Time flies

THE PICTURES ABOVE ARE OF TWO BROTHERS WITH EARLY LEPROSY BEFORE NERVE INVOLVEMENT. THE PHOTOS SHOW EARLY SKIN LESIONS.

THE PICTURES BELOW ARE FRANCES THE OLDER BROTHER WHO HAS HAD LEPROSY FOR SEVERAL YEARS AND HAS ADVANCED DISEASE WITH SEVERE NERVE INVOLVEMENT. HE HAS ANAESTHETIC HANDS AND FEET WITH LOTS OF DAMAGE.





EARLY TREATMENT WOULD HAVE PREVENTED THIS DAMAGE.

Some how we missed out on last weeks blog. As we enter our last four months time seems to be going quickly and a week can pass by with out you noticing it. It is also hard to find something new to write about. Things that seemed really novel and interesting this time last year are now not even noticed.
Money has always been a big issue here in all sorts of ways. Even as a volunteer you are seen as much better off than every one else which is true. This does not appear to provoke jealousy but does mean that people regularly ask for money. This week the children have returned to school so school fees are due. Although primary education is free many families opt to send their children to private schools as they hope that the education will be better. Many schools are boarding schools so for much of this week people have been away from their jobs delivering children. It seems to be accepted that a few days off work to take your children to school is reasonable. Families make real sacrifices to send their children to school. Any member of a family who has a job will be expected to support not only his own children but other children as well. Unfortunately the local government has not paid salaries for the last two months so all health workers, school teachers and police are struggling to meet their school fees. It is hard to believe that salaries can just not be paid but it is not uncommon here. When I ask colleagues about it they just shrug their shoulders and say “this is Uganda”.
Most patients are from the villages and are basically subsistence farmers. They have little spare cash but health care here costs money. The health service is supposed to be free but only if the drugs and resources are available. We have not had any X-ray films for over six months and there is no ultrasound. If a patient needs the investigation they have to go in to town and pay 15000 ush for an x ray or scan. I frequently see patients in need of x-rays especially to rule out TB. If they have not got the funds I am able to use some of the money that was donated before I left Hull. This month I have been dipping in to that fund quite a lot. There was the case of the women who had been bitten by a dog that was ill and acting strangely. There is rabies about in Uganda even though cases are rare. The government should supply rabies vaccine but there is none available in the hospital so it has to be bought from a private clinic. There is no chance that this woman could afford 120000 ush for a course so the fund stepped in. It would have been difficult to send her away. Tomorrow I will use some of the money to pay for a special hire taxi to take a baby with a heart defect and a young boy with Burkitts lymphoma to Kampala for assessment. Unfortunately I think the baby has a serious problem requiring surgery which is unlikely to be available here.
By chance this week there has been a team of American medical missionaries visiting. One of them was a nurse who works for a charity in the states that takes babies to the US for corrective surgery.It is just possible that Rita the infant may get her surgery there.
I managed to get out on Wednesday to follow up some of the leprosy patients. One of them asked to see other members of his family. It was an isolated homestead but it was worth the effort as two of his brothers had definite leprosy. Luckily they were early cases and did not have the severe nerve damage that Frances has. It is satisfying to find new cases, I am afraid without my encouragement the leprosy nurse would not have bothered to chase them up. There is a major problem with searching out new cases and getting them on treatment early. One of my aims before I leave is to get the district to recognise that they have a problem with leprosy and must be more active.

LIBRARY UPDATE
On my first day we got off to a slow start. First of all, I should have been going on Wednesday but as Ritah had to go to a burial we postponed until Friday. It was a common 'man with the key' problem. Once we'd gone round the houses, literally, to find the key it was almost lunchtime. As it was the first week of the new term the children were occupied with cleaning classrooms and digging the compound. This meant that the library was not open for business as usual but it did give us an opportunity to start sorting the long awaited shipment of books.It seems that this shipment from the UK has been stuck at customs in Entebbe for quite some time. Also, Ritah did not want the children in the library until some of the girls had taken the mats down to the well to be washed.
My second day, today, turns out to be Martyrs Day and therefore a national holiday so the school is closed. I will hopefully get to work on Friday. Flexibility is the name of the game!
Maggie