Sunday, August 20, 2006

Emma, Nassa, and Julius, on a trip to the Zoo in Entebbe

Friday, August 11, 2006


Hi All,

I just wrote a very long blog entry about our wonderful vacation; however, as I was looking it over the computer froze and all was lost. Probably 45min to 1 hour of work totally down the tubes. So, as not to expose myself to more agony ('acunamatata' worries in Swahili) I will simply say that I agree with what 'that one' (Aisia) has written and would probably write a very similar update myself.

Again we have some more really great pics, but it will probably be a while before they are posted.

See you all soon,

Pole Pole

So, here we are on holidays now, after our 6 weeks of volunteering and learning. We finished a couple of fridays ago and kicked it off with a night out in kampala, before rising after only a couple of hours sleep to hit the road in a beamer with our Kampalian friend., he was most kind to drive us all the way to the coast in kenya! The road to the border took about 6 hours i think, ,and we also had another friend along who is from Nairobi, so it was great to get the low down on what was to come. passed some electric green velvety tea plantations and then after dark (unfortunately) through the Great rift Valley.

Arrived in Nairobi late and stayed with Yassir at his mother's place in the suburbs. That was nice as by all accounts, ,Nairobi is a dodgy city and we didn't have a lot of interest in navigating it ourselves. the next morning we had to replace the brake pads (which had been replaced no less than a week earlier??!!, and which also had to be redone again after the car made it back to uganda! Not sure what the deal is with brakes here, obviously not of the same quality). anyhow, left onwards past tsavo nat parks, and saw a lovely elephant just next to the road, arrived in mombasa on the coast and stayed a night there.

For the next week we made our way north, a couple of days in Watamu, and small seaside village, with a long long beach, supposedly voted in the worlds top ten beautiful beaches). the placee was full of italians, tourists as well as residents. apparently they run most big businesses and resorts, and are there to handle the traffic of cocaine etc that passes through the ports. Very strange to be sipping delicious Italian espresso, eating gelato and pastries and many of the Kenyans even speak italian! IT was lovely to relax. the beach was nice, perhaps not in my top ten, but the weather right now contributed to the seaweed and less than perfectly turquoise appearance of the water. nonetheless, it was lovely to swim in the warm ocean! We attempted a snorkelling trip in the national marine park, which i was quite excited about. Unfortunately it turned into a bit of a disaster, as the waves were huge against our small boat, ,and 3 of the five of us were green and upchucking into the sea. The snorkelling also left something to be desired, and after a few minutes of the odd fish and murky water and gray coral, that was that.

The food in Kenya is quite a bit more exciting than uganda, they use many more flavours and spices, and our favourite, vegetables! We also spent a couple of days in malindi, another Italian town, this one larger. that is where nassa, our ugandan friend turned around for the return journey.

Chlo and i decided to continue on to Lamu, an island off the north coast, which contains a town that is now a world heritage site, and wow, it was amazing. We thought we mightn't make it all the way there, but seeing as we were then only a 5 hour bus ride away, we thought we had to do it, and it was so worth it. the road (all the way from uganda, actually,) is pretty crap, mottled with gigantic potholes or lack of pavement, not to mention the nutbar drivers. We did eventually arrive, and took a little passenger ferry 15 minutes to lamu town. The island is largely a muslim swahili population, and there are arabic and portuguese influences. Lamu is an old old stone town, with winding alleys, less than the width of a car. that is one of the best parts,  no vehicles, just donkeys!! so it was quiet and relaxed, far from anything. Pole pole,  slowly slowly,  is the operative word about Lamu. I loved just wandering the alleys, past mosques, a small market, stopping often for a fresh lime juice, or an avocado smoothie (alcohol is rare here, due to the muslim population,  this was a welcome respite from our Kampala lifestyle). There is also a beautiful beach, a lovely 30 minute walk from lamu town. It winds along a seaside path, and at high tide you actually have to walk in the water. THe sea is dotted with handmade wooden dows, complete with blue painted carved decorations on their bows. We found some very cheap digs, with a rooftop terrace, actully the tallest building on the island, at a whopping three storeys. It is amazing how the conditions become less noticeable, our bathroom was actually truly atrocious, the toilet didn't flush, the shower (not warm of course) was sporadic in its water flow, and the fan also inconsistent. But we didn't mind a bit, preferring to spend our money on seafood.. I tried to eat fresh fish and prawns at least twice a day! And lobster too. DELICous. So,  a few days of that, and then, lo and behold we 'stumbled' upon a reasonable flight ticket back to Nairobi. to be honest, we were scheming for weeks how we could avoid some of the long arduous bus journeys. so we were thrilled to take a mere 1.5 hr flight back to Nairobi, ,out of the cutest outdoor palm tree lined airport.

the next adventure, which i just got back from a few minutes ago, was a safari for three days to the Masaai Mara reserve, probably kenya's most famous wildlife viewing destination. We spent three days (granted much of it navigating more terrible roads) at the reserve. Two irish girls and a frenchmen in our van, along with our indispensable guide, Ken. We camped, which was so nice! Only my second campfire this summer, which i have been missing.

The reserve is absolutely amazing....the numbers of animals is just staggering, it's not like you drive for three days searching for a lion or zebra...they are so numerous! I loved the elephants, the lions, cheetah, the lepard, and we even saw a giraffe in labour! The other amazing thing is that the animals are totally unafraid of the vehicles,  for the most part (probably an eco disaster I am sure, but wonderful to be able to see them up close). Lions and cheetahs literally walking in front of us. One morning we watched as a pride of lions took turns eating from their recent wildebeest kill. Right now is the annual migration of well over a million wildebeest, coming north from the serengeti in tanzania. So these comical creatures were everywhere, with their ungainly bronco gait and hairy backs and long faces. they seemed so prehistoric, reminding me of ancient paintings on the walls of caves. Many of the animals happily exist side by side, zebras and wildebeests and giraffes, gazelles, all grazing together. It was truly memorable. the landscape of the mara is also incredibly beautiful...geez,. sorry for all the predictable adjectives. Vast open plains,  with african looking trees, punctuated by copses of green riverine forest, all under a dramatic sky. it was actually chilly, too, first time I've needed my fleece.

The Masaai people live all around the reserve, always dressed in red robes and carrying a long stick, as they are cattle people, subsisting mainly on the meat, milk, and blood of their animals. I find it fascinating that as a culture, they have consciously decided to retain many of their traditions, especially their dress. They often have huge elongated earlobes, with a large hole, and wear many colourful beads. It's just interesting that they seem to continue to follow these traditions, when so many other cultures get increasingly westernized. Apparently, individuals can choose to leave for a period of time,  but when they return to the village,  they must live in the traditional way. they are polygamous, ,like many populations in africa, with men having an average of 3-5 wives, each one living in her own house, which she builds, with her children. We did have the opportunity to visit a nearby village and see inside the homes and also they did some traditional dancing and showed us how they start fires by rubbing sticks. it always feels so corny being in that kind of situation, also we had to pay a few dollars each, which is fair enough i suppose. The money goes towards running the village school. It all did seem authentic and not contrived, but strange still. They have been at this tourist thing for less than two years, so I am curious about what impact it will have. They are a beautiful people.

NOw i sit here in Nairobi,  killing a few hours before boarding a night bus (14-15 hours) back to Kampala. We will spend a final weekend there, celebrate Chloe's birthday on Monday,  and then fly home wednesday morning! It has been an amazing journey in so many ways. looking forward to seeing everyone and spending the last few glorious days of summer on the coast, ,which still remains to me, the very nicest place in the world. Who knows if i will post again, probably not unless something very exciting takes place in the next few days. Will add some more photos when I get home though, so keep checking....

see you all soon,

love ais

Aisia Salo
3rd Year Midwifery Student-UBC
mobile 250-686-7987

Friday, July 28, 2006

I don't know how to put captions in the right spots, but this is us at church, dancing on the beach, immunizing children, and shopping at the market

time for holidays!

Well well well, today was our last day of work....feels very good. Said goodbye and gave some final donations to Ward 14. The midwives expressed how much they enjoyed having us there. Said we were so nice and 'social' compared to some others, and they felt we were non judgemental, nice to them as well as to the women, and that we lacked the 'better than them' attitude. So I am very pleased that both sides could learn from each other and enjoyed the time we spent together. We attended a total of about 60 births here in Uganda, about half of them catches.
But anyways, I have been having all sorts of other fun lately, and have lost interest in posting to the blog! Let's see...well we have been shown a good time by our new Ugandan friends. We were invited for supper at the assistant dean of the faculty of med here, whose daughter we have also gotten to know. THat was lovely, they are the sweetest couple, and we had a great time visiting them. Doreen, their daughter took us to Owino, an absolutely crazy second hand clothing market (all from the UK)....imperative to have a local guide! We have also been checking out the many bars and clubs. Every monday night outside the national theatre, there is a big jam session, with many of the top musicians from uganda performing. Best of all., it's free, and all the locals just love it so much, and so do I. One exciting thing we did recently was go white water rafting on the Nile! We were kind of neither here nor there about the idea, plus it costs $100US, but we met a nursing student from Ontario and she convinced us to go. It was so much fun!!! What a day. It was definately the most hard core river I have rafted, lots of class 4 and 5s...the fun (and terrifying) part is there are lots of places without rocks so if you want (or sometimes without planning), the raft flips and you all go flying out into the crazy rapids, sucked under and upside down and then finally spit out onto the surface where you swim desperately towards the raft or one of the safety kayaks. Very exhilarating! It is scenically beautiful the whole length as well. We spent the whole day paddling and swimming. At one point we were pelted by a tropical downpour, and to keep warm and happy we belted out just about every song we knew the words to. It was a good bunch of people we were with, although it felt weird to be amongst whites again!
Hmmm....I have spent a couple of sunday afternoon/evenings at the 'beach' on Lake Victoria, which is what many Kampalians like to do. Have to find some bilharzia prophylaxis, as the water was too tempting and we all went in. Some of our friends had never swam before! Almost all Ugandans we have met say they fear water and they don't know how to swim.
A sister of our friend agreed to take us to church last Sunday. I wanted to go the hear some singing. It was a very large born again church, which I get is somewhat different from what we perceive as born again. Chloe and I were almost saved! It was a good pastor, the message was about idleness, 'get off your sleeping mats and work!" The first part was all about 'praise and worship' which means a full rock band and choir, belting out praise songs. ANd the crowd joins in and waves their arms. THen they had people go up and speak about how god had helped them through various hard times. You could see how people are so passionate about religion here.
We chedked out the veg market, bought some vanilla pods, as well as a whole bunch of vegetables, which we made into a huge salad in a wash basin, as we had nothing else! It was delicious to us, although some said it looked like dog food. Oh well. They are quite attached to their staple diet here.
Tonight we go to a big live show at one of the bars, and then tomorrow we are off to Kenya! Our friend is driving us there, which will be very convenient, we were dreading the 24 hr bus ride. WE have gotten so soft in our old age. Ha! SO, until the next time....
love and blessings, ais

nice chubby baby at one of the rural immunization clinics

Saturday, July 22, 2006

We are still on this rollercoaster

Hi all,

Well it has been long time since an entry. We've kinda lost a bit of motivation about adding to the blog...and now I have found some inspiration. Where to start. Well before we left Masaka we spent one day going very far out of town to an immunization clinc (different from the one the day before). Ais was busy weighing a bunch of bambinos and I immunized (ie. made a bunch of babies scream)...the staff were really into getting us involved and teaching us Lugandan words. It was good to see that most babies were up to date on their immunizations in this area. Before we got to the immunazation place we had to wait at a rural health clinic...and we waited with all the other sick Ugandans who were waiting for the doctor to come...I think he didn't arrive till 11 or 11:30 (and he said later he usually will see 100 patients a day at this clinic). Oh yah and the time here is very random...I think there is no such thing as being on time. After we finished with the immunizations the workers wanted to take us to a Cave and then to the lake (lake Nabugabo...which we had been to the other end)...and just when we thought they were going to take us home so we could be back for our dinner plans...the clinical officer (doctor) decided he wanted to take us for fried fresh fish at a fancy restaurant on the lake...we didn't get home till 7pm. Its very much all about going with the flow here. Ahh then we had plans with the owner of the hotel we were staying at and his family. It was a very nice night in a very high end house...we watched all these videos of Ugandan weddings...he really wanted to Marry us off to his younger brothers. Then at 10pm they start serving us dinner (apparently this is a usual time for dinner in Uganda)...and good thing because we had already eaten dinner at 6pm.

Then our last day in Masaka we worked in the Antenatal ward and it was totally amazing. The midwife running the show here was absolutely super. She loved her job and kept her rooms immaculately clean and organized (not really something we have seen very much in these parts). She specialized in couselling clients about results from tests and focused mostly on HIV couselling. Ais had some time with her and a client spending a very long time on how to put on a condom, the expiry date, temperature to keep it in and how to talk to your husband about using a condom...she was absoletely fabulous!! I ended up helping with a backlog of hmmm 30-40 women who needed to have palpations...kind of like a crazy assembly line. Then we were leaving Masaka hospital. Kind of sad. Had tea and juice with the midwives we had worked with and some people in administration. Even considering the crazyness of the place sometimes I think we had aquired a real liking for the place and the people who worked there. There are some of the midwives that I am already missing. Some of the Ugandan students I think we will still keep in touch with...oh yah we also worked with some Ugandan med students (men) in the last week...and they were very super and interested in making change/learning from each other. Goodbye to our sweet hotel room and the hosptil in Masaka and on a bus to Kampala.

Ais and I took a three day weekend in Kampala. It was Aisia's b-day on a good day to have off. On Friday we went out to a coffee shop that has excellent Ugandan coffee (hard to find here bc they all drink Nescafe) and a great breakfast with fruit salad and muslie. They off for a Ugandan massage. Almost a two hour massage for 20 dollars...including a foot wash and massage at the to love the underdeveloped country thing! Then out for dinner at a very nice outdoor restaurant with a group of Ugandan friends. Then out dancing the night away. The rest of the weekend was pretty melow. A friend took us to a used clothing market...a very wild place and thank goodness we had a Ugandan to guide us through the chaos.

This week. Started off very slow. Not many births in the first couple days at Malago and there were many (4-5) Ugandan students there also...and they were doing alot of the work. Even though we have been here for a while sometimes the way things are done is still shocking. For instance they are super picky about wearing two gloves for a delivery and bleaching the beds and floors, but sharps are left everywhere and anywhere (also half the sharps are on top of the sharps container not inside)and never mind that all the beds have scraps/nicks in them...a perfect breeding ground for bacteria. The last couple days have been pretty nuts...7 births each day. Delivering women in the floor, in their rooms, and being torn between two deliveries at the same time. Watched a breech delivery by a midwife while I was helping Ais with another delivery. Then there are the women falling off their beds (head first!!). Had a hillarious 10 minutes the other day of running from one woman to another picking their upper half of their bodies up and putting them back on the bed (as they were litterally pushing babies out at the same time). By the end of this falling off the bed escapade...we got kind of firm ... "Now you turn have to stay on the bed". Then yikes...the way the many of the midwives treat the women is so brutal...and by Friday I was about at then end of my rope. With the midwife pulling on the woman's head and hair as hard as she could, yelling at her and then slapping her...yikes. I just try to be as nice as I possibly can, but its hard not to show my anger at these midwives for their awful behaviour. And, the students are exactly the same was...slapping the women and telling them they are weak. Interesting management also...just a bit slow on the uptake here. A baby is struggling to breath or a woman is hemmoraging and either nothing is done or it is all done in slow motion...sometimes I wonder are we all on the same planet. Overall though all very straightforward deliveries with healthy/crying babies as soon as they are delivered. We ended our fridey observing the delivery of a second twin (cephalic...head first) by a Ugandan student...very exciting. Perhaps the most memorable thing from this week was when a woman come in with a foot coming out (footling breech)...she was 7cm and this was her second delivery. The midwives assessed her and then wrote in their notes:
"Woman assessed with a footling breech at 7cm dilitation. Plan to transfer her to New Malago (the high risk ward) by ambulance. Meanwhile the ambulance is not available!!"
Kind of hillarious (they were laughing when they wrote it) and very sad. Now Ais and I say all the time to each other " Meanwhile the ambulance is not available" Hmmmmmm.

Spending our last weekend here in Kampala again. Now staying in the Mussy hotel..we are really used to the cold water showeres now. Then our last week in Malago..although we are mostly going to be doing other things other than delivering babies. Getting ready for our trip to Kenya next weekend and to actually be on hollidays.

Other Ugandan english-
-'I feel pressed'- I have to go pee
-'Do you want an escort with your tea'- this means a cookie or cracker..
-'Are you disturbed' or 'Is it disturbing'- ie. do you not like this or something like that...we are not exactly sure (but Ais and I ask each other all the time now if we are disturbed)

Welaba (goodbye in Lugandan)

Tuesday, July 11, 2006

THe plot thickens...
Well, ever since Cathy left, things seem to have gone crazy in the delivery room! First I'll start with the rest of last Chloe mentioned, our day at Lower Mulago (high risk unit in Kampala), was as crazy as the last time, with breeches flying out all over the place along with other complications and again, abandoned by the midwives! It was some good learning. I did deliver one mother who was there simply for PROM. She had been there at least 24 hours and doctors had ordered an IV with antibiotics and oxytocin, but at the time she asked me to help her she had received absolutely no care. So I carried out the orders, and she responded very quickly to the oxy and delivered without complication within a couple of hours (second baby). She spoke very good english and was very appreciative. She tried to give me some shillings to buy myself a soda! Also she thanked me for "paying attention to her." Her first delivery here she said "the African midwives are not kind." THey wouldn't help her off the floor to deliver and told her the baby would die if she didnt' get up. This woman made me realize some of the things I can offer here, when sometimes I feel like I am making no difference at all. Another interesting thing with this situation was that there seemed to be no membranes! The placenta was circumvallate, and there were a small amount of trailing membranes, not attached to the placenta, but there were absolutely no membranes attached to the placenta! Also on that day I observed a midwife slowly and without urgency, put on her gloves as a baby delivered itself. It is interesting to see that the staff do not ever seem to act with urgency. This baby was not alive and I didn't know it beforehand, I think the midwife did.
Needless to say, like Chloe said, in a mere 6 hours we witnessed almost everything in our complications manual (ALARM)!
We deserved a restfull weekend, which we had, at JInja, source of the Nile. NIce little local style resort, with a pool! OUr trip back on \Sunday night was long, took a matatu (toyota style van with 13 seats in it) to Kampala. I conclude that it is best to position myself so that I can't see the road ahead, it makes for a much less stressful experience, especially since I can do nothing to prevent many of the looming possibilities of major accidents. Then to the bus park to find a bus to Masaka. We opted for a big bus, rather than matatu, but then waited on the bus for about two hours, for it to fill up. Got into an interesting communication with a fellow seated near us. He couldn't grasp (or we did a poor job of explaining) how we communicate with God. I mentioned something about going into the forest to be alone, and he got fixated on this concept. HOw do you go there? How do you get power? The people are so deeply religious here that it is unexplainable to them how we are not Christian (or another religion). But what do you do when you get attacked by demons?, he asked....Well, have to say I haven't been attacked by any demons!
OK. so then back at Masaka hospital, without Cathy. Yesterday I caught one baby, fifth one I think, no problems. Then there was a gal with a preterm breech. I wanted to deliver it (they call it an inevitable abortion here before 30 wks or so because they have no means of helping such a young baby survive). I relied one of the senior midwives to assist and direct me....she was fully but with no contractions. Third very early baby for this 19year old mom,. this one the most mature at 26 weeks. THe presenting part was high, but Prossy told me to rupture membranes and get her to push, OK. SO I do, and then I reach in and feel a cord, and a foot. Hmm...this isn't exactly the situation we are taught to manage. The foot was so small, and the cord was prolapsed, and no contractions, I was sure this baby was dead. So I grabbed the other foot, sort of did the breech manouvres, except for very violently and with much force, as instructed by the midwife. She really just yanked on this tiny thing until the head came out. Amazingly, it was alive and they resuscitated it, it went to the preterm room. The mother looked like she had serious post traumatic stress,. totally vacant. And the midwives don't really communicate with them in this type of situation. Unfortunately (?), I found out today that the baby died during the night.
So today we went to a rural immunization clinic ( some benches underneath a grove of trees) and saw what that's all about. Women walked in with babes in arms from the surrounding area and got them vaccinated for polio, HepB, tetanus, measles, TB, etc. Vaccinations are one of the major components of health care here. And health care and education seem to be the majority of everything everywhere, so many schools and health projects.
For the afternoon we decided to pop back to the hospital for a bit. And the two medical students that were managing things were happy to be spelled off as it had been a busy morning and there were two more women fully dilated. ONe of them is having her fifth baby, but it isn't coming down, and there is quite a bit of caput (swelling on the head). The medical officer was consulted and a plan was made to try a vacuum delivery in the theatre. I am alone in the room, attending to someone else, when I hear the woman scream...she has fallen on the floor, in almost a complete splits, and is stuck on the floor, on her perineum (the head was on the perineum prior to this point). Oh my god! I try to help her up, she's pretty stuck, and the baby's head starts crowning..I yell for help, and scramble to put my gloves on (the floor is covered in countless people's body fluids and is cold, hard cement). I have two fingers in one glove finger, backwards, but manage to catch the baby, chloe rushes in and I hang onto the baby, nowhere to put it, while she ties the cord (with rims of the gloves, so it isn't exactly fast)...babe is pale and limp, with meconium staining....others respond to my appeals for help, but just stand there and watch, while chlo and I manage the situation in a panicked kind of way. We bag the baby for at least 10 minutes, apgars generously 3, 5, 7. babe ends up breathing after some tone though, and a vacant look in his eyes. Yikes I wish I knew more about how to tell if brain damage has occurred. No one is concerned in the least. Oh the baby looks good. Oh ha ha ha, they think it's funny that the mom fell down splat on her perineum, probably damaging some ligaments, if not the fetal head. It is hard to describe how crazy this place is....just crazy. Babe did look somewhat Ok by the time we left. HOpefully things will be smoother from now on. Good luck. Anyways, enjoying the country nonetheless. Am excited to get back to Kampala and celebrate my birthday on Friday. And not be so busy busy busy. We are taking a long weekend. Will let you know how it goes!

Monday, July 10, 2006

totally nuts then vacation

Hi all,

Well what can I say...things are always a bit of an adventure here. We left
Masaka on Thursday afternoon after working at the hospital (our first day
with no deliveries...although we did prep a woman for c-section). Arrived
in Kampala just in time to miss the rush hour (which is totally nuts here!)
and into the big city smog. On Friday we worked at lower Malago (the high
risk ward)...I was anticipating that it would be kinda crazy as I had only
heard the stories from Ais and Cathy about this ward since I had been sick
the previous time. The day started off fairly slowly. We spent most of our
time making sure that the women received the medications and other oders
that the doctors had left for them. This was a very interesting
ward...woman after women had orders from the doctor...most of which were not
carried out...and the doctors day after day would just re-write the orders!!
Interestingly enough the midwives often seemed like they were not doing
very much and often sitting down and chatting...while women had untreated
Malaria, PROM, sepsis and pre-eclampsia. And then, when it looked like we
would go home in an hour with no births...they started to pop out. Ais
delivered a woman who had been induced with PROM...and as we were still
dealing with her placenta and trailing membranes Cathy called me into the
other room for a breech delivery. And there it was...the bum and
balls...coming right out. In no time at all got ready and moved the women
around on the her bum was on the edge. Delivered the legs...and
the rest of the body came out very smoothly including the arms. Then
Morso-Smelly Vite (is that the spelling of the manuever?) and a very slow
delivery of the head guided by Cathy...and voila a healthy baby boy...thank
goodness for a straightforward first breech delivery. Then about ten
minutes later a woman came in who had had large amounts of bright red blood
and was term. She was in shock and her abdomen was hard as a rock. The
obstetricain was great...set up two IV's...and after both Cathy and I
determining there was no fetal heart oxytocin was put in one of the bags. A
definite placental abruption. The obstetritian said to Cathy that she was
worried about if the woman would survive considering how much blood she had
already lost and how much she will probably loose at the delivery and the
fact that there is no blood available in the hospital for her. Cathy
delivered this womans baby because the hand was coming first...this then
turned into a compound presentation (hand and head being delivered at the
same time)...and then a massive shoulder dystocia...finally after doing all
the manuvers...we moved her on to hands and knees and the shoulder was
finally dislodged. The baby was born dead...which Cathy did a wonderful job
of breaking the news to her. The mom was very sad...she had also last her
last baby because it was preterm. The placenta came with no problem and big
gush of blood, but her fundus firmed up quickly and she didn't blee any
more. When we left she was doing relatively ok...anemic and sad...but still
alive! Oh yah and at the same time this woman was delivering there was
another woman beside her...who started to push...and we looked over and
there were the babies balls coming out first (breech). Unfortunatly she was
a primip and in 20 minutes the breech didn't come out any further. We had
to leave before she delivered, but it looked like it would have been a very
grim delivery anyways. Then we rushed on our way to get out to Jinja. Ais
and I realized that in the six hours we were in the high risk ward we
covered our entire ALARM (emergency skills) manual...except for VBACs (that
were probably in a different section of the ward) and assisted vaginal
delivery (ie. forceps/vaccume...that they don't seem to do here
anyways)...crazy!! Oh yah, that day there was a woman with twins, but she
had chorioamnitis and very few contractions...and unfortunatly didn't
deliver when we were there.

Ahhh so off to the Nile for a little get away. Cathy and Mickey had booked
rooms in this great little retreat. Beatiful little huts with very nice
rooms...and a swimming pool!! Unfortunatly our only whole day there it was
clouded over. Lots of time to read and relax. Went for a bird watching
boat trip on the Nile...and even saw the source of the Nile (this actually
isn't as interesting as it sounds). Ais and I went into the town of Jinja.
Apparently the 2nd biggest town in Uganda...but actually very small. The
town we didn't find very impressive and not nearly as friendly as Masaka or
Kampala (people would stare at you...but not really in a nice way). That
night we had a east indian meal...and afterwards Ais and I both agreed it
could have been a dodgy meal...but yahoo we did not get sick. On Sat night
also we borrowed Cathy and Mickeys laptop to watch 'Memoirs of a
Geisha'....good movie and nice to do something different. Then on Sunday
after a nice sunny swim in the pool we left for Masaka (a long and tedious
trip back).

Then last night we watched the World Cup game with all the many folks who
came to our hotel to cheer on their favoured team. Ais and I chose (for no
particular reason) to cheer for Italy...good thing since they won!!

Then back to Masaka hospital today. Our first time since Cathy and Mickey
have been gone. It was good. Ais and I really worked as a team. One very
straightforward delivery. Then a woman was brought in with a suspected 28
week preterm baby that they hadn't found a fetal heart on. I found a fetal
heart on the baby and Ais and I wondered if the baby might be more like 30
weeks. Then on palpation I realized the baby was breech. I asked the
person who admitted her if they thought she was breech and they said yes,
but they had forgotton to writet it down....what! Ais ended up doing the
delivery because it was breech. Very complicated delivery. A footling
breech. With a prolapsed cord and the midwife who was helping Ais was
pulling very hard on the baby. A very small baby that required extensive
resus...but finally ended up breathing. The other midwife estimated the
baby was more like 26 weeks...yikes...very small.

What else. The culture here in Uganda is very interesting. Ais and I have
decided that we should take up some religion for our time here...because the
people don't seem to understand how we communicate with god if we don't go
to church. Some people are really very interested in our non-religion or
spirituality, but they just don't get it. Here are some Uganda isms:
-'mobalize'-To get going or to get ready
-'to move with someone'- To go out or hang out with someone
-'a short call'- to go pee
-'a long call'-to go number 2
Yesterday I had two strangers (men) tell me they loved me...I thought this
was rather hillarious, odd and interesting. The first one I just laughed at
and the second guy I laughed at and said...that's so funny because someone
else just told me that earlier on today!

till next time,

crazy births and fun times

Last week was pretty mellow. Wait, maybe that's not true. So much happens here that I can't really remember what happened an hour ago let alone last week. No births on thursday, and then that evening we went to Kampala, out for great indian food and then I went out to a few different local bars with some Ugandan friends. One was an outdoor joint with a gigantic screen showing old Fresh Prince of Belair reruns. Then on to a place called the Victoria Tavern....somewhat karaoke/mime/drag queen/performance art. Very interesting, as well as interesting discussion with my friends about is a very 'new' thing here in Uganda. Anyways, after the third bar they dropped me off at the guesthouse, and as I was past the curfew (what a bad kid!) I had to get some help from the guard to wake up the owner....sorry! Must go, cafe closing...will finish later.