This is my first blog for a couple of days as we have had major problems with the internet connections. Whilst the power might be on and you have paid for a connection with your 'dongle' there is no guarantee that you will make the connection, which is a bit frustrating to say the least.I’m getting used to the cold shower now; I seem to have found a way to gradually work through it. The worst bit of a cold shower is when the water hits your back between your shoulder blades and around the small of your back. Brrrr.... As the water comes directly down from the shower head, my solution is to stand out of the water stream and wash my hair so that my head gets used to the temperature. When I’ve finished with that I was the rest of my body and gradually stand further under the stream of water until I’m fully under the water - it’s not so bad – try it sometime!
The electricity has been on most evenings. It gets dark at about 6.30 pm and the electricity comes on at about 7pm. If we are lucky it stays on until sun up in the morning, otherwise it can go off at any time. There is a massive project underway in Uganda to replace the electrical network (poles and wiring). As this is being worked on during the day the power is shut off. There is also a rotating power share where regions of the country are shut down in turn as there is not enough power for the demand. This makes it very difficult to use computers to support staff in the work that they do, very often if something needs to be done on a computer it will mean doing it late at night and in the workplace if people do not have facilities at home to use a computer.
Our location for the clinic was a house at a crossroads. The road was a mud track with very large potholes in it, and the houses were made out of baked mud bricks with a mud floor. I didn’t feel comfortable asking to take photographs at this stage – I want to be a bit more established before I ask to do this although in a discussion about photographs afterwards I was advised that actually most people like being asked to be in a photograph, so will try to get some next time.
On Friday, I joined the community outreach team to go out and do vaccinations and HIV testing in the community. As there was only one vehicle available (due to breakdown) the community team shared a ride in a pickup truck with some workers on one child relocation projects. This meant we were 8 people and the driver in a pickup truck meant for 2 in the front and 3 in the back. Needless to say some of us were sitting in the back in the open air. We agreed we would swap over for the way back which is when it should have been my turn but it was raining so we all squeezed into the truck except one of the men!!! I was very glad I didn’t have to sit out in the rain.
Our location for the clinic was a house at a crossroads. The road was a mud track with very large potholes in it, and the houses were made out of baked mud bricks with a mud floor. I didn’t feel comfortable asking to take photographs at this stage – I want to be a bit more established before I ask to do this although in a discussion about photographs afterwards I was advised that actually most people like being asked to be in a photograph, so will try to get some next time.
The session started with health promotion information which tells those present what an HIV test means and what it means to be positive or negative. There is also a lot of information about family planning and trying to encourage families to reduce the number of children that they have. This message is particularly important for the poorest families as there is not enough food for everyone. However many of the men still have the mindset that they need to have lots of children; they base this on how many children they are likely to have if half of them die. Whilst quite a lot of women are becoming more open to the use of contraception it seems to be the men, especially in the more remote areas that are more resistant to these ideas.
We started with a handful of men from the village who listened to the talk and then a steady stream of people arrived out of what appeared to be nowhere with babies in their arms ready for vaccinations. My job was to keep the register of who attended and what they had. As well as the usual range of injections the workers were distributing Vitamin A tablets (where indicated) and worm tablets wherever a person would accept them. In all we distributed about 400 worm tablets today. The Vitamin A tablets are given to women and children at prescribed intervals as the diet is poor in dairy products. The worm tablets are given out for each member of the household and groups of passing school children as worms can be the cause of anaemia and malnutrition and can affect survival rates if there are other illnesses. One of the things that I noticed is generally how beautifully straight people’s teeth are, they don’t seem to have the problems with misalignment that we have at home – I can’t help wondering whether this is something to do with diet or possibly genetics.
As a white person I am known as Mzungo. The children especially follow along and clamber to hold my hand if they are feeling brave. If not they are very shy and peer around corners or hide behind each other to look at me. The children stare more in the more remote villages where white people are less often seen; if we pass a school or group of children in a vehicle they will come running out to call Mzungo, Mzungo. This is not meant to be offensive it is just the name for any white person who is around who is not known by their name.
I also spent half a day in the path lab. This is a wooden structure that happens to be on top of a very large termite nest. The termites seem to have had a feast on several parts of the structure especially the partitions and the roof. A new path lab is under construction alongside the hospital building, but it can’t be ready soon enough for the staff who work there on a daily basis, but it is a concrete shell at the moment. I have agreed with Denis the Coordinator this week that one of my objectives will be to try to get the lab as operational as possible by the time the German Ambassador to Uganda visits on 16 November, so that we can have an offical opening (no pressure!!).
I was lucky to be shown how the tests for HIV, TB, malaria and blood cross matching. I have looked at the stained slides and seen a malaria infection when it is just starting and a malaria infection when it is well established in the blood – fascinating. I was surprised that an HIV test takes a matter of minutes; I always thought it was complicated but it’s not. Essentially there are 3 types of indicator sticks that are very similar to pregnancy testing kits that can be bought from the chemist at home. A drop of blood is placed on the bottom of the indictor stick together with a drop of buffer solution. If it is positive then a line comes up across a particular part of the stick. There is also a ‘control ‘ line that shows up. If this is clearly positive then that is it. If the result does not appear to be clear then a second test is done on a different type of strip. If this agrees with the first test then no further action is taken however if there is a difference in the first two results there is a third test that is done. This gives the concluding result. It was explained to me that where there are confusing results but the conclusion is that the HIV test is negative, it is usually because there is also another infection such as TB present. All the different test sticks have names which are too complicated to remember, I was just fascinated how straightforward it is to test for HIV.
More tomorrow (internet permitting).
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