Mulago Hospital - The excitement begins!

After our weekend settling into Kampala it was time to finally hit the ward of Mulago Hospital for some more substantial time. During our first month in Uganda, while based in Entebbe, Cally, Ibby and I had visited the labour ward and special care baby unit on numerous occasions but I was yet to really get a feel for how things worked here and I was eager, if not slightly nervous about what I would be faced with. Without going into the gory details, visiting the labour ward for the first time was definitely not the kind of start I was hoping for. Poor Ibby, who is not medical and had never actually seen a baby being born (why would she at the grand old age of 23!), handled it amazingly. On walking into a room with maybe 30 women scattered amongst those delivering on beds and those waiting their turn on the floor and noticing that there was a woman about to give birth on the floor beside me (she made it onto a bed thank goodness) I realised that this was not the place for birthing partners, soft ocean music (yes some mothers bring this) and lovely cute baby balloons. Yes, the indignity of delivering in front of at least 29 other people out in the open is still quite confronting to me and for that reason as well as the fact that I have to walk around in there in my flipflops, I try to limit the need to head over to the labour ward if I don't absolutely need to! As for the baby unit,  we were still getting things prepared for the study and had not actually started recruiting any babies yet so I decided to join the staff on the unit and chip in for some ward work.

Mulago Hospital main entrance

The first thing that strikes any first time visitor to this ward I think, is probably the sheer number of babies there and it is easy to look around and wonder how anyone truly knows what is going on and who is doing what which each and every baby. It is sometimes the case of either freeze and feel overwhelmed by the apparent chaos or just crack on and get on with the work. During that first day, I definitely found myself at times doing both! For a Doctor trained elsewhere where resources like thermometers, scans, nasogastric tubes and even warm blankets are completely taken for granted, it takes quite the adjustment to realise what is feasible here and what you just have to do without. On starting to see some of these babies early on, I think I spent half my time examining them and the other half wrapping them up and trying to keep them warm! It has become a little bit of an obsession of mine here and perhaps in a way its because it feels good sometimes to do something simple like wrapping up a cold baby when you know that some of the more complex treatments are not going to be accessible for them.

A section of the baby unit - busy day!

To say that first day on the ward was the worst day in my career to date is definitely not an understatement but it is also not meant as a criticism of the staff or the ward itself. In the last 6 weeks, I have not even come close to experiencing another day like it so as bad luck would have had it it just didn't seem to be my day and definitely turned out to be a true baptism of fire! The feeling of helplessness was not something I am used to and something which now serves to remind me of exactly how lucky we are in the UK and Australia. I won't go into the awful details but lets just say it felt like life was somewhat cheaper here and the loss of one or on that day, multiple, felt all the more tragic because you knew that only a flight away, it needn't have happened. At times what made it worse too was that I could see the morale of the staff was affected. It has taken me a while to differentiate what can appear as indifference at times from perhaps just the belief that sometimes it is better not to go on trying when you feel a situation is hopeless. This I am sure is the case here at times for the very sick babies where all the treatments available have been exhausted and the only thing left to do is wait and see.



There are some lovely times on the ward too though! I would hate to give the impression that it is all doom and gloom as this is definitely not the case. Getting to know some of the staff here has made my time so memorable and I will definitely miss them a lot. Sister Margaret who runs the ward deserves a medal for the way she manages to control and steer what can sometimes only be described as utter chaos when the rate of babies coming into the unit far exceeds the ones discharging out of it. With babies literally sticking out into the aisles, on bench tops and on more than one occasion, in my arms due to lack of space, she seems to keep order and ensure the important things get done with the sort of calm that the sisters in charge at home could only imagine! The parents here too are amongst the most stoic that I have ever met. I am sure this is mostly to do with the fact that medicine here is still very much practised in a paternalistic way with the doctors and nurses telling the parents what they need to do, where they need to go and only occasionally, what is actually wrong with their baby. The priority is definitely not on easing the parents' fears and anxieties and for that reason I think parents just realise that they have to get on with it and do what they are told. The mothers, most of which hobble into the unit hours after giving birth are often expected to hang around the corridors all day without a bed of their own until their baby is ready for discharge. They never complain and seem so accepting of their circumstances. I was actually quite taken aback the first time I saw a mum openly weeping on the ward and I realised that mums and dads back home are really lucky for the support they get.

Dr Flavia and I on the ward

As my time here is almost over and in just a few weeks I will be back on the wards of London with equipment coming out of my ears, I know that having this experience will definitely change the way I look at my own job. I can't say I have come over here and learnt a huge amount of new clinical skills, except the ones related to the study that is, but i have definitely learnt a new appreciation for the way in which people practise medicine and manage with far less than we do.  Despite the ward working really hard under often difficult circumstances and limited resources, I do hope our time here has managed to have some positive influences and I hope that as I have learnt things from the staff and babies here, I hope that I have brought something positive in return, at worst it will be that babies need to be dry and warm warm warm!!!

Kampala, our new home!

Well, I am disappointed to report that my blogging has fallen away in recent weeks, but the good news is, it is not due to the fact that I have nothing to report but as a result of the last month or so being sooo action packed! Yes, Kampala has certainly brought many new experiences, both on the wards of Mulago hospital and in our spare time. I can't believe that my time here is nearly at an end, and because of this, I am going to try my best to write a blog per night for the next 4 nights to make up for all the recent weeks I have missed!

So, to get things started, after my amazing 4 weeks in Entebbe, the town that we fell in love with due to its relaxed atmosphere, lovely people and surprisingly good nightlife, we finally arrived in Kampala on August 1st. The thing that probably greets every new visitor to Kampala on their arrival, and which also seems to sum up the city perfectly, is the crazy crazy traffic. Turn off the engine, sit back and relax a while because you certainly are not going anywhere fast and if it weren't for Ugandans being on the whole such relaxed and patient people, I am not sure how the city would survive with such potential for road rage! Other obvious differences that I couldn't fail to notice immediately were the smog that sits calmly over the city giving it a lovely dusk type feeling 24 hours a day not to mention the vast number of people that live here and the chaotic neighbourhoods as you drive through. It definitely has that huge city feel and with that comes the promise of much new excitement!

Ibby with a hilariously small
shopping trolley at Garden City!

On arriving to our new guesthouse and settling into our slightly smaller than expected rooms, we went on to meet the land lady of the house, Rosette, a lovely woman with the most hilarious laugh which also doubles as our daily alarm clock as somehow, she always manages to be standing outside having some sort of amusing conversation at 7 in the morning. The great thing about Rosette is that she also takes the role of  everybody's surrogate mum and never ceases to check in on us to make sure we are all ok. So, after our few words of warning about how to not get robbed at night, Ibby and I headed off to the place that was to be our trusty social mecca for the next few months - Garden City Mall! After a trip to the cinemas and dinner and a drink at the trendy bar called Boda Boda (which would have been at home in any street in Soho), it was clear to us that Kampala was going to be nothing like the sleepy little town of Entebbe. Yes, definitely a little intimidating and not least because we were too scared to even hop on the back of a Boda to make the 1km journey home. As, with most things however, survival instincts soon gave way to convenience and even the death defying Bodas soon became part of our daily routine.

Crystal and I getting ready to hit the Kampala night scene!

If our first night was anything to go by, we new there would be plenty of fun bars to check out in Kampala however I wasn't quite prepared for the true extent of the social scene here. It seems that no matter what day of the week it is, be it a Saturday night or a Tuesday night, there will be a party going on somewhere with masses of Ugandans letting loose. Our first weekend was probably the best one we have had here, with Crystal, Vivienne and co showing us the best night spots Kampala had to offer. BBQ Lounge was this cool outdoor affair with hut-like bar and dance areas followed by Bubbles O'Learys, an Irish bar where the Ugandans seemed to love dancing to cheesy Brian Adams classics more than the foreigners did, and lastly Iguanas, probably my favourite drinking spot here and definitely the place to be at 4 in the morning, plus it has the added bonus of selling the best pork sticks (skewers) we have tasted, just ask Crystal, who could probably live on them she loves them so much!

Buying straight from the artist at the craft markets!

The rest of our first weekend here was spend wandering around town and getting our bearings. After numerous trips in from Entebbe to visit the hospital, I originally wondered how I would ever get to know this city, as it constantly felt like just a huge maze of dirt streets and unrecognisable buildings. After a few hours exploring however, it became clear that there was some method to the chaos, and that in time, I would eventually get to know my new home.

Entebbe, Entebbe, Entebbe!

Road outside our guesthouse

So, my last post was over 2 weeks ago now I am ashamed to say, but those two weeks have brought a lot of good times where I have fallen in love with Entebbe and finally discovered it's not so hidden nightlife!

Onto slightly more important things first, Cally, Ibby and myself have been working hard trying to get the study ready for recruitment in early July. In simplest terms, we are looking at newborns born with brain injury at Mulago hospital, the major hospital in Kampala and trying to identify risk factors for this among the population. It is a fairly prevalent problem at the hospital and in Africa in general so the research means that hopefully in the future, treatment might be targeted to prevent it occurring in such high numbers. We have still been visiting the ward every so often to commence staff training etc but I am really looking forward to getting stuck into it on a daily basis once recruitment starts. They have also asked me to come in and help out with actual work on the ward and in clinic with non-study babies which I am looking forward to as it will be a great experience for me and quite the eye-opener I am sure. On an added note, they actually have a set of conjoined twins on the ward which I have seen and are in all the papers here, such a rarity to see and they are absolutely gorgeous!

Walk back from the institute - look carefully, there is a little
monkey hiding behind me!

I have also started running which is about 3 weeks later than I hoped to but better late than never. To be honest, I have been trying to walk everywhere I can and just take boda bodas when I have shopping etc but it was still nice to start exercising properly. Still a little amazed at how much the weather seems to take it out of me though. Would love to continue blaming it on the altitude but after living in Uganda a month now, I feel I can't really use it as an excuse any longer. I think it is probably a combo of the heat, humidity and my lack of fitness, but after one jog of about 30 mins I felt like I had run a half marathon and the next day my legs barely lifted high enough off the ground to avoid tripping over. How pathetic!
I was hoping to find a really nice chilled route to run on but after an unfortunate experience a couple of weeks ago, I am sticking to my familiar route close to home which is fairly free of traffic and more importantly, too many people!
To briefly explain, it was suggested I take a nice long walk down towards the lake off the back of the guesthouse and circle back round towards the supermarket we go to. Unfortunately, Dave who recommended it didn't realise how populated the route had become in the years since he had walked it. Armed with my ipod, sunglasses and bright blue trainers (none of which you commonly see in Entebbe), I set off at probably the busiest time of the afternoon, when every school child is walking home, every worker is driving home and everyone else seems to be outside either washing, cooking or chatting. Picture an alien from another planet strolling around the street and this was approaching that level of curiosity for the entire hour of my walk! The young children, who always seem so excited to see foreigners around and constantly wave and call out to you are one thing but having hundreds of eyes watching as I went on my 'relaxing' stroll sort of pushed the boundaries of my comfort levels. All would have been fine and manageable had the young boda boda drivers not got a little too over-enthusiastic and grabbed my arm when I wouldn't stop and get a ride with them.  This sounds a lot worse than it was and I never actually felt threatened or in danger at any time but I soon quickened my pace, got out of there and learnt that walking as a lone, white female through heavily populated residential areas is not the cleverest of things to be doing! It was a shame really, as the walk itself was really cool and a great chance to get a glimpse of where and how the locals lived.

Julia's birthday with our new friends Jim, Patric and Crystal

Now onto the nightlife. After the weekend before which was a bit of a fizzle to be honest as none of us actually knew where anyone went for a night out, we were determined to find a good bar and dance-floor. Ibby and I had been asking various people around town, including our DVD guy Cliff and his friends, where the happening spots were, and after much discussion it was decided that there was a definite sequence of places to visit on a saturday night in Entebbe. This became our mission.

Knight Riderz during the day

It was Julia's birthday on the Saturday so after a lovely afternoon at Lake Vic hotel pool we all headed out to dinner before going to a bar called Red Roosters. We had met a group of Ugandans the weekend before who after finding out we would be out for Julia's birthday the following weekend, proceeded to invite themselves along for a bit of a party. These guys seemed really nice but I'm not sure any of us actually thought they might be there at the bar waiting for us, especially since they all lived in Kampala - the capital, an hour's drive away! But, as we all walked into Red Roosters, we were met by the group of Jim, Patric and a couple of others who had even bought, wrapped and written a card for Julia's birthday! This pretty much sums up the Ugandans we have met so far to a tea; really friendly people who just love meeting new people and embracing them into their culture. So a few drinks and shots later, we headed to the happening night spot or 'discoteque' as they are called here, Knight Riderz! I know, sounds like a dodgy strip club or something but it is just a local Entebbe club which plays cool music and if you can handle the odd prostitute hanging around, then it is actually a pretty fun night out. We were treated to the dancing prowess of Patric for the night who dances better than any guy I have ever met, the hilarity of Crystal who we met that night at Roosters and is able to chat the ear off a donkey and the protective nature of Jim who was there when some locals got a little too excited about having foreign girls there at the bar! For our first proper night out on the town, it was definitely a success and one we were to repeat the following weekend.

Ibby on the main road into town

Our last couple of weeks in Entebbe have utterly flown by but our experiences have made it very hard to leave indeed. Just as we have become really comfortable here, we have had to move to Kampala in preparation for the daily work at the hospital. Ibby and I have certainly racked up the kilometres in walking around town and have tried to sample as much of Entebbe as we can before leaving.
I am now on a first name basis with Cliff, the DVD guy as we call him, who appears to be a university student by day and a DVD store by, well, by day too! Not quite sure how he manages it but he has single handedly kept Ibby and I amused at night by getting us any movie or tv show our heart desires to watch. He was so sad to lose his best customers, we are now friends on facebook!

Market day!

I also finally got to visit the Tuesday night markets one week with Francis and Julia before they headed back to the UK. These markets are actually more for the locals I think and less for the tourists as you can seemingly get anything from fresh vegetables, to toiletries, underwear, cloth, clothing and the biggest array of second hand shoes I have ever seen. I would love to know where all these shoes come from but you can pretty much find anything from second hand suit shoes, to flip-flops with Barrack Obama's face on them. I resisted the temptation to buy Obama shoes but instead bought two really cute table cloths for my new flat in London!

Ibby Crystal and I at Knight Riderz

Other Entebbe favourites are definitely some of the restaurants we have been to during the last week. The Boma, a cute little guesthouse which you almost miss, made really lovely food and the bonus was that it arrived within the hour, somewhat of a rarity in Entebbe as no-one seems to be in too much of a rush (not a bad thing). The only downer to that meal was one of the guys who joined us from the weekend before who invited himself to dinner, ordered a large Pork Chop and then sat there expecting us three girls to pay for him - talk about awkward, the guy plays national rugby and has a full-time job! Rude! Another restaurant that we absolutely loved was called Phase 3 which we wish we hadn't discovered on our last night as it was awesome. Big enough for two restaurants, the food was great and Ibby finally got to have her Goat curry which was amazing! The last little gem was down by the beach called Goretti's, which makes really nice pizzas and you can sit on the sand. What would make it perfect is if you could actually swim in the water after your lunch but unfortunately its not possible due to the risk of picking up one of the water parasites!

Crystal and I living it up!

Our final send-off in Entebbe was really nice actually and proved to us why we love the place and the people there so much. After dinner at Phase 3, we caught our last Boda Boda together and hit up Red Rooster. We met up with our friend Vivienne who we first met the saturday night before as well as Crystal and some American guys who were also out the sat night before and provided a very funny day at the pool the following Sunday. You are probably realising that Entebbe is a pretty small place and you tend to keep bumping into the same people which makes meeting everyone really easy. For our last night we played endless games of pool and hit the dancefloor. I was the Queen of my pool table for 5 straight games until I unceremoniously lost to Nate! Another unexpectedly fun night out and the reason that Entebbe will be sorely missed.

Dave, Celestine, Ibby Me and Vivienne at Red Roosters

Ibby, myself and Edie by the pool

For my final morning on Friday, after packing up my things, I enjoyed my last couple of hours lying by the Lake Vic Hotel pool. Ibby and I bundled our mountain of luggage into the taxi and departed for our hour long journey into Kampala where everything and anything seemingly awaits. It wasn't long before our clean lake air and laid back atmosphere was replaced by the thick smog and rammed traffic in the capital, but that is a whole other post! I have a phonebook full of new friends and many awesome memories of this lovely little place.

See you Entebbe, hope to be back very soon! xx

Getting to know some new friends....

Well, two weeks into my trip and I feel like I've been here a month! The days here feel so long and relaxed and I am starting to feel a lot more settled in.  I now have a pretty firm grasp of where everything is around town and quite enjoy exploring new places to buy this and that, including a DVD guy who can pretty much get you any season of any show you could imagine for about 80p! Entebbe really is a lovely small place with only a few major roads so everything is close by and within walking distance.

Since my last post I have been on my first boda-boda ride (motorbike) which is the easiest form of transport around town and despite my earlier fears I am now a huge fan. I even got to go with Cally's girls on their first ride - Isla with me and Edie with Cally which was absolutely hilarious! The drivers here are great and for 40p to get anywhere I want to go - the price can't be beat! I have heard the same cannot be said for the capital city of Kampala where you take your life into your hands just by getting on one so I am certainly going to make the most of them here in Entebbe. Last weekend I actually spotted a family of 6 packed onto one - 3 children, 2 parents and a baby! - unfortunately no photo but definitely the record so far.

Guide showing us what not to do with the local spiders

Lucky for me, since I arrived here there have been two public holidays creating lovely three day weekends. During the first holiday I met up with a couple of girls over from Scotland who are also working at the institute and we checked out the Botanical Gardens here. We walked around with a local guide who I think was a virology student? and who pretty much knew everything there was to know about the plants and wildlife of the gardens. We laid eyes on everything from huge spiders with scarily hard -to-see webs, to enormous lizards and different varieties of monkeys. Apparently the old Tarzan movie was filmed in the gardens decades ago too and there were still structures left from the set which was pretty cool. Our guide also took us through the medicinal plant gardens which was really interesting and good to know if I get stranded somewhere and need a remedy for Malaria!

Greedy but so adorable!!

Definitely the highlight for me however was feeding the little monkeys in the gardens. These monkeys were so curious and friendly and our guide supplied us with some chapati to feed them with. I couldn't get over how gently they took the food from me and how soft and human-like their little hands were! I could have just sat there for hours watching the baby ones wrestle with each other and managed to capture a very cute video of this. Weirdly, the males have bright blue balls and so I apologise for including the photo but it gives another meaning to the phrase 'blue balls' and must be seen to be believed! So... after our 2 hour guided walk we had the discomfort of our guide trying to charge us well over the going rate which threatened to put a dampener on the afternoon but we compromised in the middle somewhere and it was all good in the end - bit of a lesson for me though not to be such a push-over!
That night I headed into town with Nicky who was staying with me at the guest house, and we went to a lovely restaurant at a hotel called the Gately. Really nice food and chilled atmosphere we then attempted to head somewhere for a drink being my first Saturday night here but unfortunately the bar we chose was pretty dead so after a gin and bitter lemon (my new drink here as Gin is their specialty) I was back home by 10pm - I know, what a party animal.

The rest of the weekend was spent at this gorgeous hotel pool called the Lake Victoria Hotel, which has become my little oasis when I need a break from the heat and to work on the tan! Plus I get to go on little adventures around the grounds with Edie on my back who insists that all our routes are strictly top secret and 'sneaky sneaky' so that is all I can say on that matter! The pool is in the middle of town and gets swamped on weekends but it is a fantastic place to come and relax, have a drink by the pool and even listen to complaining tourists talk about how nothing works how they want it too here blah blah blah.....where do they think they are? If anything, the fact that things take a little longer in Uganda compared to home is having a positive effect on me in that I am learning to just chill and go with the flow more.

I have also finally made it into Kampala a few times to visit the hospital where we will be conducting the study. Its called Mulago Hospital - a large government hospital in the centre of town. The baby unit where I will be working on the study is a fairly small area when you look at the number of babies they are looking after. It seems to be wall to wall babies in little metal cots which make me feel very lucky to have what we have in Australia and the UK. Obviously the available equipment and resources does not compare but they seem to run a pretty tight ship with what they have and I am looking forward to when we will be really up and running with the study on the unit. We are working hard getting all the final preparations ready to start the work and I am glad that I am here to contribute to all this as learning about the preparation is just as if not more important than the actual study work!

I haven't seen much else of actual Kampala yet but I have decided to move there from Entebbe to live on the first of July when Cally and her family move there too so there will be plenty of time to check it all out. Myself and Ibby, who is also here working on Cally's project, are going to live in the hospital guest house which looks pretty nice and will be perfect for work.

Edie and her yoghurt moustache!

And last but not least, this post would not quite be complete without a mention of out first 'big night out' in Entebbe last weekend. Myself, Ibby, Maron who was staying at our guesthouse and Francis and Julia the two Scottish students all headed out for dinner and drinks on Sat night. None of us having any idea where the happening spots were in Entebbe, we had a lovely dinner before heading to the one bar that seems to be mentioned by everyone and is a little notorious for having 'ladies of the night' there!  After sitting down at a table for little more than 2 minutes we already had some young Russian guy put a full bottle of Gin on the table with 3 bottles of coke - not a bad start. Not quite sure what to do with it, we drank the cokes, left the Gin and ordered some Vodka instead- which again came as a small bottle of Smirnoff placed on the table for us to pour as we liked - these Ugandans certainly know how to unwind! Well, the Four Turkeys as the bar was called wasn't the most amazing place I've ever had a drink in but it was definitely up there with the most interesting. The next day at the pool we met some American guys who set us straight on the happening night spots to visit and where to go to have a boogie so we are putting that down as our test run and next Saturday for Julia's birthday, we will try our luck a second time!

I told you they were blue!

So, as my tan is slightly progressing and my knowledge of Entebbe deepening somewhat,  I find myself becoming quite enamoured with the laid back attitudes! Plus, I have discovered a love for Chapati and not sure how I have ever lived without it!

Till next time....

Arriving in Africa

Well, it has finally happened, I have arrived in beautiful Uganda. With no expectations on what I would find, I nervously stepped off the aeroplane to this amazing smell! The smell of grass and trees was everywhere and what a fantastic contrast to London. I have a good feeling about this place already.

Watching everyone in the Immigration queue, it was a mixture of local Ugandans returning home, foreign businessmen and American students who I think are here to volunteer.
I was met at the airport by Richard who drove me to the guesthouse in Entebbe where I am living. The people are really friendly and at 8.30am it was already beautifully sunny and warm!

Driving from the airport to Entebbe, we passed a large UN base and then as we entered the town of Entebbe I was amazed at how green and spread out it was. Entebbe has about 100,000 people and seems to be a really relaxed little place. On the way to the guesthouse, we also passed the President of Uganda's house which was pretty cool.

The first day here I just settled into my room (which is really comfy) and chilled until I met up with Cally, whose research project I am here working on, later on in the day. Cally lives in a house with her family next door so I spent the first night with them before crashing into bed!

The last couple of days have been nice just settling in. I visited Cally's girls UN school which is pretty awesome and the security everywhere is quite incredible. I guess there have been security threats in Uganda and against the UN in recent years and so on driving into the school and even the shopping centre near it, they inspect underneath your vehicle with mirrors! Also, every compound and foreigner's house is fenced with a security person that sits on the gate all night.  I think most of it is for show as a deterrent and less because there is any real threat of violence here, but still, I have slept easier at night because of it.

Isla walking Honey with me around our neighbourhood!

Cally has a dog here called Honey who I have taken for a walk a couple of times around the block with her daughter Isla. The locals are all really inquisitive and all of them either wave to you or say hi and ask how you are when you pass them. On my walk I look over a big field where loads of young boys are playing football on a daily basis with hilarious random cows just dotted around the field surrounding them. I have managed to get sunburnt already which was partly probably my stupidity in forgetting how close I am to the equator and possibly my anti-malaria pills so will have to be way more careful!



Today is a public holiday in Uganda (think it is called Martyr's day) so I have a nice long weekend to look forward to. Heading to a local hotel today with Cally and her family to sit by the pool and chill. Her girls are absolutely gorgeous and real fun to hang out with - at the grand old ages of 3 and 6!

All in all, a pretty great first few days here. First impressions of Uganda are that the people are among the smiliest and friendliest people I have ever met, the weather is amazing and there seems to be plenty to see and do. Hope to explore Entebbe a little more this weekend and will venture into the capital Kampala next week for the first time so will keep you posted!

xx