When I wasn’t away on epic excursions, I… (part II)

In Uganda, when I wasn’t away on epic excursions, I…

5. Played doctor in my own ward round and clinic.

After a few weeks of following the doctors for different ward rounds, I was soon entrusted to do some myself! I did mine in the paediatric wards – walking from one child to the other with a stethoscope around my neck and a nurse/translator beside – in what was an incredibly exciting experience! Does this child have pneumonia, malaria or both? Should I chart some intravenous fluids together with the quinine I am giving her? Is this a S₃ that I am hearing in this boy? Is this kid safe for discharge from hospital? It was thrilling to be the one making the decisions.

It didn’t take long at all to become familiar with the algorithms for malaria treatment. Malaria was something that I was quite secluded from in Western medicine, yet it was just so commonplace here that it felt unreal. Now I feel so much more when I hear about the World Heath Organization identifying malaria as one of the four biggest disease burdens worldwide.

I think the most memorable incident is this time when I was seeing a four year old girl (according to the notes anyway) with what was likely to be a fissure-in-ano. What I did not expect to find on examination, however, was male genitalia under “her” dress – for a moment I was even seriously thinking if this was the “inconspicuous genitalia” that I’ve only briefly heard about during my neonatology attachment as a fifth year! I awkwardly confirmed with mom the sex of her child (of course he was a boy), and then even more awkwardly asked why was he in a dress. His mom replied that it was his elder sister’s dress, and that they couldn’t really afford to buy any boy’s clothes. Now I feel stupid asking that question.

I also had the opportunity to run my own outpatient’s clinic (which also functioned as an emergency department) when there was a staff member available to translate. The clinical signs can be shocking – an obvious eye bulge from a big retinoblastoma behind, huge kidney tumors, and testicular cancers that even I could diagnose (No, I won’t put those photos up!). I was very impressed too at how the people were able to make the journey so far to reach Kisiizi Hospital even while suffering from quite significant malaria and pneumonia. They must have endured so much on the way – fevers, fatigue, and just plain feeling rotten. I cannot even imagine.

6. Taught a class of student nurses.

Sister Hazel, the awesome energetic 70+ years-young UK nurse who was very involved with the Kisiizi nursing school (which was in the Kisiizi hospital grounds), invited Michael, Sue and I to each teach some classes in the Kisiizi nursing school. Of course we took up the offer in the blink of an eye – what a way to feed our ego!

I was asked to teach about good old Inflammation – one of the basic health science topics that I learned about almost 5 years ago now (acute vs. chronic; rubor calor dolor tumor… =_=”” Zzz ), that I had to look up some books to get myself re-acquainted with the minutiae. But where was the multimedia projector, or the transparency overhead projector?? Where was the laser printer or photocopier for lecture handouts?? I realized then just how ubiquitous those facilities have been throughout my education in New Zealand – that I was suddenly at an embarrassing loss in Africa without them!! A blackboard with some chalk, and a large roll of yellow paper with black and blue marker pens – were offered to us for use, instead. It was good.

I have given presentations in lecture theatres before, but this was the first time in front of a class – and I found it funny how it was so obvious when standing in front of the class who the better students were, and who the ones dozing off were. The whole experience was very reminiscent of the days when I was in Malaysia sitting in a quiet classroom (and not-so-secretly drawing my own comics in most of the classes – now I wonder how obvious it had been to the teachers). Where have those days all gone to? Time changes a lot of things.

The class was about 30 students in size, and was a little too quiet for me, but then they got really excited when I did a quiz at the end, offering sweets to whoever was the first to raise his/her hand up and answer correctly. Then a student, out-of-the-blue, asked if I could go over the concepts of bone-healing – which of course was not part of my preparation. Fortunately God has blessed me with a memory good enough to at least bluff my way through the four stages of bone-healing semi-convincingly, haha. Wait a minute… were they in fact just testing me – and seeing if I would embarrass myself in front of the class!!?? Sneaky!

7. Visited Louise’s house to make pizza.

Louise, the lovely (and very admirable too, for a young female!) physiotherapist from the UK, invited the three of us over to her place on Easter Sunday afternoon for some pizza. Her place was just behind the Rose Cottage where we stayed, and I decided to go early to help out. She had bought most of the ingredients from Kabale, the nearest town with a reasonable supermarket, while some were sent by friends from home.

Her local friend/maid (? I think Mary was her name; my memory fails), who came to watch for a little while, was quite intrigued with the whole process of making a pastry base and smearing tomato paste on top. When we were sprinkling chopped bacon and onion pieces on, she asked “what do you eat this with?” I think she was even more surprised to know that we ate “pizza” just by itself – as a meal!

Needless to say, the pizza turned out really delicious. Michael later joined us when he got back – he had gone for a Catholic mass outside Kisiizi that morning for Easter service (hired a motorcycle driver for this, and got somewhat ripped off because it turned out that the driver was also picking another person up without telling him!). He told us over pizza grandiose stories of him being treated as a VIP there, seated with the bishops. He was even asked to give a speech to the congregation; someone stood up to translate for him, and then the whole congregation roared in applause. Standing in front of hundreds (allegedly), he was then awarded by the bishop a new name – “Michael Mugambagye” – which meant “Michael the Smooth Talker”. Awesome!

We had good conversations over the table about many other things. And then we played some card games, followed by a great game of “Consequences”, which was simply ROFL hilarious. We laughed so hard that it was difficult to stop the tears.

8. Cheered along with everyone for the Kisiizi football team.

Also happening at the time was an inter-district football season (yes we called it football, not soccer); so on some Thursdays the Kisiizi primary school field – which was conveniently a full-sized football field too! – would be host to the competition games. The Kisiizi team, in yellow T-shirt and shorts uniform, was apparently a strong team that the whole Kisiizi community took pride in.

When we were first invited to watch the games on a Thursday evening around dinner time, I remember us not being too sure what to expect. The Rose Cottage was just opposite the primary school across a well-loved dirt road anyway, so we thought we might as well don some slippers and hop a few steps to cast a glance. To our surprise, most of the community was there – from breastfeeding mothers to little boys who dance regardless of who scores – which made the atmosphere superb. The game was surprisingly intense and professional – and every player and spectator took it very seriously! It ended in nil-nil, but with penalty kicks, three yellow cards, one red card, and too many near-goals, it turned out to be like a free ticket to a stadium watching an adrenaline-filled game of sports!

Not surprisingly, conversations of the game amongst the locals carried on even to the chapel service the following morning. Since then, the games to be played on Kisiizi grounds in the coming weeks have been marked in our calendars!

To be continued…! お楽しみに !!

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(Finally, a much-delayed continuation from this post!)