This and That...

One of the great things about living overseas besides meeting the local folk, is meeting other foreigners at work and hearing their stories and seeing what they are doing. We met a British couple and their children--Craig, Claudia, Leo and Bethany. Leo turned 6 and so, we packed up the folks from the Hill (us, Hines and our German friends, Mattias, Stephanie, Tabia, Joni, and Lukas).

Leo is the one smiling the biggest and dressed as a pirate!

An awesome tree fort.
Craig, Emmanuel and Aaron. Craig and Claudia train teachers and on the side have fallen into mentoring a co-op of sorts. This young man is the manager and works in one of the villages in our district. They grow, trade, and manage seeds and crops and a training that comes with all of that--very encouraging.

Did you know that pineapples grow from the ground?
The view from the Smith house. Kabale town.
Mallory's pre-school led the chapel at the Primary school. They sang songs, did skits and recited passages and rhymes! Lucy was sick that day, but here are Mallory and Tabia and the Middle Class. Mallory is slowly getting to know the kids--you can just barely see her friend, Merab in the back.
Outside of the school. In a place with limited resources, it becomes important for children to memorize and copy board work from the teacher. This is common to see the alphabet on the outside and in the room are posters with information the children are learning.
We had a surprise 2 days off of school as the P7 kids took their national exams. These exams place them in secondary school, so all other kids had 2 days off and the P7 kids took their exams in peace. I could not believe how quiet it was around town--all the children hidden away somewhere! So, we had a fall party! A friend had sent the Hines some fall decorations and crafts and we pulled together some snacks between Leslie, Stephanie and I.
Playing apples to apples and excited about eating!
This moth has hair.
This moth also has hair.
A cloud was around us today and we took some photos of the yard.

This bird looks and acts like a monkey!
One of the ways we relax is to go to Lake Bunyonyi. Usually, we go to an island, but today we went on the high road and discovered an amazing hotel and view. Had lunch and hung out!
Yes, this hotel is just built in the side of the hill--a beautiful, steep walk takes you down to the lake.
A shot of the dugout canoes on the lake.
Micah and Jesse messing around.

Click on play to hear a snippet of some kids singing and dancing. They were having a retreat--didn't get to ask them what they were up to, but their shirts mentioned a rescue effort. Lots of people with lots of stories.

Back at our house, Aaron caught this picture--they both look like they are howling at something!

Tafti has become a part of the family.

Outreach Clinic by Aaron

Each week, the hospital sends a team out to neighboring communities to offer free clinics. We load up with a box of medicine, immunizations, a scale, and hoe and axe in case we get stuck. The team typically consists of a driver, antenatal nurse, immunization nurse, a clinical officer, and a Peace Corps worker. When I tag along, I help the clinical officer see patients. We are supposed to leave around 9:00am. We first make 3-4 stops getting gas, snacks for the trip, drinks, etc. The team seems to have a loose routine getting drinks at one shop and yogurt at another. Then we set off.

So far, the time on the road ranges from 1 ½ to 3 hours each way. Most of the conversation in the car is in Rukiga, which is the local language. So I mostly look at the countryside. Being that we are in a mountainous part of Uganda, the scenery is fantastic. The winding roads can make you car sick if you’re not careful. So far, the driver has insisted that I sit up front, which helps but is an honor I don’t deserve. The dirt roads have varying degrees of bumpiness. Somehow I imagined they would be even worse. The driver usually picks the best line through the dips and pits. He seems to have an innate sense of when it is ok to pass on blind curves too.

Just before arriving, we stop the car down the road from the designated outreach site so that we can eat our lunch without a gathering crowd. The tactic works sometimes. Others find the sight of me eating my lunch too tempting to just pass by, so they hang around until I am through. There is usually a short walk from the road to where we set up clinic. The site ranges from an open-air covering to the use of a school room. There is little to no privacy. It is worse when it rains as everyone gathers around for shelter. It gives the feeling of holding clinic in a packed elevator that is stuck between floors.

The outreaches I’ve been on have seen 30-50 patients, not counting the immunization and antenatal folks. The pace is fairly brisk. The more common complaints have been respiratory infections, gastrointestinal infections, and eye discharge/pain. There is usually some arthritis among the older patients who have probably spent most of the lives working in fields. Usually 1-2 of the patients look pretty sick. If we have extra room in the car, we will bring these patients back with us to the hospital. The last village I visited seemed poorer than the others. So not surprisingly, we saw more malnourishment and distended abdomens in the kids. We treated more for parasites/worms there as well.

I’ve gotten a kick watching some of the rural folks encounter a step-on floor scale for apparently the first time. I watch in wonder at how hesitant they are to step up on the scale. The nurse leads them right up to it, mumbles something in Rukiga, but inevitably the patient will first try to step over the scale. Then when corrected will place one foot on the scale. With some further coaxing they will put their other foot on (sometimes just switching feet). Then they wobble around like they’re on ice skates. When stabilized by the nurse, they usually have landed on and are covering up the part that reads how much they weigh. After they rotate around a bit, we get their weight and it’s over, until the next one comes along.

Fairly entertaining stuff until I get the feeling that I’m looking at myself up there being weighed. And start thinking how funny I must look the rest of the week while encountering my own strange, novel Ugandan scales. No wonder a crowd will gather just to watch me eat my lunch! Must look pretty funny.

So clinic passes. And we head home. At this time of the day, there are lots of kids on the sides of the road walking home after school. Now comes the part where I become a Muzungu superstar. As we pass by, one group of kids after another yells out in excitement, “Muzungu! How are you?” I smile and wave. Some of the kids run after the car for a little while (which is a local pastime in and of itself). The cries come in all sorts of tones and pitch. And I think, “Wow, these kids really get excited about white people.” Wonder how long it will last?

It is hard to know how much we are helping sometimes. Some of the difficulties we run into include not having the right meds in our box to match the diagnosis. Other times, we don’t have the supportive tests or interventions to make a clear diagnosis. For some we run into problems too big for a mobile clinic, like patients who did not complete their tuberculosis treatment from a few years back and now have new symptoms of Tb. Some we ask to try to find a way to come to our hospital for further care, knowing it is unlikely they will be able to come up with the cost of transport or just plain won’t want to make the trip. Still, these mobile clinics are able to seek out the poorest of the poor in rural sites that would otherwise not have access to health care, much less be able to afford it. Which is why for now, I will continue to go out on these important clinics (not to mention the beautiful scenery!).

On the way to the village--this is Lake Bunyonyi--it is in the shadow of a volcano and has these wonderful array of islands all over it.

Couldn't resist taking this one.
Our caravan going to the clinic.
One of the houses.
Another house--family of 10 lives here.
One of my patients.
Immunizations. The mobile unit really serves the poor and cut off due to finances and geography.