Nets, Nets, and More Nets...

Sorry it has been a while. The last few weeks have been filled with net sales and long trips. Our hope has been to get people to buy nets for the holidays, and so far, it has been pretty successful. A few weeks ago, we made a trip out to Bwindi rainforest, the southwest corner of Uganda, for a few days of net sales. This area of Uganda (near the border of DR Congo) has no access to mosquito nets and is one of the poorest regions of Uganda. Just outside of Bwindi are the Pygmies; the Pygmies were kicked out of the area when the land became a national park for gorillas some years ago. The Pygmies are now the poorest population in Uganda and cannot afford nets. In years past, we have traded nets for jars of honey, but this year’s trading goods had quite the range: wooden carvings, bundles of matoke, sugar, and best of all, 2 eggs. It was interesting to say the least.

It was great to see some new countryside of Uganda; I think I felt cold for the first time in the last few months. I actually pulled out a warm hat at nighttime (yes, I know this is very lame). It felt like a whole new place though, and since Lusoga and Luganda are not spoken in this area, it was fun to watch Francis and Joseph (our drivers) get completely confused with the dialects in the southwest region.

It was an interesting trip, and definitely a fun experience to exchange nets for all the goods the Pygmies brought with them. It was good to get out and see some new parts of Uganda; the 14 hour drive out to Bwindi provided us with plenty of downtime to enjoy each other’s company.

Best wishes for the end of the year.

Nile River Festival 2007

Things have been a bit busy out here on the Nile. Although everything still seems to happen on Uganda time, I have managed to cram in as much as possible. Aside from working at the clinic and seeing patients with malaria, right heart failure, hypertension, or other tropical diseases such as Filariasis and Schistosomiasis mansoni (trematode eggs), it has been productive. We have had more outreach net sales, follow-ups, adventures searching for referred patients at Jinja Hospital, and a little playing on the river, too.

This weekend was the international Nile River Festival; we had people from all around the world: USA, Canada, Ireland, Scotland, England, Sweden, New Zealand, South Africa, and best of all, local paddlers from our dear Uganda. It has been quite an event, and definitely a great 3 day weekend filled with plenty of competitions: the big air freestyle on the Nile Special, a 45 km endurance race from NRE down to the Hairy Lemon, and another 10 km paddle to Silverback followed by a boda-boda race back to NRE (of course the finish line for this race was through an obstacle course of rafts and a funnel of the sponsoring Nile Special beer for the final touch). The best score of all 3 events was the big money maker and the men’s champion was Ibra, our local Ugandan. It was great to watch him take home $2,000 as the grand prize. It was a good turnout though: there were about 40 men in the freestyle with fewer in all 3 events, and 12 women (I think it is the biggest female turnout yet). It was a fun weekend filled with plenty of worldwide kayakers and lots of locals here to compete and support the event. The flat water in the 45 km race was pretty entertaining, but luckily this part of the festival was done in partners, so Anna and I kept each other laughing and motivated throughout our 3:29:24 sprint. Good times. The best part is that CDC had a table at the finish line and they were waiting for all the dirty kayakers’ blood to test for S. mansoni (bilharzia). They are working on a study to see if S. mansoni is here in Uganda and were very surprised when I told them we had a case of S. mansoni at our clinic the week prior.

We have 2 malaria outreach sessions this week and a meeting with AIDS Information Center in Jinja to discuss continuation of free HIV testing in secondary schools around Jinja.

Check out Jaime's write-up on the Festival at http://www.kayaksession.com/nile-river-festival.php

Back to the Nile Special

Hello again from the “real world” back here in Bujagali. We just returned after a weekend getaway to the Hairy Lemon – an island about 45 km downstream located right next to the Nile Special, one of the world’s best play spots. So after another week at the clinic and outreach programs, it was great to see some new scenery and take advantage of the high water here on the Nile.
The Nile Special is amazing yet again, and even better with the high water in preparation for CHOGM (Commonwealth Heads of Government Meeting). I think CHOGM has officially started as of today; I am very glad I am not in Kamapla for the queen’s arrival for the Commonwealth meeting. It has been a bit crazy around Uganda in preparation for this event, especially near Kampala and even Jinja; there has been a lot of road construction and other projects to prepare for the queen (I believe Prince Charles is even coming to Jinja to see the "source of the Nile"). It seems like it is becoming Uganda’s one chance to make a good reputation for itself internationally and they are definitely spending a fair amount of money for it. However, I somehow doubt that the queen will actually make it out here near Jinja or even be here for more than the 3 day event. Whatever works though.

The Special was great though. We had a good group of people out at the wave, including a few Brits soon to end their trip and then the whole World Class Kayak Academy group showed up last night (high school kids traveling around the world kayaking with teachers & kayak coaches). All the instructors were a lot of fun, and it was nice to see some kids out there shredding it up on the Special this morning. Hairy Lemon is a great place to be – good camping with 3 meals a day and only a 5 minute paddle to the Nile Special. We put in 3 good sessions each day (sunrise surf before breakfast, before lunch, and then a nice sunset surf). Full moon next weekend! Life is good.

Let the Madness Continue: The Adventures of Rural Medicine

Yesterday was our third HIV Testing/Counseling session at the secondary schools outside of Jinja. We have paired up with the AIDS Information Center and offer education, free testing, and counseling to these students (a total of 264 students have been tested thus far). It has been a bit crazy for many reasons, but when is it not?
Godfrey, Jen (a PA student from Colorado), and I went to go visit one of our TB patients out in Kyabirra. It was another typical day in rural medicine. We left Soft Power and stopped at the Buwenge Health Clinic to get our patient’s isoniazid & ethambutol medications for the next month; however, the doctor with the only key to get the drugs was not there and could not be reached. So…we waited around for an hour until he came back; he gave us the drugs and we were on our way. However, it turned out we only received 2 weeks worth of medications, so long story short, we stopped at two more health clinics along the way and finally got our hands on another set of isoniazid & ethambutol. In other words, our hour-long drive to reach our patient in his village took about 3 hours overall (it was only a minor trek to find him once we got to Kyabirra). Jen and I kept joking that we were having our Paul Farmer adventures for the day, but this was definitely the mini version, so maybe next time.

Time is a funny idea here in Uganda. I have learned to put my anal-retentiveness aside and just settle with Ugandan time, where you just “go with the flow of the Nile” and add an hour or two until things actually happen. Jen and I were laughing pretty hard during the trip out to Kyabirra yesterday; it is always an adventure. Or maybe it was last week at Lugani Secondary School with a line of students out the door waiting to be tested for HIV; we had limited daylight left, no more clean syringes for 44 more students, and best of all, a matatu without functioning headlights (just a minor detail that would have helped if we knew beforehand). I thought it was funny about the headlights, but a few people did not seem to agree with me.

The good news is that all the students have been negative for HIV! I have been somewhat surprised, yet relieved; most of these kids fall under the categories of populations with increasing rates of HIV: sub-Saharan Africa, youth between 15-24 years, and rural areas with limited access to health care.

I have been enjoying all the fun mishaps that keep piling together the more I work here in Uganda. I am sure there are more to come.

Mzungu! Mzungu! How Are You?

Hello from Uganda! It feels good to be back here on the White Nile; all the familiar faces are still around: boda-boda drivers, raft guides, locals, and a few paddling buddies from the trip in 2006.

So far, I am still figuring out my role at the Soft Power Health clinic. Last week, we went on an outreach education session in Bugaya village, and then a follow-up session in Muguluka to see how effective the nets have been in the last 4 months. We sold all 150 nets on Thursday in Bugaya and need more for our next trip out there. When asked how many people had malaria in the past, everyone in the crowd raised his or her hand. It was somewhat disturbing to see how many people this disease has affected.

Aside from Soft Power, I have gotten a few laps in on part of the day 1 stretch. All the boda-boda drivers are still here, including our regular drivers from last time, Robert and Moses. Robert has started kayaking since I last saw him last and it is great to be out paddling with him. The river has changed since beginning the construction of the dam a few months ago; the Ugly Sisters wave is now gone and all the water has been diverted to Silver Back, which makes it pretty huge. It is sad to say that this section of the day 1 stretch will be flooded when the dam is finished in about 4 years; it will have quite a financial impact on the river industry down here. However, I am loving the big, warm water while I can, and enjoying seeing everyone again.

Last night, Ronald took me on a tour of his local village. I was able to meet his mom and sisters, and then all his own kids running around, chasing us on the boda-boda. “Mzungu! Mzungu! How are you?” they scream; these kids were not used to seeing a white person (mzungu). It keeps amazing me how friendly and welcoming Ugandans are; they invite you into their homes without any hesitation, take you around villages, and strike up any conversation, or even let you drive their own boda-boda (it was pretty comical). I sure wish I could speak more Luganda, but maybe by the end of this trip, I will be able to get by.

Today I will be helping with an HIV testing/counseling session with the kids. We will see how it goes.

The Pearl of Africa - Here I Come Again

I am sitting here in the mighty fine SeaTac airport. Although a minor delay in my flight off to London, I find myself feeling tickled with excitement. It is finally happening! I find myself in disbelief; it feels like it has been quite some time waiting for this to happen. All the fond memories from year and a half ago are running through my head, but now I am off on my own, ready to start my own adventure.

Back in March 2006, I headed off to Uganda, and sure enough, it turned out to be an amazing experience far more than what I had ever expected. The only downside of the trip was the day I had to leave. The idea of coming back to the States was definitely not top on my list.

I left for Uganda on my own, ready to see the other side of the world. I met up with some kayaking friends who had been spending some time there already. Home base was right near Bujagali Falls, about 8 km downstream of Lake Victoria, the source of the Nile River. It is a kayaker’s paradise; the river is warm and surrounded by a green, lush jungle. The White Nile has everything I could ever dream of: multiple channels with plenty of different lines, big drops, and best of all, world-class big water play boating. We spent hours surfing at the Nile Special, the Ugly Sisters wave, and the Super Hole. What truly blew me away was watching the local kids swim right above these huge rapids, or paddle around in their homemade wooden canoes while out fishing for the day.

Aside from kayaking, it was a great place to be: cheap camping, great local food, a fun, genuine culture, and memorable Ugandan style shuttles back to camp. My local “boda-boda” (moped) driver picked me up at the take out, and the adventure home was almost as exciting as the run itself. The trick was to straddle my boat between me and my driver and hold on tight as we bounced along the narrow dirt road. Trying to avoid hitting the trees and brush, or even herding goats, with the bow or stern of my boat always made an extra challenge.

On the “boda-boda” ride back, the road went through the farms, the small villages, the schools, and the mud huts these people call home. Tons of young kids would come running out of their huts as they saw us driving by with our kayaks. Their hands waved through the air with contagious smiles on their faces. “Jambo! Jambo!” I would yell back. I loved this place; I loved where I was.

Life was so simply lived, yet so terrifying and uncertain for all of these families. It could be malaria, HIV, malnutrition, drought, or the violence and oppression in Northern Uganda, but these people I encountered every day were filled with so much joy and excitement. They were friendly and curious, as was I. The river brought me to this place originally, but the interaction with the locals is what truly brings me back.

I feel very privileged to have had this experience, and very lucky to be able to go back to Uganda and help out with the malaria project (www.softpowerhealth.org). I will do my best to keep everyone posted during my adventure. Best wishes for the winter.

Final Thoughts on WEMT

It amazes me how much can be accomplished in such a short time, whether it is emergency medicine, wilderness adventures, or the new friendships that form in only one month. All of this took place just outside of our own Bavaria, here in Leavenworth, Washington. And what brought such a fine group together? A month-long Wilderness EMT class sponsored by Rescue Specialists, Inc. Days were long - lecture time, simulations, drills, ambulance ride-alongs or ER observation time, and best of all, endless hack sessions. Don't worry, majority of us are unemployed, outdoor bums, so it fit perfectly.
Katy, with her impaled object through the gut.
And congratulaions to Justin for his newborn baby! It's a girl (I think).
Kasey getting ready for our Search and Rescue.


So, in the long run, I do wonder whether or not I will put much of this knowledge to use in Uganda. However, only time will tell, and sure enough, that time is very soon. Only two more weeks and then I will be singing my African tunes off in the far away lands on the White Nile. I am very grateful for the group we had for our WEMT course; it would not have been the same without everyone there. The last month has been intense, but definitely worthwhile. We covered a lot of information, even while trying to think schizophrenically (urban vs. wilderness medicine). It sure makes a difference when a hospital is only a 5 minute drive away. However, most of us do not live that lifestyle and that is what makes this all the more fun. Good luck to everyone from RSI; I hope we meet again sometime down the road.