Tuesday, 9 July 2013

Tuesday 9th July. Back home!

We spent the whole day yesterday returning home - We left for the airport at 6.15am, Ugandan time (4.15am here), and eventually arrived home at 9pm.  It was brilliant to see my family again.  The Devaraj's were extremely excited to see their dog, Dora.   I have spent most of today thinking about Uganda, and how clean and tidy everything looks here.  Felt guilty going to the supermarket and buying food - we have so much.  I think the biggest thing that we take for granted is going to the kitchen tap for a glass of water.

I have had a bit of feedback about the blog, and so I am going to try and tell you who everyone in it is, so that it's not so confusing to read!  I really did not think so many people would read it, which is wonderful, and no wonder you don't know many of the people I have been talking about!

The team from UK consisted of:
  • Vikram Devaraj - consultant plastic and reconstructive surgeon from Royal Devon and Exeter hospital (RD&E).
  • Woan-Yi Chan - registrar in plastic and reconstructive surgery from RD&E.
  • Karen Devaraj - Vikram's wife and administrator for Interface Uganda.
  • Alex Devaraj - Karen and Vikram's son - medical student.
  • Bex Devaraj - Karen and Vikram's daughter - journalist.
  • Jackie Fowler (myself) - physiotherapist at RD&E, Interface Uganda fundraiser and website editor.
The Hodges live in Kampala:
  • Andrew Hodges - consultant plastic and reconstructive surgeon at CoRSU hospital, Kampala.
  • Sarah Hodges - anaesthetist - soon to be working at CoRSU - she has just finished working at the International hospital in Kampala.
  • Andrew and Sarah have lived in Uganda for many years.  We met them when Andrew did his plastics and reconstructive surgery training at RD&E around 10 years ago.  They founded 'Interface Uganda' charity in 2001.
  • Naomi (21) and Rachel (16) - Andrew and Sarah's daughters.  They also have a son (Sam), but he was working in Kenya, so we did not see him.
  • Annette is their helper - she helps with meals, cleaning and washing.  She is a brilliant chef.
Staff at CoRSU:
  • Malcolm Simpson - CEO of CoRSU.
  • George Galliwango - plastic and reconstructive surgeon at CoRSU.  He came to RD&E for some training around 10 years ago, and Andrew was training him in Uganda.  He is now the first qualified Ugandan plastic and reconstructive surgeon.
  • Darius Balumuka and Martin Tungotyo - plastic and reconstructive surgery trainee surgeons.  Interface are helping with some of their training needs.
  • Christine Tusiime - head of physiotherapy at CoRSU.  She came to stay with us for 3 weeks in 2005, and spent time with the physio's at RD&E.
  • Stanley Lubega, Musa Kyanzi, Fildah Nakiganda - physiotherapists at CoRSU.
  • Florence - physio assistant at CoRSU.
  • Isaac Abor - Occupational Therapist (OT) at CoRSU.
Physiotherapist at Kagando hospital:
  • Ochom Kenneth Pascal.
Our neighbours at the guest house:
  • Resty, Francis, Joan and Linda.
I think that is everyone, but I can add to it if I find any more!

Sunday, 7 July 2013

Last day in Uganda. Sunday 7th July. Day 14. Market, badminton, swimming and Wimbledon history!

Another leisurely morning at the Hodges' house, reading in the sun and eating Rachel's amazing breakfast pancakes with chocolate sauce and fresh fruit.  Here is the view from Andrew and Sarah's patio.

We got taxis to the craft market in the centre of Kampala, where we bought lots of lovely African gifts.  And loads of stuff that we probably don't need.

We had a coffee whilst waiting for our taxis to pick us up again.  Vikram and Woan-Yi had a  'Lake Island' coffee - coffee, rum, lemon and coke!  Woan-Yi has spent the rest of the day feeling a bit 'squiffy', with rosy cheeks!

On the way back to the house, we took photos of the streets of Kampala:

We had a lovely lunch on the veranda at the Hodges', with the dogs under the table, waiting for scraps as usual.  
I played badminton with Joan (our neighbour in the guest house), then tried to teach Joan and Linda how to swim in the pool.

Then we went down to a bar and watched Wimbledon.  Tense and nerve racking followed by joy!  History has been made!  Can't believe it!

What a wonderful finale to our stay here. 

We would all like to say a MASSIVE THANK YOU to Andrew and Sarah Hodges for making us so welcome in their house, for feeding us, driving us all over the place, and showing us around in Uganda.  A big thanks also to Naomi and Rachel Hodges (Andrew and Sarah's daughters), for being so lovely about us all completely invading their space!

It has been a truly exciting, chaotic, challenging, heart-warming, shocking, tiring, sad, eye-opening, brilliant trip.  I'm so glad I came, and now I am ready to go home, see my family and really appreciate everything I have there.

Saturday, 6 July 2013

Saturday 6th July. Day 13. Sailing on Lake Victoria!

Ahoy land lubbers! Had a bit of a lie in and a chilled out morning, reading my book on the balcony. The sun caressed my shoulders and neck as dappled shadows danced with playful zephyrs romancing on the dew kissed lilac flowers and lemon grass leaves shimmering in the morning haze.... 
Karen, Bex and I went to see our neighbours - Resty, Francis, Joanne and Linda.  They showed us their beautiful wedding photos - so colourful.  They got married in Francis' village.  Resty changed her dress about 4 times on her wedding day - started off in white, then bright colourful, shiny dresses.  We gave their children some colouring books and pencils.

Mid-morning we all packed up and drove to Lake Victoria with a picnic lunch.  It was a very dusty drive - the houses and trees on the way resembled a martian landscape, with thick brick red dust from the murum road.

Lake Victoria  is amazing (unlike her Beckhamesque namesake) - a huge freshwater sea, grasshopper green with snails that are infested with bilharzia worms that can make you really sick, so we had to avoid them.

We shared a wonderful picnic with the wildlife, including hover flies, (like damsel flies mated with tiger moth aeroplanes, and the soldier ants keen to nibble any exposed flesh!  

After lunch we ventured out on the lake on hobby cats (cat-a-meringues)!  Andrew's friend Steve (a pilot), also had a catty - meringue, and I was the crew and lookout, while Vikram was the helmsman, and Steve sat back and relaxed!  After several leagues, we thought we saw the Kenyan coast, but in fact we were still only 1km from where we started.  For several minutes, which seemed like hours, we seemed to be stationary.  Steve described this as 'being in irons', a nautical expression meaning we had stalled and were stationary without any wind, and no hope of going anywhere.  We also 'ran with the wind', 'beat', 'tacked' and 'jibed'.  Next year, Strictly come Sailing!  It was brilliant.  A great feeling when we ran with the wind on one hull.

We got back home, and went for a run again - Woan-Yi on video camera today, Vikram in fast uphill mode and myself.  We were overtaken by two 10 year old boys running in shoes without laces, and never out of breath up a 1 in 4 hill.  

As I expect you can tell, Vikram has assisted with most of today's blog! Tune in tomorrow for more "pieces of late!" from Captain Jack(ie)!  

Friday, 5 July 2013

Friday 5th July. Day 12. Last day at CoRSU.

Big African snail on my walk up the path to the Hodges' house this morning!  Here is a photo for you Gem!

It may have been the last day, but it was quite a busy one in the therapy department, and I didn't get time to do my last teaching session on hand assessment unfortunately.  It was more of the same - ward round, followed by treating a patient with a radial nerve injury and shoulder pain, then into splinting mode!  

Here are the amazing CoRSU physio's and occupational therapist:
Stanley, me, Florence, Fildah, Isaac, Musa and Christine.

The last patient had a 'spaghetti wrist' - all tendons, nerves and arteries cut through.  Woan-Yi had operated on Wednesday - a mammoth task whilst teaching Darius and Martin at the same time - it took 6 hours.  I splinted her with Isaac, and we went through the exercise regime.  He will carry on her rehabilitation next week.  
Vikram and Woan-Yi have been teaching Darius and Martin (the trainees) all morning.  

Martin brought in his own chicken and slaughtered it himself (not sure if this is true or not)!
They have been practising their suturing and microsurgery on the chicken vessels!

Martin and Darius were keen to learn from Vikram's lecture.

Woan-Yi took Vikram and I on an epic run after work - all downhill to begin with!  2 children joined us along the way - a girl and a boy.  They were probably around 10 years old.  The little girl did not have any shoes on.  I asked her if it hurt her feet, and she simply replied 'I haven't got any shoes.'

Sarah and Annette (her helper) have been preparing dinner for 20, along with Karen, Bex and Rachel's help - there are many guests coming round later......

Alex is preparing some contemporary classical music for the party!

And I'm obviously blogging as usual!  In my new dress that Christine (physio) kindly gave me today!  Signing out now for today, as guests are arriving!

Thursday, 4 July 2013

Thursday 4th July. Day 11. CoRSU hospital

There was lots of discussion about the earthquakes this morning in the therapy department.  Apparently, they usually do not last as long as they did last night, and they happen around once a year.  We're experiencing so many new things!

I went on the ward round this morning - started off in orthopaedics with Stanley and Fildah (physios), then defected to the plastics ward round to check up on what splints may need to be made today.  There was a splint needed for a girl who had her operation yesterday by Vikram - she had syndactyly release (joined fingers).  

I also helped Fildah treat a boy who had a fractured wrist - he needed a wrist splint - hooray one of the ones I had brought in the suitcase fitted!  Then showed her some exercises that may be helpful for tendons stuck in scar tissue.  

After a tasty lunch of matoke, rice and peas, I made the tiniest splint ever on a one year old gorgeous little girl, with a tight thumb tendon with Musa (physio).  After which I needed to repair the aeroplane splint on the little boy with burns on the ward.  Florence (physio assistant) kindly helped me with this.  She has been working at CoRSU for 3 years, but has also worked for many years at Kumi hospital in Northern Uganda, so has plenty of experience, and was so helpful in positioning, getting equipment and translating for me.  

The girl with the gun shot wound to her hand was going home today to Northern Uganda, possibly not to be seen for a while, so I wanted to check that her splint was fitting really well before she was discharged.  Isaac helped me to check the splint and interpret for me.  Hopefully she will come back in 4 weeks to have her metalwork removed and to see Isaac for her exercises.

Karen and Sarah had a meeting with Malcolm (who is the CEO of CoRSU), and been discussing how Interface can help.  They have come up with some good ideas for projects we can help with.

Woan-Yi has been in theatre taking photos of cases and observing Vikram and Andrew teaching.  She has also been assessing outpatients.

Vikram has been operating and teaching.

We got back to Andrew and Sarah's house, and Vikram, Woan-Yi, Sarah and I went for a run with the Hodges' 3 dogs.  Woan-Yi had to take a different route, not being fond of jumpy dogs!  We watched Alex and Andrew playing squash down in the town - it was an extremely serious game - no smiling going on at all!  They looked really good - running around all over the place - manic!

After another delicious meal, Mat arrived - a new patient arrival from Fort Portal, who broke his arm this afternoon falling off his motorbike.  I think another splint may be needed tomorrow, although the cardboard seems to be doing a good job!

Wednesday 3rd July. Day 10. Back at CoRSU

Had a good day at CoRSU today, and did quite a bit of teaching.  We started with the plastics ward round, and picked up a few patients there, as well as some from theatre later on. We needed to do 3 splints all the same design, for a burn contracture release, and 2 patients with joint fusions.  I did the first one whilst Isaac (the occupational therapist here) watched,  then he did the next 2 patients.  Isaac gets to do most of the hand therapy here, and seems very interested to learn.

I helped with a few other patients that the physios were seeing.  The therapists here really are amazing, having to treat anything that comes their way.  One minute they are treating a newly referred 4 year old with cerebral palsy who has never had any previous treatment; the next patient may be someone with a bad back, then a baby with burns contractures, followed by a bit of plastering on a child waiting for leg splints so they can walk... and that was just this morning!  It is all so varied, and chronic / complex, as patients often cannot afford their treatment, or transport to the hospital, so hope it will just get better.  People are frightened of having an illness of accident, because the financial cost is so high.

After an exciting lunch of posho, beans and rice, I did a bit of teaching with the therapists.  The surgeons have done some tendon surgery this week, and I wanted to check that the therapists knew the post-op rehab for various conditions, as some of them will be seen next week.

Christine helped me to make a difficult splint on a girl who had been shot by rebels in 1999.  She was shot in the hand, and had scar contractures which Andrew had released last week.  The contractures were so bad that he could not get the fingers to fully straighten.  We wanted to make sure that the scar would not contract again by holding the hand as straight as possible in the splint.

Woan-Yi did a lot of teaching with the trainees, Darius and Martin, in theatre.  They were repairing a 'spaghetti wrist' - where many tendons and nerves have been cut through - in this case, the woman had lacerated her wrist in a car accident 2 weeks previously.  It's a difficult operation - they needed to repair 9 tendons, 2 arteries, and 1 nerve.

Vikram was also in theatre operating on children with congenital anomalies.

Bex was meeting various people including Mathias (the social worker) and Christine (physio) for interviews, and even managed to get me to appear in front of the camera!  She is making a short video for the website.

Karen talked to Mathias and did some investigating about the cost of treatments and equipment, and the intricacies of social worker assessment.

Sarah made us the most amazing curry for dinner - very brave, making curry for the discerning Vikram (originally from India)!

Later in the evening at around 10.30pm, we were sitting around the kitchen table, when a shuddering started - it was as if a train was going past very close.  It was an earthquake!  We were all very cool about it, not moving from our seats!  I thought that as Andrew and Sarah weren't panicking, that it must be OK.  There was another tremor in the middle of the night that woke me up - the curry was having an effect!

When we looked on the news later, it was an earthquake of 5.7 on the Richter scale, with the epicentre at Lake Albert 235km away, in NW Uganda!  We were experiencing the tremors.

Wednesday, 3 July 2013

Tuesday 2nd July. Day 9. Queen Elizabeth National Park and drive back to Kampala.

We got up really early - still dark at 6am, and got ready to meet our guide for the game park.  Her name was Harriet, and she took us to lions, baboons, kob (a type of antelope), water buck, warthogs, and Ugandan crested cranes (who were naughtily eating other birds' eggs).

Then it was the long 6 hour drive back to Kampala.  Karen, Sarah and I shared the driving.  Some of the roads were pretty dusty!