St Jude's: A wee slice of happiness

There's something about St Jude Children's Home that gives you a warm fuzzy feeling as you walk in the gates. It might be the brightly coloured buildings or the murals on the walls or maybe it's the swarm of children that RUN at you the minute you walk in, shouting MONO MONO MONOOOOO!, excitedly waving their hands and weaving themselves under your arms and legs. I had the pleasure and privilege of visiting the place a number of times during my stay in Gulu and every time I went I felt the happy atmosphere was highly infectious and contagious.

St Jude's is home to around a hundred Ugandan children - some of whom have disabilities and some who have been orphaned by war, poverty or disease. The first time I went there, I met with Monica, a lay Comboni missionary who explained the children live in houses, maybe 10-12 in each house, and are looked after principally by a foster mother, usually a local woman who may have a child with a disability herself. This means each child belongs to a family which is consistent and stable. 

When my friends from Sligo who have volunteered in St Jude's described it to me I was so excited to go and see the place. They also said I'd have lots of work to keep me busy in the clinic as there was no nurse there and it wasn't the most organised place on earth. I expected to roll up my sleeves and busily help organise the place, develop protocols with the woman who ran it (not a qualified nurse) and maybe do some training with her to help her with treating minor injuries and identifying the sick children who need to go to hospital. 

Physiotherapy room

Physiotherapy room

I got the most pleasant surprise when I arrived and met the new team of Comboni missionaries who are dedicating one to three years to working at St Jude's. Monica is Polish, qualified as both a physiotherapist and nurse and arrived there seven months before me. To say she has completely transformed the place is a massive understatement. The clinic now has two nurses (Monica and Brenda, a lovely local Ugandan woman), and over the past ten months they have been working extremely hard to improve both the consolation home and the clinic rooms. They have worked so hard there was barely anything for me to do! 

They've turned an old office into a bright and colourful physiotherapy room, where Monica gives proper physiotherapy sessions, vital for the patients with cerebral palsy and other forms of paralysis. They have organised the children's medical notes into neat folders filed under each of the mother's names, documenting their vaccination status and all hospital and clinic visits. They have bought new filing cabinets and shelving for storing the medications, and restocked many of the shelves using some donations I brought over from kind family and friends. They have an emergency shelf with an Ambu-bag and emergency medications.

While I was there last Tuesday, a young girl came in who had fallen the previous day in the yard at the primary school. At the clinic, Monica and Brenda see not only the St Jude's residents but also the children from the village who attend the attached primary school. Monica had advised her the previous day to go to the hospital and get an XRay because the wrist looked broken, but she had not (possibly didn't have the money to pay for it). She was in a lot of pain, so Monica found a splint in a storeroom she had recently organised and we immobilised the wrist, gave her a painkiller and sent her home with a note to say she would have to attend the emergency department. There's a good chance she won't go, but at least splinting the wrist will give her some relief and allow the wrist to heal. The next person to stroll in was Mercy, a young girl with autism who is a complete hypochondriac and loves taking medications so much they sometimes have to give her multivitamins as placebo! She thought her toe was falling off but after some reassurance and a hug from Monica she was smiling again. 

Monica and Mercy

This guy was absolutely devastated when he finished his banana. 

I made the almost fatal mistake of bringing a bag of bananas to the kids last week. The second Auntie Pamela and I opened the bag and started handing them out we were bulldozed by a swarm of children, clamouring on top of each other to get one. There was laughter and tears as many suffered crush injuries (myself included). Both the children and the mothers were delighted because they don't often get a little treat - although it only cost around 30,000 shillings (the equivalent of around €10) for 100 little bananas, that's a relatively large sum in Uganda and they simply cannot afford to buy fruit very often for the children. I was also delighted to be able to give them a large container of G-nut paste (like peanut butter) that a friend had made for me. Anyone who has been to Uganda will confirm that this stuff is the tastiest thing on the planet and is therefore LETHAL to have lying around the apartment. It is so loaded with calories it is used in developing countries to treat malnutrition and starvation. I suffered from neither of these conditions but managed to get through a fair amount of the stuff, I found it was a good cure for my own personal affliction of gluttony.

There is such a happy and positive atmosphere, and most importantly lots of love and laughter, it's not hard to see why it holds such a special place in the hearts of so many people from Sligo!

This guy knew how to put filters on a selfie.

Murchison Falls

Sunrise on The Nile

The Crew: Shout out to Margot Farrell
for the selfie stick

Murchison Falls National Park is incredible. I had the BEST weekend there a few weeks ago. We set off from Lacor at 10AM, and after two hours of 'African back massage' (ie. extremely bumpy roads) we landed at the biggest park in Uganda. I travelled with two Italians (an anaesthetist Laura, and photographer Claudio) and a Dutch girl, Famke, I'd met at BJz trivia night two days before. I half expected to see a WANTED poster of myself at the park entrance after the unfortunate incident with the baboon the last time but luckily my sunglasses and beard were enough of a disguise.

Jackson's Hartebeest and Kobs

As we drove into the park the landscape changed from dusty red to lush green and gold. We had arranged a boat trip down the Nile to Murchison waterfalls at 2PM so we barely paused to admire the giraffes, kobs and warthogs that flanked either side of the roadway. After a hasty lunch we were ushered onto the boat (literally the only time I've felt rushed to do anything in the last three months so it was a shock to the system!). In typical Ugandan unpredictable style, the heavens opened and we were met with an almighty downpour of rain. We may as well have swam down the river. This would have been ill-advised though because not long after setting sail we came across a group of hippos (*fun educational fact: a group of them is called a bloat of hippos.. (Love it) ). Hippos are the most dangerous animals in Africa and kill more humans than any other. Apparently when they open their jaws it is a sign of major aggression so we gave them a wide berth when one showed his pearly whites.

Hungry hippo

Shnaky wee GATOR GATOR
(#Nostalgia: Shane O'Brien, Kieran Crowley)

We passed several bloats as we cruised downstream, all just lazing in the water on a rainy afternoon. Along the shore we could see a few Ugandan kobs grazing peacefully. We came across two crocodiles a little further on, who were incredibly well camouflaged against the rocks. Once again I was glad I was not swimming as our guide told us they can swallow children whole without salt. Not entirely sure if he was joking.

The skies cleared as we neared the falls, and we soon heard the low rumble of falling water. We started to see white foam on the river when we were still a few miles away - the foam created by the pressure of the falls crashing on the river below. The closer we got the denser the foam became and the louder the sound of millions of gallons gushing, as the great river Nile narrowed to a gap of only nine metres. Kingfishers dipped in and out of the water. Bloats of hippos farted. Tourists ooohed and aaaahed as we turned a corner and saw the waterfall in the distance. We hopped off the boat at an optional hiking point and started to make our way upward closer toward the waterfall. There were breathtaking views of the falls and of the Nile as we climbed (*admittedly some of us spluttering) toward the top. We followed the well trodden path to 'Devils Cauldron', but instead of heat we were met with a refreshing cool fine mist. A Falls fog if you will. It is so loud up there you almost have to shout to hear yourself or others. We got to the crest of the waterfall and the force of all that moving water is one of the most spectacular things I've ever seen. It blows you away and draws you closer at the same time. There is no railing or barrier to stop you pottering over to the edge and slipping in (#Africa) but there is a helpful polite sign to let you know it is sort of dangerous. 

Peter our driver said the hike would have to be his exercise quota for 2015

After the Murchison Falls hike we headed to our hotel for the night. As we did in Kidepo National Park we stayed in bandas, which are like the local mud-huts, home to many families in Northern Uganda. They are circular, made of mud and bricks and are surprisingly efficiently cool in the daytime sunshine, yet comfortably insulating at night. (I know what you're thinking.... I should go into real-estate). They are prone to creepy crawlies so we doused ourselves with industrial quantities of bug repellant and retired after a tasty supper of local cuisine. We all had a fretful fitful sleep after we were told lions and hyenas sometimes prowl around the compound at night, so every rustle in the bushes seemed like we might be seconds away from certain death.

We survived the night. We rose at dawn when the skies were pitch black and crickets were singing, and quickly made our way to meet our guide for a game drive. Once again, we were absolutely determined to find lions. We were not disappointed. Within about an hour we came across a lioness with a lion cub in the bushes, completely unperturbed by our presence. We turned around and found another lioness with two cubs only a few hundred metres away and thought it was Christmas come early. We watched them for some time playing together, sticking very close to their mother and left them to sunbathe as we continued our drive through the park. Unfortunately there was a male lion nearby but he was spooked by other enthusiastic game drivers so we didn't get to see him!

Momma and Baby

Wee Simba Himself

Jackson's Hartebeest

I don't know what it is about safari drivers but they absolutely love the power ballads. On this trip, we went through Westlife's greatest hits twice. (Sidenote: Westlife are absolutely HUGE here - particularly Queen of my Heart and Flying Without Wings. I have thoroughly impressed a few friends by knowing all the lyrics to both). Anyway we drove along Swearing it All Over Again (and again... and again) we were not disappointed by the wildlife. We saw thousands of impala, kobs and buffalo. Some buffalo have permanent resident lodgers in the form of weaver birds. These birds sit on the buffalos back and feed off the insects and parasites there, a truly natural symbiotic relationship. We saw the most unusual looking animals called Jackson hartebeests that are only found in Uganda, and of course the Ugandan Kob, which features on the Ugandan national coat of arms.

Giraffes!

Buffalo and Friends <3

Hyenas!

We were really lucky to spot a few hyena later on in the morning, as these are hard to find. They really are such evil looking creatures. The pregnant female was persistently rejecting the male's attempts to have a special kind of hug, as described by our guide. It was our driver, Peter's, highlight of the trip! We saw loads of giraffes and a few elephants (including a wee small one <3) grazing by the roadside. We had to keep a safe distance - elephants are notorious for spontaneously charging at vehicles and they can move surprisingly fast for such huge animals.

As we were finishing up our morning driving we came across vultures, an eagle, and lots of monkeys which was such an added bonus. If pictures speak a thousand words I have several theses on this trip alone - it's hard to capture the moments properly on a camera, and safari is something you can only experience in person. It is so incredible to be SO close to some of the most majestic and dangerous animals in the world. It is particularly nice in Uganda as it is not as commonly travelled as other parts of Africa so there are not quite as many safari trucks or tours at every park. Definitely a once in a lifetime experience (and I've reeeeeally spoiled myself by doing it twice but you've got to carpe diem when you're this side of the planet!)

Weightlifting African shtyle

Musical interlude while boarding the Nile Cruise

Very unfortunate kob...

Bambi-eyed

YOU WANT TO HOLD MY AK47??

Elephant family

Eagle vs Vultures... It was quite a long standoff...

Family of baboons

Pumba

Cheeeeeeky monkey

Monkeys scratching each others backs...

Famke and I with Sam - buzzing around our heads are not birds but these awful flying ants... They are in-season at the moment so they are EVERYWHERE. They are gross. They bite their own wings off and then crawl along the ground as ants. Children catch them and eat them, and sometimes they're cooked and served as a delicacy (known as white ants).

Laura, Claudio, Peter and I at the top of Murchison Falls

ProDUCing

I reeeeeeally wish I could record some of the conversations I have here in Gulu... Or even just some of the conversations I overhear. Today we had a pretty slow day in theatre because the medical students are doing exams this week. So I just sat around chatting for a bit with some of the nurses and anaesthetists in between cases. We were discussing the wedding of one of the surgeons (third marriage) to a much younger woman. Apparently she's a very clever woman because he has the money in the bank ('IN THE BANK' was the phrase of the day really), will treat her well and she won't have to work anymore as a midwife, which is a major bonus.

Hard at work...

 When I was asked about my marital status I said I'd been divorced three times (and that's why I actually came to Uganda) the sarcasm was lost on one poor intern who wondered how my father had so many cows.

It is a completely different world here. Family is the epicentre of everything. I honestly have never heard so much discussion about children, pregnancy, menstruation and uteruses in my life. Tuesdays and Thursdays are gynaecology surgery days, and the day passes so quickly with lists full of women eager to discuss their gynaecological and obstetric problems and concerns, and everyone from the surgeon to the cleaner to the medical student contributes to the conversation. All sorts of tips and tricks to 'produce' from various plants and herbs to special rosaries. I found the use of the word 'produce' particularly strange in the beginning but now I've started using it myself (pronounced in the right way as well: proDUCE),  but then I got carried away and nobody understood my joke of calling the newborn babies proDUCTs  so I gave up on it.

I seem to have had loads of conversations with the women here about babies and pregnancy, and they know I'm starting a six year training programme in July, so one friend pulled me aside the other day to tell me that she'd worked it out and if I start proDUCing as soon as possible after I finish I could have at least four children easily before I hit the menopause. Phew. A few weeks ago I told one of the young surgeons I had to leave early because I had a headache - his first question was when was my last menstrual period and before I even answered he said it was probably just PMS. Everyone else in the operating theatre agreed and advised me to 'take some tea'.

A woman's ability to produce children is of major importance here. In a society where polygamy is accepted and very common, if a woman doesn't have children she doesn't command the same attention or power as other women or wives. Most women I've met would like to have four or more children, and this is naturally supported by the strong religious presence in society. One of the obstetricians asked me what I knew about causes of infertility and I said 25% of the time it is a female problem, 25% male and 50% a combination of the two. He laughed, and said I was right, here but in Uganda it is the woman's fault 100% of the time. It really is a man's world.

I could only tell him about the one time I knew for definite it was the doctor's fault a woman couldn't conceive. A few weeks ago we were doing a diagnostic laparoscopy (keyhole surgery) investigating infertility, where a 35 year old woman stopped menstruating two years ago after her last pregnancy. The patient arrived down for surgery and we gave her the general anaesthetic as usual and we had some trouble with her blood pressure at first, but once she was settled the surgeon began to set up and I started having a mosey through her medical notes (which were basically like a few post-its stapled together). On the very first page it documents her medical history - noting that she had 3 children and her last pregnancy 2 years ago ended with an intrauterine foetal death (stillbirth), which was complicated afterward by bleeding so she had a hysterectomy. I told the obstetrician he could put away his fancy keyhole cameras because I had the diagnosis.  He examined her and confirmed it. Obviously having no womb anymore was the cause for the infertility and lack of periods, and this part of the history had just been overlooked at the clinic visits.

Even worse than the unnecessary tests and the unnecessary anaesthetic and the expense of investigations and clinic visits, this woman had had her womb removed in another district hospital and nobody had even told her. So when she woke up from the anaesthetic that day, expecting an answer and a solution to her problems conceiving, she was met instead with the devastating news she'd never conceive again. It must have been absolutely heartbreaking, especially in a society which places so much importance on reproduction, where women are revered for their capacity to deliver and rear babies, and the womb itself in many ways symbolises the very essence of their womanhood and proud motherhood.

In addition to their role of prolific baby producing, the women I have met in Uganda are also incredible natural midwives. One of my very first experiences, almost three months ago now, was a woman arriving for an emergency Caesarean section, collapsing on the tiled floor of the operating theatre and pushing the baby out on the floor. I just stood back gaping uselessly as the anaesthetist delivered the baby while still maintaining a chat with the nurses. When I suggested moving her to a trolley I was told she needed to rest, and twenty minutes later I almost tripped over her, still lying on the tiled floor, having a wee snooze! A friend in Gulu Regional hospital told me she was left alone at one stage on the labour ward, a woman started delivering a baby and the cleaner swooped in, cast aside her mop, took the only pair of gloves on the ward and expertly delivered the baby without breaking a sweat. She presumably nonchalantly went back to the mopping after that, no big deal eh?

Sudoku