A little bit of every good reason

A few friends from the guest house took a trip this weekend. Everyone has worked so hard, and we each had our reasons for taking the break.

Sarah is here completing research for Dr Warfe, brain behind the development of ETV surgery. In Uganda, work in the community evidently means mucky work, long days and many sweaty journeys in crowded motatus.

Sarah = A little luxury

Oliver has just arrived from Leeds, but he is staying in he wash and wills hotel. Ironically, wash and wills are not providing enough hot water, So he showered 5 times in two days at our home away from the home away from home. 

Oliver = Hot Showers

A girl of my own volition, Jamie, arrived from Texas on Monday. She feels most alive when adrenaline is coursing through her body... The only question for us was how we could satisfy that thirst.

Jam and I = Fat fix of adrenaline.  

So.... Jinja was the destination, and the four friends stayed at two friends guest house, on my recommendation. We knew that this combination could offer everything we needed, we just didn't realise how quickly it would deliver.   

Within 5 minutes of arriving, our shoulders dropped an inch as the stress rolled away. We sank a beer at the poolside bar and enjoyed a long lunch together. 

.... Within an hour of finishing the last bite,  Jamie through herself 44metres off the tower and head first into the nile river. Jamie flapped her arms in the hope it would get her feet back up where she started, but after plunging her head in the water, it was the recoil of the bungee cord that sent her flying back up in the air. 

Oliver was next to jump and in similar fashion, he descended feet first.. his brain clearly telling him it was wrong - but it was too late to do anything about it, other than enjoy the feeling. 

After the initial uncertainty and moment of sanity, Sarah changed her mind and ascended the tower.  Flying off the platform with a perfect swallow dive, she let out a blood curdling scream. Her rebound seemed so fast she caught up with the scream she left at the top... swallowed it, and then let out the most almighty laughter! It was great! 

Sarah hadn't quite reached the water for the dip... So they recalculated and let me launch myself off. Not to be outdone, (you know me) I held my shape through the dive, braced my arms above my head for the entry into the nile, and before I had slowed too much... or shut my eyes, I was submerged in the river, entirely submerged! TWANG, and back up again. 

We went back to the guest house, grinning from ear to ear and had a hot shower to wash the nile off, before sinking more beers, eating great food and talking about the day. 

The weekend couldn't have been better, unless we had managed to get back to the bungee tower in time for the night time naked dives! Although we tried and failed on that count, we succeeded in having a little bit of every good reason for making the trip. 

If physios had eight hands, 3 for therapy, 5 for swatting mosquitos....the trip would be a cinch

Ensuring people commit to follow up appointments can be difficult, so on a quarterly basis the team travel to see patients in each district. Last weak I was part of that team. I was told I would see allot of cases, and they weren't kidding. We had approximately 150 people through the doors, over two days! If only physiotherapists had eight hands, 3 for therapy, and five for swatting mosquitos, the trip would have been a cinch. But we don't! So here is the round up of that week, the clinics, chaos, karaoke even malaria!

The transport we had for the trip was spacious enough for 14 people, including the driver, plus one live chicken, that joined us from the half way point!

After 7hours driving, we arrived in Gulu and rested for the night in a local hotel. One of the doctors, Emanuel, had been told about a local restaurant that served traditional ethiopian food, a welcome change from beans and rice, or rice and beans. Despite the local area enduring a third day of imposed power cuts, our friendly host cooked the most fantastic food. Our meal included some injera, Ethiopia's staple bread. The injera is made from a mixture of rice flour, teff flour, tepid water and yeast. The mixture is fermented for 4 days, and then cooked on a hot iron... It is thin, with an odd spongy texture. We used our batch to mop up all manner of different meat and vegetable dishes from a huge platter.

The great food from the night before gave us enough energy to attack the the clinical chaos of day one, at Gulu regional referral hospital. The picture bellow shows the venue. It was previously funded by an Italian NGO that has since pulled out, which means the facility is suffering as a result. We saw 65 patients through the door and I lost count of how many were on my mat for physiotherapy.

Lira was the next stop, and the numbers increased again to over 85 patients. It just isn't possible to offer that many people your best, one after the other after the other. Knowing it would be tougher, we decided to approach things differently, and deliver group therapy. This is the first time cure has attempted this and it worked a treat!

When we had finished we were happy, but all of us needed a rest....I decided to jump on the bus and visit one of my new friends, Katie Rae, who had been staying in Jinja at the Sonrise Orphanage. I decided to stay in a nice guest house and relax after sharing my room in lira, with the mushrooms that were growing from the ceiling.

I had dinner with Katie Rae and the family she has been working with. They have now adopted two great children from the orphanage who will join their family of 5 in the US. (Getting to know the children and working through the legal process has taken them over a year) Katie Rae and I stayed on for karaoke.

On sunday morning I joined them at a local church, where I met all the children living at the orphanage. Afterwards, I had lunch and headed back to Mbale. It was a great weekend, which has given me some great memories. Not least, Katie Rae's rendition of "hit me baby one more time". Unfortunately, I began to feel ill while I was away with the team, and this got worse over the weekend. My ride back to Mbale by matatu taxi was cramped, with 6 people rammed into the space designated for only 3, it was like this on every row. It was hot, somewhat smelly and I was presenting with all the typical signs of malaria. The doctors at Cure prescribed me antibiotics, which seem to work in record time. 2 days later, I was fit again and able to tackle my work with Cure, introducing a new regime of physiotherapy ward rounds, which will include education for mamas to teach them how to work with their children.

Working at the Hospital

African life is very laid back, but the hours of work are long. Ward rounds with the doctors and surgeons start at 7.30am and the day finishes at between 5 and 5.30pm. The work at the hospital is inspiring and their work is leading the way for paediatric care in Uganda. Despite this the team don't rest on their laurels, but have a drive to improve their services every day and with every patient.

It seems as though I am part of their plan to review procedures within the physiotherapy department, and have been asked to work with them to develop a number of items to improve the service. Firstly, by reviewing the existing assessment procedures, and writing a standardised subjective and objective assessment protocol based on our findings. Secondly, by integrating a mini gross motor function assessment that will serve as an outcome measure for the physiotherapy department and may be integrated this into a database that will be developed for the service. Also, we will be implementing a new system of record keeping to ensure information sharing is made possible between departments. Finally, after recommending that the physiotherapy department provides therapy to children and education to the "mamas" on the wards, as of Monday, I will be starting to roll this out. 

While I'm excited, and know to keep it basic....this is allot of work for a second year physio! Everything will be trialled and adjusted in about 6months time, when a PT from the USA comes to work full time at the hospital and this is something I am thankful for. 

Singing Praise and Worship.

The praise and worship is on every morning in the Hospitals spiritual centre. It's incredible! They sing the same line over, and over, and then just change it by one word... the drums, the passion it is intoxicating in the most wonderful way. Their voices are like an army of angels and I'm clapping, dancing, singing.. It becomes like a mantra and fills every sinew of your body. and when you know God has heard your worship, they move on... change that one word and praise him for that too. Watch this space, because I know Maria and Chris are gifted enough to lead us like this for just one day! Church would go crazy and be blessed with joy. 

Welcome ... T.I.A

Before you read on, you should know that I'm so pleased I'm here! Although this could sound like my first ever blog moan. It isn't t... TIA! and this is all a learning experience. 

Things are getting better but the shock of arriving, the disparity of rich vs poor, the African pace of life, and how the term.... "T.I.A" (This is Africa) can be applied to so many things you see and hear, was somewhat difficult to get my head around in the first few days. 

When I arrived in Kampala, my hotel entrance was strewn with rubbish, and lined with homeless, clearly in need. The market opposite was busy, even at midnight, and the security guard couldn't care less about the metal detector sounding an alarm - perhaps this was because he had a rifle?! I was over charged for my accommodation, fleeced for a bottle of water and given the room with a mosquito net attachment way too high from the bed to allow any covering. The door to my room didn't shut properly and did't lock at all. Needless to say I slept with one eye open, my bag jammed against the door and hugging my essential possessions. 

I met with the GM of Barclays Uganda and his PA, in Kampala. I was chauffeur driven around town and past a lady  who was literally crawling on hands and knees across the road. This just baked my noodle! Not one person helping her, and the driver just rolling on passed her. 

I insisted on travelling with locals rather than having a driver take me to the hospital. I set off for Mbale by coach, the Elgon Flyer service, and arrived late at night. I was swamped by local beggars, as young as 5, may be 7? to adults. It felt as though I wasn't welcome because I didn't hand everything or anything over. But I had made a friend, a local man called Apollo. He had been sat next to me on the coach, eaten the best chicken lollipops (chicken legs on sticks) from road side venders and, god bless him... after eating too much he fell asleep on my shoulder. Apollo hailed a taxi, showed me to my hotel so I was safe and sound! At times it really didn't feel like I would be. 

The reception had been very mixed, but is becoming more positive day by day and the hospital is amazing! 

Jet Setting.

Day one of my trip was only ever going to officially start once I had checked in for my flight. Unfortunately, while i thought it couldn't come soon enough... JLM, were happy to make me wait, so I spent 5 Hours, 3 re-packing sessions, 2 vimtos, 1 purple tongue and four nervous "short calls" (Ugandan terminology), anticipating this Ugandan Adventure.