Battling the menace of Malaria

This morning when i walked into Peters consulting room he had a young girl lying on the floor with a high fever. She had slight jaundice and an enlarged spleen, but she also had some signs in her chest. We thought it may be Pneumonia but were able to order a Malaria smear on site and found she had a heavy infestation of parasites. It was good to be able to look down the microscope at the blue rings which scattered across the film and be able to make an accurate diagnosis. She was admitted to our day ward and given the latest and most efffective malaria therapy, intra  muscular artemether along with IV fluids and antibiotics for the pneumonia.  When I walked past her bed in the afternoonn she was looking so much brighter. Its times like this that all the work and obstacles and frustration is worthwhile !

A special photo tonight for Andrew and Rowena Rowe . I delivered a present they sent for baby Dennis. His mother was lying on the verandah with him tonight, recovering from a hernia operation. her face lit up with a smile when i delivered the gift!

Dennis gets his pressie from Weena

I love the african children , so here too  is a shot i took today of baby david who had the emergency surgery this week and is doing very well.
isnt he so cute? he smiled at me as i walked past and chatted to him today.





David





 My last day here today and all of a sudden has come the promise and potential of a new exciting partnership with local medical practitioners which has the potential to mmake a major contribution to primary health care here . It is a story of an amazing roller coaster ride which is too complicated to share at the  moment...but.. more details later...

Andrew and Doc Vincent talk about new possibilities

 The big bus trip tomorrow, with my travelling companion Doc Laurel, then a long flight home on Sunday. Thanks so much to you for your emails and messages and prayers and support
The last few days have been pretty tough going here . I have really felt the power of your prayers  , especially in the last couple of days when some pretty amazing lows and highs have been happening... but i am leaving with hope and believe i will be back !

My work here is almost done

Malnourished child from Sudan

The medical superintendent at St Josephs Hospital has aked me to come and help in the childrens ward at some time next year. I spent some time there today with Dr Laurel and it brought back memories of  working there in 2003. I enjoy working with children and will give some consideration to returning and being involved with the 100 bed ward, the nutritional unit and a planned neonatal ward.  There have been some significant improvements in the hospital since i worked there and there is a good atmosphere there.  There is a lot of need.
Today we saw a little 1.8kg premature baby being nursed in very simple surroundings with no technology. You have to be tough to survive here!




premature baby 1.8kg with mum on the floor

 LAst night we had the privelege of visiting the home of the IGF Clinical Officer, Peter, meeting his wife Sheila and son Shadrak as well as his mother. What a simple life he lives outside of work!  I really admire this guy.
The clinic at IGF is now functioning well and can operate independently under the direction of Peter.  My "to do" list is complete with all the half finished jobs from my last visit tidied up and patients from the community being seen. the pharmacy is also working well. Please pray that the team here will work well together and be effective and receive support from the IGF administration in their work.  My influence is going to be significantly reduced when I leave on Saturday.

Judge Judy African style

Prime real estate in Kitgum

Yesterday I was asked to resolve a dispute which had arisen on some land which i purchased in 2003. At the time I was considering developing a medical clinic on the site but since then have got involved with helping Irene at IGF to expand her facilities on site. The land is a short walk from IGF on the way into town. There are two families living on the land. John Achola ( terribly disfigured as a result of LRA atrocities) and his wife wife Grace and their 4 children, living alongside a widow who works as a chef in the AIDs hospice, and her 7 children !  Quite a little community. I also discovered there is another man living in a tiny room on the land, paying rent to the previous owner !
A dispute arose over fights between the children and became quite acrimonious, leading to a district official being involved and a fine being made.
So in the hot sun, I walked up with Peter my interpreter and put on my family court (Judge Judy )hat to try and settle everything down and avoid blood shed on my land !  I believe it is settled now and i am considering what more to do with this rather nice place where the vegies are thriving.

with some african guys on the block

Today the building guys moved one step closer to completing the incinerator and ash pit. I was intrigued to watch them lifting the pipe and supporting slab up onto the top lof the chimney.. quite a precarious undertaking... i was tempted to shut my eyes on a couple of occasions.

We were also excited to receive our drug order for the month from Kampala, ready to stock the pharmacy.





We did ward rounds in the AIDs Hospice this morning and it was a great opportunity for Dr Laurel to do some teaching of the medical team.

Ward rounds

the top of our incinerator lifted into place !

Visiting an amazing Kiwi

Lois Ford is an amazing Kiwi woman who has been working in Kitgum for some years. She has a  project called Tender Trust  which provides residential care to about 100 disadvantaged, at risk and in many cases disabled young children. Steve Curtis Ch children and she has Ugandan assistants on site. We visited and Lois treated us to a feast of western food which she prepared in her kitchen. Thankyou Lois , it was soooo good! I was expecting beans and pocha (maize) but a real surprise to have shepherds pie, cooked tomatos, cole slaw, rasperry cordial, plunger coffee and finished off with banana cake.  MMm ..highlight of the day!
Its always very emotional visiting Lois and meeting her children because they have so many struggles.  Also, she is caring for Ben, a young man who had shrapnel in his neck inflicted in the Kampala terrorist bomb blast about 12 months ago. He has been left with a serious spinal injury, meaning he has very little movement in his arms and none below the neck He also needs a tracheostomy tube permanently. He is a lovely guy . We spent some time with him and prayed with him.

During our visit the children were playing happily  in their yard, collecting water from the water bore, having a wash after the hot day, and then enjoying some food prepared in their big kitchen,.

After that we could here them singing downstairs while we chatted together upstairs, at times in the dark, due to the power going out.

It was a good time.

Spending Sunday in church and with the EXODUS  team

A day away from work

my little friend Dennis

A more relaxed day today. Nursing babies, and listening to talented african dancers and singers compete in a local competition.  The building was packed with about 5000 people crammed into the church building on site here. People were also hanging out of trees outside so they could see the performance. The judges were George (exodus) ,gospel singer from Kampala and his mates, Titus, Jimmy and Gilbert. There were some pretty impressive displays of gymnastics and creativity from the young people in this recovering war zone. 
Tonight for tea we went to the chief administrators house and were treated to cooked antelope and warthog among other delicacies !  His wife Winnie also specialises in a superb fresh guava juice.  There was alos some major excitment in the house as we watched the soccer match between Uganda and Kenya being televised!

Doc Laurel and I also spent some time evaluating our experiences today and preparing some written recommendations for Irene and JP next week regarding the health project here.  Please pray for a sense of unity in purpose and direction. There are many challenges .


JP has an electrified tennis racquet to swat and frizzle nasty malaria carrying mosquitos !



Geoffrey is our sponsor child at IGF, He is attending the vocational training school and was having lots of difficulties getting to classes on time as he lives about 12km out of town and has to walk to and fro. Anne and I decided to give him a push bike and he was very happy when I presented it to him today!
We are working hard to get a functioning pharmacy and establish an accountable storage process. Janet Riessen from South Australia has worked in pharmacy dispensing so has been an invaluable asset at the current time.

Janet with Benson and Justin (our book keeper) in the pharmacy

The shelves have been set up and our existing drugs put in some order. We have an order for 1 month supplies, due to be delivered next Tuesday .

I spent a lot of time pursuing and stalking all the builders and administrators in an attempt to get some half finished jobs completed. I find this exhausting but necessary.

I am spending some time with each of the health workers listening to their concerns.  WE had a meeting of all the nursing staff today and heard about many challenges .



Doc Laurel and I are going to spend some time this weekend , reviewing the week to date and coming up with some proposals to bring to JP and Irene next week

Joel doing some microscope work in the lab

The gospel singer, Exodus and his wife Brenda as well as co singers Gilbert, Jimmy and Titus are here in Kitgum for the weekend to participate in a music festival. It is Independence Day.

George and Brenda in Kitgum

Baby David with painful inguinal hernia

I thought  I should provide some medical input  tonight. Its a story with a good ending .  Little David who is one of our children receiving nutrition and being nurtured by local pastors wife, presented  to our clinic today in pain with a lump in the groin which had been present for 3 hours. We diagnosed  an obstructed hernia and he was rushed up to St josephs Hospital  with Dr Laurel Coleman , a physician from the US who is working here with IGF at the moment. He was operated on quickly and the bowel was saved from gangrene so it is a very pleasing outcome.
Earlier in the day, Doc Laurel, myself and the medical team members did a ward round and we found Laurel's experience in Palliative Care and AIDs patient management in the US very helpful in teaching. (Laurel also has a blog site : http://www.uganda4me.blogspot.com/ )
We had  quite a busy day in the clinic seeing patients and tonight we broadcast on FM radio and announced that the clinic will be receiving patients from the community from next week.  We are trusting that the inflow of patients will be manageable !      Other good news is that we have identified a great fridge for the clinic and will be ordering this .  Time is travelling fast here and each day brings new surprises and challenges  .  More updates tomorrow !

surgical treatment underway

Meeting the top brass



Peter (CO), Andrew and Benson (RN)

 I am enjoying working with my african colleagues. We are seeing some patients together and getting familiar with computer records.
This morning at 9am Peter and I walked to the district health officer and met with the director , Dr Alex Olwedo ,to discuss the assistance we may receive from Government sources. He was very freindly and helpful , promising to forward our documents of registration to Kampala and indicating that next financial year we will be eligible for Government grants.  We are also able to freely obtain all vaccinations from the Health Department and administer these at the clinic.  We are awaiting the purchase of a suitable fridge. We had decided on one in Kampala but had to cancel at the last minute as it became evident that frequent power failures would be a major risk to our vaccines. So, we are searching for the right dual electric and gas powered fridge. Thankfully a donor in Australia has forwarded funds to pay for this for which we are very thankful. Having the fridge will allow the clinic to do effective preventive health care and potentially save many children from sickness and death as a result of preventable diseases like measles, polio, whooping cough and meningitis.



meeting the local brass

 Today we had an inservice training for the medical team and Benson, one of our comprehensive nurses did a very informative talk on vaccinations and maintaining the cold chain.

I am having some concerns about one member of the health team here and will be needing some discernment regarding his future.

Tomorrow night Peter and I will be on FM radio to do health promotion. We may also take the opportunity to explain about the new health facilities at IGF and invite more access by the wider community.  Tomorrow I will be joined by Dr Laurel Coleman  from the US and it will be good to work with her and explore ways that we can co operate in supervision and teaching of the health services here.  I must admit at times I am feeling somewhat stressed and overwhelmed by the troubles and problems that people share with me here. There are sometimes expectations that i can help but I just have to accept i have limited resources.  Also plans dont always go smoothly and obstacles crop up. There is a saying here when things go all topsy turvy and awry, and the best laid plans get stuffed up !!.. "TIA": This is africa !

The right place at the right time

Its 6pm and the end of the day. Ive just had a wash and cold shower (not enough sun to heat up my black camping shower today)
Am feeling that i has been so right for me to return here at this time.
The project is at a critical phase and needs  to be pushed forward.
We had a medical meeting today with the administration. It was a long discussion and stressful but some good outcomes i believe.
As well as improving the pharmacy and dispensary set up , we are now planning to promote the clinic to the community . The radio broadcasts on Mighty Fire FM will  be one avenue for this. A new regular health promotion program on the radio is to be named "Mighty Doctor " !  We will be kick starting it this week.
Tomorrow, Peter and I will be meeting with the Government District Health Officer to talk about our involvement in Govt and WHO programs for vaccination and delivery of essential medicines. We are praying that some assistance will be available to us to provide better health services at an affordable cost to the communiity.  It is evident that the power supply here is not so great so we have decided to purchase a two way fridge with LPG gas back up to maintain the vaccinations in the event of inevitable power outages. This is likley to be delivered tomorrow from Kampala. We will be doing some teaching on vvaccinations and cold chains tomorrow to the team . The fridge will also allow us to store test kits for typhoid and brucellosis and other conditions here as well as possibly rabies treatment. There have been a considerable number of rabies cases in the rural communiities around here. One child died a few days ago and unfortunately there is no supply of antidote in Uganda.
My presence here is a major catalyst to change and progress.  Unfortunately many of the projects we left partly completed have not been finished off and need a muzungu (white person) of influence to railroad through. One example is the incinerator which 3mths later has not had the metal pipe and cap placed on the top so has not yet been operational ! So frustrating, but evidence of one of the main reasons I am here.
There are other examples which today with a few visits to the builders I have been able to get action on.
I am really enjoying working with the cliinical officer and have an increased confidence in him.
I am just being called to go too Pastor Alfreds for dinner so will finish this later.  More updates tomorrow . Please remember our meeting with the DHO tomorrow!

Re entry phenomena

Sorry, no photos..Ive been too "busy"
Adjusting  !
Coming back into the african setting is challenging me today. I must be getting soft as i have found the rough road trip up to kitgum and the basic amenities and limited food choices here are hard going .  Also  dealing with a very different culture and less rigorous and productive work pace and expectations takes a while to come to terms with......nevertheless, some good things have happened.....
I have spent the day shadowing Peter,  the clinical officer in charge here and am feeling encouraged by his skills and competency and character. The patients here have very complex problems and it is very time consuming extracting all the information especially with the language barrier. Its also very hard not having access to specialist care. Today we saw a young man who had a seizure while working , fell and sustained a very nasty fracture of his shoulder. The head of the humerus was totally snapped off and displaced. In Australia he would have been sent for emergency surgery to restore the normal anatomy and pin the fracture together. Here it is not an option. He will most likely have a very stiff and poorly functioning right arm as a result of this. Another patient has a painful abdomen and on examination an enlarged and tender liver. We cant do ultrasound or liver function tests so diagnosing the cause of this will be a challenge. Back in Brisbane I would send him up the road for these and have answers in a matter of hours.
Its good to see the new computer system operational and to log myself on and start entering patient details.
We are looking to centralise our pharmacy in the OPD and dispense from there.  Currently, a nurse called Alice is in charge of the store and we want to upskill her to be a competent pharmacist  !   Amazingly, there is a lady staying here, Janet Riessen who has worked in this role and has agreed to spend time with Alice over the next few days.  This week we are expecting delivery of the new vaccine fridge and also a months supply of medications which we ordered today.
Overall there are some encouraging things happening.... and some hard work ahead ! Thanks for thinking of us..and praying ! I think it is only God who can bring about significant and sustainable changes in this place !
Its definitely  a  task beyond the abilities of us mere mortals .
PS my mobile is not working so i have now a local SIM card: my number is +256792511418

On the ground in Kampala

All good here. thankful for a sommoth trip over with emirates. the 24hr transit seemed to go relatively quickly with some valuable sleep on route. Met with Liam Chapman in Entebbe, a GP from UK who is involved in training village hhealth workers in Gulu, Northern Uganda. This is inn co operation wiith local churches. We enjoyed sharing and learning from each other.  Just preparing myself for the 8 hr bus trip to Kitgum.  Have a bag of bananas, muesli  bars and water. Looking forward to meeting again with my friends in Kitgum at CKS. Ready to start some hhard work with the medical team tomorrow!

Doc Andrew and Doc Laurel meet up in Kitgum October 2011

ON Friday 30th September Andrew will be leaving Brisbane to return to Kitgum and work with the medical team at Childcare.
The new clinic, Lubanga Cango Clinic (LCC) means "God Heals Clinic" is established and functioning well.
In August , 200 outpatients were seen by the team.
Most of these patients were either schoolchildren from the primary school or the families or staff members working on site at Childcare Kitgum.  We are now working toward opening up the facilities for the local community to access.
Andrew has been connecting weekly with the LCC team by Skype and this has been great. Lots of emails have also been passing back and forward. Modern technology is a great blessing in many ways!
The medical team at the primary  health clinic is headed up by Peter Omara, a Ugandan trained clinical officer. He has been working along side Vincent , a medical student on leave from studies, who has now returned to start his second year of Medicine. Comprehensive Nurses, Benson and Fransisco are assisting and Joel is the laboratory technician , performing tests to allow more accurate diagnosis.
The medical practice has had a small computer network set up to assist with record keeping, research and quality control. A software program used by GPs in Australia has been donated and successfully installed.
A donor in Brisbane has donated $1500 for  the purchase of a vaccination fridge which is very exciting.
Andrew will be on site for 2 weeks, working alongside the team and seeking to encourage them and help them as they further establish the practice.  Dr Laurel Coleman will also be joining us from the USA.
Please pray for our time to be fruitful and effective and for us to know where to give most attention.
Also for safe travelling. It is about 20 hours in the air from Brisbane, and then a rather gruelling 8 hour bus trip from Kampala to Kitgum ahead.  I will be posting blogs along the way !

Homeward Bound!

Tonight I am enjoying a nice hot shower and a quiet room in a Kampala hotel before flying back to Oz tomorrow. It is a time to reflect on all that has happened in the past 5 weeks. Working with Andrew and Rowena as a team in Kitgum has been an amazing experience as we have seen Gods favour on so many areas of work . It has definitely been a situation of God going before us and so great to be partners in His work of responding to the needs of the people of Kitgum, Uganda.  Awesome also to work with Irene Gleeson and John Paul and all the other 400 Ugandans employed by IGF (childcare) in their health and education projects.  I spent some time with Irene and JP tonight at a cafe here in Kampala and it was emotional saying goodbye to them and also Vincent, one of the sponsored medical students who has been shadowing me for the past few weeks.

 We spent quite a bit of time today getting computer hardware to set up a small network in the new clinic so that we can install the consulting software, Best Practice, donated to us by the Australian company. I believe this will do a lot to improve clinical practice, record keeping and data collection, as well as facilitating research in the clinic. It will be a first for Uganda !

We scoured the streets of Kampala, through dust and choking fumes to seek out computer bargains!.  Also had some thrilling boda rides through the traffic mayhem !


How did we get here ?

After a rather gruelling 7 hour bus trip from Kitgum on Thursday ..............................



Fortunately with seats behind the driver and chickens shoved into the luggage hold and not next to us...............our sticky crusted bodies  finally  clambered off the bus onto the kampala bus park and leonard our taxi driver  rescued us and drove us to Rubaga to the Verona Hotel.....
In Kampala...

Amazing homeland superbus which leaps over giant potholes in a single bound!

we hit the road early friday morning, praying hard that by some miracle we would be able to submit our inspection documents to the Health Department and collect a signed certificate to say we had achieved registration as a Private Non for Profit Health Centre.  I was even hoping this could be done in one day ?? Ha ! (TIA:this is africa!)
Initially the man in the office said it might take 2 weeks., then he said the lady who had to sign it wasnt coming back till Monday... 5 minutes later she walked into the office, smiled, took our forms and told us to come back at 1pm at which time she duly handed over the certificate . Gob smacked again we are !

Amazingly productive visit to bureaucracy!

On Friday morning we were also able to place an order with a local Laboratory Supplier to provide the clinic with a Microscope and testing equipment which will make it possible to diagnose Malaria, TB, urine and faeces infections , anaemia and rapid tests for syphilis and rotavirus (common cause of diarrhoea in children). The CEO of the company is from northern uganda and keen to help us, giving us a discount and some free test kits. He travels to Kitgum regularly and can provide assistance and services for the laboratory equipment. Joel , our Lab Tech was very excited !

Almo Diagnostics welcome us

We  headed back to our hotel at Rubaga, a suburb of Kampala where I tried to look presentable with my limited wardrobe so that I  could attend the wedding of George ( a local gospel artist) and Brenda at the Miracle Church, followed by a massive reception at a very upmarket resort on the shores of Lake Victoria. It was quite an amazing night, although we were all starving hungry by the time the first course of food was served at 10pm! The Africans looked truly decked out in their colourful outfits and suits. I felt a bit like the pawper off the streets !

George and Brenda at the altar

Benjamin (alfreds son) and JP daughter  Ella

Christian, JPs son in Coat Tails !

SO,  all in all it has been an amazing ride over the past 4 weeks in Kitgum. Much of the time, Andrew and Rowena and I have worked as a closely knit team and we have seen so much come to life ! The whole experience has been an incredible blessing and so faith building !,

During this time a Primary Health Clinic has been fully fitted out with internal walls,benches, painting, and electricity and furniture, all now ready to be used as a primary health clinic serving the community. ( definitely not possible without engineer andrew on the job !)Other health facilities have been upgrading and Government approval given for registration, opening up more funding opportunities. The medical team on site has been strengthened and encouraged (thanks Rowie for your amazing part iin that !) and a Clinical Officer and Laboratory Technician have been employed. A computer network and software system is about to be set up. LAboratory equipment has been purchased which will allow more acccurate diagnosis of conditions on site and more targeted treatment.  I am committted to ongoing team building and supervision (in a new and exciting role as Director of Medical Services at IGF)   and I know Andrew and Rowena will have a continuing connection with the work in Kitgum. Thanks so much to all for your words of support and your prayers over all this time It has made all the difference on the ground!.

Keep posted to this blog for further developments and please consider helping us financially with ongoing needs in the medical centre.  Pray for a safe trip home for me please, and not too much work waiting to sort out in  the office !   More information to follow!

Final Inservice meeting on Values of the Health service

Benson, RN  at Triage/Registration desk

 

Peter, Clinical Officer in Consulting Room 2

Benson and Peter in Dispensary/Pharmacy

Waiting roon in Clinic

Disengaging

The process of leaving started today . It all started with me waving Irene off at 7am as she was driven up to the bus to go to Kampala. She threatened to not return and leave me here for 20 years as her replacement but I dont think that will happen. Still, strange for me to be sending her off. The rest of the leadership team gradually left as the day went on and i had to pack my things as the guesthouse was being closed up while wedding fever sets into Kampala and the Kitgumites go en masse south !
I could have moved into the mens dorm but decided instead to try a night at Fuglys, one of the local hangouts for muzungus (white people) from NGOs.  Thought it would be good to check it out and do some fact finding for future trips as a possible accomodation venue---also was simply craving a touch of western comfort as the roughing it seems to be wearing a bit thin after four weeks !
I was able to spend a productive day tidying up loose ends and having a get together with the medical staff explaining the future to them and talking about values for our team . Our clinical officer and other helpers saw a few patients in the OPD while I seemed to be preoccupied with admin!
The topic of values in the medical team meeting brought some good feedback and they basically came up with the key values i had thought we could adopt. These included,  excellence, compassion/love, truth/trust,  respect, and confidentiality.
Employment contracts were also distributed . We said our goodbyes . There was some sadness leaving one of our nurses who at the age of 27 has just been diagnosed with Breast Cancer. She is 34 weeks pregnant and will need to go to Gulu to have the baby delivered early, followed by a mastectomy and then go to Kampala for chemotherapy. She already has a three year old child and it all seems so overwhelming. Just another example of the struggles of living which these people face so often. Its very confronting.
Therefore;...Beware anyone in Australia during my re- entry period  who complains to me about their tough life !
 "anyway" after all todays experiences and challenges, here i am at fuglys, just about to go to bed, having had a beautiful barbecued steak with roast potatoes and vegies and now enjoying a nice quiet room with running water....heaven !
Tomorrow an early start to get the big blue bus to kampala-- promises to be an adventure as Vincent, Joel and I make our way to the big city. No doubt i am going to miss the relationships here, but now focusing on getting home to be with my family! Missing you guys !

Crashing over the line

I feel like I am crashing in terms of energy and verve but also feel like we are at the finish line.
The last couple of days have been very "busy" (andrew and rowena will appreciate  the african meaning there!) .
Since John Paul, the principle administrator returned on the weekend we sat down together with Irene and talked about our mutual visions for the medical work here and it has been so wonderful to see a sense of unity amongst us and shared ideas on how we could best work together in the future.
It has been agreed that I should be the director of medical services at IGF/Childcare and oversee the development of the ministry here, starting with the opening of the Primary Health Clinic here which after consultation with the team we have decided to call:
Lubanga Changa Clinic   ( Acholi for : "God Heals" Clinic)

I think this is very fitting as it points to God as the ultimate healer and us as health professionals as his instruments, with the gift of scientific knowledge he has given us. It also allows room for the power of prayer and healing in dealing with sickness and recognises  that disease has physical, mental and spiritual roots which need to be dealt with in a wholistic setting. A christian medical practice is the ideal place to do this.
So, the outcome of all this is a sense that I am committed to further involvement here and probably it will mean regular contact with the team via skype and reasonably frequent visits on site . Im excited about this because I feel passionate about this and it has really been a long term dream and vision that I believe God planted in me to invest myself into a setting like this where the needs are so great . So I thank God for this opportunity.  I know there will be challenges but I am sure it is the right direction to be moving in, particularly after all that has happened in the past 4 weeks.
So, the last couple of days, I have been very driven... trying to put things in place before I depart on Thursday morning.  Our two new recruits, Peter, the Clinical officer and Joel the lab technician have been coming for orientation and we have been hounding the building teams to finish off all they can.
Today we officially opened the doors to patients ( mainly staff and students ) and saw 6.
The consulting rooms are functioning well and we have a system of booking in which will hopefully work well. Please pray that our clinicians will practice good medicine and show lots of compassion.  I spent some time today letting the clinical officer play with the medical software program we hope to run and he seems to be catching on.

Male dominated medical team leaders with JP

Last night we had an official medical night out, at the local hotel where we were served a tiny serve of stringy chewy chicken that must have fallen off the back of a truck, run over by passing cars and kicked around the street by local youths before finding its way into some pot of boiling oil. Anyway the company was good and it was a great opportunity for Irene and JP to meet the new recruits.
Tomorrow we have a medical team meetiing and I hope to leave them all with some inspiring and encouraging words !!  In Kampala we will be running around trying to get lab equipment-- an expensive exercise... and... going to the medical council to have our registration processed (please pray this is fast tracked !)....and then going to the wedding of Pop idol george on friday--  probably an all night affair!.
saturday--- spending time with Richard and Vincent
sunday-- church in the morning and flight home in afternoon
I am hanging out for one of my wifes beautiful roasts--- i am over rice and beans and chapati !!!

Andrew with Peter our Clinical Officer

Irene looks like she is skulling a beer with the boys but its really non alcoholic malt "alvesco"

Inspirational Sunday

As is usual, attending Community Church at Kitgum has a profound effect on me. It is an inspirational experience as the african congregation move from exuberant celebration to tingling praise and worship, which when you close your eyes tends to transport you to heaven and give you a foretaste of what it might be like in eternity in Gods presence. I am sure the African christians will be in charge of praise and worship in Gods future Kingdom , leading us rather constrained and rigid Westerners! The service is also full of surprises. Today, for instance after some solemn reflection on the passion and suffering of Christ  we moved into a celebration of the work of the cross and the freedom and forgiveness of the new covenant. The casio keyboard player then suddenly broke into
  "Oh susanna " !   A song i had never heard in church before but definitely upbeat and joyful !
Later in the service I had an opportunity to share as it was my last time in Church here for a while.
I felt prompted to share the story of my father's orphan beginnings and how despite this, he had made a decision to follow Christ as a teenager and how that had been lifechanging for him and also had produced an amazing heritage and had resulted in me being in Kitgum. I think people really appreciated me sharing a real story which was part of my life.  Even Irene was surprised and somewhat intrigued to learn that I had a wayward  American soldier in my past, much like her. According to her this is where we get our entrepeneurial spirit ! Just before I shared,  John Paul had read out a passage from Psalm 112: 1-3 which fitted in perfectly:
"Blessed is the man who fears the Lord,
who finds great delight in his commands.
His children will be mighty in the land:
the generation of the upright will be blessed"
My own father's story was an example of how following Gods ways  , being faithful and pursuing His kingdom can bring blessing to the generations following. I thank God that my dad made that decision 80 years ago because it has meant I can  be a part of what God is doing here in Kitgum .
After Church a group  of us went to the local fast food outlet called "Acholi Pride" where a smorgasbord of local food is available in hot trays! eg Goats meat, Beef hoofs (tender tendons), maize porridge , rice etc 

Enjoying fast food sunday lunch at "Acholi Pride"

Irene just loves shopping for clothes and shoes...NOT!

Then Irene went shopping for second hand shoes to wear at the big upcoming celebrity wedding of  Uganda Pop Idol George in Kampala this Friday. She really knows how to "live simply tthat others may simply live "

Vincent and I then met up with Kenneth and his fiance , Harriet for a soda......

Andrew with Kenneth and Harriet

Vincent and sister Nightie

and then took a boda (motorcycle) to visit Vincent's sister  , Nighty,  in the village where she lives with her five children. She basically raised Vincent after his parents and some of his siblings were murdered by the LRA.

Now as I write this, Vincent is strumming on a guitar in my room here and its gettting dark outside, the mozzies have come out and we are listening to the children in the dorm opposite  get their meal and wash.  Tonight we have bananas and pineapple for tea

We are preparing for a busy three days before i leave for Kampala on Thursday AM
Our medical team will be together for the first time tomorrow morning. After interviewing Peter on Saturday we decided he was the man  to take on the role of Clinical Officer here and we have also employed Joel, a Lab assistant who will travel to Kampala with us and help us purchase the necessary reagants and tests we need to set up a basic Laboratory.  I have given Irene and JP (Administrator) a written document with my vision for the health services here and they are digesting that, so please pray we have a unity of purpose and direction . Tomorrow night the key leaders of the health team will be going out for a meal with JP and Irene .
During the day tomorrow we also expect to try and get close  to completing the fit out of the OPD building. Thanks for your continuing support and prayer. It has been a great time here !