Kiboga Hospital

Sorry for the lack of posting--I promise I'm alive! I've just been working really long hours at the hospital, cramming interviews in at all times of day, and desperately trying to finish the first assignment in the project I'm doing this summer. Plus I caught a cold so I'm a gross drippy ball of virus. :/

Here's a general post about the hospital I started on Sunday night (AGES ago!), and I promise more details soon!

**************************************************************

What’s more surprising at a large, busy hospital—two chickens strolling through the waiting room and coming up to the triage desk, or a gecko slipping into the operating theater and sneaking around the walls until he’s peering down at the just-delivered neonate?


The answer is neither here at Kiboga Hospital!

I find it hard not to stare and/or crack up at all the unexpected interruptions that happen daily at the hospital, but patients and staff alike never seem to bat an eye when crazy things happen in front of them. Chickens and cows roam the hospital grounds, people cook and do laundry outside the wards on the lawn, there's rarely electricity and never running water available...all a typical day at the hospital.




Kiboga is a Level 4 hospital, which means it’s a pretty big medical center, and only has two levels above it: the regional referral site in Hoima, and the national referral site in Kampala (Mulago Hospital, where I’ll be working shifts at the end of my trip). People come from several nearby districts (the Ugandan equivalent of states) to seek medical attention and to give birth where there are skilled birthing attendants (docs and midwives). There are four wards (male, female, pediatrics, and maternity), one operating theater, an outpatient department (that screens all patients, whether they’re outpatient cases, headed for inpatient wards, or are emergency case), a large HIV clinic, a couple big health education rooms (for antenatal classes, etc), and tons of administrative offices attached to the hospital and scattered around the hill the hospital is perched on.

The hospital from the road, and the side-trail we take up to it

Despite this impressive sounding status, the hospital looks nothing like anything you’d see in America. Beyond the madness outside the hospital walls, inside it's generally dark, dirty, and pretty smelly. The hospital is horribly understaffed and under-equipped, from lab equipment to medications to gloves to blood. The wards are crammed with people--each ward is supposed to have 24 beds or cribs, but most have around 30 beds, plus mats on the floor in every available space, bringing the total to 45 on the busier wards (like maternity).

Try to image doing rounds--the morning review of all of the patients on the ward with the sole doctor and the "sisters" (nurses). We're in our white coats, trying to look like legit doctors, helping to attend to patients, listening carefully to decipher the heavy L'Ugandan accents, and desperately attempting to answer the questions the doctor is "pimping" us with. Add to this skirting around a woman completely passed out on a mat who is 8 months pregnant and has severe malaria and anemia and is hooked up to a precarious IV stand, and making sure not to step too far back to avoid squishing the 2 day old infant sleeping under a blanket with his mother (who is recovering from an emergency c-section), to retake the blood pressure on a woman with preeclampsia who lost her previous pregnancy due to the same condition. Also I'm usually sweating, have a grumbling tummy, and my back and my feet are screaming from standing for hours on concrete floors every day.

Waiting room early in the morning, before it overflows...

Yep, it's rough. It's hard physically to keep up with our clinical mentor, the Ugandan Dr. K who never seems to eat or sleep, and thinks we're weird when we insist on going to get lunch at 4:30pm (after being at the hospital by 9) before returning to the hospital for back-to-back c-sections. It's hard to see the condition of the hospital, knowing what pristine, efficient, well-stocked, well-lit hospitals in America look like. But most of all it's hard to see the burden of disease and the great need of the people in the hospital. So many of the cases break my heart, because the diseases are largely preventable and the consequences of having them needn't be so disastrous to the patients and their families. And I feel largely useless, unable to understand their stories without translation, unable to get them the packed blood or medications they need to survive, unable to hurry the process along to see more patients each day so not only the very sickest get seen.

Don't get me wrong--I love it here. It's great to do what I can, and I'm learning so so much. Perhaps my biggest skill is clowning around with the kids in peds (who love to giggle at Dr. Mzungu's funny faces), but hey--being sick and scared sucks and laughter is (almost) the best medicine, right? And already Dr. K is having us do more, so hopefully I'll be actually helpful by the end of the summer. And hopefully my project (which I'll post about soon!) will help lots of people in the community, possibly for years to come!

Email me if you want some crazy/gory details of the cases we've been seeing, otherwise I'll try to post a PG-list soon!

Adorable AIDS Orphans

On Tuesday morning Shalina and I were walking to the hospital when we heard “Good morning, white people!” coming from an SUV parked further down the street. We looked up since the accent was not L’Ugandan and the voice was friendly, and we met Brian, a construction consultant from Australia. We chatted with him and learned that he and his wife Jan were building an orphanage for AIDS orphans outside of Lwamata, the next town south from Kiboga. We exchanged phone numbers, and told him we’d be in town this weekend if he needed help with anything.

We talked to him on Thursday and he told us he and his wife were driving to a place 3hrs away to visit some orphans on Saturday, and invited us to come along. Shalina and I were feeling adventurous and trusting, so we said we’d love to go on an all day trip across Uganda with two strangers to meet some kids.

We met the Australians at 7:30am African time yesterday, which meant it was 8:15 when we hit the road. We quickly learned everything about their lives since Brian is a talker and a storyteller. The short version is that after Brian’s father died and he also received a terminal diagnosis, but then was completely healed, he decided he wanted to make big changes in his life. A series of events led him to Uganda, and to an orphanage named Mountains of Hope that was about to be forced to close due to lack of funding. Brian and Jan got involved and haved turned the situation around with their passion to help, their love for the kids, and Brian’s business savvy.

They have a 5-10yr plan to make the orphanage, which they’re moving from its current location in Mpigi (3hrs from here) to outside Lwamata (where it will be renamed Valley if Hope), and the school they’re building as well to be fully self -sufficient, and to introduce microfinance projects to the community on multiple fronts. It’s a well thought out and patient plan, and it reminds me a lot of the Ratzloffs’ work in Cambodia. Here's their website if you want to learn more or make a donation! http://wellspringcharities.org.au/home/

ANYWHOODLES, we drove to Mpigi yesterday morning, picking up a Ugandan named Sarah along the way. Sarah is the first “graduate” of the orphanage—she finished secondary school, spent a year being trained as a teacher, and is currently teaching at the primary school meeting at an old, scary-looking church building that will move to the new site next door with the orphanage once its built. She is cute and smart, and survived extremely rough times with her family before she lost them, and at the orphanage before the Australians came along. She was of course the most popular person once we reached the orphanage, since she was basically a mother to many of the kids.

There are currently 8 orphans staying at Mountains of Hope (and the two kids of the caretakers). (The number of kids fluctuates and was at 13 last year, but besides one sassy 4yr old who needs a lot of love and medical attention they are trying not to accept any more orphans til they make the move in September). They are so adorable, and clearly healthy, happy, well-fed, and well-dressed. They are very loved. It was awesome watching them interact with the Australians after not seeing them for a year. [you can see a lot of the courtyard of the orphanage here, with bedrooms and classrooms around the borders. you can also see Patrick, who hammed it up for every photo]

The kids were pretty shy with us at first, and just knelt around watching us while we met with James, the caretaker. He brought out blocks to distract them with after a bit, and I made friends quickly by joining them on the ground building towers and knocking them over. Knocking over block towers is fun in every language!

It wasn’t long before I’d stolen Blessing, the caretakers’ 8 month old baby to cuddle with, and was playing with a curious-but-suspicious two year old on the side. The older kids took longer to win over, but I just rough-housed and tickled the boys (and perfected my warrior pose and warrior grunt), and played swings with the girls (with some more tickles). Once we brought out the camera we had lots of fun taking pictures with them, and letting them try to take pictures of us (it was mostly just their fingers blocking the view of our chest or our legs…they were funny but didn’t get saved).

Shalina had been more reserved with the kids, chatting with the adults instead, until she pulled out her chapstick. For some reason the kids, who didn’t speak much English besides the usual greetings, knew “Lipstick! Lipstick!” Shalina donated her chapstick to the cause, and the kids had a riot putting lipstick on themselves and others. We think the boys enjoyed it the most.

We had a delicious meal cooked in the outdoor kitchen, and used the bathrooms which, while clean, were interesting…just a hole the size of the brick in the floor with doors that don’t close. We left around 3pm to start the drive back, and since we made it to Lwamata before it was completely dark we drove out to the construction site of the orphanage and the school (and dropped Sarah off there). It’s such a lovely, peaceful location. We know the kids will love it and thrive with a great school, good food, and medical care. The Australians treated us to a meal at their guest house in Lwamata (sooo delicious) before driving us home.


It was a wonderful day, and was such a treat to speak rapid English with people that understand you and to play with adorable kids all afternoon. We want to meet the sassy 4 yr old, Marissa, since she still has some unresolved medical issues that they’d like some advice on (she’s staying with the family of one of their Ugandan associates near the construction site), and hopefully we can direct her to appropriate doctors or medical facilities. They’ve received a lot of conflicting advice and aren’t sure what to do. We don’t know if we can help, but we’ll try! So hopefully we’ll see them the next weekend we aren’t out of town.