International health, medicine, Uganda

Breaking in


Lake Bunyonyi with its 23 islands

It takes time to break into a new setting. This is especially true for a cross-cultural, international experience. Five weeks into my time in Africa (four in Mbarara), I finally feel like a routine has set in, and I have gotten used to the way life is here. It’s nice to have made friends with some of the Ugandan residents and feel a bit of familiarity and comradery on the wards. In addition, each week, I look forward to little things like going to the tailor to get a skirt made or going to the market to get fruits and vegetables and cooking a whole meal for less than $3 USD. One has to have ample entertainment to replace television, and we found a gem today. Let me explain.

Today, we attended a Ugandan aerobics class. It was held a crowded, carpeted room in a dark corner on a 2nd story building downtown. The charge is about 5000 Ugandan schillings ($1.60USD). There were Ugandans and Mzungus combined to total of 15-20 people. Imagine a carpeted, stuffy room with no ventilation and a playlist of 1990’s pop like “Night at the Roxbury” along with a lot of integrated movements from dance, yoga, and boxing. There was also a lot of hip swaying as well. I spent the first 10 minutes suppressing laughter and the rest of the time wondering when it would end, and whether I would pass out first. It was pretty intense but a lot of fun. The director of global health from Harvard was also in town and participated in this activity with us, so it kind of made my day.

Things at the hospital has been going ok. Since my last few posts, I have switched teams to rounding on the men’s ward side. It must be that I feel more accustomed to how things run here now, because i feel more comfortable asking questions and participating on rounds. I’ve been writing notes and discharge summaries–just like a real resident. Ha. Mortality rate is still high, and it still unsettles me. This week, just like any other week, I had patients die waiting for results and workup to be completed. By now, I have kind of gained a 6th sense about who will make it and who won’t, just based on the first few minutes of assessing them. I guess It isn’t hard. When the decisions are that of: “who will get the oxygen–because there is only one oxygen tank,” it becomes apparent that acutely ill patient just won’t be able to get what he/she needs.

I had a patient this week who had the cutest little daughter. Every morning, she would wave at me from her father’s bedside and smile this big banana smile at me. Her father was admitted with symptoms of severe anemia and Hgb of 1.8 (normal is 13-15) and had clinical symptoms of peptic ulcer disease (PUD). We transfused him 4 units, treated him empirically for PUD, and called it a day because he couldn’t afford any further therapies like endoscopy. Today when I was going over his discharge paper work and instructions with him, this family asked me if I was going to be their doctor for his 2 month followup. I told them I was going home to try to save up to come back again.

They said ok.

a ray of sunshine each morning; (used with permission from parents)



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