This morning I think I’m still recovering from the careering cross country drive last night. We came (fast) through a whole bunch of remote communities all of which looked exactly the same. I admired Jojo’s ability to read the road and concentrate on the pot holes and other hazards. As Herbert said, in Uganda you have to expect the unexpected. We came round a corner to find a taxi abandoned across the road.
I’ve really noticed this year that the pollution in the city has got far worse. Many of the vehicles are very old and belch out clouds of noxious fumes. And of course there are a huge number of vehicles all vying with each other for the best spot on the road and trying to push and shove in front of each other.
After a team meeting we headed out to Entebbe to the Lake Victoria Hotel where we have spent a highly relaxing afternoon before braving Entebbe Airport, Brussels, Manchester and home.
Our drive back from Nakaseke was okay. It was hot and sticky and we were pleased to get back to the hotel. Before dinner we started a team meeting which we paused when dinner arrived and finished afterwards. I always enjoy hearing about what other people have been doing in the clinics – being outside all the time there are a lot of things I don’t see. I am more impressed than I can say at the patience and skill of the clinicians who work in very different conditions to the ones they’re used to.
It rained heavily overnight again and that helped to keep the temperature down which was good for us but not so good for the Ugandans who keep on saying it’s very cold.
We set off for our last clinic day at Bombo rather later than planned (no surprise there) and I think the rain had kept some traffic off the roads.
We initially had 4 returning patients and 3 new ones. The morning kept us pretty busy and I ran a session for some of the church elders and leaders and some of the school teachers which seemed to go down well.
This afternoon the group is doing various things – some people have gone to do home visits in the village, some have gone into Bombo and the rest are clearing up and counting medicines. We give away to local hospitals any drugs and medicines which will be out of date by next January and pack away ready for next year those which we can use again.
The Ugandan team hosted us for a barbecue to thank us for our efforts. It was very pleasant and the meal was gcooked by Pastor Ronald, who is an excellent chef.
Some of us stayed behind for a meeting with the Ugandan team while the rest returned to Kampala.
We had heard that the main road was even more congested than usual so Jojoe took us cross country down a series of dirty marram roads pitted with potholes. It was a bit like what I imagine being in a bucking rally car is like. 2 army check points later and about an hour and a half we emerged into Kampala down a road stalled to the one we usually take. A bit too much of an experience!
It’s easy to be overwhelmed by the scale of poverty and need we see around us here. I wrote yesterday about what I saw as the growing middle class in Uganda. Yesterday at Nakaseke we saw completely the opposite. There is what I see as real poverty here and that’s why the church in the village is so important in providing what facilities and services it can. We could give out as many shoes, clothes and mosquito nets as we have. Many of the patients come back year and year for a check up and to see if we have clothes or shoes for them.
Herbert says there are much poorer places in Iganda than Nakaseke.
One of my best moments yesterday was watching Pam and Ehud working with an elderly man who had arrived in the clinic unable to walk. Over a period of a couple of hours they worked him to the point where he was able to slowly walk up and down in the clinic. They didn’t know what was wrong with him and his wife said that he spent most of his day sitting. The difficulty of course is what happens when he goes home. Pam said he really needed a walker which we didn’t have. There are some in the container which is en route to Uganda.
My friend at home Richard lent me a book called ‘Toxic Charity’ which is a fascinating, if slightly troubling rad, written by an American. The premise was that many well meaning mission trips organised by churches in America had no impact on the disadvantaged communities around the world they were trying to help as they perpetuated the culture and expectation of hsndouts. The theory went on that if all the billions of dollars spent on these trips was directed to grass roots community development and micro finance initiatives. The final thought was that these mission trips, which seem to be big business now, benefit the participants more than those they’re meant to be helping.
I hope we never forget that in our charity. I think that we never want to be perceived as well meaning people who appear for 2 weeks of the year and then go back home to their different lives. I think we have an advantage in that we are small and the UK arm of an Ugandan charity meaning that we have Robert and Jojoe on the ground to follow up and maintain connections and links as we can direct our finite resources to the right places.
I write this blog as we bounce along on the bus. Mornings are better for me as I find that I’m usually hot and tired when we’re travelling back home after the clinics and can’t find the right words.
Last night at the hotel we had a torrential tropical storm which lasted for 15 minutes. We were worried that the side roads on our way this morning might be very slippery and waterlogged. We need not have worried – the roads are obviously well drained and the side road we use was fine.
This morning has been hot. It’s also felt quite slow and disjointed. The cases have been slow and complicated. Despite capping the numbers the queue doesn’t seem to be going down.
After church we went up to Stepping Stones, the charity’s social housing project on the road behind the school into the village. Over the years we have built 6 houses for individuals and families in the greatest need. They have solar panels on the roof providing light into the houses. The community/disabled centre is taking shape too and I think its been built to a very high standard.
There is land where people can grow vegetables (and Damalie makes sure they do). I think this is one of the best projects we have been involved with.
We went to Cafe Javas for dinner and were well looked after as always. After wards we went across to the Acacia Mall which has a very smart supermarket. I’ve not been here before and was struck by how many wealthy looking people and smart cars there were. The smart coffee shops and ice cream parlours were full and the shops were expensive and well and busy.
It confirmed to me what I had thought for some time on this trip – that there is a growing middle class in Uganda but it is still a tremendous contrast with some of the communities we work in.
We were meant to be meeting with John, Sarah, Tom and Drake (the architect) this evening but they didn’t make it because of the heavy traffic – it’s the start of the new school year this week and there are lots of people on the road.
This morning we were up early this morning for the trip to Nakaseke which is a bit further than Bombo.
Jeanette and I are the early birds in the group and meet for breakfast most mornings. It is the first day of the school term and we could hear a brass band in the distance at the local school heralding the new year.
We set off about 8.15. We turn off the main road north of Bombo and then it’s about 25 minutes of bumping down the dirt road and avoiding the potholes before we reach Nakaseke. It’s a very straggly village with no real centre.
When we arrived there were about 60 people waiting. Pastor Sam had arranged for 2 tents outside the church. It is often very hot here and there is not much shelter so the tents are very welcome.
Since we were here last year there have been a lot of improvements to the school.
Nobody had been registered so the first task was to do this and get everyone in the order in which they arrived.
After all the work stations and pharmacy had been set up we opened for business and got through a steady flow of patients. The UK team stops for lunch when the translators lunch is ready. We have learnt from experience to add on at least 30 minutes to the expected lunch time and we usually land up about right.
As the rain cleared so the sun came out as it always seems to here. We treated a steady stream of patients during the afternoon. One little boy has malaria and had to go to hospital. We had an unusually high number of men today. Alison saw a patient with an usual throbbing on her throat and Pauline continued her specialisation of elderly gents with particular problems.
Fascinating chat with Herbert in the bus about the current political situation in Uganda.
The visit to the Rhino reserve was wonderful. The journey back, however, was not so great.
There was an accident about 45 minutes before we reached Bombo and the traffic each way came to a stop. We couldn’t see what happened as the accident was some way ahead of us. We had been in the bus for several hours by this stage and some of our party were in urgent need of a toilet break. Becs disappeared round the back of a house chaperoned by Ibra. As others came off our bus Ibra asked a lady who lived by the road whether some people could use her toilet and she generously obliged. Her facilities were rated much higher than those we had visited this morning.
In the end we think we were stationary for about 2 hours. We stopped in bright sunshine and set off again in the pitch black. After dropping Robert off we continued into Kampala, reaching the hotel about 10. It was a long day but worth it.
I wrote a few days ago about how patient people are when queuing for a doctor. Not quite the same when queuing in traffic!
Sunday morning dawned bright and sunny and we had a relaxed start before setting off for Bombo about 10.15. It feels as if it’s going to be a very hot day and I have taken special care to cream up well.
We passed by the Tick Hotel, Hotel Passions and the Venom Guest House – the mind boggles if you put those 3 together.
11.30 and we arrived at Bombo: the service was in full swing and there were probably 300 people there.
Sarah Bunjo was leading the service and it was as always a world apart from what we’re used to. People danced and sang in the way that only Ugandans can.
Then it was our turn and we moved into our service of readings and reflections followed by 4 worship songs. Communion followed and we celebrated Shakirah’s birthday with a beautiful cake with a bright red filling. Simon and I nearly lost our eyebrows trying to light the large multi coloured sparklers on the cake.
Having written everything I’ve written about Kampala traffic in the past few days we were very happy to have a speedy journey back into the city last night. You never can tell.
We had a very pleasant, if rather slow, dinner last night and most of us had an early night after a busy few days.
As I wrote last week Friday night is party night and Kampala certainly partied hard last night. The music started early okay and went on and off during the night finally reaching a climax just before 6. Many of us didn’t get too much sleep.
We’re splitting into 3 groups today – some are staying in and around the hotel, some are going on the walking tour of Kampala and the rest of us are going to the rhino sanctuary at Ziwa.
It was wet when we set off and the traffic was pretty light. We headed north out of the city and passed through the suburbs and past the turn off for Bombo. The road is very straight and occasionally there are traffic police with speed cameras and police checkpoints.
Becs and I had an interesting chat with Pastor Robert and he told us about his life in the army before he joined the church and moved to Bombo to work with John Bunjo.
We stopped for a toilet break (the so called short call) and the lady members of the group awarded the facilities 4/10 (you might be able to guess why).
We passed a huge articulated lorry lying on its side, presumably the victim of a tyre burst.
The rhino sanctuary added to the collection of extraordinary adventures and experiences in Uganda over the past few years.
The white rhino became extinct in Uganda in 1983 because of poaching and the sanctuary now has 30 white rhinos in an area of 70 square kilometres.
Our guides, Patrick and ‘Rhino Ronald’ were excellent. We went off in the bus for about 1/2 a mile and then struck off into he bush on foot. After 15 minutes walking we saw 4 rhinos under a tee. It was now about 12.30 and the rhinos normally rest or sleep between about 9 and 4.30. We carried on waking and after another 5 minutes found a mother and baby who suddenly got to their feet and started eating the grass. The guides said this was really unusual to find rhino on their feet at this time of the day. We were very lucky.
The guides told us that the white rhino (which is actually grey) weighs up to 3 tons and can run up to 45km per hour. As our guide drily observed, ‘you need to be able to run at 46km’.
The rhinos eat only grass and about 80 kg per day and they drink between 80 and 100 litre of water from the man made lakes round the sanctuary.
The plan is to grow the population to about 50 and then split the group so that they can breed in 2 different places.
Last night’s journey back seemed endless, if I’m honest. The traffic was as slow as usual but in different places. The bus was quiet and a number of people, including me, fell asleep or dozed. That can be quite hard as in certain parts of the road there are some highly corrugated speed bumps which slow the traffic down and wake the unwary up.
We had set off from Bombo about 7.45 in the pitch black, which was rather later than intended. There had been a problem with the clutch on the bus when it returned from Ssanga.
We ate late, probably around 10, and it seems that the long hot day had ironically helped many people to sleep well.
Alison and Kirstin arrived late last night and are ready to go this morning. It’s cooler with a hint of rain in the air so I hope it will be more pleasant.
As I was applying my sun cream this morning I could clearly see the areas I hadn’t completely covered yesterday.
Kampala is an extraordinary city full of life and bustle at all hours of the day or night. Yes, it seems chaotic but everyone seems to go about their business in a very purposeful way. There are shops and market stalls selling everything you can think of, and more besides.
We stopped at the Kiseera supermarket as we often do. This is really well stocked and the people are very friendly. There was a power cut while we were in the shop which meant that every single item we were buying had to be written down by hand in a receipt book which took a very long time.
When we arrived at Bombo we had about 40 new patients registered. Herbert went off in the bus to collect some patients from Ssanga. It started to rain. And then it started to rain heavily. And then a bit more. And then a lot more. The rainwater drains were struggling to cope.
We used Juliets jacket as a make shift umbrella to help protect people from the rain as they were crossing the yard into the clinic.
We started with the few returning patients who were here and continued with a line of new patients. The bus arrived from Ssanga and it was full today.
Ehud, Tom and Pam set to work with the disability group and the other patients from Ssanga joined the queue to be seen. We had 2 more doctors today than yesterday and everything seemed quite calm and under control.
People here are used to waiting and generally very patient as long as they understand the system and don’t see the queue being jumped. We often think that we are the big show in town when we’re here – a bunch of white doctors and free medication and treatment is bound to be pretty attractive round here where people generally have to pay to see a doctor.
The site here at Bombo is just incredibly beautiful and when the rain stops and the sun comes out it’s even more beautiful.
It’s been a good day today and not quite as hot and frantic as some. And now to face the Friday evening traffic….
We had a rarity last night – an evening off and very pleasant it was too to be able to sit outside on a warm Ugandan evening having a cool drink.
As we had finished lunch about 4.45 most of us didn’t need any dinner. Apart from Tom who followed up a large tilapia fish for lunch with a large plate of beef stew for dinner. He is a better (and younger) man than me.
We were up early again for our next third clinic day and again we have been trying something different this time. For the past few years we have run clinics at Ssanga which have always been very busy. We have identified off our database (and many thanks to the many people who have spent countless hours inputting patient records into our database) those patients who have conditions such as diabetes, asthma and hypertension. After our coach dropped us off in Bombo it went over to Ssanga to pick up about 20 patients.
So today was a little disjointed as we had various groups of patients – 60 new, about 20 returning who the doctors had wanted to see again and 20 from Ssanga.
It was unbelievably hot today and, despite creaming up very throughly (or so I thought) the sun still managed to find its way through and burn me.
Meg and Damalie ran some education sessions on nutrition for those with diabetes.
We had an emergency when a young woman had an epileptic fit outside the clinic and Mike and Nick rushes out to help – she recovered after a while.
The barracks team did 34 HIV tests today with 1 positive.
Becs and I had an interesting conversation with a young woman called Stella who comes from the West Nile region of Uganda. She has 2 young children and her husband was killed in a car accident 2 years ago. Under Ugandan custom she was expected to marry her brother in law. She didn’t want to do thud and so movers over to Bombo to be with her sister. A window on a different world.
This year we have had some excellent translators to work with apart from Herbert of course. I have really enjoyed working with and chatting to Nathan and Sylvia.
Pastor Sam is a remarkable man with a remarkable story. He wouldn’t in any way agree.
He came with us as our guest today on our day off. I was lucky enough to get a really good chat with him.
He told me that he had been born in Nakaseke. Both his parents and two of his siblings were killed in the war in Uganda between 1981 and 1986 when he was still quite young. He remembers stepping over the dead bodies, many of which were rotting in the countryside and much of the fighting took place near his home.
I first met him on the Medical Mission in 2015. We were running a clinic in the church there and I remember him showing me the field next to the church and telling me that he was going to build a school there to serve the community. And of course he’s done it and that school now has 220 children and he told me proudly that all 12 children in the top class were graduating with top marks and going on to secondary school.
I asked him how many people were living in his house and he had to think for a moment before replying ‘fifteen’. He has seven children of his own and the remaining 7 are those he and his wife have taken in.
He gets about 2 days a year away from the village and I suspect today was one of those. His phone seemed to be ringing constantly and he is always busy. He sees his calling as helping others and being of service to whoever might need him, whether they are known to him or not.
He is small in stature but big in heart; one of the humblest, but also mightiest, of men.
It was a slowish journey back last night but better than the night before. We started a team meeting before dinner and then stopped after the food started arriving. I think the kitchen at the hotel is quite small: we always pre order in the morning before we leave and there is usually about an hours gap between the first and last meals being served. Not that it really matters as there is always good conversation to be had round the table.
The team meeting continued after dinner. Meg and I made our apologies and we started counting the (very) large pile of notes on front of us. We calculated that the number we were working towards was 24,780,000 shillings. We made piles of 1 million notes and the piles grew. After we got to 24 million we kept our fingers crossed that the remaining notes would total the 780.000 we were looking for. Amazingly it all worked out exactly.
We then carefully transported all the cash to reception where Fiona, who sadly for her was on duty, duly recounted all the money and fortunately reached the same amount. Sighs of relief all round and a well earned Nile beer for Meg and me.
In the morning Juliet, Simon, Becs and I met with some of the Ugandan team before we set off for Lake Victoria and a 30 minute boat trip to the Serenada eco resort.
There we were greeted by a wonderful gentleman called Ibrahim who bought the land 37 years ago and had been gradually developing it. He is a format Ugandan ambassador to many countries and was the Ugandan Foreign Minister.
We had a tour round the resort and then took a canoe trip through the papyrus having to do a rather inelegant limbo under an inconveniently situated bridge.
We had an excellent lunch in the beautiful dining room overlooking the Lake. It’s been a very relaxing day and much needed for many of us.
CRMI Medical Mission 2020 