Mzungu bye-eee

For the last 2 months, when I have walked past children and they've shouted 'mzungu bye-ee' at me, it has made me laugh and wave back, now each time i hear it it makes me want to cry because it fits so appropriately!
Saying goodbye to the girls at the school I have been playing netball at was very sad as many of them are GCSE or A level age and will soon be leaving school and going off yo get jobs or (more likely because of the culture) getting married and having childtrn so it will be hard to see them in the future.
Had a lovely long chat to Thad about the ups and downs of life in Uganda and then bid him farewell. My final stop of the day was at The mustard seed orphanage. As ever, it was so lovely to sit and entertain the kids - letting them clamber all over me and pull on every part of my body! I helped one of the aunties (women who look after the children) wash the babies and toddlers who of course loved the fact they had a white person splashing water at them and I inevitably got soaked! The babies have a brilliant ritual of being stripped, hands washed and placed, naked, around a large bowl of food. They then eat this and get covered, head to toe, in food so they then get 'bathed' and plonked (in a line) onto potties and dressed. Once they were all in their cots I went round and kissed them all goodnight and goodbye which of course set the tears flowing as many of them were crying too. The older kids were then rating so I said goodbye to each of them individually, just about managing to hold it together. As soon as I was out of the gate and sat on the back of a boda, the sobs came at the thought of not seeing those beautiful, happy, playful children on a weekly basis :'(
Popped in to Sofia's place to find that Rhi had arrived. It was great to see her and nice to have another familiar, mzungu face here! However, i was much more excited by the fact that she brought a large block of cathedral city cheddar cheese with her and Sofia and I just sat in amazement at the smell, let alone the taste - we then used it to make pasta and cheese for dinner (such a novelty) :D
My youngest sister is sadly really unwell but no one really knows what is wrong.. It seems like malaria but she tested negative for it, however she has a scorching temperature, lots of vomiting and is just generally very weak and unhappy - it is so horrible to see a little 4 year old like that, especially when she is usually so energetic and bubbly.
At work on Wednesday, we had a little race has to whose mother would have their baby first (so unprofessional) with Rhi and I against Sofia's - we won of course. Also helped a mumma with her little, but thankfully very healthy, little 30 week baby so she could feed her and keep her warm.
For lunch i was given fried grasshoppers (along with the usual beans, rice and matoke). Esau has been telling me for weeks that they are the best food ever and all that... I have to say they weren't as awful as they could have been but didn't quite live up to his description. I couldn't quite get over the fact that I kept getting legs stuck in my teeth!
On Wednesday evening we hosted a party at Sofia's house for her birthday (which isn't until next week but I wanted to be here for the party) to which we invited all the midwives and doctors and a few other staff that we have got to know, along with Charlie and heather and Rhi of course! The senior midwife, Grace, did most of the cooking and she went completely overboard on the quantities but oh well, it meant everyone had a goody bag of potatoes to go home with ;) the party was good fun and it was nice to spend time with the people we have built up such a good relationship with, outside of work. Of course it was another difficult goodbye but somehow (<<that's such a Ugandan saying) I managed to choke back the tears. Also had to sag goodbye to Charlie and heather after they walked me back home in the dark which was sad as they have both been good friends put here and k have learned so much useful obstetrics from Charlie and plenty of useless, random knowledge from Heather (I know your reading this heather ;))!
Spent Thursday morning squeezing all my stuff into 2 suitcases and bracing myself for yet another emotional goodbye. Eve is still very unwell so saying goodbye to her was particularly tough, having to leave her in such a bad way :( the farewell was tearful but brief which is probably a good thing otherwise I may never have left!
On arrival in Kampala I repacked mg bags to try and make them a little easier to shut (unsuccessfully) and then read on my balcony with Kampala stretched in front of me. Met Sofia and Rhi at a restaurant in town and we had a delicious Indian, coming away completely stuffed.
Yesterday we went on a coffee safari. This involved turning up at a coffee shop (completely drenched after catching a boda in the rain) and getting breakfast. We then visited various places learning about the importance of how the coffee is prepared by the barista, the coffee tasters who spent their day sipping and spitting coffee to check it is suitable for export and us Brits (and the like) won't complain. Then went on to a factory where they clean and sort the beans according to colour and size. Also visited a roasting house, where ironically they gave us disgusting coffee. After seeing a coffee research centre (which was a bit too much like A level biology for my liking) we went to a very rural coffee farm for a traditional Ugandan lunch and planted our very own coffee trees with a sign beside them - I will be back in a couple of years to harvest my crop ;)
Lugged all my bags to the coffee shop opposite the craft market this morning where I sat and had a coffee whilst Rhi and Sofia did some shopping and then on on to the beautiful Boma hotel I'm Entebbe, by the airport. The sun did us proud and shone all day so I snuck in some last minute tanning (and nose burning as ever) in the equatorial heat before a lovely dinner followed by a very quick goodbye (to avoid tears) with my Ugandan companion Sofia and Rhi.
I am currently sat in a (very overpriced) cafe in the airport departures and I still don't think its hit me that I am coming home although I am so excited to see my families faces as a walk out of Heathrow :D
See you in under 12 hours.... Xx

Last week in Hoima

So it is now 2 days until I leave Hoima, 5 days until I leave Uganda which I cannot quite believe.
I am saying more and more goodbyes and every time I tell someone I am leaving they ask when I am coming back. I think that is the hardest part, when I left England, yes I was sad because I was going to miss everyone but I knew I was coming back in 2 months, the trouble with leaving here is that I know I will be back for sure, but I am also going to be a student with no money for the next 5 years at least so it is going to be a while before I am back :(
Last time I wrote I was about to embrace a knew role out here as mother to the 3 girls I live with. Personally, I would say I was a very good mother... they ate on time (although I didn't cook, the maid did), they washed well, they weren't in bed too late and I even got up at 6 in the morning to get them up and ready for school. Although, I think that was my downfall... I woke them up, then sat on the sofa and dosed off to sleep again.Thankfully the 9 year old, Esther, is very responsible and grown-up and got both her and Eve washed and dressed and then they had breakfast. Once they had gone to school I went straight back to bed for another couple of hours - early mornings are NOT my thing! I did find it hilarious that the previous evening I had gone for a walk to Thad's house which is just done the road and took Eve with me, I then got a phone call from Esau (their dad) saying I hear you are walking towards Thad's, because someone had rung him to say that a white person had stolen his daughter!! Throughout that day I helped deliver 3 babies and I love looking after the baby once it is out - sorting out the chord, putting a nappy on it (not any more as we've run out), dressing it, weighing it and then wrapping it up like a little parcel to give to the mother or more often the attendant who is with the mother. The 3rd baby of the day was the 11th child of a 42 year-old woman which I think is just crazy... imagine having 11 kids :O As a result of being a 'grand multip' (having so many kids) she bled a lot after having the baby so we then had to deal with that.
Played my last netball match with the girls from Canon Njangali girls school, however, there weren't so many that were keen to play at the beginning because they were watching a film - but when the power went off they all wanted to play!
Had another new experience on Saturday; I went to an introduction ceremony. This is a traditional Ugandan function and is basically the pre-amble to a wedding. It is basically the bride's family meeting the groom and his family and checking whether they approve, then the groom has to choose his wife from a load of different groups of people who come dancing in and then there is lots of gift giving (including 4 goats). Eve and Esther, my 2 younger sisters, were some of the girls who walked in in the groups to see if any of them were the bride. They looked adorable in their little pink spotty dresses and thankfully he didn't pick any of the under 9 year olds ;) I really enjoyed the ceremony although I found it quite difficult and parts of it very dull because it was all in the local language so I couldn't understand anything and I was sat next to my other sister Eileen who wasn't particularly helpful and just said 'I don't know' to every question I asked her. In typical African style it also started extremely late, the official start time was 12pm, I arrived at about 12.30 and there were very few other people there. Masses of people started to arrive at about 2pm and the event properly started at 3pm - so only 3 hours late. I got to wear a traditional Ugandan dress to the wedding which was good fun and everyone told me how smart I looked; it was long, thick and blue with gold flowers, it had very pointy shoulders and a big gold sash belt to wear around my middle - I felt like a true African woman!
Decided to go to church with the kids from the Mustard Seed on Sunday, but it was a complete failure which is entirely our own fault as we trusted them with telling us the time of the service that they go to and that it was in English. So we turned up at 8.20 for the 8.30 service just as they were coming out of sunday school and there was still a service going on. The mustard seed kids then all left and went back home so we waited a bit for the service but it hadn't started by 9 so we just left and went to the mustard seed.
We were picked up from there by Charlie and Heather and 2 other Brits who are visiting Hoima, having lived and worked at the hospital for 6 months in 2013. Bravely, we let Charlie drive us to a beautiful little lodge right on the edge of Lake Albert for the day. The entire drive there was on a completely flat, no speed bumps tarmac road which was heaven - especially as I was sat in the boot because the car was only 5 seats for 6 of us, and being the smallest I got that honour ;) it is probably the best road in Uganda and it has been built very recently because it is the road that the Turkish have built to the oil fields. The lodge was pretty much deserted but was completely idyllic and so peaceful. We spent the morning sitting around with feet in the pool, then had lunch followed by a long and intense game of Monopoly in the sunshine until we melted and everyone got bored and gave up. We drove home through the wildlife reserve surrounded by beautiful birds, thousands of antelope and loads of warthog.
In the evening I had dinner with the family and then both Olive and Esau did little speeches which I sobbed my way through making me so sad to go home, the girls didn't really know what to say with me sat there crying in front of them but even just them saying they were going to miss me made me sob harder. They have been so welcoming and they are like my family now, it is lovely to have the little sisters that I have always wanted, even if they do live on the other side of the world from me.
Yesterday, I delivered a baby entirely on my own because the Senior Midwife Grace (who I love and is hilarious) was far too busy taking out an implant on the next bed to help me. Sofia came into find me pulling out the head and then the rest of the body came very easy. I still get such an exhilarating feeling from delivering a baby and knowing that you have just brought a new life into the world - it is made better when the baby comes out screaming its head off as this one did. It is strange to think that in a weeks time it won't be an every day thing to be delivering babies :( Charlie and Heather came round for evening tea and I was presented with a leaving gift from the family which was a beautiful orange and purple dress that the Ugandan women wear all the time! I then went to my last aerobics session along with Olive who has never come before. It was a particularly tiring and sweaty one, but I think that might just be because it is generally getting hotter now. Again had more goodbyes to say to everyone there.
Today I have just been pottering around town, doing a bit of shopping and saying farewell to various people who have become such good friends out here. Rhi is arriving today along with a new delivery bed for labour ward at Azur which people have donated money to buy so I am very looking forward to her arrival.
As much as I am sad to leave, I am really looking forward to coming home, back to the little luxuries (particularly toilet paper that tears on a dotted line)
Love to all and see you soon xxx

Kampala and back to reality

Spent the weekend after safari in Kampala, the capital city of Uganda. Said goodbye to helen and Duncan which was very strange knowing that in less than 2 weeks it will be me leaving!
Kampala was like visiting another country altogether, with high rise buildings, cars EVERYWHERE, western food and crazy boda boda drivers. Spent the day on Friday eating delicious western food like pizza, pancakes and good coffee. Had a luxury pedicure with a foot bath and everything, and Sofia risked getting her hair cut which I thought went surprisingly well, she wasn't so keen.
In the afternoon we went and found the craft markets and spent a ridiculous amount of money on souvenirs and tat! The hotel we were staying in had hot, powerful showers too which we both really appreciated, especially Sofia who hadn't just been on safari.
On Saturday we caught a public taxi which is called a mutatu (muh-tah-too) and looks like the mystery machine from Scooby doo. We had to first find the appropriate taxi in the madness that was the taxi park and when we boarded, so did another 15 people to sit on the 12 seats - safe to say it was a tight squeeze. Took the mutatu to the equator where we were very touristy taking pictures stood either side of the equator and visiting yet more craft shops. Also saw demonstrations of water spinning in opposite directions on different sides of the equator and straight down exactly on the equator - who knows whether it is legitimate or not?! Liked the idea that on the solstice days you weigh 3% lighter stood on the equator!
Catching a bus home was more of a challenge as we had to hail them as they sped along the road. About 5 drove straight past because they were full, one stopped and tried to convince us to get on even though he was already overfull but we turned down that offer and thankfully the next one was only half full so we caught that one. Spent the rest of the day wandering aimlessly around the streets of Kampala taking in the sights and smells of such a busy city and dodging the wild motorbikes. Finished off the day with chicken fajitas (om nom nom nom)
Before our return to Hoima on Sunday we went to Watoto church in the centre of Kampala. It was definitely an experience as everyone had so much energy and it is run by Americans so is very modern with flashing lights and sound systems and all that. This was great but both Sofia and I were a bit thrown by the fact that so much money had clearly gone into it yet we have met so many people that can't afford food and are lying on hospital floors to deliver babies due to lack of beds.
I shouldn't have enjoyed the journey home yet I did. I was wedged between 2 people on the back row of the mutatu with very little leg room and the drivers don't slow down for the speed bumps so I regularly bumped my head on the ceiling but it is all an experience :)
Got back to the reality of Hoima with orange dust everywhere because it hadn't rained for a couple of days. Visited the mustard seed and let them rub their grubby hands in my hair and up my arms and hold my hands because they are just too lovely to deny anything.
Had a lovely welcome home from little eve who came running into my arms and told me she missed me :') she's had her hair done in loads of little bobbles all over her head to - its adorable. Then had a less welcome cold shower and beans and rice for dinner!
Had lots of babies at the clinic this week and also been able to do things like print them new posters, to replace the orange-tinged, blood-stained ones that they currently have.
Braved going to Hoima hospital again yesterday which as ever was a crazy day! It started surprisingly gently with very few mothers in labour and no major complications. Did a ward round with Charlie and found a mum who was pregnant with twins and according to her dates was 36 weeks but according to a scan was 26 weeks so that was a curious case and may be due to growth restriction in-utero, dodgy scanning or bad recollection of dates. Went back to labour ward to find a girl had come in who had a baby in breech position with feet coming first and no foetal heart beat. Decided to let her deliver naturally to save the trauma of going to theatre but the delivery was pretty challenging too as the feet and most of the body could be delivered fairly easily but the head, being much bigger, got stuck and the arms were extended above the head. Eventually managed to get the baby out, wrap it up and put it in a box as is customary with dead babies.
Whilst we were delivering that baby another baby was delivered and according to the midwife was fine but as soon as Sofia saw it she knew that there was no way that baby was okay - it was blue and floppy! Sofia and Charlie spent over half an hour attempting to resuscitate the baby but then decided it was in vain and baby wasn't going to make it. When we told the grandmother of the baby she burst into tears and was devastated which is so rare to see here. She kept asking us how she was going to break the news to her 17 year old daughter, the mother of the baby, and then crying. It was absolutely heartbreaking :'(
We then had another woman come in who was enormous so we suspected  she had twins but it turned out to be just one MASSIVE baby whose shoulders then got stuck and the local midwife dealt with it very badly, just pulling on the babies head. She ignored all our protestations and slapped Charlie and Sofia's hands away when they tried to interfere. Predictably the baby needed resus as the chord had been really tight around its neck and we were worried we were going to lose that baby too but thankfully the little giant came back to us and we took her over to the neonatal unit for more help.
Popped my head into theatre to see what was going on and ended up watching the end of an amputation of a boys leg that had been severely burnt because he had been walking bare foot during a storm and had been struck by lightening! It was pretty gross to watch but also fascinating watching the surgeon stitch the skin, muscle and fat back up. Thankfully, i think, I didn't see the part of leg that was chopped off - I don't think that would have been a pretty sight.
In the evening I had a full body massage (for £3.50) to relax me after the stresses of the day.
I am currently acting as mum to the 3 girls I live with because both their mum and dad are away in separate places so that should be fun.
It is very strange to think that in 10 days time I will be home and wishing for sunshine whilst I am currently sat sweltering in the heat!
Lotsa love xxxxxx

Paraa-dise

Extremely early start on Tuesday morning - up whilst it was still dark! Helen, duncan and I drove to masindi (an hour and a half) and had pancakes in the sunshine for breakfast. Then onwards and upwards towards the safari park. It was a long drive but I love gazing out the window as this completely different world whizzes by. Eventually we arrived at the ferry crossing where we crossed the Nile into the park, whilst watching the hippos bobbing about in the water beside us.
When I arrived at Paraa safari lodge I honestly thought I was in heaven - it is the most beautiful place with stunning views and lovely rooms. They even had fancy mosquito nets and was in awe of the hot tap in the shower!! My room looked out over the pool with its sunloungers and thatched pool bar with a palm tree for added effect.
Started with lunch where I had proper bread (not sweet bread) with CHEESE on it, salad including my long-lost love CUCUMBER accompanied by a cold, DIET coke :D I was a very very happy girl!
After lounging about in the intense heat, Duncan and I went for a game drive. The scenery is incredible with such vast stretched of flat land and its even better with giraffe, elephant, antelope, buffalo and warthogs dotted amongst it.
There were ridiculous amounts of giraffe, almost everywhere you looked. We almost saw giraffe fight but it didn't get too serious, they left it at just hitting each other with their necks. Found a torn apart hippo carcus which was surrounded by ugly vultures and scavenging jackels, and the next day it stank!
I was welcomed back to the lodge by an amazing hot, powerful shower...I felt clean for the first time since I left England and that is no exaggeration.
Did a morning game drive at 6am and watched the sun come up and the wildlife wake up around us. We spent much of the morning following lion's paw prints but never found the lion. However, we did find a hyena which are very rare to see and it just wandered down the path in front of our car for a while - they are very unattractive animals because they have a special shaped jaw for chewing bones! Saw giraffes running which is the best thing to watch and is so elegant despite the gangliness. As we were almost back at the hotel, a little family of elephants stepped out on the road in front of us with a liddle baby and then slightly older (but still young) one who got a bit agitated with us and was very close to charging us but thankfully got distracted by food.
Again spent the middle part of the day (after a delicious breakfast with sausages and BACON) lounging by, but mostly in, the pool in the almost unbearable heat. It was great to catch up on all the gossip from home and hear about Hartley wintney life :)
On the evening drive we were mainly on the hunt for lions but there didn't seem to be any about. Duncan had said I will give up hope at 6.35 and at 6.25 we got a call from another ranger saying they had found lions so we sped over to them! There was a male and female lying side by side in the open but far off the track so no wonder we couldn't find them. We had been there watching them for about 3 mins when the male got up and mounted the female. They had a brief - 5 seconds - moment of excursion where he bit her and roared a bit, then he dismounted and they lay down again. Our ranger then told us that this was them mating and they do it every 22 minutes, day and night for 3 weeks while the female is in season - how crazy is that! So if I came back in 7 months time there would be little babies too :) we were so thrilled to have seen the lion in the end and drove back in the moonlight very happy!
Another hot shower and impeccable dinner followed by much needed moisturising of my extremely sunburned skin (again I blame the anti-malarials) and then sleep in my grand mosquito net with a fan!
Drove home through the safari park and through land that was previously impassable because it was Kony's land and crossed the Nile at the beautiful Karuma falls. It was a longer and much dustier drive home (due to no rain) but with stunning scenery to make up for it. Eventually made it home for a cold shower to wash off the layer of orange dust that had collected on my skin and then went out for dinner.
Absolutely knackered after a tiring but thrilling couple of days - what a perfect birthday present!! Now off to Kampala, the capital, for the weekend to do some shopping...
Hugs and kisses xxxxxx

English arrivals

So after the drop in numbers of babies delivered at the beginning of the week, a day at Hoima hospital made up for it...delivering 7 babies in one day! They were all bar one normal deliveries. The one that had to be sectioned was pregnant with twins, both in breech position, however, the cord of one of the babies had fallen out so there was a good 4 inches of cord visibly hanging out of the woman. As a result, this baby did not have a pulse but thankfully the other twin did so they took her to theatre and she came away with one of her 2 babies, alive. One delivery resulted in the baby being rushed over to the kangaroo ward for respiratory help. Another delivery lead to major bleeding afterwards and the woman then ran a very high temperature but other than that it was much less traumatic than our previous visit. It was also interesting to see the ward when Charlie wasn't there and hadn't been for a week!
On Friday I visited the school project that olive works at again to give out some clothes (that we had brought out with us) to new, underprivileged mums for their babies. I also helped her with a bit of her work and then she showed me where to get a pedicure. That was an experience in itself, I sat on a bench on the side of the street and had my toenails sorted out and made to look beautiful, all for the cost of £2.50 :)
Had a delightfully relaxed weekend spent sunbathing and shopping and visiting the ever lively children at the mustard seed orphanage! For some reason, on saturday night sofia let me die her (very brave) so we spent halloween dyeing here hair red. I also went to Sunday school where I got a very warm welcome and all the kids sang and danced for me. I even had one young girl fall asleep on me - dead cute.
Sunday was finished off with the arrival of Helen and Duncan from back home who have come to visit me and Hoima. Duncan is the overseer/manager type person for the charity Help Hoima which has helped build the clinic that I'm working in every day, and a few of the schools, along with doing lots of other things. It is through Duncan and Helen, and their daughter Ellie, that I have a link with Hoima as I first came here to visit them in 2008 when they lived here with their family for a year.
They came bearing gifts from my amazing mother who (as ever didn't listen to me saying I didn't need anything), had sent me luxuries like mints, chocolate and freshly, home baked banana and raisin cake. Tasting the cake was heavenly and it made me realise just how much I miss little things like home baking. She also sent lovely letters from some friends and family which, of course, reduced me to tears.
On Monday we went into the clinic and everyone was dressed particularly smartly which I later put down to the fact that the infamous Duncan was visiting so everyone was on best behaviour ;) ended up having to transfer a preeclamptic patient over to Hoima hospital because she was very ill and yet was only 28 weeks pregnant. In UK babies can be kept alive and supported from 24 weeks, sometimes even 20 weeks, but out here anything less than about 32 doesn't really stand a chance because they just don't get the treatment and attention that they need.
Went to the mustard seed again in the evening and the toy cupboard was opened so they all went even more crazy than before (hard to believe it was possible) but it did make it easier to have some one-on-one time and give some attention to one at a time as the others were preoccupied.
Early start in the morning for safari :D
Much love xxxx

Hot hot hot

Since my last post, there has been nothing quite so harrowing to deal with and there has been a distinct lull in the number of babies being born. Although having said that, when I turned up at the clinic last Friday I walked into labour sweet and pretty much straight away delivered a baby. There was another woman in labour on the second labour bed and then someone else walked in, about to deliver. So she laid down her cloth on the floor and delivered her baby lying on the floor in the cleaners room. Almost simultaneously the other lady delivered her baby so we had a mad rush of babies with 3 in the space of half an hour. We then only had one more for the rest of the day which was an emergency c-section due to prolonged labour! She later had a pph (major bleeding) which we were left to deal with because there was a whole staff meeting so there was no one else about apart from us - T.I.A!
On Saturday morning Sofia and I visited the place where Olive (my Ugandan mum) works which is an education day care project for underprivileged children funded by the Christian charity 'compassion international', so it was great to see the work that big charities like that actually do in these countries. Spent the afternoon wandering around Hoima town taking in all the lovely sights and not so lovely smells buying assorted groceries and beautiful patterned fabric. Sat by the pool for a bit and then watched our dinner be cooked in front of us on the street - we had delicious goat kebabs and chips! The first bit of meat I have eaten in a long time because I trusted it being properly cooked to my liking ;)
Sunday was meant to be spent by the pool, basking in the sunshine...however as we arrived the heavens opened and then stayed open for 2 hours. When it subsided we wandered to the mustard seed orphanage to entertain and be entertained by the kids there. For some reason we still give them sweets when we arrive and then let them clamber all over us and play with our hair making us come away feeling disgustingly dirty and sticky but its always good fun - they are all very endearing!
Monday was a very strange day at the clinic as there were no babies delivered, which is very rare. I took advantage of the lack of patients to give the beds a good scrub (who knows when that last happened) and clean the floor which was covered in old food, resulting in millions of ants, copious amount of red dust and a dirty cannula needle!
Yesterday we went and ran another outreach antenatal clinic in rural Runga down by lake Albert. It is breathtakingly beautiful down there and also ridiculously hot. The kids were fascinated by us again and at one point I was sat down and they all surrounded me, I gave one girl a high five and they all followed her courage and my hands were overwhelmed with high fives from all directions! We saw 52 pregnant women in one day, some of whom were pregnant with their ninth child and only 30. The one that shocked me most was a girl the same age as me, 18, who was expecting her 3rd child!!? Imagine me with 2 children already... It doesn't really bare thinking about!!
Went out for dinner last night with Esau and olive to the curry house which was delicious. I am very proud of myself with my adventurousness with food out here and the amount of things I eat that I would never eat at home. I drink coffee with no sugar or no milk, I drink tea with no milk, I eat pumpkin (whilst you guys are cutting faces out of them, they are a regular food out here), and mushrooms and a hella lotta beans!
It is now coming to the end of the rainy season so it is getting hotter and hotter and there is even more dust around, even though I didn't think that was possible. It amazes me that the nurses manage to keep their white uniform white, everything I own has a slightly orange tinge now!
Sending lots of love home and hope everyone is enjoying half term xxxx

Highs and Lows

The last couple of days have been a complete roller coaster of emotions!
Saturday was an absolutely incredible day. We drove about 3 hours to a rhino sanctuary and as we drove into the restaurant/office area there was one massive, male rhino just strolling about as if he owned the place - which in effect he did because no one was going to tell him to leave! Once he had wandered off a little way we could pass by and got our things sorted to go out and have a look for some more rhinos.
We drove for about 10 mins and then walked for 5 mins and there under the trees, right in front of us were 3 enormous grey animals having a little doze in the shade. We were all in complete awe of these incredible beasts that looked so serene and yet we knew how deadly they could be. We moved round so that we had a better view of them and then stood about 5 metres away from them just staring in wonder (and of course taking ridiculous amounts of photos). There are only 15 rhinos in the whole of Uganda (Idi Amin killed and ate the rest when he went mad from syphilis) and they all live in this rhino sanctuary where they can be free to live as wild animals in a very large environment but still protected by the rangers from poachers.
Once we had taken in enough of these amazing creatures and they had shuffled about enough to scare us witless, we went back and had a delicious picnic, lovingly made by Heather which included chocolate and coffee cup cakes - they were divine. The journey back was just as bumpy as the journey there as it is mostly dirt roads but we stopped off at the local King's burial ground on the way home. It was spectacularly unexciting with multiple graves of the King and his assorted family that were all pretty understated but it broke up the driving a little.
We went out for dinner in the evening at a curry restaurant and I honestly thought my taste buds were going to explode. I was overcome with taste and spice and mmmm it was so delicious after the bland food that I have become accustomed to.
On Sunday I attended church in the morning with my new family and spent the afternoon at the Mustard Seed orphanage. This week we took sweets and they are finally learning that if they behave and sit still in a line, they will all get a sweet or two so we were slightly less mobbed.
Monday was a standard day at Azur clinic with 2 septic babies that I had to take over to paediatrics for medication. We transferred one lady over to Hoima Hospital because she had had an illegal abortion (all abortions are illegal here) and from the scan we could see that there were still products left in her uterus and it had many holes in it that had become septic. I got another quick boda-boda drive into town on the back of the male midwife's bike to buy a jerry can - I love riding on the back of boda's, it is so liberating and all the Ugandans find it hilarious seeing a mzungu on the back.
Yesterday was a pretty crazy and not great day at Hoima hospital. We started by just popping into Azur to pick something up and in the 5 minutes we were there, a woman gave birth on her bed to a 32 week, premature baby that then had trouble breathing. As a result, we transferred baby (with mum in tow) over to Hoima hospital in the ambulance and installed him in the neonatal unit for better care with oxygen and an incubator. Once we had sorted him out we went over to maternity to find Charlie and Rob (one of the maternity hub doctors) and get to work there. We jumped straight in delivering a mother who had had 7 previous pregnancies and once baby was delivered she bled a lot so she needed a fair amount of looking after. I then went into theatre with a mother who had pre-eclampsia and was carrying twins both of whom were in breech position. Thankfully, both her babies came out screaming as I caught them straight from the tummy and they were both healthy and good weights - which is rare with twins out here.
After this, the lady that we had transferred the day before due to the illegal abortion was taken into theatre to be sorted out. Almost immediately after she had gone under the general anaesthetic she went into cardiac arrest. Charlie, Rob and 3 of the local doctors all tried to resuscitate her but in vain and she very sadly died on the table in front of us. It was hard to watch because the locals kept trying and trying for a lot longer than was necessary because they were convinced that her occasional gasps were a sign of life, yet in reality they are a sign that she has died. Eventually after not having a pulse for half an hour, they gave up. It was really heartbreaking to see because I had held her hand as she went under on the anaesthetic and she died, leaving 2 children behind, from something so preventative if abortion was made legal out here. When they opened up her abdomen later, it was full of puss so she was clearly severely septic. As if that wasn't enough, Charlie and Rob then did a c-section on a woman whose baby had died in-utero, so I had to take that baby, wrap it up and put it in a box (that's what they do with dead babies). The placenta had also come apart in the uterus and wouldn't come away from the uterine wall so they ended up having to do an emergency hysterectomy (removal of uterus) so that woman will go home with no baby, no uterus, and a large, painful scar :(
I also watched a gyne examination of a 7 year-old girl who had been raped by her uncle which was absolutely awful knowing what that poor child had been put through and that someone could have the capacity to do that to someone so young! To top off a pretty awful day; as we left we went to check on our baby from the morning on the neonatal ward and when we got there, there was no nurses/doctors and no baby. When we eventually found a doctor she told us that the baby had passed away at midday. I definitely dealt with far too much death for one day.
This morning, I was invited over to Thad's for breakfast which entailed his infamous American pancakes which were absolutely incredible - they are so so delicious and provided another assault on my subdued taste buds.
Hopefully the next couple of days will be a bit less morbid but you never know what is going to happen!
I am now exactly half way through my time in Uganda which saddens me as it is going to be very hard to leave this place and the people that have become my family and friends.
Lots of love to all back home xxxx

4 weeks...WHAT?!

I cannot believe that I have now been here for 4 weeks, that's nearly half way! Part of me is looking forward to going home to see all my friends and family and enjoy the few luxuries that I really miss like toilet paper that tears on a line (simple things, eh), most other things like cold showers and rice and beans everyday has just become the norm.The other half of me never wants to leave this amazing, beautiful country with such friendly, happy people - I love the smiles I get walking down the street and the extreme over excitement of little kids when you so much as wave at them. If all the people I miss could be here, it would be the most perfect place ever!
Last Friday i taught my last computer lesson because I gave up :P I think of myself as fairly resourceful but teaching computer with no computer to students who had no knowledge of them proved too difficult so I am just sticking to joining them for games lessons. So this evening I joined them in playing netball which was exhausting and horribly sweaty, but very fun and definitely an experience because they just have a bit of field with posts at either end, no lines, no bibs and pretty much no rules.
The weekend was lovely and relaxing, spending all of Saturday lying by the pool in the 35 degree sunshine - I may have got a little sun burned (I blame the antimalarials)
On sunday, Sofia and I spent the afternoon making loom bands with the kids from the mustard seed orphanage, which of course they loved, and then wandered home stopping off to buy various, ridiculously cheap groceries, including cheese which was definitely the highlight of the week.
Monday was a pretty hectic and draining day at Azur clinic. We were pleased to see that some, if not many, observations had been done whilst we had been away over the weekend. We had to take one woman for a c-section because she had been 5cm dilated (10cm is fully) for over 20 hours so that baby needed to come out. When they delivered him, he was a big 4kg babe but all was well with both mum and baby :)
Back on labour ward there was a woman who had been fully dilated for a long time and had an extremely large bump so it was query twins or big baby! After a while we decided to use vacuum extraction where you suction a vacuum onto the babies head to help pull it out. It was a hand pumped vacuum so I got the pleasure of pumping it up to increase the suction which was exhausting! It took about 10 tries before we eventually got the head out and then we had the problem of a shoulder dystocia (where the shoulders are too wide to fit through the pelvis). By this point the baby had been in distress for a long time so we were pretty convinced it wouldn't be alive upon delivery. Sofia managed to deliver one of the arms so that there was then more room for the shoulders to squeeze out and thank God the baby came out screaming and only a little blue at an enormous 4.35kg so no wonder he didn't want to come out!
The rest of this week has obviously not been a chosen one for having babies as the clinic has been generally very quiet.
Yesterday I attended and assisted in an obstetric emergencies training day for local staff run by Charlie with a load of other white doctors and nurses from UK that are living in various parts of Uganda. In the morning I learned a lot from their lectures and in the afternoon I got the honour of acting as a severely bleeding woman in scenarios so got to pretend to have cannulas and catheters stuck in me by the assorted doctors, nurses and midwives that attended - it was very hard to keep a straight face.
I am extremely excited because tomorrow I am going rhino trekking in a rhino sanctuary with the previously mentioned medics - can't wait :D
I still find it impossible to believe that I am actually - some night I lie in bed and I'm like 'wow I'm actually lying here, in uganda, in Africa, doing what I've wanted to do for about the last 4 years' - its mind blowing!
Missing y'all and lotsa love xxxx

Akiki

So I have now been given a Ugandan pet name; Akiki. Apparently, everyone in Uganda has a petname but there are only about 15 so a lot of people have the same one, which confuses me but I like it - it means Queen of the World (seems appropriate ;))
I have had a pretty tough couple of days this week which has made me miss home a lot but I am still really enjoying myself.
On Sunday, I enjoyed a trip to church with the family where of course I was the object of all stares being a mzungu! Sofia and I then took a boda boda (motorbike taxi) over to the Mustard Seed orphanage and had a lovely time with the kids there, teaching them how to use long skipping ropes and of course they found it hilarious to watch me doing it. All the children were on really good form and very smiley which was great, although we came back very hot and sticky!
Monday was a busy day at the clinic with 3 babies born in the time we were there and one of them was delivered by moi (with a little help from my friend, Sofia). It was such a thrilling experience and thankfully baby came out very happy and healthy and obviously had to take lots of photos with both mum and babe after - she was as excited about having a white person deliver her baby as I was to deliver it! I was also exposed to a whole new experience in the evening; Esau took me to aerobics class at one of the hotels (£1.25 for an hour and a half!) I found it hilarious watching lots of pretty affluent African men jumping about over enthusiastically but it didn't take long for me to run out of energy and I thought I was going to die from exhaustion afterwards. But the first hot shower in over a week revived me ;)
On Tuesday, Sofia and I walked over to Hoima Hospital which was a mistake - we both arrived extremely hot and sweaty and we hadn't even started working yet! In total we saw 6 Cesarean sections that day; 3 of which were ruptured uterus' resulting in dead babies and 1 on a woman who was HIV positive and had had polio so had a very odd shaped back and pelvis. I also got the opportunity to scrub in on one of the sections with Charlie because there was no one else to do it. He talked me through the scrubbing up process, following most things with 'but you would never do it like this in England' and we also had to wash our hands with water from a jerry can because conveniently there was no water supply to theatres that day - perfect! I loved helping out with the c section, made me feel like a proper doctor ;) and again, thank God, the baby came out screaming (in fact it wouldn't stop). I love that the one time it is good for a baby to cry is when it is first born. We followed up our tough day with a drink in town and then I went back to Sofia's for dinner where she cooked me Greek style tuna pasta which was a beautiful taste of home (accompanied by pineapple gin and lemonade (in mugs))
Yesterday was probably the hardest day yet. The day started well with the desk that I had tidied on Monday still being tidy and the midwives at Azur actually doing the observations that we have been trying to drill into them to do. One of the babies that I have now taken over to paeds 4 times for IV antibiotics because it is septic was still not getting meds when I wasn't there which was very frustrating. I ended up taking her over to paeds again and being pretty grumpy with the nurses there and they were much more helpful and we sorted it out that she would stay there permanently and mum could come too and just go back for her meds. Once I had finished in paeds I went to find Sofia in labour ward where she was dealing with a breech, macerated (old) still birth. This was really, really horrible to watch as the majority of the babies body was out, apart from head and arms, but the mother had stopped contracting so the head was, in effect, stuck inside. Because the baby had been dead, in utero, for a while and was only 28 weeks it was not in a brilliant state - the skin had almost all peeled away from the flesh leaving it very pink and bare. Eventually when the doctor came he did manage to coax the baby out by applying large amounts of pressure on the uterus (very painful). The head came out really distorted; it was a very large head that was a funny shape and the eyes were popping out, it was very distressing to see. I think the hardest part for me was that when the mother saw the deformed baby she didn't even flinch, like it was just a normal, every day thing to see your newborn baby like that :(
In the afternoon I went to see Thad who is a Texan man who has now lived in Uganda for 17 years and has a pretty inspirational story - he wanted me to help him set up a website/blog for him, seeing as I'm such a pro with this one ;) He also has a beautiful little 5 year old who lives with him and is adopted by his maid. She was found in a ditch at about 6 months old but she looked only a couple of weeks old and they took her in and nurtured her and now she is a happy and very healthy 5 year old!
I went and sweated out my emotions from the day at aerobics - I find it quite funny because my motivation for going is the hot shower afterwards not how good the exercise is for me :P
Today was Ugandan Independence day so is a public holiday for the whole of Uganda. Esau took the opportunity to take me, and the rest of the family, to his mothers house out in a more remote village and show off the large quantity of land that she and he have and the different things they have growing on it. I saw guava trees, banana trees, sweet potato plants, mango trees, jack fruit trees, pine tree plantation, bean plants, etc. Then had a nice relaxing afternoon and evening at home, reading my book in the sunshine :)
I am really missing everyone at home at the moment and hope that everyone is well.
Orale kurungi (good night) xxxxx

And then there were 2...

A busy couple of daysasever!r On Tuesday we were over at Hoima referral hospital checking up on the women who had had the c sections the previous day. Whilst I was doing an obs round on the babies I was shocked when I was checking one baby and then the mother pointed at a bundle of linen lying on the bed saying 'can you check the other one too please?' The bundle turned out to be a very wrapped up baby (like most of them here) but it was great to see twins which are rare here! I also found a baby just lying on a bed on its own and it was actually a 6 week old baby but it looked tiny because it was all skin and bone due to extreme malnutrition. Once we had found some formula milk to feed her we discovered her mother was on a nearby bed and was severely septic and has little chance of living :( I asked the mother what the baby's name was and she didn't have one so mum told me to name her, which i kindly refused but gently suggested that my name was Lucy ( it would be cool to have a baby named after me) ;)
Have spent a fair amount of time over the past couple of days sat inside waiting for a torrential downpour to end because the rainy season has now begun and trust me you do not want to be caught out in that rain!
I have now watched an episiostomy (cutting to make the hole bigger) during labour which I did not enjoy as I couldn't really think of anything worse happening to me! I then watched her be stitched up again whilst cuddling her little baby boy :') found a very septic baby on the azur ward too and again had a lovely cuddle whilst waiting for IV antibiotics to be given which, understandably, she hated. I have played a good role as babysitter too when women have been going to the family planning clinic and I was sat at the desk so they entrusted their little babes to me while they had their appointment - I was very tempted to run off with a few :P
Thursday evening was our 'last supper' with the medical teams from wexham park and Basingstoke and it was very sad to see them go so it is just Sofia (a midwife) and I left now!
Yesterday was a whole different kettle of fish when I taught my computer basics lesson to classes of 30ish with only a blackboard and chalk as teaching tools - teaching people how to use a computer who have never used one before, without an actual computer sure is tricky! However, I struggled through and got them to learn the order of the letters on the keyboard off by heart which I didn't even know before hand, but now I do! Had a nice drink in town with heather and Charlie and she gave me a present; a 100ml plastic bag of pineapple gin which costs 12p a bag!!
Today I enjoyed a morning at the school at a confirmation service for 5 of the girls. I got a special mention from the bishop and enjoyed the singing and dancing by the girls. In the (multiple) moments of boredom I was entertained by the headteachers beautiful 4 year old, Peace.
Due to the crazy weather the power has been a bit up and down so have spent a few evenings in the dark - yesterday was very funny when Eve put on her sunglasses that I had given her during the powercut where she could hardly see anything let alone with the sunglasses on!
I am really really missing home food at the moment - everything here is decidedly bland and dry and I would kill for a lamb chop and a blueberry muffin.
Hope all is well back home xxxx

Call me a baby catcher!

Had a delightful and much needed weekend of relaxation the last couple of days. Did some odd jobs around town and spent a lot of time basking in the almost 30 degree heat by the hotel pool - its the only hotel in Hoima with a pool! That is until we were driven in by the enormous rain clouds surrounding us from all sides. On Saturday night we went out for dinner with Charlie and heather to have a change from the hotel foo and on Sunday night 6 of us went for dinner at Esau's and 5 of them went back leaving me behind to settle in to my new home.
Esau has a lovely wife, olive, who has been very welcoming and 3 delightful girls - Eileen, 13, Esther, 9, and eve, 4. Eve is definitely the most excited to have me here - every time I look at her she is staring and smiling at me, bless her.
So the weekend was the calm before the storm as I discovered during the whirlwind of today. Had a fairly gentle morning having met the midwives at the clinic and I went round doing heart rate and temp checks on all the little bubbas who are all indescribably cute! Then as we were starting to think about food (although I never stop) a woman came in with extremely raised blood pressure. Spent about the next hour tending to her and trying to get the doctor and eventually had to refer her to Hoima hospital as there is no anaesthetist at azur to give her a c section.
Had my first ever journey in an ambulance down the bumpy Ugandan streets and no sirens (a little disappointing) and arrived at the hospital. The trouble with this lady - as with most of the women out here - was that she had no idea when her last period was so had no idea when her baby was actually due. We worked out she must be about 30 weeks but we also diagnosed her with preeclampsia (like Cybil in downton (which I'm gutted I'm missing)) so the baby needed to be delivered otherwise she would start fitting. Whilst waiting for theatre to be free - there is only one for the whole of Hoima (Basingstoke size) so they have 2 ops going on side by side - I watched another c section and acted as the baby catcher. I was given the baby straight out of the tummy to take and wrap and clean and weigh. It was a pretty amazing feeling holding that brand new life in my hands even if it was covered in disgustingness!
However this extreme high was followed by a low when the other woman in theatre had a still born and again we had to clean it and wrap it up - not so thrilling!
Eventually our preeclamptic (PET) lady got onto the table and I watched Charlie perform her c section which I loved although most people would hate it :P again I acted as baby catcher and was handed the tiny weeny 1.8kg, 30 week baby, who was surprisingly alive and squawking, to sort out and then rushed over to neonatal ward for proper care!
The woman next to our PET lady was also having a c section so I watched the end of that and was handed her baby too. He wasn't in such a good state and needed a fair amount of resuscitation but eventually started screaming at us to stop thumping on his chest! His mother however was bleeding a lot so an emergency hysterectomy (removal of uterus) had to be done which again was really interesting to watch but with copious amounts of blooood!
All 3 of the babies I 'caught' were stable as I left the hospital and here's praying that they continue to improve over the next couple of days.
I'm writing this lying in bed, exhausted, after dinner (predominantly carbs) with the family and a cold shower
Love to all xxx

One week gone!

I cannot believe it is a week since I said a tearful goodbye to my mother at the airport!!
I have done, seen and experienced so much in so little time. The last couple of days have been as busy and exciting as the others. I spent one of the days clearing the store cupboard that belongs to the Basingstoke Hospital charity and Help Hoima which was full of useless or out of date equipment and drugs that people have brought here over the last 7 years. But also held plenty of indispensable items. The amount of orange dust in there was ridiculous and I was covered head to foot when I came out. As a break from the store cupboard I stayed with a woman in labour for a while but didn't actually see her give birth - however the next day she came running to find us to show us her beautiful baby :)
Yesterday was a completely new experience altogether. We went on a trip to a place called Runga which is on the edge of Lake Albert. We set up an antenatal clinic and an HIV screening area. The village was completely secluded from anywhere else and was all mud huts and drop toilets. It was a beautiful place with a spectacular view over the lake - which looked like the sea - and you could just see the Republic of Congo on the other side. The children were all absolutely thrilled to see us and they kept just coming up to us and stroking our skin because they were mesmerized by how white it was. Many of the younger ones wouldn't stop crying because they had never seen a white person before so they were terrified! When we took pictures of them, they loved it and I got swarmed many a time so that they could see themselves on the camera. We set up the clinic in the church which again was made of mud with a corner for observations (temp, BP, heart rate, weight, etc) and then 2 palpitation stations to check the gestation time and approximately when the due date would be (none of them know themselves). And then I was in charge of the log book and 'pharmacy' giving out multivitamins, folic acid, worming tablets and antimalarials. We got through 62 pregnant women in 3 hours and there were some that we didnt have time to check - that's a lotta pregnant people in one village!! I was shocked by how young some of them were - one was only 16, and another was 18 and about to have her second baby - and how many children some of them had had (the most was 8 previous babies). I was also shocked by the number of pregnant women with HIV, some of whom had known already that they were HIV +ve and yet still got pregnant again, but there's not a lot they can do to stop it!
The journey there and back was an experience in itself. It was an orange dirt road the whole way which gradually got thinner and thinner until we were practically driving down a footpath. Just before we got to the village we had to pretty much go down a rock face which had massive ravines in it from water running down and I have never been so bumped around in my life. The journey back was awful too because I hadn't been able to use the cockroach infested, stinking toilets so I hadn't been to the loo for 11 hours so my extremely full bladder felt every single bump ;)
The paediatric team went off on safari in the early hours of this morning so there is just 5 of us left in Hoima. This morning, I went to the local girls secondary school with Heather (Charlie's wife who teaching there) and I had a chat to the head teacher about whether I can help out there at all. We decided that I would do 'computer basics' classes for the equivalent of Year 7, 8 and 11 - however, I later found out that there is just one computer monitor and none of them know anything about computers so that could be interesting. I am also going to join in their PE lessons playing netball and volleyball to burn off some of the large quantity of carbs that I am eating every day.
We took most of the afternoon off having scrubbed down the labour room at Azur clinic (which looked like it had never been cleaned) so I fell asleep by the pool in the sunshine and now we are preparing ourselves for a weekend of relaxation.
Everything will change again on Sunday when I move in with Esau, the director of Azur, and become even more immersed in the African life.
Lots of love to everyone back home xxxxx

What a couple of days!

Wow, so much to say! Yesterday was a crazy first day...started by meeting Esau the director of the azur clinic who I am moving in with next week. Then as a team of midwives we went and did a post/antenatal ward round and I was given the task of checking all the babies temperatures and their heart rate - most of the babies had been born in the early hours of that morning and were absolutely tiny. If they were cold we wrapped them up in woollen jumpers knitted from home and put them skin to skin with mother (how they were cold I don't know, it was boiling). After lunch we went over to meet Charlie (a UK obstetrician here for 6 months) at Hoima hospital and I was thrown in at the deep and watching/assisting in delivering a baby! It was all a successful labour so it was really exhilarating even though most of what I was doing was fanning the mother and holding her hand! It made me so happy when her little baby boy was born a little blue but he quickly started breathing :) watching the birth of the placenta was less appealing and much more gruesome - not for the faint hearted!
Today I wandered around Hoima in the morning visiting the school. This afternoon I managed catch the end of a caesarian section after a ruptured uterus and a still birth with the mother ending up having a stillborn baby :( there was a lot of blood loss and shockingly she had the last thing of blood of her type in the hospital! I helped in her recovery when she came round, keeping check of her obs and making her as comfortable as possible. Rhi and I ended up walking down Hoima high street in our scrubs to buy morphine over the desk from a pharmacy - that would get you struck off back home!
The hardest part for me was that we couldn't communicate with the family so they had no idea what was going on or that there was no baby...it was heartbreaking and eventually when they were told it was very upsetting!
It has been an exhausting couple of days but I am loving it and Charlie says he's going to make me into an obstetrician yet ;)
Lotsa love xxx

Arrived safely

Hello hello! I have arrived in Hoima, where I will be spending the next 9 weeks. The journey down from the airport was a long and bumpy one but watching out the window kept me entertained with massive piles of pineapples filling the pavements and people carrying things like beds on the back of their bikes!
Today was the first full day here and it has been gently busy. At the moment I am here with; 4 midwives, a biomed student, and 5 paediatricians/nurses. We visited the Hoima referral hospital which is the government funded hospital - it was pretty shocking even though I've seen it before and there was a distinct lack of staff (maybe because its Sunday), the amount of people lying on dirty sheets or on the floor was ridiculous! And almost all the sinks were blocked making washing hands to prevent infection pretty difficult!
We then went on to the azur clinic which was set up by the charity 'Help Hoima' which was so much better in contrast to Hoima hospital but still nothing on UK health care! With 2 women per side room in labour - no one in England would put up with that!
After unloading the 15 boxes of medical equipment, knitted clothes and toys we took a visit to the mustard seed orphanage. It was lovely to see all the children that I saw 2 years and 7 years ago, even if they didn't remember me - just another mzungu (white person). I was amazed to see a little boy who arrived critically ill, absolutely tiny and at deaths door last time I was here was so chirpy and happy and healthy :)
Just had a surprisingly warm and powerful shower after a failed attempt at one this morning which was just a cold, dribble - its very hot and sticky here!
So far I am having a great time and I'm excited about what I'm going to do, see and experience over the next 2 months :)
Much love xxxx