Back to blogging...

The last couple of weeks have been quite busy here in Gulu with visitors from the UK, and subsequently we have somewhat neglected our blog - sorry!

Marian Surgenor, the head of the link between University Hospital South Manchester and Gulu Regional Referral Hospital, spent a week out here with us (and brought us advent calendars!) Her trusted side-kick was Dr Peter Yeates who works in Medical Education at Wythenshawe Hospital, Manchester. It was great to have the support of our colleagues and share with them our experiences of the hospital as well as share with them this wonderful country!

Peter certainly didn't have a positive introduction to the medical ward. With in his first 5minutes on the ward, he witnessed a 36year old man have a seizure followed by a cardiac arrest. In this situation, resuscitation is not even attempted here as there is no further care that can be offered to support life even if we were able to revive him. To not even attempt resuscitation goes against all that we would instinctively do back in the UK so you can imagine our frustration and distress (and tears!) The average life expectancy in Uganda is 50years so we have seen many people die at what we would consider to be a young age.

KAREN:

Last week we found ourselves caring for our youngest patient yet - a 4year old little boy. Along with his younger sister, he has been staying on the adult ward with his mother who is an inpatient with no one to care for her children whilst she is unwell. It is not uncommon for children to be sharing the bed of their mother during her stay. Usually he is an energetic little boy always wanting to play or have a 'high five!' as you pass him by. So when his mother indicated that he was sick, I was concerned. I became even more concerned when I examined him and realised that he had a soaring temperature and was floppy! Alarm bells ringing, I was relieved to receive the help of our ward Doctor! When a 4year old doesn't even flinch when you take blood and inject him with medication, you know there is cause for concern! He was rapidly commenced on a drip and treatment for malaria. Usually a child of this age would be cared for on the paediatric unit, but in this case he was admitted to the adult ward in order to stay with his mother. We have actually been very surprised to learn that the upper age limit for admission to the paediatric unit here is a mere 12years or age! We left the ward wondering what the outcome would be for this brave little soldier...

DEBBIE:

The next day I went to the ward alone as Karen was doing work elsewhere in the morning. On the way in, as usual, I picked up the blood results from the lab. I noticed alarmingly that our little patient's malaria film had come back as 4 plus!!! On the scale this is the worst case of malaria that you can get...it means that the number of parasites in his blood was extremely high. When I got to the ward the report did not mention our little paediatric lodger and he was nowhere to be seen. Feeling quite worried for the 4 year old I went on a hunt to find him and his mother. Through translation from one of the nurses and help from another patient we deduced that mother and son were off the ward fetching water. I was quite relieved to hear that he was feeling better (he hadn't been able to get up from the bed the day previously) and glad to reflect on the fact that Karen had taken the initiative to help the little boy the day before. I went to hunt down his notes and found them on the paediatric ward. Once patient, mother and notes were reunited I spoke to our medical intern about what to do. Because the notes had and patient had been separated he had not had any treatment since the day before. I made up his next dose of malaria treatment and started the infusion (with help from the Dr who had to cannulate our little trooper about 4 times as his veins were poor). Whilst he was hooked up to his drip the Dr and I managed to get a small smile from our brave little man by tickling him with a glove balloon!!

Yesterday when we went onto the ward the little boy ran towards us all smiles and jumped up into our arms!! No matter how upsetting or frustrating it can be out here success stories like this are a huge reward for us reminding us exactly why we came to Gulu.