What, more wildlife?!!

Our weekend visit to Murchison National Park was as wonderful as ever. The safari ended up as an elephant chase. We’d seen a few in the first few minutes but they were too far away and we wanted to get closer. Sulieman took us to the north of the park where we had not visited before. There was a lot of evidence of elephants being nearby (fresh dung, footprints and broken branches) but not surprisingly they can easily hide in the trees. Eventually we were rewarded by coming across a large herd including some babies. Two of the males were fighting which was an amazing sight. There was a lot of damage to trees and bushes and you can see why villagers are not keen to have elephants around.
As well as elephants we saw more giraffe than we have ever seen before. They look such ungainly animals but when they move they are incredibly elegant. A herd of forty crossed the road just ahead of us. Tom learnt how quickly baboon can move when he put his packed lunch on the roof of the car for thirty seconds. The baboon grabbed it, opened the box and relieved Tom of his apple and crackers.
Two events at the weekend reminded us how fragile life is here. On the boat trip we passed a group of rangers searching the river for the body of a colleague. He had jumped in to swim to his boat that was drifting away. It sounds like he was taken by a crocodile. There was also a near fatal crash involving a bus full of children. The brakes failed and the bus rolled back down the hill in to another mini bus nearly knocking it in to a ravine. Thankfully there were no serious injuries.
This week I did manage to get out in to the villages to follow up leprosy patients. It is always an adventure going out. This time we got lost miles from any where and ended up driving down single file paths through gardens and fields until we found a road that we recognised. Eventually we found our patient who unfortunately was quite ill. We arranged for his treatment and he was so grateful he gave us money to buy a soda. Ugandans can be generous but rarely do the villagers have cash to give away. This man owns a grinding machine and was obviously making good money grinding maize and cassava.

A few more wildlife photos:

A hippo keeping an eye on the crocodile in the grass in front of him:



Just playing:


Elephant feeding each other:



Cheeky baboon taking a drink from the pool:



Now posing for the photo:

MASINDI UPDATE

RHINO SANCTUARY

It seems like no time since the last entry but it is already two hectic weeks. The first week end we travelled to Kampala to meet other volunteers and renew old acquaintances. This was my first time to travel by bus to the city. We left at 2.00 and were at the hotel by 6.30. The bus journey was fine and it was great to find so many of my patients traveling on the same bus. Lots of people greeting “the doctor” made me realise how many people I must have seen in the last 21 months. It is one of the things I will miss the greetings, hand shakes and warm wishes from every one. People regularly greet you by saying “well done” even before you have done any thing. It is particularly welcome as most of the time you are unable to do any thing useful but people are just grateful for attention.
Kampala is a different experience from living in Masindi. Parts of the city are full of muzungos, mainly working for NGOs or out here to save Uganda. There are so many missionaries mainly from the USA that you wonder what they are achieving. They are all building churches or orphanages but many seem very naive about the real problems here.. You would think with all the good will that things would change but it is hard to see progress. Sitting in restaurants or coffee shops you hear people discussing HIV, empowerment, sustainability, income generation etc. It is almost as though we volunteers are the new colonialists and instead of slaves, ivory or diamonds it is orphans, poverty and HIV that we trade in. There are so many people making a career out of all this may hem that you sometimes wonder if we are perpetuating the situation for our own ends.
But at least you can get a nice meal and a good capuccino in Kampala.
One of the things I was able to do was visit Hadija a little girl we had sent to the Hope ward at IHK. It was so nice to go on a clean ward and find caring nurses who knew the patients. She had been properly clerked and was being investigated. We still do not know what is wrong with here but at least she has a chance of being sorted out.
The trip back by bus was more of a problem. When we arrived at the bus park one of the touts from another bus company recognised me, an old patient and tried to get us on his bus. We made the Link bus and joined it. We had been told to be there by 1.00 but the bus finally left at 3.30. We had two and a half hours of entertainment watching all the people arriving and departing and all the vendors trying to sell a huge variety of goods on the buses. It certainly is an experience but some experiences you do not need to repeat!

Last week I had an opportunity to visit Kigumba a small town north of Masindi. Hugh who works for the Salvation Army runs a project in the town. The project supports vulnerable children some of whom sleep rough others who head up households. The project provides meals three times a week and Hugh wanted the kids checked over to make sure they were ok. Pam, Maggie and I went and examined 42 kids. It was a good day and good to find they were all quite healthy in spite of there problems.

New visitors gives us an excuse to do tourist things again. Reg and family have arrived so the rhino sanctuary was first trip. One of the rhinos has had a calf but unfortunately it was not on view. Next week end we are returning to Nile Safari our favourite chill out hotel.



KIGUMBA SOME OF THE CHILDREN OF THE KIGUMBA PROJECT.


ADMISSION
Fraud and corruption are common place in Uganda and it is important that we report on dishonesty and fraud. Finally under intense pressure Maggie has admitted that the picture of us on the blog has been artificially enhanced! She can not resist using her skill on photoshop so she covered my embarassing bald patch and touched up her roots. I find it hard to hold up my head in company but that is not the reason that the GMC have deregistered me that is another story.

SODIS and Tippy Taps

SODIS BOTTLES AND A TIPPY TAP IN OUR GARDEN

After last weeks excitement chasing chimps we have had a much quieter week. I have had chance to discuss the chronic care clinic with both local management and last night with officials from the ministry. We are still struggling to get a secure drug supply but at least for now have some ART. There seems to be little chance of the district finding a doctor to replace me but at least they seem to have found a clinical officer. He arrived to start work on July 1st but as there was no accommodation he went home. He has been back 3 times to try and move in but the hospital have not fund any where for him.At least he appears keen.
The Miirya project is still progressing thanks to the support of people in the UK. Pamela has been very active moving out to the villages and encouraging volunteers. We held a meeting in each of the three parishes for volunteers and were pleasantly surprised by their continued enthusiasm. It is very humbling seeing people prepared to walk several kilometres in the sun just to hear us talk and give encouragement. It is difficult to pass people by on the road but we have a maximum of seven in a small toyota saloon. Moses our taxi driver is very accommodating but even he needs to change gear sometimes so only 3 in the front! The volunteers do get an allowance for travel to the meeting but most prefer to walk and keep the 2000 ush ( about 60p).
Each meeting is different. Bigando is always our favourite because Miriam in charge of the health centre is so enthusiastic. She produced figures from the health centre showing that there had been a drop in malaria since we started distributing nets.That was great for us to see and great for the volunteers to understand that their work is yielding results.At Kigulya the volunteers are quieter and the support from the health centre is less but it was still a good meeting. At Isimba the health centre failed to send an observer but we did have a resident drunk who kept up a lively contribution until he realised that there was no free food.
Although the main focus of the project has been on malaria prevention by using long term treated nets we have recently held workshops on sanitation and safe water. It was good to see volunteers enthusiastic about SODIS (solar disinfection of water). The idea had really impressed them in its simplicity and relevance. Most of the volunteers had stopped boiling their water and were using SODIS themselves and had taught people in the villages. The limiting factor seems to be availability of plastic bottles. In town you see bottles all over but in the villages they are in short supply. We are now organising collection of the bottles to recycle them in the villages. SODIS does seem an obvious intervention for Uganda with its abundant sunshine. Any reduction of fuel needed will be helpful as well. One of the best things at the Kigulya meeting was hearing Aida a 70 year old traditional birth attendant and volunteer explaining to the group about SODIS. Aida speaks only Runyoro but had grasped all the features of SODIS from the workshop and had been telling people in her village.
We had also shown the volunteers how to make Tippy Taps to wash their hands. Many of them had constructed them at home and already held meetings to show villagers how to make them. Being a good role model is one of the important parts of being a Miirya volunteer.
Of course not every thing is working perfectly in Miirya. We had a report that one of the volunteers who is also a TBA has been dissuading patients from attending the health centre for delivery. This is against government and the project policy. It was helpful to discuss this at a meeting and hear the volunteers condemn this action. They are supportive of the health centres but we need to make sure the health centres are supported to provide safe deliveries.