Our first week...

We are coming to the end of a very interesting first week here in Gulu. As well as an introduction to the hospital, we have tried to master the local language of Acholi, ridden the local boda boda transport, tried the local tipple waragi (otherwise known as poison) and spent an evening at a local home watching traditional African dancing! The Ugandan people are exceptionally friendly and always prepared to share a smile!

GULU REGIONAL REFERRAL HOSPITAL

The hospital is very run down and dilapidated. It was built in 1934 and looks like it has never undergone any renovations. The hospital is severely lacking in equipment and facilities, even the most basic of resources such as gauze to clean wounds. The patients are incredibly accepting of the hospital conditions and never complain. The beds are less than 50cm apart, and privacy and confidentiality are non existent. Many of the beds lack mattresses and bedding must be provided by the patient. Each patient must have an ‘attendant’ - often a family member, who provides for all their personal needs. Large groups sit outside the hospital preparing food for their relatives, otherwise they go without. On a plus note, a new medical and surgical ward have been built and are awaiting to open once the toilet block has been complete. The male medical patients are however currently housed in what can only be described as a barn, and the TB ward is a shack– considering it’s the rainy season with heavy down pours – the windows are sheets of plastic flapping in the breeze! The hospital also appears to have resident chickens that just run around the place – infection control at its best!!!

We’ve spent the last 3 days shadowing Nik and Sally on A and E and the Medical Ward. It’s been really interesting to see the great work that they have been doing at the hospital and be able to prepare ourselves for starting work on Monday. Here are a few stories of the week!
I know Nik has explained this story on their blog but I think it deserves a second mention….A taxi pulled up outside A and E and Nik went to ask if they needed any help. The taxi driver said ‘fine’ so we sat down and started discussing the other patients….about 5 minutes later the Sister came over and said ‘I think there is someone in the taxi who is not breathing so well’. We went straight over to see the patient…..he had already died. He can’t have been older than 20 and his mother was asking us over and over to do something for her son. We asked the Sister what happens next and she said that they would just have to take him back home.
The A and E department is literally a room with about 7 beds. A man came in saying that he thought he had malaria. Nik started taking the history and then the man said that he was going to be sick…I asked the Sister if we had any vomit bowls and she said no, he would have to go outside. So the man had to go and be sick in the gutter outside…he was not looking well at all and there were no beds in the department so we had to examine him outside on the pavement with chickens running around…so surreal.
On the Medical Ward there are some seriously ill patients that would normally be in HDU in the UK. We have been looking after a patient with Sally this week who is HIV positive with cryptococcal meningitis. The patient is desperately in need of anti retroviral therapy and it has been so hard to get the medication to him. Sally has been going to the specialist centre every day but the medication was unavailable and, with no money to buy any, the patient will not recover. After 3 days of trying Karen and Sally ended up going into town to buy them for him as a short term solution….3 pounds to us may seem like nothing but out here it can be so important.