Mixed week in Masindi

This week has been dominated for me by the arrival in town of the Elton John Pajero. This is the vehicle that was given 4 yrs ago for work in the community. It had been off the road for over a year but I gave some money from the donations I brought out to have it repaired. It has been a complicated process but it is back on the road. The first I knew of it was when I saw it delivering children at one of the local schools but after a few days chasing it was delivered to the hospital and handed over.
After the trouble we previously had getting out to the health centres it was great this week to travel in relative comfort and safety out to Kyateri health centre. I spent the day observing and working with the clinical officer, a young women of about 23 years. There were the usual cases of malaria and diarrhoea. One child had a pneumonia and probable malaria In the UK she would have been admitted to paediatric intensive care but here she was sent home with amoxicillin and Co Artem. The area has a high maternal mortality rate even by Ugandan standards. Although most women attend ante natal very few of them deliver at the unit, most choosing to stay at home and be delivered by relatives or friends. If there is a problem, then transfer to Masindi hospital 20 km away is the only option and that is if you can find transport. Theoretically there is an ambulance at the hospital to collect patients but this rarely seems to happen.
The health centre seemed to function quite well and was providing a good service to the community.
On Friday we used the vehicle again to visit a patient who had not attended clinic to pick up his drugs. He has TB and HIV and was ill the month before with a haemoglobin of 5.9.When he sent a supporter to pick up his drugs we were concerned that he might need admission so we arranged to go out to see him. This is just the reason why we wanted to get the vehicle back on the road.
He lives near Biso about 24 km from Masindi. The homestead was several km out of Biso down several cycle paths only just passable in the 4x4. Eventually we came to a group of mud huts where we were greeted by Godfrey the patient and forty of his relatives, several of whom spoke perfect English. Luckily he was improving and the last few days he had started to eat again and was feeling stronger. His family are originally from the Democratic Republic of Congo just the other side of Lake Albert. They fled in 1983 to avoid the war and had to flee again from Buliisa to avoid famine. They now live together in this homestead of 42 people. It was remarkable how well they all seemed to get on. Godfrey’s father had had 40 children but Godfrey only had 6. When the children arrived home from school they all knelt down before the old women as a sign of respect. At 6.00 pm Godfrey called one of his sons to get the radio and he tuned in to BBC world service. He said he always listened to World Service as he liked to know what was happening in the world.
We were introduced to a little girl of 8 years. She was severely stunted and Cushingoid. She had been put on steroids at a year old for arthritis and the family had been buying them ever since. The drugs had severely affected her growth and now it is doubtful she will ever be able to come off them safely. Godfrey’s brother was very concerned about epilepsy as one of his sons had developed fits. It appears that this is a common situation in the locality and no one is sure why there is such a high incidence. Hopefully we can go back there and collect some information to clarify the situation. Unfortunately anti convulsants are not readily available here.
On Saturday we were invited to our askari’s home. He was keen to show us what he had spent the 300,000ush loan on. Soloman has been our night watchman since we moved into the house. He comes every night at 7.00 and leaves at about 6.30a.m. His job is to protect us and the property. He is a likeable chap who does not seem to mind working 7 nights a week. This seems to be the normal situation here and he is glad of a job. He lives with his 10 children and other family members on a large plot of land which he farms. His father obtained the plot many years ago when he came to Masindi with the British from the Sudan. Soloman considers himself Ugandan but his roots are in the north. He has been building his new house for 9 years; whenever he gets any money he does a little more. The money we loaned him in January he used to buy iron sheets for the roof. He now has half the roof covered and he has moved into half of the building. He proudly showed off his land and his crops. He obviously grows enough to feed every one but there is no spare cash and I expect part of his reason for showing us his home was to ask for a raise or another loan. As we left he scooped up a duck, placed it in a carrier bag and gave it to Maggie for our meal. It is hard to refuse a live duck! We took it to Court View and persuaded the chef to kill and pluck it. We muzungos prefer our meat on Perspex trays wrapped in clingfilm.
Today we have walked the Masindi trail. This is a 3 hour walk around Masindi which was originally worked out by previous VSO volunteers. It incorporates some of the historical features of the town and was good fun but very hot in the sun. The Masindi volunteers are planning to organise a sponsored walk using the trail in June to raise money for a local HIV/AIDS charity and to raise awareness locally of the issues.
There are some photos attached.If you look carefully at the one of the pick ups you can see the second driver. Soloman our askari is the one with a big grin and his long suffering wife is beside him.The others are from the trail.