A normal 15 hour plane ride has turned into over 20 hour travel. It started off with standing in line at Entebbe airport for over 1 hour to just check my bags in. Then as we are getting ready to board, we were told that the flight is delayed due to refueling because the new equipment is not working and need to do it the old fashion way. Of course this totally cause me to miss my connection into Newark. I have the option of flying into JFK and find my way back to NJ or spend the night London and leave the next day without access to my checked bags. I just wanted to get home with I chose JFK.
Ended up chatting with a guy from Brighton who was visiting his dad. We had coffee and just talk about every thing. Met some other Americans who are staying in the UK as well. So many interesting people and people are so friendly.
Finally arrived in JFK and through the custom by 11pm and got to NYC Penn station by 12:30am to take the last train into my neighborhood. Then randomly caught a taxi back to my apartment. Finally home at 1:30am. So tired, needed sleep before diving into the massive paperwork for residency, prepping my move and just taking care of errands. Will post some pics once get settled.
Went to Efendy’s on Monday nite with the other lodgers. It’s probably my last dinner with all the rest of the lodgers together. It’s a Turkish restaurant and we all ordered meze mix and hummus served with bread. It was really good and had a good time just chatting with other lodgers. Will really miss them.
Saw a patient with Madura foot, which is called Mycetoma cause by mixed fungal infection. I saw him as follow up after 6 weeks of antibiotics already. It was still weepy with a couple of open sinuses. The infection goes into the deep tissues and deforming the bones as well. The treatment can take months to years. This patient has been dealing with this for 10 years already with surgeries and various meds. What a sight.
Of course, this week was buzzing with the Icelandic volcanic eruption and the airspace being cleared or not. On top of that I’m scehdule to fly this Friday, so everyday is a waiting game to see if the flights are going in and out of UK and whether if there will be a second eruption. My worry is being stranded in London since there are news that hotels are booked solid and are charging 3x the normal prices. If stranded, I would rather be stranded in Kampala. I ended up cancelling my rafting trip in Jinja cuz I wasn’t sure if my flight is going and if not, I needed to be in town to re-book.
Last day at the clinic was uneventful, but had lots of time chatting up with the patients while waiting for Dr Stockley. It was also the last day of med school. Parts of the day, felt like I’m ready to be called Dr. Cheung but other parts of the day is like not quite there yet. There are so many interesting patients and really enjoyed my time talking to them.
Of course, I’m not quite ready to leave Kampala yet, so I procrastinated in packing. I don’t want this trip to end yet. If another opportunity like this come up again, I would do this in a heart beat. Definitely will be planning something like as part of career in the future.
Signed up with Rosada with the Red Chilli for a short safari/camping trip up to Murchinson Fall and see the Nile Victoria. Started the trip off raining in the morning so instead of taking the bodas to the meeting point, we called special hire and asked to leave a little earlier. Of course, I forgot about the Ugandan time, usually meaning double the time. So of course, with the crazy morning traffic, we were late. We arrived at the Red Chilli with 10 mins to spare before departure. This was also when I realized that to the Ugandans, Americans have the worst accent. The Ugandan say Red Chilli as “Red Chee-li” not “Red Chil-li” like we do.
First, drive north to Masindi for lunch. It took about 4 hours with the traffic out of Kampala. I slept about half of it then watched the scenery. People outside of the capital live in huts build of muc and wooden sticks as the structure and dried grass as roof. Really wonder how the huts stand the heavy rain storms and what not. The better off people or the community buildings are built with bricks. Masindi is like any other town, with shops and restaurants line the main street. We had lunch at one of the hotels there. I had traditional Ugandan food. Posho - maize flour thick porridge, so thick that it’s almost like bread. G nut sauce - peanut sauce with some chopped veggies. Chapatti - Indian flat bread. Very yummy. Rolex - Chapatti + egg with onion, tomato.
Drove into the national park. The first part of the park was tropical rainforest, much cooler and greener. Then further into the park is the savannah, much warmer and drier. It’s so vast and incredible. It’s the largest protected park in Uganda, over 3900 km^2. There were bamboons, warthogs, Ugandan antelop and lizards all along the road.
The first part of the trip started with the hike up to the top of the falls. It was hot and humid, very much like my first couple of days, non stop sweating. It was totally worth it though. It was gorgeous and amazing being able to see the rush of water pounding the rocks and the views of the fall betweens cliffs. There’s really no words to describe the beauty of the fall, thinking that God had this made so long ago and I am standing there seeing what God has created.
We then head back to the camp site and settle in the tent and ordered dinner and meet other random people on a similar trip. In our group, I met Lisa Y., also a med student from Detroit doing her rotation in Masaka. Also met a group of ladies from France. One of them actually lives in Makindye near my guest house and she’s on this trip with her friends visiting. At the camp site, I end up hanging around with a group volunteering in an orphanage in Jinja. They are from all over US and some from Canada. End up mostly talking to Sarah M. and Amy F. Also met Robyn from UK who is doing research on fair trade in Uganda. Definitely learn from everyone that I have spoken with. From Robyn, learned about fair trade and how it works. From the Jinja group, learned about Ugandan orphanage and how the kids end up there and how they are kept from disappearing.
1st night there was really loud, therefore, did not get good sleep. I ended up keep waking up every 2-3 hrs from the mosquitos flying in the tent, crazy insects chirpping also every time I opened my eyes, definitely feel claustrophobic because of the mosquito net. Also it’s cold showers weekend and trying to keep myself from being food for mosquitos.
Game drive the next day was 4 hours and absolutely amazing. We are on the same minibus but with the top popped open so we can stand and look out. Also saw an amazing sunrise over the Nile as we ferried across to start the drive to the delta. Per our guide, we were lucky that day. We saw Ugandan antelopes, leopards x2, a lionness, water buffalo, hippos, elephants, giraffes, hornbills, baboons and warthogs. It wasn’t until we stopped for break when I saw that our guide carried a pretty hefty firearms for protection. Besides that, the scenery was gorgeous, from savannah to tropical rain forest to palm tree plains to seeing the mountain lines from Democratic Republic of Congo. It’s incredible that all this is all ust one national park. The weather was great too, just slightly overcast so it was cool. We were worried that it would be raining in the morning. No picture can really capture the overwhelming beauty of the park. Really wish my brother was here, he would totally love the trip.
Random moments - once one bus found the lionness, all other buses get the text so it ended up looking like 6 buses stalking the lionness like the paparazzi. As for the leopard, once we see it, we just sit there and wait for the leopard to climb down and run with the bus engine turned off.
Boat trip to the bottom of the fall is about 3.5 hours round trip. It started off rainy but the sun came out. Throughout the trip, saw lots of hippos, some elephants and some crocs. You definitely get to see the neverending view of the Nile Victoria. I can only imagine all the history that we learn about regarding the Nile in high school. The boat took us as close as they could but not as close as I was expecting. But it was still amazing. Also saw the site where Ernest Hemingway crashed his plane and called for help. For the rest of the trip, it was nice, just spending time with newly made friends.
Throughout the day, learned lots of history from the guides. Hippos live about 45 yrs, and only 1 bull in the pod. Hornbills marry for life. Winston Churchill built a bridge across the fall 1962 but was washed out after a year. Female water buffalo has w horn shape while males have the u shape. African elephant’s ear is the shape of Africa continent. Warthogs have strong senseof smell and will digg through anything for food. Once lion tasted human, will hunt human so needs to be kill.
Last part of the trip, we went to Ziwa Rhino Sanctuary and track the rhino up to about 10 meters close. They are incredible animals, very quiet but huge and definitely dangerous. The purpose of the sanctuary is to rebuild the rhino population before releasing them back into the wild in Murchinson National Park. They were extinct in the 70s during the civil unrest. Here’s a little tidbit, when rhino show aggression of tail waving, move near a tree ready to climb or stand behind a large tree. That was so comforting right before we started the tracking. haha. One of the baby rhino is name Obama because his mother was the rhino from US (Disney) and the father was from Kenya. This is how big the name Obama has become. It’s become restaurants’ name, name of dishes and flavor too.
Felt like I have learned so much but still not enough about Uganda. This is only part of Africa and there’s still so much to see. It’s amazing that there is still a part of the world that still all nature and the country is working hard to keep the beauty via eco tourism.
Started the week with some souvenir shopping with Els who is leaving in 2 days. We went to the Bugand crafts market. The things there are beautiful and not necessarily cheap but Ugandan standard but to us it’s priced very good. I found some stuff for family and a few friends that are uniquely Ugandan if not African. Had lunch at 1000 Cups Cafe, very good coffee. Uganda has good coffee but very hard to find a place that knows how to make them properly. Definitely have to come back to get some before leaving.
Spent a couple days at Hope Clinic, what Dr Stockley calls the slum clinic. The patient population here is very poor and most services offered are free. On Monday, children immunizations and weight check. The schedule they follow is much quicker than the US one. At birth, oral polio and BCG. At 6, 10 and 14 weeks, polio and DPT. At 9 months, measles. Vitamin A every 6 months until 5 years old. I can only say sorry to the babies after I give them the shots as they and their mothers only speak Luganda, not much English. The babies I see look smaller than what their age are, very likely due to malnutrition. This happens once a week and on average the clinic see about 100 babies for shots.
On Tuesdays, it’s antenatal clinic at Hope. It includes basic check up, weight, BP, fundal height and fetal heart by fetal stethoscope. It was the first time for me seeing the fetal stethoscope. It’s a metal cup turned upside down with a ear piece at the end. Also includes tetanus shot at the 1st visit. Mothers come in for the first time at 30 weeks or so. It’s very different than home where by 30 weeks, ultrasound is done, amnio if needed, deformities and genetics were checked. Very different atmosphere.
The clinic is very well runned for lower socioeconomic population. It is filled with simple posters on the wall about malaria, STDs, HIVE, family planning. There’s a basic pharmacy available and basic lab. It is very well organized and serves the local community well for the basic medical care that we’ve taken for granted at home. For the community this is pretty much the only medical care that they will ever receive.
During one of my days at the Surgery, I stitched someone’s scalp. I have stitched other parts of body before but not scalp since it tends to be a bleeder that the attendings tend to not let the students do it at home. The wound was a star shape and Dr Stockley did 2 stitches to start and I threw 3 more to finish up.
Els left earlier this week. I felt like I have known her for much longer than the 2 weeks. It’s going to be weird leaving next weeks. It feels like I have known everyone at the hose for a lot longer than 4 weeks. 3rd week is over. Time really does fly when you are having fun. I’m not quite ready to leave next week. Really wish I had allotted an extra week of time to travel and explore. Next time will definitely plan better.
Just heard about the volcanic eruption in Iceland and now no flights in and out of UK and much of northern Europe. This is going to be interesting as I’m schedule to fly through London in a week’s time. Gotta find out what is going on and play the lovely waiting game with the natural disaster.
2nd week ended. It all just flew by. The week was filled with alternating shift, AM/PM with another student, either working the ER/inpatient or having own consult room. I would see my own patients, write the notes, recommend the labs and take a guess at the diagnoses. Since the diagnoses were tropical medicine, more times than not, I have answered the wrong ones. But I’m definitely seeing some new diagnoses like malaria, bilharzia, pneumonia, acute gastro, tropical dermatology. The ER/inpatient work consist of drawing blood, shots and seeing patients that came through ER. It was comfortable work for me cuz I just finish a month of peds EM and having done IVs during my anesthesia months.
Interesting association - pneumonia is often associated with diarrhea or distended stomach. Both adults and peds. Any explanation? I don’t really see it at home.
Saw a kid with DEET overdose. The kid had a mosquito in the net the night before, so the dad decides to spray the kid with 98% DEET that is intended for the net, I presumed. The kid reacted with hives and throwing up like crazy. Very much like systemic reaction from the DEET. But what are the DEET poisoning symptoms?
An amazing thing happened. One of the patient lives on the same hill where I’m staying and saw me leaving one day and offered me a ride back. People here are genuinely nice, open and friendly. I’m not just talking about the native Ugandans but also the ex-pats that have moved here for various reasons. Back home, offers like this wouldn’t come and if they did, we most likely wouldn’t accept it.
During this week, I had a patient that asked specifically to see me. It felt really good that I’m doing something right and that I’m actually going to be a doctor in 6 weeks time. It finally made me realize that I’m no longer playing pretending to be a doctor. Yippee!!
Took a walk to Garden City Mall after work one day. It’s the only modern mall in Kampala, but it’s not like the ones at home. The variety of stores is, clothing, electronics, grocery, food court, bookshop. But the building itself is a mix between indoor and outdoor mall. It’s almost like they put really nice street stalls together into the building.
Also spent sometime walking around the street stalls/shops around the old taxi park. There’s stalls for clothers, electronics, food, textile, and anything you can think of. Sometimes a store front has multiple stalls sharing the store. At the taxi park, it’s madness and chaos but at the same time, it’s somewhat orderly as well. There are taxis trying to get near the park to drop passengers off and get into the park to pick up passengers for the return trip. Seriously walking around to get into the park involves looking out for the bodas and the bumper to bumper taxis. Once in the park, walk between the tightly packed taxis to get the ones that are under the needed destination signs.
I did finally get sick, but not the gastro kind. Caught a full blown cold from the ferry ride back on Mon and just caught up to me on Fri. Thought it was allergies at first on Wed but didn’t realize it was building up already. Managed about 1/2 day on Fri at the clinic before just felt bad enough that I wouldn’t do much good at the clinic. Was call “prima donna” by Dr. Stockley. haha. He was the one who told me that all the students came through got sick the first week. I managed not to get sick till the end of second week. Of course that was the day that I had to get fruits for the fruit salad for Els’ good bye and fondue party. With me being sick, I could hardly pay attention to what I was buying, bought some not ripe mangoes and avocado. But I did manage to buy a good pineapple. What a complete ditz. Haha.
Had dinner with neighbor. Met new people and had a good time. Fondue/Goodbye party for Els at the guesthouse for great. The food was yummy and we chatted on the balcony. It was really nice to be able to see everyone together since during the week, we are pretty scattered schedule wise. Els - Belgian at BTC in urban planning. Debby - Belgian teaching Dutch at Netherland school. John - Irish working for Irish NGO who’s been traveling a bit for work. Alistair - British med student at the Surgery. Rosada - British med student at Korsu hospital. Emma - British workin on biodegradable waste management/recycling. Claire - Landlady teaches at an international school. Olivia - Claire’s daughter who is a very baker, swimmer and an author. The weather was great so we were still outside even after dark. We watched Goal, a football chick flick. Good times.
Got a night of diarrhea from a chicken salad with mayo sandwich. It happened twice. You would think after the 1st time, I would learn, but nope. It had to happen twice before I figure out it was the mayo. Gotta remember mayo + heat is not good.
Noticed this week that the Ugandans are calling me “Chinese” more that “Muzungu”. Perhaps I’m more tanned this week that I look more like the Chinese in Kampala. How interesting.
Ssese Islands are a group of islands that are on the Lake Victoria. I went there over Easter weekend with 2 of the lodgers from the guesthouse, Els and Debby, Belgians. We are meeting a couple other Belgians who are working in Rwanda and in Kassese, Uganda. We took the taxi to Entebbe for a 3.5 hr of ferry ride to Buggala Isalnd. Halfway through our taxi ride, we were told to get on another one because the one we were on had problems. Once we got off, we watched the taxi turned around to pick up other passengers to go back to Kampala. What bullocks! Anyways, the ferry was very crowded. It fit 9 cars and about 100+ people. Unless you were got on early to get inside seats in the cabin, everyone else is outside under the equatorial sun. Silly me, being not out in the sun for so long, I definitely got sunburn on my arms that were exposed by my 3/4 sleeves shirts. I was holding my bag in one position for only about 20min and got burn. So quick.
We stayed at Ssese Island Beach Hotel. It included food and lodging for what we paid. The room was small but still able to fit 3 beds, small vanity, closet and bathroom. It’s not new, clean and grogeous resort like back in the states but it’s very good for African standard. I was impressed. Power is solar powered during the day and by generator from 7:30pm to about midnight. The atmosphere is very camp like. Dinner is around a bonfire, which spread warmth, light and keep the bugs away and the owners ate with us as well. At this time, really miss S’mores. After dinner, we all sat around just chatting and having drinks. A great way to meet some random people.
We were served lots of Ugandan food. It was simple but very yummy. I guess it’s more of different flavors. Matoke - mashed banana steamed in banana leaves and served with peanut sauce. It’s sounds weird but it’s actually good. Other food served were fish fillet, mixed veggies with cinnamon, meat skewers. I found out that meat = beef. Chicken, fish, pork, goat and mutton are called by their own names. How bizarre. Someone even told me that chicken and fish are not considered meat. We also had fish and chips. For that, I thought it was fried fish fillet but they actually served the whole fish, head, tail and bone. Got plenty of my favorite food, fish. Also tried some of the native beer. Tusker - light and taste better than the ones in the states so far. Wished there are some that taste like it at home
Since I went with group of Belgians, they spoke mostly Dutch and French among themselves. I also learned a bit about Belgium as well. It was very enlightening for me. When they didn’t speak English, I didn’t know what they are talking about but it’s not unusual for me. After being in Newark for the last 2 years, it became a norm for me to need translator all the time to just talk to patients.
It was a good relaxing first weekend. I didn’t do much, just read, sleep, play games and get to know people and their countries. We played Bang!, Shithead, Worms, Jenga Speed and Solo (Uno). I haven’t play that much games since I was a kid. Good times and memories.
The weather there was raining every morning till lunch, so we just sat around chatting and playing games. The sun would come out in the afternoon. During the afternoon, we would either sit out and enjoy the sun, beach or if we dare, the water. Lake Victoria is notorious for Bilharzia. One afternoon, we took a hike up to the village Kalangala. The village is like any other village/town. A couple of shops, restaurants and public buildings like schools and churches.
We took the ferry back on Mon at 8am. The ferry left early because it started pouring. We asked the Captain later why. He said if he didn’t, there would be too many people on the ferry and there would be actual injuries from all the pushing and shoving to try to stay dry. Even then, we were all still packed like sardines. The cabin wasn’t very big and not very well circulated. I chose to stay outside under the overhang for coverage since I figured fresh air is better than me being sick and nauseous for the 3.5 hr ride. I didn’t completely drenched but still got somewhat soaked. It was chilly due the wind and being wet, but there were some dry spots. Overall it was a good trip.
This week has flown by and was busy. I am exhausted every night which is not only from work but also from the humid heat. I feel like I have not stop sweating since I have step out into Uganda. So far, I have pretty passed out on my bed every night sometime between 9-10pm and then up at 5:30-6am from the crazy birds and the mosque. Hopefully I’ll be more adjusted and be able to get some more sleep soon.
As for Ugandan food, I have only had rice, beans and Irish potato. The Irish potato here is what we called mashed potato. It’s actually pretty good. But otherwise, I have had sandwiches from cafes because the docs at the clinic don’t the Ugandan food served for the staff.
Started to see my own patients in one of the consult rooms and recommend labs and try to come up with diagnoses. It’s very much like home in that we do the same. But the diagnoses I have seen so far are all pretty much tropical medicine. Things like malaria, acute gastro, pneumonia, infected wounds, etc. There are also medicals which we called physicals back home, for refugees going to Australia, Canada and also for Peace Corps. Otherwise the patient population is mostly ex-pats or well off Ugandans.
Also noticed that there are few things that are always disposable. Back home, pretty much everything we use are disposable. Not here. They try to re-use everything they can and only dispose of the equipment that are in contact with human fluids. Most of the time diagnoses are very much depended on hands, stethoscope, blood pressure cuff, thermometer and some form of torch. Dr visits, labs and meds are also very inexpensiv, unlike home. It’s really amazing to see what gets done with so much less than what I have been trained with so far.
Walked down to the meeting point with another med student from Germany, Hannah to meet Dr Stockley for the ride to the clinic. It’s not far but it took over 45 min to get to the clinic. That’s what I call crazy traffic. Everyone is just trying to squeezing into the que to get into the city. Definite road rage. Dr. Stockley is very blunt and has a definite sarcastic humor with British accent. I can see that he can easily offend someone if they are more sensitive. But he’s very good at tropical medicine, definitely can learn a lot from him.
Once we got to the clinic, Hannah showed me around and how the process goes at the clinic. We get our own room to see the patients then get Dr. S for the final diagnosis and treatment, very much like home. The clinic has a little of everything, tiny ER with 2 beds, 2 bed inpatient/observation, lab for basic lab test, xray, ultrasound and a small pharmacy as well. I think it’s incredible with what is being done with everything that is available. Patients also wait for their lab results as well so that can be from an hour to several hours depending how busy it gets. Also everything is paid for before labs, scans or vaccines can be done. Even with insurance, a guarantee is needed as well.
The patients here are mostly expats who have been living in Uganda for years. If they are Ugandans, they are the ones who can afford the services. Even then, I felt that patients here have more common sense in when to come see a dr. Back home I feel like people see dr whenever they are beginning to get sick not when they are sick. I don’t know, I think it’s just a different mentality here.
I was assigned to the ER for the day. It started off with a 6 yr old needing Ketamine to get the jigger eggs out of the bottom of her foot. She reacted badly to the ketamine, not sure if it is a true allergy as she did swell up a little and arched her back to breathe. Then after the procedure, she became a puker, a lovely side effect from the Ketamine. Well, I guess she will always remember that she doesn’t do well on Ketamine.
Later on, rode in an ambulance to pick up a collapsed patient then came back. After the exam, we realized he has the symptoms of stroke so we immediately transported him to Kampala hospital for CT head. Even though it’s considered a true emergency, it still took over 2 hours to complete. The CT showed hemorrhagic stroke and my first one and Dr S’s 1st one in 18years. After that the battle of insurance and payment ensued. Insurance wants to medivac him to Nairobi but payments needed to be made before discharge. Finally arrangement is made for the next day.
Because there’s so much inconsistency in reading images, Dr S always asks his own radiologist to read the images to double check the results. That was a crazy1st day.
Finally went home and took the bodas to taxi park to take a taxi. 1st time boda ride and it was crazy. They squeezed between cars anyway they could and even onto the oncoming traffic. The taxi park has an order to their madness as well. Taxis are desperately trying to get out and other are trying to get in. Then the traffic police are directing the traffic flow to let some in and some out. It’s the most chaotic scene I have ever seen but somehow it all works.
The moment I arrive in Entebbe … it was muggy, hot, sweaty. But it was dark and couldn’t see anything. Only saw lots of people crowded waiting for arrivals and boda-boda (small motorcycle) on the roads. The roads are dark and there are no streelights. I can totally imagine me walking at night and unknowingly step into pot holes. Loads of fun with me being clumsy.
The 1st 2 days were the weekend so I tried to get myself oriented and get some necessities like food. The other girls at the guest house I’m at helped a lot in transportation and showing me some of Kampala. Taxi or matatus here is a minibus with 14 passengers + driver and conductor, Special hire is our taxi and boda-bodas are motobikes to get around where matatus can’t.
The guesthouse I’m staying at is very much like a European villa that I have seen on movies. Lots of garden space with windows and doors open to it and a terrace that overlook the city and the garden. There are 8 lodgers there now but the owner and her daughter are on vacay so it’s not quite the full house but it will be when they come back. There are lots of wildlife here, particularly the birds. The 1st night I arrived, I was exhausted and was hoping to sleep in a little before heading out. I woke up at 5:30 am because of the crazy birds singing, rooster and the car horns. That’s when I realized that sunrise is at 6:30am and being so close to the equator, day time is longer and people start their days much earlier. I hope soon I’ll be able to sleep in a little.
Kampala is a very crowded city with garbage on some sidewalk and very dusty. It’s all the red dirt so my shoes now have a layer of red dirt on them. Traffic law is pretty much non existent. Drivers here use them as guide and it causes massive jams. Kampala has everything basic that we have back home so I’m not feeling too out of place. Streets are not labeled so it will be fun trying to find my way around. The street corners are lined with bodas keeping calling me muzungu, meaning “white person” or “foreigner”. Definitely need to learn the iconic buildings to find my way around.