Gulu Celebrates!

KAREN:

HOME COMING

I'm pleased to report that I'm now feeling much better and travelled from the UK back to Gulu a few days ago. I'm now feeling back to my old self, full of energy, and raring to get back to work! Watch out Gulu here I come!!!

GULU GRADUATION

Saturday saw the whole town come alive with celebrations as the students graduated from Gulu University. Unlike formal graduation ceremonies in the UK, there was a true colourful carnival atmosphere with music, singing, traditional dancing, and a marching band. Ugandans certainly know how to enjoy themselves.

For the medical students, it was a particularly momentous day as they are the first medical students to graduate from Gulu University. Five years of training and they are now fully fledged qualified doctors. Graduation is a proud day for any student, but what really stood out is that these students in particular, began their studies when the area was still at war with an uncertain future. To now see Northern Uganda at peace must be such a heartening feeling and further add to their pride. Debbie and I felt very happy to see our ward doctors, who have become our good friends, celebrate their achievements!

The day began bright and early, and surprisingly on time at 8am with the inauguration of the newly built medical faculty building, adorned with banners and decorated with flags and flowers. I must say that the sweeping countryside views from the classrooms would certainly distract me if I was sat in a lecture! We then moved to the university campus where the endless speeches began - something Ugandans do so well no matter what the occasion! And believe me there were many speeches throughout the day! Acknowledgements and thanks take an eternity before the speech even begins!

The university campus was truly alive and vibrant with colour for the outdoor ceremony. It was highly amusing to see the university officials call for solitude and calm from the accompanying family members as they danced around and the women made their traditional guttural calls in chorus at the top of their voices as they rejoiced at the achievements of the students!

To be invited to join the events of the day was a real privilege, especially as we were joined by our Manchester colleagues Marian Surgenor and Mr Ged Byrne, and Marian's husband Tom. We were even mentioned in the University Professors' speech and referred to as his 'additional family members!'

The celebrations continued until way after dark as we joined the West Nile Graduates for an evening of more speeches, music, food, and dancing. A fun day and night were had by all!

It's back to work I go!

I must say that the first few days back at work without Karen have been quite strange! We're always a great support for each other and when things get a bit frustrating or upsetting we cope with it together. So, first day back I was slightly apprehensive about what the day would hold. However, I soon found that there was nothing for me to be concerned about because when I entered the ward I was greeted by numerous staff welcoming me back and asking after Karen (or 'Lamara' her Acholi name meaning loves her work/hard worker!)

Unfortunately, on friday, I sustained a small needlestick injury after inserting an IV cannula (the needle pierced my skin after being in contact with a patient). This is never an easy experience as you go through a range of emotions and worry about what might happen. Straight after the incident I followed the protocol that we are taught back at home and then I informed the Sister-in-Charge who was very apologetic and went to ask the Consultant for advice. The patient then consented to having a HIV test and I went home to get our emergency antiretroviral pack. On my return, feeling quite shaken and worried, the nurses on the ward were extremely supportive. They said that 'God would protect me' and that I shouldn't worry. The HIV result came back negative shortly afterwards which was a huge relief. The Consultant advised me that I should continue to take the antiretroviral drugs just in case the patient was in the window period where HIV cannot be detected. The Intern Doctor relayed how he'd had two incidences where he had needed to take the antiretrovirals and that everything would be ok. The Sister at the HIV clinic was very supportive and helped me to get the full course of medication from their pharmacy.
It just goes to show that, even when you might feel a million miles away from home, there are always friendly faces to offer help and support. I was really impressed with all of the staff at Gulu Regional Referral Hospital in this situation and, without my Acholi sister Karen with me, I was glad that I was surrounded by Gulu friends!

Today I went onto the ward to find two patients who were unconscious, one who could hardly breathe and then not long into the shift another patient started having an asthma attack. Now on days like these it's difficult to know where to begin and, with only one other nurse on the ward for 45 patients, I realised that we were in for a busy day!!
I started work going to look at our unconscious patients who both appeared to be surprisingly quite stable and not requiring anything urgently. I then went to a very unwell looking lady who was gasping for breath! After recording her observations and finding them to be extremely unsatisfactory I put up the fluids that were prescribed and went off to A and E to find the Oxygen Saturations machine (to measure her oxygen levels) and a Doctor as our Medical Intern Doctor has unfortunately gone on leave this week, leaving one Intern working between A and E and the Medical Ward. I luckily found the Sats machine easily but then two barriers stood in my way - one was the A and E Sister who wasn't very keen to lend it to me at first (I promised I'd bring it straight back!) and the other was that there were no batteries in it. So, having signed to say I'd return it, I went off in search of batteries. These purchased from a local kiosk, I went back to my patient and found that her oxygen levels were very low. I trundled back to A and E and presented the case to the Doctor who said that he'd come straight away.
We decided to put the patient on oxygen so we had to borrow the oxygen concentrator from A and E - the Sister said that she'd come and arrest me if I didn't return it!!(I can understand her worries as things go missing very easily around the hospital because it's so under resourced that every piece of equipment is in great demand!I think that it worked in my favour that I had just brought back the Sats machine complete with batteries!) So the Doctor came up and reviewed the lady and decided that she probably has TB...he asked for some further investigations and we are now giving her the maximum treatment that we can from the medical ward: 2 litres of oxygen (a very small amount by UK standards), IV antibiotics and TB treatment if her sample results come back positive. I hope she pulls through...

Another patient today was very quietly lying on her bed under a sheet and when I asked her name it transpired that she was having an asthma attack! She was very wheezy and really struggling for breath. Just as I was going to find a Doctor the Intern walked onto the ward and he reviewed her immediately. I cannulated her and gave her some IV aminophylline and within 15 minutes she was sat up chatting and giggling with her son and daughter. When I went back to see her she gave me a big grin and said Apwoyo Matek! (Thank you very much!)

Worlds Apart

KAREN

As I sit and write, I am wrapped up in a pair of jeans (tights underneath!), 2 vests, a t-shirt, jumper, 2 scarves, and a big woolly cardigan- slightly extreme for the Uganda hot season you may think…but no, unfortunately this is not the case…I am back in the sub-zero climate of the UK! The food poisoning episode pre-Christmas didn’t leave me feeling at my best. Combined with a diet whereby I was tolerating little more than marmite on toast, and unable to tolerate antimalarial medication, it was decided that the best course of action was to return to the UK for a couple of weeks. And arriving in the snow – what a shock to the system! One day I was in the 35degree Celsius heat of Gulu, the next I arrive in Manchester where the temperature was minus 12…a 47degrees Celsius drop!


The weather is just one example of the extreme comparisons I have experienced throughout the week. To leave an area of relative poverty and then return to an affluent United Kingdom is another. Its like reverse culture shock! It is hard to comprehend such extremes and allow yourself to enjoy living back in the ‘comfort’ of Great Britain. To be able to turn on a tap and drink a glass of water, to know there is power when you turn on a light switch and to keep the milk cold in the fridge, to think ‘what do I fancy to eat’ and know ample choice is available…it has all felt very decadent! And to enjoy a hot shower – simply amazing! All things that I will never again take for granted! When I went to a small supermarket the day after arriving back, I was over whelmed – the choice of products astounded me – and then I spotted the poor-quality wine that is sold in Gulu in the ‘bargain bin’ and smiled to myself – a little piece of Gulu in Manchester!

Returning home comes with such mixed feelings as it was never in the plan to come back early! It has certainly been a bonus to see my family and friends and enjoy some home comforts. But how I miss Debbie – my partner in crime, who is continuing the good work back in Gulu. Whilst the work we are doing at the hospital in Gulu is certainly a challenge, to be living and working in an African country where you are made to feel so welcome is an opportunity not to be missed and I’m longing to return and get back to work on the ward!