At disability school.preview Charlie teaching in chapel.preview Cooking class 2.preview Cooking class.preview Dom and Jamie - stroke rehab.preview Feeding class.preview Ouside Kagando hospital.previewFirst, an update from Charlotte McGrath (dietician at Torbay hospital) who has been funded by Interface Uganda to assist and teach staff in two Ugandan hospitals….

A little update from the world of dietetics…. We arrived at Kagando hospital on Sunday night after an EPIC journey from Heathrow to Entebbe to Kampala to here!! We passed the Uganda equator and drive through the most remote parts of the world that I have ever seen. The people here have so little, yet they smile always! They are truly inspirational.

Day 1 at Kagando hospital:  We were introduced to the nurses and doctors at morning chapel… 7am chapel! We had a tour of the hospital. It’s hard to describe the conditions here. The wards are damp, rotten, overcrowded. They smell awful. Each patient has a mosquito net and a bucket to wash in. Most of them use it a as a toilet also. The family camp on the grounds – they have to wash, clean and cook for their loved ones who are in hospital. They are incredible.

I was taken straight to the paediatric ward and neonatal ward where I saw one newborn being resuscitated… He survived. I visit him everyday. I have been involved in developing the feeding protocol for the neonates and children. Today I am working in outpatients in the HIV clinic with the nutrition nurse. I am overwhelmed with fear, sadness and joy with all that I’ve seen so far. Will try to update often but internet isn’t great.

Update from Jamie Currie (Occupational Therapist at the Royal Devon and Exeter Hospital) – Wednesday 5th November:

Another roller coaster day today.  The teaching that we did this morning went well with really positive feedback – it involved Mr Peters (upper limb surgeon from Derby), Ken (physio at Kagando), Dom and I.

I also got to do some proper hand therapy with the wrist fracture (case study) patient and a stroke patient.  I used them as a teaching session with the physios and OT technician.

Dom has been doing a fantastic job with both teaching and leading in clinics with just about everything they could throw at him.  The ninety year old stroke patient who has not been able to stand for two years is now able to walk with the assistance of one person, and needing minimal support to stand from a sitting position.  All techniques we have been reinforcing with the nursing staff, who we hope will continue to use in the future.

Charlotte has been doing an amazing job too.  She was teaching today with a large group of mothers and their children with malnutrition.  She was advising on balanced diets and cooking techniques to get the most out of their diet.

We also had an amazing experience this afternoon and drove in a jeep with Ken up into the mountains.  We met people who rarely see cars never mind white people.  The children we met would have made the trip worthwhile on their own.  I can’t get over how generous and friendly people can be who have nothing.  Had dinner tonight with the district priest at his house and discussed what Interface is doing for his community.  Too much has happened to fit in a text, but will update as best I can. Jamie

6th November – update from Dom Hazell (physiotherapist from Royal Devon and Exeter Hospital):

Today brings an end to our time at Kagando Hospital. Ken (the only physio at Kagando) has organised our itinerary during our stay. From a Physiotherapy view point the caseload has been extremely varied. In my time here I have completed Musculoskeletal assessment and treatment, Stroke Rehab, Paediatrics, Post-Surgery Rehab, Respiratory assessment and treatment, Wheelchair fitting along with a CME teaching on Distal Radius Fractures with Jamie and Dr Peters (UK Orthopaedic Upper Limb Surgeon) along with manual handling teaching to nursing students. I even got asked (along with Jamie!) to give Women’s Health advice, somehow we got away without needing to do this!

And more from Charlotte McGrath:

Day 4 at Kagando has been a heartbreaking one. We drove to the rehabilitation school for children with disabilities today. They babies and children we assessed have a variety of conditions such as muscular dystrophy, club foot and cerebral palsy. The babies are very small for their age and the mothers are struggling to feed them the right foods to prevent failure to thrive. Some of the babies have swallowing difficulties and need modified diets… Soft, purée foods and some needing thickened fluids or even gastrotomies (no follow up post-discharge!!) I went through food fortification techniques and energy dense foods with the help of my translator. I have had to learn so much about their diet and the cost of living so that I can make my advice realistic for these families. Yesterday was tough… HIV and malnutrition clinic from 8am till 2pm weighing the babies, mid upper arm circumference and diet histories. The malnourished children an HIV mothers are prescribed ready to use therapeutic foods (Rutf) for free. Amount and dosage depends on babies weight and target weight for their age. They are all desperate for the Rutf but sadly not all can receive them. They contain 500kcals per 29g sachet. Protein content unknown. I am trying to find out from the suppliers. We then had a cooking and education workshop for all the mothers, explaining about a balanced diet and showing them simple recipes to have at home. We made plantain with walnut oil and an oily fish of some sort. Tasted fab!!  This evening I gave a talk to the medical students and nurses about enteral feeding and refeeding.