A Taste of Paradise!

I had a dream of powder white sand beaches, vibrant aqua marine crystal waters set against perfect blue skies, palm trees in abundance, endless rays of sunshine, and a daily feast of freshly caught fish brought directly off fishermen on the beach...then I realised that in fact I hadn't been sleeping... we had been on holiday to Zanzibar!

Physically, emotionally, and mentally exhausted, Debbie and I pressed the 'stop' button and along with our friends Apolo and Ben, left Gulu for a holiday. Zanzibar is radiantly beautiful and can only be described as paradise on earth! Words and photos cannot do any justice to this picture-perfect Tanzanian island. A traditional palm-roofed house was where we lucky enough to call home for a week - 'White Sands' so aptly named for its idyllic beach front location with jaw-dropping views across the ocean. One morning sleeping out under the stars, I was lucky enough to awaken to the most amazing sunrise I have ever seen - I thought my eyes were deceiving me as the burning red sun rippled through the clouds with the colours glowing vibrantly as they reflected off the peaceful waters. A sensational way to wake up!

Uganda is a remarkably beautiful country and we have enjoyed many a weekend adventure visiting the Rwenzori Mountains, exploring game parks, trekking rhinos, white water rafting, camping on the banks of the river Nile, and swimming in waterfalls and crater lakes. This time we decided to head a bit further afield and experience a bit more of East Africa and stay in a place with very few physical demands. Whilst both Debbie and I are relishing the opportunity to work in a resource-limited developing country, owing to the nature of our work at the hospital, there is only so long that it is possible to work without a break. And Zanzibar certainly proved a perfect way to recharge the batteries.

We filled our days swimming in the sea, reading, relaxing on the beach, and playing frisbee (yes indeed we really are big kids at heart!) and cooking up a daily fish feast of the fisherman's catch of the day - snapper (red, white, and black), sting ray, barracuda, lobster, and blue fish as well as others that remain nameless but tasted delicious! Physical activity extended to include windsurfing and I'm proud to say I am now 20meters proficient even if I did spend more time crash landing into the sea than upright on the board! For me a highlight was swimming with wild dolphins off the south coast of the island- a truly magical and unforgettable experience!

Our week in Zanzibar was poles apart from our life in Uganda. We knew we were back in Gulu when we returned home to a weekend minus power, an inconsistent mains-water supply, an empty gas cylinder, and a red ant invasion. As we sat on the porch with a glass of (poor quality) red wine toasting our holiday, we were attacked by flying ants and moths nose dived and drowned in our wine ...a proper local-style Gulu experience, and we wouldn't have it any other way!

THE CURSE OF NATURE

KAREN:

Nature can be so beautiful, nature can be so ugly. Nature can cause so much pleasure, nature can cause so much pain. On the evening of Monday 1st March 2010, tragedy struck Eastern Uganda when a landslide caused multiple deaths destroying four villages in the county of Bududa. Many people were buried alive as rocks, mud, stone, and water thundered down the foot hills of Mount Elgon submerging buildings, schools, health centres, and entire communities.

Stories and images of devastation dominate the news here in Uganda as a humanitarian emergency has been declared. Over 350 people are feared dead along with hundreds of livestock. Rescue efforts have been coordinated by the Uganda Government with the support of the military and humanitarian aid agencies. One week on and only 31 survivors have been rescued from the rubble and 89 bodies exhumed after disaster response teams and locals alike have been using hoes, pick axes, spades, and even their bare hands to dig in over 3.3 square kilometers of flattened terrain.

The 200m wide avalanche of mud and debris was triggered by endless days of downpours, more typical of the cool wet season, not the hot dry season that Uganda should be experiencing at this time of year. The affected villages of Nametsi, Kubehwo, Liira, and Matuwa have been declared disaster zones. Flooding due to the above average rain falls, is causing further problems in these regions of devastation. Over 1000 people in these villages have been made homeless. A total of 4000 people living in mud-slide prone areas have been advised and encouraged to evacuate their homes and seek refuge in temporary relief camps or in nearby villages. Oxfam, The World Food Programme, Save The Children, and UNICEF are amongst the aid agencies involved in distributing food, clean water, cooking utensils, blankets, and essential medical supplies to the people seeking refuge in the internally displaces peoples (IDP) camps. Medical teams have been flown in from Kampala, the country capital, reinforced by medical staff from nearby Mbale Hospital.

And with the flooding comes further misery in the form of water-borne infections and diseases from unearthed decomposing bodies. 80 cases of cholera have been confirmed in a neighbouring district - an acute intestinal disease caused by consumption of contaminated food and water which causes severe diarrhoea and dehydration. Minus prompt treatment, cholera can result in death. The concentration of people living in the IDP camps and temporary shelters can greatly increase the risk of disease exposure and transmission from over-crowding and utilisation of basic sanitation facilities. Aid organisations have been working hard to disseminate water purification packs in a bit to halt the introduction and spread of the disease and prevent the outbreak of an epidemic, with the International Committee of the Red Cross (ICRC) at the ready to treat 1000 cases should the need arise.

Although efforts to retrieve the bodies from the rubble continue, it is expected that President Museveni will declare an end to the search operation in the next day or two as chances of recovering bodies grows increasingly slim and excavation poses further public health risks. Not an easy decision when villagers so desperately want to provide the dead with a ceremonial and respectful burial.

Whilst response efforts are primarily focusing on immediate interventions in the aftermath of the landslide, longer term re-development planning is not being forgotten. In the proposed 5 year re-development programme buildings will be established to continue the education of the survivors of the 374 children in the affected areas. Homesteads will be constructed in safe locations. Land will be cultivated to replant the 792 hectares of damaged crops, predominantly consisting of maize, vegetables, cassava, banana and sweet potato, thereby contributing to future food security. Livestock will be replaced to compensate for the lost animals including 176 cows, 50 goats and 2000 chickens- essential sources of income and food for people in developing countries. Plumbing of water pipelines to the affected villages will be reconstructed, as well as sanitation and road infrastructures.

Living here in Uganda, it is difficult to know how far news of such a tragedy has spread to the outside world. And it is even more difficult to learn how such a tragedy has inflicted suffering in a country that has captured our hearts and that we have come to call "home" causing such loss to people and communities that already have so little.

Sadly the rain continues to fall...

Any one for a pint?

Last Friday I did one of the most rewarding things of my nursing career to date that perhaps directly saved a life...I donated blood to my patient. Returning empty handed from yet another trip to the hospital lab trying to acquire blood for transfusion for our patients, I felt compelled to help. Blood supplies are always in short supply in Gulu. Many patients here suffer with anaemia as a complication of malaria, and secondary to HIV anti retroviral medications. And when I say anaemia – I mean seriously low blood iron level. To any non-medical folk, a normal haemoglobin (HB) level is over 12.0, with UK patients receiving a blood transfusion at 8.0 or under. In Northern Uganda, patients are not transfused until they have a haemoglobin level of 5 or under – and it’s not uncommon to see levels at two or three!

My patient needed blood type A negative - a rare commodity at the best of times let alone from a blood bank with almost vacant supplies. Being a blood donor back in the UK, I was keen to offer a unit of my best claret to help my patient who was admitted with a HB of 4. Calling on my trusted side-kick Debbie, our interrogation of the Blood Bank staff began with us thoroughly investigating the Ugandan process of blood donation, and rigorously examining the blood collection equipment and ensuring the needles were indeed SINGLE USE! Assured by our findings we both decided to go ahead and donate! Before we knew it we had both donated 450ml of British blood to add to the dwindling supplies at the hospital. And just like home, the reward for your contribution...a sugary drink and biscuits – complete with smiley faces none the less!

We returned to the hospital ward with a standing ovation and a round of applause from our colleagues! And two hours later, after my blood had been screened and prepared, I was connecting it to my patient! Such a surreal feeling to know that it really could make a difference to the ultimate outcome of my patient! His family became so excited that they whipped out a camera and began snapping away as I went about connecting my bag of donated blood to the drip port cited in the arm of their relative. I was completely taken aback by this as I’ve never before seen a Ugandan with a camera!

And Im pleased to report that by today the patient was looking much better and has greatly improved. For once a success story where I feel incredibly proud to have played a significant role! Now we are keeping our eyes peeled to see if we are able to identify, by donor number, the recipient of Debbie’s kind contribution.

As the nurse in the blood bank said to us post donation “thank you for helping to save lives!”