Adjumani

Oct.  6. 2014

My address for those that have asked: (letters or padded envelopes only as it will be hand carried to Uganda from Paris).  

Megan Ancker

Mission Uganda

MSF

8 Rue Saint-Sabin

75011 Paris

France

Kampala to Adjumani

After a week+ of traveling, stops in NY, Paris and Kampala, I have finally made it to Adjumai in Northern Uganda. The ride here was long, 8 hours, and the last 2 were on a very bumpy red dirt road.  We left at 6 in the morning but still the traffic in Kampala was bad. Two-way streets with lots of traffic, including motorcycles weaving in and out, many with woman on back sitting sidesaddle. Not to mention all the people walking on the side of the rode and the people sweeping the street in the middle and on the sides.  Saw a truck with dead chickens strung on the side, live cows on the bed and men in hammocks above them.  Once we got out of Kampala it was better but we went through lots of little towns with lots of little children walking to school (all in uniforms) on the side of the road.  We crossed over the Nile, which had pretty impressive rapids at that point.  Saw some monkeys and baboons near there.

Finally arrived at the MSF compound, which is in the middle of nowhere about ½ hour from the town of Adjumani, and 2 hours from the South Sudan border. It used to be a school and is quite spacious. Besides two dorms it has an administrative building, a pharmacy building and a building where meals are served and people can hang out. I have a room in the scorpion house (the other house is called the snake house so I guess this is better). The houses are dorms with about ten rooms each that were built as doubles. We have our own room so it is quite spacious. I have a double bed with a mosquito net, a table and chair and a nice fan!  There are male and female bathrooms down the hall with cold showers and flush toilets except the toilet part is missing and it’s just a ceramic basin set in the floor.  At least I will come home in shape for deep knee bends. They do your laundry for you but have to iron everything due to a parasite (the tumbu fly) that gets in drying clothes and causes nasty boils when the larva burrow in your skin. There are ~20 people from all over the world living in the dorms.  I am the only one from the US.  The overall number should be going down though as they have just finished a big immunization project. The weather is surprisingly pleasant with some rain every day.

Northern Uganda is very peaceful at this time and while we live in a guarded and fenced compound there are only pretty basic security concerns—don’t walk alone, don’t go out after dark.  Due to the fighting going on in South Sudan since last January about 70,000 South Sudanese have come to Uganda.  Mostly it is women and children as the men stay north to fight and tend cattle.  The men do come across the border freely to visit their families. All refugees are bused to the Nyumanzi transit center where they are registered, given vaccinations, food and assigned to a tent.  They stay there and within 2 months are relocated to one of the permanent camps which is determined by which tribe they are from.  Luckily for them Uganda is very welcoming to refugees and has donated large tracks of land.  In the permanent camps they all have a plot big enough to grow some food.  MSF is in charge of health in the transit camp and at two of the permanent camps, Ayilo 1 and Ayilo 2. There are ~30,000  Dinka (one of the tribes) refugees in those 2 camps, most at Ayilo 1 where I am working.  MSF has set up an outpatient center and an inpatient center.  The inpatient center, where I mostly work, is just finishing construction. It has a wood frame and some internal brick and cement ½ walls to divide up the different areas.  It is pretty dark as there are not many windows.  My job consists of supervising the 4 Ugandan clinical officers (3 years of training) that do most of the work taking care of the inpatients.  There are 4 male beds, 6 female beds, 9 pediatric beds, 2 ER beds and 2 ICU beds and a separate structure with 4 isolation beds.  “Isolation” is a relative term in that despite instructions the inside dividing walls do not reach the ceiling. I also see problem patients at the outpatient center that is run by another 4 clinical officers and sees 250-300 patients a day.  I am busy learning a lot of new stuff!  The woman I am taking over from leaves Monday so I will be on my own after that.  Well not exactly. There is a MSF Medical Team Leader, who is a doctor from Somalia, running the whole show whom I can consult.  She spends her time doing administrative stuff including meeting with the local minister of health and coordinating with UN efforts. There is tons of malaria here and I have already admitted 3 kids with cerebral malaria, 2 of whom were suffering from severe malnutrition as well. There are also a fair number of kids that get burned from all the cooking fires.  The clinical officers, nurses and translators are all Uganda.  They are incredibly friendly.  I must have been introduced to 100 people in the last few days and they always shake your hand, give a big smile and say “you are welcome”.

The camp where I work is about ½ hour drive from the MSF compound.  2 land cruisers leave the compound at 7:30 every morning to take staff over to the camp for work.  It is a beautiful drive, quite bumpy, with lots of honking at people, goats, cows and chickens to get out of the way. Due to all the rain the countryside is lush with lots of bushes and trees.

October 9, 2014

Today is Ugandan Independence Day so we just worked in the morning. On the way home we drove by the local parade of school children from different schools all marching and singing. Late this afternoon a group of 8 from the UN relief team joined us for a barbecue. We roasted a goat, and when I saw we I mean those experienced in such things, and it was excellent.  They brought lots of side dishes and it was a very fun evening complete with a beautiful sunset. Have met so many interesting people in just a few days.  We are hopeful they will invite us over soon as their compound is reputed to be quite nice.

October 10, 2014

First day on my own running the “hospital”. Fortunately it’s the day the world food bank hands out food, a gathering of thousands, so outpatient visits were pretty light and we only had a couple of new admissions.  I made it and so did all the patients!  The Ugandan clinical officers were wonderful in helping me with a million questions.  Have two new HIV patients who are pretty sick so trying to figure out how to help them.  Can treat their infections but don’t have any medicine for the HIV right now. There is an HIV counselor here who is supposed to get a supply of the right medicine next week.

Would love to send pictures but the internet is pretty slow and I will be lucky if this gets out!