The days since I left for Kampala have been jam packed, often 14 hour days. I feel like I am back on a GSE trip! There was a lot of confusion and miscommunication on many levels about my travel back to Kampala. I thought William and Beth were picking me up late Saturday after the wedding they had to attend in Mbarara, but then Kenneth told me they thought I was going to the wedding with them and spending the night in the village where William’s mother lives. I had no clothes for an African wedding. It’s an all day event and the attendees dress in very dressy formal and traditional African attire. I had only enough clothes for two days with me and they were very casual. And, as much as I would have loved the experience of sleeping in a village, the village was further from Kampala than Mbarara. I did not think I would be back in time Sunday to meet the Rotarians from Kampala Sunrise for a visit to a project. Without going into all the details of what we went through to resolve all this, the end result was that Kenneth drove to me Kampala. We met up with three of the members of his GSE team and it was wonderful to see them all again. One member was not there, because she lives in Mombasa and I will see her there. William and Beth arranged for their driver to pick me up and take me back to their house. My suitcase was there anyway. The kids were all home with the housekeeper.
Sunday morning the driver picked me up to go to the Kampala club where I was to meet Dorcas Tusubira and several members of her Rotary Club. La Jolla Golden Triangle had provided funds for a water project in a village (Bulindo) and we were going to visit. The drive was about 40 minutes from the city. When we got there, we met in a central outdoor meeting area at the local school. Women came bearing fruits, vegetables, sugar cane and chickens….live chickens! The Rotarians told me they were bringing all these things for me as a show of appreciation. One of the Rotarians acted as an interpreter, as the villagers spoke Luganda. They asked me to say a few words, and I told them that I was thrilled to be there representing La Jolla Golden Triangle Rotary Club and we were so glad to be able to provide them with these water tanks. I originally thought our money would buy 5 tanks, but it actually bought 8 tanks. The rain water is harvested through gutters into the tank. Each tank is 100.5 liters. The village council made the decision as to which residents would receive the tanks. Since the receivers had to agree to pay for and install the rain gutters as well as the pedestal for the tank, I think it was partially decided based on who could afford it and who would maintain it. It was quite a thrill to see our club name on these tanks. We visited about 5 of them. There were many photo ops (to be posted soon) and there was also a TV news channel filming. I have been promised a CD of the event. One man, who was a Muslim, asked to go change his clothes before being filmed. He got into his long white ethnic attire. He was one of the few who spoke a few words of English. What made me cry was when the ladies got down on their knees to thank me, I kept trying to explain it was a group effort, and they probably understood that, but since I was the one there, they were on their knees. Dorcas had prepared a very big meal at her home for all of us that had gone to Bulindo. Tusu greeted us there, of course. They have a lovely home and the feast was incredible. Tusu drove me back to William and Beth’s.
Monday I went to Mildmay. This facility was the first facility for HIV patients in Uganda. They have an outpatient clinic for adults and for children. They also have an inpatient facility for very sick children. The inpatient facility was where I was assigned. I have spent three days there. The things I have learned have been incredible. All care is free and the organization is non-profit. They are running short of funds for the inpatient facility. The children range in age from a few weeks old to children about 18. There is one head nurse and another staff nurse no matter what the census. Therefore, the mothers are asked to stay there with the kids to help feed them and give them medication (except for IVs). The cultural issues are almost beyond description. There was one young mother there with her 11 month old son. The woman stopped breast feeding at 7 months when she found out she was HIV+. The baby at this point is negative, which they said is fortunate and the baby should remain negative. The mother asked me how all this could happen. Her husband died in an accident while she was delivering the baby….except none of the staff believe that story. I asked this woman if her husband was sick. First she said no, and then as we talked further, she told me he had a chronic cough that would not go away. He most likely had either TB or pneumocystis pneumonia as an opportunistic infection related to HIV. Another child there was 17. She had just been diagnosed. Her mother acted surprised, but the mother was HIV+, but was not talking about it. So, there are mothers who would rather wait until their children are older and very sick before seeking treatment, because they don’t want anyone to know they are positive and they refuse to discuss these matters with their husbands….in most of the cases, the husbands are the ones that infected their wives. There are many more stories and I will discuss more of those with any of you that want to hear once I am home. I would be writing a novel if I put it all here. I participated in rounds with the doctors (all female, by the way, and one was a Rotarian!), I helped feed babies, play with them to give the mothers a rest, got information from charts, reviewed lab work and felt very much a part of the staff. The only thing I declined to do was start an IV. The reason is probably not what you are thinking. The reason is because these kids were all so wasted, small for their ages and were basically skin and bones. I’m not a pediatric nurse, and don’t like making kids cry! Some of them had arms the size of toothpicks. The babies got IVs in their feet (as we also do for small babies), but their feet were the size of a quarter. So, I watched instead. The nurses are very skilled, though their equipment is pretty basic. They had never heard of a PICC line. The kids all get peripheral IVs, even if they are getting transfusions. And no such thing as an IV start kit!
Monday night I went to a Rotary meeting, Kampala North Club. This club is Tusu’s club and he was the program. The program was about Future Visions and Global Grants. It was essentially a Rotary Foundation presentation. District 9200 has implemented Rotarians at Work Day! This was great to hear. I told them this had originated in our district with DG Bob Watson. They also kept referring to New Generations. When I asked about it, it’s quite different. For them, it just refers to Rotaract and Interact. I told them about our New Generations and they were quite interested.
Tuesday morning, I was the program at the Kampala Sunrise club. Dorcas officiated, as the president was not present. The structure of their meetings is quite different from ours, but it is quite efficient. The members of this club thought our club was HUGE when I told them how many members we have! There are not many clubs in East Africa that are more than 30-40 members. The largest I have been told about is 60. They thanked me again for our club’s participation in the Bulindo water project. Then they sang, “For She’s a Jolly Good Fellow”. It was very touching.
Tuesday night I went to William’s Rotary meeting. I saw some familiar faces. They did a presentation for Vocational Service Month. Their Vocational service is different than ours. It is truly about vocations and business practices, not like ours which focuses on kids and schools.
Three Rotary meetings in two days was enough! Last night Beth’s sister came over to talk to me. She has been HIV+ for 17 years. She has become an advocate and counselor for an HIV program. She got her master’s degree and has become quite vocal for women. She advises them how to have a discussion with their husbands. She teaches the women to be creative so the doctor can inform them at the same time. She is healthy and active, but wanted me to see her thighs which are pretty wasted, most likely from AZT. You can feel the bone. The rest of her looks fairly good with the exception of a small hump below her neck on her back. She asked me what we would do for that in the US. Especially do to the decrease in muscle mass, I told her the simplest thing she could do would be to get physical therapy. She said it was too expensive. When I was at Mildmay today, I spoke to the physical therapist. She said I was right, they would definitely try to help with Physical Therapy, and it would most likely be effective. She said it is free of charge at Mildmay if that is where you are receiving your care. When I told her where Molly received her care, she told me which hospital she could go to for treatment at no charge. I felt really great about being able to get that information for her. On the way back today, I met up with another one of Beth’s sisters who is a nurse. She works for the health ministry here. She said the next time I come back she would like to set me up to give some lectures at the nursing schools at three different universities here. She was fascinated by my work as a legal nurse consultant and said that law suits are definitely becoming more prevalent here and that the nurses could benefit from learning how to protect themselves, as well as learning how to work with attorneys.
Tomorrow I leave for Mombasa. I am looking forward to it, as the pace here has been very hectic and it’s been difficult to sleep due to the commotion of the dogs barking in the yard (not pets here, but guard dogs) and the chickens and roosters cackling! Plus, it has stormed every night, but stopped by morning.
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