Mbarara Living: Power Outages, Mango Addictions and Theatre Days

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July 8^th – 22^nd

Update on the cockroach situation. We have seen in 1 in our house, thankfully we’re still behind the other house who has seen 2. Also still have no idea what is scratching the inside of our walls during the night and probably never will.

It seems that with the arrival of our single cockroach, it means we are officially settled into Mbarara living. We’ve mastered the ins and outs of our finicky house, we know that when the bathroom tap turns off, we simply need to turn on the shower and it’ll start working again. We know what to do when our power runs out, and we know how to navigate cooking. We have a stove top and a hot plate in our kitchen but between those two we have only 3 working burners, only 1 of which boils water and 1 which has only a single heat setting. Our cooking often involves playing “musical burners” with our pots as we switch them multiple times. I don’t even mind our cooking situation because the fresh produce here is absolutely amazing. I have been living off of mangoes, pineapple and avocado. Our house will eat at least 1-2 extremely large avocado per day, and I personally eat a mango a day. However, each one of these fruits only cost the equivalent of 33 cents Canadian. We are also lucky enough to have a pineapple stand right outside our house, so a 1 minute walk and 50 cents can result in a large pineapple, which tastes delicious. Another one of our favourite is Gnut, which is similar to peanuts, we eat Gnut butter (like peanut butter) on everything. I’ve gone through 3 containers of it on this trip just by myself.

These past 2 weeks I have been living in the Pediatric Surgery Ward at the hospital. This has been such a fantastic experience. Uganda has a very young population, with 60%!o(MISSING)f the population being under 18, which means that there are a very large number of pediatric surgical cases. However, there are only 1 or 2 pediatric surgeons at the hospital, which services not only Mbarara but the entire region surrounding it. This means there is quite a heavy workload on these surgeons as they have to perform all the elective and emergency surgeries. In addition, because transport is to Mbarara is difficult to arrange and expensive for the people of the smaller communities, the cases that are seen by the pediatric surgeons are often advance and sometimes emergent. In addition to the Ugandan surgeons, there is also a resident from McGill University and Montreal Sick Kids also working on the pediatric surgical ward. This means that I am learning a lot not only about how they do surgeries in Uganda, but also in Canada. Since I have two excellent surgeons from Uganda and Canada, I am able to compare and contrast the treatments, diseases, surgical methods and so much more. For example, did you know that in Canada when treating cancer, the treatment plan is to remove the tumour and then treat with chemotherapy, while in Uganda (and many European countries) the treatment is usually chemotherapy first and then the removal of the tumor.

One of the reasons I love pediatric surgery is that I am lucky enough to see all aspects of the treatment plan. On Fridays, they do a clinic for surgical cases in the area. During this time people from all over come and have their children looked at by the surgeon. From there, she decides if the patient is surgical, and if it is, if it’s emergent or elective. I get to see the consults, learn how to interact with patients, how they book patients, how to prepare them for surgery and how to decide whether a case is emergent or not. Tuesdays and Wednesday are usually only ward rounds. During this time I get to see the pre-op and post-op treatment plans. I have been able to check the post-operative incisions, learn about pain management, and the different precautions patients have to take both before and after the different types of surgeries.

Mondays and Thursdays are some of my favourite days: OR or, as they call it, Theatre Days. During these days I spend the whole day in the theatre watching the surgeries and trying to help out whenever I can. This is usually just grabbing sutures and adjusting their headlamp, which isn’t a lot, but it’s nice to feel useful. I’ve gotten to see some amazing procedures, and the surgeons have been really great at talking out loud so that I can understand what is going on. Here in Uganda they don’t have the technology to do laparoscopic surgeries, so all of the surgeries have been open procedures. I was able to watch an open fundoplication surgery, and the Canadian surgeon informed me I would never be able to see this in Canada because they’re all done laparoscopically.

The children in the ward are so resilient and hilarious. Mostly I am a distraction for the kids while they are being examined. Many of them have never seen a white person or “mzungu” before, so their eyes get so big when they see me. The littler ones are mostly just confused and stare while they try to figure out why I’m different from everyone else. The older ones use me as an opportunity to practice their English.

Other than being in pediatric surgery I also spent one day with Mobile Hospice Mbarara. The hospice program is really well established here in Uganda, it is run entirely by nurses and they have served thousands of patients all over Uganda. It is very well organized, which is nice to be a part of because the hospital is pretty disorganized. They are also the only supplier of morphine in Mbarara and pain management is their main focus. This is really interesting to see because in the hospital it is not a priority and the only pain medications they usually supply is Tylenol. During my day with hospice I was able to do 3 home visits and see what the different housing situations look like here. The first visit was for a maid who lived in a tiny little house that barely had enough room for us all to fit in it. The second family were elderly farmers who lived in a one room mud hut with banana leaves for a roof. The last was for a wealthier family, who had a lawn in front of their house and a large sitting room in the entrance.

We ended off our week by going to the cultural centre on Saturday. Here we learned about the history of the western region of Uganda, the different tools they used, the different animals they kept and how they lived. It was very interesting but what was even more interesting was the price. They had different prices for East African and non-East African people. The non-east African fee was more than double what the East African people paid. However, we had a good time and learned a lot about the current and past culture in Uganda.

It seems that as soon as we figure out how everything works here, Africa throws us another curveball. During the entire weekend the power was our in the compound so we had no power for over 48 hours. It reminded me of Ruhija, and how we had no power there, as we had to keep packing up our electronics and walking places to try to charge everything up and get wifi. We were also very much considering buying a charcoal stove, so that we could cook something. Thankfully, it turned back on Sunday night and made us really appreciate how lucky we are to have electric lighting.

The time in Mbarara has flown by, it’s crazy to think we’ve already been in Mbarara for 4 weeks, and in Africa for over 2 months. It’s less than 1 month until I come home and it’s a bittersweet feeling. I try not to think about it too much and just try to soak up as much of Uganda as I can because before I know it, I’ll be back in Canada.

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