Not far out of Pakwach, the car suddenly veered to the right side of the road, into the path of an oncoming bus, which was screaming down the road like something possessed. The driver managed to get the car back across to the other side of the road before we were hit, but it was a little hairy. We came to a halt, and got out to check the cause of the problem... a punctured back tyre. Which would have been fine, except that the jack for the car wasn't big enough, and while we could get the wheel off, we couldn't get the spare on. And so ensued the search for a flat rock, to place under the jack, and a series of improvisational measures were employed to keep the car elevated enough for us to take the jack out from under it, and place a sturdy and big enough rock under the jack, so that we could lift the car high enough to get the wheel on, in the baking heat, with no drinking water between us, on a deserted road, in lion country. We succeeded in completing the task at hand, and piled back in the car, a tad sweatier and dustier than we'd been when we got out.
We stopped in Nebbi to visit Rose's family and to drop off some bread which we had bought in Kampala - bread's very expensive in the north, so it's a rare treat shortly before stopping for lunch, which after the tyre fiasco was welcome. We travelled for around another hour, passing IDP camps made up of round huts of mud and straw. Some of the buildings were pockmarked with bulletholes - evidence of the still relatively recent struggle with the LRA. We hit Arua, a big, bustling market town, full of pedestrians and cyclists. We checked into the Hotel Pacific - which, in a landlocked country is surprisingly nowhere near the pacific, nor did it seem to have any features to suggest a tie with the pacific ocean. Either way if was fine, comfortable enough, apart from the howling scrapping dogs in the alley behind the rooms and the roosters that crowed incessantly from 4am, in a manner suggesting that they were being skinned alive. We settled down in the hotel for a beer or 2, and had a bite to eat.
Alia wanted to go to his Dad's village to pick up some chicken that had been killed and cooked for us, but there was an issue with taking the Landcruiser. The chicken arrived, by boda boda, with a pan of matoke and some sugar cane, right after we had finished eating dinner, so we loosened our belts and tucked in.
Next morning, we got to the hospital. The patients had been screened by Alia and Barageine shortly after we arrived in town. We got to theatre around 9, and I was pleasantly surprised by the theatre, which was a far, far cry from Mityana's. The first patient was waiting, drip in hand. The day got off to a flying start. The staff were motivated, and apart from the anaesthetist who repeated the phrase, 'That's next to impossible' regarding our request for a fan to help survive the heat were very positive. We got our fan - which was just as well, or else I'd have melted. We got through all 5 scheduled patients by 4pm and screened the new arrivals. We headed off for a well earned drink - which swiftly turned into 6, plus fish and chips, Alia insistent on 'just one more beer' for all of us - makes a change from me saying it anyway!
This camp turned out to be the best so far, everything ran like clockwork, we had good light, running water, instruments and proper linen, a motivated team, the hospital's own doctors got involved and there were even medical students around! The fistulas were among some of the most complicated I've seen so far, which was interesting to see. In the end, however, we only operated on 13 women. This was a question of people not coming to the camp to be treated - everyone we saw that needed surgery got it. We left Arua on the Wednesday afternoon. Prior to leaving, Alia went off to collect a chicken from the village, which was bundled into the car, clucking manically.
We hit the road on what was to be a long drive. We stopped not too far outside of Arua to buy Mangoes from kids on the roadside, prompting stories from the guys about how they used to scrump for mangoes. They had kids running up and down the road buying plastic bags. Fruit purchased, we continued on our journey. We stopped at Rose's village to collect another Chicken to keep the one we already had company, which doubled the noise asince they decided to peck at each other. Loading the car up with more mangoes we set off again. In Pakwach, we stopped again, this time to invest in wooden milking stools with phrases etched into them. My particular favourite was 'Remember Pakwach'. What?! After politely explaining to the 20 people flocking around the 4x4 that I didn't need any wooden crocodiles, cars, crested cranes, innominate birds, balancing objects, bows and arrows or drums, and everyone else satisfied with their purchases we drove across the Nile. On the other side were tens and tens of Elephants. Alia hypothesised that they were all going down to the river to drink. Barageine disagreed, stating that they had almost certainly already drunk from the river and were heading in the opposite direction. Rose and I looked at each other and burst out laughing, suggesting that since they were all facing in different directions it was difficult to tell what they were doing or where they were going, and either of them could be right, but that they were arguing for the sake of it. After an hour we stopped again. Alia bought 4 more chickens and Barageine bought 6, bringing the total to 12, making for a bloody noisy car, and reminding me why sometimes having no sense of smell has its advantages. The rest of the journey was relatively uneventful, apart from a heavy downpour. Getting the chickens out at the other end proved to be a challenge and I finally got through the front door at 10.30.
Since arriving back from Arua, I've spent a lot of time doing project work. I've spent time preparing and co-ordinating stuff for the next exchange visitors from Liverpool Women's - registration, accommodation etc - and also trying to sort out visas for the Ugandans who are hoping to visit LWH. I've been working on a detailed proposal for a shoestring HDU, and have made the final arrangements for a neonatal resuscitation course. Many of you have donated generously, and so far I've collected almost £1000 in donations - THANK YOU! We're also hoping to present on a few new guidelines for the unit next week and so have been putting the finishing touches to these. From here until I leave things are going to be fairly intense, with 3 separate groups of visitors coming who are working on fairly different things, we'll be physically setting up the HDU at some point in the next 6 weeks and there are post-graduate exams, so I'll cover labour ward for 2 solid weeks.
Thursday was pub quiz, the first one we've been to in a while. We had some new additions to the team, Anna, a medical student, and Whiteney and Lisa, 2 nursing students, plus Phoebe and Mark joined us for the first time. We came 2nd. Slowly we're improving - perhaps next time we might win. From here we visited Elizabeth, who has just taken a job in Rwanda - we had left her earlier in a packing frenzy - to sit and drink wine on the porch one last time before she left yesterday.
Yesterday was also Adam's birthday. Phoebe and I went to pick up his birthday cake. I had explained the order, with the appropriate illustration to the lady at New York Kitchen. Rather than a whole cake, I asked if it was possible for them to give me half a chocolate cake and half a carrot cake but to put them in the same box. At some point between me explaining what we wanted and the cake arriving in the shop, somebody interpreted the order as, chocolate cake on the bottom, carrot cake on top with a layer of chocolate fondant between them, iced entirely in chocolate. What part of that combination would be normal in anyone's frame of reference.? So I waited for 25 minutes while they deconstructed the cake - since we needed it within the hour , and there wasn't time to start again from scratch - stripped off the icing, re-iced the chocolate cake and put the carrot cake in a separate box. Armed with our 2 cakes, party hat and candles, we jumped in Alfred's car. And sat in the jam. For 2 hours. School's out. We had forgotten. We got to the Italian Restaurant later than expected but had a lovely evening, and the cake, in the end, was delicious.
This weekend is my last free weekend for some time. I intend to do absolutely nothing.