Mangoes, monkeys and Maggie

Chris and Maggie
in Masindi

Sunday 22 February 2009

Maggie missing from Masindi



THE PHOTOS SHOW THE SPECIAL BOARD AT COURT VIEW AND VILLAGERS FROM KIHAMYA WAITING TO BUY NETS

This has been a strange week with Maggie returning to the UK. Every body keeps asking where is Maggie and when is she coming back. The staff at Court View still do not really believe that she has left there and are still hoping she will go back.


Masindi has been full of Muzungos this week with delegations of Bristol teachers and a christian group of over twenty. It is strange to see them all coping with the culture shock that we experienced in 2007. It makes me realise how I have adapted and things that horrified me when I first arrived I now just accept. I am not sure if that is a good thing and whether justified rage would be a better position but you can only stay angry for so long. The people who you really should be angry with are not in Masindi, they are in Kampala in the ministries and their air conditionned offices.


So I did not fly in to a rage when the medical superintendant told me that he could not get morphine for a woman dying from uterine cancer, nor did I get angry when he said there were no sticks for the glucometer so I will have to guess at the values for the diabetic patients. I was pleased that somehow he managed to get hold of some insulin so I did not mind that we do not have any other diabetic drugs. We do not have amoxil, pain killers or hypertension drugs either. The two patients with severe TB I saw on Friday will have to wait for their drugs because we have run out of anti TB drugs again. We do not have leprosy drugs either and there are at least 4 new cases to be assessed this week. We do have ARVs and we were sent some "Plumpy Nut Sachets" to use for malnourished children. Unfortunately they are due to reach their use by date in March so we can not use them properly but at least some of the kids will get a short time benefit.


In spite of the shortages there are successes here and every day you see patients who have benefitted from treatment. Most days the hospital performs caesarian sections for difficult births which undoubtedly saves lives. The maternal and neonatal death rate here is still high but it would be much higher without the skills of the surgeons who operate. Many of the patients with malaria would die without appropriate treatment and it is unusual for an adult to die in the hospital from malaria. Unfortunately often they do not get prompt treatment and the nurses forget to give them their quinine but most survive. Patients with pneumonia usually survive unless they are complicated by HIV. Most of the TB patients do well if they take their treatment and TB is one of the most satisfying things to treat here. Lots of patients have severe TB and look like walking skeletons when you first see them but after a few months treatment they are unrecognisable.


The big problem here is prevention so that is why we are trying to provide mosquito nets and get people immunised. The meningitis has gone but there was a death from neonatal tetanus in one of the villages. All it takes to prevent neonatal tetanus is to give the mother a single shot bf tetanus immunisation in her pregnancy. This mother had attended 3 ante natal sessions but was not given an injection so the baby was not protected.


We have purchased another 1000 mosquito nets for distribution this week. The vehicle is off the road but some how we need to get out to 3 more villages. We may have to take a special hire as the district appear incapable of providing vehicles and do not see the project as a priority. This all costs extra money but it is money well spent.

Sunday 15 February 2009

Obama in Masindi

PICTURE OF ISAAC AND STEVEN



















PHOTOS ARE OF MURCHISON FALLS TAKEN ON OUR LATEST TRIP.

OBAMA AND MASINDI
Happily the meningitis outbreak appears to have finished as there have been no more cases after the emergency immunization campaign. I have been visiting some of the villages involved and was surprised when John one of my senior colleagues who I travel with told me that the villagers had been asking whether I was Obama come to help them. Obama is a real celebrity in Uganda and every one is expecting great things from him but why villagers should mistake an elderly muzungo for a young Afro-American was beyond me. Thinking about it I realised that if you live in a village you will never see a picture of Obama. TV here is rare and only ever seems to show premier league football, never the news. Newspapers and magazines do not reach the villages and all news comes from the radio which most people listen to. People have heard of Obama but have no image of him. The idea is that if any one from abroad is taking an interest it must be Obama. I hope he has time to sort out Masindi among his other problems, it needs all the help it can get.
We have a great time the last week with Hannah and Sara visiting us from the UK. Our trip to Murchison Park was wonderful as usual and we saw some magnificent elephants and other wild life including a beautiful chameleon on the road. Unpacking the vehicle on Sunday night we realised Maggie’s camera was missing. After intense questioning and threats of torture I confessed that I had hung the camera on a mango tree in the car park at the top of the falls. No one could face a two and a half hour journey back to the tree in the dark over unmade roads. We were advised to report it to the park authorities. I went to the office in Masindi at seven o’clock and was surprised to find a ranger there. Do not worry he said, tell your wife not to beat you these things happen we are all human. He radioed a colleague in the park and they promised to look for the camera the next day.
On Monday morning Maggie went to the office and was told that the camera had been found. They said it would be taken to the foot of the falls and given to the boatman. He would then take it to the office at Paraa. Simon said that when a vehicle came in to Masindi they would bring it with them. In fact the next day we had a call to say that the camera was at the Park Gate 20k out side of Masindi. Simon the ranger said if we paid for his fuel he would go on his motor cycle to fetch it. The camera was returned for the cost of 3 litres of fuel, 10000 ush or £3. A cheap price to save a marriage!
It amazes me that simple things often never happen here but complicated things work out. If I had left a camera hanging on a tree in Pearson Park in Hull there is no chance I would have got it back.


This week I had to ask Isaac who runs the family spirit centre to see a boy in the clinic. This boy has HIV.He is looked after by his grand parents as both of his parents have died from HIV. This is not an unusual situation here. Unfortunately the grand father is disabled after a stroke and the grand mother is an alcoholic who regularly gets drunk and beats the boy. Steven had run away the previous day to his aunt 5 kilometres away. He is malnourished and has Stage 3 HIV. He needs to start ARVs. His grand father accepted he could not care for him and was searching for help. Isaac is a big man but as soon as he walked in to the room you could feel the tension disappear from Steven. Isaac just wrapped him in his arms and gently talked to him.This little boy relaxed and you realised he felt safe at last. It was very moving. It was agreed that he would go to the family spirit centre and live there. He will be looked after and receive an education. Hopefully he will respond to ARVs.








Sunday 1 February 2009

February already




PICTURES OF THE STORM AT COURT VIEW AND CHILDREN AT FAMILY SPIRIT WITH ISAAC THE FOUNDER

This has been a quiet week. The weather has broken and there have been some spectacular storms one of which removed the roof from the shop just out side are compound, luckily no one was around. The weather here is amazing it can change from bright sunshine to fierce rain within a few minutes. The rain is usually preceded by a wind which rattles everything in the house. You can often see the rain advancing up the valley. When it comes every one dashes for cover and everything stops. It may pass after a few minutes but sometimes you are stranded for much longer. The rain is just too fierce to walk out in it. I nearly got caught in a storm on Wednesday. The medical superintendent who is in charge of the hospital could not cash his salary cheque and needed some money to travel to Kampala on family business so he asked if he could borrow 200000 ush. I could go to the bank and withdraw it but he has no reserves. Even a man in his position is only just operating above the poverty line and has no spare cash at the end of the month. Most people here seem to live with out cash. Many people do not get a regular salary even when they are working it is not unusual for payment to be delayed. I have not had my salary from the district since July luckily we do not rely on it.
The rain hopefully will have helped bring the meningitis out break to a halt. The ministry sanctioned a mass immunisation campaign so the district rapidly trained staff and deployed them in the villages. I have not seen any one involved this week but I have not heard of a flood of cases and there have certainly not been any admitted to the hospital.It has been remarkable how the service responded to the out break once it was identified. It was not the most efficient response but hopefully it has worked. There has been no mass panic and hopefully no great loss of life.
This week has been busy with net sales. This has been the first time that the team have done it all on their own. I have not been out to supervise and it has been great to see that it all worked and three villages were visited. We are having a meeting tomorrow to plan the next stage. We still need to buy more nets and are now being approached by other villages demanding that they are involved in the project. There are no plans to extend to other villages until all the ones we identified have their nets but it is good that people are asking for nets. The rains will bring an increase in mosquitoes so it is important we get them supplied as soon as possible. A Peace Corps volunteer Chris has offered to arrange some fund raising in the US and we are hoping to raise some money when we return to the UK in March for Becky’s wedding. It looks like we will have to pay more for our next supply of nets but hopefully not too much.
I returned to the Family Spirit Centre this week end. A well wisher from the UK had sent some money for them. They had just been given two exotic goats by rotary international and needed a new goat house so the money came just at the right time. If all goes well they can breed from the goats and generate and income. I am always amazed by the centre. The children have so little but are always cheerful and polite. They are getting an education and somehow Isaac the founder manages to interest local people in the centre and gat them to offer services or food for the children. They are searching for a computer now as Susan the deputy has just done a computer course and wants to use her skills to keep better records. At the moment if they want any letters writing they have to go in to town and pay to use a computer and printer.