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My second visit to Uganda, July/August 2009 – final report
I had predicted that the last 10 days would be busy but I had no idea how busy! I mentioned that the ward had been quiet – a fatal error! Immediately after that we filled up with the usual set of problems and in fact I ended up doing four caesareans on one day which is a personal record so far!
I was very pleased to visit the Rotary Club in Kampala so that we could meet each other and they were very keen to have an update on work at the Hospital with which they have been associated since 1995. We were very warmly received. The meeting was also attended by Jill Brooks and we took Josephine and Philip Malone who had just flown in from the UK. They are professional film makers and old family friends who have very kindly agreed to donate their services to make a film about the work at the hospital. When it is available I will put a link on the website so that you can admire our new roles as film stars and, incidentally, have a much better idea of the work here. If I had known how busy retirement would be, I would have stayed at work!
Very sadly, but not unexpectedly, the young boy Joseph that Jill had been looking after died shortly after we left for Kampala. In the normal course of events his family would have had to face a large financial bill for his care in the midst of their bereavement. In this case, his original injury had occurred when he had been been knocked off his bicycle by a car and so the hospital charges were met by the driver.
Jill has left for home a few days before me. Her work here has been very much appreciated. In addition to teaching and outstanding nursing work on the ward, she has financed the purchase and making of new curtains for the surgical ward which will greatly improve the patients' privacy and make the place look a lot more cheerful. I very much hope that Jill is the first of many new volunteers who will come to the hospital from time to time, contributing skills and improving the morale of the staff here.
It has been a great support having the VVF surgeons here, particularly as one of them, Glyn Constantine, is a UK consultant obstetrician/gynaecologist. He was very willing to support me and helped out with a few tricky cases which also took pressure off the local surgeons who would otherwise have had to help. He was even prepared to attend my ward round and assist at a Caesarean section at my request so that he could give me advice and assess my developing obstetric skills. Thanks to my time at Kisiizi, I am pleased to say that I am now coping with the work more easily.
The weekend was very busy with filming and a visit from the Rotary Club who came to prepare a plan to protect the hospital from the regular power cuts which disrupt work and endanger patients. I can see that my next project will be to find a way of implementing this plan. Very unusually there were nine expatriates here over the weekend. We decided to go out to a small cafe in Kamuli which is euphemistically known as the "country club"! For a main course and plenty of beer we were charged £4 each!! Unfortunately one of our number was unwell that night and it turned out to be malaria in spite of taking regular prophylaxis. Happily, she made a quick recovery having had prompt treatment following a blood test in the hospital laboratory.
Looking back, I am delighted at the progress that has been made since January thanks to the overwhelming generosity and support that you have given:
· The hospital now has a replacement X-ray machine which was delivered in May
· A new water supply for the operating theatre which will also boost the supply for the whole hospital site has been funded by the Rotary Clubs of Henley. Work started a fortnight ago and is well under way.
· A 40 foot container has been purchased and loading has begun. Fundraising has started well and this will hopefully be shipped out later this year with a lot of vital equipment.
· Plans will be developed this autumn for a project to mitigate the power cuts which are such a problem.
· We have developed a low cost alcohol hand cleaning rub which has been enthusiastically received and will hopefully reduce hospital acquired infections.
· Most Caesareans are now done via "bikini line" incisions which are better for the patient.
· A number of people have expressed an interest in coming and doing voluntary work here.
· Contacts have been made with the Rotary Club of Kyambogo-Kampala, a German group from Rottenburg-Stuttgart who are funding the new laboratory and X-ray building and "Image the World" radiologists from the USA who plan to develop ultrasound services.
This is all very positive and encouraging. However, we must not lose sight of the enormous mountain still to be climbed. This hospital serves 700,000 people, is grossly under resourced and critically understaffed. During my brief stay of five weeks on the maternity ward, we have lost three mothers and so many babies that I do not count. In the face of these tragedies, the patients maintain a quiet dignity and are always grateful for our efforts even when we fail. In many ways we can learn more than we teach and receive more than we give.
Jim McWhirter, 16 August 2009