Last night Lisa and I had yet another romantic dinner together. Somehow we are still coming up with things to say at the table, despite that we have been together for 2 and a half weeks straight…almost. In Kampala we had amazing food options, ranging from thai to Indian to Chinese and “American” but now in Tororo are options are basically all local food. We don’t have a kitchen, so basically every meal we have to eat out. Luckily a plate of roast chicken and “chips” (fries) is about $2 and local ground nut sauce ( peanut sauce) with rice/matoke/chapatti is about $1. We are gradually making our way through all of the restraints in Tororo that would be recommended for us to safely eat at and what we are noticing is that although each menu has lots of items, in reality there is usually 3-5 choices for dinner. We usually ask if they have a couple things we want, then just ask what they do have. Last night we decided we wanted pasta for dinner and ordered spaghetti napoleon. They agreed but said it would take 15 minutes. 45 minutes later, after watching our waiter go out and buy the tomatoes and spaghetti, we had a delicious spaghetti to eat For lunch we are usually fine with eating on the go, but since we learned it was rude to eat on the street or while walking we have opted for more relaxed lunches. Basically everything is more relaxed here!
Today we spent the day at a private hospital in Tororo. I am continually amazed by the hospitality of the people here! We are continually greeted with smiles and “you are welcome” by the hospital doctors and staff and by huge grins and waves from the children that run out to see the muzungus. Even in the market and things, people bend over backwards to help us find things…of course they try to sell us lots of things too. Back to St. Anthony’s the private hospital where we spent today. Dr. Jute, the hospital administer showed us around all the wards and basically gave us free reign to experience how things work. The hospital is government and church subsidized, however patients still pay for the services they receive. There is a cashier’s office where patients go to pay before they have labs drawn. In contrast to Tororo hospital which is government funded and free, the private hospital has some more resources, I would not say a lot though. After our grand tour, of the amazing grounds with a view of Tororo rock ( a huge hill that stands apart from the flat surrounding), and the crowded shared wards typical of all the hospitals in Uganda, Dr. Jute set us free to work with Dr. Patrick who was running a chronic medical condition clinic.
This was the first time I had really encountered Hypertension, Heart disease, and Diabetes as chief complaints! I am sure that some of the patients I have seen have had these issues, but as they there hypotensive from sepsis, it is not at the top of the priority list. A lot of this is because I have spent most of my time at Mulago in casualty where the sickest of the sick are brought in, literally on deaths door. So it was interesting to see how some of these chronic diseases or “diseases of affluence” are managed. A huge priority is placed on deciding medications that patients will be compliant with based on cost and how frequently they must take the medicines and number of medicines. Dr. Patrick is a general practitioner, and it was nice to be able to weigh-in on management of heart disease since we have so much experience living in the US ;) For instance we had a very interesting conversation on the use of Beta blockers in patients with heart failure to prevent remodeling of the heart. One other interesting thing from today is that we saw a women with lots of small marks over her abdomen. I asked Dr. Patrick what they where and he told us that they were “therapeutic marks” or small cuts placed on the body by traditional healers to try to cure disease. I found this interesting. I didn’t get a chance to ask her if it worked.
Today was filled with lively conversations. The first of which was with Dr. Patrick. After telling us that we should have read the entire 600 page tropical medicine book I had in my hand before I came to Uganda, he also wanted to talk about us being women doctors. He made mention of how busy we will be with Lisa as a surgeon, and me going into emergency medicine and continued to say “your sons will curse you” and talk about how he resented his mother for being a school matron. We tried to investigate his feelings a bit further, but it was clear that he did not think it was fair for women to be professionals work a lot and have families. He is definitely the exception here in Uganda, I have met many female medical students and been welcomed by most other doctors. We politely ended the conversation with “that is why we will have husbands to take care of the children” ;) wink wink
Yet another interesting conversation occurred with Dr. Welishe and Dr. Jute. I have found that when you put Ugandian Dr’s together, they tend to vent their frustrations with corruption, and lack of resources. At one point while they joked, Dr. Welishe turned to Lisa and asked “Lisa, where does a fish rot first?” This was met with a confused look on Lisa’s face and a prolonged, uhhhhh. Meanwhile I sat trying to scientifically make a decision about what part of the fish rotted first. The two Dr’s laughed histerically at our reaction and said….”from the head”….stating that corruption starts from the top and spreads down through the rest of the “fish.” Definitely, the highlight of the day. I later commented that if they rotted from the head, the current US health care system was rotting from all over. My personal opinion I guess. The conversation was continued at lunch over fanta and biscuits. Actually a very interesting conversation with Dr. Jute comparing and contrasting the Ugandian and US medical systems. I think Dr. Jute was suprised to hear how messed up we thought the US health care system was. Maybe even relieved to hear that even US doctors (or future doctors in a few weeks, hehe) have frustrations too.
Well, that concludes my day of intersting conversations and learning about managment of "diseases of affluence" in Uganda. Besides that, Lisa and I wondered aimlessly around Tororo trying to find the craft market that apparently does not exist, or we just can't find it. The only other excitement is the amazing afternoon rains. The last few days at about 3 pm there has been just rediculous down pour! Today we watched it from the comfort of our hotel room pourch and watched it take signs of buildings, pick up a fence with metal and wood steaks and through it across the street. When we re-entered our hotel room, there were puddles everywhere from the water that came underneath the door. I have never seen rains like this...not even in Ghana ;)
Goodnight for now, mom just called me...she has a free calling card??? I am paying for internet by the minute, so she is calling back in a few...look forward to hearing how that works!
Crystal
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