The Last Chai Time
Yesterday, I had to sadly depart from my beloved Rubingo once and for all. We sipped our chai (the 90% whole milk, 10% tea deliciousness they drink here) and said our last goodbyes in the Rubingo dining hall. I have one more week here in Uganda, and I'll be spending most of it on Bushara Island, a succesful eco-tourism project ACTS started years ago. Imagine, a success. I will be spoiled there for a week where I can eat somewhat Western food and even have hot water delivered for showers. I have a big fat book to read, and I plan on sitting around doing nothing for a full five days.
A quick recap on the week's events. I worked in the aid station at our camp in Rubingo for a couple of days this week, which was eye-opening (but then again, most things are here). Most people who came through had malaria, which we can easily treat with drugs supplied by the government. It becomes pretty easy to tell who has malaria because the symptoms are always the same; really hot fever, joint pain, some nausea. The cute little kids who come into the clinic always chew up their pills, which is absolutely disgusting. Apparently they don't really understand the concept of swallowing it whole, or maybe they're just not capable quite yet. One five year old decided to chew his up, then wash it down with water, then vomit it back up all over the place. I don't really blame him, if I was chewing cloroquine, I'd probably barf it back up too.
One challenge in the aid station is filtering out who is actually poor enough to need our help and who just thinks the mzungus have endless pockets. It sucks to send people away who may really need our help, but the policy is if it's not an emergency they don't get much besides advice.
One day in the week Tanessa and I decided to go observe in the Bugamba health clinic, which is kind of the main hospital (and I use the term very loosely) in the area. By the time we got there, most of the normal patients (50% malaria) had been seen, so we were allowed to observe the antinatal care. An extremely qualified midwife showed us how to figure out how many weeks pregnant a woman is just by using your fingers on her belly, and also to figure out how the baby is positioned in the womb. She is confident that she is more accurate than even an ultra sound machine, and I can't say that I would challenge that. It turns out you really have to knead (sp? not a word i type much) those bellies, and smoosh the baby around a whole bunch. I was appreshensive at first, but gained confidence and eventually was pushing and prodding pretty darn hard. The baby usually gets pissed off and starts kicking at the disturbing hands, which helps in locating its appendages (which were referred to as nodules). When the woman is super pregnant, you can feel a very definite head just below her belly button, and you're even supposed to move it around a bit to make sure.
Yesterday we hopped into the truck (who's passenger window just shattered, the reason still a mystery) and drive to a World AIDS Day event in a neighboring subcounty. When we arrived, we were welcomed and asked to sign the guestbook, then left to ourselves. We tried to figure out what was going on, but couldn't so just sat down in some seats. Someone eventually handed us a program, and it showed that most of the day was done by about 12:00, and we hadn't arrived until about 1:00. Whatever events were left looked like they weren't going to happen for a little while, so after grabbing some lunch (beef stew and matooke) we came back and had a seat again. We sat back down, and watched a few school groups perform some songs, which was pretty cool. Then it started to rain and everyone ran for cover. It was in that cover that we found out that none of the events for the day had started, even though it was past 3:00 at that point. In true African style, a 9:00am start time had turned into a 3:00pm start time. On top of that, we overheard one of the coordinators yelling on his phone at the Guest of Honor, who had completely failed to show up, and was not planning on doing so. At this point, we quietly took our leave, and guiltily drove away. It was like a junior higher's birthday party that nobody showed up to; awkward for everyone. I write it here as an example of how things function- or fail to function- in Uganda.
After the AIDS day, we went back to camp and were going to leave, but decided to give Melanie, another intern, a malaria test since she wasn't feeling well. Turns out she was (and is) positive, so we decided to take her back to Mbarara, where there are much better medical resources. The private clinic in Rubingo was a tiny building with many rooms with sheets as doors. There was no electricity, and it was dark by the time we could head out, so we walked through pitch black halls to find her room. The health worker at the clinic had decided to put her on a quinine IV, which seemed a bit extreme, but is a pretty quick way of treating malaria. The only problem was that the IV would take about 4 hours to empty, and we had an hour and a half drive back to Mbarara. So, we decided to bring the IV along with us in the car. I was elected to drive while Tanessa (a nurse from vancouver) would monitor the IV and make sure it didn't flow too fast. We covered the broken window with plastic, rigged up a sitting place for the IV bag with some hockey tape I had in my backpack, and turned on some Christmas music. Driving here sucks all the time, but at night is absolutely horrible. We had to opt for the "shortcut" to Mbarara, as it is all dirt roads with little traffic. Going out onto any paved road at night here is a death wish. So we bumped along over crazy dirt roads on the edge of giant cliffs, Tanessa watching the drips with her cell phone light and me singing along to Christmas carols while trying to keep us from plumetting to certain death and trying to make a road made of boulders as smooth as possible for our sick friend. I have to admit I was smiling the whole time.
So that brings us to today. We made it home to Canada House in Mbarara, and we've gotten Mel some oral quinine (screw the IV, she can swallow). Tomorrow takes me to Kabale, which you can see on the map on the last post. I should get one more good one in before I fly home!
A quick recap on the week's events. I worked in the aid station at our camp in Rubingo for a couple of days this week, which was eye-opening (but then again, most things are here). Most people who came through had malaria, which we can easily treat with drugs supplied by the government. It becomes pretty easy to tell who has malaria because the symptoms are always the same; really hot fever, joint pain, some nausea. The cute little kids who come into the clinic always chew up their pills, which is absolutely disgusting. Apparently they don't really understand the concept of swallowing it whole, or maybe they're just not capable quite yet. One five year old decided to chew his up, then wash it down with water, then vomit it back up all over the place. I don't really blame him, if I was chewing cloroquine, I'd probably barf it back up too.
One challenge in the aid station is filtering out who is actually poor enough to need our help and who just thinks the mzungus have endless pockets. It sucks to send people away who may really need our help, but the policy is if it's not an emergency they don't get much besides advice.
One day in the week Tanessa and I decided to go observe in the Bugamba health clinic, which is kind of the main hospital (and I use the term very loosely) in the area. By the time we got there, most of the normal patients (50% malaria) had been seen, so we were allowed to observe the antinatal care. An extremely qualified midwife showed us how to figure out how many weeks pregnant a woman is just by using your fingers on her belly, and also to figure out how the baby is positioned in the womb. She is confident that she is more accurate than even an ultra sound machine, and I can't say that I would challenge that. It turns out you really have to knead (sp? not a word i type much) those bellies, and smoosh the baby around a whole bunch. I was appreshensive at first, but gained confidence and eventually was pushing and prodding pretty darn hard. The baby usually gets pissed off and starts kicking at the disturbing hands, which helps in locating its appendages (which were referred to as nodules). When the woman is super pregnant, you can feel a very definite head just below her belly button, and you're even supposed to move it around a bit to make sure.
Yesterday we hopped into the truck (who's passenger window just shattered, the reason still a mystery) and drive to a World AIDS Day event in a neighboring subcounty. When we arrived, we were welcomed and asked to sign the guestbook, then left to ourselves. We tried to figure out what was going on, but couldn't so just sat down in some seats. Someone eventually handed us a program, and it showed that most of the day was done by about 12:00, and we hadn't arrived until about 1:00. Whatever events were left looked like they weren't going to happen for a little while, so after grabbing some lunch (beef stew and matooke) we came back and had a seat again. We sat back down, and watched a few school groups perform some songs, which was pretty cool. Then it started to rain and everyone ran for cover. It was in that cover that we found out that none of the events for the day had started, even though it was past 3:00 at that point. In true African style, a 9:00am start time had turned into a 3:00pm start time. On top of that, we overheard one of the coordinators yelling on his phone at the Guest of Honor, who had completely failed to show up, and was not planning on doing so. At this point, we quietly took our leave, and guiltily drove away. It was like a junior higher's birthday party that nobody showed up to; awkward for everyone. I write it here as an example of how things function- or fail to function- in Uganda.
After the AIDS day, we went back to camp and were going to leave, but decided to give Melanie, another intern, a malaria test since she wasn't feeling well. Turns out she was (and is) positive, so we decided to take her back to Mbarara, where there are much better medical resources. The private clinic in Rubingo was a tiny building with many rooms with sheets as doors. There was no electricity, and it was dark by the time we could head out, so we walked through pitch black halls to find her room. The health worker at the clinic had decided to put her on a quinine IV, which seemed a bit extreme, but is a pretty quick way of treating malaria. The only problem was that the IV would take about 4 hours to empty, and we had an hour and a half drive back to Mbarara. So, we decided to bring the IV along with us in the car. I was elected to drive while Tanessa (a nurse from vancouver) would monitor the IV and make sure it didn't flow too fast. We covered the broken window with plastic, rigged up a sitting place for the IV bag with some hockey tape I had in my backpack, and turned on some Christmas music. Driving here sucks all the time, but at night is absolutely horrible. We had to opt for the "shortcut" to Mbarara, as it is all dirt roads with little traffic. Going out onto any paved road at night here is a death wish. So we bumped along over crazy dirt roads on the edge of giant cliffs, Tanessa watching the drips with her cell phone light and me singing along to Christmas carols while trying to keep us from plumetting to certain death and trying to make a road made of boulders as smooth as possible for our sick friend. I have to admit I was smiling the whole time.
So that brings us to today. We made it home to Canada House in Mbarara, and we've gotten Mel some oral quinine (screw the IV, she can swallow). Tomorrow takes me to Kabale, which you can see on the map on the last post. I should get one more good one in before I fly home!
posted by graeme at 12:22 AM
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