On the Road...

I am still really enjoying the work here, and I have managed to visit most of the clinics now, which was my objective before the 2 day workshop we are arranging at the end of this month. I spend my time at the clinics getting to know the team and seeing how the clinic runs, undertaking mini-audits of their antibiotic-prescribing practices (over-use of antibiotics is a widespread problem in Uganda), reviewing the emergency care provision at the clinic and also delivering some training in womens’ health. The other week I spent the day at a flower factory in Mukono, where one of the clinics is based, and found it very rewarding and inspiring. They offer primary care to the employees and also to the surrounding local communities, in which HIV is a big problem. They also have peer educator days during which they deliver health education to the local villages. They have invited me to hop onto the back of their motorbike in a couple of weeks time and join them at one of these community outreach sessions, which should be fun. They also make use of community-based volunteers, who offer their time free of charge to attend to house-bound people suffering with HIV, feeding and bathing them when necessary. The clinic staff do a fantastic job motivating the volunteers and patients alike and manage to maintain an excellent service with very little resource! Again, despite having quite a few patients with womens’ health issues, the clinic team were having to manage without any equipment (speculae) to conduct the relevant examinations! They are hoping to offer coils as part of their service next month, so hopefully the speculae will have arrived by then! We found that their emergency equipment was similarly limited, not even having oxygen on the premises!! So, not surprisingly, we found that despite having about 2 snake bites a month, they also did not stock anti-venom. On questioning how they manage such patients, the response was to monitor them and pray that the snake was not poisonous!!! Again, the benefits of working within the arm of a private, not-for-profit organisation, means that we should be able to stock all the clinics with emergency equipment and medication by the end of this month which will hopefully benefit the local communities enormously!!! We still have to work on the availability of anti-venom, as each vial costs about £130.00 with a limited shelf-life and since only a very small percentage of snakes are poisonous there is the potential for wasting a lot of money! Apparently there is a way of determining if your bite is that of a poisonous snake (other than if you are still standing!) through looking at the pattern of the fangs, so if there are any snake experts out there, we would welcome your input!!
We are heading out West this weekend to visit some clinics in Mbarara and Kasese. Nestled between these small towns happens to be Queen Elizabeth National Park so we are planning to fit in some safaris between the clinic visits. My sister, Nicola, is visiting at the moment, so along with Dr Rob (an American emergency physician who is also volunteering with VSO) Alan and the kids, and the resuscitation dummy, we will have a bus full!!! That is if we manage to leave Kampala! We are waiting to see how the riots settle over the next 2 days but are hopeful they won’t escalate, so fingers crossed we will have some exotic wildlife photos to show you on our next installment!