Final Day of Physio

Well that’s me just finished my last day of physio! I’ve been managing to see a few more patients on my own the last week or so which has been good – either with patients who speak enough English or with my limited Luganda along side signing/demonstrating! We had a fairly busy day seeing quite a lots of patients. It was quite sad having to say goodbye to some of the longer term ones and the wee old lady who lives in Female ward and has done since the hospital started!

The young boy with the bad burns has been having a bit of a tough time the last couple of weeks as the skin growing around his wounds is really thick and tight making it hard to fully straighten his leg. So needless to say he’s not been too keen on the physios coming around to stretch him out! But today he actually came to the department himself before we went to find him and he seemed to be keen to get going. He did really well and we were able to get a lot done in his session. It’s been good to get him to the department the last few days, so that he’s had a bit of a change of scenery from his room and the area outside Male Ward. He’s starting to make a bit of an effort to straighten his leg when he’s outside as well which is great to see. Unfortunately it doesn’t look like the family has enough money for him to get skin grafting, but in the last week or so there seems to have been a fair bit of skin growing in on his back, so hopefully the leg will follow suit.

Last weekend the boy with TB got home as he was recovering really well.  Just before he was able to go home a 9 year old girl was admitted with TB, so we’ve been working with her the past week or so. Apparently her mother just dropped her off at her Grandmother’s when she got ill and the Grandmother has had to take her into the hospital. She wasn’t very impressed with her daughter in law (I couldn’t even understand what she was saying in Luganda, but I gathered that much!) I think the girl had what they call Jiggers in her feet (some kind of nasty bug which are apparently quite common among poorer people where there maybe isn’t very good hygiene and they don’t wear shoes). Then she contracted TB from the open wound. She was a very stiff when we first saw her, much more than the boy we’d seen was, but she seems to be getting there slowly but surely, managing to walk a few meters today and yesterday.

Last week, we experienced life a bit closer to how the locals live as the running water downstairs at the guesthouse ran out! There are guys from the maintenance department who come most mornings to pump water from a large tank into our tank at the guesthouse and it was on Wednesday night that we realised it had run out, so we thought that we’d manage until Thursday morning when it would get pumped up again. However, it happened to be a public holiday the next day, so nobody from Maintenance was working! As it turned out we actually got the day off work as well - we found out when we turned up for work and found a note left on the desk for us from the physios! So we eventually got running water again by Friday afternoon. Fortunately there was a separate tank for the shower upstairs and we had a few jerry cans of boiled water which we could use! We had a few power cuts as well on Thursday, so we got a taste of how many of the locals live here! It certainly reminded me of how much I take things like running water and electricity for granted at home!

It’s been such a great experience to see how the hospital runs, how they do physio here and to learn a lot about so many diseases and conditions that are not as common at home. For the next 3 days I’ll be helping out at the kids club called ‘Ekisa’ (said ‘Acheesa’). When we wern’t seeing patients today, we were busy cutting out all sorts of things for the crafts! Please pray for energy for the leaders and the team that are helping and also for all the kids that will be coming along. We have 200 children signed up, so pray that each one would be ready to listen and that they’d understand the teaching. There was a bit of a last minute change with the venue as it was to be up at the HIV department using their facilities, but the sponsors who help fund that department decided last week that they would start some building work, which has been delayed before, this weekend! The hospital didn’t want to delay them any further as they weren’t sure when they would come back again to do the work, so the people in charge have managed to organise to use a few different areas around the hospital and nursing school which will hopefully be all right and won’t disrupt the programme too much.

I hope I’ve managed to keep you all up to date with what I’ve been doing at Kiwoko hospital while I’ve been here! I will try and do a wee update once I get home about Ekisa and how it went.

For travelling home, the plan is to leave the hospital on Monday morning, I’ll head to Kampala, then Entebbe where the airport is. I leave there that evening to fly to Nairobi, then I have a few hours before my flight leaves Nairobi to fly overnight to London and on Tuesday I will fly to Edinburgh, meet Alasdair and we’ll fly home to Shetland. So hopefully I’ll be back home Tuesday evening! I reckon I’ll be pretty knackered after all the excitement of the kids club and all the travelling but it’s probably best to get it all done in one go!

So, my second last week!

I can hardly believe my adventure is nearly over! I'm trying to make the most of it all before I leave, although it will be nice to get back home for a bit before starting Uni again in Sept!

Another physio student, Alex, arrived at about lunchtime on Friday, so I was able to take him back after lunch to show him round the hospital and introduce him to the physios before the weekend.  The weekend was really good. We had a fairly relaxing morning on Saturday. I took Alex and Katie, a medic student from America, round Kiwoko for a walk. Then we went to one of the local shops just outside the hospital gates where we bought a Rolex each (Chappati with a fried egg, onions and tomatoes inside folded up like a wrap which tastes pretty good!) so we ate that back at the guesthouse. Then we headed off to Luwero, a town about 15km away, which takes about 20/25 minutes to get to by public transport. There were no Matatus about at the time, so we ended up getting in a car that was going that way, which I think it maybe had slightly more suspension than the average Matatu  - always a bonus! (It certainly introduced the new guys to transport in Uganda as we had a new record of 4 adults and a kid in the front two seats – the driver had less than half his seat!) So we had a wander around Luwero before coming back to Kiwoko and having a look around the market which happens every Saturday afternoon.  It was pretty cloudy most of the day but it did clear up a bit and I actually got my first sunburn since I arrived here! Must’ve been getting a bit blasé and missed my shoulders with the sun cream!

On Sunday I went back to New Hope, the church I went to my first Sunday here. New Hope is an Orphanage which was set up at about the same time as the hospital here, when the area (the Luwero triangle) was left devastated after the civil war. So there were a lot of Orphans around and an American couple, who are still there now, were able to come and start up the Orphanage. it’s really quite big now, but it’s done in such a nice way, it’s all split up into families and there are Ugandan carers there as well as some Muzungu carers. Anyway, I met one of the Doctors who is over from the UK to walk to the church which is about 5km away. It took us nearly an hour, so we left just after 9 and got there just before 10, the service then lasted nearly three hours, but it didn’t actually feel that long I didn’t think. Everything is translated so the service was both in English and Luganda. Some songs were in English and some were in Luganda with English in brackets underneath, so at least I knew roughly what I was trying to sing! I love how they do the offering here, they always do it in the first song and everybody has to get up and move to the front to put their offering in the baskets, so there’s a lot of moving around. The theme of the service was ‘The good news of death!’ The speaker was the main pastor of the church, a Ugandan man, who was really good at keeping our attention and said some really good things. He spoke about fears and the fear of dying and how we don’t need to fear it anymore because of what Jesus did on the cross for us, so it was really good to be reminded of that. We had communion as well at the end of the service, where we had to queue up either side at the front to collect the bread and ‘wine’ then we went back in pairs and prayed with each other before taking them. It’s the first time I’ve ever had pineapple juice representing the wine as Jesus’ blood!! It was really great having a chance on the walk there and back to properly chat to the doctor and to speak about how and why she’d decided to come and work at Kiwoko to work for a few years and also about her adjusting to life here.

Physio-wise, I was able to treat the lady with burns on her neck and shoulders myself on Monday using some of the words I’ve learnt in Luganda, so that was quite exciting! Admittedly I did have to ask Moses to translate everything she said back to me, but I was able to ask how she was, how she slept and to give simple instructions for the exercises we were doing, even if I didn’t quite pronounce it all right! Her wounds are healing up really well and she’s now pretty much got full range of movement in her neck and shoulder again which is great.

Monday evening was an experience and a half as the hospital held a Junk sale to raise money for a few things: their medical missions, the nursing fellowship groups and to buy all the patients a small gift at Christmas time. They actually were selling everything and anything and people were buying everything and anything! I was on the stall with household things, shoes, bags and jewellery. And it was mayhem! So many things were being pushed under my nose as they asked how much they were and notes seemed to be flying at me from all directions as I tried to find the right change!!  I think we raised quite a bit of money and all for good causes though, so it was a very successful event even if it was a bit of a blur!

The boy who had Tetanus is doing really well, he’s been able to walk himself to the Rehab dept the last few days and we’ve had him throwing a ball in all directions, bending over to pick the ball up from the floor, stretching and passing the ball around to each side. We’ve definitely seen him getting stronger and more flexible again. Hopefully he’ll be able to go home by the end of the week.

Last night we had another meeting for Ekisa the kids club which is next weekend. So I think all the preperations are coming along nicely for that with games, crafts, memory  verse, talks and songs all thought out which is all very exciting. I’ve mostly been helping with games which we’ve planned for each age group each day and I’m on the team for children aged 5-7, so I’ll just be helping out where I can there. We were practising some of the games and songs at the meeting which was great fun, so I'm sure the kids will love it! The registration for kids started today and ends Friday I think. We are anticipating about 200 children, so please pray that they would get signed up so that they can come along and here the good news! Also that they would be willing and to listen and learn as well as having fun! The theme for the weekend is ‘I was lost but Jesus found me!’ and we'll be looking at the lost sheep, the lost coin and the lost Son. The club will be every afternoon on the 16th, 17th and 18th, so in the mornings the team will meet up to pray and organise everything for the afternoons when the kids come.

Swallowship!

So I think the rainy season has started here! For the past month if it has rained it’s usually been pretty heavy and it lasts just for about an hour or so, but in the last couple of days it’s been pretty grey and we’ve had a lot more rain which has lasted longer. Hopefully we’ll still get a bit of sun over the weekend since I don’t have to be inside working!

Today we managed to treat most of our patients in the morning which meant Solomon and I had time to prepare the crafts for Ekisa the kids club. The theme is ‘I was lost, but Jesus found me’ so one day we’ll be looking at the lost coin, another the lost sheep and the last day the lost son. We have another meeting next week with the team, so we were making up the crafts to show and we’ve been thinking of games to teach all the leaders aswell so that they can be used at the club on the 16^th, 17^th & 18^th of this month.

We seem to have quite a lot of patients on male ward at the moment and not so much in female or paeds, it just changes all the time with some wards quieter or busier for a spell. It’s just as well they got male ward moved last week as I don’t think they would’ve had enough room for everyone in the old one!

The boy with burns is doing well, we’re keeping all his joints that are affected moving and he’s been able to make his way outside using a walking frame a few days this week. His back is healing up really well but his leg is so badly burnt that it’s still just raw flesh really, so they’re hoping to do skin grafting soon I think. I might try to see a bit of that in theatre if I get a chance.

Unfortunately on Monday when we went to see the burns lady and her baby, they had been discharged and had gone! I was a bit upset because I had been seeing them everyday for the past month and we never got to say cheerio. Also it would’ve been useful for us to speak to her and her family to advise about exercises etc but apparently they were worried about money and they obviously had spent quite a lot having been here for 4 weeks with the two of them. I suppose people here just don’t have as much laid by for these situations like we would and they had to have other family to help them for food and washing while they were here, so the lady had her sister and her sister in-law was looking after the baby. The hospital here really is quite cheap compared to other hospitals in Uganda as they subsidise treatment massively and they don’t work with bribes or anything. (I’ve heard that in many of the hospitals then the only way to make sure you get proper treatment is by bribery.)  I had been hoping to get photos with both the lady and her baby but it wasn’t to be, I’ll always remember them but it would’ve been good to let other people see. I think they were planning to go to a health centre near their home which would be cheaper, but I’m not really sure what the standard of health care will be there. The baby should be fine, she was healing up really well and we even managed to have her through playing alongside the Nutrition group on Friday, so that was good. The Mum’s face and arms were healing up well, so she should be able to get rull range back at her elbows if she keeps moving them and thankfully the burns on her legs were just her lower leg, so she is able to bend at her knees. Hopefully the lower legs will heal up too in time, but the doctors were speaking about having to graft, so I’m not sure.

I took the HIV aerobics class again this Tues morning which was good fun! They loved it when I counted in Luganda for a few of the stretches!

Just the day after the burns lady was discharged, we had another lady referred to us with burns. Unfortunately this one is 17 and she was burned with boiling milk by the other wife of her husband. Apparently it’s traditional in some tribes here to have more than one wife and lots of kids to show that you are very manly and that you have money. Unfortunately, as can be expected, this often means that the older wife gets jealous of the new, younger one. I think that’s what happened here. This girl is badly burnt on her face, but the burns on her neck, chest and shoulder are very superficial and are already healing well. So we’ve been doing exercises with her neck and shoulder and she’s been doing very well, able to do them herself and without to much pain which is good.

 Our Nutrition group was starting to get quite small in numbers with a few of the children being discharged which is good as they were getting better. Then we got a few more yesterday, so the mats which we sit on were pretty crowded but it was good to play with them all!

And in the last few days we’ve been treating a young guy who is recovering from Tetanus. He’s about 17 I think and contracted it through a wound on his foot while working on his family’s farm I think. He’s got such a lovely big smile all the time! He’s doing pretty well, he was very stiff and quite weak, so we’ve been doing lots of stretching. Today we were able to take him back to the physio department where we were able to work on his range of movement and strengthening as we got him to throw a ball and do stretches on the mats. So plenty going on physio-wise!

I’d better explain my title now! On Tuesday night I was invited by Solomon to join his fellowship group for ‘Swallowship’!! Such a good word! It was basically when the fellowship group meet to share food and have fun together! Obviously an African English word! It was at one of the doctors houses which is just nearby the guesthouse, so we went along at about 8ish. We just chatted while we waited for everyone to come, then we sang a few songs together before we had some food. It was really nice, everyone just brought a maincourse or a pudding, so it was good to try some more African food and then there was papya cake and fruit for pudding which was really nice! J Then after food we played lots of fun games and once it got quite late I had to make a quick dash back to the Guesthouse as it was pretty wet outside. I really enjoyed my evening and it was nice to meet more people and spend more time with some that I’ve met already.

Got to see Sarah on Sunday as we made a trip to Kampala, so that was lovely to see her again before she went on to Kenya. We visited the craft market, then went to an English Kampala Baptist Church where we arrived early and were ushered into a bible study that happens before the service every week! We got a lovely welcome and it was a really good service. Then we had some lunch and met up with more of the students from the guesthouse who had been to Jinja whitewater rafting before we headed back.

One of the medical students left today at lunchtime and another student arrives tomorrow, so there’s always people coming and going at the guesthouse. This time it’s another physio student, so we’ll have doubled the physios at the hospital! Moses, the head of dept, was very excited to hear that there would now be four of us! So that’ll be nice, I’ll be able to show him round this weekend and it’ll be good to have another student from the UK to discuss treatment options etc for my last couple of weeks!

Emu, Biri, Satu, Nnya... (1,2,3,4...)

Week 4 already!

I’m not managing too well with the whole trying to learn Luganda, it’s difficult to pronounce the words right and I’m pretty forgetful as well, but counting is something I’m getting more confident at since we often get the patients to count as we do stretches and the younger ones like to count when they’re playing!

So it’s been a good week so far. It turned out that Monday wasn’t as busy as I was expecting at all. Most of the girls who had been admitted with the bus crash seemed to have been discharged at the weekend. Apparently most of them weren’t harmed too badly, just cuts and grazes and I think a few were transferred to hospitals nearer to where they live.

Tuesday was busy! We treated a few of our patients on the ward, then at half 11 I headed off to find the community health worker that I had arranged to join on his visits. So we headed off on his motorbike to visit various patients where they live around Kiwoko and in nearby villages just before 12. It was really good to see patients in their own homes and to get more of an idea of how they actually live.
We saw 11 patients altogether, most of them with some kind of physical disability. The community team are very busy with all they do and it was good to see they difference they have made. They do a lot of education about hygiene and safe drinking water etc and they try to think how they can help the patients to make their everyday living easier. One device they have come up with for people without running water is a wooden frame with two jerry cans attached for hand washing. The person presses a wooden leaver with their foot which then turns a bottle of soapy water downwards to wash their hands and then they do the same for a bottle without soap to rinse them. I saw this contraption at a few houses, so it’s good to see it’s being used. The community health workers are very good at thinking ‘outside the box’ as we’d say as they try to come up with ways to help people who either struggle to walk or carry out everyday tasks. When a patient is unable to walk independently, they often provide them with a suitable walking aid and for a few of the patients we visited they had built special toilets for them as they would normally have to squat, which can prove very difficult with one leg or if your leg muscles are very weak. For one of the patients we saw, they had made him some parallel bars out of wood so that he could practice standing and so he is able to spend some time out of his wheelchair (a plastic garden seat on wheels!). For some of them it was limited what they could do depending on the patient’s condition or sometimes they didn’t have enough money for equipment, although they do try to build with local materials to keep costs down. We saw a guy who was 19 and he had his own way of moving around by shuffling around on his bottom, so they just let him do that so he can at least move independently as he couldn’t use any walking aid because of his arms and he didn’t like the restriction of being in a wheelchair. He seemed to have a reasonable quality of life living with his family (alot of people live in their extended families) and he seemed very happy, so they check up on him every month or so.

We also visited the baby boy that we put plaster cast on his feet a few weeks ago to treat Club foot in the physio dept. So it was lovely to see him at home. I would say his feet aren’t really normal but they do look better than they did when we first saw him. They’ve now decided to get him to wear shoes on the wrong feet to help correct the positioning of his feet, but when we arrived we noticed he wasn’t actually wearing the shoes. (One of his siblings picked him up and took him inside when we arrived, then he reappeared with the shoes on!) So I think the health worker tried to tell them of the importance of wearing them, but I’m not sure if they will actually get him to wear them or not.

There’s so much more to say about the community visits, but I’ll maybe try and upload a couple of the photos which might give a better idea of what I saw. By the time I got back at about 3pm Moses had had a busy day with lots of Outpatients being sent our way aswell as the ones on the ward. He had already seen 4 and had another 2 waiting! So I was able to see a patient with back pain and one with knee pain before we both went to see the boy with the burns on his back and leg. I think they are going to have to do skin grafting, but he is improving – he was able to bend over and touch the ground which is a great improvement for him and he was able to hold his leg straight and fully weight bear on it too.

Wednesday we weren’t too busy, we managed to cover most of our patients in the morning and then I was able to read some of the physio books that have been left in the department by the physio that was here from the UK for a few years. We didn’t have any outpatients at all, it seems to be one extreme or the other!

I met up with one of the students that Sarah had introduced me to go to Nursing student’s bible study on Wednesday night.  The leader was very quiet and the discussion never really got going as they seemed to just ask question after question. I’m not sure if it’s just what they are used to learning but the leader just seemed to be quite happy to get the expected/right answer instead of questioning why or how it’s relevant to them or what they could do or change. So I’m not really sure how much anyone got out of it, but hopefully it was encouraging to meet up with other Christians and maybe it will spark some discussions among some of them later.

Then today we had the kids club for kids with HIV. It seemed to go pretty well. It’s all just so much more relaxed than working with children at home! We stuck roughly to our plan time wise, although a lot of it did seem to be a bit last minute!
Once the kids were registered we played lots of games outside which was good fun, they were all so full of energy! Then we had a tea break before starting with the story and puppets. It was pretty much all in Luganda, so I have to say I didn’t understand too much at this point, but they all listened really well. There was a slight change in the plan, so I was given the task of doing an ‘energiser’ (which is just a few minutes of getting them moving around and making noise to keep them awake!) before they did the memory verse and then got into their groups for discussions and crafts. We ended up doing colouring in for the younger group which I was in. One of the other leaders came up with a craft for the ones aged 8-12 which involved them making a little fence out of wooden sticks, decorating it with sheep on it ...and then after they had made them, they had to swap and destroy what each other had made! Apparently the aim was to see how they reacted to loosing something they had made and for them to learn from Job’s example when he lost his flocks! Certainly an interesting idea, I can’t really imagine it working at home! I wasn’t with those groups to see the reactions, but they all seemed very happy when they came back to join us in the room inside! I think they quite enjoyed it all!
They then had a wee quiz, sang a few songs and finished up about 2pm and we managed to get some lunch and see a couple of patients before the end of the day. I think the kids did take in a lot of what they were being taught, so please pray that they will take that away with them and that they might come to know God for themselves and to learn to trust him like Job did even when they don’t know why they are in the circumstances that they find themselves in.

Because we didn’t see all our patients today, we’ll make sure they are all seen tomorrow. We were able to ask the attendants of the ones we didn’t see to help them with exercises and where possible to get them walking outside, so we’ll have to check up if they did or not!

A fairly busy week...

Well the week has just whizzed by! There seems to have been a lot going on.

On Tuesday night I had one of the most bizarre experiences! A group of guys from Northern Ireland have been visiting and were staying in the training centre accommodation while they visited various schools in the area before they headed of to Jinja to do some mission work with YWAM. They had organised a film evening where all the staff and students at Kiwoko were invited to come up to the HIV shelter to watch a film together. The HIV shelter is basically a building with no walls which is used for clinics a couple of times a week. It seemed a bit strange heading out once it was dark but we made sure we covered up and were all stinking of the mosquito spray!! So we all headed up there from the guesthouse and as expected nobody had really turned up yet (It can be difficult to decide whether to go African time or Muzungu time as sometimes you are caught off guard when people actually mean the time they say!!) Someone was selling pop corn, so we got some to eat as we were sitting on the concrete floor starting to watch Indiana Jones which was projected up onto the wall. It must only have been a few minutes into the film when the whole sky around us light up! We realised after this happening a few times that it was lightening and we thought it might pass soon. But it continued for the whole film with thunder adding to the excitement in parts! So here we were watching Indiana Jones in the middle of a thunderstorm sitting on a mat on concrete floor under a roof while bats flew over our heads and lizards were casually running up and down the wall beside the film! It was a really good night, although the rain seemed to hold out until the film finished, so we had to run back to the guesthouse in the dark getting a bit wet. By this point the power had gone and the generator was off, so it was reading by candle light before bed!

On Wednesday the Male ward was moved back into their original building which has just been renovated and extended slightly. I only realised how cramped the ward they had been in was when I saw the space there was in the new ward! (Though even in the new ward the beds are a lot closer together than wards at home!) It seems really spacious and is lovely and bright having been newly painted. One side is for surgical cases and one is for Medical and they have isolated rooms for each side now as well as a separate part on the end for highly infectious diseases. It all went really smoothly and everything including patients seemed to be moved within a few hours! It did take a wee bit longer to locate our patients but other than that I was just amazed at how quickly it all happened with everyone just mucking in!

We had a meeting that morning with some of the workers from the HIV department about the kids club that they run once a month for kids with HIV. They call the club ‘Afaayo’ which means He cares. In this case they are meaning God cares and the aim of the club is for the kids to realise that God cares for them. So they pick a theme each month and have stories/dramas, games and discussions to help them decide for themselves what they believe as they learn about God. It think they usually just meet the week before to organise it, to me it seemed very African, where the meeting went on for quite a while and at the end I was wondering what had actually been decided! I then realised that I was signed up for thinking of a craft that can be done for each age group keeping in mind the theme for this month is Job! So yeah, hopefully it’ll all work out ok on Thursday! They do it every month, so I assume it’s slightly more organised than it seems!!

Physio wise we’ve been continuing with mobilising a few fracture patients using crutches and walking frames, playing with the malnourished kids and we’ve managed to get our burns patients walking a bit, weight bearing on each leg and even squatting down, so they are progressing well. However they definitely don’t get as much painkillers here as they would at home and sometimes it’s just awful to hear them crying out in pain. But the people here do have a much higher pain threshold and I think culturally they are expected to just get on with it and I suppose painkillers are pretty expensive too.

A lot of people do travel quite far to get here for treatment. We had a lady come in the other day carrying her 12 year old daughter on her back. Apparently she was born healthy and grew well and was walking and talking until the age of 4 when she came down with a flu and fever. They then realised she had epilepsy and by the time she was 6 she no longer talked and by age 8 she could no longer walk. But they had never actually visited the hospital until now! From what I could gather I think she had come a long way, so maybe that had something to do with it. From assessing her she appeared to be malnourished and the physio diagnosed some form of Cerebral Palsy. She could only really lie on her back, unable to sit independently. I just couldn’t believe that she hadn’t been seen for the past 8 years since she was first unwell. I think this kind of thing can be quite common though, and if people don’t come for help, you have no idea that they need it.

I met one of the health workers who does community visits this week, so I’ve arranged to head out with him on Tuesday to go and see what the health care is like in the community. It should be really interesting to see even more rural areas than we already are and to see what work is being done. I’ve heard from Sarah and quite a few of the medical students about clinics which run under mango trees, using the branches to hang babies off of to weigh them etc, so certainly sounds like you certainly have to be thinking outside of the box anyway!

It’s not been too busy this week patient wise, but on Friday female ward was extremely busy when we went to see one of our patients in the afternoon .Unfortunately it turns out that a bus full of school girls had came in after their bus had been turned upside down in an accident. I think about 20 were admitted and 10 were operated on during the day, so I there are plenty fracture patients for us to see next week. It was all a bit hectic on Friday with lots of people everywhere, but we’ll find out more about the situation on Monday morning.

Week 3 already!

So today was the start of my third week! I can hardly believe it. Although I’ve certainly managed to fit a lot in since I got here, including whitewater rafting down the Nile and a wee bungee jump this last weekend! The rafting was such fun, and it was just beautiful between the falls when we got to swim for a bit and see all the birds and scenery about us. The bungee jump was pretty terrifying but I loved it all the same!! All 5 of us from the guesthouse headed to Jinja together for the weekend then 4 of us headed back to the hospital on the Sunday as Sarah is now staying there to work in an orphanage for two weeks.

Today was good, we had plenty patients to see so there certainly wasn’t a dull moment. The lady with burns that I saw on my first day is really coming on, her wounds are healing well with a lot of the skin growing back and she’s managing to bend and straighten her arms and legs herself now with just a little assistance from us to get full range. The next patient we saw was a lady who had fractured her femur, and we were trying to get her up to walk but her other leg is so weak after being in hospital for a while. We did some strengthening exercises in bed and got her standing with a walking frame. It was really frustrating though because I could easily have treated her myself if either I could speak fluent Luganda or if she could speak English! I have a few words I know for treatment, but if they speak back I have no idea what they mean!! I feel like I should be doing more by my third week but I have to have one of the other physios there to translate to do anything. I find they often speak with the patient for ages, then translate a few words for me which is also a wee bit frustating!! However, after that we headed back to the Nutrition group with three little ones and I was able to do an assessment of the new patient with Solomon translating for me which was good. One of the Mums is really nice and although she dosn’t know much English, she always talks with me and tries to teach me more Luganda! We also saw the daughter of the lady who was burnt badly. The baby is healing really well and if finding moving a lot easier than her Mum who saved her from the house fire. We then saw a few more patients on Male ward before lunch, including the boy who was burnt by his Father. He is still in a lot of pain, but he is now able to straighten his leg when he stands. And we’ve managed to get him to bend over to lean on the bed, our plan is to gradually lower that until he is able to bend right down to touch his toes.

The ladies, Rose and Skovia, who work at the guesthouse really look after us well, so we had a lovely lunch ready for us. (They also do our clothes washing all by hand, which is amazing! Although I have to say I am missing the luxury of a washing machine as we have to hand wash our underwear ourselves!!)

Just when I feel I’m getting used to the way things work here, I’ve just had an afternoon where the lack of resources seems to have be so noticeable in comparison to home. After lunch we had a mother bring in her baby who is 1 ½ with Cerebral Palsy. We assessed him and were able to give her advice about the condition and what she could do. It seemed to be down to the physios to tell her about the condition, all she seemed to have been told so far was that something was wrong with his back and head. We gave her advise on different ways to encourage his development and we recommended she got a seat made that would help him to sit up. It really made me think how different it is in our country where so much can be done and there would be all sorts of equipment provided, whereas here it felt like they were just left to get on with it really! They are going to come back to see the physios in 3 months though, so there is a follow up, and I think they seemed to be able to either buy or make a chair which should help him to at least sit up. Then the lady we saw earlier with the fracture was getting discharged. Our plan was to work with her for a few days so that she could then move around on crutches, but as she was getting discharged today the family requested that they could take home a frame with them. In the UK, that wouldn’t really be a problem, there is usually enough, but here we spent nearly an hour trying to find one that she could take home for a few weeks. There were only about 5 or so in the whole hospital with most being used and shared between patients already. And there was only one without wheels which had a stopper missing off the bottom. So eventually we got her sorted with a slightly rusty old frame to take home until she is able to stand and walk without it!

I don’t want to give a really negative impression, it’s only me comparing. The people here don’t think in comparison to the UK hospitals, they just get on with what they have here and are thankful for it! There really is so much good work that is done by this hospital for the patients and it’s great that the physios are able to see such a variety of patients. Many people from around Kiwoko are saved from travelling far on dusty, bumpy roads to get to a hospital.

It really is a beautiful place here, I far prefer it to the busy city of Kampala! After work today, once it had cooled down a bit, I was able to go for a lovely walk around Kiwoko. It can actually be quite busy with people travelling by on bikes (I'm still amazed at how much can be piled on an bicycle!), people working on their land and cattle being herded along the road! The people do so much physical work here that they think it is funny that we choose to go out for walks!! There is always lots of different plants and wildlife to see around and the large red sun was turning the sky most gorgeous orange colour before it started to set! I’m definitely realising there are some things you just can’t capture by camera!

Muzungu! Muzungu!

There is so much I feel I havn’t communicated on here at all!

I don’t think I’ve even mentioned things like how we get our milk delivered to the door fresh from a farm nearby, then we have to boil it and pour it through a sieve to pasteurise it our selves before we can drink it. Or the fact that the toilet is a pit latrine outside the guesthouse (and when we used public toilets last weekend we had to take a tub of water in with us to use as a flush! Not what you call the most pleasant experience but memorable none the less!!) And how everywhere we walk little kids shout out “Muzungu” (which literally means ‘white person’ in Luganda) and they wave madly until you wave back! ...To begin with you feel a bit like a celebrity and now it feels totally normal!

Physio wise, I’m getting into the swing of the normal routine and I’m starting to be able pick up on the odd word the physios say when speaking to the patients! It is a lot more relaxed than home time-wise with a few hours chat after lunch most days! I am learning lots, the physios are very knowledgable about a lot of the conditions that they see, although there are some dodgy ideas here too - such as treating a patient with abdominal pain with ice, that was interesting! When I asked about it the physio just said it may have been some kind of muscle spasm which ice would help!! Anyway, here’s a couple of examples of patients I’m seeing everyday at the moment.

This last week we’ve been seeing a guy who is about 16 years old who is in hospital because his Father burnt him as a result of him being accused of stealing. I’ve no idea whether he did steal or not, but he has been burnt all down his back as well as the side and back of his left leg leaving raw flesh. To begin with he was kept at home with no treatment until his wounds went septic and he was taken to hospital. You just can’t imagine it happening in our country but apparently this kind of story is quite common here, where people take things such as stealing into their own hands. The boy only really has one position he is comfortable in which is lying on his front leaning slightly to the left with his left leg bent so his open wounds arn’t touching the bed. Unfortunately our job is to try and get his joints moving to prevent contractures which is very painful for him. Today I had to bend his leg and straighten it while he was crying out in pain but I know that it was for his own good.

Another patient I have seen everyday since I’ve been here is Isaac. Isaac is a five year old boy who has been in hospital for three weeks but they have actually just discharged him without really knowing what was wrong with him. It’s such a shame as he really is pretty ill. I think he came to see the physios originally because had fluid building up in his stomach which was pushing the diaphragm up and causing him to have trouble breathing. He couldn’t actually lie flat to sleep as he was having so much trouble breathing. So we had him blowing bubbles etc to try and get him doing deep breathing exercises. In the last week we’ve really just been playing with him to engage him in something as he’s been stuck in hospital for so long. He always looks so serious, like a wee old man! More recently the doctors have discovered some sort of mass on his liver but the family doesn’t have enough money to find out what it is or to spend anymore time in hospital and I think it would be too major an operation to carry out here to remove it. In the last few days after he was discharged and waiting for transport home, we took him through to the rehab department while we had the nutrition group in and we got him playing with a football so that he was moving around. I’ll miss seeing him everyday, we had good fun together, he’s helped me learn to count to 10 in Luganda with some of the games and puzzles we were doing!


I find it really hard to age people here, I would’ve said Isaac was about 3 and the boy who got the really bad burns about 12 but I discovered their real ages with the notes! And one of the nutrition kids who come along most days I thought was about 1 and a half and it turns out they are actually 3!


Oh and exciting news! For those of you who know I booked an extra week by accident... I’m so glad I did!!
It turns out that on my very last weekend here there is a childrens club for kids age 5-12 which Kiwoko Hospital runs from the Fri to the Sun. Both the physios are involved in it, so they asked if I would like to join the team! It’s called ‘Ekisa’ which means ‘Grace’ in Luganda and it sounds like we are basically going to have lots of fun playing games, doing crafts, drama and singing songs to teach the kids about the gospel. I think that they used to have teams of people coming over from the UK to run it but this year the Ugandans are running it and there are only 3 ‘Muzungu’ helpers. So, I’ve just been to our first team meeting tonight which is very exciting! I’ll be on the team which has 5-7 year olds which I’m sure will be good fun! The majority of it seems to be pretty well organised with the schedule all planned by the two main leaders already, then I think we'll have more to plan in the next month within the smaller groups.

Prayer wise it would be really good if you could just pray for wisdom for how to encourage the Christians I meet here. There is a lot of superficial Christianity around (like when you go through towns and see buses with ‘God is Good’ and ‘Hosanna shopping centre’) And because it’s a Christian hospital which was started up by a missionary, then there are a lot of the people and students we are working with here have basic understanding of Christianity and often know right things to say, but it can be hard to tell sometimes whether they really are committed Christians. The two physios are Christians and I’ve had some good chats with them which has been good!
And more practically, just for the physio aspect that I’d have the confidence to use and share the knowledge I have to treat/help patients, and also that I’d be able to take on lots of new stuff that I’ve not learnt about at Uni really.

Off to Jinja this weekend to go whitewater rafting with other students at the guesthouse and to say Cheerio to Sarah as she moves on to work in an orphanage there for a few weeks, can’t believe how quick the two weeks we’ve had together has gone!