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 !