Hiking and Building a House

It has been a busy couple of days. There is a group of students here from Scranton Pennsylvania who are taking a winter semester class. The class is looking at how Christianity has impacted 3^rd world nations by touring around Uganda and seeing different places and talking with people. They are a fun group of about 18 people but the guesthouse is now packed and a little loud and crowded. The staff from the hospital have been avoiding the crowd so I have not been able to spend time with them in the evenings. But the students are also enjoyable to talk to and provide a good change of pace.

            Yesterday I went to the staff church service down at the hospital and enjoyed seeing an Anglican service with a great message on our calling from God. After a good nap and lunch several of us did I hike to see the border between Uganda and the Congo. It was about a 4 mile hike roundtrip but we had to hike to the top of a pretty tall hill. It was a great hike and I got to know some of the other med students from Uganda better. The trail was actually the main road/walkway for many of the people who live on the hillside and have farms. It was crazy to find all the people walking up and down this steep hillside who were carrying jugs of water or baskets of food. It was not a short or easy trip up and down this hillside. We found many different kinds of things being grown on the hillside as well as many mud and brick homes built up on small terraces. At the top we were greeted by a cooling breeze from the Congo and could see just across the border. The air was filled with a moist haze which limited our view but it was still spectacular. The surrounding hillsides were covered in thick jungle and we could here the sounds of birds all around. It was such a beautiful place and all I could do was thank God for the people I was with and the place he has allowed me to see. I’m certainly overwhelmed when I try and consider the variety of places and people God has made. If anything, this trip has shown me that God is a creator who delights in diversity: diversity of places and diversity of people. The other day I started singing “Jesus Loves the Little Children” which goes: Jesus loves the little children,
All the children of the world. 
Red and yellow, black and white, 
All are precious in His sight. 
Jesus loves the little children of the world.

     

Beginning of hike: leaving the main road.

Houses on the hilside.

I enjoyed learning about the different plants on the way up.

Children coming out to greet us. on the way up. We saw many children this age carrying water jugs up the hillside.

Houses perched on hilltop.

Ugandan boy on edge of Congo. All the hills down below are in the congo.

Playing on a homemade scooter.

 Today the nurses, Jonathan my new roommate, and I joined the students and went to a Batwa community about 45 minutes from here. There are about 11 of these communities where the Batwa have been given land and the Batwa Development Program helps them with establishing a living, building houses and attending schools. There is a push to get the batwa to live in mud houses rather then grass ones. The mud houses improve the health of the family by keeping animals out and giving them a place to hang mosquito nets. It also helps to give the family and the batwa people a greater since of pride since they have a more established residence. The house is made from a lattice of reeds with mud filling in the walls. There are two layers of mud placed on the wall and a final layer of manure/sand which seals the house well. These layers are all done in phases and can take some time to complete. A well made and maintained mud house can last 60 years. It was a great experience to help build this house and something I’ll never forget.

Grass house. Not the best of living conditions.

The mud for the house was prepared in pits with water that was brought up from a stream nearby. There were two pits this size and we used them both completely.

The framework was a lattice work of bamboo like plants and timbers. The woman here is just doing some sweeping before we got busy.

Mud was stacked in-between the reeds. It was fun to do and of course we got very dirty.

Women demonstrating the throwing technique (very enjoyable) and then man showing how mud is stacked in the walls.

Me and my new roommate from Ontario Canada. His name is Jonathan and he has been traveling the world since June. He is very interesting to talk with and get to know.

Showing the phases of construction. on the right is a wall with 1 layer of dried mud and on the left is the finished product after 2 layers of mud and a coating of manure mixed with sand. This was the village chief's house.

Students who raised money for the house and family who will be living in it.

            Thank you for reading the blog it is fun to write and I’m glad to share this experience with you.

Bike ride, X-ray, and surgery

Good evening from Uganda! At least it’s evening here. There is about an 11 hour time difference so when I am up and busy everyone back home is sound asleep. Just an interesting thought. This last week I was joined at the guest house by two more volunteers from Quincy CA. They are both nurses and will be here for 3 weeks. It’s kind of nice to have more American English speakers around because it takes a far amount of concentration to follow the Ugandan/British accents of the people here, although, I’m getting much better at it. This last weekend, in addition to the soccer game, I had the opportunity to go on a 5 mile bike ride through the smaller villages in the area. The other two volunteers and I made an afternoon of it and had a great time. At the first village we came to most everyone was inside at the church service while the kids where out playing in the school yard/soccer field. When we rode up we immediately became the center of attention and a throng of children came running to greet us. We had a fun time taking pictures with them and where probably making it difficult for the adults in the church to have service. As we rode away from the first village the throng followed us and some of the children kept up with us through the next 3 villages. Four of the boys from the first village made the whole loop back to the hospital. The villages we passed where very small but surrounded by very pretty hills covered in farms and jungle. It was great to get away from the hospital for a bit and see some of the countryside. I feel like I live in a bit of a bubble at the hospital so it was great to see how people live in the surrounding area. I’m still trying to summarize the state of things in Uganda verses the US but I’ll save that for another post.

            Today was an interesting day. It’s Thursday here which means the local market is bring in a crowd of people to the hospital. There was also an orthopedic clinic today. I was busy helping one of the Docs take x-rays this morning. The x-ray room came prebuilt in a shipping container from the Nevada City Rotary club in northern California. It is an old-fashioned film x-ray that is somewhat of an art. It was fun learning how to position patients for different studies and then developing the film in a dark room which was also inside the shipping container. For imaging the hospital only has x-ray and ultrasound both of which can only be used during the 6 hours that the generator is running.

 The container on the right is the x-ray room and the gray container on the left is the pharmacy.

            This afternoon I was briefly in the theater. This is not a movie theater but the OR. Everyone here refers to the operating room as the theater which is a separate building where patients come for major to minor surgeries and also c-sections. There is no surgeon per se who works at the hospital. Instead the docs, who are trained mostly as general practitioners, are the surgeons, internists, OB/GYN and orthopedist. This afternoon I assisted with a simple closure of a wound in the theatre with one of the docs. It is pretty different from an OR in the US where most everything used is disposable. Everything here apart from the gauze is washed, sterilized, and reused.

 The silver tins on the far wall are all the sterilized equipment and materials. No ventilator, just an oxygen concentrator and then they use mostly spinal blocks or local anesthesia for surgery.

"Kid on bike", an artsy photo

Camps and Soccer

The week has gotten away from me without updating the blog. But in my defense I have been busy with lots of activities in the evenings when I am usually updating the blog.

Last week was really fun. The administration here has invited me to go with them to visit the tourist camps just up the road. The Hospital is on the edge of the Bwindi Impenetrable Forest (jungle) National Park which draws many people from all over the world who want to see the mountain gorillas. They come and stay at very nice and fancy “camps” with bars, restaurants and rooms that can cost $500 a night. The guides will then take people on “gorilla treks” which can be significant hikes through the jungle to see the gorillas. Needless to say the treks are expensive and need to be booked 6-8 months in advance. It was fun to visit the camps in the evening and talk with the guests. The hospital often visits the camps to try and promote the hospital and find potential contributors. They like having western/white volunteers from the hospital come because guests at the camp tend to like speaking with another native English speaker and like hearing about the hospital from my perspective. I’m glad to be able and help in this way even though I never thought I would be essentially fundraising while I was here. Many of the guests from the camp will at least come down and get a tour of the hospital which is good. I was struck, or rather, disappointed by the contrast between the luxurious camps and the people just outside the gates living in mud huts and walking around in bare feet. It was a difficult contrast to see. The jobs and income the National Park and tourists brings is certainly welcome (except by the Batwa which I mentioned) but I wish the tourists that come weren’t so insulated in their comfy resorts so that they could see the malnourished child living on the other side of the fence.

 I’m starting to fit in and find my roll among the staff. Most of the time I’m expected to just observe as a student but occasionally I can make a contribution to the care of a patient by suggesting a certain diagnosis should be considered or a test should be run. The doctors and staff here are very capable and do an excellent job running the hospital with the limited (and I mean very limited) resources available. As the staff gets to know me they are asking more and more what I think about a patient. The nurses are eger to let me practice placing IVs and NG tubes although I have yet to get an IV started (ever). Yesterday I got to do my first autopsy with the doctors here. They do their own autopsies (post-mortem) fairly often to help them learn and make better decisions. This used to be a regular part of being a doctor in the US but is now really only done by pathologists which is a good thing because I just about lost my lunch.

Tonight we had another soccer/futbol match with just the hospital staff. I’ve never seen so many people gathered for essentially a pick-up game. I got to play in the second half of the game and had a blast although I nearly slipped and fell a couple of times on the cow pies covering the field. As you can see from the picture there is a not-so-subtle height/size advantage. Even with the advantage I wasn’t much help because everyone else was so much quicker and more skilled then I was.  

 Sheeny (not sure about spelling) was attached to me for the first half of the soccer game. She really liked swinging from my arms.

 Standard crowd at the futbal pitch on a sunday evening.

I'm the 2 meter tall white guy on the left if you couldn't find me. 

  

First Weekend

This weekend was very fun. I worked Saturday morning but then was able to take some time off in the afternoon. Most afternoons slow down and allow me time to read, take a nap, or just take a walk which is nice. But Saturday I got a little more time and made some progress on finishing the book “1984”. Yes, everyone has read it in high school but somehow I missed out so I’m reading it now. My mother and I have developed a code phrase for taking a nap which is “I’m going to read my book.” What usually happens is we open our books and promptly fall asleep after making through a page or two. Saturday was much the same.

            On Sunday I was invited to go on the Batwa Experience (http://www.batwaexperience.com/) by one of the managers of the program. One of the primary reasons the hospital I’m volunteering at was established was to provide for the outcaste Batwa pygmy group who once lived in the forest nearby. In 1991-1992 the Batwa were forced out of the jungle so that a national park could be established to protect the remaining 350 gorillas in the area. The Batwa pygmies were not given any recompense nor where they prepared to live outside the jungle. The Kellerman Foundation, which established and supports the hospital, was created to support the Batwa people and help them get basic education, healthcare, employment opportunities, as well as help to preserve their cultural heritage. The Batwa Experience is a guided tour to educate the tourists who come to see the gorillas by showing them how the Batwa people used to live. The profits from the tour of course go to support the Batwa and their programs. The tour lasted about 6 hours and was made all the more interesting by 2 Italian couples who I joined for the experience. On the way to the cultural center/village we passed a small local village where I got to see people preparing coffee beans and making bricks. We saw the village center where the school and church where. I thought they had a great way of calling people to the service with large drums. After hiking up a steep hill covered in tea and banana plants we arrived at the cultural center. Some very lively elders of the Batwa gave the tour. We were shown traditional dances, different styles of huts, and some of the traps they used for hunting. I thought their clothing wasIt was like going to Mesa Verde and seeing the old villages but also seeing the people who lived there (except the Batwa were nomadic and wouldn’t have any structures that would survive the centuries.) It was a great experience and a certainly a privilege to see this living history.

            After the tour on Sunday I followed some of the staff down to an open field where two local soccer teams where playing. It was big game between the village where the hospital is and the village we passed through on the way to see the Batwa pygmies. I again was the only Mzungu (white person) and had many people staring at me. All I can do is smile and try to look friendly and people usually just smile back at me. The game was played on a field with mounds of dirt, tufts of grass, cattle/goats just off the side and a line of people essentially forming the boundaries. Because it was Sunday many people where wearing their Sunday best which made the whole event seem all the more of an event not be missed.

            Thanks for reading the blog and for all the prayers. I’ve really enjoyed my time here. I’m getting more and more used to life here with it’s more relaxed pace.

Bricks being made out of the mud by the side of the road. They would then be fired in a kiln. 

A man shelling the coffee beans after they had been dried.

The church bells calling the village to the service.

The Outside of the Church.

The inside of the church.

An elder describing some of the plants used for medicinal purposes. Their clothing is actually made out of tree bark.

Basket weaving and mothering.

Batwa huts made in trees to avoid predators like big cats and gorillas.

A Batwa women showing us a common shelter made under a log.

A traditional dance. 

One of the traps they showed us. Used to crush large and small animals.

After the tour on Sunday I followed some of the staff down to an open field where two local soccer teams where playing. It was big game between the village where the hospital is and the village we passed through on the way to see the Batwa pygmies. I again was the only Mzungu (white person) and had many people staring at me. All I can do is smile and try to look friendly and people usually just smile back at me. The game was played on a field with mounds of dirt, tufts of grass, cattle/goats just off the side and a line of people essentially forming the boundaries. Because it was Sunday many people where wearing their Sunday best which made the whole event seem all the more of an event not be missed.

It seemed like the whole village turned out for the football game.

            Thanks for reading the blog and for all the prayers. I’ve really enjoyed my time here. I’m getting more and more used to life here with it’s more relaxed pace.

Orientation

I am slowly adjusting to life in here in Uganda. I think one of the big differences and cause for me feeling out of place, of which there are obviously many, is the pace at which life is lived here. On the first day I was here the manager of the guest house pointed out a small book that was written to explain some of the differences between the culture in Uganda and western culture. The author noted how many westerners are frustrated with local attitudes towards the time of appointments or a set schedule. Uganda culture comes from a strong agricultural background were the time of day is broken into early morning, mid morning, late morning, etc. If a meeting is supposed to take place at 9AM it is not unusual for people to show up 1-2 hours late. I'm usually pretty casual when it comes to a schedule and so 5-10 minutes here or there doesn't bother me but this sort of laxity takes some getting used to. This first week I'm orienting to the different departments by spending a day in each. However, it has been frustrating following the doc in each department because things happen when the happen and sometimes not at all. Yesterday I wanted to round on patients with the pediatric doc and so I went to the pads ward in the morning and was told there was a meeting and the pediatrician would be around until the afternoon. When I came back in the afternoon he still had not been seen and I was told maybe rounds would happen later. I checked back near 4pm and the nurse told me rounds would probably not happen. This is frustrating because of the time issue but also surprising because I'm used to patients being seen everyday. Here, a patient may go 2-3 days without being checked on by the physician. The system seems to work and everyone gets along but this makes learning where and when to be to do rounds a bit of a guessing game. Some events are not missed by staff and those are morning prayer at 8am and tea time at 10:30 to 11:00am. I have enjoyed getting to know the hospital and it's different departments. Today I finally had a chance to round with the pediatrician in pads ward. The ward is a large open dormitory with a nursing station at one end. There are maybe 25-30 beds where the kids and usually their mother will sleep. Family, usually mom, stay if the child stays. There is no meal served by a hospital kitchen but there is a kitchen where moms can cook there meals for themselves and their child. Next to the hospital is a playground with swing where less sick kids will play. I was surprised to see what kind of illnesses are prevalent here. Easily 3/4 of the children had malaria, 1/4-1/2 had malnutrition, and the rest had pneumonia, typhoid, HIV, or any combination. One very sick girl, maybe 5 years old, had HIV, malaria, and TB. The pictures below are of the pediatric ward, the playground, and the kitchen.

I took some time this afternoon to wonder away from the hospital to see some of the surrounding neighborhood. This was necessitated by my need to find some toothpaste which I found at a small store across the street from the hospital. I was slightly disappointed to find the toothpaste came in herb flavor. Everywhere I wondered people starred at me and the kids all waved and yelled "HELLO." I went down the main street where they had a small market and felt like every eye was on me. It honestly didn't bother me too much but it occurred to me this must be how celebrities felt. They aren't completely unaccustomed to seeing foreigners since there is a national park and gorilla reserve near by that many tourists visit.

This evening as I sat reading on the porch of the guest house I was joined by a troupe of monkeys making their way through the tree tops picking fruit and flowers to eat. A couple of them were brave enough to walk around on the lawn and came very close to where I was sitting. I certainly feel blessed by God for the opportunity to be here and see these sorts of things.