April 4

April 4, 2009

Just in case anyone doesn’t know, both Jon and I are safely home!  Thanks to everyone who commented on our blogs and prayed for us while we were gone.

Until the next adventure,

Katie

Leaving physically but staying mentally.

March 31, 2009

Ok, ok. So I have been a bit lazy with regards to my blogging. Maybe it is something in the air that makes your worries/cares melt away. As you have read on Katie’s previous blog, we went on Safari in Kenya and it was a blast. I think the most memorable moment was when we were hanging out with the Masai people. The young men there were just like at home… talking about things I would talk about at home with my guy friends… pretty funny. I was able to get all of them to flex their skinny little arms in a photo with me, showing everyone how manly they were. When they saw my arms (small by american standards) they told me I should fight with their biggest warrior to see who would win. I told them we should have peace in Africa and gave them the peace sign… they all thought that was pretty funny and then started giving each other the peace sign.

I our short trip here we have been hearing and reading many stories of the continuing conflict between tribes and other groups. We are very hopeful that these differences will be settled with words but we are sure that it will require great effort on both sides to resolve these differences/grudges. It is still hard to hear about the violent groups that have emerged and those that are emerging around the east african union, but it is becoming more evident to us why they are emerging. There is so much hurt from years of violence and hate, much of which the government perpetuates. Thankfully we are seeing change in the hearts and minds of the youth and look forward to the massive changes that are in store for East Africa, specifically Uganda.

We have been so blessed with this experience and hope that there will be many students from our school to follow. It is one thing to read about the events that are happening thousands of miles from home, but living and interacting with that culture is priceless. As I titled my blog today, I will be leaving tomorrow on a plane to the USA but there will always be a part of my mind that will be thinking of my time here in Uganda. Katie and I are to give a presentation back at our school a week after we arrive home, regarding our African travels. I hope that we will be able to get the important things out in our short one hour talk.

Just thinking about being home makes me stressed! There are already piles of things that I have to do when I get back…. moving away from the student life and into the working world will be a massive change. Hope I don’t burn out!

Thanks for reading our blog. We hope you were able to get some idea of what our life has been like during our travels.

signing out,

your tan traveler,

Jon

Mar 28

March 28, 2009

We’re back from our safari!  We arrived yesterday afternoon at King’s Kids Village (the orphanage), each had a nice hot shower, and then some fantastic Indian food that Jon (Stern, not Beers) made for us.  We both got to sleep in this morning (at their guest house, in really comfy beds) and then had some lunch.  We’re planning to go to the Village Market and possibly a water park or put-put golf afterwards. :)

And now for the safari…

After Lake Nakuru, we headed for Masai Mara and arrived late afternoon on Tuesday.  Along the way we picked up a woman from China, a guy from Poland, and another guy from India.  The two guys were about our age and the woman from China, though we thought she was just a bit older than us, was actually in her early 40s.  Once we got to the Masai park, we did a short game drive, but saw giraffe, zebras (I took lots of pictures Kaela, don’t worry!), lots of gazelle/antelope, and a group of 9 lions!  The lions were just sleeping in some tall grass near some bushes right next to the road.  It was really fascinating to watch them.  There weren’t any grown males, just females with their cubs.  Our driver, Fred, told us the male lions are lazy and just sleep all day hidden in the bushes, so people don’t see them very often.  The females do all of the hunting and rearing of the young lions.  After we had our fill of watching the lions, we proceeded out of the park and to our lodge.

We had actually paid for the cheapest option, which would have been camping with sleeping bags, but the site was doing some sort of renovation, so we got to sleep in the tented lodge which was really nice and much better than what we had hoped for.  There was a large tent with a tile floor, two beds, a dresser, and a bathroom attached to the back that was a permanent structure and quite nice.  There was also a roof of sorts over the tent, so from the outside it almost looks like a small cabin with tent material for ‘doors’.  The first night got way colder than we thought it would, so both of us woke up freezing.  I was also told by one of the guards, right before we went to sleep, that they sometimes see elephants, cheetahs and/or hyenas in or around the campsite!  While I was sleeping I woke up quite a few times hearing strange noises and was a little bit unnerved by them.  There were guards walking around throughout the night though so I suppose we were reasonably safe.  Although there are boundaries to the park, the animals certainly don’t have to stay within the lines, but are free to walk around where they please and they are wild even if they look cute when driving by them!

The next morning we got up before the sun, had a quick breakfast, and headed out to the park again in hopes of catching the animals a little more awake than in the middle of the day.  The entire day was spent in the park driving around!  The top of the vehicle we were in popped up so we could stand to see the animals better or take photos.  It was rather difficult to stand while moving, but we spent much of the day doing just that as it was lots more fun.  During the drive we saw tons of elephants (and got charged by a couple of the males which is rather scary), giraffes, zebras, antelope (there are lots of varieties if I didn’t already mention this), water buffalo, wildebeasts, creasted crane (Uganda’s national bird), ostrich, and warthogs.  Most exciting of all though, were the black rhinos we saw.

Black Rhinos are rare as well as endangered and also very shy so it’s difficult to spot them and few tourists do.  While we were intently watching a family of elephants, our driver urgently asked to use his binoculars.  Before we knew what was going on, we were turned around and heading somewhere very quickly!  We asked what he had seen and he told us there were 2 black rhinos and we were going to see if we could catch them.  They don’t like the open space so the fact that they were running where we could see them was great.  We didn’t get very close before they headed into the bushes, but we were close enough to tell they were definitely black rhinos.

By about mid-day we had made it to the Mara river which is the river the wildebeasts cross when they’re migrating from Masai to Serengetti.  If you’ve watched any of the shows about the wildebeast migration, you’ve likely seen this river.  It’s not too high right now and the wildebeasts are much fewer in number at Masai since the vast majority of them have migrated (millions).  Hippos and crocs also live in this river, so we saw lots of hippos and several crocs.  The hippos group themselves according to family units and spend most of their time submerged in the water except for their heads.  They also make the strangest noises!  I took a video so I could remember the crazy sounds they made.  Hippos also like to fight with each other so some of them were taunting the others and they’d get in little skirmishes and then go back to floating.  The crocs were less exciting and I’m not even sure I would have spotted them if it hadn’t been for the guide.  They didn’t hardly move and all I could really see were their nostrils!

After viewing the hippos and crocs we carried on across the river and found a little picnic area to eat our packed lunches.  Thankfully the picnic spot also had a restroom…by the time we ate lunch we had been away from our campsite for nearly 7 hours, so you can imagine how glad I was to see a bathroom!

We had about an hour break and then headed to the Masai village.  The Masai people live very simple lives and have little to no technology.  They are one of the most famous African tribes and the people usually depicted in magazines like National Geographic.  There are many different Masai groups, but they are all related and have at least some similarities.  The most famous of these groups is the group near Ambroseli, not near Masai, but we were still excited to meet these people and see how they live.

The man who lead us around their village was the first born son of the chief and seemed very well educated.  Most of the members of the tribe, or at least the men anyway, do get a modern education.  Before we actually entered the village, we met some of the villagers outside and a few of the men did a welcome dance for us (it mostly consisted of them jumping up and down!).  Jon got to join in on this part.  Once we entered the village, we toured one house, which was smaller than most rooms in an average American house, and the whole compound of this particular village.  Inside the tiny houses is a room for the baby animals which are kept there until they are about 3 weeks old at which time they leave the house and go with the herd.  The houses are all made of sticks and cow dung and constructed by the women!  The men, from what we could gather, only tended to the sheep, goats, and cows.  The women did all the rest, including building and carrying water from ‘nearby’ streams!  A small group of women also did a dance for us and a girl on our safari and I joined in on this dance. :)  The village is basically a large circle with sticks as a fence to create a barrier for protection from the wild animals.  Inside the fence are many houses as well as a smaller circle fence where the animals are kept at night.  Just outside the fence of the village is a small market area where the women sell different craft items for extra money.  When we asked what the people do for an income, we were told that a great source of their income is actually tourists.  They make some money from selling an occasional cow, but it seemed that the majority of their income was made by showing visitors how they live.

The younger men were really easy to talk to and we were able to ask all sorts of questions.  We found out the reason they wear red is to stand out when they are herding in order to be seen and also to be seen when hunting so another hunter doesn’t shoot one of their own.  The red color is also protective against wild animals as they seem to be afraid of it.  In respect to the large holes they put in their ear lobes, this is for decoration or beauty.  They use a small spear to create a hole and then slowly make it enlarge.  The women often put beads around their ears and some of the men even put the lower lobe of the ear over the top of the top portion!  We also learned where they get the dye for the red cloth, and it’s found in a green plant that is a member of the mint family.  The plant itself didn’t smell like mint, but it definitely looked like it.  Another great thing we found out is the young men actually do have to kill a lion.  They don’t each kill one, but rather a group of them go out to kill one.  Once they have done this, they can find respect from their village members and are allowed to wear a lion tooth around their neck for good luck.

All in all, the experience was very interesting and humbling to see how simple these people live.

The next day we headed out again before the sun for a short game drive before heading back to Nairobi.  We got to see lions again (our guide spotted them…none of us would have noticed at all!), but unfortunately still no cheetahs.  Although not seeing a cheetah was disappointing, we just decided it just means we’ll have to come back some day!

On our way back to Nairobi, we picked up a guy from Germany who needed to catch his flight back home.  Somehow through the course of the drive, Christianity came up and we had quite the conversation!  There were six tourists in the van and 3 of us Christian.  The other woman that was on the safari with us is from China and her story was quite incredible.  She grew up being taught there was no god and you should not rely on anyone but yourself.  Through much searching and some missionaries who were teachers at her school, she finally came to be a Christian about 10 years ago.  The German guy was trying to use every type of reason and science to explain how foolish all of us were and I found it a bit frustrating because his arguments were anything but reasonable.  Beth (the Chinese lady), however, had lots of patience with him and very much understood his lack of faith.  She told him she would pray for him and that with time he would understand.  It was pretty incredible!

We finally made our way to Nairobi and have been here since Thursday afternoon.  Yesterday we went to a water park which was lots of fun.  It was great taking a trip back to childhood for a few hours and having Sarah and Joe around makes this much easier!  Today we went to a shopping market where Molly got some great bargains and I picked out some African fabrics.  We then got to visit the New Life Home (a home for abandoned babies) which was wonderful as you said Arlene.  The home itself is beautiful and very much baby/toddler friendly.  Most of the kids were sleeping, but I did get to hold one adorable little girl. :)

After the baby home, we went downtown for a few hours and then came back to the Sterns’.  We leave bright and early tomorrow morning for Kampala and then leave on Wednesday for home!  It’s been a great trip, but both of us are ready to get home and back to our normal.

Oh, we are going to be getting together with Chris and Jane Palacas as well.  Chris called Thursday and said somehow their phone had quit working entirely so they lost all of their contacts!  They had just found the piece of paper they wrote my number on so we’ll finally meet up with them. :)

This will likely be my last blog as we’ll be home in just a few short days!  See you all soon!

Katie

P.S

March 23, 2009

One thing I forgot…we had been told that the drivers in Kenya would be much worse than in Uganda…but surprisingly we’ve found the opposite to be true!  The drivers follow speed limits, wait for pedestrians to cross, and even sometimes let other drivers pass in front of them.  We didn’t ever feel unsafe on the bus ride here or any other time since we’ve been here.  Maybe it will get worse, but so far it’s been dandy.  We were telling Jon this, and his comment was that driving here is much better than driving at home.  When driving here, you have to stay alert every second where as driving at home is so boring you’re likely to fall asleep at the wheel and get into an accident.  Now, I wouldn’t go so far as to say driving here is safer than at home, but I do think it’s safer than Uganda!

Mar 23

March 23, 2009

Well, we’re in Kenya and it’s fantastic! The bus ride here was so much better than either of the other long bus trips we took. We left only 11 minutes late and kept quite good time the entire day. We stopped for real bathroom breaks and lunch. Once we got to nairobi, the lady from the tour company met us at the bus station and took us to our hotel, which was really nice!  We had a fantastic shower (which had curtains separating it from the toilet and sink, unlike in gulu), and the food at the restaurant was really good.  We got in touch with Jon and planned to go to church with them the next day.   The weather here is lovely (Nairobi is the same elevation as Denver) so we slept well and didn’t even have to have the windows open.  Sunday morning, Jon and Molly’s friend Andrew picked us up and took us to church.  Their church has just moved into their own building (most recently they had been meeting at a soccer stadium) and is quite large according to Andrew.  After church we went to Jon and Molly’s and had spaghetti for lunch which was very yummy!  We met 4 of their 7 kids and had a great afternoon just relaxing.  We saw the Orphanage and met a lot of the kids.  The orphanage is amazing!  It’s beautiful and definitely exceeded our expectations.  The parents were very welcoming and we had tea with one of them.  The mom of this family even had some medical questions for us, so with Molly as our translator, we did our best to diagnose and treat her!  We ended the evening by watching ‘Fireproof’ which was really good.  Neither of us had seen it and we both liked it.  Better than what I expected I’d say.

I forgot to mention how much more developed Kenya seems than Uganda.  Nearly as soon as we had crossed the border, we noticed that the farms are plotted out in a very organized fashion, we saw electrical wires running even to the smallest of villages, and some of the cattle/sheep/goats were fenced in in their own pastures.  Once we got to Nairobi, we knew what people meant by it being a ‘real’ city as compared to Kampala.  Kampala is about 1/5 the size of Nairobi though, so it makes sense that Nairobi seems much bigger. :)  We’ve noticed that people understand our English a lot better here than anywhere we’ve been in Uganda.  The best part, however, is the weather!  Apparently right now is the hottest it gets and it’s by far, more comfortable than Uganda.  It’s actually gorgeous!

Back to the list of events.  Today, we started our safari!!  We were picked up at 9 am and shortly after that, headed for Lake Nakuru, which is something like 160 km from Nairobi.  We’re the only people on our safari which is actually just fine.  There may be a couple people joining us tomorrow, but we’ll see.  About 40 miles outside Nairobi, we got to The Great Rift Valley which goes from Jordan to Mozambique.  In the distance was Mt. Longonot, which is still an active volcano but I guess they don’t think it will erupt anytime soon.  While we stopped for pictures, a man started telling us about the valley and the mountain ranges, and of course wanted to sell us something.  We were going to buy something small so I went to get my money and then came back to ask how much he was asking (expecting the equivalent of a couple US dollars),  and he said 15,000 Ksh (nearly $200!!) for the two small (approximately the size of coasters) items!!!  I think my eyes nearly popped out of my head I was so shocked.  I know they start high, but you’d have thought this sketch was made of gold!  We got him down to 1,000 Ksh (about $12.50) which was still ridiculous, but we felt like we couldn’t get out of the shop if we didn’t buy these silly things (he was blocking the door so Jon couldn’t get out and I couldn’t just leave him there!).  Quite an experience and something we at least have laughed about!

We finally got to Lake Nakuru and started on our game drive, which ended up being fantastic.  We saw 5 rhinos really close to our car, lots of giraffe, flamingos, tons of water buffalo, monkeys, baboons, and lots of antelope-type animals (the smallest being about 18 in and called dik-dik).  The rhinos  were definitely the highlight.  We were hoping to see them (sometimes they’re hard to find), but we never imagined they’d be so close!

Tonight we’re at a pretty nice hotel (we thought we’d be roughing it!) and we leave tomorrow morning for Masai Mara.  We definitely want to see lions and are really hoping to see cheetahs which are pretty difficult to spot.

I’ll write again if we have internet, but at least wanted to let everyone know we’re safe.  We get back to Nairobi on Thursday and will stay with Jon and Molly until Sunday morning.  We’re so glad to have met them and looking forward to seeing them again in a few days!

Katie

Mar 20

March 20, 2009

The infamous Match Day was yesterday, and as my mom has already posted, I will be in Omaha for the next three years! This is where I really wanted to be, so I’m quite happy.

Other than that, nothing terribly exciting since yesterday. We went to Quiz night which was pretty fun. The people asking the questions asked some really random obscure questions! A team from Holland ended up winning. I didn’t participate much, just observed mostly. After the quiz ended, we went to an outside bar that was really nice. The quiz night consisted almost entirely of mzungus, but the other place was mostly local people.

I did speak to Jon Stern yesterday and we will be seeing them on Sunday for church and he said we could just hang out with him that day. I’ll ask him about the animal nursery as I think that sounds pretty fun. Thanks for giving me his contact information Susan! We’re excited to meet him and see what everything is like there.

We leave early tomorrow morning (or at least that’s when we’re scheduled to leave) and arrive sometime in the evening in Nairobi. Should be a fun adventure! I will write while there to let everyone know we arrived safely!

Until later,
Katie

My mind is a traffic jam.

March 19, 2009

Hello Everyone,

Sorry I haven’t been as diligent in my blogging as Katie has been. Also, it sometimes seems silly for me to write about our experiences when Katie just did… even though I may have a different view of the situation, it seems repetitive. So… just one thing to add about that patient Katie described that was an alcoholic with hepatic encephalopathy and some other presumed infection… we were able to visualize the process of decerebrate posturing. This is basically the physical exam findings that you get when your brain is not receiving enough oxygen. We watched his arms bend at the elbows as he was dying. I know that it may seem strange for me to mention this but usually you do not see this as an active process (as people often die much quicker or present with this posturing). Katie did a wonderful job explaining our past adventures, so I’ll just talk about what is happening right now.

Katie and I are freaking out because we have 3 hours before we find out where we will be working for the next 3 years (it is Residency Match day today). Wish us luck! In addition to this anxiety and stress… we had a patient today that was admitted to the hospital on Tuesday and we were just seeing him for the first time today (Thursday). He came into the hospital walking and talking and now he is basically comatose and quickly deteriorating. Because he is HIV positive, he has a multitude of diseases that could be affecting him. We have just started him on almost every available medication for his possible infections… but this could have been avoided. We checked on him this afternoon and he is still alive. I hope he makes it through the night.

After he was set up with treatment, Katie and I went to a lecture about HIV/AIDS throughout the world and the various ways countries are attempting to treat this horrible disease process. This was given by a retired Physician from UCLA. It is very interesting to learn about medicine in the International setting. We (being students from the US) are so used to hearing about US medicine and it is very nice to be able to hear about medicine from across the globe and the challenges that other countries are facing. After this lecture, we were able to go to the laboratory in the hospital and learn about blood parasites. We were able to learn how to prepare slides to visualize malaria, African Trypanasomiasis (aka African sleeping sickness,), and Filariasis causing Elephantiasis. All of these diseases are special to tropical climates and we would most likely never see them at home, unless we had a travelling patient presenting in our clinic/hospital. Hopefully we will be able to see a few more slides before we return to the US, as we ran out of time in the lab.

The computer lab is closing now… so I must be going. One last thing, we were finally able to see the monkey that hangs around our house. He is pretty large and has a funny white stripe on his face. I am failing to recall the type of monkey he is, but it is the more common type here in Uganda. I am told that he is a male because the males are the ones that usually travel alone. Maybe he is a bachelor like me, just trying to see what is out there in this big scary world! I hope he finds what he is looking for.

Sorry my blog is a bit disorganized and random today. Hopefully after I find out where I will be for Residency, I will be able to organize my thoughts a bit.

your anxious adventurer,

Jon

Mar 19

March 19, 2009

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Not so many days left of our ‘boring stories’. You’re welcome. We leave Saturday for Kenya and likely won’t use the internet while we’re there. We’re told most of the animals don’t find the internet useful, so they haven’t set up internet cafes on the Masai Mara. We’ll tell you stories when we return though. :) Our safari is Monday to Thursday and hopefully we’ll see all the safari animals! A couple residents who are currently working at Mulago, went on a similar safari to what we’re going on and they saw lots of lions, a couple cheetas, and of course elephants, giraffes, and zebras. This news made us even more excited than we already were! Apart from the safari, a student here said there is an Animal Orphanage somewhere near Nairobi that’s really neat so we may try to see that and I’ve communicated by text with Jon Stern and will call him shortly to hopefully set up a time we can visit King’s Kids.

Apart from our trip to Nairobi, we are looking forward to finding out where we’ve matched for residency in just a few short hours! After we find out where we’ll be, we’re planning on going to a club called ‘Bubbles’ where they’re having a ‘quiz night’. It’s some sort of trivia game and we’ve been told it’s pretty fun. Guess we’ll soon find out!

And now news from Mulago. Yesterday, Jon and I went back to the skin clinic in hopes of learning more about leprosy. There is a leprosy clinic every Wednesday and we had tried to visit it a few weeks ago, but unfortunately the doctor never showed up. This week, however, two doctors were available and only one patient came to be seen! The patient may or may not have leprosy and the doctor advised him to come back in a few weeks to determine whether or not there has been any progression and for reevaluation. :( He did give us a nice lecture on leprosy, but unfortunately there weren’t any patients to illustrate the disease (don’t think we want people to have leprosy, but if they are going to have it, which they are, then we want to have the opportunity to see it!).

After the clinic, we went to the US Embassy to see about a multi-entry visa so we wouldn’t have to pay the entire $50 USD to get back into Uganda from Kenya. This trip was both a waste of time and a huge disappointment. We weren’t disappointed that we couldn’t get this multi-entry visa, so much as we were that the embassy was so disorganized! No one there could understand us, the hours you can actually get in are very few during the day, and if we actually needed the embassy for any reason, we have no idea how we’d actually get any help from them! The building itself seemed nice in as much of it as we saw, but what we saw only amounted to the security and a waiting room.

We next went to get our Uganda shillings changed back into US dollars so we could pay for our visas into Kenya and back to Uganda and got ourselves some Kenyan shillings as well.

Last night the power went out (has been happening more and more frequently the last couple weeks), so we couldn’t make ourselves anything to eat. We went to one of our favorite places, ‘I Feel Like Chicken Tonight’ and ordered an egg roll and samosa each. Once our order was ready, I picked up the bag and thought it sure was heavy for such small things. We thought maybe the egg rolls were giant ones…but it turns out they were a bit different from what we know as egg rolls. They were hard boiled eggs surrounded by mashed potatoes and then fried! Quite tasty even if it doesn’t sound like it. :)

Today we went back to the infectious disease ward and saw many similar patients to what we saw earlier in the week. There is one young man who is particularly sick and somehow got overlooked the last day and a half. He presented to the hospital at 10:45 pm on Tuesday night and was still able to talk until last night. Until this morning he had received no treatment and was semi-conscious and unable to respond except to pain. We did get some things done in a timely manner, but it is likely too late for him. I really still have a hard time understanding and accepting the lack of urgency.

A few of us students did have an interesting discussion last night concerning what we’ve seen here. We were talking about how there is so much need, but none of us knows where to even begin. There are so many different ways to approach the problems and so many barriers. So much of what we see that is frustrating is completely engrained in society and we wonder how much of it we, as outsiders, can or should change. Obviously we look at what is different and think the way we do it is better, but is it always? I know the country needs God, of that there is no argument. But what about the poverty and the health care? It seems to me, if people knew things could be different, they would want it to be that way, but why when so much foreign aid is invested do things not start to take off and improve? Or maybe things have dramatically improved and we just weren’t here to see the way things used to be? How right is it of us to push our ideals concerning the way organizations should be run, on other cultures? I often come back, in my own mind, to education being one of the most important tools, but I’m not sure how to do it. I’ve gotten a lot of food for thought, and just keep hoping and praying what I see and what I learn here will be put to good use in the future. It’s definitely nice having other students here to help digest the information with and it’s great to get different perspectives both on what their ideas are for solutions and what they’ve seen in the hospital.

Thanks for all of your continued prayers and comments. I think I can speak for both of us when I say we’ll be happy to be home and excited to see everyone again!

Katie

Mar 17

March 17, 2009

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First off, Happy St. Patrick’s Day! I hope everyone remembered to wear green so as to minimize pinching! I remembered my green, but it seems no one here cares whether or not you’re wearing it, so the day was rather anti-climactic as a holiday. However, both Jon and I did find out that we have both matched to residency programs so we’re both happy and relieved to find this out. We’ll find out where we matched Thursday, but at least we know we’ll be going somewhere!

I added the posts from when we were in Gulu…there a bit outdated now since we’ve been back a few days, but I had trouble with the internet and finding a wireless spot to send what I typed on my pocket pc to myself. I’m sure none of you have anything to do except read our blogs though, so now you’ll be glad to have something to occupy your time! ;)

This week, Jon and I are both on the Infectious Disease ward in the main hospital (I have to see adult patients…scary!!). It’s a bit busy with many medical students, nursing students, and residents, but so far it has been a good learning experience. Most of the patients on the ward are HIV positive and are here due to opportunistic infections. Some of them are on therapy for HIV and some are now, but most of them are started while they’re here if they weren’t previously receiving treatment. Very few of the patients ever get confirmed diagnoses, they are just treated empirically based on their symptoms, physical exam, and what stage their HIV/AIDS is. Quite a few are currently being treated for cryptococcal meningitis, a type of meningitis severely immunocompromised people are susceptible to. If they don’t get better on treatment for this, the physicians look further for a source of an infection. Nearly all of them are tested for malaria as well and of course started on treatment if it is found to be positive. Sometimes even if the malaria smear is negative, they will start treatment for presumed malaria if there isn’t another obvious sign of the source of their fever.

In addition to malaria and cryptococcal meningitis, there are several patients with tuberculosis, one patient who possibly has CMV retinitis or retinitis due to toxoplasmosis, one patient who either has delirium tremens (caused by abrubt withdrawl from alcohol) or a CNS lesion, one patient who has presumed toxoplasmosis (a CT was done and he has been getting better on treatment for toxoplasmosis, though based on the CT it could be something else) and one patient who had alcoholic liver cirrhosis. This last patient passed away this morning right in front of us. As they were trying to do something for him (a line was put it, fluids given, and an NG tube placed for the delivery of lactulose), we helplessly watched and knew that he wouldn’t be here for long. We learned from a doctor who has seen this patient many times for follow up care, that he was an alcoholic and had had severe cirrhosis for a long time. He was also HIV+, but had been receiving treatment and doing ok from that standpoint. However, he refused to quit drinking and so no matter what country he lived in, would not have eventually succumbed to his liver failure, we just felt it wouldn’t have been quite so soon. This man came into the hospital only 3 days ago able to talk and was fully conscious. Even yesterday he was fully conscious, though looking quite terrible. Although he wouldn’t be a likely candidate for a liver transplant, we could have treated his symptoms better and he could have had some quality of life. Granted, if he didn’t stop drinking there would be little anyone could do for him. This really about pushed me over the edge, watching him die this terrible death. Being here is often overwhelming for a number of reasons, but things like this make it even more difficult.

The doctor who had previously been taking care of this man, stood and talked to us for quite awhile. He seemed very wise for his years (he couldn’t have been more than 30 at the most) and had some interesting thoughts on the state of health care here. He thinks there are many things that need to be improved, but the one thing that most needs to change is the attitude of the health care workers. He thought if more people could visit the health care settings of more developed countries and see what is possible, maybe things would start to improve. He didn’t buy the argument that it is just a matter of lack of resources here, but thought the attitude was more to blame. He thinks it is helpful for westerners to come here and teach and explain how things are done elsewhere, but these people have to realize that change will happen, just slowly. Sometimes we westerners come in and want to change everything to exactly the way we do things, when that isn’t necessarily appropriate. Certainly there are many improvements that need to be made, but offending people and pushing them around as if they’re simply unintelligent isn’t the way to go about making a difference. He seemed to be of the mind that showing rather than telling was the best method toward improvement. He also thought more people who had the resources should share what they have been given, and although I definitely think this is necessary, I tend to think resources from other countries should be used to aid in teaching people how to fish rather than providing them with the fish, the latter seeming to happen more often than the former.

Although today was very sobering, it was more the combination of several things that made today have so much more of an impact. Last night after we found out we matched, we went with a group of students to dinner and had a little celebration (more of a celebration to be had on Thursday when we know where we’ll be going). After dinner, Jon and I were walking back to campus, and saw this young boy (not more than 5 or 6) sound asleep on the side walk. Not more than a few feet away from him were 2 men selling shoes. I asked the men if the child was one of theirs and they replied, ‘no, he’s just a street kid’ with no feeling. In our hands we had leftovers and our stomachs were full (too full in fact!) and this little boy had nothing. I tried to wake him up and see if he was ok, but he didn’t respond he was sleeping so soundly. It takes a lot of practice to be able to sleep that soundly in the middle of a busy side walk. I thought at first may be he was sick, but once we got him awake, we realized he was ok. We gave him our food and he immediately started eating. It was just about more than we could handle. There are often children asking for money, but I hadn’t ever seen one sleeping in the middle of the side walk. I hadn’t seen any children sleeping on the street unless they were with their parents! Of course there are people who ask for money constantly, but this child seemed so alone it just broke our hearts. Just a few blocks away, the university students were yelling and running around because their new student president had been elected earlier in the day, and yet this child seemed to have nothing and no one.

Sorry for the terribly depressing stories, but it is what we are experiencing. Certainly we have many wonderful times here as well (such as getting to know the local people, seeing the amazing animals, and getting tan in the middle of March), but so many of the big differences are the heart wrenching things.

Again, it’s good to be back in Kampala and in touch with everyone we care about!

Until next time,

Katie

Mar 10

March 17, 2009

The last couple of days have been eventful, yet not at the same time. In keeping with African time, the doctor we were supposed to meet yesterday at 1, wasn’t at the hospital. Actually, she wasn’t even in the city and today told us she is never in the city on Mondays, yet she set up the time and day at which to meet us. Why she chose a day she wouldn’t be here has alluded us.

Instead of working in the hospital, we decided to take a morning nap, get a snack for lunch, and then check out the pool at a hotel. During our snack, a young girl (age 13) came up to us and pleasantly introduced herself and asked us to buy her a drink. It was obvious after a few minutes that she was mentally challenged. Interestingly, she has been one of the nicest strangers we’ve met! There was a man at the bakery as well whom Mary (the girl) was talking to, and she very seriously informed him that although we were white, we were humans just like them. He proceeded to tell her that Jon would probably want her (this little bit is rather disturbing). I didn’t hear this, but Jon did and got the feeling that the man was trying to warn Mary and so we wonder if she gets taken advantage of by men. Based on posters we’ve seen, cross generational sex is something the country is working to erradicate, so men also taking advantage of girls who are mentally challenged seems quite possible (and certainly it happens at home too). We hope we are wrong.

Mary seemed to be relatively well cared for and she goes to school and can read and her English was nearly perfect. After sharing a snack with her, she commented that our feet were so clean (they were really quite far from it!) and hers were so dirty because someone had stolen her shoes. We couldn’t exactly walk away without getting her some shoes, especially when they’re so easy to get. People practically line the streets selling shoes! So, we followed her to the shoes and made sure they fit well and that she liked them. She was so proud of her new (used) shoes! It was really quite cute and she definitely made our day!

After parting with Mary, we made our way to the pool where we swam in a bit of paradise. It was so nice to be in cool water and get some relief from the heat. Once refreshed, we went in search of food again but had to settle on good ‘ol rice and beans. We don’t really know where the good eats are here, so we pretty much stick to our hotel.

Today, we managed to find the doctor and learned she only works Tuesday through Thursday! Not really sure if there’s a doctor there the rest of the time, but our hunch is no. We sometimes wonder if we’re still missing something, but what we see is medical students who work really hard all day and read tons when they’re not on the wards and then doctors who seem to do very little.

Once all the introductions were made, we started rounds on the patients (pediatric ones). Two hours and 4 patients later, with around 8 to go, the doctor informed us she had to leave and would meet with us again at 2 for a lecture. We arrived at 2, waited until 3, and then left deciding to read about tropical medicine. :)

We’re not sure what the rest of the week will bring, but we’ll be sure to report back with both the exciting and mundane!

Katie


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