Rant over

  • I surprised some of our team by how grumpy I was at our passage through Entebbe Airport last night. I don’t want to say anything more other that when you engage the staff in conversation they are very pleasant. So my conclusion is that it’s the system (whatever that is) which is at fault.
  • So here we are at Brussels Airport (6 degrees) 8 hours after leaving Uganda (30 degrees). It was a good flight although I do feel as I’ve been sat upright in a chair trying to get some sleep all night!
  • Fortunately we have 3.5 hours before the next flight which is just as well as the shuffling security queue seemed endless.
  • As I drifted in and out of sleep last night I was thinking about the clinics and the large numbers of people who came, and particularly the large numbers of children.
  • We had a lot of queue jumpers this year who saw a line moving towards the clinic and joined it hoping to be seen quicker than if they had gone to the back of the queue.
  • But as I thought about this last night and peoples’ desire to look after their families, who’s to say I wouldn’t do the same if I was in their position?
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    The EA experience

    I’ve written before about departing from Entebbe Airport – the EA Experience. As we approached the airport this evening Ibra told us that the airport was under construction I.e that we needed to be patient (he has been saying for this each year for the past 5).

    Part one of the experience is to push your trolley up a long steep ramp to exercise your muscles passing over some metal grids along the way which are extremely tricky to negotiate with a full trolley. Some of us failed this first test.

    Part two is to lug your heavy bags onto the belt and off at the other end. I had the additional pleasure of having my bag inspected (fair enough).

    Part three this evening was that all the airline computers were down meaning that all the luggage tags had to be handwritten. It was all very slow and laborious and I felt sorry, as I often do, for the staff here. It is very hot and there is no air conditioning. Sweltering is an understatement.

    Part four is the immigration queue which we are now in. Its now about an hour and twenty minutes since we arrived at the airport. If you were in a hurry, or late for your flight, this is not the place to be.

    All the systems seem designed to frustrate and delay. In this they succeed!

    It just all seems more stressful than it needs to be and we’re just hoping that our handwritten luggage will arrive in Manchester at the same time as us.

    Lake Victoria

    John, Sarah and Freseera came to the hotel last night to say goodbye and thank us for our efforts over the past 2 weeks.

    As always we have been made to feel very welcome, looked after and appreciated.

    This morning a large group of us went for an early morning walk behind the hotel. We walked up to the church at the top of the hill and then back through the primary school where the children were arriving and posed for photos. Then it was a walk back down through the University and along the busy road to the hotel.

    The last morning is always the time we do the online check in for those travelling back in the evening. It always seems to be far more difficult than it should be. This morning both the hotel Wi-fi and 4G dongle were on go slow (in fact dead stop). In the end after a long series of dead ends and failed attempts Margaret and I managed to get the 11 people travelling tonight checked in and the office at the Kolping printed the cards off for us.

    We then had the final review meeting for the clinics on the balcony.

    About 1.30 we left for the airport and headed off along the new Chinese financed expressway. It has cut a lot off the journey time. The toll booths are in place but but not the charges (yet).

    I’ve been looking at the stats of who is reading this blog so I’m delighted to say we have a reader in St Lucia and one in the Philippines as well as several in Australia, France and the USA. So thank you for reading, liking, sharing and commenting.

    We stopped at the Lake Victoria Hotel which is a beautiful colonial style hotel built by the British in the 1950’s. My in laws stayed here in 1953 as part of their honeymoon in Kenya (where they were married), Uganda and what was then called the Belgian Congo. It must have been quite a trip on the roads in those days.

    I’m not an avid swimmer so stayed on the sidelines and resisted attempts by others to push me in.

    Uber and out

  • Yesterday afternoon some of the team went to see the young man in Ssanga I wrote about last week. He is 22 and we think was a boda boda driver when he was shot by his passenger in September last year, left for dead and his bike stolen.
  • He is paralysed from the waist down and his marriage has broken up. However, he remains remarkably positive about the future.
  • We talked about his situation as a team last night to see what we could do to help. What I’ve discovered over the years is that the physical symptoms we see are very often the tip of a very large and complex social situation and any decisions about the future welfare of individuals and families need to take great account of these circumstances.
  • One of the team suggested that we should build him a house at Stepping Stones, our social housing project in Bombo but, while that might meet his physical needs, it is a long way from his home and may not meet his social and family needs.
  • These situations are always more complex than we see at first and we concluded that we would work through the local pastors to understand the best option before we jump into ‘solution’ mode (very tempting but often wrong).
  • I always remember the lesson I learnt last year when we visited Mariam in Nakaseke. We had brought a mattress with us to make her more comfortable (or so we thought) and Nick and I were about to put the mattress in her house when we realised that it was very presumptuous of us to think that we knew best. In fact Mariam didn’t want the mattress as it was not appropriate for her needs.
  • Big lesson learnt, but I suppose (and hope) borne out of our desire to help.
  • The morning dawned bright and sunny again and breakfast outside is always delightful (and cool, if you arrive early enough). People come down reporting various degrees of good nights sleep (or not, as the case may be). Everyone starts the day in their own way – some prefer the quiet (which can be difficult to find!) while others are louder and more voluble.

    Yesterday, I seemed to be the butt of a lot of jokes (probably not helped by me, if I’m honest!) but today I escaped. Everything is done with good humour (well, almost everything!) and its good to be part of the team.

  • Yesterday was a special day as we broke ground on the next phase of the school at Bombo. I have a particularly personal interest in this project. I have a real admiration for John Bunjo, who founded CRM in Uganda. As we were setting up some pictures with the staff and children to mark this occasion, John said to me, ‘let’s take some film’. So I got out my phone, pointed it at John snd he started talking about the school, thanking people at Nationwide for their support, and 1 minute 25 seconds later he had finished a perfectly crafted, off the cuff, impromptu thank you which was beautifully delivered. What a skill!
  • Today is the final clinic day at Nakaseke. I have stayed behind as i am running a session for some of the Church leaders and pastors in Kampala. John told me yesterday that I would be picked up from the hotel at 9.30. In Uganda time is pretty elastic (partly because of the uncertainties of travelling) so a 9.30 pick up could man anything between 9.30 and noon. Not that I mind – I’m currently sitting on the shade on the terrace writing this blog at 9.30 snd the temperature is 30 degrees.

    I was picked up by a spotlessly clean Uber taxi at 10 and we crawled into the city through heavy traffic. At one point we were overtaken by a very expensive Toyota Landcruiser and I asked my driver who could own a car like that and he simply said, ‘someone in the government’.

    As we arrived at the CRM offices I was met by a young member of the team called Derek who was amused to learn that my second name is the same as his first.

    The group of about 15 pastors was assembled ready for me to start. I had met some of them before. My topic was Personal effectiveness, leadership and how to develop resilience (actually thats probably 3 topics). I was glad to have Herbert as my translator. Because he and I have worked together a lot over the last few years he knows the way I speak and some of the language I use.

    I spoke for about 25 minutes (in reality about 12minutes of content after taking the translation into account) and then broke the group into 3 to consider whether they agreed with what I had said. This seemed to work well and there was some good feedback from the group. We then had time to think about resilience before our time ended. We agreed that we would run a day long session next year. I hope it was useful – I certainly enjoyed it.

    I stayed on for the lunchtime service which CRM run every weekday. Sarah was speaking.

    Afterwards Herbert and I caught an Uber back to the hotel and had some lunch. We chatted for several hours afterwards. I probably asked a lot of questions as I was very interested to hear about his family background and the values that are important to him.

    He is a fine young man and I was sad to see him leave. We keep in touch regularly but it will be another 12 months before we meet again.

    The coach with the medical team arrived back about 6.30. They seemed to have had a good day and had seen around 75 new patients.

    Ground breaking

    Yesterday the team split up. I and some others went to Bombo, some of the doctors went to the hospice in Kampala and others went to the Mental Health facility in the city.

    As a psychiatrist, Emily was distressed, disturbed and affected by what she and the others saw and heard about this facility. Her blog for yesterday is not easy reading but definitely worth a read http://www.emilykaye5.wixsite.com

    It was another very warm night. I decided to do something about it. I fiddled around with the position of the wall mounted fan so that it pointed in exactly the right direction and then put the pillows at the foot of the bed to try and get the maximum amount of air onto me. It did work (sort of).

    Late last night 2 other members of the team, Katie and Rachel, arrived on the flight from Brussels. They are able to reassure us that the February flight selection on the plane was much better than the Jan one.

    They looked remarkably fresh when they came down for breakfast and are on the coach with us to Ssanga this morning.

    it’s an overcast morning and the atmosphere feels quite smoggy.

    An hour or so after we set off we arrived back in Ssanga. It all seemed ominously peaceful – there were about 50 people waiting.

    Herbert and I sorted out the crowd into the returning patients and those we had had to turn away last week.

    It was busy but not hectic. The morning went quickly and we worked our way through a lot of patients.

    After lunch John Bunjo came to pick up Juliet and I to take us to Bombo to break the ground on the next phase of the school at Bombo.

    On the way we called into the hospital at the Military Barracks to drop off a young mother called Joyce and her 2 day old daughter Praise who had a bad fever but not malaria. We were seen very quickly and left Joyce with some money so she could get home.

    It was exciting to see the start of the new block. The foundations and start of the building has been made possible by the efforts of a great bunch of people from Nationwide Building Society who walked up Scafell Pike in England on a very wet day in September so thank you to Carolyne, Owen and Matt and the rest of the team if you’re reading this. We have a lot more money to raise to complete the building and are delighted we’ve been able to start.

    Privileged day

    In the end yesterday afternoon’s trip back from Bombo was pretty good and took us about one hour and twenty minutes. After a couple of hours down time we met as a team to review the last couple of clinic days.

    This is always interesting for me as I tend to be outside during the day trying to prioritise and manage the flow of patients into the clinic. So I get to hear what’s happening inside at the sharp end and what the clinicians are dealing with. It sounds like much of it is fairly routine with a lot of coughs and flu and then the interspersed with much more serious and rare conditions. Some patients need following up for extra tests or monitoring and for the more serious we try to arrange hospital visits and continuing care where we can.

    We are in Uganda about 2 weeks later than previous years and I, and others, have found it even hotter than usual. When the Ugandans say its hot you know its hot! The heat has made it difficult to sleep despite having a fan on all night.

    This morning I went through my usual routine of applying DEET which is a strong anti malarial roll on. I also add on Factor 60 sun cream which has done a very good job of keeping me unburnt (unlike others).

    So at breakfast and all through the day I (and others) look and smell pretty awful but over here I don’t really care. Comfort (or relative comfort) is the thing.

    Tony blogged yesterday about the inestimable value of our translators and I’d like to pay tribute to them too.

    Not only are they very skilled at listening and speaking almost simultaneously in 2 different languages they act as real role models in their communities. We enjoy their company.

    I had wanted to visit Herbert’s mother and family in their house for some time and today I had the opportunity.

  • Herbert and I went up to Stepping Stones, the charity’s social housing project above the school, and then got a boda boda (taxi bike) up to his mum’s house. I asked Herbert to tell the driver that I was a very nervous muzungu (white person) passenger. We bumped along the bumpy and pitted roads for what seemed like a long time and then reached the house and in the end I rather enjoyed the ride.
  • The house was much bigger than I expected and I was shown round. Everything was very comfortable. There was an old Indian movie playing on the tv. 12 people live here.
  • I felt like a very honoured guest and was happy to be there.

    We then went out for a walk around the ‘garden’ which was actually 19 acres. Before Herbert’s father died he divided up the land so that each of his children has a share.

    On the land they have 2 cows, and they grow sweet potatoes, maize, bananas, jackfruit and avocados.

    We came back and ate some freshly cut jackfruit which is a bit like pineapple, only even nicer. I ate more than I probably should have.

    Then it was back on a boda boda to the school. They don’t get many white people up here and I was charged the ‘muzungu’ price which was rather higher than the locals rate.

    As we were riding along we passed another bike – the passenger was clearly unused to white people and his neck swivelled round as if on a bouncy spring.

    It was a memorable visit and a humbling reminder of how people live in this country.

    We came back to the school and I visited some of the classrooms. It’s the first day of the new school year so quite a lot of excitement with kids in their uniforms.

  • I am continually impressed by the high standard of teaching here and the new teachers all seem to be great additions to the team.
  • Return from Jinja

    All I’m going to say is they it took 4 hours to get back from Jinja last night. This is the busiest weekend of the year as the schools go back tomorrow. The whole of Uganda seemed to be on the move and it was slow.

    Joel took a couple of different routes (bumpy) to try and avoid the worst of the traffic and I’m sure he succeeded but of course we’ll never know. All we know is we were glad to get back to the hotel and off the hot and sticky coach.

    I stood in for Juliet this morning at a meeting with Tom, John Bunjo’s son in law who supervises our building contracts over here. He is a v interesting guy and runs a charity educating people about the continuing danger of AIDS. He told me that both his parents had died of the disease and it is now on the increase again: he says part of the increase is down to complacency.

    We looked at the plans and coatings for the next phase of the school at Bombo (Carolyne, this is what you and your fellow Nationwiders helped raise money for that wet day on Scafell in September).

    Then it was onto the coach for the journey to church at Bombo. The traffic coming into the city was bad but we made good time the other way. Pastor Robert was preaching when we arrived. Pauline spoke fantastically well about the armour of God and we dressed Pastor Robert in some cardboard armour held together with gaffer tape.

    It was very humbling to hear how much impact our work has had on the local community.

    I had a chat with Herbert, his mother and many of his family after the service and am hoping to visit them at their house tomorrow morning. Herbert says he’s going to take me up there on a boda boda (rickety bike taxi) which will be a first for me and probably quite scary!

    We’re now on the bus back to Kampala – Joel thinks it could take up to 3 hours to get back (thats for about 40 miles).

    Stuck record

    I know I sound like a stuck record when I say that we had a bad journey back from Bombo last night. Kampala traffic is always worse at the start and end of the weeks. I’m guessing the journey is no more than 40 miles. Last night I think it nearly took us 2.5 hours. The usual bottlenecks were busier than usual and even places which we normally speed through were clogged up.

    In the end Joel gave up with the main road and headed off piste down the most pitted and potholed road. We bumped along very slowly for what seemed like ages and then came out onto a main road this bypassing several miles of very slow moving traffic. The benefits of local knowledge.

    Last night we had some of our Ugandan translators with us for a meal and to stay overnight – Herbert, John, Apollo and Christine. It was good to spend time with them away from the clinics and learn more about their lives,

    This morning we all set off about 9.15 for Jinja which as about 80 km east of Kampala on the road towards the Kenyan border. No surprise that it was slow going. I have never travelled east out of Kampala before and once we got out of the suburbs it all seemed quite different. Prosperous houses with green gardens, smart shops and gyms and then 100 yards further we were back into the world of roadside stalls and mobile money.

    We crawled through Mukono which was a very busy market town and stopped for a ‘short call’ break.

    The road (and traffic) improved considerably and we picked up speed. We drove through Mabira Forest the biggest forest in Uganda. Herbert tells me that people hunt here for antelope and Uganda cob – he says that antelope is a particularly delicious meat.

    At Jinja we crossed the Nile by the new Source of the Nile road bridge which was opened in October 2018.

    We stopped at a hotel beside the Nile, pre ordered our lunch and then set off on a small boat, stopping beside the shore on the other side to look at the amazing wildlife.

    The source of the Nile looks like a vortex or whirlpool in the middle of the river so we posed for pictures on the small island beside the source.

    Then lunch overlooking the Mile where much enormous Tilapia fish was consumed.

    Very relaxing and enjoyable day!

    What cream do you use on pus filled spots?

    We had a mercifully good journey back to Kampala last night and for the first time arrived back in the daylight. It has been a hot day (in contrast we know to the UK).

    We had a bit of down time before meeting before dinner for a review.

    Dinner cane (very good it was too) and we finished the meeting after the meal.

    It’s very hot at night even with a fan on and many people are not sleeping as well as they would like.

    It’s often at breakfast that you get an insight into the lives of other team members of the team. Jame had an enquiry from her husband about where his work sweatshirts might be. Answer: in the washing basket. Sarah G was asked what sort of cream to apply to pus filled spots on an arm. At least it’s good to be missed for something.

    We discovered also that Emily had spent some time this morning washing the paint off a small gecko she had found outside her room (the decorators are working around the building at the moment).

    We arrived in Bombo and from the start it was all a bit chaotic. We had intended to see returning patients only but not all of them were there at the start so sorting everyone out took Herbert and I a lot of time. And of course many returning patients decided to bring 2, 3 or 4 extra children with them to be seen, thereby adding to the confusion.

    However we worked our way through it all in the heat and, in addition, some of the clinicians ran mental health and women’s health sessions in the afternoon as well as the disability I support group.

    We saw 175 patients today, 30 returners and 145 new.

    Among them were a 6 month boy with a hole in the heart, a 20 year old who had been beaten up and will require surgery for his fractures and a lot of HIV, syphillis and malaria testing.

    ‘Its too cold to sit outside’

    We had a really pleasant dinner at Cafe Javas last night.They have a very smart business model offering the winning combination of fast free Wi-fi and good food.

    Fruseera and Jojoe came for breakfast this morning and declined the offer of joining us on the terrace as they said it was too cold to sit outside. What?!

    This morning we set off at 8 with the bus jammed full with team members, supplies and translators.

    It was a good journey out of the city this morning and we reached Ssanga by 9. To our surprise there were only about 25 people waiting under the large mango tree but we discovered that were 60 people registered, some of whom had gone away and would come back later.

  • It feels as if the morning has run very smoothly. There are of course the usual mixture of sad and interesting stories. We have seen a young boy with cerebral palsy and a blind woman of 90. We treated a man who told us that his 22 year old son had been shot by two men in September who stole his bike. He was now paralysed and incontinent. A Ugandan doctor called Dr Kevin (actually a woman) went with Juliet to see the son at his house and we hope to be able to help him.
  • it’s an extremely hot morning again and very still. We’re waiting for Doctor Mike to arrive – his flight from Manchester to Brussels didn’t get off the ground because of snow and has been rerouted via Addis Ababa (we think). He will have had a 40 degree temperature difference.

    [Stop press – he has now arrived and has typically got straight to work after his 36 hour journey].

    We have seen about 120 people this morning which seems like a good result.

    This afternoon has gone smoothly (perhaps we know what we’re doing now). We finished a bit early as our translators were playing football against a local team.

    175 patients today.

    Jame saw a 3 year old girl with cerebral palsy and a 45 year old woman who discovered she was pregnant with her 6th child.

    We met a lovely old man called Edward who had been a paratrooper in the Ugandan Army who really needs a hip replacement.

    A lot of testing today for HIV, syphillis and malaria.