Day 14

12/30/08

I was very productive today! I woke up at 6am and did my laundry. It was still a disaster but I think there is less soap left in my clothes than there was last time. I then shaved (first time in Africa! I was getting a beard tan-line) and showered and took my time with breakfast. I said goodbye to Anne who is heading to Kampala until Thursday. Then I took a bicycle boda into town and was passed by two vans of the muzungus from this weekend who were heading into town as well. They waved hi and I finally felt like a native, riding on the back of a bicycle while a van of privately-chauffeured muzungus passed by. I exchanged some money at the bank (rate was down to 1830 UGX per dollar) and then bought two DVDs to back up my photos. Then I turned down 3 boda motorcycles who wanted too much money (I told you I’m a native!) and finally agreed to 2500 UGX with one to take me to Bushikori. I got here at 9:30am and we went on rounds. The wards were packed, since people didn’t want to come in over Christmas and, as sick as they or their child were, waited until yesterday to seek help. Rounds were tough today. I saw at least 5 children under 2 years old who were severely malnourished (the best case being just half of the “safe” weight at that age) and this time I took pictures because it is something that will effect even the medically-unstimulated (that’s my term) at home. The children were born to mothers married to men with no jobs and several wives, and these women laughed at the mention of family-planning. They can’t afford to feed themselves, let alone 7 children. We moved from bed to bed, reviewing each patient and each of their situations seemed to be more desperate than the last. I was tempted to use the rest of the charity-money I brought to buy plumpy-nut, a mix of peanut butter, milk, butter, and sugar and what the WHO distributed to refugee camps around the world. But I realized that that just wouldn’t help these people. I would feed the child today and what about tomorrow. The helplessness I felt, standing there looking at a 14 mo/old baby with skin that looked like it belonged to a 70 y/o, was one I don’t really wish to ever experience again. The only way I was able to turn my back literally was to do it figuratively – to just accept that I can’t do anything and to approach the problems we could solve instead. Ladies and gentlemen, I introduce to you my most recent source of motivation to become a doc. I could go on for pages about how I wish I could do something about it, today. I’ve seen pictures before but the child was never sitting there in front of me, too weak to open his eyes and withering away by the minute. I became incredibly nauseous, not because of the medical aspects, but because of the socio-economic and cultural ones. These mothers couldn’t feed they’re babies. And that was just that for them. I felt angry and sorry at the same time.
There was one woman who was eaten by what they call “jiggers” here, scientifically known as Tungiasis penetrans. I took pictures of this too. Her skin was just eaten away in places, leaving pink patches all over her arms. The bottoms of her feet looked like slabs of wood with empty nail holes in them. The woman lives with her brother, a consequence of her children abandoning her because she drinks too much and becomes “slutty.” The rest of the patients had the “usual” illnesses – malaria, pneumonia, titis externia.
After rounds I went to watch the immunization program. Women brought their babies to one of the buildings here and one by one, the children were given an array of polio vaccine, DPT, BCG. The sat on the ground outside, babies naked and wrapped in a towel, in the same fashion with which they brought them on the back of a boda motorcycle. The women nursed the children to keep them calm as the nurses here filled out their vaccination forms and administered the immunizations. Babies were weighed by being hung in a sac from a grocery scale, the kind you see in the produce section in supermarkets in the States, which was hung from a wooden beam outside the vaccination building. One baby had albinism and at the young age just looked white, not yet expressing the red blotches and white hair. After watching this for a bit, I had lunch with Levert, rice and cabbage which was delicious, and then came back to the office and worked on the Assurance Scheme and grant a bit more. Jen came by to say hi on her way back from the Abayudaya, then went to hang out with Levert in town. At 4:45pm, I took a boda motorcycle to town with Linus, one of the administrators at Bushikori. On the way to town on Mbale-Tororo Rd., we had to pass through a big crowd of people spanning the road from end to end and extending about half of a mile ahead. It was some dancing, chanting crowd traditionally celebrating the end of the year. People were dancing, screaming. They seemed drunk but who knows. As we literally split the crowd open with our motorcycle, I heard the word muzungu more times than ever before. This time I really felt like a zoo animal as people reached out their hands to touch me. When I finally got to town, I grabbed a bar of Ugandan chocolate and bought some art. Then I took a boda motorcycle home. As we left town it started to rain, and I finally got to experience what it felt like to ride into falling water at 40mph or so. That ride was a bit scary, with the wheels of the motorcycle skidding in the wet sand, but I got home and had some dinner with Matthew – rice, peas, homemade salsa and mango. Now I’m finishing this up as we watch some cheesy English-dubbed Spanish soap opera. One week from now I’ll be sitting at the Entebbe airport waiting for my plane. Time flies. Stay tuned!