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Published: September 15th 2010
A Medical Elective:
Ibulanku - East Uganda.
Saturday 28th August 2010.
Week 1 of a 6 wk medical elective in rural Eastern Uganda complete and life couldn’t be better. Amanda and I were picked up last Friday morning from our backpackers hostel in Kampala by Sula - the administrator of the health clinic we are working at and we drove the 4 hours out to Ibulanku - a sub-district of Iganga( a town in east Uganda) with a population of about 400,000 people. We stopped for lunch on the banks of the River Nile and sat under the shade of a big old African tree drinking Passion juice (juice made entirely out of passionfruit,) eating fresh Telipia (a local fish caught that morning from the waters of the Nile) and watching the beautiful local women dressed in a myriad of colours, wash their clothes on the banks of the Nile.
We arrived at Ibulanku and had the weekend to get comfortable in our beautiful new surrounds. Our house here, we were delighted to find, has a fridge, a microwave, electricity and double beds!! Total luxury considering we had been gearing ourselves up for 6 wks in a
mud shack! The house is situated in the hospital grounds but our next door neighbours are all locals living in mud brick houses with banana leaf rooves and dusty red earthen floors. Our next door neighbour who lives out the back is the cutest grandma in the whole world. She offers to do our washing, invites us over for a ‘Happy hour’ at sunset and last Wednesday night presented us with the most beautiful traditional woven mats as a thank you ‘for coming to help Uganda’ and for being the most beautiful girls she has ever seen!
On Sunday afternoon we strolled into town (the town being a collection of about 20 mud shacks with little stalls out the front selling assorted goods such as butter, rice, tea, cassava, sweet potato and tomatoes + goat carcasses and chickens which you buy live and then take home and wring their necks and pluck and cook!) to get a chapatti for lunch from one of the little street stalls and stumbled upon a big crowd of locals gathering around a big mango tree in the centre of town. Apparently the local MP “Mr Kutonto” was coming to town and we were
ushered up the front of the group to sit in as part of the official party and treated as revered guests! We had to get up and dance with the women when he finally arrived and even got to shake his hand and say hello, we learnt our lesson to never stray outside the house looking less than presentable as everywhere we walk around here we are greeted by about 500 kids all yelling and screaming “Muzungu - Jambo” (white person - hello!) and always attract a lot of attention.
On Monday morning at 8:30 clinic ward rounds started, there are 5 main wards at the hospital - an 8 bed Paediatric ward, a 7 bed women’s ward, a 4 bed men’s ward, a 2 bed maternity ward and a nutrition ward. The clinic functions as a rural health care centre with more seriously ill patients being transferred down to the main hospital at Iganga (about a 10km drive away.) The main illness here by far is malaria, with at least 3-4 pts being admitted each day with a fever + cough/d+v/headache etc all are started on an IV drip of Quinine and dextrose and usually discharged after
2-3 days, back on their feet and feeling much better.
This week so far we have seen cases of Eczema, PUD, Pneumonia, Asthma, Malaria, Sickle cell disease, PEM (Protein-energy Malnutrition), Vitamin A deficiency and road trauma. We have put in cannulas, sutured, immunised children and seen a baby delivered Ugandan style which is very holistic and natural, hopefully we will get to deliver the next one that comes in (about one birth a day so shouldn’t be too long.) Each afternoon we go on Outreach clinics to some of the surrounding villages, we travel on motorbikes down tiny dirt roads meeting cows, goats, people on bicycles and chickens along the way. We arrive into these tiny towns and are ushered to the meeting place in the village (usually situated under a big old mango tree) and the Malaria outreach educators from the clinic teach the women and men about malaria prevention (buy a pyrethrin impregnated Mosquito net and ensure all members of the family sleep under one at night, to clear bushes from around the house to decrease the chance of larvae nesting in puddles or dark shady places and to ensure long clothing is worn at dusk and
dawn to lower the risk.)
On other outreach days there is a Nutrition educator who brings different types of food (1. Protein giving food - red beans, soya beans, eggs and little sardine like fish called “fula” which you grind up into a powder and sprinkle over the kids porridge in the mornings! 2. Energy giving food - Matoke (steamed green bananas) Maize, Rice, Sweet potato, Irish potatoes and Ugali (a kind of maise based flour) and 3. Immunity boosting food - fruit and veggies.) and teaches the women how to prepare and cook the foods to ensure the children don’t get malnourished. As 70% of the population in Uganda is illiterate, community based outreach programs such as these, not only provide essential education for the community but also help to decrease the health problems so often seen in the hospitals.
It is now Saturday afternoon and we’ve just been for a walk in the sun through the endless banana, rice and maize fields being greeted by everyone along the way “Muzungu Jambo” (white person hello!) being the main greeting from the kids and Waso-sotia (how are you?) from the adults to which we reply “Burunji” (fine thanks!)
We are driving into Kampala tomorrow with Sula to attend his cousins engagement party which over here is called an “Introduction,” as traditionally this is the first time the female brings her boyfriend over to meet her family! We have been kitted out with tailor made Gomezes (traditional Ugandan dresses) and are ready to leave bright and early in the morning (6.30am!) so will let you know the outcome of this event in the near future!
Tuesday Aug 31st
Happy Birthday Dad! Today was a good day for outpatients at the clinic, about 8 pts with malaria(a lot of sick mothers and babies presenting together) a patient with ringworm and two little 6yo girls who were sisters with these funny looking red, round lesions on their arms and scalps which Nathan (our clinical officer) diagnosed at Syphilis. But onto more important things like our weekend just passed. Saturday was busy with a visit from our local GP, Dr Baker who comes to Ibulanku twice a week from the neighbouring hospital at Busesa to do ward rounds. He spent an hour teaching us about Malaria and then we went for a walk thru the town and
out into the countryside and took pictures of cute kids along the way, fields of pineapples and funny looking goats and chickens which seem to be everywhere.
At 6.30am on Sunday morning we were up and dressed and ready and Sula came and picked us up around 7am for the long drive to Kampala for our 1st ever Ugandan traditional Engagement party, or “An Introduction” as it is called here.
This event is steeped in history and traditionally this occasion represented the 1st time a bride-to-be brings her groom home to meet her side of the family. This has become more westernised over the years however it is still VERY different to any engagement I have ever been to in Australia!
Anyway back to the story. It was a full car as we picked up his 3 cute nieces (Lillian, Lindsey and Lauren) along the way + a few more cousins and the 8 of us arrived into Kampala around 11am. We changed into our beautiful hand-made “Gomesis” - traditional Ugandan dresses with high shoulders and a big sash around the waist (that we had bought the week before in Iganga the neighbouring town - we chose
the materials and a lady measured us up and sat down at on old Singer sewing machine in the street and had them finished in about 2 hours!) and met the groom - Sulas cousin (24 yo Edwin - an architect who had met his future wife ‘Bridget’ a 21 yr old gal who works for Kenya Airways, at church about 3 years ago) and rest of the grooms family (of which there were about 30 ppl) We all got into our cars and drove the 1 and ½ hours north of the city to the bride’s family’s home and arrived around 2pm.
The ceremony began with the grooms side of the family (ie. Us) all standing in two lines, males and females at the entrance to the white marquee, beautifully decorated in blue and yellow ribbons and native flowers. The bride’s father cut a ribbon across the gate which signified his acceptance of the groom’s family onto his land and we all took our seats inside a marquee. The ceremony lasted 4 hours and consisted of a number of sections. The first part was a prayer and a welcome. There were two MC’s nominated to talk
for the day on behalf of the bride and the groom. These two men spent the whole day sitting in couches opposite each other, just conversing and pretending not to know one another. The grooms MC spent half of the ceremony trying to charm the brides family who all came out in a procession (1st sisters - 5 little girls, then brothers - 5 little boys, then bridesmaids, then aunts, then uncles, then aunts again.) into revealing who was the brides aunty.
In Ugandan culture, it is the aunt of the bride who ensures a marriage works well. She oversees the marriage, counsels the couple if they are having marital problems and ensures they do not publically disgrace the family! When the aunty finally revealed herself then next part was for her to wander around our marquee trying to find the groom who was seated inconspicuously at the back of our group. And when she finally “found” him she brought him out and presented him to the bride’s parents and her side of the family.
Then we(the grooms family) all had to go back out to our cars and collect the gifts which we had brought as offerings
to the brides family. There were about 200 presents in total - food including rice, flour, cooking oil, fruit and vegies all decorated in beautiful traditional baskets, then bags and bags of gomesis for the aunties and sisters of the bride, a huge hunk of meat (thigh of a cow) + a rooster for the brides brother - a traditional present given by the groom to his brother in law.
After this there was the ring ceremony where the engagement rings were given and then finally after a few more speeches by the brides father who welcomed his new son in law into his family, the official ceremony ended! And we feasted on a huge array of food provided by the brides side!
By this stage it was 7pm and we were dog tired.We piled back into the car and slept the whole way home, stopping once at the supermarket to buy some groceries (with everyone coming up to us in the aisles complimenting us on our beautiful dresses!!)
Home by 10pm and straight to bed!
Monday morning saw a busy day at clinic, as did Tuesday where we saw a baby with the worst
malnutrition I have ever seen - ribs sticking right out, no muscle bulk at all and crying non stop and not even feeding she was so sick.
Today Dr Baker comes again and he is teaching us about complicated malaria and then this afternoon we are doing immunisation clinics with the nurses here. We have just been down to buy some eggs and have just made a big batch of pikelets to bring for morning tea at the clinic so I better go but will write again soon!!
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Wendy Kinsella
non-member comment
Well Done First Blog
Ro, its been great to read and see the pics about your time in Uganda,its all so interesting,keepwriting. Love Mum XXXX