Malnutrition, and fearless number two’s:
Door: Oscar
Blijf op de hoogte en volg Oscar
21 Juli 2013 | Oeganda, Kampala
Allright, this one is gonna be in English, to keep more people up to date;)
Oli otyas mzungu’s! (How are you, rich white people). After a 12 hour flight I arrived at Entebbe airport, where I was I bit scared for customs: My yellow fever inoculation had not yet kicked in…. After not even being asked for my vaccination’s, paying the way cheaper student visa (20 USD) and receiving a total unreadable visa, first thing I did was get some cash from the ATM, first time (and just for my time in Uganda ) I felt like a millionaire: MAXIMUM WITHDRAWAL AMOUNT: 2.000.000 Ush!
Don’t start asking me for money now, I’m still as poor as before:P! 1 euro is about 3300 Ugandan Shillings (1USD-2500Ush). At the trip to the hostel the driver told me some prices for the touristy stuff in Uganda (which ended up to be totally off), which made me change my expectations extremely: where I thought Gorilla Tracking would take me somewhere in the hundreds, apparently it was 3000 euro’s… (although it wasn’t that high in the end, I still can’t afford itXD).
Arriving at the hostel, I had some trouble getting in, one of the guys running the house Nasser(amazing dancer by the way), fell asleep twice after calling him to open up the gate. By the time I got into a room it was 6 am, so off to bed… 10 am I got kicked out again because apparently I had a tour of the hospital by one of the students (a Ugandan named Edrin, who spoke fluent German?!). In the evening I met up with the rest of the students in the hostel (Edge House), an amazing group of international students (from Sweden to Canada), who made it feel like home right away (first night I immediately got invited out to dinner, where the topics got a little crazy(made me fit in even more of course)).
Monday it was time for the big leap of faith, onto the hospital (thirty minute walk, with huge scary birds in the trees) into the Malnutrition Unit: Mwanumugimu(took me about a week to pronounce it correctly). The structure was as follows: In the “morning” from 9:30 onwards there are ward rounds, starting at the most critical stages: resuscitation room’s where most children are in need of oxygen and have major complications(later on I would find out that about 30% of children in there wouldn’t make it out of the hospital), after that comes P(hase)1, the stabilisation phase, here children have just been admitted, may have some minor complications and the main point is to get them complaint free (no diarrhea, edema, vomiting, infections)to the next phase: P2, the rehabilitation phase, when they arrive here the prognosis is hugely improved and the main goal in this phase is to get them to a weight to reach: calculated per age or from the lowest weight. Although of course the children are very sick, and it is quite a shock so see children in such malnourished states (especially when the mother has quite the sturdy figure), the ward was actually really nicely decorated, Disney figurines everywhere and all the children in rehabilitation are up for some tossing around and there’s already some more laughter again. The resuscitation room was the opposite of course, the colorful murals weren’t hardly enough to brighten up that place, it wasn’t just the ribs you could count in the children but pretty much every bone and most of them were gasping for are constantly and were on oxygen (for which the supply could be faulty sometimes), but it did make it all the merrier when you could get them to P1 and to P2 within the week and you can actually hear them singing, and calling you Mzungu with a big smile on their face.
Another thing that really amazed me was the knowledge of the doctors, where in the Netherlands we mostly just ask a lot of laboratory tests, the only test that almost every child with fever gets is a bloodslide for malaria. The rest is done on history taking and the examination and a very little amount of diagnostics. The best parts of week where when the senior staff showed up: you basically got a mini lecture on every patient (and you see the junior staff, who makes you feel like an idiot, getting plowed by the professor:P), and it just felt they got the diagnosis from just one look (vitamin D deficiency because of a minor ribdeformation?!). Where the clinical skills are still another level for me, the patient/care-taker interaction was of a bit lower standard: Mother’s get insulted that they are not feeding their child well, when an hour later it turns out the scale was just faulty… Where the language barrier was a huge gap for me, I think the pronunciation and volume where an even bigger problem. The English is a bit different (acute becomes aschute, diarrhea- dieeria) but the volume is so low that I thought finally all the partying had destroyed my eardrums, but in the end everybody had this problem. The crazy part is that the patients and doctor actually understand each-others mumbling even from across the room, where just going like what all the time and actually thought about getting a hearing aid, later I found out that there is a relationship between the degree of education and the volume: the mothers were really un-understandable, and the professors actually speak a lot louder than me (idea for a study?? Socio-economic verbal volume?). The first day at two we finished the ward rounds, so before we went to lunch we asked the nurses and doctors what time we should be back and what we could do in the afternoon, we got the following reply: “Well, you should probably rest a little bit after lunch, because you don’t want to be tired at 16:30”…. OK… So to actually do some more stuff we showed up at 8 the next morning to weigh the children :P. The interns here have pretty crazy hours though, they have to show up at 9 in the morning and when they have night shift they spent 24 hours at the hospital.
The rest of the week went by quite fast: weighing children, taking blood from the femoral vein in children while the mother is pinning them down(quite an experience, especially when you’ve never done it before…), lunches at the good Samaritan canteen and Luganda lessons in the afternoon (slowest lectures I’ve ever had…), and with the knowledge of some words trying to take my first histories from the mothers.
The supermarket here is not that cheap as I had hoped (euroshopper is cheaper:P), but when you buy your stuff in the streets it is dirt-cheap, mango’s for 15 cts, watermelon (big one) for 1,50 euro, and I’m guessing Mzungu get a lot shittier deals than locals. Because of the long hair and beard I got mistaken for Jesus a lot of the time but it took me about two weeks before I got someone to get me discount because of that (Free mango hell yeah!).
On Wednesday there was a cultural show organized for us (called Ndere, double consonants everywhere here): mostly traditional dance and music, but after a while a comedian showed up on stage: everybody had quite low expectations when he first started, but he turned that around within ten minutes and had the whole crowd going.
On Tuesday some of the girls at the house invited me to go on Safari at Murchison Falls on the Friday, a bit hesitant at first to take a day of on my first week, I just called in sick on Friday… Hey don’t judge! I might only be in Africa once.
So last beers on Thursday evening, an evening where some pretty weird confessions came out (from dating people twice your age, to having an affair with a woman with two children, dating your mother in law, and having sex with ten girls (no not at once, but this guy was just really proud of itXD)), and one person who kept stealing my headphones, yes Ivan I’m talking about you.
In the morning on Friday it was Safari time. After waiting a bit too long for the driver to show up we almost got in the wrong car, who was picking up other people to go rafting. Fortunately the car was too small so we figured it was the bus on the other side of the road. Our driver Robert was a little bit off, but he seemed ok. The first day was mostly getting there, but on the way there the driver told us that we DEFINETELY needed three liters of water per person and hats, so after making a lot of unnecessary stops (he probably knew the people from the shops and got some commissions if we bought something WHICH WE DIDN”T Muhahaha), we got to Murchison Falls National Park. We first got a guided tour to the top of the Falls, this is apparently what we needed the three liters of water for: a 40 minute stroll. We got an awesome natural shower from the water splashing up at the Falls and some awesome views (and pictures:D). Pretty soon we found out that the girl from the UK was the best photographer, so sorry Rosie but I’m stealing some pictures from you:P.
After the tour, we got some very tasty pineapple from our driver before we arrived at the Red Chili Campsite. Here you are welcomed by a group of bones, and some live warthogs who seemed to be having some trouble keeping their huge head up (apparently a great delicatesse, not on the menu though). After receiving a bit tasteless pasta (fixed with a lot of ketchup), time for beers: and a nice Jesus picture: last supper style. We got some very “useful” tips from Robbert how to deal with the animals the day after: “When you see a Buffalo and it takes three steps back, it wants to charge you. So you do what?? You take three steps toward him, Howevah, he takes three steps again, so you take three steps again” he kept going like that for about an hour, with some really not-funny jokes, but making fun of him did get some laughs out there:P Exhausted from the journey on to bed, because in the morning it’s time for the game drive: the actual safari.
We took a ferry across the Nile to get to the animals, here we met George of the Jungle: our safari guide. This really was the best guide we could have asked for, at first it seemed at bit weird, because he was pretending to call a Giraffe: “Hey mistah Giraffe I’ve got some friends here who like to see you can you please come out?” but then 3 minutes later we saw a giraffeXD. After five minutes our abs were just painful from laughing with George: Hello mister warthog you look nice today… although you’re butt-ugly!
Soon after that I got a really nice experience with a lion. The food didn’t seem that good at Red Chili, and I got to find out the hard way: about halfway along the Safari we saw a van standing still in front of us; apparently they were taking pics of lion!! So we got over there as quickly as possible, at this point I felt my stomach starting to rumble… When we saw the lion of course we had to get some pictures there, at this point there were about 5 full vans there of tourists… At this point I actually couldn’t hold it anymore, the lion just crossed the road five minutes ago and a I jumped to the driver: “I’m sorry I really can’t hold it anymore, I need to take a dump now, can I get out of the van” “Yeah sure just go with George” So about 30 people see me sprinting out of the van with a roll of toilet paper jumping into the bush from which the lion just prowled out… Fastest shit I took all my life.
After that we went on to the Hippo’s, great that we had George with us again, this guy could make such a genuine Hippo sound he actually got responses from the Hippo PoolXD. Of course we tried but total silence after.
In the afternoon we had to say goodbye to George after seeing some more warthogs, monkeys, a lot of Ugandan Kobs, antilopes, heartbeast and elephants. And it was time for a cruise on the Nile: the beer is called Nile Special, so we actually got to drink Nile on the Nile:P Mostly Hippo’s during the trip, a lot of birds and an amazing view from the bottom of the powerful Falls.
At dinner we met some amazing people again: Katja from Germany, who did a project with chimps on an Island in Victoria Lake (great chimp impressions) and Joe a teacher from the UK with a daughter in Law in Uganda, who was in Africa for the first time (his son had been living here for twenty years).
The day after we already had to head back to Edge House, because work started again on Monday for most of us.
The second week we got to do a lot more on the ward, and it felt a lot more doctor:P. The Luganda knowledge increased, and I was able to see some patients without a translator. The week went by quite fast, with a big party on Wednesday because on of the guys was leaving (Peter, an almost dr. from Germany), where I met one of the pediatric surgeons and was able to arrange a rotation (Hell Yeah!!). An HIV outreach on Thursday, with a big tour of the Ugandan slums: not really medical but a lot of fun with a pack of about twenty kids running around you chanting : “Mzungu, Mzungu, Mzungu!” and turning around your hands and not understanding why the palms are the same colour as the back:P. On Friday it was the last day on Malnutrition, and the week after I made a start on Acute Care, but that’s for the next report.
Thanx for reading and I hope I get to post the next on a bit sooner (a bit shitty internet here:P)
Grtz Fake-Jesus
Oli otyas mzungu’s! (How are you, rich white people). After a 12 hour flight I arrived at Entebbe airport, where I was I bit scared for customs: My yellow fever inoculation had not yet kicked in…. After not even being asked for my vaccination’s, paying the way cheaper student visa (20 USD) and receiving a total unreadable visa, first thing I did was get some cash from the ATM, first time (and just for my time in Uganda ) I felt like a millionaire: MAXIMUM WITHDRAWAL AMOUNT: 2.000.000 Ush!
Don’t start asking me for money now, I’m still as poor as before:P! 1 euro is about 3300 Ugandan Shillings (1USD-2500Ush). At the trip to the hostel the driver told me some prices for the touristy stuff in Uganda (which ended up to be totally off), which made me change my expectations extremely: where I thought Gorilla Tracking would take me somewhere in the hundreds, apparently it was 3000 euro’s… (although it wasn’t that high in the end, I still can’t afford itXD).
Arriving at the hostel, I had some trouble getting in, one of the guys running the house Nasser(amazing dancer by the way), fell asleep twice after calling him to open up the gate. By the time I got into a room it was 6 am, so off to bed… 10 am I got kicked out again because apparently I had a tour of the hospital by one of the students (a Ugandan named Edrin, who spoke fluent German?!). In the evening I met up with the rest of the students in the hostel (Edge House), an amazing group of international students (from Sweden to Canada), who made it feel like home right away (first night I immediately got invited out to dinner, where the topics got a little crazy(made me fit in even more of course)).
Monday it was time for the big leap of faith, onto the hospital (thirty minute walk, with huge scary birds in the trees) into the Malnutrition Unit: Mwanumugimu(took me about a week to pronounce it correctly). The structure was as follows: In the “morning” from 9:30 onwards there are ward rounds, starting at the most critical stages: resuscitation room’s where most children are in need of oxygen and have major complications(later on I would find out that about 30% of children in there wouldn’t make it out of the hospital), after that comes P(hase)1, the stabilisation phase, here children have just been admitted, may have some minor complications and the main point is to get them complaint free (no diarrhea, edema, vomiting, infections)to the next phase: P2, the rehabilitation phase, when they arrive here the prognosis is hugely improved and the main goal in this phase is to get them to a weight to reach: calculated per age or from the lowest weight. Although of course the children are very sick, and it is quite a shock so see children in such malnourished states (especially when the mother has quite the sturdy figure), the ward was actually really nicely decorated, Disney figurines everywhere and all the children in rehabilitation are up for some tossing around and there’s already some more laughter again. The resuscitation room was the opposite of course, the colorful murals weren’t hardly enough to brighten up that place, it wasn’t just the ribs you could count in the children but pretty much every bone and most of them were gasping for are constantly and were on oxygen (for which the supply could be faulty sometimes), but it did make it all the merrier when you could get them to P1 and to P2 within the week and you can actually hear them singing, and calling you Mzungu with a big smile on their face.
Another thing that really amazed me was the knowledge of the doctors, where in the Netherlands we mostly just ask a lot of laboratory tests, the only test that almost every child with fever gets is a bloodslide for malaria. The rest is done on history taking and the examination and a very little amount of diagnostics. The best parts of week where when the senior staff showed up: you basically got a mini lecture on every patient (and you see the junior staff, who makes you feel like an idiot, getting plowed by the professor:P), and it just felt they got the diagnosis from just one look (vitamin D deficiency because of a minor ribdeformation?!). Where the clinical skills are still another level for me, the patient/care-taker interaction was of a bit lower standard: Mother’s get insulted that they are not feeding their child well, when an hour later it turns out the scale was just faulty… Where the language barrier was a huge gap for me, I think the pronunciation and volume where an even bigger problem. The English is a bit different (acute becomes aschute, diarrhea- dieeria) but the volume is so low that I thought finally all the partying had destroyed my eardrums, but in the end everybody had this problem. The crazy part is that the patients and doctor actually understand each-others mumbling even from across the room, where just going like what all the time and actually thought about getting a hearing aid, later I found out that there is a relationship between the degree of education and the volume: the mothers were really un-understandable, and the professors actually speak a lot louder than me (idea for a study?? Socio-economic verbal volume?). The first day at two we finished the ward rounds, so before we went to lunch we asked the nurses and doctors what time we should be back and what we could do in the afternoon, we got the following reply: “Well, you should probably rest a little bit after lunch, because you don’t want to be tired at 16:30”…. OK… So to actually do some more stuff we showed up at 8 the next morning to weigh the children :P. The interns here have pretty crazy hours though, they have to show up at 9 in the morning and when they have night shift they spent 24 hours at the hospital.
The rest of the week went by quite fast: weighing children, taking blood from the femoral vein in children while the mother is pinning them down(quite an experience, especially when you’ve never done it before…), lunches at the good Samaritan canteen and Luganda lessons in the afternoon (slowest lectures I’ve ever had…), and with the knowledge of some words trying to take my first histories from the mothers.
The supermarket here is not that cheap as I had hoped (euroshopper is cheaper:P), but when you buy your stuff in the streets it is dirt-cheap, mango’s for 15 cts, watermelon (big one) for 1,50 euro, and I’m guessing Mzungu get a lot shittier deals than locals. Because of the long hair and beard I got mistaken for Jesus a lot of the time but it took me about two weeks before I got someone to get me discount because of that (Free mango hell yeah!).
On Wednesday there was a cultural show organized for us (called Ndere, double consonants everywhere here): mostly traditional dance and music, but after a while a comedian showed up on stage: everybody had quite low expectations when he first started, but he turned that around within ten minutes and had the whole crowd going.
On Tuesday some of the girls at the house invited me to go on Safari at Murchison Falls on the Friday, a bit hesitant at first to take a day of on my first week, I just called in sick on Friday… Hey don’t judge! I might only be in Africa once.
So last beers on Thursday evening, an evening where some pretty weird confessions came out (from dating people twice your age, to having an affair with a woman with two children, dating your mother in law, and having sex with ten girls (no not at once, but this guy was just really proud of itXD)), and one person who kept stealing my headphones, yes Ivan I’m talking about you.
In the morning on Friday it was Safari time. After waiting a bit too long for the driver to show up we almost got in the wrong car, who was picking up other people to go rafting. Fortunately the car was too small so we figured it was the bus on the other side of the road. Our driver Robert was a little bit off, but he seemed ok. The first day was mostly getting there, but on the way there the driver told us that we DEFINETELY needed three liters of water per person and hats, so after making a lot of unnecessary stops (he probably knew the people from the shops and got some commissions if we bought something WHICH WE DIDN”T Muhahaha), we got to Murchison Falls National Park. We first got a guided tour to the top of the Falls, this is apparently what we needed the three liters of water for: a 40 minute stroll. We got an awesome natural shower from the water splashing up at the Falls and some awesome views (and pictures:D). Pretty soon we found out that the girl from the UK was the best photographer, so sorry Rosie but I’m stealing some pictures from you:P.
After the tour, we got some very tasty pineapple from our driver before we arrived at the Red Chili Campsite. Here you are welcomed by a group of bones, and some live warthogs who seemed to be having some trouble keeping their huge head up (apparently a great delicatesse, not on the menu though). After receiving a bit tasteless pasta (fixed with a lot of ketchup), time for beers: and a nice Jesus picture: last supper style. We got some very “useful” tips from Robbert how to deal with the animals the day after: “When you see a Buffalo and it takes three steps back, it wants to charge you. So you do what?? You take three steps toward him, Howevah, he takes three steps again, so you take three steps again” he kept going like that for about an hour, with some really not-funny jokes, but making fun of him did get some laughs out there:P Exhausted from the journey on to bed, because in the morning it’s time for the game drive: the actual safari.
We took a ferry across the Nile to get to the animals, here we met George of the Jungle: our safari guide. This really was the best guide we could have asked for, at first it seemed at bit weird, because he was pretending to call a Giraffe: “Hey mistah Giraffe I’ve got some friends here who like to see you can you please come out?” but then 3 minutes later we saw a giraffeXD. After five minutes our abs were just painful from laughing with George: Hello mister warthog you look nice today… although you’re butt-ugly!
Soon after that I got a really nice experience with a lion. The food didn’t seem that good at Red Chili, and I got to find out the hard way: about halfway along the Safari we saw a van standing still in front of us; apparently they were taking pics of lion!! So we got over there as quickly as possible, at this point I felt my stomach starting to rumble… When we saw the lion of course we had to get some pictures there, at this point there were about 5 full vans there of tourists… At this point I actually couldn’t hold it anymore, the lion just crossed the road five minutes ago and a I jumped to the driver: “I’m sorry I really can’t hold it anymore, I need to take a dump now, can I get out of the van” “Yeah sure just go with George” So about 30 people see me sprinting out of the van with a roll of toilet paper jumping into the bush from which the lion just prowled out… Fastest shit I took all my life.
After that we went on to the Hippo’s, great that we had George with us again, this guy could make such a genuine Hippo sound he actually got responses from the Hippo PoolXD. Of course we tried but total silence after.
In the afternoon we had to say goodbye to George after seeing some more warthogs, monkeys, a lot of Ugandan Kobs, antilopes, heartbeast and elephants. And it was time for a cruise on the Nile: the beer is called Nile Special, so we actually got to drink Nile on the Nile:P Mostly Hippo’s during the trip, a lot of birds and an amazing view from the bottom of the powerful Falls.
At dinner we met some amazing people again: Katja from Germany, who did a project with chimps on an Island in Victoria Lake (great chimp impressions) and Joe a teacher from the UK with a daughter in Law in Uganda, who was in Africa for the first time (his son had been living here for twenty years).
The day after we already had to head back to Edge House, because work started again on Monday for most of us.
The second week we got to do a lot more on the ward, and it felt a lot more doctor:P. The Luganda knowledge increased, and I was able to see some patients without a translator. The week went by quite fast, with a big party on Wednesday because on of the guys was leaving (Peter, an almost dr. from Germany), where I met one of the pediatric surgeons and was able to arrange a rotation (Hell Yeah!!). An HIV outreach on Thursday, with a big tour of the Ugandan slums: not really medical but a lot of fun with a pack of about twenty kids running around you chanting : “Mzungu, Mzungu, Mzungu!” and turning around your hands and not understanding why the palms are the same colour as the back:P. On Friday it was the last day on Malnutrition, and the week after I made a start on Acute Care, but that’s for the next report.
Thanx for reading and I hope I get to post the next on a bit sooner (a bit shitty internet here:P)
Grtz Fake-Jesus
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