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