Measels and more

There is currently a major outbreak of measels in Uganda. They have a ward for measels and it is bursting at the seams - 76 children admitted and many passing away daily. It makes you appreciate the vaccination rate in the United States. We had a look at the death record for measels in the last month and it was very sobering. The children looked extremely sick - most of them who pass away, do so of pneumonia complications with measels. Most physicians in training in the US have never seen a case of measels but here were 76 in one large room. I had only seen it once before, in India.

The difference between the rich and poor here is incredible, like many countries. Kampala is a great city with a lot to do and a large amount of wealth but also and incredible amount of poverty. Many families do not have any food to eat, at all. Its not that they don't have any tasty food or pleasing food - they have no food and no means to obtain it. Many families subsist on one meal a day and that may be a boiled plantain - called mtoke or some starchy vegetable. Not a square meal exactly. The nutrition programs they have in the medical centers are amazing. In fact, the whole program is amazing. It is a multifaceted team approach - including psychological counseling, adherence counseling, nutrition, pharmacy teaching, free medications, home health workers on motorcycles, monthly nursing care, financial counseling and on and on. It is the way it should be done - a model for the rest of the world. The patients are lovely, greatful, beautiful people. Kampala itself has many of these programs servicing the city very well. We are discussing how we will fit in to all of this. I think I will be doing many things including clinical work, trainings, outreach, rural clinic/program development, possibly some hospital work. There are rural hospitals that are very short of physicians - pediatric wards with 80 kids in 40 beds who need physicians. All of this is being sorted out currently. The majority of the population lives in the rural area but the vast majority of the physicians are in the city. We will be making site visits the second week of september.

I miss everyone and am hopeful that Angela will be joining me before too long. Hello to Ben, Sam, Luke, Lensy and Joesy! Uncle Dan is thinking about you! Take care.

Lake Victoria

Top photo is the Mulago hospital - the government hospital in Kampala. It is a sprawling rambling huge all inclusive structure. The clinic i work in is on the campus but in a separate building. There are many buildings on the campus.

We took a day trip to Lake Victoria yesterday. It is only a 20 minute taxi ride. As part of the apartments we are currently staying in, we have free access to a huge pool at a hotel by Lake Victoria. It was pretty spectacular. I will try to attach a photo of the lake. This is just one small bay....it is quite large. Talapia is the main fish that people eat from there. I have yet to try it but it looked the size of a large bass. The ecosystem of the lake has changed radically over the years with introduced species and lage scale sewage polution and therefore algae growth. There are lage Nile perch that live in the lake - can be about 6 feet long. There are supposed to be beautiful islands to visit in the lake - sesse islands. Will have to do that sometime soon. Also the headwaters of the Nile start east of Kampala in Jinja.

The city of Kampala is great. Very friendly people, safe to walk around in. Everyone is extremely welcoming to us and happy we are here. The city is very dynamic with lots of non-govermental organizations, restaurants, shops, hotels, street vendors etc. Diesel is also very popular which can be a little much if you are walking behind a large truck! Motorcycle taxis are also very frequent - called boda bodas. I have not hopped on one yet and will likely steer clear of them. Being a bit of a scooter/motorcylce fanatic it is had not to join in on the chaos and buy a scooter! Apparently there is a YMCA where outdoor basketball is played - a league. I may have to try it out - not too far of a walk from my apt.

Tried some traditional food today - boiled bannanas (the kind that taste like potatoes not sweet) with groundnut (peanut) sauce, cornmeal, beans, chicken (seriously free range, in fact the chickens may actually lift weights based on they way eric's teeth were straining) or fish is a traditional meal. It was pretty good - i didn't eat the chicken...

I miss everyone but am enjoying my experience thus far. Ready for Angela to arrive! Hopefully soon but no good word on the house yet.

First day of Clinic

Life is good for me in Uganda so far. I saw patients in the "family clinic" yesterday, a new model for the pediatric infectious disease clinic where the whole family is seen together, as often all are positive so it makes sense. They are happy to have another Family Practicioner or "community practicioner" (new specialty in Uganda) to help in the Family clinic. The amount, severity and variety of disease is fairly alarming. Simple shingles is a full blown eruption across 5 dermatomes and is mentioned as an "oh by the way" type of problem. For the medical types reading this blog on my first day I saw all HIV pos patients but with: LIP - swollen parotids, interstitial pulm infiltrate, cough, etc; one child with caseating draining TB scrofula, hydrocephalus with a VP shunt; several cases of active TB and HIV, teen pregnancy HIV pos not on meds and both parents deceased; HSV - several cases; parotid enlargement - several cases; pneumonia, chronic bronchitits; sickle cell disease with HIV and active TB in a toddler and finally rickets and malnutrition. One day. What will I see today? Speaking of that I have to go to work. I walk to work, sweating like mad when I arrive from a 10 minute walk through the bustling streets of Kampala. The climate is actually quite lovely - warm mid-day and cool at night, much the same temperature as Santa Rosa. I am just a sweater. More blogging soon.....

arrival!

i arrived safe and sound in kampala last night. after around 22 hours of traveling i was greeted at the airport from a taxi driver with my name printed on a sign - always a good thing. it was a 45 min drive to kampala, passed lake victoria but couldn't see much in the night. after some difficulty in finding my apartments got settled in a couple hours later. got the introductions at the clinic today and toured around the city a bit. so far, loving it. the clinic is overflowing with lovely, beautiful children - many smiling at me as i walked around like an alien with curly red hair. when i waved at one little girl, she took it as an invitation to approach me and stare into my eyes while holding both of my hands. very adorable. they all wear their finest to the clinic - satin dresses with broken zippers sliding off their shoulders for the girls usually. tomorrow i will see patients with a couple of other doctors. they are very warm, friendly, smiling, cheerful people so far as I can tell after 24 hours here. got set up with my banking, cell phone etc. e-mail me if you want my phone number. an early start tomorrow so i will blog more soon. glad to have arrived.

Map of Uganda

Thought i would post a map of East Africa and Uganda so when we talk about different places we travel to it would be easy to see where those places are. Also, you can see where you will travel to when you come to visit.

Hot Houston

It will be nice when we get to Africa because it will actually be cooler than Houston. I am looking forward to the weekend in MN hanging with family and friends. I will finally see Angela before leaving for Uganda. Should be a great adventure.

still in Houston, setting up blog

Just testing this blogspot to see if it is going to work for our trip to Africa.