Day 2

12/18/08

I didn’t really sleep last night, a mix of the time difference and the animals making noise outside, as well as everyone in the house being awake at 5am to start their chores. I decided at 6:15am to organize my stuff, packing 1 suitcase with all the medical supplies and the other with my clothes, since I split them to begin with in case anything got lost. We lost power in the process but I used my flashlight and whatever sunlight there was. I left my room at 7:15am, said good morning to everyone, and washed up using bottled water for teeth-brushing. I dressed and sat down to breakfast, which was porridge, tea, bananas and eggs. There was bread available with some buttery spread and a fruit jam (both imported from Kenya), but I couldn’t have any because of my wheat allergy. I had plenty of porridge though, with lots of sugar.
At around 8:30 I went back to my room to take a nap before the driver picked me up at 10am to take me to the clinic. This is when I realized why everyone awoke so early. It was too hot to sleep at 8:30am. So I read a bit, wrote a bit, prepared for my day. I met another houseguest named Rasmus who is from Denmark/Germany. The driver came at 9:45am and I loaded my suitcase with the medical supplies and took my backpack with my laptop, notebook, and insect repellant. I put so much of that stuff on but I’m still itching everywhere that is exposed. The clinic was about 5 miles away; we went through town so it took about 15 minutes. The driver, John, was extraordinarily nice. He showed me the post office, the banks, and other destinations in town…well it’s mostly just the post office and banks. The drive from town to the clinic was gorgeous. The scenery is incredible, with mountains and trees of all different kinds. People were everywhere, walking, riding bicycles, driving boda-bodas. It’s hot but still comfortable because it’s so dry.
The clinic is more in need than even I expected. It is difficult to describe the situation without seeing it for oneself. They have “wards” which consist of 3 beds cramped into a room smaller than my own at school. There is a men’s ward, a women’s ward with 6 beds, a pediatric ward and an isolation ward with 2 beds. The maternity ward is in a separate structure (no, not a building, but a structure) and has a single delivery bed, a resting bed and room for the mother and child directly after birth, and then a ward of 3 beds for the next few days. There is a lab, which consists of a microscope and centrifuge. The autoclave is a tiny metal box which looks out of place but it seems to be able to do the job. The only things autoclaved are the single set of tools for deliveries and clothing (lab coats). There is a fridge, about 5 cubic feet, and a freezer, about 3 cubic feet. That is where vaccines and certain drugs are kept and they are administered on Tuesdays in the adjacent room. There is a single reception/examination room, a dispensary for drugs, and a drug stockroom. None of these rooms are larger than 100 square feet. There is a treatment room with 2 beds, where nurses administer drugs. Nurses aides are the gofers, bringing the doctors and nurses all the necessary equipment (or whatever they have that day) from the stockroom and monitoring patients.
I started my day, after a cursory tour, with the CO (clinical officer – the acting doctors in the clinic) Juliet seeing patients in the reception/examination room. Doctor Levert Wafula (also known as Dokta, Levy, or “Levaat”), the doctor with whom Maital and I coordinated this trip is home in Kenya until Saturday (and he took with him the internet…not sure what that means but I’m guessing its some sort of portable modem). So unfortunately I won’t meet him until Sunday and won’t have internet, in the clinic at least, until then. Anyway, there were 6 patients waiting for Juliet. The first patient had a brother who had ringworm; she was given a prescription for the first two weeks of a month-long drug to bring to him. The next patient spoke Lugandan so I didn’t understand anything but I think she had a cold. Oh, it is 12:35pm and the power just came back for the clinic. Next patient was pregnant and is considering an abortion. From what I understood, Juliet talked her out of the abortion and gave her directions to the main hospital’s maternity ward. The next patient was circumcised yesterday. He is 14 years old. The ritual circumcision here takes place on one month every two years, and all boys between the ages of 13-15 are circumcised in front of the community. If they flinch, they are not manly. This patient didn’t flinch. But from the looks of it, he should have. I won’t get graphic but it didn’t look good. The CO, Juliet, re-wrapped the penis in gauze and sent the boy on his way. They cannot dispense antibiotic cream as a preventative measure, not until there in an infection because of the scarcity of the medication. The next patient was a 1-month old baby with pneumonia and malaria. Enough said. The last patient we saw this morning was just a follow-up for a young child. Not sure what went on there. Ugandans speak very softly and it is hard to make out the words, even when in English, because of the accent and soft tone. After seeing the patients, Juliet and I went to the drug room to hang out and we watched WALL-E on my computer (thanks Yoni!) Every so often she is called out of the room and that is when I write this. So that’s where we are now. Today turns out to be a fast day so no lunch was made. So the driver came and offered to pick me up and take me home to eat and rest but I feel like there is more for me to do here today so I am going to stay until 4:30pm. Screw lunch. I’ll have a peanut butter nip instead (thank you Danielle). I will write again soon!