A day in the life of Karen and Debs.....

Wakey wakey, cold shower!

Breakfast with the family (Sally, Nik and.....leaving Joe in bed).

A gentle wander through the dusty streets of Gulu past the green fields in the hot sun to work.

Morning mango juice from our local street seller.

Arrive at work: try and find patients and match them to their notes - patients are often outside, have swapped beds, be on the floor, or in some cases have 'runaway' (self discharged). The notes are often in disarray and so even finding them can be problematic!

Observations: We try and get around to each of the 35 patients and record Blood Pressure, Pulse, Temperature and Respiration Rate identifying the most sick patients on the way around. We're learning so much about clinical examination though as patients here seem to compensate for so long before their observations reflect it. Observations can take quite a long time as everything is done manually.

Ward Round: the Intern Doctor (house officer), Sally or Consultant Doctor will do a ward round. So many students come to watch that it is quite chaotic on the ward and it's quite difficult to get things done! We try and go on the ward round though so that we can pick up jobs on the way and listen to the plan for each patient.

Medication round: no easy task as there are no prescription charts and a large percentage of the drugs are not stocked on the ward. Sometimes the patients are missing which makes it a bit harder!

Jobs, jobs jobs! These include taking blood tests, trips to pharmacy or HIV centre, trying to contact the Social Worker or Physio, going to the lab to take specimens or get specimen pots, siting cannulas, admitting new patients.

There is a small distance between the male and female parts of the ward and we are often cheered up by 2 little friends who seem to live around the back of the hospital with their mother. The 2 little boys always have a high five, whistle or great big grin for us!

End of the day: exhaustion, exhilaration, frustration and a sense of achievement washes over both of us and we plod home debriefing on the day that has gone before. We go and watch the lovely sunset over our house and generally fall asleep soon after dinner!