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THE PICTURES ARE OF CHARLES WHO HAD SEVERE MALARIA WITH ANAEMIA. HIS HAEMOGLOBIN WAS DOWN TO 4.0 BUT WE HAD NO BLOOD TO GIVE HIM. HAPPILY HE RECOVERED AND IS NOW WELL. THE OTHER TWO ARE FRIENDS OF MAGGIE.

It has been strange to be back in Masindi after 3 weeks in the UK. Every one has welcomed us back. People who I do not recognise shout “welcome back doctor” when I walk round town or in the market. The staff at Court View were particularly pleased to see Maggie back after she had been lost for 5 weeks but disappointed when they realised she was not going back to work. They were all keen to hear about the wedding and wanted to see pictures. The informality of Becky and Gordon’s ceremony surprised them and when they heard the reception was on a boat sailing down the Thames they did not believe us.
I was back to work on Tuesday to find no change. Happily we have managed to borrow TB drugs for the moment. It was world TB day on the 24th and the Ugandan celebrations were held in Masindi. There was lots of marching and brass bands with speeches from the politicians. Many people in the town are wearing new T shirts with TB slogans. The man from the ministry admitted that Uganda has run out of drugs but they are expecting a shipment this week. There was also a visit from a team monitoring the TB/CAP programme this is a donor funded programme trying to improve services for patients with TB and HIV. They shared my concern about lack of drugs and were surprised when I reported that we had no x-rays or sputum containers in the hospital. The programme does have a vehicle and I was grateful to be able to use that on Wednesday to go out with the leprosy nurse to review patients. Gradually there seems to be some improvement in the leprosy service and people are getting reviewed and assessed.
Just before I left for the UK Uganda had its first case of polio for 12 years. There have now been 7 cases confirmed in the adjacent district. The out break seems to have moved down from Sudan where immunization programmes have been interrupted by the conflicts. Polio was due to be eradicated from the world but wars in Congo and Sudan and problems in northern Nigeria have delayed the process and there has been a recent upsurge in cases of this dreadful but preventable disease.
President Museveni made a presidential decree that said that all children under 5 years should be immunised in the at risk districts. Somehow with the help of the WHO Uganda mounted an emergency campaign and over 90% of children have received the first of three immunizations. Refusal to present your child is an offence and the police are involved in monitoring the campaign. The UKs efforts to provide immunisation seem feeble compared to such an effort by the community department. John Kirungi who heads up the department is one of the unsung heroes of public health who are scattered through out Uganda and Africa. They keep battling on against all the odds to try and protect their communities.
The Miirya project has continued while we have been away. Fund raising is going well and it looks like we will exceed our target thanks to the generosity of friends and colleagues. It was good to see Comic Relief concentrating on mosquito nets when we were home. Aron the teenage son of Rose our house girl came to see me on Wednesday he was sick with fever and vomiting and looked really ill. He does sleep under a net but still had malaria nets do not give 100% protection. Happily with the right treatment he was better within a couple of days. Teenagers recover well but it is the young children who have the most risk. We have now distributed 2391 nets in 24 villages and have another 15 villages to visit. Pam Llewellyn my nursing colleague who has been fund raising in the UK is coming back out next week to work on the project and hopefully we can further develop the work. There is a lot to do.