Final episode

Last week I returned to Uganda to hand over the TB project to Grania (far right, pictured with Ian Clarke CEO of International Hospital Kampala and Bosco Byekwaso microbiology lab technician).
The project is on track to market and supply a highly sensitive rapid culture test for TB by the end of this year. Grania will also be talking to local movers and shakers about upgrading Tb diagnostics in Uganda as a whole.
The work is being sponsored by the Suubi Trust (suubitrust.org.uk/) in England.
After some serious frustrations in June and July it was good to end the year in Uganda on a high note, leaving with lasting good memories of people, experiences and landscapes.

Home Again

The blog petered out as we got ready for coming home. So this posting is for completion's sake. Jan managed to persuade a bright young American volunteer called Craig to take over her managerial duties at the Hope Clinic from September. He and Philip now have a year to work on a longterm sustainable plan for the clinic.
On the Saturday we left (4th September) Bosco plated up his first cultures using the MODS technique in the new TB lab. Funding is in place to cover operation and development costs for the first year and I'm heading back out to Kampala at the end of September to hand over to Grania who will replace me as clinical lead on the project.
Its good to be back at Tremenheere and to wake up to this view every morning!!

simplicity 2

Simplicity 2

In Saturdays Monitor(national daily newspaper) there was a full page devoted to “Top 10 Time Saving Gadgets”, complete with pictures. I left the paper somewhere and can’t remember them all, but included in the list were;

Washing machine

Vacuum cleaner

Microwave oven

Blender

Egg whisk

And, my own particular favourite;

Long handled broom.

It is truly a wonderful privilege to have spent a year living in an environment where these items are seen as something other than basic necessities....

Florence

Florence

We’re leaving soon. On the whole I can’t wait. But there are a couple of people who’s future I’m worrying about.

One of them is Florence.

She’s a nurse who came to work at Hope just after my arrival. I thought her appointment was a mistake and didn’t take to her at first. During the ‘rationalisation process’ in May several members of staff were sacked. Florence survived by the skin of her teeth. She came to see me the following day, told me how much she needed her job and asked me what she needed to do to keep it.

“Make yourself indispensable” I replied. And she has.

Why does she need the job so badly? She’s twenty something, has two children of her own (aged 6 month and 2) plus two more that are her husbands by one of his other wives who ran away. When she married she was unaware that he already had two wives and a handful of children, and he’s married again since her. He hits her, and the kids, doesn’t give her any money and refuses to use condoms despite his multiple women.

So, recently she left him. She could only do this because of the £9 a week she earns working for the clinic. With this she has to pay rent, employ a house-girl for childcare, feed herself and four kids and pay for medicines when they get sick. I have absolutely no idea how she does it. She doesn’t know how she is going to manage to pay for their schooling but is determined. “I’ll manage, somehow.” She says if I ask.

Now she knows me she’s lost her reserve. She’s actually warm and clever and funny. I’ll miss her and I just hope she’ll be OK...

Shopping again

I went to get a SIM card for Fred and Sara who arrived from the UK yesterday.

The conversation went something like this:

Hello, how are you? I’m fine, how are you?

I’m fine. Do you have an MTN SIM card? Yes, 10,000 shillings.

No, I won’t pay 10. I know they cost 5. Oh, where are you from?

I’m from England, but I’ve been in Uganda for a year. Oh, do you like Uganda?

Yes, very much. When do you go home?

Next month. Can I come with you?

No, but you can sell me a SIM card for 5. Why can’t I come with you to England?

Because my husband and children wouldn’t like it. No, it’ll be OK. I like England too much. Take me with you.

What about this SIM card? Which premier team do you support?

Sheffield Wednesday, what about you? MANCHESTER UNITED! Sheffield aren’t a premier league side.

No, but they used to be good. Oh, are they historic?

Yes, one of the oldest. Can you give me your email address?

No, what about a SIM card for 5? Oh OK........Give me your phone number?

No, no phone number, but thanks for the SIM card.

Smiles and handshakes all round.

How can you not love it?

TB lab progress

Work has begun on converting the aviation office at International Hospital into a small microbiology lab specialising in TB. We’ve had promises of $26,000 for all the work and equipment necessary to get us to start up and should be able to set up our first culture on 25^th July.

The technique we’re using, called the MODS (Microscopic Observation Drug Susceptibility) test, allows us to offer a cheap and reliable test for TB for the first time in Africa.

The ambition of the International MODS Network is to make this tool a routine component of TB management in low resource settings. In practice this means we will diagnose and treat people with TB much more quickly. We can also identify those with drug resistant TB before we start treatment.

Gorillas - 29th June

We finally got round to seeing the gorillas when Ad arrived last week. I’d been ambivalent – its an expensive, luxury tourist trail affair. But they are remarkable. For an hour the 8 of us in our party stood in a tropical woodland glade while a family group of 10 got on with their lives around us. They’re huge and impressive and it’s easy to anthropomorphise as they have such familiar expressions and behaviours.
Their mountain rainforest habitat is protected now but not very big and under constant threat from the rapidly growing population all around.
There are less than four hundred mountain gorillas remaining in the world. I was left with a demoralising sense of humanity as a destructive plague....

Soweta - 23rd June

At 7am on Saturday morning we picked up Rachel and Gaye and headed for Jinja. This time, we weren’t there for the white water. Twenty five of us, including fourteen VSO volunteers from Kampala were heading for Soweta. It’s a displaced persons camp just outside Jinja. Hardly anyone knows it’s there and, it seems, even fewer want to know. Four thousand mainly women and children from Northern Uganda, displaced by the war, live there in unbelievable squalor. No latrines, a few standpipes, open sewers, mud huts crowded together, no place to grow food. An overpowering smell of home brewed banana spirit hangs over the place.
Mark and I had gone to visit the week before and had met the extraordinary Mary Kafuka and her daughter Grace. Mary is a social worker who volunteers there with some financial help from the Catholic church. Grace helps her mum “because she gets very tired”. Together they provide the only source of hope and assistance in the whole place.
“What can we do to help?” I asked.
“Anything” she replied.
So we went. With de-worming pills and vitamin A and cream for ringworm and sticky eyes and antibiotics and malaria tablets.
In the longest surgery ever we saw 720 people. They queued patiently in the sun, a number on one palm in marker pen and a cross on the other when they got their pills. We saw everyone who wanted to be seen, and some of the more enterprising ones twice.
And we “did a good thing”. And we left. Driving away in our four-wheel-drives to cold beer and hot showers and good food and a comfortable bed for the night…