Nick and Tessa in Kisiizi

Hours of waiting. Even more epic for the patients...

It is only 1:30 in the afternoon and this day has already been moderately epic

Mornings here are gorgeous, the morning chorus here is incredible, matching the forest in New Zealand. Countless birds sing to me and some even flutter in and out of my room. Chapel is a good way to start. We learn Christmas carols in  English and Ruchiga. Extremely dissapointing that their “Hark the herald angels sing” had a completely different tune… All is redeemed though when, with one failed start we manage a lively rendition of  “see him lying in a bed of straw” (trickiest carol known to man).

I turn up to the ward to discover I am doing starting ward rounds on my own. I am relatively confident to do this now and refer the patients I really have no idea about to our uber Dr. Denise, an astoundingly good and extremely nice doctor. Right, time to start on the 35 patients…

1. The first patient I meet deteriorated overnight, he was here after an alcoholic hypoglycaemic coma. This is the most common cause of coma admission here and happens when males (always males…) drink too much of their local brew and get low blood sugar. They quickly come right in hospital and go home. Anyway this guy is a lot worse. He responds with murmurs, and I noticed he is only moving his left arm… turns out he couldn’t’ move his right side and his reflexes were kicking on me just touching them. A stroke . There is no way to look at his brain here to confirm this, but it would not help much anyway. I prescribe aspirin, make sure he has nothing in his lungs and try to explain through a translator to his family what has happened and that recovery will be long and he may not walk again. Note to get Dr. Denise to come back to talk to the family again and make sure there is nothing obvious I have missed…

1. After a couple of malaria patients, another man has “elephantiasis” a common condition here where a limb swells up massively due to little worms in the blood stream…. Incidentally he has had an extremely sore hip for years, and can barely walk. I have a look at the x-ray… not good… his hip joint is literally ground away, the arthritis has destroyed it. We would just get a hip replacement, but here this is reserved for rich tycoons who can afford the expensive operation. We just give pain relief and try to keep him moving as much as he can, even with the pain. Pray for him…

1. Ach, the ultrasound could see everything except the gall bladder and that was the only thing I was looking for! The lovely ultrasound lady recommends I order a chest x- ray in the mean time. Not sure why????

Great, Dr Denise has arrived J

1. Another woman has white under her eyes = > severe anaemia. We look at her old notes and she has a bone marrow disorder (myelodysplasia) causing decreased numbers of all her blood cells. Of course they did not explain this to her at the hospital where she had the test… Explaining to the family is difficult, I don’t’ think there is a word in ruchiga for bone marrow. Earlier Dr. Denise explained gall bladder by referring to a chicken. Everyone here has seen the gall bladder of a chicken. 2 units of blood and move on

1. Great a woman I admitted yesterday! Oh dear she has not improved. The poor woman was given drugs for her fever but vomited them all L The previous tests she had were positive for typhoid, but negative for malaria so I retested her for typhoid while treating it. I pick up her results. WHAT, positive for malaria but negative for typhoid!!!, the opposite??? I start to explain that I am sorry I gave her the wrong treatment and will change to malaria. Dr. Denise stops me. She says patients will never come back if we tell them we have made a mistake. She just tells the woman that she has tested positive for malaria and we will treat it. Wise I am sure, but it feels wrong.

1. Bitten by a spider and swelled up like a balloon! Better today though on steroids and can go home praise the lord 

Its only 1:30 and these are just 6 of the patients we saw this morning. Still a bit weak from my malaria too (oh that’s right haven’t mentioned that yet…) More to do this afternoon. God is good to us, me and the patients.