Saturday, October 4, 2014

Day Eight - Another Operating Day - Rotary International VTT 2014 - Kampala, Uganda

{This is a series in posts about our trip to Uganda for the Riley/Rotary Vocational Training Team. To start at the beginning, go to this post. Check out the team blog at If you visit the team blog, please leave a comment! The team loves to hear your encouraging words!}

This day started just as the others. The first patient back to the OR was Ukasha. He was the one who had made friends with Priscilla who was to be the second patient of the day. I spent much less time observing today in the OR but did notice that the UHI continued to play a large part in both surgeries and recoveries.

Little Princess was still on a ventilator when we arrived but otherwise doing well.

Barbra was doing great! 

We spent some time with Dr. Joel who is a Pediatric ICU Fellow working here at UHI. He is originally from Iowa and lives here now with his wife and two kids. I think he is here for two years and his next stop is United Arab Emirates (where we go on Sunday) to continue studying. We quizzed him for quite some time on all things related to Ugandan health care. Such an interesting conversation! Here are just a few highlights…

There are only three pediatric cardiologists in all of Uganda. Dr. Judith, who was in the photo with Dr. Cordes yesterday, will be the first female and only the fourth overall.

There are almost 100 babies born every day at Mulago Hospital. The overall rate for congenital heart defects is 1% and that is regardless of country or ethnicity. That means that 1 baby is born with a heart problem, just in Kampala alone, every day. The goal for UHI is to do 2 surgeries per week. While some of the babies born are not treatable or surgery is not a treatment, this means that only 1/3 of the children for the year will be served. However, this is still much better than before this program when all children who needed surgery had to travel out of the country and only then if they could afford it or receive sponsorship.

It can be very scary for people to come to Kampala for treatment from the outlying areas. The first patient, Patience, came from Gulu, which is 4-6 hours away and came by public transportation. When coming to clinic, they get in line very early in the morning and are seen on a first come basis. If they are not seen and do not have family in the area they either turn around and go home or find a place to stay and try again the next day. When they come for inpatient stays, they bring all of their own supplies and food for their stay as well.

Hospital infections are not as common as malaria here in the hospital. Each bed is covered with mosquito nets and Dr. Joel says that a lot of people are good about using them at home too. They are pretty expensive though at about $30 USD per net! 

This information is not from Dr. Joel, but interesting nonetheless. Blood products are bit of an issue here. For these surgeries, 60% of the children were O and 40% were B, which is unusual. We haven’t had issues with this so far, but it is consideration for surgery.

The girls in the step-down unit were the big stars today. Patience and Barbra entertained all of us with reading, playing and talking today. You can tell they’re feeling better! Barbra even gave me instructions on making tea!

For those unfamiliar with Rotary, one of the "big deals" of Rotary is it's 4-Way Test. We repeat this at every meeting and agree that living by this 4-Way Test is the best way to go. 

1. Is it the truth?
2. Is it fair to all concerned?
3. Will it build goodwill and better friendships?
4. Will it be beneficial to all concerned?

In terms of goodwill and better friendships, I had seen that as my role between the Rotarians of Kampala-North and our club. The team of doctors and nurses certainly do so in the hospital. This week, however, I realized that is working amongst the patients and their families as well. These two are the best example. They don't speak much of the same language but seem like great friends!

There have been a couple of power outages since we’ve arrived. I believe there were two today. No one here seems affected by it all that much. Apparently, they had the generator for the OR fixed earlier in the year so surgery is relatively unaffected. 

Around noon, Rotarians began arriving. We’ve had visitors every day! This is a shot of the very busy hallway.

This is Nurse Sylvia. She is so sweet with Barbra and Patience. And, she speaks the same language as Patience so has been wonderful to translate for us. Although, we’ve found that little Patience knows much more English than we originally thought!

This is Past District Governor, Tusu, from Kampala-North. His district encompasses all of Uganda and Tanzania! 

Finally, it is Priscilla’s turn for surgery! This is the third day she has not eaten in preparation for surgery that kept getting pushed back. (She was able to eat once we realized surgery was not happening.) It doesn’t look like she minds too much!

Mulago Hospital was built in 1962 although there have been renovations and a brand new operating room for this department. There are some things you see here that you don’t see every day in the US. Patients in the ward are required to bring their own bed linens and clothes so laundry hanging to dry is a common sight.

These are the nurses' uniforms. 

A view of the upper floors. 

We went to visit Benita in the ward as she was supposed to be the third surgery of the day. Later, when anesthesia went back to check her out, they found her eating, so no third surgery of the day. She was quite tired!

Priscilla came out of surgery just fine but for some reason we weren't around to snap photos! Probably busy being entertained by the two movie stars, Barbra and Patience!

It was another tiring day but it was probably our earliest finish. We were all ready to go by the time the night shift arrived. I don’t think I’ve mentioned how dark the hallways are at night! You have to watch your step on the way back to the bus! We got stuck in a terrible “jam” on the way home but still made it in by 8:15 or so. Dinner and bed and it was a day! Tomorrow is the last day of operating! 

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