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!