Back in Bombo for another beautifully sunny day, we set about setting up for, what we thought was, a follow up clinic before the teaching on women's health and mental health in the afternoon... 145 new and 30 follow up patients later however, it became a little more chaotic than we had hoped! As part of the follow up clinic, I was able to take a detailed history from Joyce, the mother of Milly who has severe learning disabilities. Milly had calmed down a little when she was taking the Promethazine however she had run out of the supply we gave her in the Summer. Unfortunately, since this has run out, Milly has become far more agitated and frequently runs from the home. In fact, Joyce had not seen her since last night. Joyce stated that Milly will go and eat raw cassava from other people's land and then will be beaten due to this. Joyce tries her best to look after her however finds this very difficult as she looks after 3 young children too. After a long discussion, although she refused further Risperidone, Joyce agreed for Milly to take something regularly so I will try her on Olanzapine if we can get this in Uganda. I will enquire about this at Butabika on Monday. In the afternoon, Kirsten and Meg held a women's health session, involving a very large pair of underwear with a uterus drawn on them! The laughter was audible far away from their room! I then led a mental health session which was aided wonderfully by Tony, Sarah R and Joejoe. We discussed depression, postnatal depression and anxiety, personal experiences and some CBT and mindfulness techniques. It was quite fun making 12 confused ugandans hyperventilate in order to demonstrate the vicious cycle of a panic attack! Tony provided a very helpful demonstration of feeling like you are backed into a corner when struggling and provided helpful strategies for breaking the cycle of depression. I was shocked to hear about how many Ugandan ladies who do not want their babies abandon them. Sarah described brilliantly the importance of support in the ante and postnatal period. After the teaching, many people stayed back and wanted to discuss their problems with their mental health and social situations with me. Each person had been through a terrible trauma and their situations continued to be very difficult. We discussed truly horrendous situations including child sacrifice, bereavement, abandonment and abuse.The people i met were so matter of fact and resilient that i was amazed. One suffering 13 year old girl, Lynda, who had no shoes, touched my heart greatly. She had such awful social circumstances and had been through so much in her life that she was now fainting and having panic attacks. Lynda had come to the clinic originally due to believing that she was having a heart attack. After her grandmother died in June 2018, she moved to stay with her aunt and uncle. She is one of 12 children who stay there however but her aunt and uncle struggle greatly to provide for them all, especially as her uncle is to unwell to work as a builder at present. To make matters worse, the villagers have turned against this family casting them out of homes and schools, in addition to assaulting them - with their focus especially on Lynda. The team will investigate what is going on and work out how best to support the family. Tonight, we have 4 translators staying with us in the hotel: John, Herbert, Apollo and Christine. For some, this is their first time in a hotel! We all have a day off together tomorrow and I must say that it has come at a good time as I am shattered!!
- emilykaye5