Hey Everyone this is Bena!

YAYYYYYYYYYYY!!!!! Africa!

Yep! I saw an african elephant in the wild! Definately in my top 3.

Sorry it's been so long for me to get on this blog. It's been pretty non-stop here. I've been loving it here in the motherland. I've known this is my home since I first felt the soil, or when I played “Circle of Life” on my phone as we drove through the Murchison's fall game park, looking at giraffes, and elephants. Such an unforgettable experience!

There's an amazing homely feeling about this place. The people greet you on the street, even when you have never met them before. You have to come!

The other day I fulfilled a lifelong dream- to be the only white person in a church. It was amazing! So happy. One of the proudest sayings i've conquered in the local language is “comma moonoo, chwinya ochol” (I have no idea if that's how you spell it) which means “my skin is white, but in my heart, i'm a black man” the locals laugh at me, but I know they know it's true.

We've got 10 days til we drive back to the airport and commence our return journey, but i've been so impacted by what I've already seen. Particularly things that have impacted me are the land, the people and the culture, along with the economic, political, personal and health struggles the Ugandan people are facing.

The land is so fertile, bright red soil bursting in green crops. Even flying in the plane, I was amazed at the density of forests and green plains that cover the continent. It's sad that the land cannot be used to its full capacity. When you drive through Australian outback, you see acres upon acres of a crop being produced on a mass scale to be transported, and used nationally, or internationally- which is a great economy booster. When you drive through Africa, all you see either jungle, or small plots of family land usually growing a range of crops which sustains that small house hold with mostly everything it needs. People don't really look out to the national benefit, they are so much into micro-communities that large scale money-producing production lines are nearly non existent in this nation.

The culture is a resilient, yet short-sighted culture. You can't talk to a Ugandan and not be blown away by their story: the low living standards, along with their contrasting resilient and joyful spirit. It has blown me away that they have nothing yet their posture towards life and God is one of thankfulness, and joy. We have more than enough, yet our posture towards life and God can often be one of regret, anxiety, or anger. They have such a beautiful communal culture, people are always willing to walk you to wherever you're going, or stop to say hi. However this nation needs a cultural revolution that looks above the immediate environment and instils values of productivity, and growth.

A core issue in the poor economic state of this nation is its political state. I hear stories of millions of dollars being poured into military supplies, or into the luxurious lives of a few political leaders that have control of the nations funds. The government here is incompetent, greedy, corrupt, manipulative, and rich. And frankly they're responsible for countless deaths in this nation to malnutrition and preventable diseases. It's so discouraging when you try to help people out here with their financial problems, $10 at a time, and see the distance that that money can travel over here, then to find out the millions of dollars of government money that is being used in such a greedy way. I just wish we could get the Australian government to run this place!

One of many 'unfinished projects' you see around. Stationary, because of lack of funds.

This trip has been a major experience in terms of medical education. Everyday here, I'm exposed to a child who's sicker than any child I've seen in my 2 yrs of medical exposure in Australia. The health professionals here laughed when I told them in 2yrs in a 500 bed hospital in Brisbane, i'd never seen a case of malaria, or measles, or childhood AIDS. In Uganda, It's just an every day occurrence to see a child in hospital having seizures from meningitis, or malaria, or seeing a 3yr old who doesn't know how to crawl because of a continuous onslaught of serious illness, and malnutrition since birth. In the 11 days of clinical experience here, I've seen a child die of malnutrition, many children with HIV and TB. I've assisted in 3 Caesarian sections, 3 laparotomies, an amputation, 3 or so hernia repairs, a circumcision, and 2 keloid scar removals. I've seen countless cases of malaria, meningitis, pneumonia, sepsis, horrific burns and a lot more. The other day I was elbow deep in a man's abdomen looking for the cause of his intestinal obstruction- amazed at the experience this was, and I thought to myself- “i should do a whole year of this”. That's a dream, that maybe is not feasible right now, but God is definitely placing Africa and medicine more and more in my heart.

I had the pleasure of assisting my good friend Charles Abonga in a Laparotomy on Tuesday.

Along with a lot of other things, the state of the medical system in this country is shocking. St Joseph's is a 300 bed hospital, and they don't have a single ECG (a heart monitor) in the whole hospital, which essentially means they can't diagnose a heart attack. And in the 30million population of uganda, they have one CT scanner, and one MRI machine in the whole country. And they only work when the power's on! The doctors get paid between AUD$5,000 and AU$8,000 a year nurses even less. So as you can imagine, the staff are not motivated, and the health system is being stretched in all directions. The hospital costs $90,000 to run per month including wages (rediculously cheap- considering I've sat through a single 2hr operation that costs $20,000 in Australia). All of the funds come from international support, because the government is impotent, and is robbing this people of their right to health. It's so frustrating. If you're looking for a place of need to give to, give to African hospitals! (ask me how)

An example from today in the surgical ward- right now there is a 40yr old man in a coma after an injury 2 weeks ago, and the closest CT scanner is 8 hrs drive away, and costs an average Ugandan monthly wage. So there's nothing they can do unless they want to drill random holes in his skull hoping to relieve the pressure on his brain. So they're just waiting for him to either recover or die in his own strength. The majority of drugs we have the luxury of using in Australia are not available here in Uganda, the diagnostic, and treatment tools are also not available. They don't even have ventolin puffers here! It's just a never ending up-hill battle of trying to meet an overwhelming need with a insufficient human, financial, and medical resource. So suffering is just a way of life here. It's pretty hard to see, but seeing is better than ignorance.

A group of cuties walking probably 1 or 2km's back home with these 15kg water containers on their
head. I picked one up, they're heavy! they'd do this a couple times a day.

After all that, I want to say thank you!
We so appreciate the prayers coming from Australia, and all around the world more than you can know- It makes such a difference knowing we have spiritual support in our time over here. There is definitely an obvious spiritual component to what we're doing. And the spiritual warfare is very real here. So thank you so much. Please continue praying for physical, mental, emotional, and spiritual strength for the whole team, as well as unity and success in our endeavours. Prayer makes the world go round! So thank you!

For me, I'm learning a lot. Being here is revealing more of what it is to be human, and what it is to be a christian. It's also revealing more of God's heart to me. To see that people here are thankful even though they are struggling. It's a big lesson to learn- that absence of 'stuff' is not absence of God's love, provision, or goodness. His love, provision and goodness is not measured in my state of wealth, it's in his character, and who He is, and who He's proven himself to be throughout the centuries. It poses the question, what am I thanking God for, and what would I thank Him for if all my material possessions and comforts were pulled away. It makes me see more into what Paul said to the Philippians: “ I've learned by now to be quite content whatever my circumstances. I'm just as happy with little as with much, with much as with little. I've found the recipe for being happy whether full or hungry, hands full or hands empty. Whatever I have, wherever I am, I can make it through anything in the one who makes me who I am.”

It has been an amazing 2½ weeks here in Kitgum, and I'm really looking forward to the next 1½ weeks!

Thanks again for your support and prayer!

Bena

Just photos!

Hard work at the moment. Please pray for us. One big need is for the power to come on and stay on  !

Dr Kenneth Kaunda was assisted with his medical studies by Yotkom medical scholarship fund and is just completing his first year of residency in Northern Uganda

dinner is served for vulnerable children cared for by Lois Ford. tender trust home

this young lady, Prisca is seeking assistance to continue her studies as a Laboratory assistant

this little boy with Tuberculosis has been having painful treatment with needles in his chest but still came up and held my hand as i sat on the childrens ward steps this week. Soulful expression!

Ben was bitterly let down when he thought his order for ice cream was going to be delivered. Instead he got an ash tray ! problems with translation i think and wishful thinking seeing there is no power for 10 days !!!

Dr Vincent and I have asked a retired government vaccination specialist to set up a child vaccination program at Bregma Clinic

Exploring Rural Uganda

Ben and I were both feeling the need for a break from our routine today and St Josephs Hospital kindly allowed us to pay for fuel and take one of their vehicles and a driver whose name was Augustine to drive out to Lamor district to the township of Padibe and surrounds .  Interestingly, Augustine is also the only person at St Josephs who has been trained to maintain and repair all the medical equipment so it was intersting to talk to him.
The scenery is great with high hills rising out of the green plains and very few cars on the dirt road , only children carrying jerry cans, people picking cassava, water being pumped at bores, pigs being led along the road or shepherds herding their cattle.  We had a lot of laughs together, constructing all sorts of bizarre phrases in the acholi language and in the process learning a lot of new words. Ben is certainly providing the locals with a lot of laughter !

This trip was an opportunity to learn about the health needs and challenges being faced by  the rural communites outside Kitgum town. Besides Dr Charles, we also had with us Dennis Nyeko who grew up in the community and was able to introduce us to some of his family. We stopped and shared a soda with them under the mango tree.

our friend Dennis with his uncle , a retired school principal who lives in Padibe

At a small rural health centre we met Beatrice, a clinical officer who is permanently posted to the facility and is responsible for the outpatients clinic as well as a birthing unit, vaccination centre, adult inpatient facilities and childrens ward. She and the nurses she supervises are obviously struggling and now face the added challenge of impending removal of financial supports they previously had relied on for survivial.We seriously need to look at ways that the Yotkom health project can contribute to the needs of these outlying facilities and help them continue to provide much needed medical help to the rural community of Padibe.

the outpatients building of the padibe clinic

the clinical officer Beatrice outside the small laboratory

Storms and Blackouts !

Ward rounds at Bregma Clinic with COs Peter and Richard

I am sitting in the boardroom of St Josephs Hospital, waiting for the very loud thunder lightning and rain to clear so i can walk through the hospital grounds to our guest house accommodation. The bells from the nearby catholic church are ringing out a call to prayer and Mass. Children are singing out excitedly after each thunder clap . I have plugged my computer in to the only source of power available so as to get a recharge. The town of Kitgum has basically been without electricity for the past week. Productivity is massively reduced as businesses and local industries all rely on power to function. At the Bregma clinic the back up generator is broken and Dr vincent has brought a small home generator to work so we can perhaps operate one computer or recharge our phones. The ultrasound machine also seems to manage with a small power input but it is not possible to do X rays and the laboratory cannot adequately function.  This just adds another layer to the challenges people face here in doing their work. This afternoon it took me about 2 hours to get some US dollars changed into Ugandan Shillings--- trying to keep calm ! I have to let go of my Western mentality and the need to reach targets as efficiently as possible. Keep telling myself , "TIA" (this is Africa), settle back and enjoy the slower pace !
I am part way through setting up the practice computer network and have run a couple of teaching sessions for Dr Vincent and Richard, the clinical officer on how to record patient information on the Best Practice Software program.
I have spent some time with DR Vincent fleshing out the future structures of Yotkom and Bregma Clinic and our relationship as we move forward, seeking to facilitate the good work they are already doing by providing funds for equipment and wages and training . Partnering to improve primary health care in Northern Uganda.   Growing relationships, resources and self reliance. This is our focus. We will have another team meeting of the Yotkom project on saturday night and focus on the core values we wish to be our distinctive.

Ben and Dr Charles attend to a child with Malaria

Clinical medicine has continued at Bregma and within St Josephs. We managed a young man with typhoid fever today. he looked quite unwell with a fever of 40 degrees and was shivering, sitting in a chair with his head resting on the doctors desk. He has been admitted to Bregma clinic overnight.
Last night, Ben was called out to a Caesarian section in the early hours  of the morning and was involved in resuscitating a newborn baby.

DR Vincent and Peter incise a large abscess using Ketamine and Valium to sedate the patient at Bregma

We were able to go out with Lois Ford, director of Tender Trust Orphanage and celebrate my birthday last night with a nice meal of roast lamb followed by a birthday cake, sitting on the verandah, listening to the frogs. There is a lot of water about as it rains most days. Puddles and mud on the dirt roads. many pedestrians and bicycle riders get mud splattered on their nice clothes as the motorbikes or cars go by !
Unfortunately we had to say goodbye to jade this week, sending her off on the 8 hour  bus trip to Kampala. We miss her!

jade was reassured to know the bus driver was  focussed!!

Securing our Land for Primary Health Care Clinic

Back corner of our land looking down side boundary to front boundary tree by the road
the land extends to right of the picture

Part of the vision of our project, Yotkom Uganda is to assist local primary health care centre sustainability and increase capacity of these clinics to provide services to the people here who are in need. In line with this we are aiming to assist the local Bregma clinic , headed by Dr Vincent, to find a permanent home  Currently the clinic is significantly burdened with large rental costs. In 2003, when Andrew was working at St Josephs he had a vision to build a primary health clinic at the base of a rocky hill near the centre of town. This would provide a future home for the health professionals sponsored from the community to come back and work in . Up till now this land has been occupied by the family of John achola, a man significantly maimed by the rebels of the LRA.  Now we are looking to raise funds to build a clinic on the site to house the team currently working at Bregma clinic, one of whom is our sponsored clinical officer, richard yulam.It was exciting today to see the survey team mapping out the boundaries of the land . This is the first step in our Ugandan project, Yotkom, obtaining land title and being able to proceed with a building. Several lays of local bureaucracy have been encountered this week as we made our way through a 10 step check list leading to land title. we are half way down the list.!

Our local councillor was very supportive of the proposed clinic

Remarkably today, the man who sold Andrew the land, David Livingstone suddenly and unexpectedly  appeared next door and was able to assist the surveyors locate the correct boundaries and also act as a support to us. We have assisting us an architect/building project manager, Andrew who will help design the building on site. He has some great ideas. The photo below shows him at the front of the block with John Achola who currently lives in the hut on the land. The land seen in the background of the  picture is all our plot.(approx 2000m2)

The last few days we have also been setting up the medical soft ware program Best Practice in the bregma clinic. This was donated by the Software company in Australia and will be a great assistance to the medical professionals in the clinic, as well as allowing data recall and research in the future.

Last night YOTKOM UGANDA had its first ever general meeting where the management team got together to focus on our vision and values. It was so encouraging to listen to the feedback and ideas of the amazing team of Ugandans we have here and the sense of unity and purpose we have is very evident. We are all seeing so many opportunities and potentials in the future and very real benefits to the health care of the community as a result of our partnering together .

St Josephs Hospital Childrens Ward

Much of our daily life this week has been centred around the childrens ward working alongside Dr Charles and the other medical and nursing staff. We have many with malaria and its accompanying complications. Seizures can be a feature of Cerebral malaria and because the possibility of meningitis needs to be ruled out, these children need lumbar punctures to get samples of spinal fluid for analysis. Yesterday, Ben did his first LP on one of our children and fortunately it was normal and she is now improving on treatment.  We also had a child admitted today with severe malnutrition and have been able to learn from the medicos here some of the latest treatments being used to help these little ones recover and regain weight. Some children here contract HIV/AIDs virus from their infected mothers and as a result are susceptible to Tuberculosis and failure to thrive.
The team who work here permanently  are making  a huge difference to this community and work  under very difficult circumstances . Every morning we all meet for a time of talking about current new admissions and also local health challenges. Today we were told about the community outreach program for education on nutrition. Groups of mothers are helped to choose local food mixes which provide the best balance of nutrients. New crops like oranges and paw paws are planted to give a source of vitamin C. Yesterday Dr Lawrence also told us about some ways to improve vaccination coverage of the population. They have been working with local churches and came up with the idea of sending a health team to church and lining up all the children as they come out to give them vaccinations. I wonder how that would be received at our churches in australia ?

Childrens ward

We have POWER !

Our team has settled in to work here in Kitgum. We are staying in a small guest house on the hospital compound at St Josephs Hospital Kitgum. Everyone here is very welcoming and we have all we need. Our days start at 7 am with breakfast and we share a devotional from John Pipers book, "A Godward life ". This has been a great start for us. Ward rounds start at 8am. We are spending our time working with Dr Charles and his clinical officer and nurse assistants on the childrens ward. It takes us all morning to move around together assessing the 80 patients currently in the ward with conditions like malaria, HIV Aids, TB, Gastroenteritis and Pneumonia.  WE are all doing our best to also learn some Acholi language-- greetings and history taking sentences, much to the amusement of our listeners.
The health system here is in major trouble with cost cuts, poor morale and corruption making it very hard for the health professionals working at the coal face. Every day is a struggle for them.
In the afternoons we have been going to Bregma Primary health care clinic and working alongside dr Vincent and his team. Also we have had some time to visit another project here called  tendertrust run by Lois Ford from NZ who cares for about 100 orphans, many of who have major disabilities.  Its very impacting. Also our visits to the homes of some of our health workers has been a major highlight. More information to follow. Bedtime approaches and i need to get under my mosquito net away from these little malaria bearing mosquitos buzzing about me. We were all very excited tonight when the power came on after several days of blackouts. We rushed aorund and plugged in all our appliances to get charged up! The water heated up and we had hot showers!

YOTKOM UGANDA DRUG SHOP HAS OPENED.
Justin administrator. Sheila Nurse with Andrew and Dr Vincent