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

TseTse Fly attack

The team have been risking life and limb travelling across Uganda to reach our destination in Kitgum. On one leg of our road trip, the driver calmy instructed us to wind up our windows. Soon after, these same windows and the windscreen  were covered with swarms of flies seeking to penetrate the glass and insert their probosci into our white flesh!. Its the first time i have ever come face to face with the Tse Tse fly , famed vector of the horrible African Sleeping sickness, carrier of the tryanosoma parasite capable of  inflicting much human suffering. Ben  was able toincrease the fear factor by opening his  i phone ap and read out all the gory clinical symptoms and signs of those unfortunate enough to receive bites from these little critters! He also managed to in a moment of madness wind down the window and lety a few of the critters into the cabin !

Despite this potential set back, we have managed to have some time to rest up following the long flight from Australia. We have been able to see some African animals in the wild and view the Nile river and Murchison Falls. Tomorrow we will spend the day driving on to Kitgum, where our work begins.

 

Yotkom Medical Team 2012

June 27th 2012  --------our small medical team will be leaving Brisbane

Dr Andrew Wright will be accompanied by Ben Warlow, a final year medical student who will be spending his elective involved in Tropical Health Care at St Josephs Hospital Kitgum and the Bregma Primary Health Care Clinic . For 4 weeks in July we will be assisting the medical teams who work full time  on the ground in Kitgum, Northern Uganda.
Jade Mansfield is a Nurse working currently at the Mater Hospital Brisbane. She has visited Africa in the past and would like to spend 2 weeks  in Kitgum learning more about the delivery of Primary health care in an African setting.
We have been meeting together as a team to prepare for our time away. We value the prayer support of our family and friends and home churches during our time away.

Andrew will be helping Ben and Jade to make the most of their time in Uganda, as well as building further the Yotkom partnership with health care professionals in Kitgum.

Yotkom Uganda is about:

PARTNERING  TO IMPROVE ACCESS AND EXCELLENCE IN PRIMARY HEALTH CARE

We are seeking to grow

RELATIONSHIPS

RESOURCES and

SELF RELIANCE

Here is an update on progress since last year:
We have registered as a company in Uganda and have a management board which includes Andrew,  Dr Oringa Vincent (from Bregma Clinic)and Dr Charles Abonga (from St Josephs Hospital ).


A detailed project application has been submitted to Healthserve Australia and approval has now been given for   tax deductibility for donations received in Australia.
Donations can be made to Healthserve  online at :  www.healthserve.org.au

or by mail to  PO BOX 3032.   Erina.   NSW . 2250
If donating please quote our project name: Yotkom Uganda


Medical equipment is being stored here in Brisbane to be included in a container being sent to Kitgum in the second half of 2012.

In the last few months we have been continuing our sponsorship of Richard Yulam as a clinical officer.  He will qualify in July this year

We have also been providing the salary of a clinical officer,  Peter Omara to allow him to provide support for Dr Vincent Oringa in the Bregma Clinic.

There is a search underway to locate and purchase land within Kitgum town boundary with the goal of designing and constructing a purpose built primary health centre . This land will ideally be located near to a future council land grant to allow for expansion. WE need to raise funds for this. The land will be approximately $20,000 AUS. By relocating the Bregma Clinic into a purpose built centre built and maintained by Yotkom Uganda ,the clinic will save over $1200 AUS per month in rent which can assist the ongoing sustainability of this enterprise.

A small business has been started storing and distributing medical drugs and equipment to the Kitgum district. An office/shop front has been rented and fitted out and an accountant/administrator and two nurses employed to work in the Yotkom Drug Shop/Pharmacy. We believe this will generate a small profit each month which can be re invested into the health care service and reduce reliance on donor funding for sustainability of our project.

Please remember us in JULY and check this site for our posts and photos .
with thanks
ANDREW  BEN and JADE