Beginning of a New Year

This year has had an interesting start here in Uganda: riots in neighboring Kenya, skyrocketing fuel prices as a result, deaths of a patient and our dear friend from Mama Joyce’s restaurant, or telling a local friend he is HIV positive. I guess it has not been the best start to 2008, but oh well, I am trying my best to make the most of it.

On a happy note though, last week was the birth of the Ugandan Kayak Club; after all the hard work from Karl and Tara, all the gear has officially been donated to the UKC with special thanks to all the sponsors: NRS, Wave Sport, SR helmets, AT Paddles, and Astral PFDs. So after Karl spent 3 weeks fighting to get the kayaks and gear through customs, the opening began. It was great to be involved in this event; all the locals were very excited to be part of this co-op that provides access to all the gear for an annual fee of only 5000 Ush. However, no good deed goes unpunished; of course, 2 days after the opening of the UKC, 3 of our paddles were stolen while scouting some of the back channels. And they thought we would not notice that our paddles went missing? I am sure that hand paddling down Blade Runner could be an option as well. It was a frustrating day to say the least. The back channel “expedition” day definitely turned out to be a true mission, not necessarily the rapids, but more so running around the village and finding the guilty thieves. I have made a few trips back to Kampala to refer some of out patients to the International Hospital; I keep finding myself in disbelief that I am still in Uganda whenever I go to IHK. Everything seems so clean and up-to-date, however, there are still moments of frustration: misuse of antibiotics without ever doing a culture or not even looking at the wound to see if it has made any improvement.

My main goal of this week is to get a friend to the AIDS Information Center in Jinja for further work-up and possible ARVs depending on his CD4 count, and of course, sell some more mosquito nets and continue being the condom fairy. The good thing is that everyone who wants to join the UKC will be required to attend our malaria and family planning sessions; in the next week or so, I am sure Anna and I will be doing our best to get the nets and condoms distributed.

Looking Back on 2007

Here it is again at the closing of another year—and another occasion where I find myself in disbelief of how quickly the last 12 months have passed by. This year has provided me with countless adventures and an opportunity to head off on my own excursion that has combined my passions into one.
It has been an adventure that is for sure: I have been working at the Soft Power Health clinic here in Kyabirwa, teaching malaria education sessions and family planning throughout the villages, HIV testing and counseling at secondary schools, and completing follow-ups to see how effective the mosquito nets have been. It is disheartening to witness how these tiny Anopheles mosquitoes are responsible for Uganda’s number one killer of pregnant women and children under five. Looking at red blood cells infected with the Plasmodium falciparum parasite sure makes this disease seem much more significant and dangerous than initially thought. Microbiology class back in the States never seemed as personal as it does here.

Of course, there are frustrating moments as well, specifically, accepting the limited access of healthcare available in Uganda. If back the in States, the patient would have seen a cardiologist years ago, gotten an MRI (which does not exist in all of Uganda), or had surgery for osteomyelitis long before it became chronic. It may be an asthma patient coming into the clinic, and the best we can do is hope we might have received a donation of albuterol some months earlier; if not, we just send him on his way and hope for the best. Aside from the moments of helplessness, the tropical medicine has been fascinating and far more than I could have ever learned in a classroom: malaria, filariasis, Schistomiasis mansoni (bilharzia), and best of all, jiggers! Among the mzungu staff/volunteers at Soft Power Health, we have already had a few cases of malaria and plenty of jiggers. I suppose the excess time spent enjoying the kayaking of the White Nile puts us at a higher risk of jiggers and bilharzia; however, it always seems well worth the risk.

I have found myself working with public health, yet avoiding traditional medicine for as long as possible – whether it is from an overnight evacuation of a friend with a fractured patella out of a 2000’ nearly vertical gorge in the jungles of Costa Rica, sitting in the back of an unmarked van running the Syringe Exchange Program in a fast food parking lot on a rainy day, or going from hut to hut to see if Ugandans have mosquito nets and are using them properly. Maybe traditional medicine and clean lab coats are just not for me; I just have to add a little excitement and get my hands dirty. It is life at its best, and it truly comes down to being surrounded be the right type of people who are willing to go the extra mile to make things happen (no matter how difficult or painful it may be).

All the events that keep piling together the more I work here in Uganda have been enjoyable. It has been a great combination of some of my favorite things: healthcare to the underserved, kids, adventure, kayaking, simple living, spontaneity, and being surrounded by a great family of Ugandans, co-workers, kayakers, and travelers. I am very content and excited to continue this drive and passion.