8

Just gave an 11 year old girl dying of TB a paper wire butterfly and got a big smile. Her name is Jane. Beautiful girl dying because her parents stopped her course of antibiotics too early, and because she’s so malnourished her immune system isn’t working well. So thin and so ill. She needs the consultant to review her but he hasn’t turned up in 3 days. Would be good to pray for her.

There are around 80 patients in paediatrics at the moment but it gets up to 300 during malaria epidemics. When that happens it’s 3 kids to a bed and more on the floor and about 3-4 kids die every day. There’s 1 paediatric consultant, 1 registrar and 13 nurses. 90% of the kids have malaria/anaemia, some also have pneumonia or meningitis. About a quarter of the kids are HIV positive.

Then there’s the malnutrition unit which is pretty heartbreaking. Yesterday we saw one little boy who had protein-malnutrition. When you don’t have enough protein in your blood fluid leaks out which is why they have swollen feet/tummy. If it’s really bad the skin starts to peel away. This poor kid had raw skin all over him and his clothes were wet with the seepage from the skin.

Some of the kids are here because their parents have starved them as punishment. Most of them are here because their parents can’t afford food. Most people grow matoke (savoury bananas) on a plot of land but apparently lots of families have to sell their crop to pay for school fees or rent or the dad spends it on alcohol. So the families don’t have enough to eat even though they grow lots of food. They’re not really big into family planning here so lots of people have more children than they can afford to feed.

Most of the parents take the kids to witch doctors first. Modern medicine is a last resort for a lot of people. If the child has an enlarged spleen (which you get with malaria) they make cuts in the kid’s skin or burn the skin with a hot metal grid over the spleen because they think that will shrink it. They think the big spleen causes the kid’s fever rather than the other way round. The doctors try to educate the parents but don’t know how much they listen to them.

There’s a sweet little boy called Mike who was abandoned so is living on paediatrics until he can walk, then the priests mother will adopt him. He’s so cuddly, he gets a lot of love. Despite all the above paeds is less intense than o&g, really enjoying it :) It seems quite simple as well because everyone has malaria and there’s limited treatments! Feel like I’m a bit more useful now I know how lab forms/notes work. Life in the hospital is good, there’s a great group of people here so we have big dinners together which is really nice! Am exciting about the weekend in Jinja this weekend! Have just downloaded skype so if you fancy a chat add me and let me know when you’re free :)

Lots of love!
Christine

7

Today I woke up once again to the sound of the swarking ibis and the nuns singing mass at 7am. It’s quite a useful alarm in the week but you’d think they’d have a lie in on a Sunday. Beautiful sunny day, me and C-M are at the pool that belongs to the Danish cafe church – so nice!!!

On Friday I got a burn on my calf getting off a boda-boda, it turns out the petrol pipe is quite hot. Fortunately it was on the way to a nice cool swimming pool at Tropica Inn so it got about an hour of cool water soaking. Got some lovely big fluid filled blisters so I asked the doctor I’ve been with what to do and he said I should drain them with a sterile needle. That was fun and the other medics had to watch because we like that kind of thing. The swimming pool is really nice. There was the odd bug in it and the water was a little bit murky but nice and big and cool. Maribu storks flying overhead. When swimming underwater with my eyes closed I still have a bit of childish fear that I’ll meet a crocodile/hippo in the deep end but I didn’t so it was ok.

I did meet a crocodile and hippo yesterday at Lake Mburo. We went with the medics, the 4 Irish nurses who came on Monday and the 4 Irish nurse/midwives who moved on last weekend – nice to see them again, we had some laughs! The crocs are really big we went really close to one on the boat and then rode over it when it swam underwater which was a bit scary. There were loads of gorgeous sea eagles and loads of other birds. Lots of hippos and we saw zebra, buffalo, antelope things, monkeys and wart hogs. I thought wart hogs would be friendly as per Lion King so I went near one to get a photo with it but then it turned on me and I saw that it had big horns so I ran away. So if you ever meet one there’s a tip for you.

I love Africa, love being here. The whole time yesterday we were like “We’re on safari in Africa!!!” Can see God here all over the place. Just driving round seeing the people and kids and houses and all the birds and wildlife and yesterday there was a massive moon. And see people from desperate situations like the mother in shock and the baby who was starved to death coming back to life. There’s a lot of tragedy here and sadness but God is breathing new life so there’s so much hope. The pastor at church was talking about the spiritual climate of a place and he said when he goes back to Denmark he feels choking but when he’s in Uganda it feel like breathing air again.

It’s brilliant to have stumbled upon the Danish cafe church. It’s really small but really filled with the Spirit. The pastor has been speaking about spiritual warfare- really great talks, lots of stuff to think about. On Thursday a man from the church gave us a lift home in his pick-up truck with an open back. 5 of us climbed into the back and stood up holding onto the bars – SO scary going over the bumps and potholes- SO much fun!!

Moving onto paeds tomorrow and we’re going to do the odd day in the community but for now I’m going to dry off and then watch England beat Germany (obv).

Love to you!!

Christine

6

This week has been a strange collision of life and death. Rupturing membranes and resuscitation. The saddest thing was I turned up this morning and the doctor told me a mother died yesterday from a PPH (bleed following delivery). It was because the doctor prescribed 3 units of blood to be given immediately but she was only given one unit of blood this was 4 hours after the doctor requested it. She was only 31 and has left 6 children. So sad especially as it was totally preventable. No one should die in childbirth anymore.
Lots of resuscitating this week! First one was a baby who I was left resuscitating with a nurse because there were no doctors around. There was only one oxygen machine which another baby was using. There’s no neonatal unit here yet. There’s one baby on the ward who is severely malnourished, so bony. The o&g doctors who are supposed to look after them are too busy to do paeds as well.
The second one was a woman in shock following PPH (bleeding after delivery) Found myself squeezing saline bags to get fluid into her because the cannulas are so small. She came round after a while and is now looking ok.
The third one was a woman with twins who had had 9 children already so a very stretched uterus. The F1 decided to trial normal delivery because the first twin presented head down. But the labour went on for so long and she was getting really severe abdominal pain so we thought she was about to rupture and had to rush her into theatre. They opened her up and pulled out one massive baby! I was SO happy it survived I thought I was going to cry. That’s what happens when you don’t have ultrasound scans.
That’s the other side of o&g – LIFE. Absolutely incredibly the woman in shock with the ruptured uterus survived. Total miracle because she had an unrecordable BP and the doctors couldn’t even auscultate her heartbeat when they took her into theatre. They couldn’t anaesthetise her because it would have killed her so they did a section with no anaesthetic as she was unresponsive to pain. Wow. I think God was in on that one.
I managed to catch a normal delivery yesterday after a long wait! Freaked out a bit when the midwife left me alone with the placenta. Fortunately got it out ok. Also freaked out when I thought I’d given a baby on the weighing scales back to the wrong mother. Quick scout round labour ward saw that no other mothers had delivered yet. Close call.
Yesterday I ditched placement for the afternoon to help the Irish team who are redecorating the paediatric unit. I sanded some walls and doors which was a nice break from the wards/theatre. Today we walked into Masaka and are at the Danish cafe/church/charity for their meeting at 7 – they make yummy food as well.
The kids are all lovely here. Just sitting in Ten Tables where we watch the football 2 beautiful girls came over and they just want to hold your hand and sit on your lap – sweet. There was a gorgeous little girl in the paeds unit as well, lovely afro hair and black and white spotty dress. Her friend was there but she had tinea (fungal infection) all over her, looked really ill as well, she was just looking up at me and wanted me to pick her up too, really sad but I thought I better not transmit fungal infection all over the hospital.
This weekend we’re going to Lake Mburo which is about 3 hours from here. We’re going to do a bit of safari, it’s not as good as Murchinson (which we’re going to at the end) but has lots of zebras and hippos. The surgeons went last week and ended up running for their lives from a hippo. Foot safari = mistake.
Will be back here on Sunday so will update again then :)
Much love X

5

Hello! I’m sitting in the Danish cafe with butterflies all around. The sun is so hot but the air is cool so it’s the perfect weather!

Walked into Masaka the country route on Friday through all the little villages. Loads of the houses are literally just a concrete square building with an iron door bolted shut and no windows. Some people are really poor, there’s loads of really dilapidated buildings, can’t believe people live in them and the people are really dirty. There’s loads of NGO projects here though all over the place.

Yesterday was hilarious all round. Me, C-M and the 2 medics from Queens found ourselves in the back of a slightly dilapidated mini-bus full of nuns with plastic leopard skin seats and the odd seatbelt, heading up country to one of the sisters sister’s graduation party. I now know what pot holes are. The sister is one of 11 kids, all of whom have been to uni which shows you how rich the family are. Even so, their house was pretty simple but they had quite a lot of land. They had set up 3 markees with chairs and sofas and an alter in. There were priests and monks and nuns, the family and us in one markee and all the other guests in the other 2. They did a lot of speeches with the odd interspersed motivational quote in English like “Better to be a lion for one day than a sheep for your whole life”. And one speech on the virtues of a woman which were in order wife, mother, organiser, beauty, manager, negotiator. There was a chicken tied up which was one of her graduation presents. It tried to escape twice when no one was looking but only got about 6 feet. It must have known its days were numbered.

Then the rain came, and it RAINED. Our marquee was a wooden poles and tarpaulin contraption and the water got so heavy it started leaking and I thought the whole thing was going to collapse. The next thing I knew there were nuns and fathers with chairs in the air, water everywhere – and the guy doing the speech kept going through the whole chaos. We were in hysterics. I made a couple of videos. Then there was masses of food. Some of which was gross.
We brought some English food (shortbread from the pound shop and a packet of toffee bonbons and a 2 for £3 M&S fruit cake) with us to give to the family as a little taste of England. We ended up presenting the daughter with the sweets and shortbread in a procession of guests with massive beautifully wrapped boxes. The only thing we had to wrap them in was a Tesco carrier bag which we decided against. Then they thrust a microphone at us and we had to give a speech about the fruit cake before presenting it to the parents as a gift.

Then the music started and all the kids and this crazy old man started dancing. We started filming the kids and they loved it so they came closer and closer. One of them was totally going for it, so cute, the guy should be on X-Factor. Then people kept asking us to dance. Bearing in mind there were about 200 people there we just laughed at them thinking it was a joke. It wasn’t. We were ushered into the middle with a handful of nuns and had to dance for a whole song in front of all the guests (we’re English, we can’t dance) You had to laugh. As I sat down this old man leant over and said to me “Thank you for your dance. It was interesting.” which was followed by hysterical laughter. Fair comment. There are videos which I hope no one will ever see.

The rain meant an interesting journey back. I was slightly disturbed when the sisters started singing a prayer for protection. More disturbed when the driver got out twice to check the tyres. but we made it.

Today we’re back at the Danish cafe getting the internet. It is a church as well so we went to the service this morning. There was about 20 people here, fab to worship with them and the guy who preached runs the organisation (they have an orphanage as well) he was brilliant, really spoke to me. Afterwards he gave me a 1 year old beautiful baby boy called Gideon then he showed me a picture in the news paper of him a few months ago. He was found under a bed starving to death because his mother was didn't want him and was trying to kill him. He looked like a skeleton but now he’s gorgeous and chubby. Loved it when I spun him round. The pastor said he was a different kind of miracle. We’re going to go and visit their baby orphanage at some point- can't wait.
I keep writing so much! Happy Father’s day to my dad!
Christine

4

Hello!

Have had an interesting last few days :) One of the big highlights was this beautiful baby girl all wrapped up blinking up at me brand new from a C-section. I love new life. Keep popping into labour ward (3 beds with dolphin shower curtains and a big gutter all the way round) waiting for someone to be pushing so I can deliver a baby but I think most mothers deliver at home here, we get all the difficult ones so there’s not many normal deliveries.

I thought I would see some tragic stuff here but you can never be prepared. I’ve seen some disturbing sthings before in medicine and a lot of people in pain but nothing like here. So much of the obstetrics here wouldn’t even exist in England.

They have hardly any resources, no one gets pain relief in labour and at least half the section/hysterectomy wounds go septic. Patients get left for hours and hours, someone was admitted with peritonitis last night and had had no pain relief by the round this morning.

Spare you too many details but a lady was admitted yesterday whose baby had died at term (quite common here) so she had to give birth to it. At about 2:30pm we went to see her and the baby was stuck with its head out. The doctor tried and failed to deliver the rest of the baby but he had to leave to do something else so gave the relative some gloves. We found out the next day that the rest of the baby was delivered at 9pm that night. No one thought to deliver the placenta so by the ward round the next day the lady still had a retained placenta and the uterus had contracted around it. I’m writing this at 8pm and she still has a retained placenta which is now septic because the doctor hasn’t had time to manually evacuate it. She is getting more and more ill but there are so many patients to see, even before her on the list.

One of those is a woman with a ruptured uterus whose baby has died at term. She was in shock and they couldn’t feel the pulse or find her blood pressure. She was foaming at the mouth and breathing was really laboured. The only thing they could give her was saline and oxygen while they wait for a transfusion. They can’t take her into surgery until they’ve resuscitated her, so she might die. I went back later and her saline and blood had run out and no one was with her. I prayed for her and then her relatives came. There are 4 o&g doctors here, 3 are in theatre and 1 is covering all the wards including labour ward.

There is another lady who’s had a miscarriage which has gone totally septic as she’s been left for 2 days. She needs a manual evacuation as well but she’s even further down the list. It’s crazy that this is happening. Here the mothers’ lives are at risk whereas in the UK even the babies would probably be saved. And this is a good hospital that people get referred to from all around.

It really makes you think. Now I know what limited resources means. The flip side is it’s brilliant that they are getting any medical care at all. A lot more people would die if no one did a manual evacuation even though it has to be done with diazepam.

I love being here and I think I really need to see what goes on here. We live in such a cosy world as students in some ways. You can get so cut off from reality for the rest of the world. Here, for me, to have an eternal perspective is so important. These women may have very little hope medically but we trust in a God who can heal and gives new life and hope for the future. I really believe that. It’s lovely doing a ward round with a gorgeous little boy holding your hand. And it’s lovely seeing all the brand new babies all wrapped up.

A load of Irish students arrived yesterday, two second year medics, two midwives and three nurses. We’re all off out for dinner and to watch the England match in Masaka tonight, going to walk there through the villages. So blessed to be healthy and to be here. The Ugandans keep saying it’s so easy for us to come here but they have no chance of getting a job in England, they can’t even cross the border to Tanzania or Kenya. Feeling really grateful for a British passport.

Hopefully this weekend we’re going to visit one of the sister’s families up country and she’s going to show us how they make all their traditional food. Also planning to go to the pentecostal church in Masaka, apparently they really go for it, awesome.

Hope you’re all well and enjoying the British summer :)

Christine

3

Hello!!
Am trying to write fast in this internet cafe!)

Absolutely loving it here. Masaka is brilliant, so African. I just keep walking round staring at everything. Beautiful weather as well and the docs I’m with are really friendly.
Wow the hospital is so different. It’s quite big, loads of little buildings scattered around. The wards smell pretty gross but it’s not too hot despite the white coat! I’m doing obs&gynae for the first 3 weeks which is brilliant, the doctor said I can assist in theatre and deliver babies- perfect.
Saw my first kid with marasmus. Did my first pv examination on a pregnant woman. Got a bit bored waiting for a primi to give birth. Saw a hysterectomy, big fibroid uterus. Theatre is massively different! It’s just a random room and their theatre gowns and masks are material and you reuse masks and hats and scrubs without washing them. There was a fly on the sterile field. The door was wide open the whole time. Some of the instruments were a bit blunt. There was a lovely flowery clock on the wall and a blackboard for writing how many swabs you’ve used. One lady was having a manual evacuation of retained products after her 6mo gestation baby died the day before. I asked what anaesthetic they were using – and it was just IM Diazepam. And she was in a LOT of pain. The doctor told me that was the only anaesthetic they could afford. Wow.

They wrap their babies up so much right over their heads. On the ward round we came to this lady and I thought she must by a gynae patient (post-nates, ante-nates and gynae are all mixed up over a few wards) but then she unwrapped all this material and there was the tinest premature baby at the bottom of all the blankets. It died today sadly.

There are some seriously swarky birds in the tree by our accommodation. I thought it was a labouring cow last night but it’s a tree full of these massive black birds with long beaks. There was an eagle owl in the tree this evening, we were staring at it for about half an hour, the Ugandans thought we were mental!

We went on an explore round the hospital grounds. You can see Lake Victoria in the distance. Uganda is really really green. Then we left the hospital and there’s a little settlement right by it with some shops and lots of kids. 2 of them came running over so I took their picture and showed it them and they loved it! Really poor kids with rubbish clothes but gorgeous, totally beautiful. They laughed so much at the pictures of themselves and the video I took. I was in hysterics at their excitement. It was lovely. Loads more appeared so we took more pics. I showed them the pictures of my sisters hen-party on my camera, they were like “Mzungus!!” I’m hoping they don’t think all English people wear bunny ears, feather boas and fluffy tiaras. One little girl was called Sharon, I gave her a piggy back and everyone around was staring at us. Then some annoying ex-pats walked past and told us to watch out we might get an infection. Couldn’t care less. Probably got TB.

We have two cooks one called Regina and one called Maria. Regina has a big smile and Maria laughs a lot. We gave them some shortbread to see what they think of it. They are reporting back! Pau-pau tastes mildly of vomit but is eatable. Pineapple is the nicest thing in the world. So sweet. Absolutely love the g-nut and banana thing.
Back to the hospital on a boda-boda!!!!!

See you soon!
Christine

2

We made it to Uganda! It’s amazing here, so African! Gorgeous weather, it’s 28C so not too hot. Just met a little girl called Josephine walking back from Entebbe who declared she wanted to be our friend and then was too shy to say anything else - cute.

The journey was good despite massive lack of sleep. Waking up in Glossop at 3am to go to the airport after a 1 hour nap was a definite low point. When we were waiting for our flight in Manchester I looked out of the window and it was light outside – so weird! The first flight to Amsterdam is a bit of a blur, I think I slept quite a lot! Holland looks like the land for people with OCD. All the fields are perfectly rectangular and the houses are in straight rows. It was really flat and watery. There was nice cheese at the airport. I don’t think I’ll ever bother going.

We were so excited when we got on the second flight! KLM is brilliant, you can take two 23kg bags (obv took them up on that!) and they give you so much food and it’s really nice food as well. And those hot towel things. You can watch a billion different films or this screen which tells you how high you are and how fast you’re going and exactly where you’re flying over. There were loads of Americans but fortunately they kept quite quiet. Looking out the window was incredible, I can’t believe how much world you can cover in 7 hours!

We flew over Italy and you could see mountains with snow on and then a nap later we were over the Libyan desert. The Libyan desert was incredible. It just goes on for miles and miles, SO much sand, I can’t believe there’s that much sand, where does it all come from? C-M spotted a little settlement, people live there, and God knows them and their whole life – amazing. Then we got over Sudan and the sun was getting lower and you could see the Nile river and it’s so wide. There was worship music playing on my iPod – we are so small.

This guy picked us up at the airport in a rickety landrover with no seatbelt. He was a Man U supporter(obv). The hostel is well good we have our own little house with double bed bunkbeds and lovely retro flowery curtains and a gecko which is v cute. I shared a really hot shower this morning with some kind of giant beetle which unfortunately died a slow death as I couldn’t direct the shower at it to end it’s misery. RIP. We wandered into Entebbe and saw loads of storks and an avocado tree and we ate mango. Just waiting for the hospital to pick us up and take us to Masaka – can’t wait to see a bit of the country! It’s amazing being here I feel totally blessed.

(Wedding was SO SO lovely, see facebook for photos!!)

Christine

1

So here I am in Glossop at the start of this journey. Feeling thankful for the grace that brings me to this point in life and excited to be on the edge of what could be a big adventure. At some point I thought it was a reasonable idea to go to the airport from my sister’s wedding reception. So I am anticipating the following in a 24 hour period:

1. Being a bridesmaid for my lovely sister
2. Boarding a plane for Entebbe, Uganda
3. Leaving Europe for the first time
4. Not losing my passport
5. Eating haggis sausages
6. Getting very little sleep
7. Not flushing the plane loo whilst sitting on it
8. Being very bored
9. Being very un-bored
10. Having a big reunion with old friends
11. Meeting some brand new faces
12. Sweating in the Hilton sauna
13. Sweating in the Ugandan sun
14. Traversing the equator
15. Being very excited and very scared

One of those days where you’re thinking how on earth did I end up at this point? 6 weeks ago me and C-M were looking out over Sheffield from her attic bedroom on the phone to a Irish Catholic nun in a supermarket in Uganda. In a couple of days we’ll be there. A few years ago me and Liz were arguing over who was better at piano, now she’s getting married. This is brilliant. I’m excited. Off to try and learn some medicine and see what it's like living in a totally different context. Try to get a hunger for justice and shake of some complacency. Try and meet God in a new way and live out his heart. Try to see if I could do this kind of work in the future. Try being thrown off a raft into the Nile. Try and see a few hippos. Try not to get bilharzia. That’s the plan.

See you in the other hemisphere.

Christine