medicine

The Health Centre That Wasn’t To Be

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Phase 1 – Great hope In March, we rode out with our enthusiastic nurse Walter to the frontier town of Elegu on the South Sudanese border. High population, no health centre, traders with a bit of money. What location could be better? The location even came with our Bishop Johnson’ recommendation.

Phase 2 – Bewilderingly slow Things started surprisingly slowly. Only 60 patients came the first month. 97 the second. Walter was bored. The patients who came appreciated the service greatly, but we were bewildered by how few there were. After an amateur advertising campaign where we shouted through a megaphone, smeared A4 notices around town, and gained the trust of the local Maadi tribe, things started to pick up.

Phase 3 – Maybe yes? In July, the clinic broke even for the first time, with a bunch of sick patients coming for IV treatment, in addition to more minor conditions. 175 patients for the month. Walter called excitedly with the statistics, sharing that the word had spread, that people were appreciating him, the health centre, and the care – the only high quality care available in the area.

FLOODED OUT  – We’ll never know On Tuesday August 22, at around 4:00pm the banks of the Onyama River burst. The flooding was swift and violent. The scale is huge – as of now at least 3 people have been found dead, and over 2000 are displaced. Our nurse Walter ran 50 meters to the clinic from his hut in an attempt save the drugs, but only managed to gather half before the water reached waist deep. By the time he filled a bag with drugs, his own home was flooded. He lost all his rice and beans, but he and his wife made it safely up to the safety of the raised main road.

I thought he exaggerated when he said the water level reached over a meter, until I saw the water line on our drug cupboard today. Around 1.2 meters high. Today, a week later the water is still ankle deep, and Fiona from our Health office went to Elegu to retrieve the cupboard, desks and other equipment that were covered in mud. Amazingly the clinic hadn’t been looted. We spent this afternoon washing them up, so we can use them in another health centre soon. It hurts to lose Elegu clinic. something that could have done so much good. Time to mourn and move on.

There’s a great song, “Flood Waters” by Josh Garrells (do listen) which discusses a deep love which can’t be washed away. A love which can’t fail no matter what. Our love for this place, and Walter’s love for the people he treats won’t be washed away by this flood. We’ll all find new ways to put it into action.

Carnets of hope

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When patients arrive at the Hospital of Hope they buy a small booklet called a “carnet” where our prescribers write lab tests and order medicines for the patient to buy. Throughout each day these carnets end up in the pharmacy. Sometimes in neat little stacks as information is entered into the computer system and sometimes in rows across the bench, stuffed full with medicines that need to be checked before being handed out to the patients.

In the seven months since the Hospital of Hope opened its doors 10 000 of these carnets have been given out to patients. So you can imagine why one of the catch phrases we have in the pharmacy is “Sooooo many carnets!” Apparently it was something I inadvertently said one day, but the technicians now have great pride in informing me of this fact when I return from an errand around the hospital and see 20 carnets neatly lined up waiting for me to check. Somehow I have also ended up with the nickname of “Check Master”?!?

Unfortunately we’re not able to see all the patients that arrive at the hospital gate each day. One day last week we had 600 people more than we could treat. Non-urgent patients are given an appointment for up to two months later. Apparently word is getting out that we are the place to go if you are looking for doctors who accurately diagnose medical conditions and for high quality medicines at a reasonable price (yah for the Pharmacy!). Actually we’ve discovered that the pricing of our medicines may actually be a little too competitive as people are willing to travel past perfectly good medical centres in the capital cities of Togo, Ghana and Burkina Faso just to get a deal from our hospital. We even ran out of the 400 000 paracetamol tablets that we expected to last six months. Fortunately this is a medicine we can buy more of locally to last us until our next order from Holland arrives.

Kɔtɔkari cɛsse

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Here in Northern Togo not everyone speaks the national language French and the major local language of the village we live in is Anufɔ. So while I am continuing to have French lessons each week, I have also been having Anufɔ lessons and have found that there are a few phrases in the pharmacy that I get to use multiple times every day. While the phrase “Entana biɛsou” (“Please sit down”) is highly useful, the phrase I have become known for is “Kɔtɔkari cɛsse” (“Go and pay at the cashier”). While it can be at times frustrating to master the correct pronunciation of some of the words, seeing the patient’s faces light up when they realise that I am speaking their language always brings a smile to my face.

Now when I enter the market in the middle of Mango I am often greeted by cries of “Kɔtɔkari cɛsse” from the grinning faces of ladies who recognise me from the Pharmacy. So I guess that is my new nick name.

An Update from Nadia

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The last month has seen a lot of changes, a lot of challenges and a lot of achievements.

For the last two weeks I have been the only ‘Muzungu’ left at Potter’s Village as Sue and Mike have been home on leave and Rosie needed to head home to be with her family for a while. So how did that affect things? Well in some ways it didn’t… everyone has been as lovely to me as ever, though perhaps they check up on me a bit more to make sure I’m not too lonely! In the medical centre it has meant that we are a little tight on staff and I have been on-call the majority of the time which is draining, but it has been a quiet month which, perhaps, is for the best.

The medical centre still demands my creativity and I never stop learning new things. A recent bout of typhoid cases has taught me a lot about the management of the illness and an unusual case in the nursery had me researching for days!

In terms of my education projects, the staff from Kisoro hospital who have been selected to work in their new Special Care Nursery have begun to come over and spend some time with us and learn about how to care for neonates and run a nursery. It’s a little over-whelming trying to figure out where to start on teaching people when they need to know everything and there is so little time! I talked so much the first day my throat hurt! There is a long way to go with this but a start has been made and they seem very enthusiastic though which is encouraging.

Feeling a little over-tired I decided to get away for a weekend last week since I was rostered for a long-weekend off. I went and stayed at a lodge right on the edge of Bwindi Impenetrable forest. I admit, I spent most of the weekend just catching up on sleep, enjoying not having to cook and relaxing on my little veranda that was barely two metres from the edge of the forest, enjoying the view and reading books. I’m so thankful to have had the opportunity for this mini-break and also to see a little more of the exceptional beauty of nature here in Uganda.

Recently, with the medical centre staff, I have been going through neonatal scenarios looking at how to identify what is wrong with babies and how to decide on the appropriate treatment and management. It was, therefore, a big moment of pride across the board when, on getting back from my weekend away, the staff presented a complex case to me, which had come in over the weekend, and their management of the case which was spot on! I was so proud of them for their achievement and it was great to see their excitement and the growth in their confidence in neonatal care.

My time at Potter’s Village is fast coming to an end with my last day of working in the medical centre set for October the 24th, exactly a month away! After this I will have a week break to refresh myself and also renew my visa before heading to my next destination, Kisiizi Hospital.