesitation, and full of trepidation, I'm finally off to Uganda on Sunday!  Luckily for me, I'm going with lovely people, some of whom have been before - Vikram, Karen, Alex and Bex Devaraj, and Woan-Yi Chan.  We are going to Kampala for the first week (staying with Andrew and Sarah Hodges) and working / teaching at CoRSU hospital.  For the second week, we are visiting a more rural hospital in Kagando.  
Thank goodness we are allowed 2 suitcases!  This one is already full with splints and material for the physio and OT department at CoRSU.  The other one is rapidly being filled with toys and craft / school equipment for 'Hands for Hope' charity in Namawongo - a poor, informal urban settlement in Kampala.  Hopefully there'll be a little room for some clothes!
So this is the start of my 'blog' - hopefully there will be some interesting stuff to tell you about - that is if I can get internet access!  If not, I'll do it when I get back.