So, I've had another really interesting week here in Uganda. I spent some time on the gynaecology oncology wards. There is a big problem with cervical cancer here in Uganda. There is no screening service to speak of, other than opportunistic visual inspection if women attend the gynaecology outpatients department. Women present, often with advanced disease. Diagnosis is made by examination under anaesthetic and biopsy. Seven women had an EUA on this week's list and all but one had stage 2b disease or worse. It's something that's really made me appreciate just how good the NHS is, and certainly is something that should encourage all women to be screened where screening is available. So that's my soapbox issue for this blog entry. Girls, go and have your smear done if you're due...
I spent Tuesday night on labour ward with one of the SHOs, to cut my teeth properly in theatre. I've had to learn, pretty quickly, how to do a section using only one large swab and 2 lengths of suture material for the whole thing. For the old fashioned obstetricians who might be reading, I now understand the virtues of catgut as a suture. I'm going to be one of those people who whinges when I'm in theatre in the UK, 'if only I had a bit of catgut...' Anyway, we had a relatively quiet night for Mulago, 9 sections done, 3 pending when we finished the ward round at 11.30 the next morning. No such thing as the EWTD here! Wednesday was spent in a bit of a general daze, wandering round Kampala, drinking coffee at various points on my amble. Too awake to sleep, too tired to function.
Thursday is the 'Major Ward Round' in Oncology. I've never seen so many consultants on a ward at the same time! Ward rounds are done the traditional way. There's a lot of really interesting pathology to be seen. I'm hitting the books again, going back to stuff I've not read since med school - tuberculosis, malaria etc etc.
Thursday afternoon was a wash out in many sense, the rain hammered down like all the water in the world was falling out of the sky in one go. Cracking thunder and blisterung lightning everywhere. It did affect the teaching session, with only a few people attending to go through shoulder dystocia. Managed to get some mannequins, and whilst not ideal they helped people to really get some hands on and practice entry manouvres, and also to understand the underlying principles of each one. Which was great until one of the dolls' heads fell off... so much for gentle traction. It was fun though, and I'm really looking forward to teaching vaginal breech delivery!
After the teaching, I attempted to tear arse across Kampala, to catch a lift to the Hairy Lemon Island in New Jinja. I say attempted, since due to the rain, the jam was worse than ever. Of course, when you're relying on your driver to be late, sod's law dictates that for once, he'll be operating on British ti9me, and not Uganda time. So I had to dive out of the matatu, against my better judgement and hop a boda, since we needed to catch the last 'ferry' - read wooden dug-out canoe-esque boat - to the Island with a two hour drive to get there. Of course, the boda driver thought the best plan would be to race his friend down the pavement, dodging pedestrians and bollards, while I'm hanging on for dear life, soaked, muddy and cold, wind lashing in my face, while he aquaplaned to our destination. Of course, in true 'scream-if-you-wanna-go-faster' style, suggesting that I really wasn't in THAT much of a hurry only encouraged him to speed up even more.
Anyways, Elizabeth, Adam, Pierre and I made it to Hairy Lemon, all limbs and senses intact. What a cool place. It's a small Island in the Nile, cheap as chips, all meals included, beers for peanuts, a couple of wicked Island dogs, wildlife galore and no hassle. We stayed in a hut called the 'Sugar Shack' - not as seedy as it sounds - and really chilled out for three days. Arrived back in Kampala Saturday night, relaxed and refreshed for the week ahead...
I spent Tuesday night on labour ward with one of the SHOs, to cut my teeth properly in theatre. I've had to learn, pretty quickly, how to do a section using only one large swab and 2 lengths of suture material for the whole thing. For the old fashioned obstetricians who might be reading, I now understand the virtues of catgut as a suture. I'm going to be one of those people who whinges when I'm in theatre in the UK, 'if only I had a bit of catgut...' Anyway, we had a relatively quiet night for Mulago, 9 sections done, 3 pending when we finished the ward round at 11.30 the next morning. No such thing as the EWTD here! Wednesday was spent in a bit of a general daze, wandering round Kampala, drinking coffee at various points on my amble. Too awake to sleep, too tired to function.
Thursday is the 'Major Ward Round' in Oncology. I've never seen so many consultants on a ward at the same time! Ward rounds are done the traditional way. There's a lot of really interesting pathology to be seen. I'm hitting the books again, going back to stuff I've not read since med school - tuberculosis, malaria etc etc.
Thursday afternoon was a wash out in many sense, the rain hammered down like all the water in the world was falling out of the sky in one go. Cracking thunder and blisterung lightning everywhere. It did affect the teaching session, with only a few people attending to go through shoulder dystocia. Managed to get some mannequins, and whilst not ideal they helped people to really get some hands on and practice entry manouvres, and also to understand the underlying principles of each one. Which was great until one of the dolls' heads fell off... so much for gentle traction. It was fun though, and I'm really looking forward to teaching vaginal breech delivery!
After the teaching, I attempted to tear arse across Kampala, to catch a lift to the Hairy Lemon Island in New Jinja. I say attempted, since due to the rain, the jam was worse than ever. Of course, when you're relying on your driver to be late, sod's law dictates that for once, he'll be operating on British ti9me, and not Uganda time. So I had to dive out of the matatu, against my better judgement and hop a boda, since we needed to catch the last 'ferry' - read wooden dug-out canoe-esque boat - to the Island with a two hour drive to get there. Of course, the boda driver thought the best plan would be to race his friend down the pavement, dodging pedestrians and bollards, while I'm hanging on for dear life, soaked, muddy and cold, wind lashing in my face, while he aquaplaned to our destination. Of course, in true 'scream-if-you-wanna-go-faster' style, suggesting that I really wasn't in THAT much of a hurry only encouraged him to speed up even more.
Anyways, Elizabeth, Adam, Pierre and I made it to Hairy Lemon, all limbs and senses intact. What a cool place. It's a small Island in the Nile, cheap as chips, all meals included, beers for peanuts, a couple of wicked Island dogs, wildlife galore and no hassle. We stayed in a hut called the 'Sugar Shack' - not as seedy as it sounds - and really chilled out for three days. Arrived back in Kampala Saturday night, relaxed and refreshed for the week ahead...
kate..u will truly make a difference to these women..reading your article has really hit home to me of how lucky we are in this country, even though all we do is moan about the NHS..keep up the good work babe..sarah ryder is joining u soon too...take care!!
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