Today was our first clinic and it was in Bombo. After an early start of breakfast at 7:00, we piled ourselves onto the bus amongst multiple boxes and bags of kit, to commence our journey to Bombo. We made great time at first, however, just around the corner from the school was a lorry carrying vast amounts of charcoal, which was perpendicular to the road and spanned the width of it.... Joel, our incredible driver didn't even hesitate and took our large (at least 25 seater) coach down a back road to the school! We drove past metre deep pot holes within a milimetre's distance, but Joel knew exactly what he was doing! It was quite a useful technique to wake us all up with our Adrenaline pumping to start clinic.
When we arrived at the school, it appeared a lot calmer than previous years as the patients who had come to the clinic were down in the church instead of on the terrace outside the school classrooms where we hold the clinic. We could hardly see them, which meant this seemed far less daunting! We set up all our 10 stations:
2 GP stations (Kirsten and Jane) with Simon Kaye as a floating GP to answer questions
1 trauma and orthopaedic station (Simon Radcliffe)
4 nursing stations (including one malaria testing station - Sarah Radcliffe, Sarah Gorst, Kathy and Meg)
Pauline's station for glasses and elderly health complaints (linking up with Simon Kaye)
A registration station for Margaret's incredibly comprehensive checking in and patient note organisation system
A checking out (plus giving out mosquito nets/ clothes/ shoes etc) station run by Ruth
My station - a general medical station which ran a lot slower than most (spot the psychiatrist) and with the idea to see mental health patients if needed also.
So, after 11 hours of slogging, we did it! We made it through our first clinic! What an interesting and tiring day and what a contrast to the rather disorganised clinics that I've done in the past! The team seemed to work so well together. From organising patients from the moment they entered the Bombo school grounds and sorting their records, to seeing and treating patients, giving them mosquito nets and organising follow up plans, everyone gave it there all! I am very proud to work with such a fantastic team. We saw 225 patients today in total! There was a huge variety of problems that people came with. Of course, we had the usual culprits with "coughs and flu", "stomach ulcers" and "even eyes", but, in addition to these, we met multiple rather extraordinary and incredibly resilient people. I have asked some of the team who their most memorable patients were and they told me about some of the following:
Kirsten's first patient and a massive baptism of fire into the clinics for her (which she managed brilliantly) was a struggling gentleman who was HIV positive and had a very large spleen and palpable liver. If this wasn't enough, he had chronic osteomyelitis (a bone infection), which was oozing out of the wound and strange fleshy lesions down his arm. Kirsten referred him for some investigations at Bombo Barracks medical centre and asked him to return to clinic on Friday.
Jane saw a very malnourished 1 year old who had diarrhoea, was refusing to eat and had wounds around his ears and legs. Jane sent him to Kiwoko hospital for urgent investigations.
Kathy and Simon Kaye saw a boy who was physically assaulted causing him to be unconscious for 2 hours. It was likely that he had a broken jaw so he was sent for an XRay and given pain killers.
Simon Radcliffe saw a diabetic lady with blood sugar of 20, who appeared very unwell due to this. She could not afford her diabetic medication. He also saw the gentleman who was doing the Conga with his crutches yesterday in church! This gentleman had a tibial none-union fracture, which was strapped together with short sticks of bamboo. Simon was able to give him an orthopaedic boot, which he had kindly brought from England.
I saw a gentleman in his late 50s who had Parkinson's and could not afford to keep getting the medication. In addition to this, he complained of premature ejaculation! This was rather interesting to try to get to the bottom of through a translator! In addition to this gentleman, another memorable patient of mine is a frightened but very polite 8 year old girl looking after her 1 year old sister, but who was otherwise entirely alone. She had waited all day to see me because she had "flu" (a runny nose) for 3 weeks! She did have a fungal skin infection on her head however, which I gave cream for and she was given mosquito nets and toys, so we made the wait worth her while!
The most memorable person that I saw in clinic was a valiant 9 year old boy who had been horribly beaten by his father when his father was drunk. He had an infected large wound on his back and a swelling on his abdomen due to bruising. This boy is sponsored already and some of the team sponsor children within his family luckily. One of the Pastors is going to investigate the problem urgently and to see what action can be taken (bearing in mind the difficult Ugandan culture of beating children for being "stubborn" and the laws regarding parental ownership of children). I find the levels of abuse and assault in Uganda terrifying. This little boy was so brave and showed no signs of PTSD or even depression/ anxiety. He showed fantastic levels of resilience, a trait that I seem to come across again and again in Uganda.
In addition to the above, we diagnosed a lot of malaria, wonderfully tested for by Sarah Radcliffe. Finally, we returned back to the hotel for a quick meal and then bed before we do it all again tomorrow! Goodnight!!
Please check out https://disboblog.wordpress.com/ for photos of the day taken by our wonderful photographer who has captured the day fantastically, along with providing us with water and ensuring that all kinks were ironed out in the clinic - thanks Tony!
