Just another week at the office ...

This post is a little on the tardy side due to our lack of internet access. But, here it is anyway. These are a collection of photos from our third week in Kampala and working at Mulago Hospital. It is interesting in that both of us have started to see an ever-enlarging myriad of issues when we examine life in Uganda. In particular, we question many of the fundamental attitudes and values of some of those living in Kampala. For example, it takes only a walk down the sidewalk of a busy street to see what we perceive as a lack of the respect shown towards others and the nearly non-existent reciprocation of good will in the interactions of people.

Here, drivers fight for every inch of space on the road and show little grace towards other drivers. Furthermore, even in a traffic jam with no space to move ahead, drivers will fail to wait for pedestrians to cross. And, the worse part of it all is the reckless driving of the Boda Boda drivers. These Boda Bodas are motorcycle 1-3 person point-to-point taxis that cost about $1 CDN a trip. Unfortunately, there are usually no helmets worn and these motorcycles scoot in-and-out of the traffic and squeeze between lanes. When there is a traffic jam, they pop the curb and ride along the sidewalk without even slowing for pedestrians walking on the sidewalk. We have treated two children with closed head injuries from being hit by a Boda Boda while walking on the SIDEWALK to school! Yesterday while walking home from the hospital on a little-traveled dirt road with no traffic a Boda Boda passed within inches of Sean for no reason as the road was wide open! Sean was able to brush the driver's helmet with his elbow as he was that close! No, we are not making friends with everyone here! If these driving attitudes are an indicator of general regard towards other humans than we fear that Ugandan society will never work together to grow, develop, and prosper.

Ok, enough of our rant... Here are some more uplifting pics!



Sean and Emmanuel sharing a Bell beer at an Ethiopian restaurant in Kampala.

Sean before the Ethiopian feast! No, he didn't eat all of this on his own, but he was glad to see meat!

Sean and Glenna on a night on the town in Kampala.

The traffic jam that continues for a good part of the day here in Kampala. See the merchants trying to peddle their wears to those stuck in traffic?

Two of Sean's friends at Mulago Hospital. Names?

Much to Glenna's dismay, our pool has been closed due to poor maintenance. According to the "pool guy" the water had not been changed in many months and the pool had not received maintenance care in nearly 12 years.

And we wonder why we see so many head traumas - check out the guys on the back of the truck.







To avoid the traffic smog, we took a walk through the Golf Course. Here is a caddy sharing a moment with a school boy walking home.

Some kids at play at the Mzungu Mall - Garden City.

Our local Irish Pub - Bubbles O'Learys. This is match night for the U.S Medical students and our American friends are in good spirit following a successful match. Quotable quotes for the night:

"I can't believe that I put 10 litres of IV fluids into that guy!" Robbie, matched to Pediatrics.

"I'm covered in urine and sweat from head to toe!" Josh, matched to Radiology.

"I think I need to be autoclaved" Rob, matched to Dermatology.

Here's the happy couple after inhaling a meal of Irish stew!

Glenna "relaxing" after our mass casualty disaster.

Yes, Sean loves his food - especially the meat!

Glenna spent a day on the labour and delivery ward. What an experience! 80 mothers, all in labour - some on beds, many on benches, and the rest on the FLOOR! 4 C-section rooms going with patients "in distress" awaiting "urgent" sections. Fetal death rate is nearly 5% and a mother dies almost every other day!

Dr. Glenna wearing Mulago scrubs as our Canadian scrubs were not "clean enough". See the towel on Glenna's head? Well, when she tried to put on the scrub hat it wouldn't fit. When Glenna returned to the clerk to get another one she was told, "Your head is too big as the hat fits everyone else!" The lady didn't seem to understand the fact that Glenna couldn't readily change her head size.

Glenna delivered by C-section two twins! Yep ... twins! Can you imagine how excited she was to tell Sean this?

Ok, away from the hospital and because our pool is closed, we had the privilege of walking 30 minutes to the Golf Course Hotel pool. Wow! Look at this pool. Nearly 40 metres long and with fountains! Here is Sean "swimming" at the pool. In fact, the hotel photographer took the same photo so keep an eye out for the Sean on their next brochure!

This is our Olympian swimmer Glenna - look at that form.

Glenna doing synchro! Naw, just a really neat shot of the water trailing off her hand.

Professor Sean teaching resuscitation basics to residents, nurses, and medical students.








Yep, Professor Sean again.

Sean on the streets of Kampala talking with some local children.

Sean still talking ...

Glenna with her matching shirt to the Banana lady! It would have been a better picture if Glenna was wearing the basket, no?







So Sean has been having sleeping difficulty - he thinks it is the Mefloquin. Here is his solution to the noise and light issue at our apartment!

That's it for now. Stay tuned for another update ....

Missing everyone back home.

Glenna and Sean

Save The Mothers!

We had a great day trip out of Kampala to visit Dr. Jean Chamberlain and her family in Mukono. Dr. Jean, a Canadian Obstetrician and Gynecologist, has been living with her family in Uganda for nearly the last decade. In conjunction with the Ugandan Christian University, she has started a Master's level program in Public Health Leadership called "Save the Mothers!". This program is geared towards community leaders and endeavours to bring pregnancy, childbirth, and motherhood issues to the forefront of their minds while enabling the leaders to make grass root changes toward safer motherhood in their home communities.

Please check-out Jean's website at:
http://www.savethemothers.org/


Here Jean explains to Glenna how Save the Mothers got off the ground while touring us through the Ugandan Christian University grounds.






Here are Sean and Glenna in front of the UCU Main administrative building. Looks like Oxford, no?





After a few hours of program review and testimonial from current and past students, we headed off the see Jean Chamberlain and Thomas Froese's home at the top of a hill overlooking Mukono. Thomas is a journalist, writer, "engineer", landscaper, interior designer, ... (in fact Jean's description of Thomas' skills was quite extensive). Glenna enjoyed making dinner with Jean while Sean played with the kids in the sandbox! The difference in Africa is that the sand is red and STICKY!


Jean and Thomas have two gorgeous children - Elizabeth and Jonathon (spelling may be off - sorry). The kids are holding dolls made by Sean's mother's CWL group. We provided each of them with three dolls to give to children that they knew who didn't have many toys. Immediately, Elizabeth started making a list of Mukono girls who had very little.














And, how could Glenna resist this cute little face? She stated, "it's so cute I want to just eat it!" ;) Even now she is telling me, "That's my baby!"



After a great meal, partially thanks to I Love New York restaurant in Kampala, we enjoyed a fabulous chocolate fondue and then bid the Froese/Chamberlain family goodnight and headed back to Kampala.

Thanks Jean, Thomas, Elizabeth, and Jonathon for a great day!


Glenna and Sean

Building Collapse!

There I was helping Glenna with the resuscitation of an eight-year-old boy who had been struck by a Boda Boda (motorcycle) when the nurse popped her head in to the resuscitation room and said, "A building has collapsed and we are expecting many casualties!"







Leaving Glenna to tend to the boy, I tried to locate the hired Medical Officer for the Surgical Casualty Unit, but she could not be found! Next, I tried to find the local Intern rotating in Casualty, but she too could not be found! Taking a quick inventory of our staff, I had Mzungu (white-man) me, three Mzungu medical students from Harvard, one local Mulago medical student, two nurses, and four or five student nurses. In my North American bossy voice I ordered every non-emergent patient and visitor out of the casualty area, including those waiting for x-rays. Most seemed quite shocked at my authoratative voice, but promptly moved for me! It was only minutes before we started receiving the first wave of casualties.













Initially, we had four or five casualties arrive at once and so started the Mass Casualty triage: No pulse - leave 'em dead. Pulse, but weak or not breathing - start bagging and start an IV. Breathing, but weak radial pulse - start an IV. The three medical students were invaluable in assessing and doing the ATLS trauma assessment. All the traumas that they had seen earlier in the week had paid-off! The sickest patient that we treated had profound respiratory distress. He was promptly intubated, but immediately started gurgling blood out of his ETT (intubation tube). We suctioned and sent him to ICU for chest tubes and possible surgery. Apparently, the ICU team (minus Glenna who was in CT with the unconscious boy), worked on him for about 3 hours (the entire time that we assessed the remaining 19 casualties). Unfortunately, he succumb to his internal chest injuries.

Glenna returned within an hour of taking the boy to ICU and helped me and the now present Medical Officer to finish the trauma assessment, radiological review, and dispositioning of the remaining casualties. In total was had received two waves of patients with a trickle of patients after the waves. In total, we estimated that we treated 20 people. 19 lived! That is, they were still alive when we went home 6 hours after the building collapse. Apparently, one other person died at the scene and had not been brought-in to the hospital.

We later found-out that the building was a mall that had construction immediately adjacent to one of its walls. The outer wall of the building had collapsed pulling down one section of the two-storey complex. Interestingly, in reviewing the photos we see that the building wall had collapsed outwards causing the floor to slope down. This would have tossed the people outwards onto the rubble pile as opposed to the building falling-in on top of them. This explained the low number of crush injuries and the minor nature of most injuries to our casualties. Lucky for them - lucky for us!


This was the first time we actually saw the resuscitation room hopping at a fast pace!



Sean reviewing with Rob, a fourth-year Harvard medical student hoping to do Dermatology! (Not taken during mass casualty situation)




Josepine, the Mulago resuscitation nurse bagging a patient.

















Sean and Josh, a fourth-year Harvard Medical student with plans to do Radiology. Ever seen a Radiologist with a bag-valve-mask in hand? This guy's good!


















Here's (left to right) Josh, Rob, and Michelle resuscitating a patient in the casualty resuscitation room. This was a patient who had been beaten-up by a gang of Boda Boda drivers. Michelle is a fourth-year medical student from Northwestern in Chicago.










Glenna and Josh doing the ATLS protocol - our most practiced protocol at Mulago.


















Dr. Martin (icu resident) and one of the paramedical anaesthesists at the bedside of a ventillated patient.

Sean teaching some ATLS to Josh and Michelle.

Glenna at the end of the crazy day of work!

Sean, looking a little tired, a little sweaty, and a little frazzled after the mass casualty.

The aftermath clean-up.






All in a day's work here! We obviously needed to unwind after this day so we took-in the 40,000 Shilling Irish Stew and Guiness at the local Irish Pub called Bubbles O'Leary's! Great name, eh?

The End.

Sean

A weekend with the Chimps!

Last weekend, we took off to go and see our 98% genetically similar friends, the chimps! Our weekend started with a scenic tour of the traffic and streets in our private taxi.

A typical scene in the city, with piles of people and cars in all directions. (a good photo by Glenna)

Little shops are all along the roads selling what they can. And the kids are EVERYWHERE! Of course, we are convinced that the price is nearly double given that we are Mzungu!

This one for example, obviously has bananas of every kind.

A neatly kept little house on the main road. In Uganda, image is very important, even if the houses are small.

For the ladies, image is especially important, and they often head out to their errands all dressed up. Glenna's all black attire probably doesn't cut it.

Yet another small homestead on the road to Entebbe.

Transport and traffic... we have noticed over the last 2 weeks, that Boda Boda's (motorcycles) and road bikes are used to carry anything and everything. Seeing these photos, we're not surprised that "mass casualty" occurs at least once per week!

Here is a Boda Boda carrying a dresser. I wonder what will happen if he forgets that the back of the bike is a little bigger than the front.

This looks like a good way to prime cyclists for competition. I think these Ugandans would do well in a duathlon. Unfortunately, he is likely a courier service!

What the heck is that on the back of the boda boda and why is it placed so as to hit the most number of passer-byes?

If you buy an important piece of furniture such as a fridge, you wouldn't want anything to happen to it... sure looks well secured in the event of an RTA (road traffic accident!)

If you are in a hurry, jump on a boda boda. You are sure to get to the trauma bay fast!

After our scenic tour, that is the drive from Kampala to Entebbe, we arrived at the Entebbe Wildlife Education Centre. We boarded a boat tender for 12 and headed-out on our 45 minute ride across Lake Victoria to Ngamba Island Chimpanzee Reserve.

Here's the African tourists - darn we look geeky!

Sean, looking so lovingly at Glenna!

Glenna playing hard to get!
Doesn't she look so human-like!

Kickin' back and enjoying a abdominal buffet.

"Hey, pass over here!" He actually caught the fruit tossed at him!

No, not a chimp, but a white guy bargaining for a Coke - Sean had to promise to return the bottle as the deposit is more than the cost of the soda!

Us and our fellow Islanders for the day!

Following our return trip, we stayed a few hours at the Entebbe Wildlife Centre.

Again, two great looking geeks.

Even in Africa, Glenna is appalled at the idea of "going slow". That said, she is an advocate of helmet-wearing.

What a cutie! Glenna just wanted to "eat" this little one. In fact, he stood only 20cm in height (this is a telephoto picture). Look at the details in his hands and how he's using them - just like us!

This monkey found a way to the dining room and was "rewarded" with chips - he even dipped it in Ketchup.

Look at the King of Jungle! So majestic, so magnificent, so ...

... lazy! That was a yawn, not a growl!

Safari Sean! "Dr. Sean, Dr. Sean, where go you?" (said in the voice of short-stuff from Indiana Jones). Isn't he cute?

We had a difficult time capturing anything except butt-shots of the animals. This is the best we could do for the Rhino!







Peek-a-boo, I.C.U.! hee hee.

One of the local workers separating herbs from grass.

A group of kids of all races touring through the park. We couldn't figure-out if it was a Missionary group, orphanage, or some other group. Sean got in trouble for taking a picture of the blonde's bum! He says he was trying to capture the kids' photo ... SURE.

And, "Photo of the week". Sean captured this shot of a young girl working in the fields while children of the same age attended school on the other side of the fence.






And that's the photo-journey for this week. We thought that the photos tell more than our words.

Next up, weekend with Dr. Chamberlain in Mokono.

Glenna (and Sean).