The Fish That Went Around the World

Back Home!

2007-08-18T10:05:00.000-07:00

Well after seven weeks I am back home. Landed in Louisville on Thursday evening just about 4 hours after I left Tokyo....fast huh? Spent Friday recuperating with the jet lag but today I am back to normal. I have put up all the photos from Africa online to view at this address:

http://www.dfproduction.com/africa

Working on the photos from Hong Kong and Japan.

Thanks for all the messages and support during my trip and I hope that my posts and photos brought some of the beauty back to you...and maybe the desire to one day go to Africa or Asia too!

Heading Back Home

2007-08-15T10:39:00.000-07:00

OK so I have been pretty lazy with updating the blog over the last two weeks...Sorry but I have been quite busy. I tried putting up pictures yesterday but it just would not work. I leave tomorrow at 2 pm Japan time (1 a.m. east coast) and I will be back in Louisville, KY at 6 p.m. local time. Honestly I am looking forward to come back home. I have had tons of memories, experiences, and just plain fun over the past seven weeks but it is definitely time to come back home.

As for Japan, I never climbed Mt. Fuji. This week is a Japanese holiday and so pretty much all kids and parents are not working and as a result it is the most popular time to climb. We could not get bus tickets Monday night and we were going to climb Tuesday night without Lee (he had to get a wisdom tooth removed) but Taylor and Sara opted Tuesday morning to not climb and did not buy tickets for me and Trout. They tried to get a hold of us but failed. Was pretty bummed because it really screwed up our Tuesday night but I got to climb Mt. Elgon so oh well. Gives me a reason to come...as if I could not find any others. Today we went to the Yasukuni Shrine. This was something I really wanted to go to. It is near the emperor`s palace and it is a shrine dedicated to all the war heroes of Japan. It is controversial though because it honors Japanese soldiers who are internationally known as war criminals--plus the Emperor comes every year and pays tribute. Was very interesting and today was also a special day because August 15Th is the day Japan surrendered to the US. So the shrine was full of protesters, arguing for world peace or others to still hate the US. Was quite crazy, there were riot police out and it was packed. But the museum next to the shrine was very interesting, especially WWII stuff because you get to see how the Japanese see the war. Basically, in their words they were against the war but were forced into it because the US put an embargo on oil and goods to Japan. They tried repeated attempts during the conflict after Pearl Harbor to have a peace conference but they claim that the US was just not very open to anything. It definitely reflects there current position on self defense only and their past history with samurai--the samurai were very tough warriors but they felt fighting was wrong--so you could see how this had formed there decisions. It also was quite interesting to see how little they talk about the atomic bombs. No pictures just a few short lines and dates on when they happened. I am pretty sure it will still take some time to get over these events. Plus did you know the japanses also had suicide submarines in addition to the kamakazi pilots?

But most of our time has been spent in Tokyo--it is a large city that is spread out with seperate centers so we have seen most of the big areas. When I get back I will put up all the pictures for everyone to see.

But until then goodbye Japan, Hong Kong, and Uganda. It has been fun and I hope it will not be the last time.

More Hong Kong

2007-08-11T20:20:00.001-07:00

Ok so it has been hard finding time to blog here in Hong Kong and Japan so I am going to just run through what has happened a bit quicker. Some of the big highlights in Hong Kong where this:

1. Going to the Peak. On one night we went up to the moutain peak behind Hong Kong city and got a great surprise. We were going to take the cable car up but there were so many people (it was last weekend) so we just had to settle with a taxi. Once up there the view was spectacular but the sun was going to set soon so we decided to wait. Once the sun was down it was even a better view. The glow of Hong Kong and all the neon was amazing but we found out why there was so many people up there....they were having a fireworks show on the Hong Kong harbor. So not only did we get the great neon glow but we also got a fireworks display....a making of a great Hong Kong night.

2. Macau. On Tuesday last week we decided to go to Macau. Macau is similar place to Hong Kong. It was a portugese colony, like Hong Kong was a British, and it also was turned over to China in 1999. So both Hong Kong and Macau are considered SARs (haha I know it is ironic) or rather Special Administration Regions meaning they govern themselves but China gets to be happy they they techincally own the area. Macau is cool because it is western (it is known for some of the best gambling in the world and apparently brings in more money than Las Vegas) but it also has more history which is very different than most of Asia. The look of the streets and architecture looks more like Europe because of its Portugese heritage. To get there you take a ferry which is really fast because it is a hydrofoil. Meaning once it gets up to speed the boat lifts off the water and just rides on a fin below the boat--it goes around 50 mph. So it takes about an hour to get to Macau and immediately you notice the gambling. The shoreline looks like an Asian Las Vegas--they are building another Venetian there. But since the island is very small you can walk around everywhere to find the historical areas. We went to two forts and the ruins of St. Peters church which burnt down but left just the rock walls. We also got to see lots of the Portugese architecture in buildings. But after the history lesson was over one cannot just go to Macau without checking out the casino. Haha...Trout claimed to have a sure fire way to win at roulette but both me and Taylor were sceptical of its statistics. So we headed to the Casinos after dinner. Well Trout wimped out because the betting was different than Las Vegas so he said his theory would not work but I set out to find Texas Hold`em Poker. This was the only game I would play because techincally it really is not gambing because there is skill involved with bluffing. So after trying three casinos I found one with Texas Hold`em and decided to try with $500 Macau dollars or about $50 US. I went in with just $100 and lost it all but that was my plan to learn about the other players. Then I played with the $400 left. Well to put it shortly I immediately got my winnings up to around $2000 after some good hands and made a name for myself at the table. But I wasn`t done. The players were not that good and I left after getting up to around $4000. If we had more time I would have kept playing because the Asians really were not that good but you can`t beat winnings like that so I was satisfied. Now my Japan trip is paid for!

3. Eating Chicken Feet. Before we went out on saturday, the same day we went to the peak. We went to Dim Sum for brunch and had all sorts of food and we tried chicken feet. It was pretty gross. Tastied just like chicken skin with no meat but you could feel the foot bones. It was nasty but we had to try it.

Ok well it is my Birthday today...which is crazy because it is actually just turning my birthday back home but we are 13 hours early. So we are going in to Tokyo for some sightseeing then to some nice restaurant for dinner and finally to a club. Will update more on Hong Kong and Japan. I can`t put up pictures because my computer is not internet connected but I am going to put up all my pictures on a photo gallery site as soon as possible when I get back.

Hong Kong and Karaoke

2007-08-10T19:08:00.000-07:00

Ok so finally have found some time to divulge about Hong Kong. Well the week went by fast and it was great. Taylor was set to arrive one week ago on saturday morning instead of Friday as was originally planned. So Friday was spent without him (we went sightseeing and went to a Chinese market, where Trout was asked more times than he wanted for a fake watch or bag). Friday night we were going to hang out with Tets` friends (Tets is Lee`s friend in Hong Kong). They are local Chinese Hong Kongians and they were going to some local restaurant. This was going to be interesting because Lee cannot speak Cantonese so we were limited to sticking to the English areas. Trout did not want to come because he had found a new friend, Jamie, who is Mari`s boyfriend, and they seem to have similar traits--i.e. both like clothes, their body, and working out. So Trout and Jamie were going to the gym and me, Lee, and Tets were going to eat at the local restaurant and we would all meet up later at a club called Tribeca. The restaurant was very good, we got there and all the Chinese kids were very nice but only a few spoke English so we mostly just ate and chatted among ourselves. We ate hot pot or rather it was a boiling pot of some watery sauce that you would throw vegetables and meat into. Was very good we ate ostrich, lots of different vegetables, and other regular meats. After our fill we were going to head out to the club but the girls with the group wanted us to go to karaoke. I could not resist watching Asians sing karaoke but we decided to go to the club first then join them later. We met up with Trout, Mari, and Jamie at the club which was pretty cool, though quite expensive for guys. Met a lot more of Lee`s friends there, and some more people that I had met with Lee at Henley the year before. But the club was also a bit lame and there were a lot of locals there and what seemed to be a lot of underage boys and girls so we headed out to the karaoke bar. For some reason Asian people like to just go to a karaoke place where you get your own private room for your group and then you have a wrap around couch that faces a giant TV/karaoke machine. You just sit there eating, drinking, and signing. And yes it is as funny in person as you might expect. We met up with the group and everyone in our group was chicken to sing so both me and Trout decided on a duet. We started with Jessie`s Girl but that did not work out very good...actually the Chinese group was booing us and wanted the mikes back. Annoyed we setout to improve on our past performance with a riveting duet to `Tainted Love.` Well this one was better and at least we were not booed but the locals wanted to still have the mikes back. Oh well at least we tried. We hund out a bit more but eventually headed home because it was quite late and ferry takes another hour or so before we would actually be at our apartment.

I would post pictures of the karaoke but they are on my facebook account and this computer is in Japanese so I don`t have a clue on what I am clicking on...doing it just out of memory. So if you can go to my facebook profile and you can see the performance.

Hong Kong

2007-08-08T17:10:00.000-07:00

Wow sorry for no posts about Hong Kong. It has been just really crazy...but extremely fun. I am actually leaving now to go to Japan. Will give a short summary then when I get to Japan will describe everything. I landed last Thursday and did not do much that day but just situate myself and group up with Lee and Trout and Mari (Lee's sister). On Friday we were expecting Taylor but he got delayed because Orbitz never sent him his paper tickets and he did not realize he had paper tickets. So we spent the day sight seeing. Lee's friend Tets came with us and we went to a rural chinese market in Hong Kong and just toured the city. gotta go the flight is leaving more in tokyo.

Mt. Elgon Continued..

2007-08-05T06:41:00.000-07:00

Ok sorry for the delay, I have been in Hong Kong and been very busy. I landed last Thursday and everything went smoothly. Lee arrived later that night and we made it to our apartment room for the night. We were under the assumption that Taylor was coming in the next day, originally we thought he was coming in on Thursday too but he booked a flight to leave on August 2nd not arrive then. But no big deal we would get him the next evening. Well Trout being Trout was joking around that Taylor was probably not going to be on his flight. We had not heard much from Taylor the days leading up to leaving so we were a bit worried. On Friday morning we went to a coffee shop before heading out to sightsee that day and Trout logged onto his email. To his amazement and all the people in the place (he was laughing very loud; as were we) Taylor had missed his flight and was not coming in until the next day, saturday morning. He said he could not describe the entire story why but he had missed his flight. But I will save more for the next post. We have been sightseeing and Taylor is here now fine but I went to finish Mt. Elgon.

So back to Mt. Elgon and "Dead Man's Wall." This area of the hike is the hardest on the entire mountain. The name was given because before recently ropes were used to get up the rock cliff and many people fell to their deaths. Now there is a much more safe way to climb up with a couple wooden ramps to assist in certain areas. But this by no means it is actually that safe or easy to climb. The area is full of mud you can sink almost 1 ft; it is slippery, full of small and large rocks, and there is about only a couple feet between you and the edges of the trail. So all this combined it is still quite challenging. But as they say in swahili, "pole pole ndio mwendo" or rather slow is best. So both myself and Moses trekked up dead man's wall and we made it just fine. My porter, who was not wearing shoes got up even quicker than us! After the wall you have now entered a rain forest and the trail is a lot less steep but still very muddy and wet. Since I had not eaten since breakfast the altitude (which was not that much at this point) and the quickness we had been moving to get to the camp before evening made me a bit lightheaded and I got quite tired. But I pushed on and continued to drink lots of water. The rain forest is very beautiful and I will post more photos a little later. There are also pockets of bamboo forests within the rain forest area too. We finally reached the first camp in about 4 hours, which most do it in 6 so it was grueling. The camp was still in the rain forest and we joined with another group, a guide and a Canadian couple who were hiking up the mt. and had been in Africa touring for 2 months. I set my tent up and the porter and guides got a fire going to make dinner and just relax. This would be how the rest of the days would go. Hiking in the morning and getting back to a camp by mid afternoon before it rained. Then the evening would be just relaxing, taking a nap, eating, or just enjoying the company of the guides or Chris and Zoe the Canadian couple because they would follow me the entire time. That night I slept in my tent, which I rented, and it did rain but I stayed quite dry.

The next day was the easy day. All we would do that day is move from the 1st camp to the 2nd camp which only had a change in altitude from 2900 meters to 3400 meters or around 9000 ft to 11000 ft or so. This day is meant to let you adjust to the altitude and to prepare you for the ascent to the peak the next day. So even though it would be short we still left early in the morning, around 6:30, so that we could drop our stuff at the camp then make a short side trip to this waterfall nearby. We left after a short breakfast and headed up. For about the 1st hour of hiking the rain forest continued but once we got above 3100 meters or so the large trees can't get enough water anymore and they disappear leaving more bamboo forest. But the bamboo forest eventually disappears too and just simple greasses and these strange trees that look like Dr. Seuss items are the only stuff left. Plus it gets much rockier. This is good because now you can see for miles and really take in the scenary. Upon reaching the 2nd camp we just dropped our stuff and grabbed some food and headed out for the waterfall. Rain was on the horizon so we were in a rush to get there and back dry. It was a short walk but it was downhill towards the waterfall but that would be the opposite coming back. I have a photo up of the waterfall and I will post more but it was beautiful, probably around 10 meters tall. But we did not stay long, just stayed for a few pictures, and then raced back to beat the rain. We actually arrived just before the rain and I have to thank Moses for rushing me because the Canadian couple waited to long and were leaving just when we arrived and had to walk a bit through the rain. As the night before we setup camp, relaxed, and had some dinner.

On monday July 30th we were planning on reaching the peak. The trek is very long and another large elevation gain, from 3400 meters to 4331 meters. We were going to leave again early in the morning so hopefully we will get to the peak when it is clear from clouds. The trek is expected to take 4 hours but right after we started I had a feeling we would get there a lot earlier. We were moving very fast but I enjoyed that it was getting me back into shape so I did not complain. The trek is very beautiful because you hike up most of the altitude to the crator rim and then walk along the rim to the peak. Hiking up the air was fairly clear so that you could see more miles. Once upon the crator rim you can look out to the otherside, which is Kenya, and over the entire Mt. The caldera is actually the largest in the world reaching over 40 square miles. Since we had been moving so quickly that when we reached the crator rim I felt lightheaded again and very tired but I knew the peak was only a bit farther so once again I pushed on. The last bit to the peak is extremely rocky and is more like a climb. Once at the peak it really was not that impressive because clouds rolled in and you could not see much more than about 50 yards. In addition it was below freezing and with winds of around 15 mph. So we only stayed for pictures and then descended again. At this point really the trek was pretty much over. Everything else would be downhill though it still was not going to be that easy because there was about another 40-50 kilometers to walk back through to get to the starting place, Budadiri. We started going back down and ran by Chris and Zoe. They had taken a much longer time to reach the peak--we did it in a blazing 2 hours instead of usual 4 hours. Which this actually hurt us because they luckily had the clouds part for just a few minutes giving Chris and Zoe and great view....oh well.

We headed back down the mt. now even faster because it was downhill and got to the 2nd camp around noon. We grabbed some food and packed up to head to the 1st camp. We were going to spend the night there so there would be less to travel on Tuesday morning so I could get back to the hospital at a decent hour. Once we got back into the rain forest I realized it was not actually easy descending. It had been raining in the morning in the forest and it was terribly muddy. So I had to have the porter make me a bamboo walking stick so that I could stabilize myself. But eventually we reached the first camp racking up around 30 km or around 18 miles of walking in the day. There was another group there, a young boy Luke and his father Nick who have been living with there family in Uganda for 10 years as missionaries. It was great to talk to them and I made good friends with Luke--he wanted me to climb again with them. We talked until late in the night and then went to bed.

The next morning we got another early start to head back to Budadiri so I could get a cab to Mbale to meet my driver. Then I would go back to Mukono and take a taxi to the hospital....it was going to be a long day. We started around 7 and made great time until reaching dead man's wall again. This had to be done just as slow as going up because it was very wet still and muddy. Though this time I seem to have more skill and I had a walking stick so I got through it without even one fall into the mud. We left the park and got to the final village and then had to walk on the dirt road back to the ranger station. The hike was tough and I was relieved to finally get on a taxi. But this was once again just the beginning as I had another 4-5 hours of being couped up in a car or even worse a taxi. But by 6:00pm I had reunited with Dr. Kabuye again and was relieved to be back at "home" again.

But this was only short lived, I had to say goodbye to the hospital staff and pack everything back up again because we needed to leave by 9 a.m. to get to Entebbe for my flight at 3:00 p.m. on August 1st. I was sad to say goodbye to my friends but I really hope to go back. I told them though I was going to learn better Luganda before coming back. So now I have tons more to tell but I can't take writing anymore so I will update tomorrow. We are going to Macau to check it out and I have setup the internet on my phone so I can update at any point. Having a blast in Hong Kong and Taylor and Trout are having a great time too. It has been really funny to see Lee be back at his home and to see how exact he is compared to his sister....haha. So will put more pics up tomorrow and more articles.

In Hong Kong

2007-08-02T09:47:00.000-07:00

Just wanted to put a short update that I am in Hong Kong and everything is going great. Met up with Chris Trout and Mari (Lee's sister) at the airport. We then checked into our apartment which has an amazing view of downtown and Hong Kong bay. I will put up pictures. Lee arrived late because his flight had to be redirected around the typhoon that is heading towards Japan. But he is here now and Taylor arrives tomorrow. Not sure what the plan will be for the week but Lee has a list of things we should do so we will be busy. Getting a bit tired which is perfect because I slept during my flight here and do not have any jet lag. So I will update tomorrow on more of my hiking adventures.

More Pictures from Mtn. Elgon

2007-07-31T14:05:00.000-07:00

Here are pictures of Mtn. Elgon while driving up, Mbale Clocktower, Moses (guide) and me, and first porter (unnamed) Moses and his sister.

Down the Mountain and off to Hong Kong

2007-07-31T13:58:00.000-07:00

Ok well my last blog left off during the night before I began my ascent--it also had quite a bit of spelling/grammmar mistakes which was due to the fact that I typed the entire thing on a Palm Treo. But anyways, I went to bed that night with the idea that I would get up at 7:30 and go get breakfast at the hotel restaurant and eventually get into town at 8:30 when the banks open to get more money. In reality I did get up at 7:30 and had breakfast but the bank part became a bigger problem. The hotel flagged a private taxi down to take me into town for money and then eventually to the ranger station at the beginning of the trail (about 15 miles away). I got into town but once again my cards did not work at the ATM, so I had to resort to Traveler's Cheques. Please note, NEVER BRING TRAVELER'S Cheques to Uganda. I went to Barclay's bank and they said come back in a couple hours because they have not received exchange rates for the day....no go. Then I went to Stanbic bank where most Ugandan's leave there money, or at least the ones in Mbale. The place was packed and it took about 30 minutes just to get someone working on my exchange. To pass the time though a group of British kids, around 16 years old, came in to exchange money. They had just finished the mountain and were now preparing to do some community service stuff. The one boy was peculiar and his most random question was, "What do Americans think of the movie Borat?" or "Do Americans make fun of Canada?" Finally after an hour and a half of "processing" they were finally prepared to exchange the cheques. So I got the money which would pay for the park fees, tent rental, and more driving costs--all of which turned out to be a bit more than expected.

I arrived at the ranger station around noon, which was quite late because they recommend to start hiking in the morning so you do not get hit by the rain plus it can take up to 6 hours to get to the first camp. It also did not help that I tried, unsuccessfully,to get a 25% student discount. Finally at around 1 pm I was ready to start hiking. I was introduced to my guide, Moses, and a porter which I never got his name---apparently he was just my porter to the last village before the park entrance because then I got my actual porter who's name was also Moses. The beginning of the hike was fairly easy, we were still outside the park and we were walking through the small villages. The best part was that because the mountain is spread across Uganda and Kenya the people here primarily speak Swahili (because back in the day kids were used to smuggle items across the mountain from each country and so Kenya's language has stuck). I was pumped and immediately started to use some of my Swahili, though most of it was not coming back to me that quickly. Finally we got to the last village before the boundary line between the park and villages. We stopped to have a break, I bought some passion fruits for the journey and also had a taste of a local brew. Basically imagine a really watered down bad beer with dirt and flour mixed into it and thats a local brew. It is pretty nasty and both my porter and guide gulped it down. Eventually we set back off and my real porter joined us. As expected it started to rain and I became very proud of my gear purchases--my backpack came with a waterpoof cover so nothing would get wet plus I had a waterproof jacket on. So I was dry except for my feet. Even with my new hiking shoes they were no match for the muddy mess that was soon to come. Once you get into the park, on the trail we were hiking, it goes up quickly, very quickly. We were not even over 2000 meters and I was getting tired because I had not eaten since breakfast and we were moving rapidly to make up for leaving late. Then we reached, "Dead Man's Wall."

To Be Continued...

In Mbale

2007-07-27T07:44:00.000-07:00

well lucky me my cellphone is connecting to the internet without charging me so I am hopefully going to be able to update all weekend while hiking. So I left nkokonjeru at around 9:30 but we have to wait until the taxi is too full to actually comfortably fit people in it. Leaving at 10:30 I was crushed in the back of the taxi with my 20 pound hiking pack sitting on my legs completely blocking my face--the locals were lauging. after about thirty painful minutes driving the taxi just died and broke down. So I needed to be in Mbale before 5 or earlier so I got nervous. After 20 minutes of waiting I was almost ready to call off my trip that it was just going to be too much. Luckily another taxi came and I got to put my bag in the trunk and we headed off to mukono. while riding I made a decision that riding taxis the entire way-i would need to switch to another in jinja on the way- so I decided to go to the bank and get some money and hire a private car. it cost me around 90 dollars instead of 30 but it was going to be the only way to make it the weekend work so I bit the bullet. but I soon realized it was worth the cost, the ride was going to be around 2-3 and I got a nice big back seat and a trunk for my bag.

After two and a half hours we got to mbale and went to the park office. talking to the ranger I realized the lodge I was going to stay at was another hour away and it was a lot farther from the peak than leaving from here. coupled with the fact that I would need more money and mbale was the only place to get money I asked the ranger to get me a hotel in mbale so I can hike from here plus I didn't want to pay the driver to drive anymore. so we headed out to the hotel and stopped at the supermarket to get food supplies for camping. so my hotel is nothing like the lodge I was going to go to--the other was set right next to a 200 meter waterfall. but it has tv,electricity, and my own bathroom with hot water so almost as good. so now just hanging out tonight at the hotel and will leave early in morning.

Out of Water

2007-07-26T13:02:00.000-07:00

Well this week has been pretty quiet. Did a few hernia surgeries and one bitubiligation but apparently the person in charge of preparing for the annual water pump repair did not actually do any preparation. So the main water pump that pumps water from a nearby stream to the hospital is off and the main tanks are dry. So that leaves just the rain collection tanks which is not nearly enough to meet the needs of the hospital. So all surgeries have been postponed till Monday---there was going to be a hysterectomy today...oh well. Been working on med school applications and have already finished one and have made head way on some others.

Planning to leave tomorrow and travel to Mbale to hike up Mt. Elgon. Got a reservation at this cool lodge right next to a waterfall on the mountain. I have my own banda or grass hut but I think I might just camp since I am renting a tent for the mountain and it is a lot cheaper. Food is included for Friday night and then saturday I am hiking up with a armed guard (not really for my protection but to investigate for poachers), porter/chef. Should actually not be very expensive since I have set it up on my own---the travel agency wanted to charge me $1400, which $900 of that was for my own private car that waited around while I hiked, ridiculous!

The hike will have to be fairly brisk because it usually takes 4-6 days but I want to do it in 3 so I can be back down the mountain on Monday and stay for the night and come back to Nkokonjeru on Tuesday. Then I fly out on Wednesday to Hong Kong at around 3 pm from Entebbe so we will leave Nkokonjeru early on Wednesday.

With the water out and not much going on I could not pass up an opportunity to see more of Uganda on my last weekend. Should be fun and the mountain is over 16,000 feet high, it is actually an extinct volcano but the slopes are not very steep so it is not a technical hike at all. But I am looking forward to the altitude training.

Well it rained tonight and there was a big lightning show. Been awhile since I have seen rain or lightning like this (LA is burning up this year) so I put on my jacket and just walked up the road a bit and watched. It was really beautiful. Made me think about this book I just read on African Elephants. The author travels all around Africa learning about elephants but along the way he struggles with the idea of a developing Africa. In the west we see development as life expectancy or the country's GDP but Africa is struggling to figure out its development. I mean when it comes down to it is the materialism and advancements of the west really a better life than life in a poor country? Each side will argue its own way but I feel it comes down to happiness. Pretty much everyone I have met here, mostly poor, are happy with their lives but sadly my presence and those before me have shown the west to these people. There lives have become torn between the luxuries of the west and their own cultures. So this is how Africa grows, pushing to move forward in western terms but being pulled back and trying not to lose the beautiful cultures and landscapes that make Africa, Africa. I wrestled with the idea but just found myself standing still with the rain pouring down and watching the sky light up the land.

Fixed past blog

2007-07-25T09:38:00.000-07:00

I realized that the old blog for more photos from last weekend was not working so here it is again:

Here are some more photos from the wedding and then driving in town. The truck in front of us is carrying what looks to be green bananas--which they are but much different from US style bananas. They are called matoke and it is the food of choice here. Basically it is a bland, not sweet banana, that everyone eats and it has little caloric value. Not sure why they love it so much but if it is not served at a meal then it is considered a crime (well not really but thats how they will treat you if you don't serve it). I don't mind it but it really is nothing special.

Ugandan Runners

2007-07-24T08:49:00.000-07:00

Well I just finished a run from the hospital. Not sure how far it was--probably something around 2-3 miles away and then the same return leg. I had run a few times before but this one I got my first taste of Ugandan runners. I left when school was letting out so everyone is going home from jobs or school so there are tons of people and kids. Well when the mzungu comes running, I have learned it is fun to run with him or show how much faster you are..... actually I outlasted all the runners which at times I would look behind me and see around a pack of 15! But it was not because I am in great shape but rather they had arrived at their destination or got bored because I was so slow.

Oh yeah and the kids I am talking about are probably between the ages of 6-12....embarrassing. But it was a great motivation. There was one older kid maybe a little older than 12 actually that stayed with me nearly the whole time even when I turned around---he was never breathing very heavy at all and smiling or I think possibly laughing at how hard I was working.....hahah

Well it was extremely fun though and I did congratulate my friend on his running skills.

Back at the hospital and did some rounds today and some ultrasounds yesterday, no surgeries though. I tried to setup to go chimpanzee tracking or even better habituation this weekend (you work with the chimps all day long with the warden and researchers to get them acclimated to humans!) but neither was available, so I am trying to go climb Mt. Elgon---will see what the costs are and if I can fit it. They say it takes 4-6 days to hike the trail but I told the tour guide I am in shape and will make sure to do it in 4 or less....so you can see why I am running today.

Hopefully so more exciting surgeries will come later in the week...all the patients now are pretty much malaria, pregnancies, and burns or complications associated with those.

And an update on my toe from the Nile, well did a bit more than stubbed it, I bruised it underneath the nail so it swelled a lot yesterday and now the nail looks like it might come off....uggh. It really is not bad though...I am running on the foot....but the doc has me on some antibiotics just in case so it does not get infected. So not as tough as Dave's, the Navy Seal (still has not emailed any pictures) injury but I can say that the Nile roughed me up....or better yet I should make up a story about a Nile crocodile trying to bite me but I wrestled it down and all it got was just a nip at the toe.....

Monkeys

2007-07-23T03:24:00.000-07:00

Some Monkeys that were nearby Nkokonjeru village. There was a bunch but they were vary hard to photograph because they were constantly moving but I got a few good ones.

Photos from the Weekend

2007-07-23T02:34:00.000-07:00

Here are some photos from the weekend. The first is a truck that looked like it would tip over--apparently in the early morning and during the night these trucks will illegally load too much on them because the cops are not out. I thought it was funny. The others are from the wedding for Dr. Kabuye's cousin---much different than the other wedding. Both families were quite wealthy (Ugandan standards) so the wedding was very elaborate. The other photo is getting ready to raft, waiting on Dave, the Navy Seal guy to send me photos...lets hope he does.

Will post some more photos of various things, like the monkeys me and Dr. Kabuye ran into while driving.

Sorry for no updates

2007-07-22T05:29:00.000-07:00

Sorry for not updating but the internet at the hospital was not allowing me to logon to the Blog, I am at an internet cafe outside of Kampala. Have to be brief but I hope to update more when I am at the hospital---will have to try in the middle of the night when the internet is the fastest.

But it has been a great week, more surgeries (including one that I needed to sit down from because I got light headed, did not drink much water the whole day...but I am fine)also I spent time in the laboratory looking at malaria and TB slides and performing the staining. I can now identify both with no problem. Other than that the week was pretty light, but this weekend has been a blast.

Late friday, Dr. Kabuye tells me he is going to a wedding for his cousin in Jinja on saturday and I should come so I can see the town. Well in Jinja the Nile River begins and there is apparently great white water rafting, plus it is not that expensive. So a quick 10 mintutes later and I am booked for a all day rafting event on saturday and then will meet Dr. Kabuye at the wedding reception.

So to sum it up, I met tons of people---even a USC grad who knew Dannny Friedman. Medical students, bizzare Ex Navy Seals who could not really tell me what they do. Plus we were rafting for about 7 hours through Class 5 rapids--the toughest are Class 6 and we can't do those. We flipped a couple time and I stubbed my finger and toe but it was awesome---one of the Navy seals ironically got pretty messed up, we went down a tougher area than we were supposed to and he got thrown and bang a bunch of rocks, but he had scars from being shot in well who knows where so he was not bothered at all. If it would have been someone else might have been a lot worse, or just more complaining.

Then went to the wedding and met Dr. Kabuye's family. And now I am just hanging out today and heading back to the hospital tomorrow. Going to try and set something else up next weekend too.

One of the Navy Seal dudes, will email photos he took from rafting so hopefully he remembers and I will post them

Update again hopefully soon.

Pictures From the Wedding

2007-07-18T02:45:00.000-07:00

Here are some photos from the wedding. The first is a picture of Masaka, the town it was located in. The church was pretty much one of those pre fab metal wharehouse structures and it was all dirt floor. But they had a carpet laid down for the procession and some decorations up. Apparently this was an extravagent wedding. The blog only lets me upload 4 photos at a time so have to upload them in batches of 4--I will put another 4 up after this.

Been back at the hospital for the last couple days, not much has been going on because our power has been out. Umeme the power company--which has a monopoly on Uganda--decided after 1.5 years to finally install a bigger transformer at the hopsital so that we could use the new x-ray machine. Everyone is very excited but as usual they work not very hard, but I think today it should be done. Now we just need to hook up the x-ray machine and calibrate it.

On Monday I came home from Kampala pretty late. Christina (I have to apologize I just realized I was writing Katrina not Christina in my last couple posts, not sure how that happnened but I have been calling her the right name in person...) and Teresa ran late with their dental appointments and then they wanted to go get cheesecake from this new cafe that is run by a New Yorker--I think I mentioned before we ate there also that morning for breakfast to eat the bagels. But they wanted more so we went there and had some late lunch. While we were there a father and his two boys, 6th and 8th, graders, form Illinois came into eat some of the only New York pizza in Uganda. We chatted with them and found out he and his wife run a NGO that gives money to families but also works with them to teach them over 3 years how to manage and earn money. Whats remarkable is that they started in Riwanda but got kicked out a year ago. Well if you have ever seen Hotel Riwanda, the guy that the movie is based upon, lives in the US and helped to raise money at a charity drive for this NGO in Chicago. Well the Riwandan government found out and apparently he is seen as a mortal enemy to the government. Because he is a Hutu (i thinkt that is spelled right) and the entire government is Tutsi---mind you this is 14 or so years after the genocide that occurred in the early 90s that the movie portrays. Well the Riwanda government contacted this the NGO and interogated the American man we met and his workers to see if they were supporting the Hutus--there lives were threatened too because as luck would have it the only Riwandans working at his organization happened to be Hutus too so this fueled the fire. The entire group was expelled from the country and as of now 3 of the Riwandans that worked there have been found dead. The Riwanda based manager is also hiding in Uganda and they are trying to get him into the US.

Pretty nuts! But the family and the group keep working and now are doing the same thing in Uganda. The two kids were also fun, they acted just like any other pre/teenager boys. One was even trying to teach me magic tricks so I could amuse the Ugandan kids---he was actually very good.

So after that we were in a rush to get over to the taxi park and make the 6 p.m. taxi back to Nkokonjeru. Christina and Teresa were very worried we were going to get stuck and were flipping out. I was not really worried because I knew the doctor would come pick us up but they were starting to remind me of times during our family trips when everyone just goes crazy...haha I just tried to keep up. We stopped at a grocery store right next to the taxi park and I picked up strawberry jelly, honey, peanut butter, juice, and spaghetti sauce---I was in heaven. And yes we made the taxi with time to spare and there even was another after that---but that did not stop the two women from complaining about how bad things were...arrghh.

The ride back was nice and it was really fast, I think the driver wanted to get to bed or something because I have never seen anyone go so fast over these crappy roads but I thought it was fun.

We got back and I showed the doctor my new goodies, he had never heard of a bagel (I bought a few to go) but I have soon found out that he really enjoys strawberry jelly and honey---sweets are hard to come by usually. So at this rate I will have to pick some more up this weekend.

Yesterday was not filled with much, saw some patients but power was out most of the time so did not accomplish much. Today is looking like might be the same with power out this morning and might go out in a bit too. Will see.

Well I have less than two weeks left here and it is really flying by, I am enjoying myself but as the days go by I am getting more excited to go to Asia.

Will put more pictures up.

Kampala Weekend

2007-07-16T02:12:00.000-07:00

Well I am still in Kampala...hanging out at an internet cafe until Teresa and Katrina get back from there Peace Corps dentist appointments. It has been a crazy weekend but a lot of fun. On saturday we went to the Fase 2 restaurant--I mispelled it before and it was nice to eat some good food--Indian chicken dish and rice plus apple pie for dessert..yum. We were there for a while it was an outdoor restaurant with a waterfall and resort type feel, the stars were out and it was pretty beautiful night. Katrina had her boyfriend type guy come meet her, his name is James and he is a Ugandan from western Uganda. They had not seen each other in months and I don't think they were ever very serious but he was nice, but very quiet. Apparently he was really stressed from work, he works for two non profit groups with orphans and unlike most Ugandans he really works very hard and I guess it is killing him--plus he pays for his two younge brothers education with this money--we were all pretty impressed. After dinner we were thinking of going out to possibly the casino or a club but Katrina and Teresa were very tired and the other peace corp members were not staying the night. I would not have mind to go out for a bit to see more of the town but I drank two Nile Specials at dinner and they are quite strong compared to American beer--7 or 8 %--so I was pretty tired myself. So we slowly meandered back to the hotel and just went to bed.

Yesterday we had to get up early and get something to eat before heading to the taxi park to find transportation to Masaka for the wedding. Nothing was open on a sunday morning other than gas stations so breakfast was quite light. We rode on a bus instead of a taxi--more comfortable but a bit more expensive. The ride was very enjoyable and I slept for a bit and just enjoyed the countryside landscape. Then we got to the wedding which had not started but the sunday service was going on which preceded the wedding. We were the only other white people there and we got special treatment, we stayed with the bride's family in the front of the church--I have lots of pictures I will upload tomorrrow. But the service took forever and it was mostly in Luganda so I did not understand anything. But they love to sing and dance and greet each other--I got swarmed by young children wanting to shake my hand. Then the wedding service started and it took forever. Each member of the wedding party processes in very very very slowly dancing to the music playing. Then the pastor says some blessings and they exchange vows and say some other stuff I did not understand. A strange tradition is that a younger brother is the last person that formally gives her sister away to the husband. This little guy went up and made some jokes about marriage and then literally handed his sister to the man (their names were James and Judith). Then they sing and dance a lot more. At this point the entire thing was nearing 4 hours and we all were starving. So we decided we would not go to the reception because it would mean getting back to Kampala very late. So we ducked out, saying thanks to the families. But before we could leave they demanded we get in for their family photos--once again because we are white and I guess that impresses people. So somewhere in Masaka James and Judith will live through their marriage with a photo from the ceremony with a strange white guy from California standing there---hahah I really want to get a copy and so does Teresa and Katrina.

So then we headed back to Kampala, but before we got on the bus we wanted something to eat and the bus driver--apparently lived in Colorado for some time agreed to find a place for food for us before we left and would wait. We were relieved but the small house that served the food was not very clean at all and the food was cold which is a big problem. We were pretty scared to eat the food and just picked a bit at it then got on the bus. The ride was going great and this one was a greyhound bus and actually cost a lot less. But we soon realized why it cost so cheap--they pack tons of people on the bus. We were crammed in the back shoulder to shoulder and I was sweating profusely but I think everyone was. I fell asleep but woke up and realized we had hit another car and the road was backed up for miles. It was miserable but worst was Teresa got sick and threw up on a plastic bag--it was probably not from the food though she had been feeling bad days before plus I would be the first to go if something was not cooked right. So she switched with a man at the window and just kept her head stuck out the window holding her bag of vomit. At this point the entire bus was restless but there was nothing to do except suck it up and wait until we arrived. Finally after another 4 hours we got to Kampala.

All we wanted to do was go shower and Teresa wanted to go to bed. So after showering me and Katrina went out for food. There is a Nando's chicken here and I wanted to go. It was not very good but they sell the sauce so I want to get some before I leave. But we chatted and I found out she used to row for 1 year at UCSB and I did know she lived in LA for sometime but now she lives in San Francisco. So we talk a lot about LA and then a Harley biker gang came by making tons of noise. Apparently the only one in Uganda. But she used to have a boyfriend who had a motor cycle so she was jealous and wanted to be back in Malibu riding a bike down the winding stretches of PCH. What a small world! I have trouble finding people in the US who know what rowing is let alone find one in Uganda.

So we then went back and went to bed. Now today I am hanging out at Garden City while they go to their dentist appointments. A new cafe opened yesterday called I love NYC. It has authentic NYC bagels, cream cheese, cheesecake, and other NYC food. Had it for breakfast and yes it was just like the US. The lady who runs it is from NYC and spent 6 months figuring out the recipe since we are at a high altitude and the change in yeast, flour, and water. But it was good. Teresa and Katrina enjoyed it more--they have been without something like a bagel for 17 months. So I can only imagine, it has been almost 3 weeks for me, that is nothing. Though it still was very satisfying because once back at the hospital it will be rice, potatoes, and matoke (a banana type food that is not sweet like a banana but bland and has not nutritional benefit but it is the most popular food in Uganda)

So when I get back to the hospital I will upload pictures.

Update on my health from last weekend

2007-07-14T07:47:00.000-07:00

Oh yeah, sorry for not updating it but I did feel really sick last weekend and eventually broke out the Cippro. I was very nervous because I had gotten a fever so my first thought was malaria. This scared me pretty bad but the Cippro made me feel very good real quick and I did not have any other fevers---a good sign of malaria so the doc says it was just probably from something I ate---which by the way I cooked two of my own meals that weekend because I was alone at the hospital. So pretty sure it was my cooking, which was not very tasty to begin with.

I am fine now and feeling great...and have asked for help with cooking from Teresa.

In Kampala for the Weekend

2007-07-14T07:24:00.000-07:00

Hey everyone, I am in Kampala for the weekend and at an internet cafe so I will have to be brief. On Thursday, I did not do much because the doctor said he was taking a lighter day so eventually I went running and well...missed pretty much all the excitement. To Dr. Kabuye's dismay several patients came in needing help so he operated several surgeries and I missed them. Finally after dinner another lady came in at around midnight so though I was tired I was happy to go and help. She needed a c section and I went and assisted. The patient was very unusual because this was her fourth baby and all the others were miscarriages so we were performing a c section (which all her others had been) to guarantee the baby would not die...hopefully. Well when we removed the baby we noticed something very strange--she had two uteri. The doctor claimed it was bicornuate uterus, meaning a uterus with two horns. It is very rare and as I pointed out was probably the cause of the miscarriages (the baby did live too so everything worked out). The next day I researched bicornuate uterus on the internet and it turns out that it does cause an elevated risk of miscarriage and pre-term babies--which these were by a few weeks. So I was pretty pumped that my theory turned out to be correct. The rest of the day was the off day that the doctor was hoping for the day before so I continued with my medical school applications.

On an even more positive note I got word from my dad that my sister, Abigail had dropped more time in the 200 butterfly, her best event, to put her about 5 seconds under the olympic trial cut and probably around the top 10 or so in the country!!! I am so blessed to have such a great family and I wish her continued success.

So now I am in Kampala for the weekend, I left with Teresa in the morning to go see the Harry Potter movie, which we just watched (it was good but I am ambivilent over the series). We stopped at the casino in Garden City which is where all the white people are, there are more here than I have seen since leaving the US. We played a few rounds of blackjack just to say we did it and I came out even not wanting to lose anything. I met a lot of other Peace Corp members, they all hang out at Garden City on the weekend and we are all going to hang out tonight. Before that we are going to a restaurant called Phase 2---apparrently it is really good, but slightly pricy.

Will update again on Monday when I am back in Nkokonjeru, going to a wedding tomorrow so that should be interesting.

New Surgeries

2007-07-11T09:27:00.000-07:00

So finally I got to see some different surgeries beyond c sections--though these were nothing major. There was a long list of things to do yesterday so the doc had all the nurses setup the surgeries back to back---we would do one in the first surgical theater then immediately proceed to the second theater and start then next one.

Our first was an evacuation of a incomplete abortion. Women go to local doctors to get abortions and they usually just end up with more problems. These so called doctors perform the abortion in the most crude manner and use herbs to treat---sometimes Dr. Kabuye says you will find twigs in there uterus still (which also means the uterus is probably perforated). So we just had to go and suck out remaining membrane material that will make the uterus continue to bleed. It is very easy, you just scrape the uterus walls with a suction device until it feels rough. This means that the membrane is gone and you are down to the uterus wall. We did not find any twigs but the uterus was perforated.

So it was nice to do something else, except I still find myself acting as an OB/GYN and a new area would be nice...

Well I got what I asked for but it did not take much. The next two patients had large swellings of puss---one on their face and the other on his hip (the man had severe HIV and actually had many swellings but he was too fragile to do them all). The procedure is simple, just put the lady/man on anesthetic then cut open the area and drain. Simple and well just nasty. Both of the patients had a lot of puss and it just is pretty disgusting. But I did get to cut with a scalpel, so that was exciting but it fades once the puss starts flowing...

Then we finished up with another incomplete abortion. Same procedure, very simple. Once again no twigs but another uterus perforation.

The last operation was to remove a piece of a twig from a young girl's leg (pretty ironic). This one was even more simple with just a local anesthetic and then cut open and remove--turned out there was just a few strands in the wound and it was just mostly infected.

So yesterday was fun because while the surgeries were simple it felt like a US hospital, running back and forth. Well actually the nurses and the Dr. liked to go a little slower and I found myself moving the heart monitor and tools and such back and forth between the surgical theaters.

Well today was not so busy so will mention it too.

We did another c-section today and I was the only assistant. If you notice in the pictures from before, I am standing next to a younger Ugandan woman in scrubs---her name is May and she is a Ugandan medical student so we usually both assist. So I was happy she was busy because now I was the only one. So with greater ease I helped with another c section. Nothing really too interesting other than this lady bled a lot and so it was pretty messy. However, it just made for a more Gray's Anatomy moment (No I don't watch the show). When I was helping suture up, Dr. Kabuye offered for me to do it by myself but I declined. Not sure why, I should have but she was bleeding a lot and I just wanted to finish quickly. But I will not make that mistake again...

Then a school girl, around 15 came in with a septic foot. She had fallen about 2 months ago and cut her foot but it had gotten much worse. I have a photo but its on Dr. Kabuye's camera so will try to upload it. Basically, we think some flesh eating bacteria got into the wound and just started going at it. Pretty much the entire top of her foot was necrotic tissue. So we had to anesthetize her and just cut off all the dead infected tissue and then let it heal some--in about 14 days she will get a skin graft. So I did not do much other than chat with the young girl, she was pretty nervous and spoke English. So I found out she wants to be a neurosurgeon, yeah thats right...a neurosurgeon. But apparently she still needs to get over the fear of needles....

Back again soon, going to Kampala this weekend to see Harry Potter with the Peace Corp (there is one movie theater and it is in an area called Garden City where all the mizungus or white people hang out), not my idea on the movie though. Teresa invited me so it lets me get away and see more of the city. Plus I think I might tag along on Sunday too. She is going to a local wedding for a person that works with one of her other peace corp friends. Not sure what it is like but hopefully some tribal dancing?

Tip: Don't take herbal remedies for labor

2007-07-10T09:36:00.000-07:00

Ok so yesterday was a pretty big day. Dr. Kabuye was coming back to the hospital from his weekend retreat back home to Kampala. I did not do much in the morning, other than begin my obssession with The Office, which Teresa happens to have practically the entire 1,2,and 3rd seasons. Finally after lunch, at around 2 the doctor arrived and we were to begin in the labor ward. There were three patients there and all of them were bad cases. The first lady, which we delivered as c section last week--the one where I helped give oxygen to the baby--had developed a very bad infection. We analyzed her and I learned the types of shock (loss of fluids, neurogenic, and septic--however there is even a more rare one associated with the heart which I read later). It was sad because this infection was post operative and most likely caused by the beds the patients lay in. These beds do not get new linen for each patient and blood or fluids has soaked into them. Basically it is a petri dish for all infections and patients just have to lay on them because that is all there is--next financial year they are hoping to upgrade the beds or at least seal them with plastic.

We then moved on to the two surgeries we had to complete. They were both c sections. In these surgeries I was going to scrub in and help as the surgical assistant. I was pretty pumped and not really nervous because I had seen several c sections by now. The lady had seen a local herbal doctor and she was given an herb that mimicked oxytocin and thereby inducing labor. But to have a proper labor the cervix must dilate to 10cm or more. This lady was at 2 cm but she had contractions as if her cervix was 10 cm. This causes fetal distress because the baby is now constantly being pushed on by the uterus but it is going nowhere. So a c section is required as soon as possible. So we started the surgery and I did not do much: I helped with towels to soak up blood inside and out or the abdominal cavity, I also helped with suturing and giving Dr. Kabuye the right tools. When we removed the baby it was not very good. The first sign is the amniotic fluid is now filled with excrement from the baby because it expels when distressed. Then the baby was puled out and it was very blue. The nurses took it and put it on oxygen but its heart rate was at 198 (should be 130-140) and it O2 concentration was 50 (needs to be around 100). So as the nurses monitored the baby I helped suture up the uterus and abdomen. The baby did improve with its heart rate dropping and the O2 stabilizing around 95. So once again hopefully there is no permanent damage.

Then we quickly moved onto the next c section. I was once again scrubbing in and helping. This lady had refused surgery earlier even though once again she had taken herbal medicine to induce labor--also compounded with vaginal warts which were too numerous to allow the baby to squeeze out. But we had to comply and she now had agreed to let us operate---at this point her membrane had ruptured in the uterus and the baby was severely distressed--or so it was told by the nurses. I performed most of the same functions though with much greater speed and efficiency--I knew the tools names and could follow the suturing very easily. But this operation would turn out to be very bad. When we cut the uterus and Dr. Kabuye went to pull the baby out--it was feet first but then he noticed immediately it was twins. I was excited because I had never seen this. But as he pulled the first one out, things were very wrong. Both babies were dead.

The babies were easily recognizable for being dead because the skin had started to fall off--Dr. Kabuye had said that the babies probably died around 4 days prior. He was very frustrated because in a developed country he could be sued possibly. The babies were preterm (which you would not perform a c section for) and also the nurses had not checked for a fetal heart very well--because if we knew they were dead we would have just gone with a regular delivery because the vaginal warts could have caused problems but it would not have mattered.

It was sad to see these human babies just dead and thrown in a bucket with the placenta but this lady just had too many problems. Apparently malaria might have had a hand in the deaths, plus she had vaginal warts, and used the herbs. But we sutured her up and finished for the night.

So it was kind of up and down. I was happy to have helped and really learned a lot more. But two babies were dead and one had lost several precious minutes without oxygen which might have caused brain damage.

So the tip of the day is don't take herbal remedies for labor.

Also, when we looked at the first patient with a lot of infection Dr. Kabuye decided not to work on her because she was just too fragile and he left me with a very good quote:

"The best surgeon is the surgeon that knows when not to operate."

I have more stories from today but will post them tomorrow, gotta keep a steady stream and not divulge them all at once.

Oh yeah these are photos from the second c section with the two dead babies.

PS. also thanks for listing comments, I do read them and appreciate them. Trout, I can't wait for the Orient.

2007-07-08T03:45:00.000-07:00

Well my first full week is finished and it has been great. Have been at the hospital the entire week and for the most part I have been just observing patients with Dr. Kabuye. There has been several very fascinating things that have gone on. The first is I have been able to watch two C sections. Both were emergency lower c sections. The first one, the lady had obstructed labor and needed the baby removed. It had not been too long so the baby was not distressed. The entire surgery takes about 20 min for Dr. Kabuye and it is fairly simple--I have all the steps written and memorized. It was the first time I had ever seen a baby take its first breath and I was speechless for a few seconds. Then this thursday we ran into another problem. Dr. Kabuye and myself checked on a younger woman who was having her first baby at around noon. She was only 8cm dialated and needed to be 10cm. So the doc said we would give her another 2 hours to dialate but since it was her first her knew it might take longer so 4 hours was the max. Well the day continued and the doctor did not go check on her again but rather was waiting for a nurse to tell him that it was time. The nurse showed up at around 10 pm and I guess it was both the doctor, myself, and nurses fault for not being on top of things. We rushed in to now remove the baby because it was obstructed and at this point it had fetal distress. The young lady was put on anesthestia--by way of ether, the doc said he would pay me money if I found another ether machine in the states! The surgery went fine until the baby was removed, the young girl was entirely blue and did not start crying after removal--a very good sign that the baby was not healthy. The nurses took the baby and the doc was ordering to put her on oxygen and beat on the chest and warm her. The entire time I am just watching and not feeeling very confident the baby will make it. An O2 conc. machine was put on the baby at it was registering at 87---it needed to be around 100, and it even dropped to the lower 80s. The baby was still blue, though the face was improving. I continued to watch but became very frustrated because the nurses, I felt did not understand the severity of the situation and werre fumbling around with the oxygen and not really administering it. I could not continue to sit idly and I rushed in and grabbed the oxygen machine and a face mask and immmediately made sure the baby's airway was open--it was not and I ordered for a tounge depressant, but at this time was using my fingers to keep her mouth open. I stayed there for the next 15 min as slowly the O2 went to 91/92 but it was still not doing enough, because the extremities were still blue. However it was breathing fine and the oxygen was attached so I left the baby to the nurses and the surgery finished up. (Since then the baby has been fine, and we think it does not have any permanent damage.) I was fairly proud of myself, but also nervous that I overstep my boundaries and should have just watched, but no one said anything and the doctor seemed to be impressed---but I still felt bad that the nurses here are in such short supply that they just have not had the proper training. But all seemed fine and I headed to bed.

On Friday, Dr. Kabuye, a nurse, and me were going to take the hospital truck to go do spot checks of the health centers for the district--this hopsital is the head of all these smaller clinics. I was very excited because we were going to Lake Victoria and I would be able to ride in a truck offroad.... We went out at around 10 and we were not back until around 4/5. We saw three health clinics. Two were next to the lake and another was closer to our hospital. The two by the lake were functioning ok. They obviously did not have enough workers or supplies but that is just the way it is. However, they were doing the best with what they had. The problems were they were not keeping good records, and they were not testing for HIV and TB enough. If a patient comes in with either symptoms both should be tested because they come hand in hand. However, the tests for HIV were always more frequent. The last, closer, was actually a full hospital. It was brand new and was funded by the Czech government. It was amazing to see a hospital in this good of shape. There were several czech workers there too so it was strange to see a lot of white people too. The hospital was doing everything right, actually it was doing things too good. It was being run like an American hospital but since it is still heavily funded that is not a problem (basically they had specialists for different surgeries) This is great but the Czech government will not fund it forever and at that point they will not be able to afford so many doctors and nurses. Dr. Kabuye tried to explain to them that they need to get used to stretching there resources and the Ugandan doctors needed to be doing c sections and other surgeries instead of a gynecologist. But if the new equipment just donated to the Nkokonjeru hospital was at this hospital it would resemble an American facility so it was reassuring that money and help is coming in.

We came back to the hospital and did not do much after that, Dr. Kabuye was going to go home to Kampala and I decided to stay because there is more I can do here with electricity and water. Plus he was going to a family function on saturday. So Teresa and Katrina, the peace corps members, would be staying I was planning on hanging out with them, there would also be about two other hospital administrators staying too.

So saturday came and I really did not do much, read books, worked on some of my seconday medical school applications. Until the evening. I was haning out with John, the accountant for the hospital, watching TV--which sadly I might have ruined his love for the WWF, it came on and I said it was fake and did not know that he loved it and thought it was real...oops. Then a nurse came rushing in saying a man was very badly cut and could I stitch him up. Well....the answer was no I probably could not but if it meant leaving him to bleed to death or for me to at least help, I decided to at least check out the man. I put on my doctors robe and rushed over---this was probably the best part because I did get to feel like a real doctor. However, once I arrived my glimmer of hope that I might be able to help the man faded...actually it was destroyed. The man had been macheted in the forest by a man who was attempting to steal his timber (I learned this today). From his upper lip to his chin was split open and his front jaw was also cracked. To make matters worse he also had a deep cut on top of his head which was squirting blood. Now I was very nervous. I tried to stay calm and thought about the situation, mean while ordering for his blood pressure checked--which turned out to be fine, as did his pulse. I told John that I really could not help his jaw but probably could stitch the mouth, though they would have to take it apart to fix his jaw later. I ordered for the nurses to clean and bandage him and to apply pressure to his head to slow bleeding. I then decided to try and get a hold of Dr. Kabuye, which at first failed. This made me even more nervous because I did not want to do nothing but I also feared doing something wrong. I tried also to get a hold of Poppy or my parents but this also failed. Luckily though the doctors phone went through and I did talk to him. He said that I did not need to do anything, just put him on antibiotics and fluids--the srugical nurse could stitch his mouth, but nothing could be done about his jaw. They would also stitch his head. So everything seemed fine but I was severly shaken. I felt that I was inadequate and that it was embarrassing to not be able to do anything. But I finally talk to my parents and calmed myself down, in another situation I think I would have done the same thing, I made sure the man was stable, I called a superior, and offered as much help as I knew would not harm. So I headed to bed, once I knew the nurses were taking care of him but it was hard to fall asleep. I feared the man had internal bleeding in his head and possibly internal swelling.

My fears were not realized in the morning today. Apparently the man had stabilized and was trasported to the main hospital in kampala for surgery on monday. I felt relieved. It was tough not knowing anything but at the same time this makes me want to be a doctor even more--so that I am never in that situation again.

The rest of today, I have not done much. My stomach has been upset and I think it might have been triggered by both eating something not great and the trauma in the night. Waiting to see if it gets better, or I might have to break out the cippro.

But while it has been a little crazy, I have learned so much. Never would I have an experience similar to these in the US, and while I am inexperienced I am helping to some degree so I guess it works out best for both parties.

Will try to update more frequent but the internet here is just so slow that it is frustrating to use.

Even More Photos

2007-07-03T08:34:00.000-07:00

More photos

2007-07-03T08:33:00.000-07:00