So I only picked up a few words in Uganda, one of which is thank you- webale. I have so many reasons to thank Uganda and my experience there. Thanks to the amazing nurses and doctors at CURE who have forever changed my view on healthcare and the importance of having a passion for what you're doing. Thanks to my awesome roommates (Sarah, Oliver, Shabani and Chris- I miss you already!) They made an awesome experience even more awesome. Thanks to the amazing food which has inspired me to attempt to open my own Chapati company back in the states (it was given the name Jamie's Chaps by one of the nurses at CURE- be on the watch out). Thanks to all the mothers who I will remember forever for their courage strength and love for their children. I won't go on much more, I think my 5 minutes are up!
The past few days have been quite a whirlwind! Safari was fun, saw elephants, lions, giraffes, hippos, crocs and lots and lots of wart hogs (Pumba was wayyyy cuter!). Met some amazing people. A couple from Holland who were living in Congo volunteering. A couple from Canada living near Dubai, the wife was teaching english to the amirati children. So many interesting stories from their experiences! I have loved meeting so many new people while travelling, it's awesome to hear how different life can be.
Currently I'm sitting in an internet cafe in london, enjoying an afternoon snack of frozen yogurt and strong latte. Tonight I'll be seeing Billy Elliot, then catching some sleep before I head out in the morning home to Dallas! As badly as I wanted to stay in Uganda a bit longer, I'm very excited to see my family and friends back home! No pictures to post this time, but I can't wait to go through the 1,000s of pictures I took here! Ekk!
Monday, August 1, 2011
Monday, July 25, 2011
Cockroaches and burnt bananas
So it is my final week in Uganda! I don't feel ready to go, but unfortunately I have to return to the real world and a lovely place called work. Here's a bit of an update since my last post:
Friday I traveled to the CURE outreach clinic with a team consisting of myself, 2 doctors, 2 clincal officers (similar to a physician's assistant from the states), 2 social workers, 2 spiritual directors and a physical therapist. It was a great trip. The drive went by fast, road trips in Uganda are much more entertaining than in the states. There is so much going on outside always, people are everywhere. We drove past all the school children in their matching bright colored uniforms barefoot carrying their books, herds of cows blocking traffic, goats running freely and naked babies dancing. The clinic itself was very productive and time efficient. Everyone got down to business and in a matter of 4 hours approx 50-60 patients were seen. The follow-ups were brief and to the point. I loved it because I rarely have the opportunity to see patient's after they leave the hospital. Some patients looked great, they were walking, talking, developing appropriately. Others came back reporting fevers, headaches, seizures, and referrals were made for them to come back to our hospital the following week. I worked with one of the doctors for a bit, assisting in vital signs and assessments and learning the flow of a typical outpatient appointment. One baby that we saw was a 3 month old with spina bifida who underwent surgical repair of his spinal cord defect at CURE. The baby's inicision had healed well, but the doctor was concerned that he was becoming overweight. Granted he was a chunky monkey, but I wasn't overly concerned due to the fact that he was 3 months old... But the doctor looked to me and asked how we could make this baby lose weight. I was stunned, never in my 2 weeks here has that ever been the concern! The baby was breastfeeding, so I told him that would be a bit hard unless the mother cut his time short while feeding, and she immediately said that he would never allow that. I think his diet planning may have to wait until he's no longer an infant... Another concern was that the parents had not begun catheterizing the infant. I won't go into too much detail about this (probably not the best dinner conversation), but moral of the story is that patients with spina bifida often require assistance for the rest of their lives going to the restroom. The doctor was again a bit upset with the parents because this had not been started, with concern that the kidneys could have been harmed. So the parents were sent into the back room to learn how. I went with them because I was very eager to see how catheterizing was taught in Africa. As we were waiting for the nurse to bring the supplies for the teaching, I asked the father if he knew what catheterizing meant, which he repilied no. I was not terrible surprised because often times patient and family education is not the focus at the hospital, so I was able to spend a few minutes explaining the general principles to the parents, which I loved. Educating families is definitely one of my favorite aspects of nursing. The rest of the clinic went smoothly and I really enjoyed the time I got interacting with patients and the CURE staff.
The weekend was perfect. Saturday my roomates and I travelled to Sipi Falls, about an hour drive from Mbale. So beautiful, I realized when we got there I don't think I've ever seen a proper waterfall in my life. There was a series of 3 waterfalls working their way down one of the hills of Mount Elgon (the mountain range located between Kenya and Uganda). We hiked all day; saw a woman doing laundry at the top of the waterfall wearing a santa claus hat, hid out in a cave on the side of the mountain while it started to rain on us, met a family with 10 children who welcomed us into their home and gave us fresh avocado and passion fruit, and then ate the most magical indian dinner after returning to Mbale. Sunday we ventured to a nearby hotel in Mbale that had a swimming pool! Unfortunately i didn't pack my swim suite, but we spent the afternoon playing cards, reading books and chatting pool side. I was also able to skype with my parents who were on family reunion, so I saw many of my aunts and uncles and cousins and my dog Sam!
Today I got to go to theater! This is what they call the operating room in Africa. And boy was it exciting. I was able to see an ETV, spina bifida repair, removal of a shunt and repair of a lipomeningocele (similar to spina bifida, but there's fatty tissue and skin covering the protruding spinal cord). The ETV was the most fascinating. The baby's ventricles were HUGE!
Here's a little bit of background for those who want to know more: The ventricles are the areas in the brain where the brain fluid hangs out pretty much. below is a picture of a CT scan of a pt with hydrocephalus on the left vs a normal brain on the right. On the left, the dark area in the middle that looks like a butterfly are the ventricles. On the right they're much much smaller, giving the brain room to grow and hang out.
The roommates and I at Sipi Falls.
In the jar are what remain of roaches with all the substances we tried to use to kill them. We're keeping the jar on the center of the kitchen table as a center piece.
I don't know if I'll be able to blog again while I'm here, but thanks for everyone who read! I really enjoyed being able to share my experince!
Friday I traveled to the CURE outreach clinic with a team consisting of myself, 2 doctors, 2 clincal officers (similar to a physician's assistant from the states), 2 social workers, 2 spiritual directors and a physical therapist. It was a great trip. The drive went by fast, road trips in Uganda are much more entertaining than in the states. There is so much going on outside always, people are everywhere. We drove past all the school children in their matching bright colored uniforms barefoot carrying their books, herds of cows blocking traffic, goats running freely and naked babies dancing. The clinic itself was very productive and time efficient. Everyone got down to business and in a matter of 4 hours approx 50-60 patients were seen. The follow-ups were brief and to the point. I loved it because I rarely have the opportunity to see patient's after they leave the hospital. Some patients looked great, they were walking, talking, developing appropriately. Others came back reporting fevers, headaches, seizures, and referrals were made for them to come back to our hospital the following week. I worked with one of the doctors for a bit, assisting in vital signs and assessments and learning the flow of a typical outpatient appointment. One baby that we saw was a 3 month old with spina bifida who underwent surgical repair of his spinal cord defect at CURE. The baby's inicision had healed well, but the doctor was concerned that he was becoming overweight. Granted he was a chunky monkey, but I wasn't overly concerned due to the fact that he was 3 months old... But the doctor looked to me and asked how we could make this baby lose weight. I was stunned, never in my 2 weeks here has that ever been the concern! The baby was breastfeeding, so I told him that would be a bit hard unless the mother cut his time short while feeding, and she immediately said that he would never allow that. I think his diet planning may have to wait until he's no longer an infant... Another concern was that the parents had not begun catheterizing the infant. I won't go into too much detail about this (probably not the best dinner conversation), but moral of the story is that patients with spina bifida often require assistance for the rest of their lives going to the restroom. The doctor was again a bit upset with the parents because this had not been started, with concern that the kidneys could have been harmed. So the parents were sent into the back room to learn how. I went with them because I was very eager to see how catheterizing was taught in Africa. As we were waiting for the nurse to bring the supplies for the teaching, I asked the father if he knew what catheterizing meant, which he repilied no. I was not terrible surprised because often times patient and family education is not the focus at the hospital, so I was able to spend a few minutes explaining the general principles to the parents, which I loved. Educating families is definitely one of my favorite aspects of nursing. The rest of the clinic went smoothly and I really enjoyed the time I got interacting with patients and the CURE staff.
The weekend was perfect. Saturday my roomates and I travelled to Sipi Falls, about an hour drive from Mbale. So beautiful, I realized when we got there I don't think I've ever seen a proper waterfall in my life. There was a series of 3 waterfalls working their way down one of the hills of Mount Elgon (the mountain range located between Kenya and Uganda). We hiked all day; saw a woman doing laundry at the top of the waterfall wearing a santa claus hat, hid out in a cave on the side of the mountain while it started to rain on us, met a family with 10 children who welcomed us into their home and gave us fresh avocado and passion fruit, and then ate the most magical indian dinner after returning to Mbale. Sunday we ventured to a nearby hotel in Mbale that had a swimming pool! Unfortunately i didn't pack my swim suite, but we spent the afternoon playing cards, reading books and chatting pool side. I was also able to skype with my parents who were on family reunion, so I saw many of my aunts and uncles and cousins and my dog Sam!
Today I got to go to theater! This is what they call the operating room in Africa. And boy was it exciting. I was able to see an ETV, spina bifida repair, removal of a shunt and repair of a lipomeningocele (similar to spina bifida, but there's fatty tissue and skin covering the protruding spinal cord). The ETV was the most fascinating. The baby's ventricles were HUGE!
Here's a little bit of background for those who want to know more: The ventricles are the areas in the brain where the brain fluid hangs out pretty much. below is a picture of a CT scan of a pt with hydrocephalus on the left vs a normal brain on the right. On the left, the dark area in the middle that looks like a butterfly are the ventricles. On the right they're much much smaller, giving the brain room to grow and hang out.
The baby that was operated on today was much worse than the picture above. It's ventricles took up probably 90% of the space within the skull, with the remaining 10% left for space for the brain to be. When they performed the ETV, they brought a camera into the ventricles which allowed the whole room to see the brain from inside, it was awesome! I saw the pituitary gland up close and personal and was able to watch on the camera as they created the ETV.
And now I only have one day left at the hospital before leaving for Kampala to begin our African Safari. I'm in slight denial, it's crazy how attached I've become to this hospital and the people in it in such a short matter of time. But I'm thankful for everyday I have spent here, and hope tomorrow will be as great and blessed as all the others. We cooked chapati, guacamole and I bought snickers to bring to work tomorrow for the last day, can't wait! I can't be too sad because I'm so excited about safari time!!!!
And as for the title name, tonight as I was putting away the dishes, much to my dismay I noticed a jar in the back of the cupboard with 4 huge cockroaches in it. After an embarrassing screaming fit, my roommates and I begun the adventure of attempting to kill the cockroaches (for the fear that they would make it back into the house if we simply released them outside). It was a long battle, but after pouring hydrogen peroxide, bleach, kitchen cleaner powder, beer and spraying bug repellant in the jar, the 4 roaches stayed strong and were still swimming. We finally did them in by pouring some boiling water on them. We later did some research, apparently soap and water is sufficient, we'll remember that next time hopefully. And for the burnt bananas, one of my roommates (the neurosurgeon!) was microwaving a grilled banana we had bought off the street for dessert the previous night and forgot that you can't set a timer on our microwave. So he sat back down and next thing you know the kitchen was full of smoke. We stopped it, and when we opened the microwave and big puff of yellow smoke came pouring out into the kitchen. Luckily there is no smoke alarm, or if there is one it doesn't work so we simply opened all the doors and left the microwave in the side yard.
And for those who read my last post about Peter with the brain tumor, he is stable. Still in the ICU, still not really waking up and now having to be tube fed because he stopped breast feeding over the weekend. Definitely keep him in your prayers, but they are hoping to transfer him to the ward tomorrow.
Picture time!
This is Rose, a patient I met at the outreach clinic. She has spina bifida which was repaired at CURE. She walks on the insides of her feet and requires a cane for support, but doesn't seem to phase her a bit!
The roommates and I at Sipi Falls.
See the santa hat? Not a bad view to have while you're doing laundry.
Some of the children we met at the house with 10 children that we stopped at while in Sipi. My roommates Sarah and Shabani had met the family on their first trip to Sipi a few weeks back, and the mother was so excited to see them again.
In the jar are what remain of roaches with all the substances we tried to use to kill them. We're keeping the jar on the center of the kitchen table as a center piece.
I don't know if I'll be able to blog again while I'm here, but thanks for everyone who read! I really enjoyed being able to share my experince!
Thursday, July 21, 2011
This one's for the mom's
This week I've spent my time in the ICU. The first few days were a bit slow. So much so I spent one morning in the kitchen learning how to fry chapati with the cooks(only mildly burnt my thumb). The reason for it being a bit quieter was because the attending surgeon Dr. Mugamba is battling a bad case of malaria and is only able to do a few cases in the OR each day. He has been ill since my arrival, he even had to come into the ward for the nurses to start an IV on him to receive antibiotics last week. I nearly died! I couldn't imagine one of the attending surgeons back home asking me to start an IV on them, no pressure...
However the past 2 days have really picked up. Mainly because of the tumor cases. The hydrocephalus babies are usually uncomplicated overnight stays. They come from OR, wake up to breastfeed, give them a dose of Panadol (the African form of tylenol) and they're hanging out. But the first tumor case was Peter and he came to the ICU Tuesday night after the resection. He's a 1 1/2 year old from a village in Western Uganda that is very far away. He has a posterior fossa tumor, which I was told was quite large. Initially his mother brought him to a witch doctor before she understood what was wrong with her baby. He still has the marks down his back from that. He was in the ward all last week, and he cried all day every day just about. The poor mother walked with him and cuddled with him and carried him everywhere. They were waiting for equipment to arrive at the hospital to assist them with the surgery. In the mean time they tapped the resevoir they had placed early last week to drain off CSF to help with the increasing pressure on a daily basis. But finally on Tuesday it was his turn for surgery. Currently he's still very sleepy, awakens enough to breastfeed but other than that does not move. He started having seizures this afternoon, things were a bit stressful in the ICU for a bit. But he's now been started on antiseizure medications, things are still very tense with his situation, keep him in your prayers!
His mother amazes me. Her strength and love for her child is very inspiring. She is all alone at the hospital. All day Tuesday she sat outside the ICU on the ledge in the sunlight. Some mothers sat with her during the day, but for the most part she sat off by herself. I wanted so much to comfort her, however due to the language barrier I could only smile at her every time I passed and share some of my pineapple with her. I kept thinking back to the typical family support systems we see in the US when a child is having a brain tumor removed. Those are usually the cases where the whole family has come in the morning to pray and support the parents all day while they wait. But at CURE the mom's are on their own (I've seen 2 cases where it was the father who brought the patient in, but still on their own). They stay, sometimes for weeks, by themself. Many have phones to call home, but that's it. But the community amongst the mothers is amazing. During the day they sit outside the ward, braiding eachother's hair, caring for eachother's babies, and talking. It's quite a unique situation they're in. As I was typing this blog I heard singing coming from outside. I went to explore and found one of the nurses leading all the mothers in praise outside the chapel. It was quite beautiful. Many of these mothers travel from so far away, often times they are outcasted from their village because it's thought that an evil spirit causes the babies heads to grow large. Yet their love for their babies brings them here.
Overall so far this week has been great. Many eye opening experiences at work. On Wednesday we had to say goodbye to one of our roomates Chris. He's headed back to the UK and will be sadly missed in the guest house. Tuesday night a big group went out for indian food and a few beers for his last dinner in Mbale. Indian food is the only option for eating out here, good thing it's so magical. Wednesday night I travelled into town with Shabani to the market and cooked up some guacamole and we ate it with chapati with grilled banana for dessert. Tomorrow I'll be going to a satellite clinic near Kampala. They do follow-up appointments for pt's who have previously been taken care of at CURE for follow-up and also see new patients with concern for neurosurgical issues. Because travel can be so difficult and many of the families don't have the money to come to Mbale, CURE does several clinics each month spread out throughout Uganda. It's about a 4 hour drive to Kampala, which we will be doing there and back all tomorrow. Will be a long day, but atleast I don't have to travel in a matatu!
Few pics from the week:
The view of the walk from the ICU to the ward. This is where the mom's hang out all day to the left, to the right is where they do all their laundry.
The roommates: Sarah, Chris, Shabani and me. Picture after dinner Tuesday night done with self timer. This was probably picture number 30.
Baby Cassian, one of the sweetest babies I've ever encountered in my whole life. She had an ETV done for hydrocephalus, this is her the morning she was discharged. When I took care of her in the ICU we cuddled and talked all morning. The flash is a bit scary but atleast you can see how beautiful she is.
Some of my favorite nurses in the ICU: Rose, Okinei and Irene.
Rebecca and Gertrude who so kindly taught me how to fry chapati. I now understand why they are so amazing after seeing how much cooking oil is used...
Baby Abonya, my second favorite baby. He has spina bifida, which is when the baby is born with part of the spinal cord outside their back. Many of the babies have their repairs done at CURE and follow-up throughout their life time for the long term care required.
However the past 2 days have really picked up. Mainly because of the tumor cases. The hydrocephalus babies are usually uncomplicated overnight stays. They come from OR, wake up to breastfeed, give them a dose of Panadol (the African form of tylenol) and they're hanging out. But the first tumor case was Peter and he came to the ICU Tuesday night after the resection. He's a 1 1/2 year old from a village in Western Uganda that is very far away. He has a posterior fossa tumor, which I was told was quite large. Initially his mother brought him to a witch doctor before she understood what was wrong with her baby. He still has the marks down his back from that. He was in the ward all last week, and he cried all day every day just about. The poor mother walked with him and cuddled with him and carried him everywhere. They were waiting for equipment to arrive at the hospital to assist them with the surgery. In the mean time they tapped the resevoir they had placed early last week to drain off CSF to help with the increasing pressure on a daily basis. But finally on Tuesday it was his turn for surgery. Currently he's still very sleepy, awakens enough to breastfeed but other than that does not move. He started having seizures this afternoon, things were a bit stressful in the ICU for a bit. But he's now been started on antiseizure medications, things are still very tense with his situation, keep him in your prayers!
His mother amazes me. Her strength and love for her child is very inspiring. She is all alone at the hospital. All day Tuesday she sat outside the ICU on the ledge in the sunlight. Some mothers sat with her during the day, but for the most part she sat off by herself. I wanted so much to comfort her, however due to the language barrier I could only smile at her every time I passed and share some of my pineapple with her. I kept thinking back to the typical family support systems we see in the US when a child is having a brain tumor removed. Those are usually the cases where the whole family has come in the morning to pray and support the parents all day while they wait. But at CURE the mom's are on their own (I've seen 2 cases where it was the father who brought the patient in, but still on their own). They stay, sometimes for weeks, by themself. Many have phones to call home, but that's it. But the community amongst the mothers is amazing. During the day they sit outside the ward, braiding eachother's hair, caring for eachother's babies, and talking. It's quite a unique situation they're in. As I was typing this blog I heard singing coming from outside. I went to explore and found one of the nurses leading all the mothers in praise outside the chapel. It was quite beautiful. Many of these mothers travel from so far away, often times they are outcasted from their village because it's thought that an evil spirit causes the babies heads to grow large. Yet their love for their babies brings them here.
Overall so far this week has been great. Many eye opening experiences at work. On Wednesday we had to say goodbye to one of our roomates Chris. He's headed back to the UK and will be sadly missed in the guest house. Tuesday night a big group went out for indian food and a few beers for his last dinner in Mbale. Indian food is the only option for eating out here, good thing it's so magical. Wednesday night I travelled into town with Shabani to the market and cooked up some guacamole and we ate it with chapati with grilled banana for dessert. Tomorrow I'll be going to a satellite clinic near Kampala. They do follow-up appointments for pt's who have previously been taken care of at CURE for follow-up and also see new patients with concern for neurosurgical issues. Because travel can be so difficult and many of the families don't have the money to come to Mbale, CURE does several clinics each month spread out throughout Uganda. It's about a 4 hour drive to Kampala, which we will be doing there and back all tomorrow. Will be a long day, but atleast I don't have to travel in a matatu!
Few pics from the week:
The view of the walk from the ICU to the ward. This is where the mom's hang out all day to the left, to the right is where they do all their laundry.
Baby Cassian, one of the sweetest babies I've ever encountered in my whole life. She had an ETV done for hydrocephalus, this is her the morning she was discharged. When I took care of her in the ICU we cuddled and talked all morning. The flash is a bit scary but atleast you can see how beautiful she is.
Some of my favorite nurses in the ICU: Rose, Okinei and Irene.
Rebecca and Gertrude who so kindly taught me how to fry chapati. I now understand why they are so amazing after seeing how much cooking oil is used...
Baby Abonya, my second favorite baby. He has spina bifida, which is when the baby is born with part of the spinal cord outside their back. Many of the babies have their repairs done at CURE and follow-up throughout their life time for the long term care required.
Sunday, July 17, 2011
1, 2, 3 BUNGEE!!!
First week complete! It's been such an amazing week, I feel so comfortable here already. The second half of my week at the hospital went great. I got up to taking care and charting for 10 patients. By the end of the week I was surprised by how confident I was feeling and was able to do lots of things on my own.
Here are some of the important lessons I've learned: how their IVs work (bit different than the US); where they hide all the supplies; that the syringes are a bit wonky and if you push all the air out of them before drawing up your medicine the syringe locks and you can't use it anymore (only took 3 times of wasting syringes, finally got it); that the mothers leave for lunch promptly at noon and take the babies, so if you have medications due at noon you best be getting your gears moving atleast by 11:30 because they won't wait for you. Much more to learn, but progress for sure.
One pt I took care of this week was a 17 year old named Anna who had a shunt placed at the age of 3 months due to hydrocephalus. Initailly the shunt did not work so she had a revision done one month later. But since then she had no issues until now. She was functioning well in school and home, above level in her classes and a very very sweet girl, the only difference was the shape of her head. She came to CURE because she had begun to have headaches and what the family thought were to be seizures a few months back. They made the 3 hours journey from the village in northern Uganda to CURE because they were concerned something was wrong with the shunt. The doctors at CURE weren't convinced that it was the shunt causing the seizures, but they wanted to obtain a shunt series x-ray (they take x-rays of the head and abdomen to see if there are any obvious kinks or areas where the shunt has become disconnected). However our machine for the shunt series was broken. Instead the doctors asked if the family could travel to regional hospital to get the x-rays done there which could cost 40,000 shillings (approx. $20). The other option was to wait at the hospital until our machine was fixed, but it was unsure if it would happen that day or the next day. They did not have the money so they chose to stay and wait at the hospital. Luckily they were able to fix the machine later that afternoon. Everything with the shunt looked ok, she looked great, didn't have any seizures while at the hospital, definitely didn't present like the typical shunt malfunction. So she was started on anti-seizure medications with the plan for the family to return if things worsened, otherwise they were to follow up in a month. This famliy was one of the few families I worked with that spoke English which I really enjoyed. The father was a teacher in a primary school, and after finding out that there was a support group here in Mbale for pt's with shunts and their families, he planned to start a similar group for his daughter and families like them back home. Anna asked for my phone number (but I didn't think she'd want to make a call to Texas) so I gave her my email address instead. She was very confused when I said email address, but her father said her sister had used a computer before... So we'll see, maybe I'll hear from her again someday.
Friday night we went to a going away barbeque for one of the doctor's from CURE who was leaving to start a residency at a different hospital. The food was yum! Goat, chicken, sausage, chapati (which is similar to a tortilla, except it's like the best tortilla you ever tasted from Taco Cabana, thicker like a pancake), watermelon and pineapple for dessert. We danced for a bit, learned some new moves, lots of fun.
This weekend we travelled to Jinja (about 2 hours away). The transportation here can be pretty crazy. We rode what is called a matatu (a taxi van with 5 rows with typically 20-25 people shoved in as close as possible}. It's a good thing I'm not claustrophobic! I've really learned how to be a laid back traveller here, that's the only option. In Jinja we stayed a hotel that was more like a resort, but so cheap! Jinja is where the dam was built that separates Lake Victoria and the Nile. So there are lots of activities to be done on the Nile. One of which is bungee jumping with the option of having your head dunked into the nile which my roommates and I did. OMG so much fun!!! Very very scary but totally worth it. Here's a few pictures of the location and me after the jump.
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Here are some of the important lessons I've learned: how their IVs work (bit different than the US); where they hide all the supplies; that the syringes are a bit wonky and if you push all the air out of them before drawing up your medicine the syringe locks and you can't use it anymore (only took 3 times of wasting syringes, finally got it); that the mothers leave for lunch promptly at noon and take the babies, so if you have medications due at noon you best be getting your gears moving atleast by 11:30 because they won't wait for you. Much more to learn, but progress for sure.
One pt I took care of this week was a 17 year old named Anna who had a shunt placed at the age of 3 months due to hydrocephalus. Initailly the shunt did not work so she had a revision done one month later. But since then she had no issues until now. She was functioning well in school and home, above level in her classes and a very very sweet girl, the only difference was the shape of her head. She came to CURE because she had begun to have headaches and what the family thought were to be seizures a few months back. They made the 3 hours journey from the village in northern Uganda to CURE because they were concerned something was wrong with the shunt. The doctors at CURE weren't convinced that it was the shunt causing the seizures, but they wanted to obtain a shunt series x-ray (they take x-rays of the head and abdomen to see if there are any obvious kinks or areas where the shunt has become disconnected). However our machine for the shunt series was broken. Instead the doctors asked if the family could travel to regional hospital to get the x-rays done there which could cost 40,000 shillings (approx. $20). The other option was to wait at the hospital until our machine was fixed, but it was unsure if it would happen that day or the next day. They did not have the money so they chose to stay and wait at the hospital. Luckily they were able to fix the machine later that afternoon. Everything with the shunt looked ok, she looked great, didn't have any seizures while at the hospital, definitely didn't present like the typical shunt malfunction. So she was started on anti-seizure medications with the plan for the family to return if things worsened, otherwise they were to follow up in a month. This famliy was one of the few families I worked with that spoke English which I really enjoyed. The father was a teacher in a primary school, and after finding out that there was a support group here in Mbale for pt's with shunts and their families, he planned to start a similar group for his daughter and families like them back home. Anna asked for my phone number (but I didn't think she'd want to make a call to Texas) so I gave her my email address instead. She was very confused when I said email address, but her father said her sister had used a computer before... So we'll see, maybe I'll hear from her again someday.
Friday night we went to a going away barbeque for one of the doctor's from CURE who was leaving to start a residency at a different hospital. The food was yum! Goat, chicken, sausage, chapati (which is similar to a tortilla, except it's like the best tortilla you ever tasted from Taco Cabana, thicker like a pancake), watermelon and pineapple for dessert. We danced for a bit, learned some new moves, lots of fun.
This weekend we travelled to Jinja (about 2 hours away). The transportation here can be pretty crazy. We rode what is called a matatu (a taxi van with 5 rows with typically 20-25 people shoved in as close as possible}. It's a good thing I'm not claustrophobic! I've really learned how to be a laid back traveller here, that's the only option. In Jinja we stayed a hotel that was more like a resort, but so cheap! Jinja is where the dam was built that separates Lake Victoria and the Nile. So there are lots of activities to be done on the Nile. One of which is bungee jumping with the option of having your head dunked into the nile which my roommates and I did. OMG so much fun!!! Very very scary but totally worth it. Here's a few pictures of the location and me after the jump.
Picture below is from Friday when there was a hydrocephalus conference at the hospital. Information about hydrocephalus was presented to past and present families. I took this picture with some of the kids who were playing while the mom's were listening. The boy in the back row is Tom, he's 13 years old and had surgery with CURE when he was a baby. We talked for a bit, and he's doing awesome now. It was so great to see a success story like his. The other kids are siblings of kids treated at CURE, we had a fun time smiling and laughing at eachother, all so sweet!
This picture is from the going away party friday night. My roommates Oliver, Sarah, and Shabani (with the hand raised) are in the picture.
Long post, thanks if you read it all haha!
Wednesday, July 13, 2011
World of Ward Craft
Ohhh weeee what a crazy couple days it has been. Days start at 07:30 with the worlds quickest rounds with the attending surgeon starting in the ICU then heading to the ward. For my nursing friends that are reading, the ICU is more like the floor back home. It's an 10 bed unit where all the patient's go after any surgery. They typically recover and head to the ward the next day. I haven't seen any patient's requiring intubation, one requiring oxygen. It is very strange to walk into an ICU and see a pt sitting up in bed eating breakfast.
Then we head to the ward. Wooooo was this a shock my first time walking in. It's about 30 beds all spread into smaller inlets but no actual walls separating them. Lots of babies crying, I would say greater than 90% of the patients here are under a year. The rounds in the ward are as brief as they are in the ICU, and then the team disperses. I have been staying in the ward this week. I've spent the past few days trying to figure out their charting system and how things work here. It's funny how things can be so different but at the same time also very similar. Here the mothers are expected to do all baths, linen changes, wash their own bed sheets and a lot of the nursing care I'm used to doing in the states. It's a change I'm having a hard time getting used to, on my first day as I was changing the bed for a father, another nurse looked at me and said "why are you changing the bed?". It's stressful here in the ward, but the nurses are all very welcoming. We laugh often amongst the chaos. The diagnoses are very similar to my patient population back in the US, but much more severe. The cases of hydrocephalus especially, I've never seen heads so big in my whole life. But there is no denying how hard everyone works here and how passionate they are about helping these children get better.
Life at the guest house is great. We live a few steps away from the patients. At night I can hear babies crying until I put my ear plugs in. My roommates are fabulous. We're all from such different walks of life yet it's perfect. They're all interested in doing trips on our weekends so lots of fun things planned (like a safari at the end of my stay!! hello elephants!!)
Here are a few pictures that I've taken so far:
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Below is a picutre of the line of mothers waiting for their babies to have their CSF tapped. This is usually done when they're waiting for OR or have an infection and can't go to the OR until it's cleared. Usually 6-10 taps are done a day.
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This is me with my new friends Martha, the clerk and Okinei my best nursing buddy enjoying tea. Tea time is strictly at 10 and 4 everyday and is never missed no matter what! African tea is da bombbbbbb.
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Then we head to the ward. Wooooo was this a shock my first time walking in. It's about 30 beds all spread into smaller inlets but no actual walls separating them. Lots of babies crying, I would say greater than 90% of the patients here are under a year. The rounds in the ward are as brief as they are in the ICU, and then the team disperses. I have been staying in the ward this week. I've spent the past few days trying to figure out their charting system and how things work here. It's funny how things can be so different but at the same time also very similar. Here the mothers are expected to do all baths, linen changes, wash their own bed sheets and a lot of the nursing care I'm used to doing in the states. It's a change I'm having a hard time getting used to, on my first day as I was changing the bed for a father, another nurse looked at me and said "why are you changing the bed?". It's stressful here in the ward, but the nurses are all very welcoming. We laugh often amongst the chaos. The diagnoses are very similar to my patient population back in the US, but much more severe. The cases of hydrocephalus especially, I've never seen heads so big in my whole life. But there is no denying how hard everyone works here and how passionate they are about helping these children get better.
Life at the guest house is great. We live a few steps away from the patients. At night I can hear babies crying until I put my ear plugs in. My roommates are fabulous. We're all from such different walks of life yet it's perfect. They're all interested in doing trips on our weekends so lots of fun things planned (like a safari at the end of my stay!! hello elephants!!)
Here are a few pictures that I've taken so far:
Below is a picutre of the line of mothers waiting for their babies to have their CSF tapped. This is usually done when they're waiting for OR or have an infection and can't go to the OR until it's cleared. Usually 6-10 taps are done a day.
Sunday, July 10, 2011
And I made it!
Hello from Uganda! Made it safe and sound. Boy oh boy has it been 2 longggg days. Had an overnight flight to London Friday, then had a 12 hour layover before my flight for Uganda. I forced myself to just keep walking all day to keep awake, although I did sneak in a cat nap in Hyde Park. London is so crazy!! So busy busy, I bought an all day tube ticket and got to explore lots of London and meet some interesting characters on the way. By the time I got back to Heathrow, I could barely keep my eyes open. I was able to catch up on some sleep on the overnight flight to Uganda.
Once we landed, a driver from the hospital was waiting to drive us to Mbale. A british medical student was on the same flight as me and will be staying at the hospital for the next month. It was over a 4 hour drive, but went by quite fast. Uganda is amazing. I've never seen anything like it in my life. There are people everywhere, the roads are filled with people walking alongside or riding their bikes. All the houses are right alongside the road, so you there was so much people watching to do! And everything is so green, it's absolutely beautiful.
The hospital is fabulous. I only got a quick tour, but saw the outsides of the OR, ICU, and general ward. There were some mothers out doing laundry, saw a few babies, but for the most part the hospital is pretty quiet on the weekends. I'm staying in the guesthouse which located just a few steps from the hospital. There are 3 other people staying in the house with me. Dr. Shabana, a neurosurgeon from Tanzania staying at the hospital for 2 months to learn from the neurosurgeon's here, then Sarah a medical student from the US, and a physical therapist from the UK who I haven't met yet because he's out travelling. I'm sooo happy to have housemates. We did some exploring in the village this evening, bought some food from the market and then ate dinner back at the house. So far I'm loving everything. can't wait to see what tomorrow brings as it will be my first day really working with the children. K well time to go take a tylenol PM and sleep forever!!!
Pictures coming soon!
Once we landed, a driver from the hospital was waiting to drive us to Mbale. A british medical student was on the same flight as me and will be staying at the hospital for the next month. It was over a 4 hour drive, but went by quite fast. Uganda is amazing. I've never seen anything like it in my life. There are people everywhere, the roads are filled with people walking alongside or riding their bikes. All the houses are right alongside the road, so you there was so much people watching to do! And everything is so green, it's absolutely beautiful.
The hospital is fabulous. I only got a quick tour, but saw the outsides of the OR, ICU, and general ward. There were some mothers out doing laundry, saw a few babies, but for the most part the hospital is pretty quiet on the weekends. I'm staying in the guesthouse which located just a few steps from the hospital. There are 3 other people staying in the house with me. Dr. Shabana, a neurosurgeon from Tanzania staying at the hospital for 2 months to learn from the neurosurgeon's here, then Sarah a medical student from the US, and a physical therapist from the UK who I haven't met yet because he's out travelling. I'm sooo happy to have housemates. We did some exploring in the village this evening, bought some food from the market and then ate dinner back at the house. So far I'm loving everything. can't wait to see what tomorrow brings as it will be my first day really working with the children. K well time to go take a tylenol PM and sleep forever!!!
Pictures coming soon!
Thursday, July 7, 2011
Hello!
So it's my final night in Texas. My flight leaves tomorrow evening! This trip has been in the planning for a long time and I'm in slight disbelief it's finally here. Needless to say I haven't packed yet, but surely it will get done before my 6 PM departure tomorrow. Procrastinator to the core, I'd have it no other way. The best things get done under pressure.
So for those of you reading that don't know about what I'll be doing in Uganda, here's the story. I had an awesome coworker (love you Alex!) who travelled with CURE to volunteer at their hospital located in Zambia back in October. A little background on CURE: they were founded in 1996 and now have hospitals in 10 different countries all focused on the goal of bringing healing to children with treatable disabilities that otherwise have few options for treatment. After hearing about Alex's amazing time in Zambia, I decided to apply with CURE. Travelling abroad to do medical work has been a dream of mine since I started nursing school. So after applying, CURE wrote back asking if I'd be interested to spend some time at their neurosurgical hospital located in Mbale, Uganda. And I said... um of course!
The hospital in Uganda does surgeries for many types of brain disorders, however their primary specialty is the treatment of hydrocephalus. Ok here goes the more in depth info about what they do at the hospital, feel free to tune out. But I think it's pretty fascinating so I will share for those that are interested. Hydrocephalus involves accumulation of brain fluid that is normally reabsorbed in a healthy brain. There are many different causes of hydrocephalus (premature birth, trauma at birth, spina bifida, tumors, infections, etc.). Babies' heads with hydrocephalus will grow to be very large because of the growing amount of fluid, which eventually starts to put pressure on their brains. If left untreated, these children will have severe delays and many will not survive. CURE in Uganda is teaching surgeons from across the world the surgical options for treatment of hydrocephalus.
I can't wait to see what the medical world is like in Uganda vs my experience here in America. I work on a neurosurgical unit at a children's hosptial in Dallas, so it will very interesting to see how things are both different and similar. I CAN'T WAIT!!!! However I'm starting to have some serious anxiety about flying to Uganda by myself. Looking forward to a nice little layover in London where hopefully I'll get some tea and crumpets to keep me awake while I fight the jet lag. Prays appreciated, I can't say thank you enough to my family and friends who have supported me in the process!! See you later alligator!
Also for those interested in supporting CURE- right now each dollar that is donated to CURE Uganda will be matched up until their goal of $26,000. https://secure.cure.org/uganda-jff-match/donate
So for those of you reading that don't know about what I'll be doing in Uganda, here's the story. I had an awesome coworker (love you Alex!) who travelled with CURE to volunteer at their hospital located in Zambia back in October. A little background on CURE: they were founded in 1996 and now have hospitals in 10 different countries all focused on the goal of bringing healing to children with treatable disabilities that otherwise have few options for treatment. After hearing about Alex's amazing time in Zambia, I decided to apply with CURE. Travelling abroad to do medical work has been a dream of mine since I started nursing school. So after applying, CURE wrote back asking if I'd be interested to spend some time at their neurosurgical hospital located in Mbale, Uganda. And I said... um of course!
The hospital in Uganda does surgeries for many types of brain disorders, however their primary specialty is the treatment of hydrocephalus. Ok here goes the more in depth info about what they do at the hospital, feel free to tune out. But I think it's pretty fascinating so I will share for those that are interested. Hydrocephalus involves accumulation of brain fluid that is normally reabsorbed in a healthy brain. There are many different causes of hydrocephalus (premature birth, trauma at birth, spina bifida, tumors, infections, etc.). Babies' heads with hydrocephalus will grow to be very large because of the growing amount of fluid, which eventually starts to put pressure on their brains. If left untreated, these children will have severe delays and many will not survive. CURE in Uganda is teaching surgeons from across the world the surgical options for treatment of hydrocephalus.
I can't wait to see what the medical world is like in Uganda vs my experience here in America. I work on a neurosurgical unit at a children's hosptial in Dallas, so it will very interesting to see how things are both different and similar. I CAN'T WAIT!!!! However I'm starting to have some serious anxiety about flying to Uganda by myself. Looking forward to a nice little layover in London where hopefully I'll get some tea and crumpets to keep me awake while I fight the jet lag. Prays appreciated, I can't say thank you enough to my family and friends who have supported me in the process!! See you later alligator!
Also for those interested in supporting CURE- right now each dollar that is donated to CURE Uganda will be matched up until their goal of $26,000. https://secure.cure.org/uganda-jff-match/donate
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