Christmas at Sipi

I have never been a big holiday person, but this last week has been full of good times surrounded by the right people. Early morning on Christmas Eve, a few of us jumped in the Delica and off we went up to Sipi River Lodge in eastern Uganda. Our friends cooked up a storm of amazing food and we all had a relaxing Christmas day of eating, drinking, and enjoying each other’s company and the good view of Sipi Falls. My time at Sipi was also a great opportunity to do some more paragliding. I did some solo flights and more exploring and flying with Steve Fisher after he and Des arrived on Boxing Day. It was great to get up in the sky again and fly around some new terrain. The area has huge potential; I ended up flying at over 5 sites with many more potential spots. The best part of flying at Lower Sipi is the view: once I was up in the air, I was able to enjoy the view of all 3 waterfalls flowing down Mt. Elgon. I have realized that the hardest part of flying here is finding a landing zone that is not full of kids. As I soared along this ridgeline, I looked down at the roads and goat paths to see tiny creatures running from every direction. I was in farming country, and suddenly, I became the mzungu falling from the sky. There were about 200 people surrounding me at the LZ on the first few days; by day 7, it was maybe down to about 50. Either way, I had plenty of company at launch, landing, and even on the hike out. Now I am back home in Jinja just in time for New Years. It was good to get away for some good company, flying, and even a little climbing.

Kampala

This week has had some long days for sure. I have made a few trips to Kampala for one of our patients; she is a 32 year-old female, mother of 4, who was diagnosed with Hodgkin’s lymphoma back in May. We began sponsoring her chemotherapy treatment in Kampala. However, after showing little improvement at Mulago Hospital, another biopsy was performed at the International Hospital and the diagnosis changed to non-Hodgkin’s lymphoma. It was sad news, since there is a much higher hope of surviving Hodgkin’s lymphoma, especially since she began treatment at such a late stage. Now it has reached stage 4.

Between treatments, I visited her at her home after her brother called saying she was not well. She was too weak to stand alone, with no appetite and vomiting for the last few days. She was complaining of pain on her right side and a tender right abdomen due to the cystic tumor masses that have spread to her liver. Although scheduled for another round of chemotherapy in a few days, I was worried she would not survive the drive to Kampala. We started her on oral morphine to help with the pain, and fortunately, she was looking much better by Monday. We decided to get her to the International Hospital in Kampala to continue her pain management.

I kept thinking to myself of the unofficial oath of medicine: do no harm. At this point, she is too fragile to undergo further chemotherapy. I discussed the options with her doctor. We decided it was time to discontinue treatment; the plan was to undergo blood transfusions to increase her Hb and counsel her to make plans for her children after she is gone. The doctor then spoke to her in Luganda, and I assumed told her what we had just discussed. I had offered to donate blood on Monday but all the nurses said there was enough (she is B+ and I am O+, the universal donor). Although I was hesitant to believe them, I left anyway.

I returned to Kampala yesterday after getting a hold of the doctor and learning that there actually was not enough blood for her. After donating in the lab, I walked upstairs to the Hope Ward to tell her that blood was coming her way very soon. Although I have donated many times, never before have I actually watched my own blood go to someone else, especially a friend and someone so dear to me. I began explaining that she will get this transfusion to boost her Hb and then she will come home to Bujagali in the next few days. She was very grateful, but then asked when she was going to get her chemo.

I took a deep breath, realizing that everything I had discussed with her doctor 2 days prior had not been explained to her. She had received no counseling and had not been able to mentally prepare herself for the steps ahead. I reached that point where I felt completely helpless; all I had left to give was a language barrier of emotional support and a pint of blood.

Paragliding Near Lake Victoria

After watching the birds catching thermals in downtown Jinja, I finally managed to go flying this last weekend. There has been too much talk and I was going a bit stir crazy; I had to go flying again. After arguing with security guards to let me scout a flying site on the Kakira Sugar Farm just outside of Jinja, I left and went to another ridge site and launched from a secondary school. All the kids were super excited when I showed up; they guided me over to the launch site where a friend of mine has flown before. It was a pretty tight, dodgy launch but totally worth it. It was great to get up in the air again and quite entertaining to have such a big audience, both launching and landing. I was able to get in 3 flights and catch a bit of lift, soaring with the birds. I looked down and watched the kids chase me from one end to the next; I heard screams of laughter and excitement as I made 180° turns. After soaring around for a while, I started to head down to land. I looked ahead to see the beautiful Lake Victoria, the second largest lake in the world and the source of the mighty fine White Nile; it is a pretty cool view.

It was a good way to spend my Saturday afternoon. I worked for a bit in the morning, went flying, and then hopped on the back on Muhammad’s boda-boda for a sunset cruise back home.

'Tis the Season of Circumcision

This weekend turned into an adventure of sorts. We had a net sale just outside of Mbale, a few hours east of Jinja. We packed up 600 nets and off we went. While teaching the session in Bugusege Central Village, we heard chanting and singing off in the distance as we watched crowds of people dance through the streets. People were dressed in banana leaves and covered in white paint. I realized it was circumcision season and the whole community was gathered for the day’s event. I saw countless people dancing in circles, then realized one of them was our driver, Francis; he had snuck off, dressed himself in his own costume, and joined the fiesta. He never seizes to amaze me. As I watched these groups dance and sing through the streets, I realized the soon-to-be circumcised males were 18 years old. Many of these tribes still practice circumcision for males at this age, and female circumcision for teen girls as well. If one shows any emotion of pain, he is not considered ready for manhood; many Ugandans are very surprised to hear that some mzungu males are “ready for manhood” 3 days after birth. As much as I try to respect cultural traditions, it is hard to not look at these practices without a medical concern. Multiple circumcisions are performed in these deep villages using one knife; it is anything but sterile. It is scary to think of the infections that occur because of this. Aside from the countless circumcision ceremonies that passed us during the 4 hours, we still managed to sell 380 mosquito nets. With the long drive to Mbale, it was a perfect excuse to stay the night and visit our friends’ place at Sipi River Lodge. It has definitely changed since last time I was up there in April when Ian, Fraggle, and Will were tearing it to pieces to start over. The lodge is up and running now and looking great.