Sad Week

Unfortunately this week Chris's mum became ill and died in St Georges Hospital London. This was difficult and made us realise how far we are from family and friends. We have arranged to return to the UK for the funeral and to be with the family.
Mum was a wonderful person and an inspiration .She never really understood why we came to Uganda but always supported us. She valued life and was always conscious of the good life she had with dad. At 86 she was an age that very few Ugandans will ever reach. Death at a young age is a common occurrence. Eighty percent of the deaths are from preventable diseases and that is why we are here. Somehow we have to make a difference so that Ugandans can look forward to old age as we do in the developed world.
We have been in Kampala this week as part of VSO training. It has been a great opportunity to meet up with fellow volunteers and share stories and frustrations. We are all finding difficulties in our placements but we have learned from others that there are ways forward and hopefully we can use these ideas in Masindi.

Safari salaama

While Maggie was in Kampala I took the opportunity to visit the Family Spirit Centre. I had met the founder Isaac at the clinic and he had told me of the work he had been doing. He looks after over 20 orphans and vulnerable children from the age of 3 to 15. He has been doing this for several years and seems to have financed this on his own. As the venture grew he decided to open a school to give the children an education. He now has a school for 50 children and attracts some from the local village. These children pay a small fee which he uses to subsidize the orphans. He has some paid and some volunteer teachers.
I was impressed by the centre. The children all seemed well nourished and lively. I was given an impromptu concert of songs and nursery rhymes after a prayer led by a 4 year old! The children all seemed to have a good relationship with Isaac and many called him daddy. For a lot of the children he was the only father they could remember. There were 4 children who had arrived this week. The oldest girl was about eight and she was looking after the 3 younger children. They had been abandoned by their family and were sad and lonely among the other children. This process of vulnerable children being left is happening all over Uganda. The childrens’ families are destroyed by war, poverty or illness. It is left to people like Isaac and the staff of the centre to pick up the pieces and help these children.

As Chris says, I had yet another trip to Kampala. So far I’ve always managed to get a lift with Sallie; we stay over for two nights as she has business to attend to. This gives me a great opportunity to shop and stock up on supplies but, believe me, it is far from pleasurable! I’ve been persuaded to buy an oven and as I’ll be the only volunteer here with one I can see I’m going to have lots of orders for cakes and puddings (they’re non-existent in Masindi unless you count drinking yogurt in a bag). We return from Kampala feeling incredibly hot, sticky, dirty and tired. On a good day the trip only takes three and a half hours. Unfortunately yesterday was not a good day! We were already running late and didn’t leave until 4.30. As we pulled out of the car park onto the road, I looked out of the window and noticed that the front passenger side wheel was suspended in mid-air over a ditch. Sallie couldn’t move in either direction. Luckily help came and a few men ‘lifted’ the Land Cruiser back away from the ditch. On the way home we got a puncture. We were in the middle of nowhere, and the only traffic was the occasional lorry or bus pelting past at full speed. It was dark, very dark, as only Africa can be but a lady appeared from out of the bush with a lantern. We tried to find appropriate tools which meant emptying the boot - I wasn’t very popular with all my shopping! We failed miserably to change the tyre. The phone signal was intermittent but luckily we eventually managed to get hold of someone to send a mechanic. We then got a call to say that someone had seen the Masindi bus leaving Kampala after us and they would phone the conductor and tell him to look for us and help. So much for travelling safely in day time! The crowded Masindi bus arrived and came to the rescue. The car we were driving happened to belong to the owner of the bus. Networking here is great. In fact, everything relies on it.
Kampala is crazy at the moment. CHOGM (Commonwealth Heads of Government Meeting) is being hosted there this week and for months it is all everyone has talked about. An obscene amount of money has been spent to ‘beautify’ the City. The infrastructure is nowhere near ready and everywhere you go there are construction workers working around the clock. Some of the repairs on roads that will take our Queen from the airport have already been washed away with the heavy rains. It is easy to see which route the VIPs will take. A huge amount of money has been diverted from other essential areas just for these three days. A school and teacher training college in the centre of the City was bought (allegedly for 10 dollars!) by a Saudi prince so that he could demolish them and build a hotel for CHOGM. After demolition he changed his mind. Many hotels have sprung up (with worrying speed) specifically for this occasion but apparently some countries are not happy with standards and are even planning for their VIPs to stay in Nairobi and fly them into Entebbe everyday.
It is an everyday occurrence to hear of many injustices and nothing seems to shock anymore. It’s also easy to become cynical living here.
Perhaps I should go for my Sunday swim and relax a bit!

Chocolate heaven

The most important news this week is that a lone bar of Galaxy chocolate arrived at our Post Box much to Maggies delight. We have had a post box for the last 4 weeks but this is our first delivery. It arrived safely if a little misshapen after only 1 week. Thanks to Kare for her trust in Ugandan Post. We have a post box but so far do not have a key for it. Maggie goes every week to ask for the key to be told 'the man' has not made it yet so come back next week

Last weekend we had a visitor, Dada from the Philipines one of the VSO volunteers working in Kampala came to Masindi as part of her work on environmental issues. She and Daryll, another volunteer, cooked a wonderful Filipino chicken dish and we all watched Motor Cycle Diaries round the laptop. Who says you cant have fun in Masindi? This was the first time we had bought chicken here. You have two choices: buy a live chicken from the market or off the back of a bicycle, kill it, pluck it and then cook it, or go to the Shell garage and see if there is any frozen chicken in their freezer. At least Shell have a generator so you hope the freezer has not defrosted too many times. We opted for frozen.

Maggie has been busy at Court View Hotel. Sallie, who owns the hotel, has been in the UK and she asked Maggie to keep an eye on the place especially the kitchens. The first food hygiene courses were held this week and well received. One of the biggest challenges is to get the rats out of the kitchens. Another challenge this week was that Masindi had run out of gas for a few days so everything had to be cooked on charcoal. (notice we have adopted VSO's way of saying 'challenges' rather than 'problems'!) We are thinking of asking Gordon Ramsay to visit and advise. It would make a good TV programme. Court View is probably one of the best kitchens in Masindi but it is not quite to UK standards! Maggie is quite enjoying working with the staff who seem pleased that someone is taking an interest in their work. It is off putting eating there after Maggies description of what happens behind the doors but the food tastes good and we haven’t caught anything yet.

The HIV clinic is the main focus of my work. We see about 50 patients on Tuesdays and Thursdays. This week we have had 3 visits from the ministry of health . They are continually checking on what we are doing and looking at the documentation. Unfortunately this usually means stopping the clinic and keeping patients waiting for a couple of hours. Ugandan patients seem willing to accept long waits. We have supplies of ARVs but most other drugs are not available so it can be very frustrating trying to deal with patients' problems. This week I have needed to admit 2 patients from the clinic; one was dehydrated with dysentery and another had pneumonia and oesophageal candidiasis. Luckily we were able to access drugs to treat them. There are lots of patients with dual infection with TB and HIV. One of my tasks is to better coordinate their treatment as they can easily default from treatment which is a risk for the patient and the community. Another young patient at the clinic has cervical cancer as well as HIV. She was referred several months ago to the cancer specialist but as it is in Hoima 2 hours away she has not gone. She has no money for the fare and no prospect of being able to afford to stay in the hospital for treatment. Treatment is free in Uganda but you need to supply your own food and have an attendant to cook it and look after you. This young womans family can not support her so she will almost certainly die from her cancer if she does not succumb to the HIV. Another young woman with HIV on the ward has developed a stroke probably due to infection with toxoplasmosis. The treatment for that is not available so she has been taken home by her family to die.
The reality in Uganda is that many people are dying and it appears to be accepted. Patients are not demanding better treatment. There is a fatalism and people just say “this is Africa”. There is a lot of faith and that gives people the courage to carry on but sometimes it appears that it also prevents them from looking for solutions.

These are pictures I took in the HIV clinic - you can see how cramped it is. This was a quiet time. The guy in the fetching yellow outfit is a prisoner; we see lots of prisoners each clinic. The prevalence of HIV must be very high there. The man squatting has Stage 3 HIV and had dysentery. He looked alot better 2 days later after some antibiotics and fluid. His long term survival is unlikely I am afraid.

I also managed a trip in to the field to see some health centres. These clinics should provide most of the primary care but are sadly neglected. Staff are poorly motivated and often absent themselves from the job. The worst clinic we came across was anHC III which provided obstetric care. the delivery room had a foul smell which we traced to a dead bat in the corner. So much for infection control!

These pictures show patients at a health clinic plus the pile of used drugs and needles left on the windowsill.

Pictures of the market the clinic and health centres seem to go where they want and the captions go somewhere else. It is hard work being a blog virgin this posting has taken over an hour so hope you enjoy it.

It is Sunday morning and we have just had a walk round town but it is very hot. Morning coffee beckons and we have just had an invite for afternoon tea. It is tough in Masindi!

Better late than never!

It’s taken Maggie a month to brave a ride on a boda boda. These come in two varieties: a motorbike and a pushbike. As the road from town to our house is up hill, she decided not to inflict herself on the cyclist and opted for the motorbike. VSO actually advises against using these but when it’s scorching hot and you’re carrying big bunches of bananas, pineapples, bottles of water, etc. etc. it’s easy to give in. (She hasn’t yet mastered the technique of carrying everything on her head!). The other problem is returning after dark (7pm). It’s unwise to walk but, if you want any sort of a social life, a boda boda is the answer. Bear in mind these roads are just dirt tracks, full of craters and potholes and treacherous when wet, but exhilarating all the same on the back of a boda boda!
It’s worrying how excited we get when the power comes back on. There’s a mad scramble to rush round the house charging phones, laptops, cameras, putting the water heater on and even washing and blow-drying hair (Maggie that is, Chris doesn’t bother!). The latter is a bit risky as sometimes it’s off again before finishing.
The other highlight of the week has been the arrival of a Rocco Set (3 piece suite), dining chairs and shelves. (We have such an exciting time!) We actually managed our first bit of entertaining of the other VSOers though catering was a bit limited with a two ring burner. We’re finally getting our house staff together. We’ve already got Solomon who patrols the grounds at night looking very fearsome with his bow and arrow. He doesn’t like using his torch as he doesn’t want anyone to know he’s there and decrease his chances of using his weapons! Some other volunteers are leaving Masindi this week so we’ve taken on Rose, their house girl (not exactly a girl as she has five children), and Sam their gardener. Rose and children will live in the quarters in the garden but Sam will live out and come three times a week. Last night we went to the departing volunteer’s leaving party which was quite an experience. It was modeled on an English wedding with a top table. The outgoing volunteer and incoming volunteer cut the cake together whilst being sprayed with some sort of sparkly dust and the speeches were interspersed with outbreaks of Celine Dion.
In desperation of not wanting to just eat tomatoes, onions and aubergines forever more, Maggie plucked up courage to buy fresh Talapia from the market (caught in nearby Lake Albert). It’s a bit off-putting when it’s exposed to the sun and swarming in flies but it’s very fresh and not a problem if cooked straight away. The meat will have to wait a bit! This is a picture of Christine’s shop which is literally at the end of our garden(oh no it isnt we can not upload it for some reason). It doesn’t have the choice of Sainsbury’s but we can buy fresh eggs from the chickens which have had free range of our garden!
For anyone who thinks we’re getting on a bit to learn a new language, they’re absolutely right! It’s fair to say we never have been natural linguists. We’re struggling with our weekly Swahili lessons but struggling even more with the fact that only some of the population speak it and the rest speak the local tribal language of Runyoro. By the time you’ve established who speaks what, a conversation has already been struck up in English!
Chris finally managed a trip into the district. It’s supposed to be a weekly event but has only been achieved once. Even then, it was touch and go whether he would make it but a vehicle finally turned up two hours late to take him. The HIV clinic is extremely busy and will take some time to organize. The first priority is to sort out management of pregnant patients. It appears they they are not getting preventative treatment which is a tragedy when you can prevent children being born with HIV.
Maggie is still spending a bit of time each day trying to improve the catering and service at the hotel. She’s running food hygiene sessions but has had to go right back to basics. It’s certainly a challenge but hopefully only a short term one. We’re slowly finding out about projects in the area where there might be a possibility of helping.
Generally, life is okay here. The weather is very hot (due to get hotter!) and there are storms most days, though these are short lived. The scenery is beautiful and it’s very easy to ignore it when all around you is such poverty. We haven’t encountered any nasty creepy crawlies yet! The house is starting to look more like a home and we met our immediate neighbours recently. One is the gentleman who lives in the hut at the water tower with I don’t know how many children and he tends the compound. Next door is a carpenter, so we know where our next order of furniture is coming from! The locals are all very friendly; the small children address us very politely in English and then fall about in fits of giggles when we reply.

We are having difficulty loading our pictures but we will keep trying

The first 4 weeks

We have now been in Uganda for 4 weeks and are beginning to realise we are not on holiday. It has been a major culture shock adapting to the Ugandan way. The heat and the incredible rain showers no longer phase us.We justsweat and paddle about in the mud like every one else. Travel is a major issue in masindi. Our house is 15 minutes walk from the centre of town which is ok during the day but a challenge we have been advised not to take at night. So far we have been lucky and been able to beg lifts if we are iut at night.

Maggie has been to Kampala twice this month for shopping trips. No surprise there but in reality if you need anything other than basics you have to go to Kampala. This is a day each way. As the house is completely unfurnished she has needed to buy a fridge and washing machine as well as material and "luxuries". The process of purchasing is relatively simple but how do you then get the goods back to Kampala. Those in the know arrange a pick up or if necessary arrange to put it on a lorry or bus bound for Masindi. It some how arrives intact a few days later. We have been greatly helped in all this by Sally and her staff who seem used to helping out naive muzungus.
We have finally moved in to our house this week.We do not have a postal addresswe just tell everyone we live on Kuzungu hill, (the white mans hill) opposite the resevoir.We are having furniture made locally a 3 piece suite for 200,000 ush about £60. Reasonable for solid oak furniture.
Being house owners we have had to employ an Ascari or night watchman. Soloman comes at 7.00 pm and stays patrolling our compound throughout the night to disuade intruders.We have had to supply him with a torch, flask,coat and gum boots. these had to be brought from Kampala but the boots arrived as a pair of left boots!.It is just one of those frustrations you can not nip back to change them.Various people keep arriving to offer their services as domestic staff. Unemployment is high and people are desperate for work.There is no real system and it is difficult to recruit staff who will be happy to work and reliable.There is a big element of hope it all works out.
The house already has some uninvited lodgers. There are lots of geckoes which are fun to watch but maggie refuses to share the shower with. There are bats and unfortunately some lve above the bedroom and leave there deposits on our bedroom floor!We have lots of birds in the garden and inthe early mornings you can hear the monkeys on the roof and in the trees.Early mornings are a reality here.People start moving around about 5.00 am. We are regularly woken by the mosque and singing and chanting from the local church.
Our social life revolves around other volunteers at the moment. Sunday has been a swimming trip, Monday is Swahili lessons,Friday is food and a drink at Murchisons bar in Masindi.
Maggie has been advising in the kitchens at Court View hotel, she is realising that food preparaqtion in Uganda is a little different from the UK. She has also visited a local seamstress training school run by Felicitas the wife of a local American missionary.Gradually Maggie is finding a role but sensibly not rushing in to anything yet.
I have managed one trip with the community team to visit a local school.Masindi public school is one of the primary schools in Masindi. Over 1000 pupils, classes oversubscribed with one class of 117.The head struggles to provide a service to the pupils with very little resource. The main issue he identified was no water on site,the tap has been vandalised and the kids are all hungry. Many of the children arrive not haviing eaten and will have nothing for lunch. It is a surprise if the manage to learn at all.

mutterings from Masindi

Things never go quite as planned in Uganda! Our lift could not take all our luggage so we had to leave several bags behind in Kampala. We were supposed to leave early afternoon but did not get out of Kampala until after 6. This meant we broke rule no. 27 in the VSO handbook which says you should not travel after dark. Luckily Suliman the was an experienced driver and got us to Masindi safely at 10.30 despite the state of the roads and the lorries with no lights. Apparently many Ugandan lorries travel with no battery. Once they have been started the driver takes the battery out in case it is stolen! There is a belief that driving with lights slows the vehicle down. The Ugandan highway code seems to be 'size matters' - the biggest vehicle has right of way. As our house isn't yet ready we had arranged to stay at Court View Hotel. Unfortunately, as we arrived late they had let the room but luckily the wonderful Sallie found us another hotel (we were serenaded all night by a frog under the bed - not the the wide-mouthed one!). We returned to Court View the next day and still remain. (Maggie is enjoying the hospitality, especially the red wine!). We have had several dates for moving into the house. Today we have been told it will be ready by Wednesday. Good news is that Maggie returned to Kampala and has bought a fridge. As we speak, our bed and table are being made locally (though with all the power cuts, who knows when they'll be ready). Power seems to be off more than it is on so we've stocked up with candles.
We're slowly adapting to the pace of life and keep being told to stop trying to get to the end of the race before it's started. Why is it that driving is the only thing that happens quickly in Uganda.
The hospital is incredibly short of resources but very busy. Malaria is the commonest problem. If a patient has had a fever in the last 3 days you presume malaria and treat, if the fever has been for longer you do a blood smear, if it is positive you treat for malaria. If it is negative you do not believe it and you treat for malaria. Unfortunately the hospital pharmacy has run out of adult dose Co-artem the recommended treatment. HIV and TB are common and there is a real shortage of drugs for opportunistic infections. There are no xrays and few reagents for blood tests. This makes diagnosis a real clinical challenge and Chris has a lot to learn from the clinicians here. The remarkable thing is that people seem to survive and it is a sobering thought to learn how resilient the human body is and how great the will to survive.
The social high spot of our week is a trip to Kinyara sugar plantation's swimming pool. A trip denied to most of Masindi but gratefully accepted by the VSOers.
Please keep us abreast of your news. The outside world seems a long way away.

Kampala at last

We have been in Uganda for 6 days and are just beginning to adjust to the heat and the pace of life. Today was the last day of our course the day we met the employers.Unfortunately the hospital transport was not operational so Richard one of the clinical officers was sent on the bus to meet us.He was able to give me a quick run down on the hospital which sounds a challenging environment. He says they have run out of most drugs which is not unusual and there is no paper for clinical notes. With my hand writing that is probably a blessing. The work sounds really interesting and it looks like I will be working in medical out patients and in the community. It looks like the information about my surgical skills has got out and no one is going to let me near a scalpel.
We are in the VSO offices now waiting for a lift to Masindi for us 6 cases a mattress pots pans and Maggies box of wine.

Chris and Maggie

The final countdown Sept 18th

We are in our last few days in Berwick!!! Panic is beginning to set in now. What have we let ourselves in for? What should we pack? How shall we manage all these bags?
We have had a good few weeks here and really enjoyed walking around Berwick and the coast. There is so much to see and the weather has been really kind to us. We are going to miss the coast and the for ever changing sea but I am sure there wil be compensations.
We are expecting to arrive in Masindi on Sept 30th. We havent heard about the house but I keep reassuring Maggie that it will all be alright and the accomodation will be all sorted. If the worst happens we can always stay at Court View Hotel for a few days. There have been bad floods on Eastern Uganda but as far as we can tell this has not affected Masindi although the experts say there will be bad rains this year. As the road from Kampala was bad in the summer it could be a real challenge in the rains.
We are really going to miss every one in England but at least the internet will allow us to keep in touch. We hope lots of people find an excuse to come out to see us. Africa is a fascinating continent and Uganda needs tourism. There is a lot to do and see.

Chris and Maggie

Berwick Bridge

August 23

Thanks to who ever has set up a wi fi connection on Berwick North Bridge.
Maggie and I are sitting on the bridge watching the salmon netters, seals and swans as the sun gently sinks over the Tweed bridges.
We have finally moved into the flat in Berwick after a hectic week visiting Sheffield, Grimsby and picking up our last remaining things from Hull. Today we have had a visit from our neighbours from Hull Dave and Di and spent a relaxing day showing off our new neighbourhood.
Berwick is all that we hoped it would be friendly, quiet with plenty to see and visit. We only have 4 weeks left in the UK and are due to spend another week visiting and saying last farewells to family and friends. As Sept 21st approaches we are beginning to get down to deciding what we shall actually be packing. VSO have arranged missionary tickets for us so we will have an extra 23k baggage allowance each.I have never thought of us as missionaries but the extra baggage will be helpful. I expect from the collection of things we want to take that we will have to hire another Jumbo to fly out with us. How do you decide what you will miss and need in Uganda.

The final countdown

Starting the process no anaesthetic required.

There was no going back
Exposed

Shaving as a spectator sport.

Tuesday was my last day at New Hall Surgery and lots of patients past and present turned up to wish Maggie and I good luck. The highlight of the morning was the shaving of my beard of 36 years. I had never thought of shaving as a spectator sport but over a hundred people waited to see whether I really was a chinless wonder.
It was all a good humored affair and entirely painless thank goodness. Every one including Maggie and me were surprised to see what was under all that beard.
Maggie had been worried after all these years whether she would remember what I looked like.
It was a good way to finish 28 years at the surgery. Every one had a great time and I got to say a final farewell to lots of old friends. It was very disruptive of the work that day but once in a lifetime for me. I am now trying to grow the beard back.

It's not retirement

The last 2 weeks have been very hectic. Patients have been incredible and we have been overwhelmed by cards and donations both to VSO and to take out to Masindi. As we have reached our goal for the VSO appeal my beard will definitely be coming off next week. It is all set for Tuesday, my last day at New Hall. I do not expect to do much work that day but lots of patients are planning to come in just to say goodbye. It will be strange after all these years to finally say farewell.
We had a wonderful party on Friday night with all the surgery staff. Vince had arranged the entertainment and every member of staff did something. There were songs,sketches and even poetry and a large amount of fun! A great time was had by all.We were presented with a digital video camera which was used to record the whole event. We managed to produce DVDs for everyone.
We have had lots of invitations out for "farewell dinners" Thanks go to every one who has asked we really grateful.Every one seems very supportive and interested in what we are planning to do in Masindi.Time is getting short now there seems an awful lot to do and people to see.
We are desperately trying to pack this week. We have thrown out so much accumulated rubbish. It's amazing how much one family can amass over the years. The van is booked and we have decided to store the left overs in Sheffield so it is all systems go.

Another week gone

This week has flown by and I can't believe how quickly time is going now.We are leaving this house mid August and should have spent the week end sorting things out but decided to go to Berwick instead. This was the first time I have seen the Boult but I was not disappointed.We camped out there as we haven't furnished it yet but managed to have a great weekend. It is so relaxing in Berwick. Everything is in walking distance and the people are really friendly.
I spent the week in Birmingham on a VSO course.It was good to meet other people at a similar stage and see how their preparations are going. Everyone seems to be at the same stage of panic.
This week we really must get on with packing!

Sat June 30th first post

A rush job to get the blog set up before the party. Now we are set up we will probably forget about it.There is the usual chaos at Victoria Ave as we try and get ready for the big night.