Tuesday, May 14, 2013

FINAL BLOG POST...My Ugandan adventure comes to an end!

Over our last two weeks in Uganda we traveled to two beautiful lakes, finished our research projects in our villages, wrote our final papers for medical school, had our last chronic care clinic and said goodbye to many of our patients and new friends.

Uganda was my first experience with a continuity clinic and after two months of seeing my patients on a weekly basis, I was sad to say goodbye.  It is very likely I will never see these patients again, and I can only hope I did my best during my brief interaction with them in my life.  This is me on one of my last days in the hospital, running around as usual, with lots of things around my neck: stethoscope, blood pressure cuff, and bag with my iPad, TB masks, malaria and HIV tests, (the essentials!), etc. 

Nelson (translator) and me talking to one of my many tuberculosis patients- he improved greatly and is finally ready to go home where he will complete the 6-8 months of treatment.

view of our apartment complex
fabrics at market
rain water catching system for running water in the village

cabbage being sold at market


Our trips to the lakes on our days off were filled with canoe adventures and relaxation.  Lake Mutanda is close to Kisoro and for about $5 we paddled in canoes built out of eucalyptus trees for 3 plus hours with guides, in search of Kabeka, the giant python.  We had heard that most people don’t see it (probably a marketing scheme), but of course wanted to try.  By the end we were racing the thunderstorm (and each other) home and had the best upper body workout in years, followed by a delicious meal with quite the view. So quite a successful trip.

Lake Bunyonyi, a much larger lake with 29 islands, is a 2 hour drive from Kisoro near the city of Kabale.  We stayed at a lovely eco-friendly hotel called Byoona Amagara and met a handful of worldly travellers with interesting stories.  A doctor from New Zealand taking a year to work in hospitals abroad, another Kiwi doing Cairo to Cape Town before moving back to Jerusalem for international law, a young Lithuanian woman working for the UN in South Sudan and her Spanish dentist-Phd-stem-cell-making-cancer-curing boyfriend, and wanderlust Israelis who had just finished their mandatory military years.  We had large family style dinners and talked of everything from world politics to the ethics of legalizing marijuana to our favorite musicians.  We read books and played cards and swung 15 feet in the air off a rope swing into the lake.  After 3 nights of fun and relaxation, we started to have a bit of island fever and we were ready to return to Kisoro for our last week in Uganda

running to Lake Mutanda (about 1.5 hr run)

Masha, me, Deus embarking on the search for the big python

dock at Lake Mutanda
panoramic view of the volcanoes from Lake mutanda

Typical mode of transport.  Also my dad's dream car.
the crew getting a ride home after an epic day on the lake

view on our ride home of the kisoro sunset


View from the dining room at our hotel on Lake Bunyonyi

Lake Bunyonyi

bird that hung out with me on the dock
lake bunyonyi...every night its like this...



Celebratory party at Golden Monkey and african drum circle...also inspired me to bring back two djembes / bongo drums...




The last few days in the villages were wonderful.  We focused on home visits and I enjoyed hanging out with my VHW’s, Benon and Suzanne, and their families.  I discovered the best “chai” tea ever in Buangana for about 10 cents.  They mash up fresh ginger and 3 types of local leaves (peppermint, a vanilla-smelling leaf, and one other) and boil everything with some cane sugar, then add the chai tea at the end.  I have tried replicating this recipe a few times, but can never succeed!  I will miss the yummy tea and the nice young boy who sold it to me—even though he always charged me a “mzungu” price, higher than the locals. 

During one of our last health talks on cancer in women, it took me a moment to understand why, at 9am, the group was so animated.  We had wandered into the “downtown” part of Bunagana, where the waragi producers worked.  Waragi is a triple-distilled, multi-grain alcohol mixture that if done correctly, tastes like flowery vodka (even though commercially its labeled as “gin.”).  I realized the clear liquid they were drinking that morning was not water, but waragi.  Most were women, eyes glassy and bloodshot, their children scattered around their feet, often lying in the dirt playing or eating bread, naked except for a holey t-shirt five sizes too large.  Surprisingly, they listened to Suzanne as she spoke of breast cancer warning signs, sometimes asking questions, and sometimes shouting out things that didn’t relate at all.   An elderly woman who I had met the day before, and who was known as a “town drunkard,” sauntered down to our group.  She interrupted Suzanne’s talk to shake my hand and then demanded that I take her BP (she had refused the day before).   After the talk was over, I was hesitant to even acknowledge this woman, as she was very intoxicated, but then I thought that I couldn’t pass any judgments, and I should treat her like anyone else.  I’m very glad I did because her BP was 180/100.  We talked for 20 minutes or so about getting her to a clinic to start medications, her alcohol problem and her lifestyle.  She laughed at me when I asked her if she could stop drinking alcohol…so we talked about decreasing the amount she drank daily. This was accepted as a slightly more realistic goal.  I saw her a few days later when she wasn’t as drunk, and we talked about the same issues.  I can only hope that she will seek care and take her medications.  What disturbed me the most about this small part of my village was the environment in which the waragi-maker’s children are growing up.  Alcoholism is a problem worldwide of course, and it was the topic of my research project.  Poverty, boredom or idleness, cheap, easy access and lack of law enforcement magnify the problem in this area of Uganda.  (If you have any interest in my research project, email me and I can send to you).  Enforcing laws, education and job creation are all desperately needed to help stop the propagating forces of teenage, and then adult alcoholism.
Nelson, my wonderful translator, showing off his sense of style.
Some of the audience members in my last talk to the villages on adolescent alcohol consumption and sexual behavior. We had over an hour long conversation afterwards on how the villagers could work toward fixing these issues.
Suzanne's family and me in the living room
Sweet potato, matoke, dodo greens and beans- my last meal with Suzanne!

My buddy Nobat with my sunglasses

One of our last days was spent at a Congo refugee camp near Kisoro, where as many as 5000 refugees can stay.  (At our visit "only 900" were at the camp).  The camp leader, Tony, is inspirational as he dedicates his life to helping those who had to flee with nothing from their country, which could no longer provide them the basic security we take for granted every day.

Congo refugees in their kitchen

Congolese Refugee Transit Camp near Kisoro

Overall, my 2 months in Uganda have been life-changing, challenging in ways I did not expect, and a LOT of fun.  What I will take home with me are two concepts that I will hopefully continue to practice the rest of my life.

Test my comfort zone.   It’s so easy for me to get comfortable in my life at home. Between responsibilities of school and starting a career in medicine and the luxurious life we live as Americans, I rarely find the need or chance to move outside my comfort zone.  I did while in Uganda and it has been one of the most enhancing personal growth experiences I’ve ever had.  I’ve learned more about how I react in situations, my weaknesses and strengths, and the limit to which I can handle certain things.  I feel more grounded, and yet freer knowing these things about myself.

Be of service.  There is always someone in the world that really needs help- and I’m sure one day that will be me.   Helping others is truly the best gift I’ve ever given because in the same gesture both parties are on the receiving end.  My favorite moments over the last two months have been with my patients.  While I may have played a role in dosing their medications or giving them words of comfort, they have given me  much more than that: trust, education about their body or illness, and lessons about the faith of the healing human spirit.   I am every so grateful for these opportunities and I hope that I will remember to be of service whenever I can.

Thank you for your love and support over the past two months—couldn’t have done it without you all—and thank you for reading!

Until the next adventure,


Vanessa

p.s. some pics from Kampala...

My drum and its maker- after he cut a third of it off! He re-painted the bottom for me and added a longer rope to carry with ease.
Kampala...very busy city (this is nothing compared to what its like during the week-- you can't drive here)