It’s imminent!
So, after many years of hesitation, and full of trepidation, I’m finally off to Uganda on Sunday! Luckily for me, I’m going with lovely people, some of whom have been before – Vikram, Karen, Alex and Bex Devaraj, and Woan-Yi Chan. We are going to Kampala for the first week (staying with Andrew and Sarah Hodges) and working / teaching at CoRSU hospital. For the second week, we are visiting a more rural hospital in Kagando.
Thank goodness we are allowed 2 suitcases! This one is already full with splints and material for the physio and OT department at CoRSU. The other one is rapidly being filled with toys and craft / school equipment for ‘Hands for Hope’ charity in Namawongo – a poor, informal urban settlement in Kampala. Hopefully there’ll be a little room for some clothes!
So this is the start of my ‘blog’ – hopefully there will be some interesting stuff to tell you about – that is if I can get internet access! If not, I’ll do it when I get back.
Monday 24th June. Day 1. Arrived!
So we’re here! It’s been a whirlwind of experience so far. The plane took off from Heathrow at 9.30pm Sunday evening, shortly after which Vikram Devaraj was already saving a life on the plane after a call from the pilot for a doctor! After little / no sleep, we arrived at Entebbe airport at 7.30am, and were met by Andrew Hodges. We came with 12 suitcases and 8 items of hand luggage – we just about managed to squeeze it all into his car (plus ourselves). We were all extremely surprised to see it was raining – not just raining either – chucking it down! Must have brought it with us.
Andrew drove us straight to CoRSU hospital, where we were given an extremely warm welcome from all the staff. We met Malcolm Simpson (the CEO of CoRSU), who seems incredibly motivated to make great changes there to enable even more patients to be treated.
We were then shown around the hospital. My first impressions were that it is larger than I thought it would be, in beautiful grounds. The rooms are spacious, and all the staff that I met seemed well motivated and all so friendly and welcoming.
I personally spent a lot of time with Christine Tusiime, head of physiotherapy and occupational therapy (OT) at CoRSU. It was so lovely to see her again – she came out to spend time at the RD&E for 3 weeks in August 2005, and stayed with us. I did some teaching on hand therapy to all the physio and OT team, which I think went well.
Then we opened the suitcase of goodies – new splinting equipment personally donated by David Burdon and myself, along with loads of splints from reps that had not been used, and some second hand splints which could not be re-used at the RD&E. I think they were happy!
After teaching, I was almost immediately put to use to make a splint! It was a very different experience from making a splint at the RD&E, where all the equipment is set up to use so easily. Lots of improvisation was needed.
Lunch was provided by the hospital – it is all cooked over a log stove in huge pots for all the patients and staff. We had rice, peas and matoke (a kind of plantain / banana) – it was really good, and I went back for more! More splinting was required after lunch on a small child with cerebral palsy. As there was no sewing machine in the therapy department, we tried to adjust a fabric splint in the workshop with an amazingly patient man called George on the sewing machine! Poor chap – he had to make around 5 different adjustments for us, never complaining once. I could not have used his machine – it had some sort of device for making it ‘go’ which he used his foot for (not a normal pedal)!
So that pretty much made up my first day at CoRSU.
Meanwhile, Vikram Devaraj, Woan-Yi Chan and medical student Alex Devaraj were seeing a huge amount of patients in clinic with George Galliwango (Ugandan plastic and reconstructive surgeon), Darius and Martin (who are training to be plastic and reconstructive surgeons). Malcolm Simpson (CEO at CoRSU) had advertised that specialist hand and reconstructive surgeons were coming from England with Interface Uganda, and many people had turned up with all sorts of complex conditions, some of which could be helped, and others which sadly they may not be able to help.
Karen and Bex Devaraj were busy taking photos, speaking to staff and generally finding out what Interface can do to help in the future.
We left the hospital at around 5pm, and went back to Hodges’ house, where we are staying. What amazing hosts! We have a room each, some with a bathroom! We are being extremely well fed with delicious food, and watered with passion juice, wine and beer!
Altogether an extremely productive and incredibly tiring day!
Tuesday 25th June. Day 2 – Namawongo slum and Hands for Hope charity
An emotional and incredibly interesting day for myself, Bex and Karen. We visited ‘Hands for Hope’ charity. I found this charity when they contacted the Interface Uganda facebook page, asking for surgical and medical help for one of the children they have helped to educate. When I looked at their website, I was motivated to sponsor a child to attend the school. So being in Kampala, I could not resist visiting! So this is me meeting Catherine and giving her the cards that my children made for her (plus a very small gift).
This is meeting Ryan – a child sponsored by another physio friend, Ann. Her little boy (Jack) wrote him a lovely letter with a photo.
Thursday 27th June. Day 4. In theatre
A very exciting, though slightly nerve-racking day for me today.
It started in a lovely way, with Christine discharging home a lovely 16 year old boy who had never previously walked, having fixed flexion deformities of his knees. He used to crawl around, but with help from Christine (gradually splinting his legs into a more extended position) and the people in the workshop at CoRSU, he is now able to walk with crutches. How fulfilling Christine’s job is! His mother calls her a miracle worker – I agree. He was wearing a brilliant t-shirt, saying ‘Parents for sale. Buy one get one free’! Made me laugh.
Then I was off to theatre to splint the little 22 month old boy with burns. It didn’t go quite to plan, and lots of improvisation was needed in theatre. Luckily I had Stanley (another physio from CoRSU), who helped a lot, along with Alex Devaraj, helping to keep the child’s head still while we were trying to get the material around the back of his head. It’s something I have never done before, and I think it turned out well. Dr Andrew Hodges was happy with it.
I felt very important as I was called to the other theatre to splint another little boy!!! He had burn scar releases on his hand by Vikram, Woan-Yi and Martin.
Lunch consisted of rice, peas and matoke – I’m going to try and write this in a different order each day I think.
Then it was back to help Stanley in the physio department. I treated a little girl with a stiff elbow following an arm fracture. Then I watched Stanley treat a 17 month old with cerebral palsy. The physios here are amazing – there are only 5 of them, compared with about 70 at the RD&E, so they all have to know a lot about many different conditions. They are extremely skilled, and take on anything that is thrown at them, however complex (which it very often is)!
Lastly we saw a 28 year old man with cerebral palsy who had fallen and broken his leg, which was in plaster. We tried to get him to walk in the parallel bars, but he was having none of it! I had to take a picture of the most ingenious bit of recycling I have ever seen!
… It’s a plaster shoe made out of an old bicycle tyre – brilliant!!!!
Bex has been interviewing the 2 trainee surgeons today for the Interface Uganda video, about how the charity has helped them over the past few years. They were really good sports for doing it, as they had been operating in theatre all day before Bex collared them at 5pm to be interviewed!
Vikram and Woan-Yi were involved in quite a dramatic case where a young boy had his arm amputated due to a tumour.
Karen spent some time in theatre and had fantastic time watching all the trainees in action. She also got a chance to talk to some patients and relatives, finding out exactly how the charity has helped them and made a difference to their lives.
Frida y 28th June – Day 5. CoRSU and Fort Portal
We spent the morning at CoRSU, starting with the ward round. The complicated splint that I had made in theatre yesterday seemed to be OK, so that’s good. Then I had to assess a lady with with increased tone in her arm. Needed to do a full muscle and sensory assessment, then made a splint, which was not easy, as her high tone kept making her hand close. It has been a morning of difficult splints – that one, followed by a young lady with a 2 week old flexor tendon and median nerve injury, who was in so much pain that I could hardly touch her, then a tiny splint for a one year old who wouldn’t give me her hand or stop crying! By this time it was 2pm, and I had missed lunch, but Christine found me some on the private ward. We had a memorable lunch, surprisingly consisting of rice, matoke and peas! Vik, Woan-Yi, Alex and Andrew were in theatre operating on a mixture of birth anomalies and severe life threatening infection, after their ward round.
We had a fun evening with DJ Chan in charge of music – she’s a natural. A bit of singing and dancing with beer and wine. We slept inside tents inside the house due to bugs! Enormous moths amongst other things, but we felt safe tucked inside the tents! There was no running water, and a short walk to the loo (which freaked Alex out with all the flies looking up at him from the ‘pit’)!
Saturday 29th June. Day 6 – chimpanzee trekking.
We got up extremely early to go chimp trekking in Kibale rainforest. When we went outside (to get to ‘the pit’), we were greeted with an amazing view from Andrew and Sarah’s balcony – it looks out over Lake Mbajo, with the Rwenzori mountains in the distance – the sun was about to rise.
Vikram drove us over extreme lumpy bumpy roads to the chimp centre. We met our guide (Farida), and walked us into the rainforest. We walked a long distance, it was quite hilly. We heard the chimps before we saw them – they call very loudly, and drum on the gigantic roots of Banyan trees – this apparently is the ‘chimp telephone’ system, according to Farida.
We learnt a lot about chimp behaviour from Farida – shocking to hear about some of it – not publishable, in case my children are reading! We saw some funny behaviour – one male chmip was waiting for the female to come down from a tree, but she wouldn’t come to him, so he had a bit of a strop. A ‘chimp domestic’.
Then we saw another male chasing a smaller male up a tree, showing who’s in charge.
Meanwhile, Vikram and Woan-Yi went for a walk around 3 nearby crater lakes.
They picked us up from the chimp centre, and we went for lunch overlooking another lake.
We looked at the menu, and all chose, but when the man came to take our order, he said we had to chips and vegetables, as that would be quicker! It still took over an hour to come though, by which time we were playing silly games – who could hop / skip that fastest (Alex won), and what we could wear for a masked ball in the evening! A monkey came to see us there too!
After our prolonged lunch (which was quite nice, considering it was chips and vegetables), Vikram drove us to the ‘Top of the World’. The Mitsubishi got stuck in a massive trench whilst trying to turn a tight corner, so Bex video’d the moment and we all took photos! Helpful! Vikram wants me to stress that it’s only a 2 wheel drive!
The ‘Top of the World’ is a beautiful view point over 3 crater lakes.
We returned to Andrew and Sarah’s lodge, then some of us went for a swim in the lake. Sarah and I ended up swimming all the way across and back – the hypnotherapy I had for open water swimming is still working (I was scared of swimming anywhere except in a pool a few months ago).
Sunday 30th June. Day 7 – Lakes, lunch and Kagando
We leisurely got up at 8am, and packed up. We went to another crater lake to see the monkeys there while Andrew and Sarah moved their bee hives, which has been an ongoing scary saga!
The lake we went to was lovely. Vikram pretended to be Gollum from ‘Lord of the Rings’ on a rock by the lake! Hilarious – he could have been an actor.
There were loads of monkeys in the trees there.
We met Andrew, Sarah and Naomi there, then went to yet another crater lake for a quick swim before lunch at a wonderful resort (Kyaninga). We had not had a shower for ages, so we washed in the lake.
Lunch was delicious. We then went separate ways – Vikram, Woan-Yi, Andrew and Naomi drove back to Kampala, whilst Sarah, Karen, Alex, Bex and I drove to Kagando hospital – in rural West Uganda, near the Rwenzori mountains. Sarah gave us a quick tour of the hospital, before we had dinner, a bit of Ugandan TV and an early night in the hostel there.
Monday 1st July. Day 8. Kagando hospital, orphanage and boat trip
We visited Kagando hospital in the West of Uganda (around 6 hours drive from Kampala), where Andrew and Sarah worked when they first came to Uganda around 21 years ago. They still visit regularly. Sarah showed us around the hospital, and everyone was very welcoming.
I met the physio whist we were there. He is called Ochom Kenneth, aka ‘Ken’. He is doing a fantastic job, being the only physio at the hospital, he sees all the inpatients and some outpatients from as far away as Congo! So he has to know everything about everything. He also has very little equipment to do it with – he showed me his home made traction equipment. It is now my mission to get some equipment out to him with a student physio who is visiting from the UK in August. I think I’ll try and get our physio department to help with some fundraising – beware RD&E when I get back! He says he never gets any visitors, so he really appreciated our visit.
After our visit, he was going to see a man with polyneuralgia which was so bad that he could not walk when he first saw him. Now he is able to walk with crutches. He showed us a woman on the surgical ward who was burnt from her neck to her chest. She had refused to let her husband take another wife, so he put a mosquito net around her neck and set it on fire. You hear about shocking stories like this too frequently here.
We are so lucky in the UK to not have to worry about paying for treatment. He says that some patients spend around $15 to get to the hospital, then they need to pay for their treatment, so he never turns anyone away, and always tries to help everyone. Being the only physio there, he hasn’t had a day off for ages, as he says the queue will only get bigger. He needs help.
Karen talked to the administrator and the finance team to find out the costs that patients have to cover, so that we can think about how we can help in the future. Some patients cannot afford their stay, and often have to sell family items to afford their hospital stay.
After that, we went to see the Nzirimbi orphanage. Andrew and Sarah have been personally involved in the orphanage for years, and even have one of the dormitories named after them. A lady called Dorothy started the orphanage years ago, and has gradually built it up with new land and buildings funded from a church in Leamington Spa. They now look after 110 children, mainly from mothers who have died in childbirth and their families cannot afford to care for them. Again, we heard some sad stories of children being left in rubbish dumps / saved from being sacrificed. Millie (Dorothy’s sister) kindly showed us around, and we met some of the children.
We gave them some of the book and toys we had brought with us – kindly donated from friends in the UK. They loved them, and we caused a bit of chaos! Thank you so much to Millie and the children for giving us such a wonderful welcome.
Then we were on the road again, heading south, passing the equator, and driving to the Kazinga channel, which joins lakes George and Edward in the Queen Elizabeth National Park in the West of Uganda. We went on a boat trip and saw water buffalo, elephants, hippos, crocodiles. Totally amazing, and a total contrast to our morning.
Tuesday 2nd July. Day 9. Queen Elizabeth National Park and drive back to Kampala.
We got up really early – still dark at 6am, and got ready to meet our guide for the game park. Her name was Harriet, and she took us to lions, baboons, kob (a type of antelope), water buck, warthogs, and Ugandan crested cranes (who were naughtily eating other birds’ eggs).
Then it was the long 6 hour drive back to Kampala. Karen, Sarah and I shared the driving. Some of the roads were pretty dusty!
Wednesday 3rd July. Day 10. Back at CoRSU
Had a good day at CoRSU today, and did quite a bit of teaching. We started with the plastics ward round, and picked up a few patients there, as well as some from theatre later on. We needed to do 3 splints all the same design, for a burn contracture release, and 2 patients with joint fusions. I did the first one whilst Isaac (the occupational therapist here) watched, then he did the next 2 patients. Isaac gets to do most of the hand therapy here, and seems very interested to learn.
I helped with a few other patients that the physios were seeing. The therapists here really are amazing, having to treat anything that comes their way. One minute they are treating a newly referred 4 year old with cerebral palsy who has never had any previous treatment; the next patient may be someone with a bad back, then a baby with burns contractures, followed by a bit of plastering on a child waiting for leg splints so they can walk… and that was just this morning! It is all so varied, and chronic / complex, as patients often cannot afford their treatment, or transport to the hospital, so hope it will just get better. People are frightened of having an illness of accident, because the financial cost is so high.
After an exciting lunch of posho, beans and rice, I did a bit of teaching with the therapists. The surgeons have done some tendon surgery this week, and I wanted to check that the therapists knew the post-op rehab for various conditions, as some of them will be seen next week.
Christine helped me to make a difficult splint on a girl who had been shot by rebels in 1999. She was shot in the hand, and had scar contractures which Andrew had released last week. The contractures were so bad that he could not get the fingers to fully straighten. We wanted to make sure that the scar would not contract again by holding the hand as straight as possible in the splint.
Woan-Yi did a lot of teaching with the trainees, Darius and Martin, in theatre. They were repairing a ‘spaghetti wrist’ – where many tendons and nerves have been cut through – in this case, the woman had lacerated her wrist in a car accident 2 weeks previously. It’s a difficult operation – they needed to repair 9 tendons, 2 arteries, and 1 nerve.
Vikram was also in theatre operating on children with congenital anomalies.
Bex was meeting various people including Mathias (the social worker) and Christine (physio) for interviews, and even managed to get me to appear in front of the camera! She is making a short video for the website.
Karen talked to Mathias and did some investigating about the cost of treatments and equipment, and the intricacies of social worker assessment.
Sarah made us the most amazing curry for dinner – very brave, making curry for the discerning Vikram (originally from India)!
Later in the evening at around 10.30pm, we were sitting around the kitchen table, when a shuddering started – it was as if a train was going past very close. It was an earthquake! We were all very cool about it, not moving from our seats! I thought that as Andrew and Sarah weren’t panicking, that it must be OK. There was another tremor in the middle of the night that woke me up – the curry was having an effect!
When we looked on the news later, it was an earthquake of 5.7 on the Richter scale, with the epicentre at Lake Albert 235km away, in NW Uganda! We were experiencing the tremors.
Thursday 4th July. Day 11. CoRSU hospital
There was lots of discussion about the earthquakes this morning in the therapy department. Apparently, they usually do not last as long as they did last night, and they happen around once a year. We’re experiencing so many new things!
I went on the ward round this morning – started off in orthopaedics with Stanley and Fildah (physios), then defected to the plastics ward round to check up on what splints may need to be made today. There was a splint needed for a girl who had her operation yesterday by Vikram – she had syndactyly release (joined fingers).
I also helped Fildah treat a boy who had a fractured wrist – he needed a wrist splint – hooray one of the ones I had brought in the suitcase fitted! Then showed her some exercises that may be helpful for tendons stuck in scar tissue.
After a tasty lunch of matoke, rice and peas, I made the tiniest splint ever on a one year old gorgeous little girl, with a tight thumb tendon with Musa (physio). After which I needed to repair the aeroplane splint on the little boy with burns on the ward. Florence (physio assistant) kindly helped me with this. She has been working at CoRSU for 3 years, but has also worked for many years at Kumi hospital in Northern Uganda, so has plenty of experience, and was so helpful in positioning, getting equipment and translating for me.
The girl with the gun shot wound to her hand was going home today to Northern Uganda, possibly not to be seen for a while, so I wanted to check that her splint was fitting really well before she was discharged. Isaac helped me to check the splint and interpret for me. Hopefully she will come back in 4 weeks to have her metalwork removed and to see Isaac for her exercises.
Karen and Sarah had a meeting with Malcolm (who is the CEO of CoRSU), and been discussing how Interface can help. They have come up with some good ideas for projects we can help with.
Woan-Yi has been in theatre taking photos of cases and observing Vikram and Andrew teaching. She has also been assessing outpatients.
Vikram has been operating and teaching.
We got back to Andrew and Sarah’s house, and Vikram, Woan-Yi, Sarah and I went for a run with the Hodges’ 3 dogs. Woan-Yi had to take a different route, not being fond of jumpy dogs! We watched Alex and Andrew playing squash down in the town – it was an extremely serious game – no smiling going on at all! They looked really good – running around all over the place – manic!
After another delicious meal, Mat arrived – a new patient arrival from Fort Portal, who broke his arm this afternoon falling off his motorbike. I think another splint may be needed tomorrow, although the cardboard seems to be doing a good job!
Friday 5th July. Day 12. Last day at CoRSU.
Big African snail on my walk up the path to the Hodges’ house this morning! Here is a photo for you Gem!
It may have been the last day, but it was quite a busy one in the therapy department, and I didn’t get time to do my last teaching session on hand assessment unfortunately. It was more of the same – ward round, followed by treating a patient with a radial nerve injury and shoulder pain, then into splinting mode!
Here are the amazing CoRSU physio’s and occupational therapist:
Stanley, me, Florence, Fildah, Isaac, Musa and Christine.
The last patient had a ‘spaghetti wrist’ – all tendons, nerves and arteries cut through. Woan-Yi had operated on Wednesday – a mammoth task whilst teaching Darius and Martin at the same time – it took 6 hours. I splinted her with Isaac, and we went through the exercise regime. He will carry on her rehabilitation next week.
Vikram and Woan-Yi have been teaching Darius and Martin (the trainees) all morning.
Martin brought in his own chicken and slaughtered it himself (not sure if this is true or not)!
They have been practising their suturing and microsurgery on the chicken vessels!
Woan-Yi took Vikram and I on an epic run after work – all downhill to begin with! 2 children joined us along the way – a girl and a boy. They were probably around 10 years old. The little girl did not have any shoes on. I asked her if it hurt her feet, and she simply replied ‘I haven’t got any shoes.’
Sarah and Annette (her helper) have been preparing dinner for 20, along with Karen, Bex and Rachel’s help – there are many guests coming round later…..
Alex is preparing some contemporary classical music for the party!
And I’m obviously blogging as usual! In my new dress that Christine (physio) kindly gave me today! Signing out now for today, as guests are arriving!
Saturday 6th July. Day 13. Sailing on Lake Victoria!
Mid-morning we all packed up and drove to Lake Victoria with a picnic lunch. It was a very dusty drive – the houses and trees on the way resembled a martian landscape, with thick brick red dust from the murum road.
Lake Victoria is amazing (unlike her Beckhamesque namesake) – a huge freshwater sea, grasshopper green with snails that are infested with bilharzia worms that can make you really sick, so we had to avoid them.
We shared a wonderful picnic with the wildlife, including hover flies, (like damsel flies mated with tiger moth aeroplanes, and the soldier ants keen to nibble any exposed flesh!
After lunch we ventured out on the lake on hobby cats (cat-a-meringues)! Andrew’s friend Steve (a pilot), also had a catty – meringue, and I was the crew and lookout, while Vikram was the helmsman, and Steve sat back and relaxed! After several leagues, we thought we saw the Kenyan coast, but in fact we were still only 1km from where we started. For several minutes, which seemed like hours, we seemed to be stationary. Steve described this as ‘being in irons’, a nautical expression meaning we had stalled and were stationary without any wind, and no hope of going anywhere. We also ‘ran with the wind’, ‘beat’, ‘tacked’ and ‘jibed’. Next year, Strictly come Sailing! It was brilliant. A great feeling when we ran with the wind on one hull.
We got back home, and went for a run again – Woan-Yi on video camera today, Vikram in fast uphill mode and myself. We were overtaken by two 10 year old boys running in shoes without laces, and never out of breath up a 1 in 4 hill.
As I expect you can tell, Vikram has assisted with most of today’s blog! Tune in tomorrow for more “pieces of late!” from Captain Jack(ie)!
Last day in Uganda. Sunday 7th July. Day 14. Market, badminton, swimming and Wimbledon history!
We got taxis to the craft market in the centre of Kampala, where we bought lots of lovely African gifts. And loads of stuff that we probably don’t need. We had a coffee whilst waiting for our taxis to pick us up again. Vikram and Woan-Yi had a ‘Lake Island’ coffee – coffee, rum, lemon and coke! Woan-Yi has spent the rest of the day feeling a bit ‘squiffy’, with rosy cheeks!
On the way back to the house, we took photos of the streets of Kampala:
We had a lovely lunch on the veranda at the Hodges’, with the dogs under the table, waiting for scraps as usual.
I played badminton with Joan (our neighbour in the guest house), then tried to teach Joan and Linda how to swim in the pool.
Then we went down to a bar and watched Wimbledon. Tense and nerve racking followed by joy! History has been made! Can’t believe it!
What a wonderful finale to our stay here.
We would all like to say a MASSIVE THANK YOU to Andrew and Sarah Hodges for making us so welcome in their house, for feeding us, driving us all over the place, and showing us around in Uganda. A big thanks also to Naomi and Rachel Hodges (Andrew and Sarah’s daughters), for being so lovely about us all completely invading their space!
It has been a truly exciting, chaotic, challenging, heart-warming, shocking, tiring, sad, eye-opening, brilliant trip. I’m so glad I came, and now I am ready to go home, see my family and really appreciate everything I have there.
Tuesday 9th July. Back home!
Some of the donations for the school from our friends in the UK – they really appreciated it!
I met Christine, and we got to work immediately to take a pattern for a splint that will be made tomorrow in theatre for a 22 month old child who has had burn contracture releases around his neck and arms. I had contacted David Burdon (occupational therapist at the RD&E), as it looked quite complicated, and he has kindly emailed me the instructions of how to make it. Here are the bits I made today!
We also saw a little boy of around 8 years with a brachial plexus lesion (many muscles in the arm not working – from birth) who Vikram had asked us to assess for possible tendon transfer surgery next week – we came up with a plan to splint him today and do some stretches, then he will have surgery next week.
Woan-Yi was teaching her very own ’round -the-clock’ suturing technique all morning to the trainees, Martin and Darius, a possible future trainee, Linda, and to Alex (medical student).
Lunch consisted of rice, beans and posho (something carbohydrate-y made with maize flour).
Some pictures of the important ones, doing their important stuff:
