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