My Diary 2014/15

 

Kumi Diary 2014/15

 

Spring Visit 2015

 

Monday 30 March

Two visitors before 7 am! Gerard Moses who carelessly told me his shoes needed replacing and Priscilla who came to inform me that her goat which Dr Grace had given her a while back had given birth to twins and all three had died.  She was in tears. Now the rains had arrived, she was going to plant sorghum and groundnuts and the crop cycle starts all over again. I had no time to delay as my last morning has to start with Morning Assembly at 8 am. I passed the schoolchildren calling out “give me sweets” (there is no “please” in Ateso and I’m used to this seemingly impolite manner) and tiny tots toddling towards me.

The benches were filled at Morning Assembly with a new influx of student nurses very excited at being let loose on the wards and so spruce in their pink dresses, white aprons and tiny caps fixed somehow onto their shaven heads. Now, it was time for me to say good bye to Dr Olupot and George W Omoding and to thank the staff for their support. The Assembly was immediately followed by a meeting with Motivation Uganda, the organisation which provides wheelchairs for children, in Dr Olupot’s office. Here, I met the first white person since I had arrived and she was South African! We had arranged for the driver to pick up Vivian from Joppa School as she has a Motivation chair and I had wanted them to see its condition after a year of usage. The meeting was fruitful and, after a tour of the relevant departments, their team left and we now have to wait until we hear if they would like to form a link with Kumi Hospital which would mean that about two years of my efforts will have come to fruition. There are many disappointments here and so my expectations are never too high.

A round of the departments to say farewell to all as though it was the last day of the school term and then a final walk back to the Guest House to conclude my packing – or so I thought as there was an endless influx of visitors. Max, the Catechist, brought a bag of mangoes which his wife had picked off their big tree. Frances Okerenyang took his seat in the porch and was soon followed by Stella Ajilong and Yolam, the hemiplegic who I had been introduced to at Adesso School. He was the orphan who had never had a school uniform and was cared for by a rather reluctant guardian. Stella had brought him to show me his school uniform and he was so proud. I had given him some soap and it was quite evident that he had found the new idea of washing a novelty as he was looking squeaky clean. I also had some cookies which he could take home to eat and I wondered if he would like them as they would be something new to him.  The porch was filling up and then Margaret Rose Akol, retired Children’s Village housemother who had come all the way from Bukedea, appeared to join the happy throng. The skies darkened and the rain drops started slowly at first but then rapidly became a tropical storm until a torrent of water flowed along the murram and spouted off the iron sheets and was accompanied by lightening streaking across the sky. Soon, we were getting wet and so we were forced to retire inside and I knew this was the end of my packing episode. I gave Yolam a battleship game with the pegboard to keep him amused. He soon had made an excellent interpretation of a mud hut and a tree using the red and white pegs. In spite of his disability, he certainly showed signs of being a very bright child and so I hope he is able to develop to the best of his ability. By the end of the afternoon, the rain eased and, one by one, my visitors left and packing became compulsory.

Andrew and Genevieve came in from school drenched from the rain. Dr Komakesh played a thoughtful game of chess with 8 year old Andrew while Genevieve did her homework with encouragement from her mother, Anna, and joined by Gabriel, Genevieve’s niece! Grace cooked the supper inside because of the rain. We were joined by Dr Owen and the three of us enjoyed our supper together. I would miss them all.

 

Sunday 29 March

The rain has definitely freshened the air and now I feel able to cope with the heat. Sadly, the petals were torn from the trees and the ground is covered in flower heads like confetti; mauve of the jacaranda, red of the flame tree and yellow of a tree I don’t recognise.

Arriving at St Joseph’s Hospital Church, I realised it was Passion Sunday, the Sunday before Easter, and the congregation were gathered outside the church holding palm branches up high. Prayers were being said and hymns sung before processing into the church and waving the palms vigorously. The little dancers came down the aisle doing their routine to the music of the drums and large acungo and the service started. The Gospel was read in three parts, Narrator, Crowd and Jesus, as it is everywhere else in the world on this day. Here it was said in Ateso, a language which has far more syllables than English and therefore lasts a good twice as long. It didn’t help matters that two of the readers were not fluent in reading and I was waiting to see if, once finished, it would be repeated in English. Thankfully, it was not. There are always many extras once the service is finished and today was no exception. The offertory collection was totted up and announced. Two eggs and a bag of onions were in the basket and so these were auctioned to boost the offertory total. A second collection was made for the construction of the pit latrine which is a Government requirement for all churches. Tata Elizabeth (yours truly) was asked to go to the front for my final farewell of this visit. By this time, I had a small baby sleeping in my arms and I announced that “my husband will have some questions to ask me if I turn up at home with a baby!” Then, back in my seat, I was deeply embarrassed. Simon Peter spoke in Ateso and, from what I could make out, he was saying that I had supported the church and it was time for the people to support me and so a third collection took place. Can you imagine? The very poorest placed their offerings in the basket and I was presented with 7,900/=, almost £2 to pay for my flight! Of course, I had no choice but to accept it graciously and then to stand silently while everyone faced me with an arm raised towards me to bless me for a safe flight whilst a hymn was sung. Having read on the BBC News page today that there has been a threat to Westerners in Kampala and it is suspected that a suicide bomber has tried to enter the country. I feel reassured that the blessing is a good insurance for me and all will be well at the airport. Kampala hotles have cancelled events and I’m not looking again for fear of an increased alert status! It is a little disconcerting though when, in 48 hours, I shall be passing through Kampala on the way to Entebbe.

Angela brought some ground nut paste for me to bring home. I already have some simsim paste and I know the Nutrition Unit will welcome anything I cannot manage to bring home safely. She also brought her baby, Elizabeth, but left before the deluge. Angela’s husband is Paul who is a social worker in physiotherapy and keeps everything in apple pie order. He has cerebral palsy and was found as a child during a home visit. His is a success story and the perfect example for us to explain to youngsters that they too can have a future in spite of disabilities. Local people criticised him for fathering children as they predicted that his offspring would be disabled as he is but he has three perfect children.

Grace washes my clothes each Sunday and this will be the last time for her for this visit. They are always scrupulously clean and washed without the ease of a washing machine. Ironing is not possible as there is no power. Now that there was a possibility of rain, she left me in charge of bringing in the washing if the heavens opened. I’ve got out of the habit of household chores but I did fulfil my responsibility when the wind rose and the skies darkened; just in the nick of time as it rained cats and dogs and the thunder crashed. I was expecting visitors and I wasn’t surprised when they failed to turn up. Even boda bodas cannot take to the roads when the rain is too heavy. Hence, a lazy afternoon and nothing to write about until I was about to retreat to my room after a good supper of mashed Irish and greens. A visitor waited in the porch, Betty who had finally brought the remaining letters from the Adesso Girl Guides to the Dalkeith Girl Guides. By now, I was actually cold and wished I had some shoes and socks. The temperature dropped to an all time low for this visit to 81 degrees F! Pyjamas were a must and also a she

 

Saturday 28 March

Initially, my day was free but gradually it has turned out otherwise. Preparations for my departure were underway and there was little to pack except for the growing supply of musical instruments of three drums, two acungos and an adugu. Sam called for his remittance and asked if I needed any more! As I sat eating my breakfast, I watched little Genevieve washing her teeth and with her nephew, Gabriel, looking on, a process which is taken very seriously and with thoroughness. Her brother, Andrew, must have taken at least 5 minutes of concentrated brushing!

The head teacher of Ngora School for the Deaf phoned me and told me he was on the ward with his nephew who had been bitten on the ankle by a cobra (I have since learnt that, here, cobra is a generic word for a snake which makes the provision of the most appropriate treatment tricky. I wanted to speak to the head teacher and found him at the bed side of 17 year old Sam who was noticeably shocked by the experience. His foot was swollen and he could well lose his leg if he survives. I was told that his father, a policeman, was in prison serving a forty year sentence along with two others for the shooting of a man. He had served two years. The Bishop’s wife is also in the hospital following a snake bite.

I had asked for a driver for the morning and Peter arrived to take me to Ngora High School to deliver books, a school bag and a blanket to Leah. We failed to see her as she was watching an inter-schools football match, in spite of going to the pitch and searching for her amongst hundreds of other students, she was not to be found The school staff told us that her other request for a suitcase and dictionary were valid and so off we went to Ngora shops, not exactly the most comprehensive shopping centre, on our mission. I left Peter to jump in and out of the vehicle. With the mission accomplished, we returned to the school to find Leah had returned for her lunch and so we could hand everything to her.

Now to Ngora School for the Deaf to pay school fees for Apulamera who has started her tailoring course. The school was deserted of staff with only the boarding students unsupervised. All was quiet due to no conversation, just sign language, from the young children and so we left the money with the askari after informing Charles, the Head Teacher, of my intentions. Driving through Kumi Town at 2pm, I asked Peter if he would like to take lunch at the Come Again café as I was feeling a little peckish. The idea of another chicken carcass was too much for him to refuse and so he repeated the order but, this time, there was far more white meat than on Wednesday. A plate of chicken, rice, matoke and sweet potato, enough to feed a family of six, all for less than £2! The wind started blowing and we could sense rain was on its way and didn’t it pour as we drove towards the hospital? No rain at the hospital. I needed to see Vivian at Joppa School and so I collected letters from her to bring back and, finally, I called in to see Modesta who was still so sick with pneumonia. I could see she was getting weak and I’m hoping she is over the worst before I leave on Tuesday. Yes, that really is the shape of Vivian’s spine!

Back at the GH, the children were playing happily with the old frame of a suitcase being used as a ride-on toy! I prepared for the visit of Stella, Adesso teacher. I am usually given an omelette when visiting and so I had asked Anna to prepare one for Stella so that I was conforming to the culture. Stella came bearing gifts of a necklace and earrings she had made and also a bag full of cookies which she always makes for me. Her son, Joshua, came also and we sat watching my movie clips and then looked at the Philips Modern School Atlas which I had brought. The youngsters’ knowledge of world geography is seriously lacking! On leaving, I escorted her to the road as is the custom when a few large drops started to fall and, by the time I turned round and reached the GH, I was drenched and, what joy, the temperature dropped to a most acceptable level.

As I summed up the day’s events, a rat appeared at the door of my room, turned round and scampered back. They are smaller than a British one, quite sweet when dead but not so much when you don’t know where they have returned to.

 

Friday 27 March

Two visitors before breakfast – Gerard Moses, the young blind man, and Stephen Obwongo. Usual story; a relative had died, the burial was today and he needed to buy a burial sheet for the body. He would deduct it from what I owed him for the adugu. We have a good working relationship, Stephen and I, and so he was given 10,000/= (£2.50) and off he went.

No need to rush today as my first appointment was 9 am at Adesso School to discuss the budgets for the Girl Guide camp in August and the Volleyball Tournament in Entebbe in June. Crossing the airfield, I noticed the grass was a tinge greener in spite of the minimal rain we have had whilst others even as nearby as Kumi Town have had torrential downpours. Some people have even started planting their crops.

I met with Hellen (double l here), head teacher, and Betty, Guide Captain, to discuss the budget they had presented to me earlier. They were dumbfounded when I told them what I was prepared to pay for and what I was not prepared to pay for. “But we need six jerry cans!” “Take six from here!” “We hired tents last year so we want to buy them this year.” “A bad investment as they will deteriorate or the rats will eat them.” And so it went on until I was prepared to pay them 50% of the budget. We agreed not to send all the Guides, not to buy them shoes for their early morning run along the shores of Lake Victoria, etc etc. Well, we may not have agreed but I had the upper hand and then pronounced that I would give them a round 3,000,000/=, 75% of their request  which delighted them as they have room now to prioritise for themselves but they must give me accountability for every shilling. Also, I think their estimate for fuel was too low and so they would need room to manoeuvre.

Betty left and Sam, sports teacher, entered and I had to start fresh negotiations over the volleyball requirements. Would I contribute to the expenses for tomorrow’s match in Nyero? No! Then, the June international match in Entebbe which was the start of the transformation of Adesso P/S from one of academic indifference to one of enthusiasm and improvement. Twice, the Senior Boys have brought the trophy home and they are determined to repeat the achievement again this year.

I have funding from UK for this event as well as the Girl Guide camp and so I know what I can work with and we managed to come to amicable conclusions in both our favours.

Now, I could start my day at the hospital but, on leaving the school, I made the mistake of saying good bye to Mary, Sam’s wife. At school, they live in one of the classrooms causing the children to be taught outside. I looked round the door (in fact, a piece of material which hangs limply). I knew only too well that a visitor has to sit down and take tea so I was brought a Thermos of hot water, some tea leaves and pieces of a chapatti which I ate alone before being able to leave.

At the hospital, I had plenty to do and I did my rounds passing through the Maternity Ward. I was checking up on the mattresses from Darlington Memorial Hospital and kindly funded by Darlington Rotary Club a few years ago. They are still in good condition, showing signs of use but the covers are not damaged and so very different from the local mattresses. I took a photo of a newly born babe which meant they all had to be snapped. I asked one of the mothers what her baby would be called and she asked me to name it. I suggested after one of my sons, Dominic, Nicholas or Peter and she chose Nicholas. In the Labour ward, a mother was about to give birth and another was well on the way. I needed to go to the cash desk to pay a bill. In days of old, each entry was entered into a large ledger by hand but now it is computerised and Dina who used to be the physio department cleaner is now so efficient with the programme. It is encouraging to see her move on.

Little Prossi’s mother, Amwali Joyce, had come to collect her fees for the Tailoring School she is attending. I was able to give her the year’s fees as well as material and uniform and she left with a hop, skip and a jump!

The rest of the day was spent planning Monday’s meeting with Motivation International, an organisation which donates bespoke wheelchairs for children. I have been negotiating with them for a couple of years and now they have announced that they are visiting on Monday but we don’t know why. We want to be well-prepared and so we have prepared the statistics and hope it is enough to convince them that Kumi Hospital would make an excellent centre for them. The jewel in our crown is the Orthopaedic Workshop which not every hospital can claim to have.

I walked back to the GH stopped on my way as always by the little children. I could sit under a tree for a couple of hours before dusk fell and read my book. Soon, Ruth and Harriet rode up on a boda boda and so we continued a discussion about one of Ruth’s ideas she had given me a while ago. To explain about Ruth, I must go back to the time when she was severely depressed, left work and was admitted to Soroti Psychiatric Ward, enough to make one more depressed for sure. During her sickness, she had tried to swallow poison twice and had been found hanging from a tree. Slowly, slowly, she improved and we started working together with the outreach families. When the hospital started to re-employ workers after the management trouble, I recommended Ruth to be given back her CBR job and, since then, she has not looked back. She is devoted to these children and their families and works way beyond what is expected of her. She lives in a rented room in Soroti and visits the families either on her bicycle or she hires a boda boda to go further. She had asked me if she could have a loan to buy a motor bike as then she could increase the area which she covers thereby identifying and following up more families. I had dismissed the idea as being unrealistic but, today, when in my room and considering my packing for Tuesday, I looked at my cycle helmet which I no longer use but store when not here. My days going out with Martin are over as I have had to come to terms with the fact that I am no longer a youngster. I have always refused to go on tarmac roads because I have seen too many horrendous crashes involving bikes, lorries and buses. The tracks are pot-holed and bumpy and my joints have lost their resilience. To move on, the day before I left home, the Trust which funds my flight and expenses (and for which I have a duty to perform), sent an unexpected cheque for me to do whatever I want. Ruth was so happy to think that she will now be able to improve her work and the helmet fitted her like a glove. There are conditions that she is responsible for tax, insurance, maintenance, repairs etc. I am wondering if I have ever seen a woman riding a motorbike but, when CBM funded the hospital programme, she used one and so I know she is capable of the task.

Anna who runs the GH joined me after Ruth and Harriet had left to ask me how I found the GH and so we discussed a few points. There is no comparison with when I first came when there was hardly any power, no shower head, it was full of cockroaches and that is for starters. Stephen dropped in with my adugu as well as an acungo. No worries about my case being half full! We bartered over the price and I reminded him of this morning’s agreement when I had bought the burial sheet for the aunt.

Now, I could get on with reading but, then, Mr and Mrs Turkey attacked Conrad, my white cockerel until they had it pinned to the ground with Mr Turkey’s big beak round Conrad’s neck. I leapt from my chair, threw my book at Mr T but he was resolved not to give up. Anna came to the rescue and released the neck and Conrad hid neatly underneath Mr T, evidently a self-preservation exercise which seems to work. What if we hadn’t been around? It would have been chicken for supper, no doubt! My second tall, brown cockerel, Claud, kept its distance.

No time for reading and anyway it was getting too dark and so I came inside. A productive evening talking with Dr Komakesh about the Nutrition Unit which I’m hoping he will take under his wing and improve its operational management.

 

 

Thursday 26 March

It’s surprising what a drop of 10 degrees F has made! Life is less of a hardship and the day doesn’t seem such a daunting prospect. It’s only in the low eighties now when I wake up at 5 am and a sheet is required to keep off the chill during the night. Even the cockerels have more vocal energy in the early hours.

Clinic day in Palissa and we discussed the possibility of having few patients due to the arrival of rains. The people have been praying for rain so that they can plant their crops at long last. There were few when we arrived but they started to pour in steadily all day and so we were kept busy till almost dusk. Sadly, we were inside the Health Centre and not under a tree which I prefer. Windows are never sufficient to cool the place and the crying of the children seems to be magnified ten-fold.

My diary will be brief today and I shall mention a few of the 66 patients we screened.

Omungole Ben, aged 36 years, was an athetoid Cerebral Palsy man who had to crawl to get along. He wanted a tricycle so badly but we doubted the strength in his arms and hands to manage the pedals. I wanted to give him the chance and so, when the tricycles finally arrive, we will contact him to come to the hospital to see for himself if he could ride a tricycle. I sincerely hope he can prove us wrong as his life would be so much better. He had never attended school and he may well have done well if he had given the opportunity.

There was an old, old man who hobbled in with a long pole and rags round his ankle. On removing the “dressing”, he revealed an ulcer as big and deep as an ink well and the stench was overpowering. He was an old leprosy patient from Kumi and would, undoubtedly, lose his foot. No photograph was called for, just a word of comfort.

Many adults queued, some severely impoverished, others, rather hoity toity, dressed in their Sunday gomaz’ and probably expecting preferential treatment and able to jump the queue. They are given numbers and so have no choice but to await their turn unless I see some poor old soul on whom I take pity.

So, that is the last outreach clinic of my visit and now I have only a few more days to tie up the loose ends and wallow in the warmth.

 

Wednesday 25 March

I could see Obwongo’s bicycle outside my window long before I was dressed so I laid low until he gave up waiting! Susan a young girl who sometimes does some cooking also came and I knew she must want something and so I warned her that nothing was forthcoming and not to ask for anything. I was right, she wanted some iron sheets for the house she was building. Obwongo returned and he needed a few shillings to buy some wire or whatever it is he uses to make the strings of the adugu (harp) he is making for me.

It was cool this morning; only 82 degrees F and so my energy levels were better and I walked to the hospital with almost a bounce in my step I went to see Modesta before she was discharged home, still so sick as a result of pneumonia and I doubt she will recover very quickly when she returns to her appalling living conditions. The occupant of the bed next to hers was a noisy chicken flapping its wings and causing much dust! The TV had been installed in the OPD waiting area which, I suppose, does improve the hospital experience for these poor patient people. With a couple of other staff to see, some printing to be done, we set off with Rose from the Nutrition Unit for home visits.

We picked up Akol David, our mobiliser, who guided us to our first child; Akol Mary who had been in the Nutrition Unit four times in the last year. The mother had been given family planning advice as she was unable to cope with her three children and she had decided to wait five years before thinking about having more children. The father was doing his best and they were looking after a relative’s cows which were not giving milk for little Mary. There was absolutely no food and they had not eaten today. We could provide a goat which would boost their morale but they needed food and so we gave them some money to buy at least something for the family.

Passing their home, were two ladies carrying a stack of grass on their heads to thatch the roofs of their huts. The toothless old grandmother was spreading fresh cow dung in the compound to provide a clean area to dry the cassava.

We continued to Oseere Health Clinic where we were to meet a mother but, on arriving, we found her on the ground unconscious having suffered an epileptic fit. Her head was damaged and her two small children stood nearby obviously used to this occurrence. (It seems she has a couple of these seizures a day and was also suffering from burns having fallen into the fire at home) There was nothing we could do but leave her to come round whilst others were there to take care of her. She will be registered at Kumi Hospital for regular free epileptic treatment.

Atiokin Skovia was 2½ year old who had been admitted to the Nutrition Unit last year and was doing well. We were near the lake, a completely different environment from other areas we visit, very flat, less bushy and somehow fresher. The father was a fisherman and would go out each day in his dugout, cast his nets and bring home his catch of little fish to eat and sell.

We passed the hospital pump house which I had last visited a few years back during the floods when the water was above window sill level. I had reached the little house in a dugout but now it stood well above the water level of the lake. It was interesting to see again the machinery now looking so well worn. Pigs were wallowing in the mud of the lake shores whilst women collected water for drinking in their jerry cans Incredible to think they would use this for drinking!

Apagi Veronica was an 18/12 child of Itimol Betty, a mother who was clearly suffering abuse from her husband. Her face was badly swollen and, if she had been a white woman, both eyes would have been so black. They explained to me why she was trapped in this situation with nowhere to go and so she had no choice but to continue being enduring this dreadful abuse. I explained how Ugandans were not alone and that we had the same issues in UK much to their surprise. Little we could do but ask the mobiliser to keep an eye on the family, motivate her with a goat and give her a few shillings for herself.

Alungat Mary, a 3 year old, looked fit and healthy. Helen and I had bought a hospital cow with calf for her last year and I found them well but in need of de-worming and de-ticking. The cow came with a he-calf and has since had a she calf. One calf, when old enough, is supposed to go to Apolot Carol but her mother has not had any input for example helping to fetch water for the animals and so the hand over is on hold for present. Mary’s mother does well considering she has a heart problem. We gave her treatments for the animals.

Now, as we passed through Kumi Town and being about 2.30 pm, I suggested a bite to eat at Come Again café. Surely, we had earned a rest! Harriet and Rose chose tilapia, an ugly fish with ogling eyes and many bones, Peter chose chicken and I had beans, rice and ebor, a wise choice in my opinion. Peter’s chicken arrived without legs, breast or wings, just the carcass. The neck stuck up and the innards were all present. He started by eating the “bag”, the most prized part and always given to the visitor. Then, his hands dug in deeper and out came the liver, the entrails, in fact everything until the last scrap of meat, gristle, neck, skin, even two eggs the size of rice grains had been devoured. He was more than delighted

The next mother disappointed me and made me so angry as she lied about what her children had eaten that day, probably because she wanted to please us. Earlier this year, one child had been admitted to the NU with malnourishment not of the ribs sticking out variety but kwashiorkor which manifests itself in oedema. My spelling may be far from correct!  The mother said they had eaten the small fish and porridge. Fish, yes, maybe, but porridge absolutely not as she brought out a bag of quite the wrong ingredients for porridge thinking Rose would be fooled. No way can you cook beans and sorghum with groundnuts and soya. The father came and told us an extraordinary story about the mother getting angry with him and burning the mud hut down. The father had taken a second wife and they were all living in the same house. I really don’t understand these situations at all and I will never get my head round the culture. The mother could not mistake my anger and all I gave her was some money for food for her children saying that her child would have been given a goat if she had not lied. Not fair on the child, I know, but it seemed the right thing to do.

Omoding Daniel, a 2½ year old ex-patient, was “fair” having been in the Nutrition Unit last year. On questioning, the mother was giving the child a good balanced diet having learnt the importance of each type of food whilst in the unit. Her home was tidy and so pretty with flowers resembling busy lizzies. She lived near the lake and the flies were quite intolerable and so we made a speedy departure after praising her for her efforts and motivating her with a goat.

Last but not least was Akirot, a severe CP child of 5 years who sits in a CP chair. I have known her mother, Amwali Joyce , for a while now and we are putting her through a tailoring course at Kumi Rural Skills development Initiative at her nearby trading centre, Atutur. She has been first and second in her year and has a final year to do and then she will be able to support her family. Whilst in Kampala next week on the way to Entebbe airport, we are going to buy two second hand machines which I hope are much better than the cheap Chinese ones to be bought here. The other machine will be for Abukunyang Stella Rose, the amputee teenager we saw on 3 March. I gave the children balloons to play with which were much appreciated. It’s strange having to show a child how to blow one up! Then, Joyce surprised me with the gift of a cockerel.

Homeward bound and not completely exhausted as it is cooler now. When my arm is outside the car window, the air is cool! A big improvement! We left Harriet at Kumi Hotel for her Rotary meeting and I came home for a shower but had a visitor, Paul and his two children just as I was about to get wet. My well-earned cup of tea followed by supper of rice and ebor.

Sitting on the porch, I could see the night sky lit up by almost continuous lightening but no thunder until I was in bed when the rains started. It didn’t keep me awake and the night was good.

 

Thursday 19 March

 

Outreach clinic in Achowa far into Amuria, a journey which would take long and so we needed to start off as early as possible. Breakfast of an omelette sandwich went down well except I found the bread I had bought in Mbale smelt more like a brewery than bread but when needs must… A chicken had laid an egg on a bed in the GH and I would have that one tomorrow.

We set off, through Soroti and Asamuk until we reached Achowa Health Centre where we found a mass of people sitting in the shade of the trees awaiting our arrival. Where they come from, I do not know as the vast stretches of bush land appear to be totally deserted but somewhere there are hidden mud huts all with their inhabitants leading their simple peasant lives. The visit of a medical team provokes great interest in a land deserted of such distractions and they come out in their droves waiting to be seen. Children first we insist and so they queued with the odd oldie sneaking in thinking we wouldn’t notice. 106 patients sat before us and, hopefully, each one left having had a satisfactory consultation. Agnes who is the young physiotherapist who has been in Kumi for nearly 3 years does well and I am impressed in her organisation skills. Not many photos for today nor a lengthy diary as our time was spent in registering everyone and then dealing with their problems. Cerebral palsy, gluteal fibrosis, burn contractures, cleft palates. Then when it comes to the old folk, back pain followed by more back pain and they are not happy until they leave with a lengthy prescription of drugs. There is little point in trying anything else as nothing works like pills!                                         

We sat under a tree moving the table and chairs further into the shade as the sun moved round. The wind was strong blowing the dust into every crevice and making my eyes so sore. Suddenly, Ruth shouted, “Wind!” and I was slow in realising that she knew that a whirlwind was about to whisk around us bringing a dust storm reducing the visibility to nil. In a few seconds, it was over and I was able to emerge from my only means of shelter. I had covered my face with the register book which probably did nothing at all to help me.

It was dusk by the time our last patient had been seen and our team collapsed into the vehicle for the long drive home. I can imagine us all showering in our own way with me coming off best with my overhead shower head which delivers water from the lake. The men will be taking their shower perhaps in a shelter with walls of banana leaves. The wives will be bringing them water, soap and a towel. The women will be coping the best they can with definitely no help from the men!

And so to bed as there was little time nor energy left.

(As I write this, I have watched Anna let the turkeys out of their raised house and now Mr Turkey is chasing poor Mrs Turkey. It’s comical to watch him as he glides along as though he is on rollers and with his feathers displayed to his advantage. A black hen is clucking along pecking at the sand in the hope of finding an insect or two and she is followed by 13 baby chicks, new to our household. Six jerry cans are lined up outside Anna’s hut waiting to be filled and she is outside cooking me an omelette for my breakfast. Her children, Andrew and Genevieve, have left on the school bus which arrives at 6 am each morning.)

So, I shall close my Thursday diary and set off to walk to the hospital.

 

13 February 2015

 

Three months since my return from Kumi in Uganda and now I’m almost ready to go again on 26 February. I thought I would write a brief resume of what has been happening here in England as this will get me geared up for the next 5 weeks.

After my return, it was straight off to Kenya with Chris for two weeks and then back home for two weeks to prepare for Christmas. I managed to print off photos of the children in their dresses and knitted baby clothes to send to the donors and also to make my Christmas cards, selling enough to pay for the materials I used.

Emails pour in daily requiring a couple of hours at the computer to keep up to date. Promises of goats, bicycles, school fees and tricycles keep arriving and the coffee pot is kept going for visitors.

A cupboard is filling with tombola prizes for our Open Day in June thanks to Pat and Barry and never a day goes by without something happening for Kumi.

The Dalkeith Girl Guides have turned their £2 given to them out of Guide funds in September into £1,000 and I had the pleasure of attending a meeting where I was presented with a cheque and school bags which the girls had made. I shall fill them with stationery items from a Kumi shop before distributing them. Whilst in Dalkeith and staying with Peter, my youngest son, and his family, I updated Laura aged 7 on her chicken which she kindly bought out of her pocket money a year ago. I couldn’t exactly tell her about that chicken as I’m not too certain of its whereabouts or perhaps destiny but she was happy to hear that it had “grandchildren” and would soon be bartered for a goat!

I have arranged for a portable dental chair and micro motor for Henry, the dentist, so that he can continue developing his outreach dental work. He will then be able to add fillings to his repertoire of treatments.

Darlington Rotary Club gave me a generous donation which will pay for the 10 tricycles I ordered in November. They should be ready when I arrive and we will be able to distribute those already promised and with a few to spare. Oloba Michael, a 25 year old cerebral palsy boy, has been promised one as well as Sagarti Dina, a mother of three who hobbles with a long pole along with others whose lives will change dramatically.

I will visit Vivian, the 12 year old with arthrogryposis. Tony who pays her school fees and extras called and I showed him the Philips World Atlas (99p from ebay) and a little gingham dress costing £1.50 which came from Matalan thanks to Sandy who is also a Nordic walker. I will also give Vivian’s best friend a dress as there is much to do when looking after Vivian.

My team have also been busy in Kumi. Martin Inegyet has serviced the Motivation wheelchairs, a three monthly exercise, and Moses’ house has been finished apart from plastering which is not essential but which maintains the building from the heavy rain. Now he can sleep alone rather than with his grandmother, not advisable as he is now a man and also doubly incontinent as a result of his TB spine. Ruth’s two new women’s groups in Asamuk are organising committees and formalising themselves; school fees have been paid and the outreach clinics have been continuing.  Promised goats, mattresses and blankets have been distributed. I shall be working closely with Rose from the Nutrition Unit following up the families discharged from Kumi Hospital and seeing if the child’s improvement has been maintained. Perhaps a little help will be necessary to start them off on the road to independence.

In January, Harriet and Henry held their traditional marriage when the parents exchanged the bride price. I wasn’t surprised that Harriet was worth a good deal and 10 cows, 10 goats, 2 cockerels along with sacks of crops were accepted by the bride’s parents during the ceremony. The day is a story in itself which I shall not relate but all’s well that ends well and I am looking forward to staying with man and wife in their village for a weekend.

So, my cases are being packed with the most extraordinary items and I pray that the Customs don’t notice me slipping through. There would be a lot of explaining to be done. I need only a handful of clothes as I leave almost an entire wardrobe behind. I think I am ready for the hot, dry season but I know that, when approaching Kumi, the temperature will rise as it is so much hotter there than in Kampala. The rains should arrive in March and I sincerely hope so!

My thanks go to everyone both here and there for all their support and generosity without which everything would be impossible. Not forgetting Chris who is abandoned yet again but who enjoys his golf and ready meals! I hope I manage to keep my diary up to date. 

 

Autumn Visit 2014

 

Wednesday 19 November

The couple always leave early for work and so I had a leisurely breakfast all laid out buffet style. There are usually extra members of the family in Ugandan homes and here was no exception with three orphan nieces who look after your every need; Marisa, Nice (a nice name!) and Rachael, a girl from Burundi and who spoke no English were all being educated by Sam and Christine but they still had their household chores which start around 5 am. If they greet or bring Sam anything, they drop to their knees in respect every time. Over breakfast, Marisa and I discussed the different cultures and she explained that it was their duty done most willingly to look after their uncle in return for all he was doing for them and it all seemed so natural and correct.

I had asked a girl who had been orphaned and educated by Good Samaritan, an organisation started by Sam, and who had started up her own organisation for marginalised girls making jewellery and bags to call and I managed to fill the rest of the corners of my case with some of her goods. I admired her for her skills and quality of goods.

But I was here for a purpose and I returned to St Stephen’s Hospital where I met Lawrence, the radiologist who is eager to have an X ray unit to supplement the present ultrasound facilities; a pleasant young man who is a credit to the hospital. The meeting was over; I was back on the road and on my way to the Professor’s new office in town which I had previously visited when it was more of a building site. It was impressive with conference halls, a potential restaurant and even a future lift! His wife, Christine, has a very successful business also incorporated in this building making graduation gowns, hospital uniforms, dresses etc and employs many women all working most efficiently at their machines. There was a model of a newly designed gomaz, the Ugandan dress. Never had I ever had the “must have” desire in Uganda but this was for me. I wouldn’t need a dresser to help me put on my Mothers Union gomaz, no need for any undergarments and therefore cooler, a false sash but still lined with thick black polythene resembling X ray film and decidedly appropriate for a western woman but probably not acceptable for the Kumi locals. I was measured and a little alarmed to see my waist size was jotted down as 40 inches and so kept my eyes shut for the rest. The length allowed inches for my high heels and it was much frowned upon when I said I would be wearing flat shoes as this would totally ruin the finished effect but my comfort is paramount and when I think of the rough ground in Kumi! I chose a red, black and gold synthetic material as my wish to have cotton was swiftly rejected as being totally unsuitable for such a garment. No wonder my Mothers Union dress gets the thumbs down! I had no money which caused a little stir among the staff but, when I mentioned that Christine, (the boss), would take responsibility, they reluctantly allowed me to leave without paying. I would now have a wedding outfit and perhaps the first time I will wear it will be at Harriet and Henry’s church wedding next year. 1 newly designed gomaz = 2 goats!

Back to the Professor’s for lunch and a quiet afternoon lay ahead and I stayed in my room reading my Kindle (not mentioned very much in previous diary entries as it has hardly been opened). I had brought groundnuts for the family and the silence was broken only by Nice’s rhythmical pounding of the nuts with a large pestle and mortar supported between her outstretched legs as she converted them into groundnut paste. An hour and a half it took her and without one pause for rest.

4 pm and Gonzaga came to take me to Entebbe Airport, far too early I knew but then I have, in the past, been stuck in the city traffic for several hours and without moving one inch. (I usually stay on Entebbe Road which means I don’t have to go through the city.) Of course, today, we were hardly hindered in our progress and I arrived long before check in but I was there.

Straight into another world and no longer was I to be spoilt with my every need. My bags had to be X-rayed and the usual procedure passed away the time until I was on board the plane and ready to return home with very many memories of my alter ego.

 

Tuesday 18 November

Tuesday and it was time to say good bye to Anne and Grace and to thank them for looking after me so well. My tin trunk was padlocked and a case full of my clothes was put into a store room until next time. A pile of dirty washing was left for washing, a wonderful arrangement!

Little Paul, my driver, arrived to take Rachel and me south and, after hugs and promises to return soon, we left for Kumi Town calling in at Mary MacAleese P/S to collect some groundnuts from Jane whose baby surely must arrive any day.

The journey was uneventful and I really do think that the vehicles (or maintenance of) must be improving as I have seen far fewer overturned lorries during this visit. We left Rachel in Jinja as she was planning to go white rafter rafting at the Bujegali Falls on the Nile. I had spare room in my case and so a visit to Banana Boat in Lugogo Mall was made and I topped up with a few Christmassy gifts. Surprising how a few hundred kilometres can alter one’s perception of Christmas. In Kumi, Christmas is the celebration of the birth of Jesus but, once into the civilisation of Kampala, it becomes a commercial commodity with decorations and sparkle. I know which I prefer!

I met up with Alex who kindly offered to drive me to St Stephen’s Hospital as Paul didn’t know the way. Alex drives for the Ministry of Health and so has a red number plate on his vehicle making progress easy except for the fact that there had been a tropical downpour and the streets were flooded with water gushing down the gutters and sewers making progress difficult. Children returning home from school were splashing around not caring about the cleanliness of the water and I wondered if there was anyone to care if they were drenched on reaching home.

St Stephen’s was busy and I had an opportunity to have a brief meeting with Olivia and Dr Cathy to start discussions on the X-ray project. We then retired to the Professor’s home where I was to stay the night. On arrival, I found I was staying in a guest room separate from his main house which had been converted since I last visited. Five star luxury awaited me with a big bed with mosquito net on runners and a bathroom en suite with running hot water in the shower and a fluffy towel! Sadly, there was no power for hot water but I was so used to the cold version that one more day made little difference.

We spent a pleasant evening over supper with Dr Cathy, Olivia and Christine, the professor’s wife and then discussed St Stephen’s matters in hand. At last, I could retire as I was so looking forward to my bed that I didn’t bother with a shower until morning hoping that the residue of Kumi murram would not be too obvious on the sheets.

 

Monday 17 November

My last day and packing is a must at last. I cycled to the hospital, locked my bike and gave the keys to its worthy recipient, a young man with a disability who will appreciate something which will enable him to be more mobile. Morning Assembly and the usual farewell words but, this time, also to 14 physiotherapy students who had come to Kumi Hospital for 2 weeks as part of their training. Their placement will concentrate on community based rehabilitation and I am sure there is no better place in all Uganda for them to gain experience in this field. They looked so smart in their white coats.

The usual farewells, delivery of new mosquito nets for the Nutrition Unit, a helpful meeting with George William, Hospital Administrator, and still the need to top up my cash as I had nothing and it is not nice to have an empty pocket; even worse if you have no resources to amend the situation. The old Land Cruiser was off to Mukongora for a vaccination programme and there was just room to squeeze me in although I wouldn’t have wanted to go far. This vehicle really has reached the end of its life with everything falling off and it would definitely not be allowed on our roads. Harriet was in town and we withdrew ample funds to finish off my programme. We had much to discuss and so we had a bite to eat in a café whilst we tied up all the loose ends. The work must continue after my departure with house building, school fees, income generating projects etc and all to organise with Harriet as my Team leader. A fond farewell with good wishes for her Introduction to her future husband, Denis, in January. The couple are from the same tribe and so I am sure the parents will agree to the union and the bride price will be paid with much ceremony followed by celebrations lasting into the next morning. Then, the church wedding will follow later and I am hoping I shall be able to attend. Packing was now imperative and I was grateful to have very many ground nuts, sim sim, local rice to use rather than bubble pack. There was till lots of spare space but, for some reason, the cases were so heavy.

Five o’clock soon arrived and I was to visit Sam, Adesso sports teacher, for supper so it was back over the airfield but this time with my shoes and socks on in case of stepping on to a snake. Sam lives with his wife, Mary, and 8 year old daughter in a converted classroom. I don’t quite understand the theory that the teacher’s home has priority over the children’s need for a classroom and so taking lessons under a large tree becomes the norm and the teacher has a “house”. Strange! The classroom had been divided by material hanging on string making a living quarter with space for cooking and sleeping screened off. The blackboard still had the last lesson chalked on it and there were multitudinous calendars going back to the last century pasted on the walls. I am almost certain the transformation had been done for my benefit even down to borrowing comfortable chairs, settee and table. I seated myself wishing that I could spend my last evening outside under the stars but I was to maintain standards and take advantage of these home comforts. Mary is a simple soul and her place was behind the sheet where I could hear much clatter of cooking and smell the smoke wafting over the screen. Patricia, a most beautiful child wearing a well-worn dress, sat with her father who talked non-stop on volleyball, football and netball and the funds required for tournaments. Concentration was difficult but necessary as there was the odd question slipped in which needed a response! A very colourful supper of omelette, tomato, rice and greens finally appeared and I requested the company of Mary and Patricia as this was my main purpose of my visit. This is not their culture but Patricia joined us after much persuasion from her father. I could tell that she had never sat in a chair to eat nor used a knife and fork and so she gratefully accepted my suggestion to use her fingers. I had brought a pop-up book about fairies and magic wishes and a paperback for Patricia and she was entranced by the pages. Her command of English was good and she could read fluently. After the meal and with hands re-washed, I requested to sit outside and there I found Patricia sitting on a black water butt with her friend and singing in perfect harmony the words of the fairy book. Where else would I experience such simple pleasure but here? But nothing lasts forever and, with good byes said, Sam escorted me over the airfield until I reached the hospital track and I made my own way up to the Guest House lighting the way with my torch. The shadows of tree roots and twigs resemble snakes and so every step is taken with the utmost care and attention!

More gifts had appeared including two jars of honey from Francis Okerenyang’s bee hives, one for Helen and one for me, and these were carefully positioned in my case before finally zipping it up.

 

Sunday 16 November

A good night’s sleep and what a difference it makes to my day! I felt fresh and willing to cope with whatever the day brings. Read on…

Hair wash, breakfast and prayers with Marion and Doreen and we sat at the back enjoying the music. A girl no more than a year squeezed in between Marion and Doreen and then slipped in and out grinning from ear to ear as she ran up the aisle to join us once more. The service was over but that is never the end of the proceedings and we were soon called to go to the front to be introduced. Whilst standing before the vast congregation, the aforesaid little girl stood before us holding up a large cricket between two fingers while Marion was introducing herself. When she failed to get a reaction from us, she put it on the ground, lay on her tummy and watched it try to escape. Her mother then dragged her away and the cricket continued on its way .We were not to return to our seats immediately as they were to pray for us and so we stood with eyes to the ground while the drums beat and the man sitting astride the large acungo plucked at his adapted bicycle spokes and the congregation raised one arm and sang; “

May the spirit of the Lord come down, amen

May the spirit of the Lord come down,

May the spirit of the Lord from heaven come down

May the spirit of the Lord come down

May the blessings of the Lord etc

 

which was so moving. I hope some readers are familiar with the tune.

Returning to our seats, we then had the auction of the Offertory gifts. Those with no money may have no coins to give but an egg or a small bag of cassava may be offered instead and then these are auctioned off and the proceeds added to the cash. Two eggs were up for sale today and Doreen and I bid against each other until I managed to beat her with a high price much to the entertainment of all! Then it was a bag of grossgrams (no idea of the spelling but they are tiny peas!) and Doreen was successful with this bid. We didn’t want to hog the lot so we left the rest for others to buy. Margaret, the leprosy resident, was given the eggs and Doreen gave hers to Rose who was going to cook supper for them next week. So entertaining! Finally, we filed out of church and I was introduced to Betty and her new baby which had been named after me. It seems that leaving church is the same the world over and there are many greetings to share with people to the extent that, on walking home, I realised that I had gone by bicycle!

Back at the Guest House and the whole day ahead was free until 5 pm when I was going out for supper. No sooner had I made myself a coffee than Margaret Rose, retired House Mother of the Children’s Village, arrived with her granddaughter from Bukedea. She was bearing gifts for me to take home; ground nut paste and oranges. We had planted the orange trees together a few years back after we had learnt how to graft orange trees on to lemon trees and now she had picked some of the resulting enormous fruit for me. Then Modesta arrived with little Emma who was sent home to wash his school uniform. We sat in the shade hut and with plenty to talk about until Obwongo turned up with the pestle and mortar he had made for Modesta and somehow had managed to get me to pay. A few days ago, I had refused to pay his asking price for an acungo he had made and, blow me, didn’t he give it to Doreen right under my nose! By the time they all left, it was lunchtime but we had not ordered a meal and so Jenny made toast, I acquired tomatoes, onion and avocado from the “kitchen” and we had a delicious impromptu meal. So much for my free day! A dull moment is never experienced here and I saw that Jenny who was hanging out some washing, seemed distracted by some activity in the compound. Grace had seen a snake slither past and was finding a stick to beat it to death but it was one step ahead of her. Two youths took over and found it coiled up in the undergrowth and almost invisible to our inexperienced eyes as it blended in so well with the dead foliage. The boys became so animated in an effort to kill this unwelcome visitor and threw old bricks into the undergrowth until it made a move. It slithered onto the road side where they thrashed out with long sticks in an effort to stun it but the crafty creature escaped back into the hedge. There was no way there was to be no kill until, finally, the snake lost the battle and the boys hooked the snake on to one of the sticks and held it high in victory. As they lay it on the ground, blood seeped from its nose but it seemed to grin at us with its little beady jet black eyes and smirking mouth. Perhaps it had just eaten lunch as there were a couple of bulges half way down its body which were still squirming.

One of the young men was Steven, who I have known for many years when his brother, Gabriel, was a hospital patient. He has kept in touch and this year was no exception. He had brought me a fine looking chicken and a bag of groundnuts, such a kind gesture which means a lot to me. We shared our news although his command of the English language is poor but he could not stay all afternoon as today was my day for preparing to leave and so I hope I politely told him I must go. I put the chicken in the top shelf of the kitchen cupboard as there was already one below but this one escaped only for me to find it was my previous gift from one of the wedded couples and which Anne had thought I would give away. It flew to freedom but not for long as it was soon captured by one of the frantic cockerels which chased it while the other cockerels stood wondering if they had a chance also. It must be a very beautiful hen in their eyes and I would agree as the speckled plumage is most attractive. I took a chair under the trees and speckly hen came and sheltered by my side as four noisy cockerels stalked around.

No sooner back in my room than Grace appeared at my door to say that her daughter, Joy, had come specially from school on a boda boda to see me. I always enjoy this 14 year old’s company and we had lots to tell each other. She dreams of a secondary education in UK (out of the question) or perhaps a laptop (ditto) and I think I was convincing enough to dissuade her. She had forfeited her best school meal of the week to come and we had eaten all the bread for our lunch. All I had was a small packet of crispbread which I brought from the plane six weeks ago, a bag of oranges and a tub of groundnut paste. She would share with her friends on her return to school even though her stomach must have been empty.

Glancing at the sun, I could see that the time was such that I must change into my African dress to go to Stella’s for supper. A shower was essential and I was soon walking across the airfield to Adesso School where Stella teaches and lives. The sky was threatening and the thunder rumbled and now I am not only scared of snakes in the dark but also of being struck by lightning. So many people here are killed and one 10 year old from down the road was struck and died since I arrived. The evening passed pleasantly with Stella and Tom; the meal was delicious with a new dish called “nakat”, similar to sumaweeke, another one I cannot spell but it is a green vegetable which was tasty and, I am sure, nutritious. Tom would escort me across the airfield and lighten my way in case there were any of those nasty reptiles crossing my path. The lightening was comfortably far away but it lit up the sky from so many directions but no thunder and I soaked in the vision of the carpet of stars  and the fire flies so that I could keep the memory until my next visit(?).

So a day of expectations of packing had passed and another opportunity will have to be found.

 

Saturday 15 November

I must be winding myself down as I prepare to leave for Kampala on Tuesday because my room is looking decidedly empty and, at last, there is a sort of order in my life. A case is inside another case being empty because of all the things I brought and am leaving behind. The inner case holds a drum, acungo (thumb piano), lengths of material, a clay pot and I can’t recall the rest but it is not yet full but is too heavy for the plane.

I am off to Soroti with Sr Margaret and Florence for my annual visit to their mother who suffered leprosy in the past and who lives in a very remote area of bush-land and with hardly any neighbours. I have hired a hospital vehicle for the day with Peter, the driver. A vehicle rarely leaves with an empty seat especially on a Saturday as the locals can take advantage of a free lift to Odello market where there are hundreds of stalls and thousands of people. It’s sad to think this is my last journey this year over the speed bumps and Awoja bridge with the waters below stretching far into the distance.

Their mother’s home is very isolated with barely a neighbour nearby. There was so much LRA rebel activity here that people left and the land has become wild. A young boy of about 10 helps the mother to collect water and firewood and the odd person may pass by. Firstly, we need to buy the items to be cooked for lunch from Soroti market which was so hot and airless. A pastor was shouting words of salvation while people were haggling over prices for their goods. We bought rice, Irish (spuds to us), greens, ebor, cabbage, onions, tomatoes and so the list went on and on. By this time it was about 2 pm so lunch would be late. As soon as we arrived at the home, the vehicle was emptied and I was surprised at what was in the back; iron sheets, chickens, two tables, two mattresses, sacks of crops, a young turkey in half a jerry can, the things kept piling out. The food was taken to the “kitchen” and they set to while Peter and I sat talking and going through the photos stored in my camera. The chicken was slaughtered and put in the pot and the mother sat on a mat by me to de-stalk the greens. I was very happy to assist which caused some amusement because visitors don’t help in the preparation of meals and this had to be recorded on camera!

My tummy was rumbling and it seemed an age until a boy of about 14 years brought out one of the tables we had brought and placed before us water and a plate of ground nuts. The table wobbled and so a small stone was brought to put under one leg to level it out. I must add that the attention to detail offered by the two young lads could not be improved upon and, what impressed me most was that all these actions came spontaneously and without prompting. Finally, around 4.30 pm, Florence appeared looking exhausted and dirty from the fire and food was served. Grace was said and we tucked into a delicious meal and had our fill. It really is very special to be invited to these homes and to be accepted as one of them. Then the sky darkened and thunder rumbled continuously in the distance, the wind rose with leaves blowing off the trees and it became decidedly chilly. Of course, by now, it was late and we said our fond farewells leaving Florence with her mother.

The evening was spent sitting in the Guest House porch drinking beer out of the bottle with the other visitors. A bat almost flew into Marion who I thought was well-restrained from the fright. An insect landed on my back which I removed and which I must have squashed leaving an unbelievable and unsavoury smell on my hand which required immediate washing, The crickets (if that is what they are) were making their usual African night chorus and I shall miss so much these moments unique to here.

 

Friday 14 November

My hospital day today and I attended Morning Assembly which was followed by an excellent presentation on nutrition by Marion and Doreen, the Dutch nutritionists who are staying at the Guest House. I tidied up some loose ends, arranged further dental outreaches with Henry, did some printing and worked with Martin in completing the Motivation wheelchair evaluation forms. I needed more information on Vivian’s wheelchair and so we hopped on a boda boda each and went to Joppa where Vivian is a pupil. I had letters from the children to collect from the School Director, Stella, and Martin interviewed Vivian about her chair.

Now I was to return to the Guest House for a surprise of which I had an inkling as I had already arranged a free date. As I approached the GH, I could see much activity going on outside at the back. Large pans were steaming on the wood fires and women were bent double as they do to stir the contents. I didn’t interfere and went to my room to change into my African dress and was joined by Ruth who had come to say good bye. She did my zip up for me and we chatted a while. The start time was 1 pm but it was soon 2 pm and even later when the activity was still increasing. Balloons were being blown up and fixed to the trees together with branches of bourgonvillia (spelling?) flowers. Chairs and tables were taken out and even a discreet screen to camouflage the pit latrine was erected.

Women were gathering in Anne’s hut, men looking very smart in shirts and ties were seating themselves down and Max, the Catechist, was donning his white robes. Then they were ready and I went out with Marion, Doreen, Rachel and Jenny to be greeted by seven married couples, the ladies  in their wedding dresses and their grooms. Frances Okerenyang, church leader and MC for the day explained that the couples wished to thank me for arranging their wedding on Easter Sunday. A short Thanksgiving service followed with the Gospel reading of the ten lepers which I thought was appropriate being the very spot where literally thousands of leprosy men, women and children had ended their sad, diseased lives and were buried in the hospital grounds during the last century. Introductions followed and then the table was brought out and laden with food. And what a feast it was! With Ugandan plates piled high and mzungu plates less so, we ate until we were satisfied before the next part of the programme: speeches and there was I thinking I’d given mine when I introduced myself! Francis then then announced the presentation of gifts and, firstly, one of the grooms, Simon Peter, handed me a letter of thanks signed by all the brides and grooms. How touched I was and that was all I could have wished for but each couple came forward with their gifts; ground nut paste, a live chicken, ground nuts and a loaf of bread and when they have so little to give! I was overwhelmed but, of course, duty bound to accept everything. I was pleased to be able to reciprocate with my small tokens. A photo call followed and then everyone entered the Guest House for me to show them the movie clip of the start of the Easter Sunday wedding which Harriet had arranged to have taken. They sat there entranced to see themselves on the screen and to hear the music once more. Their faces were a picture with blank looks of awe as well as great amusement. The youngest couple aged 19 and 20 were cradling a beautiful week old baby and two others were breast feeding. The old couple (age indiscernible), John Michael and Elizabeth, could not stop embracing me Ugandan style and thanking me for their opportunity to be wedded.  It had been a wonderful afternoon but it was time to take our leave. All I had to do was to make a cup of tea whilst Anne and her gang cleared everything away and the children took down the balloons to kick around until they popped.

This was all thanks to Hambleton Catenians who, last November, had held a raffle and had given me the proceeds to use as I wished. I deviated from the norm and decided to go ahead with a mass wedding and so it was to be. The event has started off a flurry of marriages with couples joining together and sharing the day. On 30 October in Oseere, a neighbouring parish, I was told that the couples had even not got wedding attire but just their best clothes and this is exactly what I had hoped; that the poor would find a church marriage attainable at hardly any cost.

The very day I arrive home next Thursday and following a two day journey, I shall pass the thank you letter from the married couples to the Catenian President as we are celebrating the Rising of the North with Brother Robert celebrating Mass in Markenfield Hall near Ripon. It will give me enormous pleasure to do so! What a different world it is back home!

No supper required but plenty to deal with until bed time.

 

Thursday 13 November

Outreach clinic today and so my diary entry will be short but the day was not!

Yesterday, Peter, the driver, had collected little Lazarus’ wheelchair which had punctured tyres to have them repaired and so today, before anyone had stirred, he had returned the repaired chair and I’m sure his mother, Mary Goretti, will be very happy to be able to push him again instead of carrying him together with her new baby. Follow up of equipment is so important and, understandably, not cost effective for the hospital and so I find it is an important part of my visit to check up on what I have supplied.

He then collected the team together and we set off for Kolir Health Clinic where we were confronted with a mass of people waiting for us. We were a small team of seven today and would we manage them all? We had picked up Denis, one of our mobilisers, and it wasn’t long before he had divided everyone into three groups; eye, children with disabilities and dental. (I am trying outreach dental clinics to take the message out to the people as well as have the hospital clinic.)

My place was with the children and their guardians or even children who came alone. It wasn’t long before everything was chaotic as my orderly queue which had been given numbered papers so that they came in turn and one by one, collapsed completely because mothers were squeezing their children in and standing behind or, worse, pushing others out so they could jump the queue. Only seated adults were given numbers which caused some arguments which led to anarchy and so I had to find Denis to calm things down. My lack of the Ateso language has severe drawbacks! With law and order restored somewhat, we still had to do something with the throng and we subdivided into “quinines” and the rest. Quinine as it is known locally is gluteal fibrosis which I have often described in my diary and which is the result of carelessly administered quinine injections for malaria. In all, we saw 97 gluteal fibroses, probably a record number of children for one clinic. Each one needed a referral slip and so I did little else but to complete the form 97 times as well as for the others who had the usual diagnoses such as CP, epilepsy etc. The queue never seemed to shorten as, no sooner had one been seen, than another joined in hopefully at the back. We were in a trading centre and, across the road, was a sort of place where you could get a bite to eat and from which was emanating loud, local music all day long and soon I realised that the same music was repeating over and over again. Children were crying left, right and centre and the general cacophony became almost unheard as we were concentrating so hard on the job in hand. The sun was setting when we left Kolir and we had completed an 11 hour day! We had seen 201 patients, eyes 142 and dental 18 so I can say with confidence that the day had been productive. Now, the next hurdle is to get the children to the hospital and so many of them cannot afford to pay for the surgery. Last year, a Dutch organisation held a gluteal camp and performed over 200 operations but I doubt they will return again so soon. I only hope the families manage as the condition can be so crippling – or perhaps an orthopaedic surgeon will read my diary?

I managed to buy a “rollex” each and sodas for the team and so I was far from hungry for my supper but it was good to arrive back and relax awhile.

 

Wednesday 12 November

Home visits for children who had been in the Nutrition Unit with Rose today but first I wanted to attend Morning Assembly as Carlyn, the young Dutch midwife, was leaving. I cycled to the hospital and then set off with Rose to start the day, forgetting to take my bike home! Jenny, the young Dutch nurse who is here for 3 months, joined us for the day. She has been travelling with the medics for a couple of weeks and returned full of stories of Murchison Falls, Queen Elizabeth Park and Lake Buyoni and I was hoping to show her how equally interesting field work is!

I have almost completed my visits to my children and next on the list was Alogai William, a 12 year old brain damaged, malnourished boy who was lying in a dark, dismal room in a trading centre, very sick yet again. The local clinic had put him on a drip to help the immediate condition but the future is bleak. We are renting 2 “gardens” for the mother to grow crops for food and to sell and I wanted to check in what state they were as she looked so depressed. We set off across other people’s land, straddling the millet crop and wading through the sorghum until we reached a garden well stocked with cassava which will be ready to harvest next year which will prove useful. The other garden, she told us, was planted out with maize which she was using and next year she will rotate her crops hopefully growing some ground nuts, a good source of protein. I was pleased with her efforts which have proved that it is worth renting the land for a further year. I asked her how life was with William and she replied that it was God’s will and she must care for him as long as she had him.

Elongyat Joseph, 18 month old, had been severely malnourished in July this year and admitted to the Nutrition Unit for a month. The mother told me that the Nutrition Unit had taught her about nutrition, that the treatment and the “formula” had helped and that Joseph had not been sickly since.

Okia Ivan was a ten month old baby who had spent a week in the Nutrition Unit in August with his grandmother and Rose was pleased to see that the improvement was maintained. He did have a full leg POP on having broken his femur supposedly from falling off the grandmother’s back as she tried to tie him on with her wrap. The hut was small and bare and, on looking up, the sky was clearly visible through gaps in the thatch. We could re-thatch the roof and give her a goat. A long discussion followed and we entrusted a young neighbour to undertake the task of the replacement roof. An old woman who said her name was Education wanted to sell us some cassava as she wanted to buy soap so off she went to dig up a basin full which I bought presumably at above market price as her ululating could probably be heard half a mile away!

On to Odongo Elias and Opio Anold, 20 month old twins who had been in the Nutrition Unit in July for a month. One was looking well but the boy was still malnourished Rose said by looking at his bottom. I thought perhaps it could resemble slightly that of an elephant! The mother needed to supplement its diet and so we helped her to buy milk, sugar and oil as they are taught in the Nutrition Unit and gave them two goats. The mother of twins’ role is not an easy one and she yanked with their arms while they screamed in turn and together as they grappled for her breasts.

The final child was Okello Peter who continued to be malnourished in spite of a month’s stay in the Nutrition Unit. The family were not living in poverty and so what was needed here was education rather than financial support; a perfect place for Marion and Doreen to give their presentation which we will suggest when we discuss our day’s activities over supper. We passed a small boy who was pushing a homemade toy of a small cooking oil container resembling a jerry can with a long stick through its side and an axle with four wheels cut from old flip flops; ingenious and free!

The day had been different from seeing children with disabilities but interesting to follow up these children and to evaluate the effectiveness of the Nutrition Unit. I actually returned with enough energy to collect my bike from the hospital and cycle to Adesso School to see Stella whose phone never seems to have either money or network.

 

Tuesday 11 November

Another “snowy” vision this morning but, this time, I had two witnesses as Marion and Doreen emerged from their rooms to share our bathroom and I almost dragged them outside so that I could prove that everything really was white. They agreed!

Gerard Moses, the blind man, called by and we passed the time of day before I had breakfast. My last outreach day of home visits for this year and we were to go to Nyero with Martin and the mobiliser, James. Before, though, we had some shopping to do and I bought 42 glass tankards (6 per couple) for the wedding couples who have invited me to a surprise lunch on Friday. The lady in the market shack arranged for us to collect them at the end of our day when she would have them gift-wrapped! In total, the cost is less than £3.00 per couple. I also bought twelve mosquito nets for each bed on the Nutrition Unit as the old ones are full of holes.

The children we saw were:

1.       Omuria Joseph, a cleft palate repair at CoRSU but still with a slight aperture in the palate which allows the passage of food. If it has not closed spontaneously, he will be on the list for Mr Viva in October 20015. The father had abandoned the family as he did not want a “disabled” child although he looked perfect. The sad mother, Amodong Jesca,  and child lived in a small empty mud hut and so we bought a mattress, mosquito net and a goat!

2.       Agwi Modeste had been given a Motivation wheelchair which, on examination, had a broken table, a cracked front tyre and a missing nut and bolt from the right brake. I am reporting these faults to Motivation UK in the hope that the next batch will have these problems rectified. The child also needed the seat and foot rests adjusting for her growth. She looked thin, though, with a persistent cough.

3.       We continued on foot to Amulun Ben, a 16 month old Downe’s and floppy CP child. The mother had 7 children and so an animated family planning discussion took place and we will wait and see how effective our advice has been. The child had a CP chair which fitted well and we also provided him with a goat. We footed our way back to the vehicle passing a home where an old man made clay pots for keeping water cool. If only my luggage allowance permitted large packages, I would have bought many at £1.75 for the large type and I bought a manageable one for 25 pence, giving the man perhaps a few more shillings for his entrepreneurship.

4.       Opio Sam’s father was dedicated to this CP boy of 5 years looking no more than 1 year old. The mother was blamed for his condition because she didn’t push and so he didn’t breathe when he was born. The mother was told to put her breath into his mouth and, at a month, she took him to a Health Clinic where she was told that the boy was weak and where they applied plaster of Paris to the whole of his body below the arm pits! After a month, this was removed and he was advised to go to Kumi Hospital. We gave him two goats.

5.       Aboot Agnes was an 8 year old CP girl who had also been given a Motivation wheelchair. Its condition was not so bad and, since she had been given the chair, she has started primary school where she is in second place in her class. We visited the school and soon had a mass of children swarming round us, all wanting to see the strange mzungus. I gave her my last St Teresa’s Hospice bags which I had collected after the Midnight Walk earlier this year.

6.       On to, again, the main purpose of the day, to visit my dear family, Joseph, Vincent and Agatha, the family stricken with a progressive neurological condition and who I have known for many years watching them deteriorate some faster than others. To start off with, we kept them as mobile as possible and later followed by the provision of wheelchairs but, now, we have nothing but moral support and friendship.

The track to their home is almost impassable and we have to have the windows shut as we wade through the bushes with the branches of the glue and the toothbrush bushes sweeping past the front windscreen. Often, we are at a 45 degree angle to the ground and I wonder how far we can tip before finally going over.

In their dark mud hut, Joseph was sitting doubled up on the edge of his bed which Helen had had made for him whilst he ate some unrecognisable food from a blue, plastic dish. Vincent was lying face down under a sheet, just a mass of skin and bone and barely living. We had as warm a welcome as they could muster and, although we tried hard to decipher Vincent’s distorted speech, we were unable to understand a word he wanted to say. A sister, Mary, was looking after them and it is the likes of her who need recognition in this life as their devotion to the family far outweighs anything that we could possibly expect. How they manage day after day, month after month, year after year, I cannot imagine. She told me her story of how the grandmother was being punished for the evil deeds her family had done in the past. Three branches of the family had been affected and the rest were free. She had prayed for days that God would help them and now we were able to give them the slightest hope which we could not perceive but which gave them great comfort. Agatha, the beautiful youngest daughter, could no longer walk nor stand and her face, too, had taken on the dreadful distorted look of her brothers.

There is only so much one’s emotions can take for one day and that was it for me. We left deciding to return on Monday to see how the plans were working out. (Not sure if Monday is going to have enough hours in it to manage everything)

I wanted to say farewell to James, the manager at North East Villa, and to have a de-briefing with Martin as this would be our last day together so we took tea and had a fruitful session. The presents were wrapped beautifully and ready for collection – what service! Then, very tired and very dirty, I arrived back at the Guest House ready for supper and bed.

 

Monday 10 November

Definition: DOWN HEATING – adding cold milk to hot tea!

Waking early, even for me, I looked out of the window to see the roofs of the two mud huts before me, the ground and the trees shining as white as snow. I had to go outside to investigate and there I found an almost full moon high in the sky and a mass of shining stars. I was transfixed by its beauty which is impossible for me to describe accurately as words fail me. Even the early rising cockerels were speechless. A short while later, the effect had gone and now I only have the memory. Dawn appeared and the girl passed the window carrying a jerry can to collect water from the rain tank and a young man was slashing the grass with his panga. A man encouraged his cattle on with a long, thin, flexible branch and the odd cow let out a doleful moo. Life was starting again.

Rachel would join us today in our fieldwork and we set off to Soroti once more, an hour’s ride over the road bumps, and, firstly, to the supermarket and market to buy provisions for Michael Ekonyu’s family and calamine lotion for Brenda whose sister, Priscilla, had told me had spots diagnosed as chicken pox. We left the bottle with the gate keeper of Halcyon School hoping that he would be able to give it to Brenda. We called in to Madera School for the Blind to collect a thank you letter from Betty to St Mary’s School in Richmond. The Sisters there are most disgruntled as I have failed to sell a pile of beads which, to be honest, would never find a buyer even though they had been made by the blind pupils. I hadn’t wanted to accept them in the first place but they had insisted. I have since written to the Reverend Mother as poor Ruth was having to take all the flack.

We called in at Paradise Hotel where Simon peter, one of my boys, has finally got a job of sorts working in the office. Often, when newly graduated, work is difficult and a start at the bottom is better than nothing. I asked him what his monthly wage was – 70,000/= - £17.50 a month!

The main purpose of the day was to visit Michael Ekonyu at his home since he had finished his Senior 4 exams and was now at home until February. His further education depends on his results. A full project for his family has been in my mind for a few years now as he, at 18 years, is the head of the family and also has a syndrome resembling dwarfism. His father has died, his mother, Apio Margaret aged 35,  has had a stroke and can no longer walk, his brother, Elangu Julius, and sister, Amajo Judith, are similarly affected as he is. The brother is in Primary School and the sister is uneducable. They were expecting us and so they were unusually clean albeit in rags, the home in pristine tidiness and they had eaten nothing all day as Michael wanted everything looking just right for us. Much discussion followed with the decision made to start on our original plans of building a simple house with iron sheeting roof which would last for several years as opposed to the short life span of a mud hut. This project will be allotted to a friend at home who has given enough to fund the house. We also plan to repair the leaking roof of Michael’s thatched roof and to buy a mosquito net. I have no idea what would happen to this family if no one assisted them and it feels right for us to do so. The mother crawled on her good arm and leg to show me her cooking area and the effort required was extreme. Michael is the one who has everything to do for them but, when he is at school, one of the few neighbours helps with fetching water and giving them a few crops to eat. All this won’t happen quickly but, at least, they have a future of sorts.

Now, we went to the World Vision office where we met the Manager and we discussed the possibility of forming a link between World Vision and Kumi Hospital which would be most beneficial. The manager promised to visit Kumi on Monday and so time will tell. It was interesting meeting.

The day was done and we were pleased when we reached Kumi after the slow ride when so many road bumps have to be crossed.

 

Sunday 9 November

Three quarters of an hour late for prayers today and I was far too early as I had to sit through 50 minutes of a homily I couldn’t understand! A wild woman was shaking violently in front of the altar and thrashing her arms around until Okerenyang sprinkled holy water from a jerry can over her and she calmed down and was settled for the rest of the time I was there which was not to the end, I can assure you! I enquired about her afterwards and was told she was possessed by evil spirits and this was the result of dealing in witchcraft.

I was entertaining Paul Ekellot, his wife, Angela, and their three children to lunch. (Paul is “one of my boys” and a very important member of Kumi hospital staff working in the physiotherapy department as a social worker. He walks with difficulty due to cerebral palsy.) One by one, the rest of the Guest House visitors changed their Sunday plans until there were twelve for lunch. Anne and Grace were cooking and lunch was to be in the thatched hut. The little family arrived on time and we settled ourselves with Angela and the children sitting on a mat as is their custom. They had kindly brought a tub of ground nut paste which was most welcome. The children sang and danced and played with balloons whilst we watched on. Grace having been said by the children, we shared our delicious meal of chicken, rice, beans, cabbage and chapatti before the afternoon came to a close and the family left.

An uneventful evening followed and so to bed!

 

Saturday 8 November

A brief entry today as I have had quite a restful day which, I can assure you, was welcome.

Hanneke, Ouke and baby, Anne, left and Miriam and Doreen arrived. I tidied my room and waited for Harriet and her future husband, Henry, to arrive as we were to go to Ruth’s village for lunch. Henry was driving a smart, red car and we set off firstly along roads and then tracks, until, all that lay ahead was 8 foot high grass. He didn’t seem concerned at advancing into the unknown but then there was a thump and he was soon out of the car to inspect the cause. A termite hill was the culprit but no damage had been sustained and so we continued at a slower pace. Ruth’s family’s home is isolated as so many are but, entering past the screen of the grass, there I saw a mass of family members, young and old, going about their daily life. The welcome was sincere and it was good to see the old mother looking strong if not a thinner. New family members were introduced; some only days or weeks old; some the mothers of the brother’s children. A family tree would not be possible to compile due to the complexity of these relationships.

Entering the mother’s house, the building of which I had seemingly managed to instigate through a Government scheme, I sat at a small table which was soon laden with a flask of African tea (tea made with full cream milk straight from the cow), hard boiled eggs (straight from the chicken), boiled pumpkin from the garden and ground nuts from their store. We duly blessed the food before we partook of it. You can understand why money is not always necessary to eat a balanced diet. Replete until supper but, no, this was only to welcome me, and no sooner was the table cleared than lunch appeared. Ruth had been cooking all morning and her eyes were streaming from the smoke of the wood fire. She brought in atap (local bread more like Playdoh),  local rice, two freshly slaughtered chickens and ebor (greens with ground nut sauce). Fingers before forks so lots of hand washing and mouth swilling before and after eating. Lunch was followed by a visit to their well, a most dangerous situation with nothing but branches laid across to prevent accidents. The presence of water allows the growth of cabbages which are an unusual crop here due to the dry earth. Ruth’s old uncle doubled up from TB of the spine is the one with green fingers and he is going to attempt onions, egg plants and tomatoes once he can get the seed. The time had come for us to make our departure but not before the family photo was taken.

A delightful afternoon with a special family and I will keep happy memories of the occasion until my next visit.

Back home, Modesta was waiting with her children who drank sodas, a rare treat for them, and we watched the movie clip of the entrance of the seven brides on Easter Sunday at the hospital RC church.

After supper, I managed to get on line to find an offer for 1 penny prints from Snapfish and so I ordered 50 which will be delivered to Darlington in the next few days. Incredible what the Internet can do! Miriam and Doreen had been travelling night and day and retired to bed after supper and so it was not long after that I followed suit only to find it was an hour earlier than I thought. Never mind, an extra hour’s sleep wouldn’t go amiss!

 

Friday 7 November

A morning in the hospital and another visit to Adesso School today and it’s a relief to end the week  Anne by not going anywhere. Following Morning Assembly, Ruth, Martin and I sorted out the photos and names of the children needing wheelchairs which was time consuming but necessary. Ruth and I organised the provision of CP chairs for some of the children we had seen in the field and we were up to date with our plans. A patient suffering from back pain arrived wanting treatment and so I groaned as I read her physio notes which detailed her last treatment by Freda, the newly appointed volunteer physio. I thought that, fresh from college, her treatments would resemble ours but, no, nothing has changed here and infra-red, massage and exercises were the order of the day with the exercises delayed until following an x-ray to determine the diagnosis! This is 1960’s stuff and I had worked hard over the years to eradicate such methods from the department. The old infra-red machine had been thrown out at my request but an organisation had offered the hospital some brand new electrotherapy equipment which, of course, was accepted gratefully! How true the saying that nothing changes! The problem is that, with such a treatment, the patient “improves” and, with our western ideas, the patient returns home feeling disgruntled and dissatisfied and so which is the most appropriate method? I had to leave her to Freda as I could not bring myself to use an infra-red lamp and leave her for 20 minutes. We visited Busimo, the medical ward situated alongside the leprosy houses, to see a 70 year old stroke lady who was lying on a mat outside the 6 bedded block. What a pitiful sight and to think how it would be in UK! She could sit by leaning on one hand and was reasonably responsive but how did she get down there and how would she get up? We asked for her to be brought to the department to be assessed as I had no intention of trying to move her. Busimo Ward is a dismal place but no one ever seems to want to renovate the medical side of the hospital and I have a strange feeling that the patients are happier in these surroundings than they would be in a clinically acceptable situation. Who are we to judge?

Feeling somewhat useless, I cycled home to prepare for the re-plays of Junior and Senior football matches at Adesso School. I was joined by Hanneke, Ouke and baby Anna and, on arrival, we were escorted to a classroom where an unexpected lunch was laid on for us. Following which, we were entertained by the Girl Guides singing and dancing followed by Primary 3 wearing grass skirts and enthusiastically performing a traditional Ateso dance for us. On to the football field, we watched the junior and senior teams play, the junior being far more skilful and ending up with a nail-biting penalty shoot-out. These were followed by a new idea of Lorna’s (Mr Viva’s physio) who had suggested a girls’ team so a short match was played which identified the need of much training! “Gold” medals distributed, the shield was presented to the winning House and I could take my leave.

 

Thursday 6 November

Outreach Clinic and a new experience for me as I have not attended their new arrangements for a clinic in Asamuk, Armuria, and far from Kumi. They load the bus with everything needed for clinics for eye, physio, HIV, nutrition, leprosy and general medicine. Also needed are plastic chairs, the large awning, tables, chairs, in fact everything required as where they hold the clinics in Asamuk is uninhabited and so nothing must be forgotten. Carlyn was to come with me and, rather than wait at the Guest House, we decided to join the team at the hospital. Morning Assembly was finishing and staff were congregating by the bus but there were two men working underneath as the clutch was “down” ie broken. Would we go? Who knows but a spare part was produced and no more than an hour later we were on our way. The bus was packed, not only with all the equipment, but also staff, discharged patients with their mattresses and belongings as well as chickens. I uttered a prayer that the bus would not let us down far from home.

The journey was long and rough and I was already weary by the time we reached Asamuk at around 1 pm where many people were patiently awaiting our arrival. Some had started to leave as we were late and they had walked a long distance but there were plenty who remained. They were quickly sorted into the different categories and we sat at a table we had brought under a tree and with the children with disabilities waiting to be seen. The usual – many gluteal fibroses , burn contractures, CP’s etc. The workshop had measured three children at the last clinic a month ago for a corner seat, standing frame and a walker which the mothers collected. Ruth and I discussed the possibility of starting a group of mothers with CP children and I suggested starting immediately and so she registered the patients and divided the sixteen children into two groups. Within no time, they returned with a committee already formed and Group two having chosen the name Opia Koyu which means “Wipe away your Tears”. I met Martin, an ex-leprosy patient who had come to see me but I had failed to recognise him. It is about three years since I visited Asamuk and he looked much older than then. His leg had become infected and he had decided to have it amputated and so he had a prosthesis and was managing well. Many hundreds of patients had been screened or treated and, when all had been seen and dusk was approaching, we packed the bus and set off back home.

The road seemed even longer going back and the bumps much bumpier. The dust from the lorries in front made visibility bad and I realised that it is the same during daylight but now the headlights picked it up as they do with falling snow. We stopped on leaving Soroti until 26 white armoured tanks stacked on lorries and bound for Southern Sudan slowly passed us. The staff had been given their remuneration and so it was an experience to witness the transformation from a pleasant and efficient employee to someone much the worse for wear having stopped frequently to spend their small earnings which is meant for food on alcohol.  Surely, the wife would be disappointed not to receive this money. Apart from this, the rest of the ride was thankfully uneventful causing Carlyn and me much amusement and 3 ½ hours later,we reached the Guest House too tired to eat but not to have a shower.

 

Wednesday 5 November

My diary entry for today is DAY FREE! A day to myself sounds welcome and should re-charge my batteries. So how did the day fare?

7.30 am and a visitor; the mother with the little boy with the windswept legs came asking for hospital fees to be paid. She was first brought about a month ago but I reprimanded the person who had told her and not her so, again. she wasn’t at fault but this really can’t happen. I advised her to return to the hospital and wait and all’s well that ends well as it was agreed that the Compassionate Fund would settle the account.7.45 am and Joseph arrived with his stooped posture, nobbled joints and facial features resembling a daschund.  His mud hut had completely collapsed on him and he had nowhere to go. Could I help? He’s one of those who look at you with such pleading, droopy, sad eyes and, although you want to refuse, the heart strings are pulled too hard.  Grace was translating for me and we ummed and aared and I couldn’t turn him away.

Breakfast followed and then the arrival of Peter to take me into town. I had planned to use a boda boda but somehow they are looking after me as if I’m old! I had arranged to see Dr Ekure at the Orthopaedic Centre, the hospital he has built in the last few years in town. The progress has been swift and remarkable with a 3-storey block under construction at present. We climbed the precarious wooden ramp to the top of the scaffolding to see the potential rooms marked off by hundreds of vertical wooden poles. The idea of a lift in the plan would probably not work with the unreliable power source and so the ground floor alone is for patient use.

I met Harriet there and we then walked to Kumi Prison as Sam, the Chief Prison Officer, and I got to know each other when installing the fuel-saving stove and organising the dental clinic. I take him the UK prison newspapers and he enjoys comparing here and there. We sat outside his home with the cows being urged on by the odd prisoner and the chickens running around our feet. The wind was strong with the large leaves of the overhead branches whacking down upon us. I was surprised to hear that a TV is now installed for the prisoners’ use and so, no doubt, they keep up to date with the UK Premier League. What next? We discussed many issues including morals but we could not sit there all day as he had a meeting to attend and we made our leave having been given a heavy bag of oranges.

It’s quite a walk to town and to Centenary Bank where we made some queries about the transfer of funds in Euros and Sterling and to see Pius, my most successful student who is now Loans Manager there. He arranged to call at the Guest House in the evening.

Harriet and I parted and I walked along Market Street where I bought a rolex for my lunch. (Rolled chapatti with omelette, tomato and onion = roll-eggs) and cow treatment for Priscilla’s cow. A boda boda ride home, a tasty lunch and I was free. Paperwork dealt with, diary up to date, some washing on the line blowing in the strong wind (I must buy more pegs) and my room straightened a little. When school was over, I rode to Joppa School to visit Vivian, another of my children, who has severe arthrogryposis and, as she crawled into the Head teacher’s classroom, I saw the true extent of her deformities and her tiny body.  I was sitting carefully upon a settee which had very few slats under the cushions and I was relieved when she climbed up and managed not to slip through. She is a true delight with a big smile and happy disposition and, thankfully, is so bright. She was so happy to read her letters from Tony, Martha and Beatrice and her face beamed when she say the socks I had brought but they were too large so she would give them to her friend. I asked the teacher if the children would write to those at St Mary’s in Richmond as they had sent about twenty letters to Betty in the blind school and it was not possible for Betty to reply. I didn’t want to disappoint the English children so I hope I will have replies next week.

I cycled back and waited for Pius to call and I was surprised when a Centenary Bank car arrived to bring him. This young lad of mine had certainly made the grade. We had plenty to talk about until he left to visit his aunt, Sr Margaret who is Senior Nursing Officer.

Supper and bed to mull over the events of my day off.

 

Tuesday 4 November

Carlyn had found yesterday so interesting that she asked if she could come again and so I explained that no two days are alike but she was welcome. Today was certainly no exception and we started by us going to Soroti with a few calls to be made starting with a visit to Charles Okular, the newly retired Kumi Hospital Administrator, who had started his new job as Hospital Administrator just that morning. Bethesda Hospital is only seven months old and so is in its preliminary state. Very smart it was and I am sure Charles will enjoy the challenge of setting up the various departments. Ruth was waiting for us to go to St Francis School for the Blind in Madera. P7 exams were taking place and so it was good of the staff to let us sit in the grounds with Betty who is growing tall and is well-spoken in English. I gave her the pictures made with different textured materials which Betty could feel and Ruth read a letter from Sophie, a 9 year old from St Mary’s School in Richmond. St Mary’s had also given her a prayer card with a cross for her pocket and Sr Mary Kevin said that they would print out the prayer in Braille for all the class to read. The visit went well and we gave her some soap, sugar, dry bread, toothpaste and sanitary pads; no need for pencils!

Whilst there, I decided to visit St Patrick’s Church which had been largely funded by the Diocese of Hexham and Newcastle and which I had read about  in the Northern Cross from our church. We asked for permission to enter the church which is undergoing construction only to find a vast building which will be able to accommodate hundreds of people. I hope I will see the finished article. Fr Frederick to whom  I gave the beautiful vestment from the Poor Clare nuns in Hereford and who came to officiate at the marriage of two couples in Kumi is based here and we were able to see him for a few minutes as he teaches at the seminary there and had just finished taking a Latin class.

Outside, the trees were laden with literally thousands of large black bats hanging upside down from the branches like pears. Occasionally, they took flight en masse with their wings swooshing through the air and their calls giving an eerie atmosphere. I had warned Carlyn that each day was different and here we were half way through and not having seen a patient.

We picked up a mobiliser who would guide us to the families which he has identified as having a child with a disability. At the first one, we met Emo Patrick, an 11 year old CP who was born normal but had a fever at 6 months which caused severe brain damage. He would need a wheelchair and was given a goat.

Ekonyu Joseph was the son of the mobiliser who, again, was born normal and, when 3, he suffered a fever leading to brain damage. He was lying on his side and his father proudly showed us how he could sit up but this method was by sitting with legs akimbo and the body leaning forward so that he was virtually folded in half – not an appropriate or suitable method of sitting. Goat number 2!

We were walking to each house as they were all near and connected by narrow tracks. Erabu Moses was 3 years old and yet another CP. The mobiliser had been shown how to make parallel bars to enable Moses to stand but he hadn’t quite got it right and so it was good that we visited so that this could be corrected. I didn’t think the child was ready for weight-bearing but they insisted he was being stubborn during our visit. Goat number 3!

Last child was Emula Irene, a 7 year old who was born normal but suffered a fever at 2 months. How frequent are these stories? Too much so! Goat number 4 and a mattress as the children slept on three torn pieces of foam which had seen better days.

The day had passed and was fortunately less tiring than yesterday. The ride from Soroti to Kumi involves speed bumps and was dusty as the day had been dry so, although we thought we had got away lightly with thick layers of dirt, it was almost as bad as ever. A shower, supper with a beer tonight, good intentions to write my diary which failed and sleep were the order of the evening.

 

Monday 3 November

The start of another week and what will it bring? All is prepared for a day with Martin and we are to be joined by Carlyn, the young Dutch midwife, and Rachael, the young stenographer, both of whom want to experience fieldwork.  Hanneke, Ouke and baby Anna have returned from their weekend away and Rachael’s grandmother, Betty, has settled in her granddaughter and moved on to stay with Sr Sophie in Soroti. (I don’t suppose Betty will mind me mentioning that she is a young 85 year old and quite remarkable. Let’s hope I manage the same record!)

The day started somewhat disorganised just when I wanted all to go smoothly for the girls and we were about an hour late in setting off. I called in at MTN to buy more airtime to find an assistant sweeping out a dead rat. There were many, he told me.

Martin told us we were going to Bukedea which isn’t too far away but what I failed to realise was that the district of Bukedea extends as almost as far as the base of Mount Elgon where we could see in the misty distance the Sipi Falls. This journey along bumpy roads took long and I thought that we would have to turn round to come home as soon as we arrived. Finally, we reached Kolir and the first home having picked up our mobiliser who would guide us along the unfamiliar tracks.

Oloba Michael, a 25 year old orphan whose parents died when he was a baby, was normal until he contracted malaria when he was 10 years old. Since then he has been unable to walk but was sitting in a wheelchair in the village compound of his aunt, Oloba Rose, a cheery, chubby woman busying with her daily activities. They lived in a small trading centre close to the murram road. My immediate thoughts were focussed on a tricycle for Michael who would then be mobile and independent and this would change his life considerably as his only affliction was his contracted legs. He demonstrated how strong his upper limbs were. We explained we would need a 10,000/- (£2.50) contribution (a third of my usual request but somehow it seemed as though even this small amount would not be simple to find). Was there anything else we could do? We could motivate the aunt with small capital to start a business and, after much discussion, she  decided she would like to have a small “stall” by the road side selling small dried fish (can’t think who would want to buy these but they are a popular and cheap source of protein) , tomatoes, onions, salt. The list was long but we suggested she start small and build up slowly. The mobiliser would follow this up and, when the tricycles are delivered from Mbale, Michael would be supplied with one.  He was a little bit spoilt as we also gave him a goat as a dependent with a goat suddenly becomes an asset rather than a burden.

The father of Okunga Gerard, a 12 year old who suffered convulsions when young and was now brain damaged with a low mentality stopped us by the road side as he wondered if we could help. His compound was surrounded by a pile of newly dug up groundnuts all laid out in rows. A successful crop is important for their food supply for the coming months  and, when these are dried, they are stored still in their shells in maize sacks or in their store woven from wicker and shaped like a globe with a thatch roof which lifts off to gain entry. Although Gerard attended Primary 1, he was ostracized by his class mates and excluded from interaction with them. The girls proved to be a blessing as they blew up balloons, arranged the children who had gathered to see these strange mzungus in rows and played balloon games including Gerard in the proceedings.  Harriet counselled the father during these activities and advised him to include him within the home and to speak to his teacher asking him to be at the front of the class. I doubt there will be much improvement but, if his class mates will accept him as one of them, life would become more tolerable. There was little else we had to offer.

Kedi Janet was a big 14 year old girl who lived with her sister and her husband and two small children. The father of her sister had died and, as is the custom here, the mother married her brother-in-law and produced Janet who had a severe deformity of the leg following osteomyelitis. The father did not want a wife with such a child so he threw her out and then the mother left to be a concubine.  Their home was a small mud hut in which the five of them stayed. No wonder they looked so depressed and quite understandably! We planned to provide an even smaller mud hut for Janet so that she would have her own private sleeping area and this would make a big difference to their situation. Denis, the mobiliser, would supervise the procedure to ensure that all went well. The money situation was sorted and we provided a goat for Janet to start her off with an income generating project. They hardly looked any more cheerful when we left but I’m sure this plan would give them some sort of a future.

Whilst seated in Janet’s home, parents with children arrived to see us having heard that Kumi Hospital had come to town. The mother of Igoe Beth who was a 3 year old with webbed fingers on both hands,  brought her girl to seek help. These fingers could be worked on by Mr Viva next year and would go on the already growing list.

Opedu Joseph, a 12 year old boy in Primary 3 limped towards us and we could see that he had a hip problem. He pulled up his ragged shirt and we hitched his trousers down an inch or two to reveal a hip deformity caused by a fall from a mango tree when he was 6 years old. There seemed to be a head of femur out of its socket but an x-ray was needed to ascertain the true cause.  He was given a hospital referral note.

Okello Patrick, an adult, walked with a piece of stick about 18 inches long to aid the swelling he experienced in his left leg. It took a lot of convincing that this stick was far too short and even exacerbated his problem so I gave him a rough pole lying nearby and showed him how to use it as though punting a boat. It took much persuasion to get him to try and I thought I had failed until he told me as I was leaving that the white woman was right and he would look for a longer but smoother pole.

We left this makeshift clinic and were driving along the road when a father ran across a school playing field to bring us his child, Okam John, a 5 year old who had had an infection in his toes, two of which had dropped off but two remained with a small lump which, if ever to wear shoes, would be an issue. (The big toe remained unaffected). As it was unlikely that the child would wear shoes, I could not make a conclusive decision and so I took a photograph which I would send to Mr Viva for his opinion. We left with the father knowing that he had done his best for his son.

We drove along the tracks until we reached the home of Apuno Annet, a 3 year old with severe congenital deformities of her little limbs. Six fingers on each hand and could one be a thumb? Only an X-ray would reveal this abnormality. Where was the elbow, was there a radius? I didn’t know but once again we had little to offer but to provide them with a goat. The mother and the two other children were all similarly affected we were told but they were not present.

Finally, we went to our last home. Today, we had had to foot it to many of the homes as they were not reachable by driving and thankfully the sun was not too intense as we followed each other in crocodile formation along the narrow tracks bordered by the crops of sweet potatoes, sorghum and cassava. Lydia was in her hut and she crawled out to greet us; a big girl who attended Koli Secondary School and was taken there on the back of a bicycle. Her mother was suspicious of our presence and I wondered if we were welcome. A tricycle would alter Lydia’s life but the mother spoke abruptly and it was only later that I realised that she had been disappointed previously by the offer of help and had felt deceived. It took some convincing that we would fulfil our promise but they would have to be patient as we were waiting for delivery of the ten tricycles from Kamlesh in Mbale. Later, a phone call to Kamlesh confirmed that the tricycles had not been started and so I was pleased that I had given him a nudge.

The day was done and we were duly tired and extremely dirty with sweat and dust. I thought of the long journey ahead of us but we took another shorter route which brought us to Kumi Town along a straight, murram road, probably better because it avoided the tiresome speed bumps on the main road to Mbale.

A shower and hair wash were essential, a meal welcome and then to bed.

 

Sunday 2 November

Opening the door to greet the morning as the day dawns is a delight! The coolness of the fresh air is in contrast to what is to follow. The sound of the many cockerels and birds is all that disturbs the peace.

Prayers this morning and Betty, the grandmother of Rachael, a young stenographer who is here for a couple of weeks and staying in the Guest House, came with me. We walked to the church at my usual time which was about an hour late to find we were very late but then there was plenty of action before everyone left. I was to introduce our visitors to the congregation and the offertory items other than the money were auctioned. The Primary 7 exam candidates were blessed and, as usual, the hymns were sung and played on the local instruments with enthusiasm. Hand shaking at the Sign of Peace has been abandoned as a precaution against Marburg (a close relative of ebola) and, instead, we waved to all around us. On leaving the church, there is, of course, much hand shaking and African type hugging. Rose from Nutrition Unit told me that little Ekonyu Michael, not the one from yesterday but the 6 year old looking no more than one year old, had died after being admitted. Ruth later contacted me to say that she and Paul (physio social worker) were meeting to arrange the return of the body to the family. A day can’t pass without a sadness.

Back at the Guest House, Robert Ecelat and his family were calling briefly and they arrived in style, five on his motor bike; well, almost six as Jane’s baby is expected this month! It’s good to see them again and I had a letter from Marie, a retired UK teacher who writes to him regularly. The children sat on a mat in the shade hut and we shared our news and drank sodas.

At 2 pm, I was to visit Modesta for lunch so I had bought her a few provisions which her son, Peter, had collected after prayers as rice, cooking oil and sugar are very heavy to carry especially as I was going on my bike. Crossing the airfield and reaching the trading centre, I met Hellen who was cooking chapattis to sell. Her “employer” pays her 2,000/- a day (50 pence) and she grafts away in the heat for hours on end. Modesta’s house (14 bricks square) was so clean and tidy with the furniture ie a bed for her husband moved against another wall. I settled myself on the seat I had had made many years ago by the students in the Ngora School for the Deaf workshop otherwise everyone sits on the floor. Most things are shared amongst the neighbours when a visitor arrives as forks and plates are non-existent but it feels so much like home. Not sure about night time, though, when 12 bodies lay like sardines on the floor. A delicious meal was placed before me and I ate from a plate and Modesta from a lid. Afterwards, we played Uno and, of course, I ended up leaving the pack of cards behind. 

Time to leave as I had promised to visit Priscilla, daughter of the late Asio, and my fingers were crossed that I would not have to eat another meal. She is a short cycle ride away and this was my first visit since her mother had died. Priscilla had been a wayward girl and a disappointment to her mother but had come up trumps since and was now at home with her two children, growing crops and being a good housemother. She never strayed far from the home rarely going to the trading centre or Kumi town. It was the same with her mother as the local people have never been all that friendly. The family history is sad and difficult for me to write down for all to read. She proudly showed me a small cow which she had bought as a result of the goat that Dr Grace had given the family on her last visit. `I decided it was time to take my leave as the wind and dust were rising and the skies darkening. Priscilla picked up her turkey in one hand and the baby chicks in the other with great skill and locked them away before walking along the road with me and her two children but I soon decided I was going to cycle the rest of the way as the lightning and thunder were already performing. How right I was as the large drops started to fall and we needed to shelter in the porch of the Guest House together with the other visitors and Stephen Obwongo who kept us well amused.

A pleasant supper and, dear me, I was so tired and ready for my bed.

 

Saturday 1 November

My room is completely disorganised having moved and I’m having difficulty finding even the basics so today I went out without any sun cream but I did find the insect repellent which, although not quite the right thing, might possibly be better than nothing. It’s impossible to stay out of the sun when in the vehicle as I always seem to be on the sunny side both coming and going as the sun moves from east to west.

Katakwi today and Dr Owen, one of the young Medical Officers here, asked if he could join us. Ruth, Harriet, Peter, the driver, Owen and I were joined by Alex who has been in charge of arrangements for the building of Lawrance’s house which was our target for the day. Passing through Soroti, we stopped to buy provisions for Lawrance as well as Antony and Michael, two of my students. Laden with bags from the market and supermarket and stocked up with lunch of samosas and chapattis, we started at Antony’s school, St Stephen’s Primary School. Antony Edonu doesn’t get any better from his “post traumatic stress” having witnessed the slaughter of his parents by the rebels when he was much younger and I continue to have doubts about his exam results. This is his second chance after which we may have to re-think long and hard. Michael Ekonyu at Light Secondary School was the opposite - radiant and optimistic as he prepared to take his Senior 4 examinations. They had both been given their bags of sugar, bread, Blue Band, toothpaste and money for transport home and I hope to visit Michael’s home as he reports that his mother, following a severe stroke, is now unable to walk.

Now, we could set off for Katakwi to Lawrance’s home. The roads were terrible and we bumped our way there passing children and youths swimming in the water – neither ponds nor lakes – just a stretch of water suitable for fishing and welcome for splashing around in. Purple water lilies flowered profusely in the waters and, as we passed over a bridge, many snake birds swam gracefully along.

At last, we reached Lawrance’s home and saw the shining corrugated roof of his new house. He was sitting in the doorway in his wheelchair and wearing Mr Singh’s suit looking so excited and proud that his involuntary movements were completely out of control. His grandmother, Ruth, gave us a warm welcome and told me that her husband was with his second wife. Lawrance’s house looks just as we had drawn the plans with a stick in the sand a year or two back. There was still a way to go before he could move in as the inside walls needed plastering and a little more brick work but I am very pleased with the result so far. Alex has done well and we will be able to call it a day with a few more cash injections.

Time to leave and start our long drive back which I measured as 95 km which, on these roads, equates to what seems like much further. The speed bumps, the dust, traffic and animals wandering along make progress slow. We passed an upside down Coca Cola lorry carrying literally thousands of bottles in crates on the Soroti road otherwise nothing of great note.

 

Friday 31 October

My hospital day comes round once more and I had lots of loose ends to tie in my room one of which was to catch up on my diary and I also wanted to read the hospital Annual report for 2013. I discovered that Hanneke, Ouke and baby Anna aged 9 months were coming to stay for 10 days and I would not feel comfortable if I stayed  in “my room” which is the best in the Guest House  and let the three of them squeeze into the smaller room which had been Helen’s so I offered to move out. I am now sitting with my cases, boxes, tin trunk around me but, at least, I’m only one person and not three. My new bike came into use for the first time and I cycled along the hospital road until my saddle tipped backwards so that I was almost sitting on the carrier above the rear wheel! “Rollng” the bike followed and I took it to the Workshop where they kindly tightened the nuts and bolts. It was a late start at the hospital and I began with collecting copies of the second part of my survey on re-usable sanitary pads for Adesso Girl Guides. I wanted to see Henry, the dentist, as he was arranging an outreach dental clinic which will be next Thursday. I told him about Dentaid’s email regarding the digital x-ray costings and he was shocked realising that they were unrealistic. On Ojikhan ward, I was disappointed to find out that the plastics patients had been discharghed which meant that the physiotherapy which they needed would not be given. However, there were patients for physiotherapy but Agnes, the physio, is off work for 14 days having been attacked by an intruder into her home in staff quarters in the middle of the night. She has moved into town as she fears to stay in the hospital grounds. One of the patients, a man who claimed to be an artist had broken his leg in a motor bicycle accident and another patient had been brought in after another motor bicycle accident and was waiting to be cleaned up. A third had fractured his tibia and fibula by similar means and so it appears that, if there were no motor cycles nor mosquitoes, many hospital beds would remain unfilled. A sick 27 year old mother of three and with hardly an ounce of flesh on her was lying on the corner bed and suddenly she rose up in the air with a loud wail and landed crash on to the floor. It was a frightening experience as her arms and legs were long and spindly and she went with such force that I’m sure she must have damaged some part of her. The doctor was sent for and I left after suggesting she was nursed on a mattress on the floor.

Lunch had been brought from the leprosy kitchen and we ate rice and cow (with beans for me) in the physio department.  Afterwards, an old lady who claimed to be 85 year old was pushed in by her daughter for treatment. She had fractured her femur and had been discharged but her mobility was very poor. How they possibly manage at home, I cannot imagine. There she was hardly able to move and yet she would sleep as well as sit on the floor and her latrine, if she had one, would be a fair walk from her hut. By the time she left, she could manage to walk with a Zimmer frame with her daughter’s assistance but we did not practise floor sitting! I am presuming she came to the hospital on the back of a motor bike. I cannot imagine any person in UK enduring such conditions and especially at such an advanced age. There is no ambulance service apart from the emergencies and most mothers in labour will use the same methods. A CP baby was next and I left her to Freda who is a volunteer physio newly qualified in Kampala and unable to speak the Teso language and so requiring Ruth to translate.

I would return to the Guest House collecting Carlyn, our new midwife from Holland, as I was planning to go to Joppa School to see Vivian, my arthrogryposis girl, but it was too hot to make the effort. A cup of tea at the GH revived me and it was great to meet Hanneke and Ouke again and be introduced to their baby. With a little energy restored, Carlyn and I walked across the airfield to Adesso School where the children were sweeping the compound with locally made brooms. The Primary 7 exams are on Monday and Tuesday next week and the candidates were preparing their classroom. Let’s hope they manage to find enough desks for them to sit at. I ahd the second part of the survey to give to Hellen, the head teacher, as well as balls of wool left by the plastics team. Betty, Guide Captain, is teaching the Guides to knit and will be pleased to have this bag of oddments. She has been given No 8 needles but I haven’t seen her do the “through, round, under, off” bit. Sam, sports teacher, was so insistent that we arrange a replay for the junior and senior football house matches that I relented and agreed to go next Friday afternoon.

The Guest House is full and we all sat at a long table for our supper with many conversations in progress while little 9 month old Anna tried to attract her parents attention. back to my room to catch up on emails and early to bed for me.

 

Thursday 30 October

I was all ready to go to the Outreach Clinic in Kachumbala when Martin called me to say that it hadn’t been mobilised so there would be no patients. My mind immediately raced to the opportunity to have a day off but then my days here are few and I suggested we have a makeshift programme. No sooner said than done and Peter drove up with Michael (eye outreach) and we set off for town to pick up Harriet. There are families I have known for ten years and more and I don’t always have a chance to visit them and so today was perfect to see Max’ family, Melissa, Stephen and Lazarus’ aunt.

Setting off through town we called at a wholesale shop (cheaper than the supermarkets but you have to climb over sacks of beans, rice, sugar etc.) to stock up on the usual provisions for Max’ family and another for Lawrance, Saturday’s home visit, so that this would save a further shopping session. Items were weighed and stacked up on the ground outside the shop and, when everything on the list had been checked, they were sorted into three boxes and put in the back of the vehicle. Lunch of two mandazis (similar to doughnuts) were bought and we were ready to leave.

The family of Max, who is one of my boys and who has been through secondary school, graduated at Mbale Islamic University and is now seeking employment, live in a small clearing in the district of Palissa. They have two girls with severe disabilities and, over the years (ten I was reminded), we have seen this family develop from one of extreme poverty and hopelessness to a degree of security with the second boy, Sam, about to enter Senior 5 which the father, Stephen Pande, has achieved by selling his crops.  We have stepped back with our assistance except for an occasional treat such as today’s hamper welcomed as though it was the best of Harrods.

On to Melissa who was given a tricycle a few years ago. Her little house was empty but we were told that she had gone to buy fish to deep fry and sell. Before she had the tricycle, she remained at home and was abused by the local men who provided her with three offspring who are now 17, 14 and 9. Not to be beaten, we decided to find her if possible and we set off towards the lake until Peter, who never misses anything, spied a tricycle outside a hut. It was, indeed, Melissa’s and she had sent someone to the lake to buy her fish. She would then take them home, deep fry and sell them at the local trading centre making 1,000/= net profit on a 3,000/= outlay which relates to a 25 pence profit per day and a lot of hard work. She was so happy and looked 100% better than the wretched woman we had first found. She was clean and relatively decently dressed and had showed such initiative that she deserved a little more. What could we manage? After some private discussion, we decided to increase her stock with cooking oil, salt, matches and soap so that she would have a few more items to sell with her fish. When I asked her how the tricycle had helped, she told me that she felt more confident and could move around to socialise and attend church.

A girl whose eye ball had “dropped out” following a corneal ulcer came to stand near us and Michael was able to give the father a note to bring her to the eye department next week and she would be fitted with an artificial eyeball.

Lawrance Opio was next and it was a couple of years since my last visit. His brother, Samuel, had been dying and lying under the shade of a suspended blanket. All so sad! Now, Epodi Apulasi , the aging mother of 70 plus years and having had ten children , was caring for her remaining son, Lawrance, who stayed in his hut all day and night, lying on the ground and unable to do anything for himself. When nature called, his mother would place a piece of black polythene underneath him and then remove it and clean him. Her dedication to this grown up man was so moving that Harriet had to come out of the hut. What could we do but give small assistance which his mother placed near his head and then he cried and cried with happiness. I wish I could explain better as words fail me.

Thank goodness we had bought provisions for the other Lawrance as we were able to give them the box instead.  I wonder if I will ever see them again! One can only wish that Lawrance soon enters a better life.

Finally and almost back in Kumi town, we went to the aunt’s home of Imanginat Lazarus who is the blind boy at Magale School near Mbale. The home is very poor and it is good that Lazarus has this opportunity to be educated and to be able to socialise with other children. There was a small home- made table on which there were about ten onions, six tomatoes and a basin of what I would call whitebait all of which were for sale. I doubt she would have many customers as she lived well off the beaten track. We sat on the low chairs to listen to the story of her husband. In 2006, he was taken ill and his abdomen swelled and so they took him to the local witch doctor who diagnosed poisoning. He gave the man a concoction but his condition did not improve so the witch doctor admitted him (not quite sure what this could possibly mean) and he died. The witch doctors fee was about 100,000/= (£25.00). No one will ever know what the outcome would have been if he had gone to Kumi Hospital instead which he had almost passed on the way to his fate. I am grateful to the aunt for her care of Lazarus and so we have funded a goat.

Now our day’s unexpected events were done and, although the absence of a clinic does not bring in new patients to the hospital, I was very happy to have followed up these families.

 

Wednesday 29 October

Helen was up early to be prepared for when George drove up with the hospital bus to take her to Kampala. Modesta called to say good bye and asked if she could have a lift to Ngora. We were off to Serere with Rose from the Nutrition Unit and with a couple of school visits on the way. First stop was to see Apulamera at Ngora School for the Deaf and we learnt that she will be taking her P7 exams on Monday and Tuesday next week. This is her second attempt and so fingers are crossed. I had forgotten the importance of a success card and was reminded by the head master. Apulamera appeared very nervous and, as this is her second attempt, she will not want to fail again.

Then to see Leah who, instead of being the shy, silent girl of old, is a radiant, confident, smiling young lady at 13. Lovely to see her develop so well. Instead of being top of the class, she is now 10th out of 170 and no bad thing, I think, as she will have some competition instead of sailing through unchallenged.

Now, the task I had been dreading and that was to see Amos at HOW Orphanage in Kyere. I had heard he had lost his job but, no, he was still there as an accountant (and after he had cheated me a few years back) I won’t give up on this matter and I now wait yet again for him to pay his debt by the end of January. The problem is that sometimes these people don’t know what is right or wrong  as we see it and that the priority is to look after one’s own family if given responsibility for others. This issue was discussed at our CNU meeting in Macclesfield earlier this year as it seems to be common practise. Enough  so I shall pass on to better topics.

Nora reminded me that it was 8 years since I bought her a tricycle which transformed her life. She has kept it in excellent condition as she does her whole home. The compound was swept and tidy and surrounded by flowers. In fact, it reminded me of an oasis in the desert with banana trees on the periphery and chickens and the goat we gave her last year with its kid rummaging underneath. We had brought her a box of provisions and, on placing them on the ground before her, I have never seen anyone so completely speechless with joy! Just rice, sugar, salt, soap etc but probably the first time in her life she has received such a gift. It will take long for me to forget the moment.

On to Stephen Tukei, our 17 year old hydrocephalus and spina bifida young man who we have been visiting for many years.  It is so sad to see him, a handsome fellow who has done nothing in his life but sitting on the floor until we gave him a wheelchair and that is his past, present and future. The joys and sorrows of our visits are extreme. His goat had had two kids, the cow had had a calf and his wheelchair needs replacing.

Finally, Janet Amuge in Ngora, our severely brain damaged 11 year old with brittle bones and a sight to break anyone’s heart. Her mother loves her so much but gets nothing in return. Their bull is enormous and she is trying to sell it to start off building a permanent house but is unable to find someone willing to pay a fair price. The cow has had a she-calf and is expecting again. Janet’s mother, also Janet, asked if we could provide the girl with a type of cot to prevent further fractures so we tried to design what  we thought would be good by drawing  out a plan in the sand. The mother will contact a local carpenter to see if this is possible.

One more deed to do which was to deliver a success card to Apulamera before returning to the Guest House.

 

Tuesday 28 October

Getting myself dressed for the day, I saw a shadow pass the window easily recognised as the very tall Modesta leaving the Guest House. Although only 7.00 am, I was pleased to see her as usual and, having knocked on my window, called her back. She had come to see when Helen was leaving and would return this evening with a small gift, undoubtedly g-nuts, for her.

We were off to Mukongoro with Martin for more home visits. The road was almost impassable in March but work in progress, although promising, didn’t, ease the situation. Lorries were tipping tons of murram almost over the entire road, gigantic steam rollers waited their turn and men sweated profusely as they raked the murram flat. Progress was slow but finally we turned off onto the tracks to our first family.

Sagarti Dina was a mother of three whose legs were so weak that they almost crumpled beneath her when standing and she used a branch to hobble around but found it easier to crawl. Her eldest daughter was 20 years old and married, the bride price being three cows and two goats. (Her birth was the result of a man abusing Dina due to her situation which is an abomination in my mind) The second girl, Adeke Stella, had a similar but, as yet, not so advanced condition as her mother which manifested itself as bow legs. The third child was Obuge Joffry, a 7 year old in Primary One. A loving family and what a difference a tricycle would make to Dina’s life and so, when the present order is delivered, she shall be the first to be given one. We decided to visit Adeke Stella’s school to ascertain her problems and she was soon found among the 130 pupils in P3. Her condition was not advanced but her legs were markedly bowed. We would arrange for her to be assessed by Dr Malagala, the Orthopaedic Surgeon, and to pay all the expenses as, for a child to end up in a similar situation if preventable, would not allow me to sleep at night. There were 130 children in Primary 3, 207 in primary 1 and 73 in Primary 7 which indicates the drop out as the children progress up the classes. Can you imagine a mass of black faces all smiling in a small classroom without a desk and chair in sight?

Kulume Florence: 12 years old and a hydrocephalus and spina bifida. She had been given a wheelchair again by the freewheelchairmission which I have yet to Google. Regina, the Italian physio who first introduced me to Kumi identified this girl and included her in the hospital programme. I noted that her toes were absent on her right foot and was told they had not been amputated but had become infected due to her paralysis and had subsequently dropped off. Her father was an LC1, a local Counsellor of some local status and presumably not living on the poverty line. Although her condition was not pleasant, I did not consider her in need of aid. However, I gave her a dress which Margaret Graham had made.

Aluke Jennifer, an 11 month old floppy CP baby, on examination, was found to have slight head control and so we showed the 22 year old mother some simple exercises to help the baby to life the head and to be able to start the process of learning to sit. She was also trying to roll which is a good sign. We planned a CP chair and the mother would take the child to the CP clinic at the hospital to be measured next Thursday. She was given a goat.

Iculet Berna: a 30 year old lady who had polio when 3 years old and who had had a tricycle for the last 8 years. the tricycle was in good condition but without mudguards and so we gave her 20,000/= (£5.00) for 3 new ones… as well as a goat!

Oluka Lazarus: an 18 month old hydrocephalus child whose father had thrown out the mother and so she had returned to her mother’s home. The child was sick and the rest of the children were standing with pangas to collect firewood which meant them missing school for the afternoon. It is sad when school is longer the priority when education is so important. She will also come to the hospital to be measured for a CP chair and was also given a goat and mattress.

Asio Anna Lucy a 4 year old hydrocephalus and spina bifida girl whose mother had been abandoned by her father. Anna was the last of the seven children. She had been to Cure, the children’s neurology hospital in Mbale. She would need a small wheelchair when a little older.

 

A quick turn around with a shower and change of clothes to return to NE Villa for a final meal with Mr Viva and his team. After a good supper, the singing and dancing commenced with the team and staff singing and dancing with great gusto. Helen, Peter, the driver, and I left at 10 pm but we heard that they kept going till midnight!

 

Monday 27 October

I was going to think Monday was Tuesday and tomorrow was Wednesday after doing fieldwork on Sunday so I started the week in muddled mode! My routine is to get up early, prepare for the day and then settle down to write my diary before the rest of the world, apart from the cockerels, awakens. Today was no exception but, as I passed the door on my way to get my umpteenth cup of tea with water from the Thermos, I saw I had a visitor. Seven am is a little early and I was yet to get dressed but Priscilla had come with her two children, Antony and Margaret, and I was pleased to see them. By now dressed, I greeted her and we spent a short time catching up on her life since I saw her last in March. She was very positive about everything which was so encouraging as I usually hear all their woes. I really had no time to share with her so I agreed to visit her home on Sunday afternoon. But then Gerard Moses called wanting money so that he could attend the burial of his wife’s sister-in-law. I had to speak to him severely and tell him that I wasn’t the bank and he must never ask me for anything again as he has stepped over the line as far as requesting for money. He walked away sheepishly feeling the way with his white stick but enough is enough.

Off to Soroti again for another day with Ruth. She had done us proud yesterday with a perfectly prepared programme for Mr Viva which, for me, could not have been improved. The list of children will never end and we continued on our way after buying a samosa and chapatti each for our lunch.

Ekoyu Michael 6 years floppy CP and so sickly and chesty. He was born normally but sustained a fever at 15 months which caused the brain damage. He needs a CP chair to be made at the hospital workshop and will go the Nutrition Unit on Thursday. He will be re-assessed after discharge as we could set the family off with IGP in the form of a goat and also give him a mattress and blanket.

·        Ewechu Raphael 10 years CP and epilepsy also born normal but, after one year, he too had a high fever which caused the brain damage. He had been given a wheelchair and I must look up freewheelchairmission.org to see if we could link up with them.

Today we had to “foot” it too much as the sun was relentlessly beating down on us but the vehicle could not go any further. There is little more exhausting than walking in this heat and, in order to see Engolu Simon, we needed to use the sweet potato mounds as stepping stones. The ground was as solid as rock in spite of a better than usual season of rainfall.

·        Simon was an 8 year old CP child who needs parallel bars for standing and weight bearing and, hopefully, walking. We are always provided with local seating of some sort usually brought from neighbours as they hardly ever need seats of their own. I always do a quick risk assessment before lowering myself onto the seat and, this time, I left Harriet with little choice but to take the 3 legged chair with the fourth corner propped up on a tree stump. Tricky to say the least!  He was given funds for a goat and a mattress.

·        Eroku Brian, a 7 year old, had severe burn contractures of both hands but somehow did manage to write with his right hand. he attended primary school but was very self-conscious and reserved. Too late, again, for Mr Viva this year but he is on the 2015 list. We gave him crayons and a book.

·        Agono Salome, a 6 year old CP from birth, had been admitted to the Nutrition Unit and discharged in July. She had a CP chair but continued to look malnourished so was given a goat to start the family off with some form of security. I’m not sure what I would have done without the Dutch medics’ supply of 55 goats from their family and friends!    

·        Ruth had organised a small group of 3 families.

·        Okirir Jonathan 8 years Gluteal Fibrosis

·        Iyilor Debra 9 years Gluteal Fibrosis

·        Elaru Solomon 7 years post injection paralysis (dropped foot)

They needed surgery and we ahd to decide to turn them down although I can’t say there were more needy cases but somehow we can’t do everything.

The fourth child was Ameso Joyce, a 5 year old floppy CP child with epilepsy who was looked after by her aging stepmother who had been the first wife to her father. She had had no children of her own and seemed happy to take great care of Joyce. Now, this was a case which I could straightaway select as one who was worthy to help.

She will come to Kumi to be supplied with a CP chair and she was given a goat and a mattress.

By now, Helen and I were too hot and tired to go any further and so that was the end of our day’s visits. We had been footing a lot in the heat of the sun. The day had been fruitful and interesting and we had enough to digest in our minds.

 

Sunday 26 October

I have noted that the clocks have gone back an hour in UK and now the evenings will be dark so early as compared with here where the day’s length throughout the year remains almost the same with only 20 minutes or so difference between them.

Good news today! The abducted 10 year old girl has been found in Bukedea, thanks to the radio announcement! An unknown woman had taken her and now the mother was looking for money to go to collect her. We would definitely have helped if asked but she must be someone of great pride. Anyhow, we are very relieved that all is well.

Helen has had a bad night with a tummy upset (could it have been last night’s chicken?) and she has decided to remain behind today as she didn’t fancy being far from the loo. The plan is to take Mr Viva and some of his team to Soroti to visit our families as it is their day off and we called at their Guest House to find them sitting outside having breakfast in a most civilised manner and with a table spread with food. What luxury!

Mr Viva and four of the team, Harriet, Peter, the driver, and I set off for Soroti and it is always strange to take visitors who find everything so interesting and what we take for granted. The cameras never stopped with photos of the general life, the surrounding countryside, the cattle and the women.

Ruth had prepared the day for us and what an interesting day it turned out to be. There she was waiting for us as we entered Soroti and the day started by visiting Akubol Sam who we first met last week on 21 October. Today was dry in contrast and the ground did not threaten us with slipping into the mud. Yesterday, Ruth had visited the home in the slum area of Soroti where the families live in close quarters all busy with their daily routines. She had made parallel bars for Sam as we had discussed earlier and I thought these would allow Sam to stand and learn to weight bear but I was not fully confident but better than not doing anything. Little Sam had already had a go and, by the time we arrived, was walking up and down the bars in spite of his jerky movements which warmed the cockles of my heart as I had never expected such sudden progress. He tired quickly and, when back in his mother’s arms, he spied Mr Viva and took fright when he saw the old “muse” (old man!)

Another mother brought her floppy CP boy and he will be given a CP chair from the Orthopaedic Workshop.

On to Eluke Silas who is the brother of little boy whose photo I used last year for my Christmas card. I was pleased to see that Silas was looking well and that his animals were increasing. The goat had had a kid and was expecting again. The first sheep had died and its offspring had had a lamb and I’m hoping I can use one of my photos with an appropriate caption for a Christmas card again. (I have been informed that, if ebola reaches here, I shall be put into quarantine for 21 days on my return to UK. At least I’d be able to get my photos in order!)

Emadu Emmanuel was operated on by Mr Viva two years ago and, when I visited him last year, I found a pitiful sight with his mother seriously ill with a gynaecological problem and Emma the head of the house. I thought Mr Viva would like to see him again and so it was a pleasant surprise to find his mother so well and Emma, although still badly disfigured, with much more confidence. Mr Viva was happy with Emma’s eye lid and upper lip and would continue with more work on him next year. This time there seemed to be a father who emerged sheepishly from his hut but then we were told he had had a circumcision three days earlier so perhaps he had an excuse to look glum. The poor lad’s house leaked like a sieve and his mattress was non-existent as was his mosquito net so that was easily solved with a dig in my pocket.

Engadu Elias was on Mr Viva’s list for last year when he unfortunately had to cancel the trip. Elias was, instead, sent down to CoRSU who were running a cleft palate initiative to have a cleft lip and palate repair. When we visited the home, the mother reported that the palate repair was incomplete and that porridge still “went through” so it was so good to be able to take Mr Viva for review. Too late for this camp but he is on next year’s list.

Our final visit of the day was to Oregia where God’s Grace group was assembled to greet us. The ten children with disabilities and their mothers sat on mats on the ground whilst we introduced ourselves and then the ten goats were escorted in – one each all belonging to children in the group. I offered to take the tethering ropes while the mothers picked up their chiildren for a photograph but I ended up like the centre pole of a Maypole entangled in these ropes and one goat with slightly longer horns than the others deciding to but its neighbour. I continuously learn by my mistakes!

For my records, the children were:

·        Atim Joanne   Deaf and Dumb at Ngora School for the Deaf

·        Edecu Sam  10 years   cerebral palsy

·        Acino Karen 3 years   CP

·        Nawigulu Ester 7 years hydrocephalus and spina bifida

·        Okello Joel 3 ½ years osteomyelitis

·        Aloch Julian 5 years CP

·        Ibiret Grace 1 ¾ years hydrocephalus and spina bifida

·        Abiaro Malissa 15 years CP epilepsy

·        Etengu Benjamin 10 years epilepsy

·        Ekunyu Musa 13 years epilepsy

Our visits were done and we were in need of some food and drink so we stopped at Sipi Falls restaurant in Soroti where we ordered chapatti and beans and sodas all round. Hands washed, perhaps a brave trip to the loo for those who needed to go as the team were not used to the latrines in local cafes. I generously offered to pay the bill for 7 of us on the condition that Mr Viva paid the next time. I am sure he will have drawn the short straw as the total bill came to £6.00!

Home, shower and Helen and I were back into town to have supper with Dr and Mrs Opolot. Fortunately, Helen could keep the conversation going while Consolate was cooking in the kitchen. Helen knows everything about Premier League football and I was perfectly happy relaxing. The evening was spent catching up on our respective families with John and Consolate sharing their concerns over the impending marriage of their eldest daughter. John usually drives us home but it wasn’t until we made a move to leave that we learnt that he had no car and he would get a boda boda for us. Neither of us would have liked being driven up the 10 km road to the hospital in the dark so we phoned Peter, the driver, who was sleeping and patiently came down for us. He is so patient with us and nothing is too much trouble. Back at the house, we found two frogs a-leaping in the porch much to Helen’s dismay and the door locked. We had to knock on the metal door of Anna’s hut to wake them up also and finally we were in the house and tucked up under our mosquito nets.

 

Saturday 25 October

The wedding of two couples at St Joseph’s Hospital Church today and Helen and I were invited. There should have been three couples but the bride of the third had been admitted to the ward (she is positive ie with HIV)

I needed a dresser to put on my royal blue Mothers Union gomaz so Anna kindly strapped me firstly with my all-purpose sheet/ towel/ wrap around, then yards of blue material and finally topped with a sash lined with thick, black polythene. I was going to be hot! At 8.30, Helen and I set off to walk for an 8.30 start to the service and settled ourselves in a bench with a back to it and outside the church. The music blared forth from loud speakers which they love to import for such occasions and then the church choir thankfully took over. To start off with, we were entertained nicely but then one hour passed and two with no sign of priests or brides. This was getting somewhat tedious, we wished we had brought our Kindles and the sun’s rays trickled through the branches as it rose in the sky and increased in strength. At last, a car brought two priests who disappeared into the church to give instruction. I have no watch so I don’t know what time the brides arrived. The grooms had settled themselves into seats at the front and there we were at the back and unable to see much at all. The brides finally made their entrance and, with the troupe of little dancing girls anything from 3 years leading them on, I went forward to have a better view and we were escorted to a spare bench just behind the grooms and their best men. Augustine, the elder of the two, smartly dressed in a suit sat in front of me and I could see that he was of advancing years and with few teeth. The priest started the proceedings and mothers came forward with their babies to be baptised together with one groom. This followed with confirmation of youngsters and the groom and then the marriage ceremony began. The couples stood before the altar and professed their vows speaking clearly into the microphone. (PA systems are so popular on such occasions). Finally, the rings were exchanged but poor Augustine’s ring for his wife was too small so it never reached past the second joint and neither did hers for him. Augustine was quite a character who was already the life and soul of the day. I discovered that they had been together for 47 years and obviously in a very happy union. The priest gave the final blessing, the choir continued and the congregation dispersed.

There were two priests one of whom was a young man, newly ordained and I had a gift for him. Okerenyang had told me of this newly ordained priest in Soroti who would like a vestment. When I was staying with the Poor Clare sisters in Hereford, Sr Josephine gave me an obviously African cotton one and I was delighted as this would do for Fr Frederick. However, a few weeks later, a Special Delivery parcel arrived at home from the sisters and inside was the most beautiful cream and gold vestment lined in red, richly embroidered and all made by hand by the Sri Lankan sisters. My first reaction was that it was more suitable for a cathedral but it was given to me for Kumi and that was where it had to go. Fr Frederick’s face lit up as he took it out of the bag and in no time he was posed for a photograph looking like a handsome actor portraying a priest rather than one for real. Anna and Grace in the Guest House were obviously expecting the priests and rolex chapattis had been prepared together with fresh fruit juice and laid before them (a rolex, which I think is a newly invented name here, is a rolled up chapatti with an omelette, tomato and onion inside).

Helen and I had been invited to the reception at Augustine’s and Christine’s home in Kachaboi but we had had enough after so many hours at the church and I couldn’t wait to be stripped off of my garments. We could rest and, with the Dutch girls gone, the house would have been more to ourselves except for Anna’s children who have taken over. Martin and Elaine returned from their couple of days’ in Mbale where they relaxed by a swimming pool and supper and beer was shared with them and Dr Owen, a House Officer. I was so tired that I went to bed but thought I wouldn’t drop off to sleep as the noise of the music which could well have been coming from the wedding reception a few kilometres away as sound travels far here was so intense but I don’t remember a thing!

 

Friday 24 October

A hospital day was initially planned to be an easier day but it didn’t work out that way. Visits to the theatre to see the plastics team and staying for a coffee, a meeting with Dr Robert as I had a few issues to talk over (he is very pleasant and reasonable and I’m sure will be an asset to the hospital), Henry, the dentist, regarding the portable dental chair Dentaid have offered to donate, with George William to request a lift to Kampala when I leave if a vehicle is on a drug run amongst other things. I had bought 36 mosquito nets for the Children’s Village but, on checking, only 15 had been put up so I complained to George William and we visited the Village to check and there they were, all present and correct. They must have known I was on the prowl! On the private ward, there is a young lady called Harriet who had been slashed by her husband and she has sustained serious wounds. Fractured radius and ulna, nerve damage on the other arm, first finger and thumb partially amputated, dropped foot, slashed arms, legs and body. Lorna (Mr Viva’s physio) was working hard on her and was hopeful of partial functional recovery.

Back at the Guest House for a quick change and off to Adesso across the airfield for Sports Day with Lorna. Thankfully, they had listened to my request for a low key event and, after the school sang the National Anthem with hand on heart, the games were under way with netball, football (Junior and Senior) and volleyball. In spite of the lack of ceremony and speeches, the time passed too quickly and we were going to be late for our next appointment. Food had been prepared and we had no choice but to be rather rude and ask if we could take our meal to our seat by the volleyball pitch. The scores were added but the junior and senior football matches were both drawn and so a replay must take place before the winner of the House trophy can be announced.  We did manage to give out the “gold” medals for the winners and Helen chose the “Man of the Match”; a small boy on the junior football team who is evidently an excellent athlete. Andrew, a teacher, took Lorna back to NE Villa as we saw the hospital bus pass us without a sideways glance. Helen and I and the 3 Dutch girls who looked a million dollars piled into George William’s 7 seater car to join the plastics team and some hospital staff for supper at their Guest House.

A very pleasant evening followed with a delicious meal for 25 of us followed by singing and dancing from all the countries which were represented; Uganda, UK, France, Denmark, Kashmir.

 

Thursday 23 October

Janet Akurut called at 7 am (good that I’m an early riser) and I had a letter and some shillings from Wendy Richardson for her. Janet was doing well and had been selected to go on an agricultural course for HIV ladies which reinforced all she had learnt a few years back at Aliasit Farm where I took a team to learn sustainable agricultural methods. She was very enthusiastic to put her new knowledge into practise. Before she had left, Gerard Moses, the young blind man, arrived wanting, wanting, wanting from Helen but he got no joy from her. It’s time he learnt that we do not hand out money just like that. Then, a distraught mother sat on our veranda with her head in her hands. Her 10 year old daughter had gone missing from home almost a week ago and, in spite of visiting the school, friends and relatives, she had reached a blank. She wanted a few shillings to make a radio announcement as a last resort. Young girls can be abducted here for many reasons one being for human sacrifice.

We were waiting for the vehicle to go out for field work but it failed to arrive until 9 am. Finally, we set off to Serere where we were to split up for two separate clinics in different locations. The first clinic hadn’t been told what conditions we would see by the last physio who I had never met and he didn’t last long in Kumi employment and, from what I could make out, was pretty useless. Agnes (physio) saw the patients briefly before we all left together for Bugondo, about an hour’s drive away. Many patients were waiting for us and we settled ourselves at a table in the shade of a tree to see them one by one. Then a few drops of rain fell through the leaves and we wondered if the tree would be protection enough but then the skies opened and we had to find a room inside the health centre. We were based at the end of a small ward full of noisy children and mothers and so, with rain pounding down on the iron sheeting and the children making so much noise, we tried to hear the patients tell us of their problems. The rain persisted so heavily and the passage was awash with water. By now, the patients we had seen lingered as it was quite impossible for them to leave before the rain abated. The queue didn’t seem to shorten either, the eye clinic was over and still we had patients to see. Finally, we could close the books and pack our bags. Never have I been so relieved as to pile into the vehicle and start off for home. However, this was not to be as the back wheels of the vehicle had sunk deeply into the soft ground. No matter how Peter tried hoeing the earth away from the wheels, wedging them with bricks and stones, trying the jack and revving the engine to no avail, we were well and truly stuck. In fact, and I don’t know what this means, the differential was also stuck in the mud! We were in the middle of nowhere with no passing traffic, no habitation apart from a woman making tea and atap which Harriet advised we didn’t take. Helen had crayons and a colouring book so, with the pages torn out, some children set to and were happily occupied throughout. I was frozen and luckily had a blanket in my clothes-to-hand-out bag. Dusk was falling and the prospect of staying in this Health Centre did not appeal but seemed more likely by the minute. A welcome motor bike was hailed and Peter, our driver, went to the trading centre where earlier we had bought maize cobs and roast cassava from the roadside but this was far and took long. Helen had a good idea that we all sat on the bonnet and the rear end would lift but nobody agreed but me. I also had a less sensible idea that we should yoke a couple of oxen and let them haul the vehicle out but then someone pointed out that, when the oxen heard the engine roar, they would be off to kingdom come, vehicle and all. So we waited until Peter returned minus truck for pulling us out as there were none. However, he had a team of hefty men who set to with hoes and brute strength digging deep down to release the differential. Lots of chatter and muscle power achieved success and in no time we were on the road again. What an enormous relief! We didn’t fancy the latrine and so we were in need of toilet facilities but waited till we got back. 8 am to 8.30 pm is a long time. I had one banana which we shared between nine of us. With food on the table, Helen and I were too hungry to eat and, somehow, not in need of the loo but very dirty and tired.

PS If you go onto Google Earth and put in Bugondo Uganda, you will see where we were!

 

Wednesday 22 October

Suzanne and Aline gave a presentation on Infection Control relating to Ebola at Morning Assembly and so Helen and I attended Morning Assembly although we had listened to the rehearsal in the evening. Kumi Hospital is preparing for a possible outbreak of ebola or Marburg which entails a tremendous amount of consideration. Being a leprosy centre in former years, it is an ideal situation for isolation. Uganda has been declared free of Marburg following the death of a victim last month and the necessary three weeks quarantine with no new cases reported but caution is still imperative.

Whilst at the hospital, there were a few loose ends for me to tie. I needed to discuss the        three patients who we brought yesterday with Simon Peter in the Workshop. They will be      attended to today and then they will return home by public means. I found Lorna, Mr Viva’s        physio, in theatre but wishing to join us in the field. So, Suzanne, Aline, Lorna, Helen, Harriet, Rose and I set off with Peter driving to go to Oseere and Omatanang to visit some of our families.

·        Acom Scovia: 2 year old cerebral palsy girl who had a CP chair. Last year, we gave her a goat and a sheep and it was encouraging to see that the goat had three kids and the sheep one lamb. The child had been in the Nutrition Unit and looked well. I gave her a dress which a lady in my road at home had made and another one for her sister. The mother was very grateful for the assistance and I must say that she was a good woman who looked after her home well.

·        Alongat Joyce Mary: a 1½  year old cerebral palsy child had been given a cow by Helen in March but was to share with Apolot Caroline, a 2½ year old who was at her home and sitting in a corner seat but so tiny for her age. The cow’s hide had tight curls as did its calf and had been named Delys (Helen’s idea). Worming was required so we gave the mother 40,000/= for de-worming powder and tic spray. We had given Caroline a chicken which had laid 6 eggs which were sold when chickens and had “turned into a pig!” Lorna was quite upset at the size of the girl and the crying and wanted to see how she was when not in her corner seat. Her mother laid her on an old maize bag and she immediately went into extension spasm and her crying reduced. I thought she may be hungry or thirsty so the mother fetched a beaker of porridge and transferred the contents from one beaker to another until it was cool enough to drink. The little girl was so thirsty and probably hadn’t eaten all day. There is no perfect answer to the seating issue as the mother needs to secure the child when she needs to attend to her crops. The father was fishing in the lake which we could see not too far away. Two goats for this family.

·        Agwang Irene: a two year old who had been admitted to the Nutrition Unit. She had had constant diarrhoea since birth but no diagnosis had been forthcoming. The tests are limited and no serious investigations are available so the true cause remains unidentified. The mother had 10 children and the house and compound was filthy so not too much of a surprise to have a sickly child. No point in just given her an IGP so we have loaned her two goats on the condition that she tries harder to keep her home and children clean. Let’s hope it works! We are getting more confident in suggesting family planning and they think it is a good suggestion but I wonder if they carry it out.

·        Odong Emma and Apio Marion (you will recall that Emma is a boy’s name) were   year old twins who had been admitted to the Nutrition Unit three times. Rose was pleased with their condition and so, after playing ring-a-ring-a-roses and blowing up balloons, we left confident that the Nutrition Unit had served its rightful purpose.

·        Lazarus Ochanya: an 8 year old who we have visited many times. His mother, Mary Goretti, has transformed her life by growing sorghum and orange and avocado trees, too young yet to provide fruit, and the cow we gave her a few years ago had presented her with a calf only two weeks previous to our visit. The earlier calf had sadly died. Milk has provided her with an income and the opportunity to improve Lazarus’ health. In her mud hut, she proudly showed us her mattress which she had bought with the profit from the sale of excess milk. She had given birth to her fifth child 6 months previously and so another family planning lecture was necessary. Her husband would come infrequently and then abandon her but she thought he would agree as all he wanted was a second daughter. He hadn’t even stayed to see this last daughter. Mary Goretti was only “fair” as she had too much work to do. Her roof leaked and she was unable to leave her children to seek grass for thatch so we gave her a helping hand. There must be little worse than sleeping under a leaking roof and being wet and cold even here in this hot climate.

·        Akon Emima: a 3 year old with a congenital deformity of the legs; most strange and we knew not if there was anything to be done but amputation at a later date. She walked on the base of the femur and with no tibia nor ankle joints. We have since discussed with Mr Viva who has, in turn, discussed with the orthopaedic surgeon and they have formulated a plan of action to make the legs functional. Peter, the driver, collected the child at 7am the following morning for examination.

·        Okwi: 6½ boy with a neglected club foot (NTEV) who came towards us on all fours as his foot does not allow weight bearing. We disappeared into the mud hut to find a sad picture of true poverty and so we bought a mattress, blanket and mosquito net and the Dutch girls gave funding for a goat.

It had been a good day for me as the Dutch girls had used their funds to buy the goats which has eased my financial output for the day.

On our way back, we dropped Lorna off at NE Villa and joined the plastics team for a drink and nibbles which makes us realise what we are missing in our Guest House.

 

Tuesday 21 October

I searched in everything I had and in vain for my modem without success so I left the hospital for Soroti with all I may need to buy a replacement. The road north is much improved but road works continue and they have this tiresome method of compressing the tarmac by adding speed bumps which are very close together. On one stretch alone, I counted 86 allowing us to travel around 10 mph. The rain seemed to have fallen all night making everything so muddy but it did reduce the dust when lorries passed.

We were to meet Ruth in the Main Street and she caught up with us in the Orange shop as we tried to arrange a modem replacement. Mr Viva had requested pen nibs so we went to a couple of book shops but without success as they didn’t know what pen nibs were. We were also joined by little Paul who was fitted with a below knee prosthesis in March and he was doing well but the prosthesis needed repair. He had to hold the strap as he walked along to keep the leg in place. We would pick him up on the way back and take him to the hospital workshop for repair. In all, we visited 9 patients and one group.

1.       Akubol Sam: a 4.5 year old athetoid cerebral palsy child whose birth injury was caused by a prolonged labour leading to delayed crying. He lived with his mother on the outskirts of Soroti in a mud hut surrounded by many others and a buzz of activity from the mothers all busy washing or going about their daily chores. Chatter, laughter and music filled the air and chickens strutted knee deep in the mud. Perhaps he could start weight bearing if he had parallel bars to practise on so Ruth will arrange the construction of these. He also seemed quite bright and so we left him with crayons and paper.

2.       Asio Rebecca: the girl whose prosthesis we repaired in March was in the market selling potatoes and charcoal. We had given her 20,000/= UGS and so it was good to see what she had achieved. The ankle joint needed repair and so she would join Paul, stay overnight in the hospital and have her leg sorted. She kindly offered to give me some potatoes but I decided to buy 2,000/= worth and was given a large plastic bag which I could hardly lift.

3.       Abukunyang Stella Rose: 17 year old amputee who had had osteomyelitis when she was 8 years old. She had completed her education to P6 level and walked with one crutch. She did nothing but hang around the market but approached us asking if she could have a new leg like Rebecca. She would be the third patient to accompany us on the way home but I had reservations about being able to have a prosthesis as the stump was poorly shaped and very short. Worth a try!

4.       Asimo Brenda: 17 years and the daughter of my dear late friend, Margaret. A long story why she is in my programme but briefly a VSO worker who lived in Kumi Hospital for many years has supported the family for many years and so I am continuing to help with this arrangement for him. I got the impression that she was finding the work in her new school hard and, when I mentioned her mother, tears ran down her face. So sad! Her mother was HIV +ve, and then had a severe stroke. No wonder if you knew her life story and then she finally died of pneumonia.

5.       Aladot Evaline: a CP girl who had been given a goat in March and which was now pregnant. She is to be considered for a Motivation chair.

6.       Namwanja John: the 7 year old who we funded in March for a gluteal fibrosis release which had been a success. We decided to give him a goat.

7.       Elweu John: a spina bifida boy who had been provided with a Motivation wheelchair. The chair was not surviving the terrain and the front wheel was not working well and one brake was short of nuts and bolts. He slept on a reed mat which, when paraplegic, may not be too uncomfortable but can lead to serious pressure sores. We would give him a mattress and a blanket. Since he got his wheelchair, he was admitted to school and was in Primary 1. His younger brother would push him to school and, due to John’s double incontinence, would change his clothes when necessary. To thank him for his efforts, we gave him a goat as he certainly deserved something for his loyalty to his brother. His grin was enough reward for us! We asked him what he would like to call his goat and his immediate response was; “Lilliput!”

8.       Edechu Samuel: a 10 year old cerebral palsy who, since given his Motivation wheelchair, was attending the nursery class at the local primary school. Although this may sound strange, it is good for him to socialise with other children and away from the isolated existence of the village compound. The front wheel of his wheelchair was not in good working order and the foot strap was broken. It is important to inform Motivation of these issues as they need to be rectified.

9.       Oriega God’s Grace Group

This was the group which we set up last year and which has been officially recognised by the Local Council with a stamp of approval on very official looking papers. Ten members with their children sat on reed mats under the branches of a mango tree while the meeting was conducted in formal fashion. “Next item on the agenda: a few words from Robinson!” and that being me meant that I had to rise and spout forth and they expected my speech to be at length! I thought I did quite well when a ripple of applause followed so I sat down glad that that was over. We will give each child a goat but they will belong to the group. Conditions were applied and Ruth will buy the goats and distribute them and I think I may have to be present.

The end of our working day and we had a couple of treats to follow.  On taking Ruth back to her rented house, we found that her neighbour had been preparing a meal for us. Ruth’s house is rather small for 6 people so we went next door and enjoyed a delightful feast in her slightly larger room. Rice, chicken, beans, avocado and, of course, cabbage. Once the plates were empty, we took our leave for the second treat but before that, there was a kafuffle outside and a cow had pinned a small girl against a wall. Not sure of the outcome.

The zoo from Entebbe had come to town and we (correction; they) didn’t want to miss it. We parked the Land Cruiser on a sports field and went to the box office which consisted of a few maize bags hung up and with a tiny slot behind which sat a cashier. We had to stoop down to speak through the gap and ask for 6 tickets at 1,000/= each (£1.50 in total) Many stalls selling wooden giraffes, flip flops, kikois etc etc , ghastly music blasting forth from the different stalls, a roundabout on similar but different lines to the one in Edinburgh’s Princes Street last Christmas and then…the zoo. Another maize bag with slit to buy even more tickets to see the animals and this time 1,5000/= each. Extortionate but school children on an outing  queued up and there was no shortage of enthusiastic locals. On entering through the maize bag tunnel, we espied the first animal, a lion which lay sleeping in a cage resembling those in cartoons. It was tired, we were told. We passed on to the next one, a leopard lay sleeping. It was tired, we were told. Perhaps the third creature would be a little more exciting but a stationary python lay curled in a cage fronted with glass. The fourth animal must be the piece de resistance and, there, in all its glory stood an old ostrich like a shop window model. We could have been in Madame Tussaud’s!  Thank goodness we have animal cruelty rules in UK. A journey for us from Entebbe to Kumi is bad enough but, for these poor animals, it is quite intolerable. Well, that was the zoo which Helen and I found more amusing than anything.

We didn’t need supper so it was a good scrub under the shower and a hair wash for me and bed. I shall never relish the thought of the first splashes of cold water on my skin and, oh, for some hot water!

 

Monday 20 October

What a dark, dull day! Grey clouds overhead and how I missed the bright sunshine! A young girl, Goretti, the wife of my blind friend, Gerard Moses, was waiting on the porch with their baby, Raphael. She had ridden her bike with Raphael tied to her back for many miles and was grateful for a banana and half an omelette. They have a tough life as Moses cannot work and they live in a very remote village where they light fire by rubbing grass together and cooking potatoes by digging a hole in the earth, lighting a small fire and then covering the potatoes with soil. I gave her a few clothes and shillings and she waited till the rain had stopped until she made her long way home along the narrow tracks which must by now be flooded.

Peter, our driver, arrived to take us to Pallisa for a day’s home visits and what a day it was to turn out to be! Many families all in desperate need of help.

I shall list the visits numerically for my reference.

1.       Akol Emmanuel: a 5 year old looked after by his grandfather aged 74 since the mother died. He had a lipoma in his neck and was referred to Mr Viva for possible surgery.

2.       Apolot Martha: 4.5 years

Akello Sharon: 1 year

Parents: peasants

Martha was normal until she had meningitis at 4 months. She also had a congenital abnormality in that her right arm consisted of a tiny button attached to her “shoulder”. We gave her a red spotted dress and shorts made by Bev from home. I took a roll of material back with me in March for her to make into these dresses and shorts and they are perfect. We also gave little Sharon a red gingham dress made by a lady in her nineties from home.

The father was quite ingenious and had fitted a tiny light like a star to a battery in the mud hut to provide lighting! He was proud to show it to us. Their compound was so tidy but they had nothing to their name. It was decided to give them a couple of goats and a mattress.

3.       Okwi Paul; a 13 year old who had had a cleft lip repair but not his palate. He had two large front teeth which accentuated the deformity but hopefully Mr Viva will sort him out.

4.       Opio Lawrance: 8 years with acquired cerebral palsy which means that he was born normal but brain damage occurred following a high fever. The home was dirty with rubbish scattered everywhere and the house was untidy. The mother was unkempt and seriously depressed. Her hair was matted and her clothes torn (which isn’t all that unusual but she wasn’t making any effort). The father had left her and given her a small piece of land which was not enough to grow food for her five dirty children. Our plan was to take the mother and boy to the Nutrition Unit and then follow up the family to encourage her and provide her with a goat, blanket and a mattress.

5.       Among Alice: 12 years with cerebral palsy following meningitis at 4 months. Her father carried her in his arms and so we were thinking of putting her on the wheelchair list but he then he told us that she could walk. We gave her a goat.

6.       A group of ladies had been given a cow and calf by Helen who had named the cow Madge. The cow had given birth to a further calf and so there was now a cow with 2 calves.

The group consisted of three families: Acom Juliet 10 years CP; Odong Moses 3 years CP; and Tina Margaret, a TB spine paraplegic with a tricycle. After much deliberation, it was decided that the mother of Moses would be given the first calf to care for as no one had direct ownership of the animals in the group and the aforesaid calf was handed over to a beaming new recipient. The keeper of the cows was a lovely but domineering woman and I thought there may be some resentment but it seemed not (at least while we were there).

By this time, many surrounding children had gathered to watch and one poor little soul with a very swollen face had been stung in the eye by a wasp.

7.       Peter’s Home

By now, we had reached the home of Peter, our volunteer, who covers this region on his bicycle visiting the homes of the children with disabilities. He is most diligent and is proud of his connection with Kumi Hospital wearing his new polo shirt with the logo and, on the back, “Help Others Help Themselves”, the Kumi Community Fund’s motto. We walked round his compound to see his progress with his orange trees and crops but he had a sad story to tell. Some neighbours are jealous of his association with the hospital and mzungu and his success. Someone broke the leg of the latest calf and it died; a despicable act which I cannot understand but have experienced previously.

He had gathered three neighbouring families who waited for our arrival under a tree near the road. Again I shall number them:

1.       Obwato James

2.       Atodo James

3.       Tukahirwa Joyce

Moses, the son of Peter, was doing well and was so cheerful.

Atodo was a 6 year old who couldn’t walk and was suffering great pain. He looked sick and needed help but our knowledge was inadequate and so we referred him to the paediatrician in Mbale giving him financial assistance. The other children were given a goat each. Asekenya Patricia was a tiny 2 month old, underweight baby with a cleft lip and palate.  We were not sure if the surgeons would take a child so small but the father promised to take her to the hospital next morning but was aware of our doubt.

8.       Ariong John Baptist, a 41 year old man, with a large cyst in the right side of the neck approached us and he, too, will come to the hospital in the morning.

9.       Last but not least was Oytebe John, my young lad with the knobbliest knees and joints ever. We first met him last year and so, while we were nearby, we called to his home to find the old grandmother and grandfather going about their daily duties. We were greeted warmly but John was still at school. The goat we gave him last year was tethered amongst the bush with its kid a few yards away and so our plan to provide an IGP was working. They were very happy with their mattress and blanket which the grandmother and John slept on while the grandfather slept alongside on a reed mat. This is unusual as the man usually has the first choice and no one would choose to sleep on the ground. On impulse, I offered to buy the man a mattress so that all three could sleep in comfort; a digression for me but without regrets. I had to see John and so we drove a long way to the school realising that John had to walk this distance twice a day. He came out of his classroom and looked even knobblier than last year. There is nothing to be done for him medically but he could be helped. We will buy him a bicycle so that someone can cycle him to school and back in the evening. Their lives are so incredibly hard but education is everything to them.

The day’s work was complete and we returned home tired and very hungry having only had water and a small biscuit. I lost/mislaid my modem in the Guest House which was most annoying but it means that keeping in touch with home and checking emails is not possible. As I write, I am still not on line and am not sure when I shall get it sorted so this diary will stay on Microsoft Word for the moment.

 

Sunday 19 October

Prayers today so it was a walk to church as my bike still has a puncture. The church was heaving with people and I could hardly find a space to squeeze into. The children proceeded up the aisle dancing to the music of the local instruments. I never tire of the hymns and singing and the hour passes easily until I was called to the front to introduce myself as is always the case when I arrive. Then there were notices and an auction whereby the congregation bids for the items put into the collection plate. Those who do not have money may bring a bag of rice, a couple of eggs and, this week, a pumpkin which I bought for 9,500/= not knowing if I had a bargain or not. It was, indeed, a bargain as it would have cost 25,000/= in the market, so I was told. I didn’t really want a pumpkin but I soon found a willing recipient; Margaret from the leprosy village was quite delighted.

I called in at the hospital on my way past and found Ivy and Christine doing dressings on Ojikhan Ward. Mr Viva was taking a rest in theatre and Paul was sorting out a patient list for Monday. The hospital compound is so busy these days which is so encouraging.

I showed her the movie clip of the entrance of the brides on Easter Sunday and she was amazed to see herself and her friends on the screen! Obwongo also called and tried to sell me a drum and a very crudely made tiny seat as is the norm here. I managed to bring him down on the price of the drum to less than £4.00 which I thought was a good deal in my favour and I bought a sack of oranges for 5 for 25p which little Emma struggled to carry to the Children’s Village to give them out to the plastics children.

I wanted a short rest before starting our trek to Frances Okerenyang’s village and so I made my excuses to Modesta and had a brief lie down. The walk took about 30 minutes but in the midday sun it makes hard work. Frances welcomed us all; Helen and me and the Dutch girls. Children came “out of the woodwork” until the compound was awash with them. A banquet lay before us and we made sure we did justice to each of the ten dishes. Family members came and went and we stayed until we saw the hospital bus pass which meant that the plastics team had finished their theatre list. Frances whistled to a passing boda boda who returned to take Helen and me into town. Helen sat astride behind the driver and I sat side saddle behind Helen.  We must have looked comical as everyone took notice of these two mature ladies, the furthest back one only half seated on the metal carrier. I really did think I would fall off at some point and I wondered if I could last the ride. My left leg got cramp and my foot turned purple as the blood supply was restricted. My fingers were tightly clenched round the carrier and no one was more relieved than I when we finally reached North East Villa. We sat in the garden drinking beer or whisky and eating Pringles and nibbles brought by the team. What a civilised way to spend the evening but George, the driver, returned from visiting the market and we had decided to return with him rather than take a boda boda in the dark. Then, in his headlights, he saw an upside-down  tricycle and the rider lying in a ditch. A young lad of about 9 was escorting Eliot, an athetoid cerebral palsy boy who lives within the hospital compound. We stopped to upright the tricycle and check that Eliot was unhurt which fortunately was the case. He could proceed but in the complete darkness he could easily repeat the process so the bus followed him at about 1mph until we turned into the hospital road. I can’t believe he would attempt that trip in the dark and I wonder if he had been lying there for some time. Vehicles don’t always have lights so it was a serious accident waiting to happen.

A busy day almost over and no evening meal required as we had eaten plenty at lunch time which was half way through the afternoon. So the end of another weekend and a welcome bed awaited.

 

Saturday 18 October

The plastics team arrived yesterday evening after a very long journey from Kampala and has settled in well in North East Villa. From now on, it is all hands on deck until the camp is over in two weeks’ time. The hospital staff were prepared and, after their breakfast, the team made their way in the hospital bus and were greeted by Dr Olupot, the new Medical Superintendent. It was straight down to work with the four surgeons screening the patients in the physiotherapy department while the nurses and anaesthetists sorted out the contents of their big yellow bags in the theatre. The families were already lined up on benches outside the department and Paul, after conducting a prayer for the success of the camp, ushered them in through the certain procedures, and they were finally seated before Mr Viva. He is an inspiration with his knowledge and it was awe-inspiring to listen to him sharing his findings with the doctors and discussing the required procedures. Soon, the patients were all seen and the theatre lists sorted until Wednesday. It was good to meet team members who had previously been to Kumi especially Ivy and we shared lunch of rice and beans in the theatre. Although the team must have been so tired after two long days of travelling, Mr Viva was itching to get started and the first patients were rolled into theatre on the trolleys. A full afternoon’s work completed, they must have returned to their Guest House absolutely shattered and hopefully there would have been water for a cold shower and beer in the fridge. Sunday may be a rest day for some but a full theatre list was planned.

I haven’t described the conditions of the patients; many cleft palates, burns contractures, neurofibromas and so many keloid scars worse than I have ever seen; lumps and bumps and strange skin conditions. It is unbelievable what some of these people live with unable to have any satisfactory treatment and I wonder how they manage to lead their lives being shunned by others. Mr Viva explained to me how the keloid scars can start from something as minor as a thorn prick or scratch which develops into a large, dark, shiny, convoluted and raised mass often inches wide and can cover such large areas of the body. Black skin is affected more than white skin. I wish I knew more but I must be content at this time of my life with my limitations.

Helen and I returned to our Guest House. The team and hospital staff have their systems in place and we were not required but, to be honest, we were feeling the heat and were ready to take it easy. On entering the Guest House, we encountered a terrible smell and the medics wearing masks as it was so disgusting. They were emptying the fridge and pulling it our expecting to find a decaying creature but all they discovered was some pungent fungus and, by removing this, the smell disappeared. I enjoyed sitting under the shade of the thatch and Skyped the family and friends whose phone numbers I could remember. Susan and Aline, the two Dutch medics, who had joined us for our home visits last Wednesday, had written to their family and friends telling them about their day and how we had provided goats for the very poor families. I can’t think what they wrote but they must have been impressed with what we do because they have been showered with requests to buy goats. Between them, they have asked us to buy 55 goats and so we are making a spreadsheet so that we can keep a record and let them know who has their animals. This is good news as it has released part of my funds for other areas such as wheelchairs where we have a waiting list and we may well be able to complete the list once Motivation has provided CoRSU with a fresh supply.

A long evening and the only thing to mention is the cockroach which scurried between the gap in the bathroom shelf.

 

Friday 17 October 2014

Hospital based today so no panic to be ready and I’ve decided to take life a little easier this year so that I last the pace. Helen and I sauntered up the road greeting the children and ladies passing us with large sacks of potatoes or cassava balanced on their heads. The plastics children and mothers were settled in the Village and they appreciated our visit as they think all mzungus are doctors. Helen decided to join the Dutch girls who were going to the field for a nutrition and malnutrition clinic and had a hectic time weighing and measuring the circumference of the upper arm and overall length of 300 children. I remained behind to continue the preparations for next week’s surgical camp. Dr Naomi Kakisa was screening the patients for malaria and also their haemoglobin who had already been registered to ensure they were suitable for surgery. She is a doctor from Kasese in SW Uganda and will start her studies for plastic surgery next year and is hoping to gain some experience by working with the UK team. Lots of clefts, burn contractures and  some very strange conditions which I sincerely hope can be improved. The morning flew by and I had to be at Adesso School for a meeting with three of the teachers.

My bicycle had a puncture so I had it inflated and then I cycled across the airfield only to find a grand reception of Girl Guides ready for an afternoon of entertainment. So much for a brief meeting with the teachers. but we did manage to exchange a few words and I told the teachers about the plan to try re-usable sanitary pads for the Girl Guides and to ask their opinion. I had prepared a questionnaire which the staff will distribute to the girls and I handed out my box of Afripads samples. The afternoon turned out to be a grand event to tell me all about the camp they went to in June and what an experience they had! They sang and danced, gave me a tour of a camp they had replicated complete with tent, latrine, briquettes they had learnt to make from charcoal and mud, draining board and shoe stand and many other things. Their enthusiasm and energy were a delight and I enjoyed every minute. Finally I had an opportunity to say a few words and was able to distribute letters from Dalkeith Girl Guides to the girls who had written to them in March. They could not hide their pleasure at receiving their own letter and all beautifully decorated with sketches and colouring from their friends in UK. I had also brought a homemade photo album compiled by the Guides of their summer camp at North Berwick. I hope the links last even if it is only between one or two sets of friends. The children were able to go home but a plate of food was brought out to me and I managed to share an omelette, greens and tomato all washed down with a Stoney (ginger beer). Now, I really had to dash as I was being picked up to go to town and the local radio station, Radio Continental, for an hour long Talk Show telling the people of the visit by the Plastic Surgeon followed by a questions and answers session. My speedy return failed as the tyre was flat again necessitating a trek back. At the last moment, Paul Ekellot came round to tell me the Talk Show was off as the Ministry of Health had ousted our session to talk about boreholes. Power talks! Our show was to boost the number of patients for next week but, as there are well over 100 registered, we may not need to bother.

Instead, I’ve caught up on my diary and read my book. As I write, Helen is knitting a frilly scarf, the 3 Dutch girls are watching something they’ve downloaded on to their laptop and Dr Naomi hasn’t stopped doing something on her mobile phone all evening!

 

Thursday 16 October

Heavens above! We’ve been here a week already! In some ways, it seems an age since we left home and in another way it seems like yesterday. I shouldn’t have eaten the peas at supper last night as my tummy has not settled at all once more. They were good though!

At 7.30 am, I had a visitor with an orphan child who was told to bring her to the Guest House as she could not pay hospital A 3 year old with windswept knees and I was not pleased that they had been sent to the Guest House which should never happen as it could open the flood gates. Thursday is always outreach clinic day and we were again to be joined by the two Dutch medics, Susan and Aline. They only have a week left and we will miss them a lot. We set off, thirteen of us in the Land Cruiser to a Health Clinic in Opwatate. The eye patients were separated from the children and we started our clinic with mothers, grannies or fathers bringing in their children with a wide variety of complaints. We saw 50 in all: cleft palates, burns, knock knees, lumps and bumps, gluteal fibrosis. I’m sure, if I re-read through my diaries, I would find myself repeating myself each year. No time for lunch, old ladies wanting to be seen when it was their turn but I insisted on seeing all the children first. The elderly have the conditions of old age which take a while to even think about a diagnosis. It can be quite comical hearing how an abdominal pain can manifest itself in almost every square inch of the body. This is where the medics came in useful as we could lie the old folk flat on the concrete floor and the girls could use their stethoscopes to impress the patients. This procedure worked a treat and soon all the old folk started walking home not having minded being made to wait an hour or two. All was forgiven as the consultation had been so thorough!

On reaching home, I walked up to the hospital to check if the mosquito nets in the Children’s Village needed to be round or square as I want each bed to have its own net for when Mr Viva arrives. Square so Harriet will buy 36 in town. Then an uneventful evening reading and writing before an early night to catch up on some sleep.

 

Wednesday 15 October 2014

The night was noisy with so much thunder, lightning and rain pounding on the iron sheeting roof. In fact, sometimes it can be relatively cool to the extent that I’m wearing a cardigan as I write this sitting on the Guest House porch drinking a beer with Helen.

I feel better today thank goodness and it’s only now that I realise how awful I have felt. I broke my fast with a pancake with lemon juice and sugar and then we set off for Nyero with Rose from the Nutrition Unit. It was a good day visiting families which had had children admitted to Kumi Hospital.

The first mother had twins of 18 months who were born 2 months prematurely and it was Catherine Adonga who had been a patient 7 months previously. Her sister, Apio Jennifer, was fine although they both looked half their age. Their home was so poor but well-kept but the kitchen was bare as is often the case. We decided to give the mother 2 goats to start them off with an income generating project. Due to the foot and mouth issue, goats cannot be bought on the open market but only locally and a permit is required to move hoofed animals.

The next child was Ingole Jonathan, a 9 year old who looked no more than 9 months. He lives with his grandmother because the father of the mother left her because of the birth of a cerebral palsy child and then the mother went off with another man who wouldn’t take the child so the grandmother looks after him which cannot be easy. She looked very, very old. The child had potential and, if he was in UK, he would have expert treatment and could well improve although this would be limited due to his brain damage. We lay him on a torn piece of plastic and a ragged sheet which was his bed and tried a few basic physio exercises. I wanted a rolled blanket for him to lie over so that he could lean on his elbows but there was nothing of the sort available. The nearest would have been a section from the trunk of a banana tree! By this time, he had pooed, not in his pants, but in another rag. You really do have to witness these situations to understand fully the extent of this poverty as my descriptions are nowhere explanatory enough.

We checked out his mud hut to find nothing but rags on the floor but, thankfully the thatch was waterproof. A goat for Jonathan and a mattress and two blankets were needed and then the child and granny could be warm at night. You couldn’t expect the old woman to find these so Martin (Kumi CBR worker) and James, our voluntary immobiliser would organise the purchase and delivery.

Number three was Ongodia Norbert, a two and a half year old who had been in the Nutrition Unit in February. The mother had been killed in a road traffic accident and so was being looked after by a caretaker together with his cheeky brother, Silver. The caretaker, Asimine Hellen, was a 40 year old who had a baby of her own and so was struggling to cope with her extended family. Inside her hut, we looked up to see the sky peeping through and, as the rain has been heavy of late, we could imagine what it must be like lying on the ground getting more and more wet by the minute…and then so cold. A goat each for the adopted children and money for some bundles of grass to repair the thatch left the mother very happy.

In March, we visited a sad family and, since then, we have renewed their roofless house from top to bottom and the mother, twin babies and 3 year old had returned home from Kumi Nutrition Unit. We were disappointed with what we encountered as the mother was visiting her mother-in-law with the twin babies since August and the father was with the rest of the family at home. The 3 year old whose name escapes me hardly looked any better than he did 6 months ago although his upper arm circumference was 11 cm as opposed to 7 cm. (Mine is 29cm) This is supposed to indicate an improvement but the little scrap of a child was forlorn and had no idea of standing. What future lies ahead for him? The father told us he was collecting his family tomorrow which seemed a coincidence to us and so we left the home telling the father that James, our volunteer, would be returning to follow up the family. He would surely be disappointed that he didn’t receive anything from us but we were not there to give hand outs but to encourage.

Our final family will take a little understanding. A child of perhaps 2 years and with a strange appearance was sitting on its mother’s knee. It was so sick with a chesty cough and runny nose but also with a syndrome as its eyes looked strange. She told us that she had a 2 week old baby as well as this one which was brought out of the hut and we saw a tiny baby with a mass of curly black wiry hair. This offspring had strange eyes also. Then another mother appeared with her baby who also looked odd and then we were told that the common factor was the father. The second mother had had another similar baby which died at 7 months and it seemed as though the father was providing abnormal offspring every few months! What could be done here? After much deliberation and many suggestions including family planning advice, we gave them both money for drugs from the local health clinic to help the immediate situation. An appointment with a paediatrician would only give a diagnosis as the mothers will have to come to terms with the situation and hopefully not increase the size of their family. Another mother came with her sick child (but not from the same father as far as we know) and so we took her to the health clinic and also gave her a few pennies for the drugs. The rain was falling heavily now and we decided to call it a day. Visiting homes in the rain is difficult because sitting outside is impossible and inside a mud hut it’s dark and short of space.

It’s a pleasant change to arrive back at a reasonable hour and a cup of tea was more than welcome. It was a good opportunity to attend a Rotary meeting in town and, after a shower, fourteen Rotarians and visitors piled into the Land Cruiser to go to town. I was pleased we were not going far! The weekly meeting is held at Kumi Hotel which was buzzing with hotel guests. Due to the heavy rain, we could not sit outside as usual but we gathered on the veranda where the President presided over a formal procedure with much talk about US dollars and global Rotarian issues.

Supper, bed and more thunder, lightning and rain.

 

Tuesday 14 October

No point in sitting around and today’s plan was important for me so I skipped breakfast and Peter, the driver, Helen, Harriet and I set off on a long journey to Magale south east of Mbale and where we entered the Kenya network zone according to our mobile phones which welcomed us into Kenya. We were to visit Lazarus who is one of my boys supported by Newton Aycliffe Inner Wheel Club. We found him in his classroom and, in the last year, he has grown into a tall young man with a deep voice. Whereas, when he first went to the school, he was unable to speak English and was so reserved, he is now charming, fluent in his conversation and so grateful for his opportunity for education. He had no school sweater as he had grown so much so we bought him one from the school and also read the letter from the Inner Wheel. He demonstrated his skill on the Braille printer and answered their questions. We visited the rest of the class rooms where the children, all sitting at desks, greeted us with their usual “Good morning, visitors!” Claudia then took us to the Sisters’ home where we were given pancakes and bananas with tea and were presented with gifts for us both. Good buys said and a somewhat half promise to visit for two days next time, we left in pouring rain and stopped off at Mbale to see Kamlesh who makes the tricycles for the post polio paralysis patients. We bought ten which should be made before Christmas as there are none in store at the hospital. For some reason, there is no demand for them in Kampala in the south but we need a steady supply to give out.

That was enough for one day as the drive to Kumi from Mbale is long and slow due to perhaps hundreds of speed bumps.

Stomach still not normal and still feeling achy so no supper, a shower and then I’ll be in bed early again

 

Monday 13 October

A work day and so, after our usual breakfast of hard-boiled egg, banana and bread, we set off to walk for a day in the hospital. Morning Assembly was a must and, as ever, we had to go the front for an introduction and to meet George William Omoding, the new Hospital Administrator. Formalities done, we had a meeting in his office when I explained what I do in Kumi. Let’s hope he approves as I have been rather irregular with my activities.

We needed to take a boda boda into town to check on the accommodation for the plastics team and we were warmly greeted by James, the manager, and who treated us to refreshments and lunch as though we were VIP’s. We also met the owner of the Guest House who lives in Wandsworth and is in Kumi to stay for a while with his 92 year old mother. We were in no great hurry to leave this comfort sitting in the shade of the house and with a pleasant breeze to keep us cool. The boda boda boy finally took us back to the hospital where we met with Simon Peter in the Workshop who agreed to repair the seats in the bus by patching them up temporarily as well as the hole in the floor at the entrance which will be covered by plywood to make it slightly more acceptable for the plastics team. Let’s hope it doesn’t let them down in the next two weeks!

Somehow, supper didn’t agree with me and I spent some of the evening on the loo and then went to bed at 8.30 pm feeling rather rough. Would I ever have a good night’s sleep as, by now, I’m feeling very jaded? Little sleep if any as I felt so rotten and I decided to stay behind tomorrow and rest.

 

Sunday 12 October

A dreadful night’s sleep probably because we were just too tired. Strange noises, thunder and heat prevented any thoughts of dropping off for forty winks. The morning couldn’t come quickly enough so that I could get up and start unpacking whilst it was still cool.

I decided a Sunday without church prayers was called for and Helen and I would have a lazy day. I unpacked without enthusiasm and, as I write, I still have the third case strapped up. I had half an hour on the bed, interspersed with an omelette for lunch, sitting in the thatched shade hut and generally being idle. Frances Okerenyang cycled past and told us of the impending weddings, not the 19 couples as expected but groups of three in their own parishes.

Finally, we put some energy into going for a walk down to Modesta’s modest home but it was locked up and so we went to see Stella and Andrew, teachers at Adesso School. Dusk was falling but, as is their culture, we could not leave without partaking in a cup of tea, cookies and soya beans. Rain looked imminent and so we left to walk across the air field with Helen’s torch guiding us along the track making sure that snakes, or in Helen’s case, frogs were not in our path. Unfortunately, the frog season is here and Helen does not like them at all. Most of them are squashed flat but plenty were leaping along the road.

Eight of us sat round the dining table and we enjoyed a convivial meal before retiring to bed hoping that we would, at last, sleep soundly but the thunder rumbled and it was too hot for comfort.

 

Saturday 11 October

Time to set off again to Kumi this time and Moses and his “wife”, Rachael, picked us up with our 116 kg of luggage having had to borrow a larger car which was so smart with velvety seats and a camera for reversing. The Uganda Cranes were playing Togo at football and it seemed the whole population of Kampala was making for the Nelson Mandela stadium on the far side of the city. The traffic was unbelievable with motor bicycles squeezing in between the matatus and cars and each one missing the other by millimetres.  Vendors thrust the daily papers through the windows and foolhardy pedestrians darted through the traffic risking life and limb at every turn. Sets of traffic lights are few and far between but it appears that progress is only made when they are red.  At least three hours later and having picked up Alex, Moses’ brother, we emerged from the city and had a slightly easier run past the sugar and tea plantations and through Mabira forest to Jinja where we stopped at our usual fuel station with its restaurant and sort of flush toilet. Then on to Mbale where, for some irrational reason, they had decided to resurface all the roads without informing the drivers so we drove down mud tracks till we could drive no further, try to turn round and then would try another road until, finally, we had to do quite a detour to proceed north. I saw one car swinging like a seesaw with a back wheel clear of the ground having dislodged itself on the edge of a steep incline. It had not been moved when we passed it having failed to encounter a way through.

By now, the countryside had changed considerably with thatched mud huts in profusion and the land less green and bushier. The people suddenly looked so poor and, indeed, they are so much poorer than south of Mbale. The trading centres were busy and I bought a hand of 14 bananas for 50 pence from a woman selling from her basket.

Kumi Town at last and we turned right to go up the road to Ongino and then onto the hospital road. Strange the faces I recognised already! We were too tired when we arrived and unpacking could wait till morning. Lovely to see Anne and Grace again and to be shown our rooms. I had my usual one and Helen had the corresponding one at the other end of the house. Some visitors prefer hers but it has no hanging facilities for clothes and the toilet seat is broken.

Supper time and we were joined by one of the new young Medical Officers and Martin and Elaine from UK. Two Dutch medical students and a Dutch nurse are away for the weekend as I write and should be returning this evening. We learnt that there is a foot and mouth scare at present so no hoofed meat is cooked not that it matters to veggies like me.

 

Friday 10 October

We were to visit St Stephen’s Hospital today but Dr Cathy phoned to tell us that there was a patient admitted with haemorrhagic vomiting. Shock horror from both of us as we thought we may have walked straight into an ebola crisis. Instead, their driver was to take us to Professor Luboga’s home so that we could discuss the issue of providing St Stephen’s with an x-ray facility. On the way, we visited the office for Afripads as one of this visit’s projects is to investigate the usefulness of re-usable sanitary pads for girls. I have brought samples from UK and will issue these and the African version to Adesso Girl Guides who are linked with the Dalkeith Girl Guides.

Professor Sam Luboga gave us a warm welcome and it was a pleasure to meet his wife, Christine, again. He had 3 visiting doctors from Vermont staying and who were working in Mulago Hospital in Kampala. We shared an unexpected lunch and then Sam and I managed to discuss the x-ray issue.

Gonzago drove us back to CoRSU and then Moses drove Helen, Susan who works at CoRSU and me to a pizzeria where we enjoyed pizza and beer sitting outside in the moonlight. What an enormous moon it was, dark orange and turning paler as it rose in the sky. The power failed in the restaurant and something brushed my legs which is so much more scary than at home. Thankfully, it turned out to be no worse than a cat’s tail!

 

Thursday 9 October

Upsall Drive at 3.30 am and the alarm woke me from a deep slumber and it was time to set off for the airport. Helen stayed the night so Chris and we two girls arrived at Durham Tees Valley to check in our 116 kg only to find one of my cases was 3 kg overweight and I refuse to pay for excess baggage! With the lengthy cow tethering rope used to secure the offending case finally untied, I unzipped it and rummaged around to remove some items whilst the queue grew longer. I probably provided entertainment as I displayed lots of baby knitting, crayons and absolutely no personal items.  Finally, I decided the girl on the other desk may be more co-operative and, although the case was still overweight, she allowed it through.  Apart from that flustering episode, Chris, despairing at my inefficiency, waved farewell and the rest of the journey went well and we arrived at Entebbe airport after an hour long stopover in Kigale, Rwanda, which is so infuriating as we have to stay put on the lane and the time drags on.

As soon as we entered the airport building, we were greeted by a masked and gowned lady who took our ebola check form and gave us bacterial disinfectant spray for our hands. We continued to the visa queue where a second gowned nurse pointed a thermometer at our heads to check for fevers. It was good to know that some precautions were being taken to prevent someone with a fever entering the country. No Matthias to meet us at the arrival gate as he has moved to a new job in Zanzibar but Moses who is a driver with CoRSU drove us with all our luggage to the hospital Guest House. We were to spend a couple of comfortable nights although sleep did not come quickly enough on the first night as there was loud music to contend with until the early hours. We started Friday feeling as jaded as we did when we went to bed if not even more so.

 

CONCLUSION

Was a month-long trip worth it or should I keep to my usual end of the year visit, I asked myself. Definitely worth going twice a year! When the days are limited, it is important to be focussed on what is hoped to be achieved and this was certainly the outcome of this visit.

My aspirations for the provision of wheelchairs were achieved and I exceeded my expectations. Now that we have a facility to provide wheelchairs for these children, it is important to maintain the momentum so that Motivation Africa may select Kumi Hospital to be its centre in eastern Uganda after 2015. At present, they have centres in Kampala, Entebbe, Gulu and Masindi.

We have helped many families living in extreme poverty by initiating income generating projects, improving their leaking thatches, continuing with the building of small, modest “permanent “ houses and setting up groups of families with children with disabilities so that they can help support each other. We have also started to register our first group with the local council thus enabling them to be eligible for grants. If this is successful, we may consider registering more groups.

It is important to follow up our sponsored students and to give them encouragement. This visit, there some decisions to make as Apulamera and Brenda had failed their Senior 4 exams and it was decided to give them one more chance. Antony who had been disappointing was improving and I am sure it helps him to know that there is someone out there who cares for him.

Adesso Girl Guides are developing a link with Dalkeith Girl Guides which, hopefully, could lead to greater things in the future. Who knows? They may, one day, have the opportunity to exchange visits which, at present, seems totally impossible.

I am writing this on Good Friday and on Easter Sunday, the Kumi wedding of the year will take place. The dresses are made, the rings which were the wrong size have been exchanged, the men have their outfits and I’m sure the preparations are well under way.

The team continues their outreaches and I manage to find plenty to keep me going. I’ve compiled another digital photo book with Kumi photos as Snapfish had an excellent offer which I couldn’t refuse. Letters and reports await and soon we will start our preparations for our Open Day on 7 June. A cupboard is filling with tombola prizes.

Harriet keeps me up to date with emails and with requests if she finds a child in need of help. It would be impossible to keep the projects going without her tremendous support.

 

Monday 24 March

We were to fly at 11.30 pm but that didn’t mean we had a day off.

I met Christine, the head physio, and we discussed the results of the Motivation wheelchair project. We were both happy with the outcome and I hope to repeat it as soon as possible so that more children with disabilities can have the opportunity to be mobile.

Gonzago, the driver from St Stephen’s Hospital in Mpererwe, picked us up from CoRSU and drove us in the hospital ambulance across Kampala taking the back roads as it was a busier than usual time for the traffic. Helen had not been to St Stephen’s before but I was sure that she would be able to look at their situation from a nursing angle. The hospital was so busy with the outpatient benches filled with patients and over 50% bed occupancy in the 28 beds, a sight I had not witnessed before. This was great news and we were impressed with the efforts being made to make the hospital viable. It was so useful having Helen with me and I am sure that Dr Cathy and Olivia were proud to show us around.

Time to leave and now we had a few hours to fill before leaving for the airport. Helen has been much better than I have at keeping up to date with her diary and I think she was right on target on the final day. I was hoping to write my report for St Stephen’s whilst all was fresh in my mind but somehow the hours slid by and I would have so much to catch up with on my return home.

Supper with Susan and Matthias at the Indian restaurant on the banks of Lake Victoria and almost in Entebbe airport was such a pleasant way to end our visit. We watched the sun sink down over the horizon (an optical illusion, I recently read), enjoyed our meal and then left to take the final stage to the airport. This time, we had to get out of the car to be searched but, unsurprisingly, we were squeaky clean and got through without mishap. It was probably the last time that Matthias will see us off as he is spreading his wings before the end of the year as his CoRSU contract finishes. He will be missed!

Nothing much to tell now; a smooth journey home but with little sleep, met at Durham Tees Valley by Helen’s husband, John, as Chris was in Mombasa and back in the house which was far too quiet and I had no one to share our experiences.

PS We came home with the swallows which we saw gathering in preparation for their flight to spend the summer months in England!

 

Sunday 23 March

Sunday Mass was held at the White Father’s church where Fr Rudi, the German priest, is in charge. I have met him a few times before and he is a lovely, gentle man. Today there was a visiting German priest who was in Uganda for a conference and he too was quite charming. We joined the regular German families who sang hymns unknown to me but I was able to follow the order of service only because the words were recognisable. Talking to Fr Rudi afterwards, I picked up on the fact that he was visiting Katakwi in two weeks and, on asking him if he knew of any possibilities for Lawrance to take a computer course, he did not discount the possibility immediately. He says he will do his best and so will Lawrance one day be able to continue his education?

 

Saturday 22 March

It’s always sad to leave Kumi Hospital and its farewells all round until the next time. Anna made us our last omelette before Peter arrived to take us to Kampala in the only road-worthy vehicle left in the hospital. The other two are forever breaking down due to old age and hospital management will have to take the bull by the horns before too long and replace at least one of them. Pretty much an uneventful journey to report and progress was good until the outskirts of Kampala were reached and then the traffic built up to an almost complete standstill. We moved forward inch by inch with vendors walking past between the queues selling their wares; a dozen rolls of toilet paper, chewing gum, New Vision or Monitor papers and, this year’s latest addition, Monopoly, Scrabble and Snakes and Ladders board games.

Banana Boat at Lugogo Shopping Mall is always a shop not to miss if circumstances permit and Helen and I promised not to be too long as we needed just a few more Ugandan purchases to fill our cases all in the good cause of supporting the local initiatives.

Arriving at CoRSU eight hours after leaving Kumi, we were greeted by five smiling Kumi children who had been fitted for Motivation wheelchairs. We sat little Vivian in hers for a photograph and she was so happy to be sitting comfortably with her twisted spine moulded into the seat. She had been accompanied by her sister as her mother, Christine, was working and so I called her on my mobile and passed the phone over to Vivian. What a delight it was to watch the child’s face shining with happiness as she explained how she had spent her week being fitted with the chair. We had combined our trip down with taking the children back and so Peter set off at once on the return journey and heaven knows when they would reach Kumi; well after dark for sure.

Now we could settle ourselves into the CoRSU staff house, take yet another shower and then go to Goretti’s Pizzeria on the shores of Lake Victoria for supper. I’ve learnt more about the wildlife in Uganda this visit. First it was the flying white ants, an excellent source of protein, and now I experienced the final hour in the lives of the lake flies. We had to wait for them to conclude their short lifespan as they swarmed around a bright light in their hundreds of thousands resembling the heaviest of snow blizzards before we could walk down to our table by the shore where the waves were lapping the sand. A silent dugout slipped past us as another fisherman returned home for the night.

Back to sharing a bed with Helen and we both hoped for a deep sleep but the room was lit by brilliant lightening and deafening thunder which prevented us sleeping.

 

Friday 21 March 2014

Our last day! Gerard Moses was waiting yet again and I sensed that things are not so good with him since he got married. I think the responsibility of a wife who came with a child and their own baby is too much for him with his blindness. His roof leaks and his shoes were soul-less. I could give him some money for new shoes but he was not too grateful as it was only enough for a second hand pair. I didn’t add to it though.

Helen’s tummy was a little unsettled so I cycled to the hospital for the last time and attended Morning Assembly where I said my good byes and thanks. The workshop is next to the Hall of Hope where Assembly is held and I found Hellen, the manager, at her desk. We discussed the Motivation project and the training for three staff members the following week. Great strides had been made on this visit making everything worthwhile without anything else we had achieved.

A friend of mine, Chris, a physio who works tirelessly in a hospital in DRC, wants to send a member of their staff for prosthetic training and so I took photos of each area of the workshop to forward to her. (Chris and I are both members of ADAPT< the Chartered Society of Physiotherapy international section.)

The three patients (two post polio and one TB) who we have identified for tricycles will be mobile once the tyres and inner tubes have been replaced. These perish quite quickly when not in use so I like them to have them in good working order before they are handed over.

By this time, Helen’s tummy was more settled and she joined Harriet and me for our farewell meeting with Charles Okular, Hospital Administrator. Charles will be retiring in August so it really is a fond farewell. I am hoping we will keep in touch and that we will be able to meet in different circumstances later in the year and, one day, maybe in UK. We discussed the training for the continuation of the Motivation programme as well as agreeing on a price for the three hospital farm cows which we have bought. We had agreed earlier on a price but the three we have chosen all came with calves and sso it was only fair to agree on a higher price. Charles had also said he would write to Darlington Rotary Club to request support for their panty project for schoolgirls who often stay away from school due to their modesty. There are three remaining school in the area where the girls have not been provided with panties.

Next I arranged to meet up with Julius, the young Human Resource manager, as I really feel strongly about the lack of communication between the hospital “partners” and I would like him to set up an organised resource centre for us all so that we are aware of what others are doing for the hospital. He promised to have this ongoing by May!  He said April but I thought that to be unrealistic and I will still be surprised if anything happens as he is not the most efficient member of staff.

Sad farewells were said in Physio especially to Paul Ekellot, the mainstay of the department, and Rose and Winnie in the Nutrition Unit. The family of three is slowly improving with the twin babies responding well to an improved diet but it is becoming obvious that the three year old is suffering from a syndrome and his future looks bleak. The mother has blossomed since being admitted and is unrecognisable from the confused and depressed soul we found in her village. The roof of her dreadful house will soon be repaired before she is discharged and then the family can return home and sleep without being drenched especially as the rainy season is starting but not in comfort as we know it as the house is no more than a shed.

I had letters to collect for delivery in UK as well as one from Sister Skolastica who worked in the theatre with Mr Viva, the plastic surgeon from Teesside. Kumi Hospital is hoping to develop a nursing school and I think she must have been asking for financial support.

Finally, it was back on my bike to return to the Guest House while Helen walked in the heat of the day past the magnificent flame trees which line the road. Packing for our return home was not a difficult task. We came with four large bags each containing about 22 kg and we were returning with three. I was leaving one behind, the second one was strapped up empty and the other one was barely half full of my few belongings. No dirty washing as I leave everything for Grace to wash and the she will put them in my case for next time. My blue tin trunk was as full as ever with my motor cycle helmet (unworn on this visit), my bucket which is indispensable in so many ways,  toiletries, stationery supplies etc and it took my body weight to manage to attach the padlocks and lock it once more.

Now we were ready for what is always a busy evening with several visitors coming to bid their farewells. Francis Okerenyang wished us a safe journey and we hoped the jars of his honey would travel safely in our baggage as it could not go in our hand luggage. Sam reported that the volleyball team would be playing on Saturday in Nyero thanks to our provision of the required funding. Janet brought letters, ground nuts and sim sim balls. Stella had made my favourite cookies for us and also gave me a large container of groundnut paste. Modesta always gives me a bag of millet flour for Chris ever since she brought him a daily supply when he was so ill with malaria. She stayed until it was time to say good bye and we hoped we would manage a good night’s sleep but, no, there had been too much to dwell on from the lst few weeks and daylight surfaced without managing a deep sleep.

 

Thursday 20 March 2014

7.30 am and Andrew, Adesso teacher, called to update me on the construction of the fuel-saving stove for his church/nursery school and to be given 50,000/= to kick start the congregation into raising the funds for the total requirements.

Our early start failed to materialise as only one hospital vehicle was roadworthy. Things will reach crisis point soon (if it has not already arrived) when there are no reliable vehicles to depend on. Michael and Martin, CBR workers, both have motorbikes but these, too, have seen better days and are forever needing spare parts which are not readily available in Kumi town. So, we left in Peter’s Land Cruiser which is far more comfortable than Landheer’s but there were many of us to squeeze in. Sr Rebecca had taken up my request to join us so that she could experience an outreach clinic for children with disabilities and eye patients as her responsibilities now cover all aspects of community work. Els, the Dutch lady, Martin and Elaine, two from the workshop, the eye team and so it went on until there was no space to spare and I was in the front seat with Helen and almost sitting on the driver’s knees! We were off to Acowa in Amuria, a journey of over two hours,. My plan to buy a spare button for the wedding dresses and two more wedding rings as we drove through Soroti was shelved as it would only delay matters and others would want to get out and start shopping also. We continued north until we reached the Health Clinic to find not quite so many patients as usual sitting patiently in the shade awaiting our arrival.

The eye patients were separated from the children and we started with an assortment of disabilities; knock knees, bow legs, burn contractures etc etc and then a mother brought her baby with a medical condition which is not our forte. Fortunately, Sr Rebecca took over and soon a drip was inserted into its arm and the sick baby would hopefully pick up. Its little chest was struggling to breath and the fever was high. Its eyes were rolling backwards and it was decided to take the mother and babe back with us and have them admitted on the children’s ward.

Coming back was a struggle with the mother and the sick baby in the back by the rear doors with the drip tied with a rag to a hook on the vehicle’s roof and Sr Rebecca sitting in the middle row adjusting the flow as required. Martin and Elaine from UK were in the front having replaced Helen and my places as we couldn’t take the most comfortable seats there and back. In the middle row with Sr Rebecca were Helen, Harriet and Elizabeth sitting concertina-wise so that they could fit in as best they could. Behind with the mother and baby, we were six and with our knees under our chins as the large spare tyre took pride of place on the floor. I likened it to the cattle wagons filled with POW’s in the war as we sat, unable to move our feet an inch in any direction, and feeling every pothole as we bumped along the damaged tarmac. The baby was struggling to survive and I feared it wouldn’t make the tough journey but suddenly, it opened its little eyes and the mother managed to pour some water from a litre bottle into its mouth.

At long last and after a few stops, we peeled ourselves out of the vehicle and tried to straighten up with difficulty. Peter, the driver, continued to the hospital to take the mother to the children’s ward. What a blessing it was to have Sr Rebecca with us as she was far more skilled than we were with the situation.

A welcome shower and supper made us feel renewed but I wasn’t madly keen to find I had a visitor waiting outside the door. I inwardly groaned but when I saw it was Modesta, my heart lifted and we spent a delightful evening sitting in the porch under a myriad of stars.

 

Wednesday 19 March

My friend, Paul who works in the physiotherapy department, had promised to bring the hospital attendants’ choir to Morning Assembly and so we had little choice but to attend. (all patients must be accompanied by an attendant who cares for and cooks for them and it was these people who formed the choir) They processed into the Hall of Hope and sang with gusto ululating forcefully and gesticulating wildly. This was a stirring start to the day!

We were to go down to the farm to select three cows which have been offered to us to buy and we have agreed a price with Charles, Administrator. As ever, to get everyone including the chief accountant and senior nursing officer together at the same time takes a frustratingly long time but at last we went down to the hospital farm where five cows were waiting. Helen and I are by no means cow specialists and could only choose by feminine intuition; one with half a horn, another with nice black and white colouring and the third with attractive ears! They all had calves and so, when we have our farewell meeting tomorrow, I have a feeling the price will be increased. We shall see!

Now we could commence our day’s outreach home visits with Rose from the Nutrition Unit.

Lydia, a friend of many years who was a physio assistant here in Kumi, had requested to borrow some money from me and it is always difficult to decide what to do. A little loan can help an enormous amount and I decided to help her and so dropped off the money on our way to Mukongoro, our destination for today. The road is poor with much of it washed away by rains but passes through acres of papyrus grass and white or purple water lily-covered small expanses of water. We were to visit children who had been discharged from the hospital Nutrition Unit to review their situation. This is an area of care which is not included in the hospital working practise and which I think is paramount in the life of these children if not their very existence. We can only do these home visits when there is a visitor here to provide funding and which I hope to have included in the hospital budget one day.

We met a grandmother on the way who hailed us and she accompanied us to her village where we heard a sad story. Last June, a married couple went to a funeral and, whilst away from home, the 14 year old was cooking the meal on the open wood fire when someone entered the hut and added poison to the food. The eldest boy survived, the next two were seriously ill and taken to Kumi Hospital and one died. Twins, Odongo and Apio, survived and now the family lives in such poor conditions so we gave funding for a goat to set them up in a small way.

One year old Okiriot Joseph and his sister, Apio Stella Rose who attends Primary School, were discharged from Kumi Hospital last year and Rose was happy to see that they were doing well. The mother was a member of a farming initiative which had supplied her with dodo seeds (a green food crop) which grew so plentifully that the neighbours all helped themselves! Not such an effective income generating project for the mother! They also were given goat money. The rood to their home was a deep gulley completely washed away which necessitated leaving the Land Cruiser and footing it.

Next was an extremely sad situation where we found three small children all suffering from sickle cell anaemia, one with a fever and all having been admitted to Kumi Hospital last year for malnutrition. The mother, a second wife of three, was struggling to survive. They had only had dry tea (tea leaves with hot water) that day and a ten year old was cooking cow peas (split peas) on the open wood fire. There was a plate of black ash which they told us was bicarbonate of soda from the ashes which was added to the cooking to soften the peas and hasten cooking. I dread to think what the end result looked like! The hut was minute, the roof was leaking, they slept on a bamboo mat with barely a rag to cover them and it was unfit for even an animal. What could we do to help? They needed so much but we decided that priorities were milk and eggs for now, a rain proof roof for the oncoming rainy season and surely a mattress. On the other side of the compound stood a relatively smart mud hut which, on questioning, we found to belong to the third wife, younger and happier and carrying a baby. We entered to find a locally made bed with a red cover; so smart and, for me, this made the second wife’s situation so much worse. We said good bye to the mother with one solitary tear rolling down her cheek. “Are you happy?” I asked and she replied “Mam! (no)” Let’s hope we have made things a fraction better for them and perhaps it’s a comfort for her that someone cares. Rose will return next week on her way to an outreach clinic to deliver the eggs and milk and check up one her.

Ocham Moses was a 1 year old malnourished cleft palate which would be operated on when it was in a more stable condition and so we supported her with funding for a goat. Three year old Isoto Gladys was also malnourished and looked so sickly. Rose noticed a rat with a long tail exiting the hut and I’m sure it won’t be alone. Twins, Opio and Odongo, were doing well having been in the Nutrition Unit for a couple of months last year.  They looked  strong and I felt the family should be rewarded for their good care of their children and so they also were given funding for a goat. There will be a big rush to market this week to make sure there are still some big goats for sale.

The fathers of the last family of the day were identical twins and we found them minus shirts as they were drumming for white ants. They were inseparable as though they were conjoined! One had an earring which I haven’t seen here before and I had to ask the reason why. “Because, when they were young, the mother couldn’t tell them apart so one had two earrings and the other one.” I didn’t quite follow this logic as surely only one twin needed to have his ear pierced. Their offspring had both had severe malnutrition but now they looked fit.

An interesting day reviewing the progress of discharged children from the Nutrition Unit. How good if the improvement could be 100% sustainable but it is all down to poverty and a lack of opportunity to get out of it. Let’s hope that the little we have given the families will help some if not all.

We finished early and returned along the dusty roads contemplating on the return of the dry weather and its effect on the crops which were planted so rapidly as soon as it seemed the rainy season had returned. There is much concern amongst the people that maybe their crops will fail yet again thus causing hunger and hardship.

 

Tuesday 18 March

I’m writing this at 5.00 am on Wednesday and already a mozzie has taken its breakfast from my foot. There are plenty more buzzing around with the rainy season arriving and my anti-itch cream is proving to be worth its weight in gold.

Back to Tuesday morning and a busy day lay ahead. We know every pothole in the SorotiKumi road but the good news is that the dust is not so extreme following the rain. Parking the vehicle in Main Street, I wanted to find some more reasonably priced gomaz material for the wedding dresses. The shops with their shabby fronts and non-existent displays of their goods are mainly owned by Asians who were once ousted by Idi Amin but seem to have returned to start up again. I delved into the depths of rolls of material and, to my delight, there was a roll of white and silver material, enough for 7 gomazes, and a third of the price of the beautiful material I found in Kumi. I needed braid for the edging, two buttons per dress and a belt which is made of satin, has a fringe and contains heavy-duty black polythene for stiffness. I wanted the belts or sashes to be all the same colour but this proved too tiresome so the brides will have a variety of colour for their sashes round their waists. The tailor will now come to the hospital to measure each lady and the final cost of each dress once made is £12.50!

Now, we could proceed and, joined by Ruth, we left Soroti and finally came to the village where we had been introduced to the families with children with disabilities who were to form a group. Helen would have found the way until the paths and tracks became narrower and narrower and the wheels crushed the cassava plants, but I wouldn’t have had a clue.

David, a competent young man whose brother is a severe epileptic, would be the obvious choice for Chairperson and soon a committee was formed and approved.  He had already been to the sub-county and district offices to enquire about group registration and what was required. A title for the group was necessary and it was decided to name it God’s Grace – Oregia. The meeting progressed well and it was decided that, once the group is registered, a fuel-engined grinding mill would be donated and they would then move forward.

Home visits followed with 4 year old Aloch Julian a CP who they said didn’t cry for two weeks (?). Ruth was to show David how to make parallel bars from local materials so that Julian may manage to walk and he would be re-assessed when he was about 6 to see if a wheelchair would allow him to go to school.

Ibiaro Sarah was the fattest little 14 month old ever. She sadly had spina bifida and hydrocephalus and could well have also had a syndrome of some sort. There was little to offer her as her head was too heavy and she was too floppy for the workshop CP chair and so I shall consult CoRSU on the possibility of a Motivation CP chair.

Okello Oel was 2.5 years old and had osteomyelitis of the knee and so he was referred to Dr Penny, a Canadian surgeon who is visiting Kumi in May.

Hemiplegia is a common condition for which there is little help. The patient’s leg and arm on one side is affected causing different degrees in lower and upper limb disability. Abiaro Martha was 14 years old and also suffered from epilepsy which was treated with medication.

Ekwenya Juliet was a child we know well and we returned to offer the father a goat as he does well caring for this fractious girl. It was two weeks since we visited the home and, lo and behold, he had a new wife, a young girl who can’t have been attracted to the father by his good looks let alone his prospects nor daughter. Juliet was given money for a goat, her father a Darlington Building Society sweater and the new wife some of Dr Kate’s clothes she left behind.

We delivered Aladoit Jennifer’s mattress in its Tom and Jerry cover and gave her funding for a goat also. Now, we had tied up lots of loose ends from this visit to Kumi and Ruth could start a new list of children for my next visit in October! She enjoys her work so much and devotes most of her time to these children. When I think how seriously depressed she was about 3 years ago and how, by motivating her into action, has transformed her into a diligent and responsible young lady. Looking back, I consider her to be one of my favourite success stories.

Supper and bed at 9.00 pm as I couldn’t keep my eyes open a moment longer. Another frog for Helen, this time in her sandal on the porch. I didn’t tell her about the large cockroach I found resting on my toothbrush!

 

Monday 17 March

The rainy season is officially over! The land is looking greener and life springs up again reminding me of our snowdrops pushing up out of the ground and the buds on the trees almost ready to burst open. There is so much activity with the oxen and ploughs digging straight furrows through the earth revealing the dark russet of the freshly turned soil. The men accompany the beasts shouting commands to them and whacking them with flexible canes. Sometimes, a young boy will also be required as the importance of getting the land prepared for planting far exceeds the need for education for these families. Men straddle the apex of the thatched roofs of the mud huts.to repair the damage caused by the violent winds. Women and youngsters stoop to plant the ground nuts or the potatoes and they await further rain to stimulate growth and the reassurance that their food supply will be replenished before too long.

Today, though, the skies were cloudless and the heat seemed to have returned. At midday, my thermometer registered the mid-nineties and exhaustion was once more taking over.

We have a new toaster (toast has never been on the menu until a kind visitor brought a toaster here) and we can now pop in a bread slice and leave it rather than get a book to read whilst sitting with one’s finger on the lever. Only when there is power though! No need to sit by the door and so we may not see our visitors arrive quite so easily and today we had Gerard Moses, the young blind man. Helen and I had decided to buy his wife a bike as they don’t have an easy life and this would make a world of difference for her when she fetched water from the borehole. He was soon followed by Sam, Adesso sports teacher, who tried hard to persuade me to visit his house for supper this evening. I really had to be so firm in my refusal as our time here is short now and, to be honest, after returning from our outreach days, we need to recover for the following day.

It was to be a day of one step forward and two steps back but we can’t expect smooth sailing all the time. With our tank fuelled, we set off to Serere, over the waters of Lake Busima which looked incredibly blue and calm and with white water lilies floating on the surface, past all the agricultural activity and on to the home of Stephen Otuke, a spina bifida/hydrocephalus boy who I have known for years. The CBR worker who no longer works for Kumi Hospital had failed to provide a cow for the boy and I wanted to see if it had been delivered as promised. No, it was not there but the two goats I had given a couple of years ago both had had twins. Now Stephen’s lovely big fat mother, Katharine, had bartered a goat and four kids for a cow and was left remaining with one goat to continue the process as well as the cow. The boy will go on my Motivation wheelchair waiting list and I gave his mother some money to buy him a radio as he spends all day sitting in his wheelchair which has now seen better days and with nothing to do but wait for the days to pass.

A mother brought her 3 year old CP daughter, Amulin Joyce, to us and, after assessment, it was decided that she attend the CP clinic with a view to being fitted with KAFO’s and, hopefully, the possibility to even walk in the future. The mother was taught exercises to perform each day to make sure that the joints maintained their range of movement.

Today was a day to catch up with past projects and next was Agudo Nora who thought she could be about 30 years old but I think a few more than that. She is a post polio paralysis lady who was given a tricycle a while ago and it is important to check that all is well. She was, as ever, sitting peeling mountains of cassava but this time with her 14 year old daughter who had had to stay away from school to help her mother. No wonder these youngsters who attend day school don’t do too well academically. I can understand why their needs are so different from ours and realise that all hands on deck are essential. We exchanged a bag full of soap, sugar, beans etc for a bag of unshelled groundnuts of the finest quality which she could hardly spare with the shortage of food as it is these days. It would not be polite to refuse a gift however graciously.

That was the best part of the day and now I had to tackle a delicate problem with regard to Amos. He was surprised to see me enter his office at HOW Primary School and he had much explaining to do as to why he hadn’t delivered the cow to Stephen and where the money was for the cows which the school had sold. I have given him only one more chance to settle this dispute and he has to bring the school money to the Guest House here on Thursday and to pay off the personal debt at 100,000/= per month. It is always so disappointing to have been cheated by someone you thought you could trust. I was exhausted by the time we left the school and I was about to encounter a further frustration. We called to see Moses Okenyekure to see if the ramp had been built so that he could enter his house whilst still seated on his tricycle. It was a disaster and more modifications must be made to solve the problem. Could there be a third hiccup today?

Last call was to Ngora High School where I hoped to collect a letter from Leah to take to Alwyn at home. It took a while for her to come from her classroom but her letter was ready and so I was happy.

Passing through Kumi Town, I started looking for gomaz material for the wedding dresses and found a beautiful 6 yard length for £15 which, times seven, was a considerable amount to pay. I would look in Soroti.

I then remembered that I had a letter to collect from Joppa School from Vivian who was in CoRSU being fitted for her new wheelchair. She had left it in her tin trunk so the day finally ended more positive.

Francis Okerenyang called by while he waited to collect his cow from the farm to tell me that he had prices for the grooms’ wedding outfits. Shirt, tie, trousers, socks and shoes for £15.00 per groom! Not too bad!

The evening went well until a tiny frog appeared at Helen’s feet and that was the end of the peace and quiet! I went to bed at 9.00 pm and must have fallen asleep as soon as my head touched the pillow as I never heard all the commotion whilst Anna chased the frog with a broom.

 

Sunday 16 March

On looking out of my window on waking, I saw thousands of white ants flying around with their paper-thin wings reflected in the sun like confetti fluttering in the breeze. As the sun rose, they became less obvious and then, as the day progressed, they became like a carpet of petals covering the ground. Their life span in this form was over and, according to what I have been told, the body of each fly enters the ground and a week later a mushroom pops up. Once I am able to go on the internet and browse, I shall see what the experts say. Little Goretti danced around snatching handfuls from the air until she had a pan full which she fried on the charcoal stove; an excellent source of protein!

Sunday prayers start at 7.30 am so I arrived at 8.45 and timed it perfectly to get there as soon as the homily was over.  being in the Lenten season, there was no choir nor music, just the people singing hymns which was a pity for me. At the end, the couples who were to wed went to the front of the church and I was beginning to realise that this was going to be the event of the year. The visiting catechist then started to preach once more and I had to leave as I found his approach to spreading the Word was too much for me to cope with and not what I had been used to at all. On the way back, I called into the hospital which was so quiet with it being Sunday as I wanted to see the mother of the three children we had brought on Wednesday and I was pleased to see her looking bright-eyed and well settled into life in the Nutrition Unit. The 3 year old and 7 month old twins were cleaner and were having two hour meals ie twelve meals a day so should, hopefully, start putting on weight very soon. I doubt they will ever reach their optimum weight though.

Back at the Guest House, I was expecting Paul with his wife, Angela, and their children Mercy, Solomon and Jonathan. Well, the latter are theirs and Mercy came with the wife. They played in the hut with the few remaining colours and paper I have left in my stock and enjoyed a soda. Modesta and her son, Emma, also joined us so we had quite a gossipy session. There are some things that I cannot put in my diary due to the possibility of others reading it but there have been intriguing events since December!

Helen and I had ordered some lunch as today was one of rest and supper was far away. We shared a beer, our first lunchtime tipple since we came! Then it was down to serious diary writing until Janet came to see me. She was the Chairperson of my AIDS/HIV ladies group which has disbanded as there was a dispute over finances. A new one has been formed but it will be October before I have the opportunity to attend one of their meetings.

During the afternoon, I spent much time on the phone sorting out an issue regarding the funding of the trip to CoRSU for the wheelchair project. It’s not always plain sailing with the people here who I had hoped to have full trust in and Martin has let me down again. He is avaed from my full wrath as I doubt I shall see him before I leave and perhaps I’ll have cooled down a little by the end of the year!

So that’s the weekend over and it’s back to the grindstone tomorrow with a visit to Serere.

 

Saturday 15 March

Should I have a lie-in this morning? It sounded tempting but I’m used to getting up early and it’s difficult to change my routine and so I was up and about just a little later than usual. 7.30 am and Priscilla arrived, Saturday or not! It was lovely to see her and I am pleased I was ready. She looks after her mother, the late Margaret Asio’s children and, having not been diligent in her duties for the last few years of Margaret’s life, she is now reformed and an excellent substitute. They live on very little and survive on the crops they can grow when the climate is favourable but the children are well cared for.

No sooner had we bade our farewells than Andrew arrived having already requested help with a fuel-saving stove for his nursery school. He had checked with the hospital staff member who quoted a ridiculous price which was quite out of the question. I offered him a few hundred shillings and told him that he would have to find the rest which suited me. He seemed satisfied and I thought my morning was now free but, no, Martin arrived to find out the arrangements for his visit to CoRSU this week with five children and attendants and Paul from the Workshop. They were to have training on the assembling of the Motivation wheelchairs. They needed accommodation and allowance money and to find out where they were to stay. Surely, that was all but Margaret Rose Akol called and I was delighted to see her. She retired earlier this year from being the children’s village housemother in the hospital but had returned to clean the small houses out in spite of not being employed. She brought me a pawpaw and I gave her a nightdress and skirt so we were both happy with our gifts.

By now, we were expecting a boda boda to take us to Robert Ecelat’s for lunch. He is a teacher in Mary MacAleese School and I have known him since the day he was married in 2004 and I have watched their three children grow. A new secondary boarding school has opened next to their school and the barbed wire fence was strewn with the week’s washing and resembled a Chinese laundry. What happened to the clothes when the wind blew, I hate to think. Everything would be torn to shreds. We walked over to the staff houses where we met the music teacher, Josephine, who showed us a long drum about 3 feet high and covered with a monitor lizard skin. The children danced and sang for us with great enthusiasm. We hardly saw Jane, Robert’s wife, who was cooking our lunch of rice and cabbage outside on the wood fire. Susanna, the oldest girl of 9 washed our hands and then knelt and spontaneously said grace. Afterwards, we took another boda boda and returned to the Guest House to take a nap before 3.30 when the catechist was to come to discuss the mass wedding. Francis Okerenyang was to join us and he had arrived early. I had to excuse myself and take my nap and fell into a deep sleep before I knew it. The wedding will take place after the Lenten season, the brides will wear gomazes and the men trousers, shirts and ties. The food and drink will be simple and the church choir and band will provide music. Each couple will have a wedding cake and the riungs had been bought. So now I leave the arrangements for others to sort out and step backwards. Delegation is my motto for the day.

Only one more engagement today and, following a shower and change into my African dress, we climbed onto another motorbike and went to town to have supper with Consolate and John. It was lovely to see Consolate again and to catch up on news about our families until supper was ready. A feast was laid before us and we were joined by an assortment of insects whichw ere attracted by the light. One of those large, horned beetles dropped down beside my plate twice and, in the end, we turned out the light.

Back home to reflect on my Saturday and all I had done before I fell asleep.

 

Thursday 13 March

Well, we are either complaining about the heat, the rain, the humidity and are never happy with how it is at the moment. Today, the rain continued with more thunder and the roads more flooded by the hour reminding us of when we left the UK. Outreach clinic today at Akulony and a packed vehicle left the hospital an hour later than the norm as the distance was less than usual.  There were many people waiting for us; gluteal fibrosis, TB spines, Downe’s, burn contracture; a varied assortment of conditions all of whom were seen and we finished reasonably early for a change.

Vivian’s mother, Christine, was waiting to see me as I wanted her permission to send Vivian to CoRSU for her Motivation wheelchair. The school has agreed to her taking the week off so that was all sorted. She was followed by Sam, Adesso sports teacher, who had brought the breakdown of the budget for the volleyball match next week. Helen gave him some painting materials for the school so we set to to show him how to use water colours. It was interesting to learn that he had never used a paintbrush and had no idea how to put the paint on the paper. We spent an hour or so painting a picture of a mud hut, trees, sun, portraits etc which looked very colourful. He carried it home like a child taking its art work home to show its parents.

Dr Kate’s last night so she had invited some of her friends from the hospital round. Supper was taken on our knees and the room was full of youngsters enjoying the evening whilst we oldies whiled away the time sitting in the porch drinking the Club beer and chatting idly until all had left.

 

Wednesday 12 March

Outreach home visits around Atutur and Nyero with Rose from the Nutrition Unit. The rains had cleared the air and the dust was a little more settled.

We were following up some families to assess their home situation and we had our eyes opened even wider than before with the conditions we encountered. The first child was Akirol Prossy, a 4 year old cerebral palsy child who had been provided with a CP chair. The outstandingly beautiful mother had become pregnant when in Senior 3 at the age of 23 and has the child to care for alone. What could she do to help herself? After much discussion, it was decided to help her to learn tailoring at a local trading centre and then to review her when I am here in October. If things are going well, then she may be given a sewing machine and material etc so that she can practise her new skills at home and start earning a few shillings. She had no mattress for her and her child so I said that she could choose between the sewing idea and a mattress and she chose the former. She chose wisely and she was given funding for both.

Alagai William was the 11 year old CP boy we identified last year when we found him lying unconscious and suffering from severe malnutrition. After a stay in Kumi hospital, he had been discharged and we found him looking very much better but the home situation was appalling. He was lying on wet rags in the dark hut and with his long legs bent up under his chin. This was his existence day after day; unbelievable! The mother had come from the Congo, married, had this child and then the father left as the child was disabled. He returned after 7 years to find the mother had had three more children and so abandoned her and their son. There she was on her own, with no land to grow crops and with barely a thing to eat. The youngest girl started to make millet porridge in the tumble down hut (a “kitchen”) for William. As there was no food to be had, we went to Kanyum market where we bought a stack of food for them; sorghum, cow peas, beans, posho, salt, sugar,, soap etc. Not the answer, I know, for helping them in the long run but a start or there would be no William to care for.

Oselle George William was a 3 year old CP child who had only been discharged from the Nutrition Unit yesterday. The father was at the market and the boy was surrounded by neighbours and so we decided to catch up with him in Kanyum market on Friday as we thought a goat may help them for starters. Not a large market which was made up of stalls erected with bamboo canes and shade provided by banana leaves. Vendors sat on the ground selling their produce. We bought small dried fish, cow peas and beans for protein, two basins of dried cassava and sugar for carbohydrate, salt, soap. I am not happy in such places as I feel so much like a tourist enjoying the safari. Mzungus are not the norm in Kanyum! Also, a gust of wind knocked down a thick bamboo pole which crashed missing me by inches!

We continued our home visits with Emma, a 17 year old boy suffering from malnutrition who lived in a trading centre in a mud hut, one of many squeezed in together on a small patch of land. These homes have little or no land for growing crops and so there is perhaps more hunger amongst the families than in the more rural areas where the peasants can at least usually grow some food. , Leaving the centre and returning to the bush, we visited Nyia Rose, a 2 year old also suffering from malnutrition. Elizabeth, the Dutch midwife who had joined us for the day, decided to buy the family a goat. By this time, our energy levels were waning and we just managed to climb in and out of the Land Cruiser to see two more children, Odengo Ben and Arigat (not baptised so no Christian name). I had visited the home of Arigat last year and we had decided to buy back the land which they had had to sell to pay for medical expenses. This led to malnutrition as there was no opportunity for them to grow their own food. I didn’t get good vibes from the father as the land had not been prepared for planting when the rains came. I was aware that the previous owner could keep his cassava crop on the land until it was ready but I felt Arigur’s father could have done more. The violent winds of last week had whipped off the thatch roofs and he was yet to start repairing them. I will return later in the year and see if he has listened to our stern words.

We were at last on our way home, thank God! But, no, we turned off the main route and continued for many miles to another village where we encountered the family of Imonget William, a 3 year old boy looking like a newly born monkey, and his twin siblings of 7 months weighing no more than a couple of kilograms each. There was one mud hut with the roof swept away and then a rectangular brick building also with the iron sheeting blown off. The family of eight were sleeping under a small section of the iron sheeting in absolute squalor. The mother was at a loss as to what to do and looked stunned as we took her and her three youngest children to the hospital for admission and feeding. Tomorrow they would be admitted and a treatment programme commenced.

By now, we were so tired and dirty that we were past everything and all we wanted was a cup of tea but visitors awaited. Francis Okerenyang came to pass the time of day and also Brenda who had had a problem getting her exam results from her old school. And then it rained and the thunder roared and the lightening flashed. Helen tried hard to take a photo of the lightening but just seemed to miss it every time! Thank goodness those little infants were saved from the torrential rain!

 

Tuesday 11 March

No sooner was I showered and dressed than Sam, Adesso sports teacher, called. I think he wanted to ask for funding to send the volleyball teams to a match next week but he failed to pluck up the courage. I would like to know how they would have managed if I hadn’t been here! Then Gerard, the young blind man, sat on our porch and he too faltered over asking for something.

A hospital-based day was a welcome relief from the many hours we have endured travelling along the incredibly dusty roads in the Land Cruiser. It was also a pleasure to ride my bicycle now the brakes were functioning and the bike would slow down at my command.

Loose ends were to be tied today. The six children, who we have identified for our trial run for Motivation wheelchairs, need to go to CoRSU in Entebbe next Sunday with a CBR worker and a workshop technician. A physiotherapist and technician are also to attend a two day training in Kampala later this month and then, if all goes well, I am hoping these children will be the first of many who will be given purpose-built chairs which fit the child so much better than the standard type.

We need two tricycles for the post polio man and the TB spine lady so these will be given a quick service by the workshop staff and then the potential owners informed that they are ready.

I had a meeting with Sr Rebecca, Senior Community Nursing Sister, as I think it would be good to combine nutrition and children with disabilities outreach work and especially follow-ups. I was pleased that she has agreed to attend an outreach clinic so that she can gain experience in this area.

I was delighted to meet Martin who was about to take six cleft palate babies and their mothers to CoRSU for surgery. They were to travel by public transport which takes hours in extreme discomfort and heat and then, when they had concluded their journey by public taxi, Martin would immediately return to Kumi travelling throughout the night and then report for duty on arrival. This project was started when I was here last and I didn’t really expect it to continue as it is so it has proved to be very successful.

Some attendants were cooking on their charcoal stoves, a practise which was stopped a few years back when we introduced the fuel-saving stoves, and so they required a stern warning that they had to stop. They said there were no spare stoves in the cooking area but, on inspection, there were several. Some needed repair and I happened to pass Joseph, the leprosy amputee, who supervises the repair of the stoves and I asked him to replace a few which were broken.

I had hoped to visit the farm to select three cows but this needed arranging and so we will go on Wednesday next week. However, a good morning’s work had been achieved and it was time to return to the Guest House to get ready to go for our “luncheon” date at Modesta’s. A shower was essential and I was wearing my local dress as it wasn’t quite ready for the wash and we were continuing to Adesso School for the Girl Guide meeting. Arriving at Modesta’s, we entered her tiny home and Helen sweated so much that Modesta took a gingham bag, soaked it in cold water and almost garrotted Helen as she wrapped it around her throat and wiped her brow covered in beads of sweat. As usual, we had a feast laid before us; mugs of African tea (full cream milk boiled with very few tea leaves), borehole water, local rice, avocado and a strange looking concoction. Helen took a polite but tiny portion and then Modesta piled up her plate with Helen raising her voice in objection. It consisted of chapatti with egg in groundnut sauce and tasted much better than it looked. In fact, Helen took an extra spoonful. We were generally well entertained by the family antics until we were just far too hot. I went to see Diana, the goat, and the unnamed pig which was fed by one of the many children. The pig swill did, in fact, resemble our egg and chapatti mix but this came from a “restaurant” and certainly lived up to its name of swill. The pig walked right through it and I was amused to see the girl pick up the slops and return them to the trough!

We really had to leave and go on our way to Adesso School. There we were seated in the shade of a tree and joined by teachers and James, Chairman of PTA. We met the new Head Teacher who, on first impressions, is a pleasant lady and appears to be efficient. The entertainment commenced with the Girl Guides performing their drama, song and dance which they had practised to perform for the President last Saturday but their offering was not selected. It was so colourful and lively and, once over, we retired to a classroom where I showed them the Powerpoint which I had been sent by 3rd Dalkeith Girl Guides. I now have to produce a reciprocal version for the Scots guides.

Returning home, I found Grace Girwhal waiting to have a serious talk with me about her finances. We tried to find somewhere quiet but there are so many visitors here that there never seems to be a moment’s silence.

The black clouds were gathering overhead and, lo and behold, big drops fell to be followed by the first rains since November. Could this be the start of the rainy season? We hope so!

 

Monday 10 March

The start of the second week and we are beginning to feel the effort required to keep going in this heat but, hey ho, it’s off to work we go if you can call it work!

Soroti today with Ruth, her Mobiliser, Sam, and we were joined by Els, one of the Dutch ladies. Arriving in Soroti, I had some shopping to attend to; 12 wedding rings, Secondary School past papers books and another 12 yard length of material for me to bring home.

A couple of years ago, Helen bought two cows and we were to check up on their owners’ families. Oiko Joseph, a 6 year old hydrocephalus, has been on my books for a few years now and we had started by making parallel bars to help him stand and walk. Now, he is a happy little boy running around normally. Helen’s cow has produced both a he- and a she-calf so the family are in a very different situation from my first visit. I gave them money to buy de-worming and tic medicine for the cow which, in spite of the lack of grass, was still able to provide its offspring with some milk.

The second cow belonged to Odeke William, a stubborn boy who has always refused to wear his KAFO’s (knee ankle orthoses) and to stand and walk in the parallel bars. He was a changed boy behaving reasonably well and trying to walk with a smile on his face. At last, we could consider school for him if he had a wheelchair so this was equally successful. The cow was at the watering hole due to lack of grass so we failed to see it but we were reassured that it was doing well.

Emwamu John, a 10 year old CP, needed a bigger wheelchair and we gave the grandmother money to rebuild the thatched roof as the wind had destroyed it and the sky could be seen through what was left. Incredible to think that families have to sleep in such conditions when it rains. They stand flattened against the walls where there may be a little shelter from the precipitation.

We had brought sandwiches from the hospital bakery and needed somewhere to sit to eat them. We found a small brick, iron-sheeted shelter where the local schoolchildren walked past and it was like being in a cage in a zoo. They would not have seen mzungus before and they stared at us as though we were something very strange and I’m sure we were! It would have also made a perfect stable in Bethlehem!

Onto the village of Sam, the mobiliser, where he had gathered thirteen children with disabilities, all with very fascinating conditions and which saved us climbing in and out of the vehicle which was taking all our energy and more.

Epru Simon; a severe gluteal fibrosis who will come to Kumi Hospital for surgery.

·        Eyonu Ben; 4 years CP from birth. On Motivation waiting list.

·        Ewanya Francis: 16 years CP. An orphan requiring a self-propelling wheelchair.

·        Akello Judith; 3.5 years. Burn contracture released by Mr Viva in 2013.

·        Amichu Brenda; 17 year old TB spine in Primary 6 who would like a tricycle.

·        Apio Gracious;Visually impaired CP. Has had plaster of Paris to release leg contractures but this was unsuccessful.

·        Okello Patrick; 7 years. Dumb hemiplegic. Ruth and Sam to make parallel bars to allow standing and walking.

·        Angura Lazarus; 17 years Bilateral neglected club feet in Primary 6. he would love to have a bicycle so that is easy to arrange.

·        Amito Sara; 8 month old floppy CP for a CP chair to enable her to learn to sit.

·        Otelu Daniel; 17 year old in Primary 7.

·        Asibo Alice; 13 years Acquired CP Dumb. For a wheelchair.

·        Opio Kenneth; 17 year old epileptic who silently sat and drew pictures of mud huts in great detail. If only he lived somewhere where his talents could be nurtured.

·        Okirol Michael; 8 month old with an ear flap which could be removed by simple surgery.

We gave out crayons and drawing paper, some clothes and soap and left everyone with plans. Kenneth was delighted to have soap and I hope he would wash his clothes. By now, we were incredibly exhausted and dirty; probably worse than ever before. By now, we were incredibly exhausted and dirty; probably worse than ever before. I had to ask permission to take Helen’s photo because she looked like I’d never seen her before and she refused! I would have done the same! We were so ready to start our return journey but there was one more patient so once more down from the vehicle to see Amuga Susan, a 6 year old CP whose mother was hoping for a life-changing experience which we hadn’t got to offer her.

Homeward bound, and I can’t emphasise enough how dirty, sweaty and tired we felt. The journey was bumpy and painful on the bottom. We picked up Max, the catechist, who kept us diverted from our discomforts for a short time. Reaching the Guest House, we fell out of the vehicle hardly able to stand upright and I was greatly disappointed to find I had a visitor; Okerenyang Francis. In desperation, I had to say I needed a shower or I would have not lasted one more minute.

 

Sunday 9 March

Having been rather remiss at Sunday prayers last week, I decided to do better this week. The rumour went round that I left early because I was so ashamed of being late! They somehow got their facts wrong! Anyway, I set off on my brakeless bike only 45 minutes late and still arrived before the homily which I never understand so I find little point in sitting through the full length of it and in the heat of the church. I shall try to get it better next week. On the whole, the service went well; I was amused by a cute little girl who sat on my knee and spent the time following my aged blood vessels in my arm and hand and almost dislocating my shoulder! With the service over, they auctioned 3 eggs and a bag of sorghum to raise funds to repair the catechist’s house and, if you ever saw his house, you would not believe that a family could live in such squalor. He deserves better! I found that I had bid 3,000/= for the bag of sorghum which I handed to Rose who works on the Nutrition Unit as their needs were greater than mine. I knew I would be summoned to the front to give a few words to the congregation and I was right. Back in my pew, Max, the catechist, was talking about the couples who wanted to be wed. This is something I had briefly mentioned and so afterwards I asked him what it was about. My inkling of an idea was now fact and there were six couples who had registered an interest. This needs some organisation so Max and I will meet next Saturday to make some plans. Dresses and suits, wedding rings, food, music perhaps and then permission from the powers that be and a priest. Having made the necessary arrangements, I left the church and asked Peter, Modesta’s son, if he would call by the Guest House and take my bike to have its brakes attended to. He collected the bike and left with 1000/= (25 pence) and returned less than an hour later with the job done. It will be so much better to be able to stop the bike purposefully rather than aim for a tree or verge…and more dignified for someone of my age!

Time to get prepared to leave for Alexander MacKie’s 85th (actually 84th but I hadn’t the heart to correct their deduction) and I wore one of my African outfits. Helen and I mounted the motor bike and sped off towards his home where we found the clan elder sitting in pride of place amongst the other clan members. We were very honoured to be invited and we sat next to his second wife and were handed many babies which presumably fitted into the overall picture somehow. A music system was at full volume and the ceremony started with two reverends and two laymen reading the bible, alleluja-ing and praising God for the birthday boy. We didn’t know when things would draw to a close but then the cake arrived from Kampala and placed on a cake stand of five beeer glasses. MacKie, his wife, Helen and I stood with hands on a sharp knife to cut the cake. Unbeknown to us, someone behind us was shaking a bottle of Coke and, in true Formula 1 fashion, sprayed everyone around with the sticky foam! A meal followed and, with hands washed, we helped ourselves to the usual but in small quantities as a second meal was being prepared for us. Meal eaten with fingers, hands re-washed, we said our farewells and left to the neighbouring home of Alex, our driver and nephew of the clan elder, where his wife, Hellen, had spent many hours cooking in her cramped mud hut kitchen. Rice, chicken, greens and cabbage were spooned onto our plates and meal number two was eaten after hands were washed and then re-washed once completed. The Sunday afternoon proceeded until it was time to return on the boda boda and then to reflect on the day’s events. But Brenda came to update me on her hopes to return to school and there was little opportunity to catch up with diaries etc.

 

Saturday 8 March   

International Women’s Day and President Musseveni is coming to Kumi Town! The police and army were out in force looking suitably fierce and dressed in their bovver boots and uniforms. Banners of yellow, red and black being the colours of the Ugandan flag were draped on every available post and swarms of people descended on the town by the coach load or by foot. Organisations were all ready to provide the entertainment including Kumi Hospital where drama and singing had been prepared but unfortunately, on inspection, the drama was refused because it was considered to be too “women orientated”!

I didn’t really mind at all that today was another working day and we had to leave all the festivities behind. We were on our way to Soroti to visit three of my boys. Antony was first and I wanted to see how he was progressing with his studies. He had changed schools having failed his Senior 4 exams and we had arranged extra tuition. This is his last opportunity to succeed and he knows it. I was pleased to see that his end of term report for Senior 3 showed great improvement and that he had been promoted to Senior 4. I only hoped that this was a fair marking and they weren’t trying to keep me off their backs! He showed me round the school which was rather shabby to say the least. Most of the windows were broken, there were few desks and chairs in the classrooms, the dormitory wasn’t too bad and I saw Antony’s bed and his tin trunk and possessions most of which I recognised. Saturday morning must be washing day as the boys, or should I say young men, were bent over buckets of lathering water and diligently rub, rub, rubbing away at their clothes. As we sat in the classroom, there was a sudden rush of noise like a large lorry passing and I thought we were going to be in the midst of chaos but it was a sudden whirlwind which came from nowhere and went in a few seconds. Antony’s tutor who we had arranged for him to have extra tuition spoke kindly about Antony and promises to continue with his efforts. I had brought a letter for him from Tony in UK who is his sponsor and always takes a keen interest in his progress or otherwise.

Leaving Antony, we went to see Michael who had not done as well as expected in his Senior 3 exams but had been promoted to Senior 4. He told us that his mother who has suffered a serious stroke a few years ago was not well in his village which is exceedingly poor. I gave him some shillings and I asked him what he would buy. “I will send some home to my mother!” They always think of others before themselves and so he was given a few more shillings as he had been so thoughtful.

Now, we left Soroti and continued up to Katakwi on a road that went on forever. It’s so hot these days and travelling so tiring. Hunger had overcome us and all we could buy was a chapatti each. Sometimes these are quite nice but this one, I found to be no more than flour and water paste which was difficult to swallow. However, it served its purpose and filled my stomach! We were going to the home of Lawrance, my boy who has passed Primary 7 in spite of his severe disabilities. There he was sitting in his wheelchair and wearing the suit which had belonged to Lakinde Singh, the Darlington eye surgeon, and which I had brought him last year as well as a shirt and a tie. He looked incredibly smart and handsome. His involuntary movements have improved and, deep down, you can see the young good looking man that he would be if he was without this athetoid CP. He wanted to know what next there was for him and, sadly, I have found no school in Uganda which would take someone with his disabilities; only one in Kenya which is not a feasible option. He would like to do computer studies and says he could use the keyboard with his toes. I have been given a friend’s unwanted laptop which was too heavy for me to bring out but I may be able to consider it on my next trip. His grandmother, Ruth, greeted us warmly and showed us where Lawrance is sleeping until his house is complete. There was a broody hen sitting by his mattress and keeping its clutch of eggs warm and cosy. I could easily sleep in a hut such as this and I felt completely at home. We are building a simple permanent house for him and it is progressing well. His old grandparents will know he has a roof over his head when they leave this world and I shall feel I have done all that was necessary. How great, though, if we could have inspiration and find him work somewhere! I was presented with a white chicken and I could tell that it was light and therefore not ready to lay eggs yet.

Our return journey was so tedious and, reaching Kumi town, we found that the President had left and the hoards of people were making their way home in coaches, on bikes and on foot. The day had gone well and with no disturbances but it had been long for the people standing for many hours in the heat. My chicken was duly placed in the kitchen cupboard and went to sleep very quietly whilst we took supper. Then Modesta called and we sat outside for a while discussing this and that. She would have been given my chicken anyway but why not now as then we would be saved the smell of chicken droppings inside the Guest House in the morning. After escorting her to the road, we settled ourselves down and prepared for bed.

 

Friday 7 March

Day five and with the weekend in view! Phew! One of us, either Helen or I, has already been attacked by a mozzie. I successfully caught and squashed one in our “bathroom” and found there to be a blob of fresh blood which had oozed from its innards. It had already taken breakfast!

Following our long day yesterday, we decided to leave at 9 am and what a difference that hour made! We went out for home visits with Martin, CBR worker, and Ikarov James, Mobiliser, towards Nyero.

Our first home was that of Okalany Joseph, an 11 year old epileptic CP boy and the 5th son of 6 children and severely brain-damaged. The mother was a teacher and the boy was with his aunt and 82 year old grandmother who was an amputee and who traversed the compound by sitting on a sack and pulling herself along with her one and only foot as babies do. The aunt could see Ugandan shillings floating before her eyes and thought they were in for many treats but, apart from putting Joseph on the wheelchair waiting list, we decided to consider funding something at the end of the day when we had seen the other children. The father had four women and had left Joseph’s mother when she gave birth to this child with a disability. The aunt had been diagnosed with a mental illness in 1992, her husband left and now she has to pop her pills every day and she is alright.

The next little child was 9 year old Atim Joyce Mary, a mentally retarded girl whose family was one of four in a group which we formed last year. They had been given a cow called Josephine to share between the four and, when the pregnant cow produces, the calf will be passed on to another family and so on until all the families are equal. Or that’s how they say it is and this system seems to work without any disagreements between them. Martin will show James how to make parallel bars out of local material and then Atim Joyce can practise standing and progression to walking.

Okiring is a 12 year old dumb cerebral palsy boy who would benefit from a Motivation wheelchair and this would be arranged when the mother who was at market was informed. They also had a cow, Rose, now pregnant which we provided last year to a group of four families.

Abot Agnes is a child we added to our list last year and she had already been given a wheelchair and had been admitted to the local primary school which she was enjoying. She will benefit from a Motivation wheelchair also and now we have about completed our required total. Let’s hope this scheme succeeds and this first group is the start of many.

Opio Galivan was 5 years old with mental retardation and who may benefit from parallel bars to get him upright and weight bearing. He was the 5th child of 8 and lived in very, very  poor conditions.

Ageo Modesta was our final child, a cerebral palsy diplegic of 9 years. We gave her one of bev’s little dresses and shorts and left her looking so beautiful and happy.

Nearly done for the day but we wanted to see if Janet with the fractured femur was home from Ngora Hospital so it was back down that bad road by car and foot to find that she was, indeed, home but in great pain. The plaster was too tight and digging into her skin at the groin and calf. We could not leave her in such discomfort so Martin attacked the plaster with scalpel and razor blade until the plaster was torn off and the child visibly relaxed and fell sound asleep in her mother’s arms. We arranged for her to go to Dr Ekure’s private hospital in the morning to be re-assessed.

The day’s work was done with its emotional highs and lows but we were so hungry. We needed to discuss the plans for the children so it was decided to take a soda and food at Paradise View, the local eating place with no hope of ever gaining a Michelin star in a million years. Helen shoo-ed the chickens which had taken up residence at our table and the dust thus produced from their feathers and the thatch filled our eyes. Our order of dubious-sounding food which, hopefully, would satisfy our hunger pangs, was given to the big, fat mamma cook and I must say that the service was fast if not quite as requested. Helen’s eyes popped out of her head when she saw the rectangular grey slab of meat, the fish of the same colour overhanging the plate, the brown mass of atap and the white stodge of posho. My plate of cow peas, g-nut sauce and mushrooms no doubt off the termite hill looked the worst with its bile (not vile) colour and slimy consistency but I was hungry and the years of the local food have mellowed my taste buds. Helen had chosen wisely by requesting a chapatti and two arrived for her. I noticed that she didn’t quite manage to finish one and the other was soon snapped up by the rest of our diners. The beers and sodas were fine! The bill arrived – total of less than £1 each -  so, considering the cost of the beer and the soda, complaints were not forthcoming.

Once again, we returned tired and hungry and now it was time to reflect on the week’s results. We had achieved so much.

 

Thursday 6 March

Helen and I slept like logs which was a welcome change from the brief snatch of a few hours of the last couple of nights. We were almost bright and breezy! Outreach Clinic up in Orungo north of Soroti and a long journey lay ahead. Before though, we needed to take little Paul with his new leg and Rebecca with her repaired prosthesis back home. The Land Cruiser came for us and was already laden with the hospital team and the patients. Helen and I were joined by the two Dutch ladies who are staying here, Marjon and Els, and we all squeezed in with the utmost difficulty. Harriet and Elizabeth joined us in Kumi Town and we drove to Soroti like peas in a pod. Paul’s grandmother was so happy to see him with his new leg and he managed well up and down the steps only holding my hand. Rebecca was also happy and she has exercises to do so that, when I see her next. she will be able to extend her knee fully and thereby improve her gait.

Off to Orungo which took so long and we arrived to find very many people already seated on the ground in the shade of a tree and waiting for us. We sorted the eyes from the children with disabilities and settled ourselves down to the task of screening children first and then adults. Helen went inside to work with Michael and Harriet and where they didn’t stop until the last patient with an eye condition had been seen and 119 satisfied patients walked away from their clinic inside the Health Centre. We sat in the shade of a large tree and saw nearer 150 patients, writing their details furiously and causing writer’s cramp. The clinic had been well organised and all the patients were appropriate for our programme; many children with gluteal fibrosis, osteomyelitis, lumps and bumps, knock knees, epilepsy, cerebral palsy and, oh, so many different conditions. They kept on coming, more and more, and I thought we would be there until dark and so Ruth and I settled ourselves on a fallen tree trunk and screened the adults. I like these old people with their aches and pains but we have little to offer except a piece of paper on which we write some advice and maybe a prescription for medication but they struggle to their feet and wander off perfectly happy with their consultation. One old lady announced she was 200 years old and another just 7 years old! No one was left unseen and we were more than ready to climb into the vehicle and head for home.

The journey back went on forever. Dusk fell and then the darkness and still there was no end in sight. How Landeer managed to miss the vehicles with no lights which headed straight for us to avoid potholes, the cyclists also with no lights, the herds of cattle returning to their corale for the night., stupid people dashing across the road, I’ll never know! We were still incredibly squashed together (although I must be honest and say that Helen and I, being by far the most senior) sat in the front seat in comparative comfort. I had the idea to tie my knees together with the straps of my back pack to make a few more spare inches for Helen but had to remember to release the knot before I descended from the vehicle! Finally and 13 hours after we had left home, we arrived and fell out of the vehicle barely able to stand up straight. The Dutch ladies were equally tired, absolutely filthy from the dust and hungry. Yet, in all, it had been a good and successful day and surely, after a pint of Club beer, a shower and a good meal, sleep would descend on us all.

 

Wednesday 5 March

Whilst the locals were flocking to church for Ash Wednesday, we were setting off on our day’s mission starting with a visit to Dr Ekure’s hospital, Kumi Orthopaedic Centre. What an incredible place! Every time I call, there is a new block being built and this time was no exception. He really is doing well and the beds are full! It was good see Lydia, the physio assistant, again and we greeted each other warmly. But we couldn’t stay for long because there was much to do and I wanted to call in to Kumi Prison to visit the Officer in Charge, Sam. I usually bring him the UK prison paper, Inside Out, which he always enjoys and he can compare the Ugandan prison system with that in UK. Entry is not difficult, just put camera and phone on a table and then they unlock the metal gate and you are in. I wanted to check on the fuel saving stove we had installed and Sam proudly proved that it was being well-maintained and well-used. A prisoner was stirring the large basin of posho and so I thought I would have a go. After stepping up on to the surrounds, I tried to lift with all my might the enormous paddle but it would not budge from the revolting looking posho stodge no matter how hard I tried. I returned it to the prisoner who calmly pulled it out and continued stirring. The other prisoners were somewhat amused!

Back to daily duties, and we were off to do home visits with Rose from the Nutrition Unit around Oseere which is an area not far from Lake Busina. I haven’t mentioned about the vegetation at this time and the land here was a good example of demonstrating how dry everywhere is. It’s almost like a desert with barely a blade of grass to be seen, a few bushes and little else. Crops have failed and the usual glossy leaves of the orange trees are curled and grey. The cattle look sad and scraggy due to lack of water and one wonders if the land will ever revive but, at the first rainfall, the greenness will return and life will start again as with our springtime. My pawpaw tree which I planted in November is without a leaf and there was I hoping to see that it had grown a foot or two if not even bearing fruit. No such luck!

We called by Margaret Asio’s home but the huts were empty and we were told that she was staying with one of her daughter’s in town. She is the retired secretary to the Medical Superintendent and, sadly, discovered that she had breast cancer just before she finished working. She was invaluable to me when I first came to Kumi and before I knew how to do so many things for myself.

Then it was down to work and the home visits. We were visiting children we had previously seen and we started with Achom Skovia, a 17 month old CP baby who had been given a goat which had had 3 kids but a dog had sadly eaten one. The kids were strong and healthy and were getting plenty of milk from the mother’s bulging udder. The father is very caring and, before we left, I gave him money to buy another goat which made him smile profusely. Now he would be that much nearer to being able to swap his goats for a cow. Alungat Mary, 1 year old, had been in the Nutrition Unit and was doing well. Helen has funding for a couple of cows and she decided to provide one for this family but only on loan as we did with Lazarus and Mary Goretti. If the family doesn’t make any effort, then they lose the cow. Apolot Karen was a 19 month old CP child who had also been in the Nutrition Unit. She was a pathetic soul, all skin and bone and in such severe extension with muscle spasm but looking so fragile that I could not bring myself to try to break the spasm for fear of fracturing her tiny bones. Apio Eveline was 3 years old a CP who turned from rags to riches when given one of Dorothy’s little dresses to wear .

Finally, we went to visit Lazarus and his mother, Mary Goretti, who was heavy with child. She continued to do well but, with the dry season, it is impossible to evaluate the effectiveness of her crop growing as everything is withered and brown. The fruit trees which we had given her were not in as nearly a bad state as my pawpaw tree so I think the rain will revive the land for her.

A shorter day than usual as we were to attend the Rotary meeting and also Helen and I had had a terrible night’s sleep and were good for nothing. I immediately flopped on the bed whilst Helen showered before dressing to go out for the evening to Rotary. It is interesting to attend other people’s meetings and, this evening, we heard about their project of providing panties for the schoolgirls. We almost had our hands tied behind our backs to promise to help fund this but nothing was forthcoming. These schoolchildren are without disabilities but I did write to Darlington Soroptimist International who I thought may consider a donation. Otherwise the meeting closed and we took a circuitous route home as the others seemed to have tasks to do and took advantage of being in town. Life in town is lively in the evenings when there is power with very many people promenading and buying in the still open shops or stalls on the roadside some of which cook their wares on charcoal fires. Helen and I were so hungry and, by this time, eager to return and we were relieved when we finally reached home, ate and fell into bed.

 

Tuesday 4 March   Pancake Day

Our first night together went well and I think all will be OK. The heat wasn’t so intense and we are finding our way round the piles of clutter.

My morning visitor was Sam, sports teacher from Adesso, and Helen presented him with the two footballs from her husband and I gave him the updated trophy which I have had engraved at home. Fortunately, I had partaken of my breakfast and was prepared for the day as, before I knew it, Landheer arrived in the vehicle to start our day. I managed to send him back to the hospital to deliver some correspondence for me to delay an immediate departure.

Our destination was Soroti and I was pleased to find that the road had been re-surfaced for about half the way making the journey much speedier and more comfortable. There, it was lovely to meet Ruth (CBR _ Community Based Rehabilitation - worker) once more. She looked well and had prepared the day’s activities down to the last detail. We bought two copies of Oliver Twist, a school bag and some red shorts and top as requested by Leah and Dickson. I bought a long length of African print material for Bev back home for £7.00.

Ruth had identified Paul, an 8 year old boy who lived behind a hair dressing salon and who had had an accident in 2011. He had to have his leg amputated below the knee and was walking with one crutch. His arms were weak as he had also fractured both arms, one only a few weeks ago. We asked if he would like a prosthesis and he shyly nodded. His grandmother, who was seated on the floor as is the custom, was reduced to tears of happiness and hugged us with great joy. We would collect him that evening and return him home with his new leg on Thursday morning.

Next was 22 year old Rebekkah who was given a prosthesis last October. She was an epileptic who had fallen in a fire when young and her leg became infected and had to be amputated. Her stump had wasted as had her quadriceps causing the prosthesis to fit badly and her walking pattern to be poor. We would collect her also and return her to the hospital for adjustment. I was disappointed to find the materials for these legs was not as good as it had been in the past and was heavy and not a good colour. Better than nothing, I suppose!

Now, we left Soroti town to visit the rural families and started with Janet, a severely brain damaged 13 Year old girl. Janet. who shuffled along on her bottom which had caused a pressure sore. I asked to see inside the hut she shared with the mother and found it to have a weird smell. Her bed was a pile of rags on the earth so it wouldn’t be long before infection set in the sore. Helen decided to provide a goat and I would get her a mattress. Whilst there, a mother brought Namajja John, a 7 year old with severe gluteal fibrosis who needed surgery before his walking and sitting became more seriously affected. Another child for Helen’s funds which would cover the hospital costs.

On to Ekwu John, a bright looking spina bifida 8 year old who was a definite candidate for a Motivation wheelchair. He attended school already but travelled on the back of his father’s bike; so much better to be able to be independent and get round the school himself. We took his photo to send to CoRSU and gave him money for a goat.

Ejechu Isaac I already knew as he was the most stubborn boy on earth who had had a gluteal and quads release last year and had completely wasted his opportunity to be able to walk by making such a fuss over doing his exercises. He was sitting with almost 180 degrees angle at his hips making his life difficult as he was almost sliding out of his chair. I realised how most of the children benefit from their surgery and there are few who do not improve. Good to have seen him though but I don’t think he was too delighted to see me as we hadn’t seen eye to eye at the time.

The small-faced father who I met last year was following us as he wanted us to visit his home and to meet his daughter, Juliet, again. She was a difficult child who we had given a wheelchair to last year as well as a solar light. It wasn’t long before I realised that he had in mind a new roof for his small mud hut but I’m sorry to say that he was refused.

Achen Milka, the lanky CP teenager who was given a wheelchair in October, was as happy as ever living in her own little world and with a permanent grin. The wheelchair was doing well and so we gave her mother some money to buy more toothpaste and left.

Ruth had arranged to meet a few mothers with the intention of considering to form a group and we found them gathered together waiting for us. They consisted of Atim Joanna, a deaf and dumb girl whose mother needed 312,000/= to top up the school fees at the school for the deaf and we had this amount available from a donation we had been given; Edechu Samuel, a bright hydrocephalus and cerebral palsy 8 year old who was a good candidate for a Motivation wheelchair and who would then be able to attend school; Ekinyu Moses, a large 13 year old who had suffered a fever when small and who was now an epileptic with CP; Eluzani Grace who had post injection paralysis following quinine injections for malaria. Other mothers had been able to bring their children but it was hoped to have a maximum of 10 families. They were to identify a chairperson who would probably be Atiku David, the brother of Moses and a most capable young man having qualified as a social worker but still unable to find employment. He transported his brother on the back of an old bicycle and I thought that, if he were the chairperson, then we would provide him with a new bike so that he could also visit the homes of the families. They are to discuss the way forward for the group and I wouldn’t be surprised if they would like to be given a grinding machine fuelled by diesel to set them off. This will enable them to grind their flour themselves and also have customers thus generating an income. The old method of grinding flour on a stone is still common practise but a tedious task made much simpler by mechanisation. We will return in two weeks for further discussion.

Tired, dirty and hungry, we returned home to find Brenda was waiting for me. She was another of my students who had sadly failed her Senior 4 exams and she was not looking forward to telling me. We talked for a while and she told me that she would like to repeat the year but not at Bishop Maraka School as she had been unhappy there. She asked my advice and I suggested Ngora High School where I already have 2 students one of whom is her sister, Leah, and her face lit up as this is exactly what she had wanted. This is to be arranged and I am hoping they will accept her into Senior 3 and she will repeat years 3 and 4. She’s a bright girl, had a difficult life and I wouldn’t want to give up hope yet. Her ambition is to be a nurse which is a good profession as there is always a need for nurses.

Francis Okerenyang was also waiting to see us but he knows Helen so she as able to give him the bee keeping magazines and suit which her husband, John, had sent for her. Francis and I talked at length about the possibility of arranging a “mass wedding” for couples who have had their traditional wedding but never followed it up with a church ceremony. It’s a long shot to organise this but time will tell.

I couldn’t wait to get under the shower and wash off the dust and sweat  and I was happily under the cold spray when Helen called out to ask if I had finished with Brenda. The poor girl was waiting in the dark for me to say she could go!

Supper and the nightly pint of Club beer were most welcome before we retired for the night hoping it would be a little cooler.

 

Monday 3 March 2014

Few people will realise how privileged we are to be able to do what we are doing here. Today has been day one and very fulfilling. We started with the usual welcome at Morning Assembly followed by a fruitful meeting with Charles Okular, Hospital Administrator, when we were able to proceed with the wheelchairs arrangement, nutrition issues and the purchase of three hospital cows as well as many other areas.

Harriet, Helen, Landeer, the driver, and I then left to start our visits and so, once the vehicle was fuelled, we were off to Agu. On the way, we visited another school where there was a nutrition clinic in progress and we saw, amongst all the pale, sickly babies, one brain damaged child who would in time need a wheelchair. We then continued to let Helen see the house that she had financed for Moses. The ramp allowing his tricycle to enter the house had been constructed at the rear instead of the front and so we had to arrange for a further ramp to be made to allow for easy access for the tricycle. Moses was enjoying sleeping in his new abode amongst the piles of dried cassava to provide his food during the dry season.

At Ngora School for the Deaf, we met Apulamera, the Head Teacher and her class teacher. She had sadly failed her P7 exam and she was visibly upset and depressed. It is so difficult for a profoundly deaf student to pass the same exam as one who hears and with no concessions for the disability. We agreed to give her the opportunity to repeat the year and I asked her teacher to make sure that he gave her plenty of encouragement and that “he must pull his socks up!”

Ngora High School and we found our two successful primary level students, Leah and Dickson, who started secondary school only two weeks ago. They are happy there but asked for some books; Oliver Twist and A Child of a Decade, Dickson asked for a school bag and Leah shorts and top for athletics.

Janet was one of my priority children as I wanted to see how the cow was doing. On arrival, we found that she had fractured her femur the day before and her mother, also Janet, was looking for money to take her to hospital. She declared that God had sent us to assist! Little Janet, a severely brain-damaged CP, was lying motionless on the ground in her mud hut but in obvious pain and her thigh wrapped with cloth. I had taken a youngster’s dress and shorts made by our neighbour at home , Beverley, and a second hand skirt and jacket which I laid on the mattress. We went to see the cow whilst the two Janets prepared to be taken to hospital. The original cow was well even though her ribs were rather prominent which is not unusual during the dry season as there is barely a blade of grass to be seen. Her son, the bull which we met in October, was even larger with broad shoulders and vast body. Best of all, the cow had given birth to a she-calf so the herd is expanding and this is giving the family so much security. Janet emerged from her hut proudly wearing her new outfit and carrying her daughter also wearing her new dress. They were ready for the journey so we started to walk in the heat in convoy up the track to the vehicle. Arriving at the hospital, we escorted mother and daughter to a room where they awaited the doctor and then we departed having arranged to settle the expenses.

Atebo Agnes was next. She is the bright TB spine child who we first came across in October and was now mobile in a wheelchair and attending primary school. We checked her exercise books and her school work looked promising. Surely, here was another candidate for a Motivation wheelchair. Her great grandfather who claims to be 108 years old greeted us warmly gesticulating that he had body pains. I couldn’t reassure him due to the language problem that this would be usual for someone his age but a smile and hand shake may well have helped.

By now, we were so hot and tired that we returned to the GH in need of serious scrubbing  and hair wash as we were thick with dust and sweat. Betty, Adesso teacher, was waiting for me as I had asked to see her to pass on the letters from the Dalkeith Girl Guides. I am to attend their weekly meeting next Tuesday when they will perform the programme they are giving for President Musseveni this Saturday in Kumi Town to celebrate World Women’s Day.

Helen and I are now sharing a room as two Dutch ladies came and they had booked a room through the hospital but the message hadn’t reached Anne. The two of us have agreed to a lot of give and take as Helen is an owl and I am a lark (or, more appropriately for here), a cockerel which does not do much for a long night’s sleep between us. Also, 112 kg of luggage are somehow dispersed about the room but fortunately we are (so far) totally compatible and managing well.

The temperature remains high!

 

Friday 27/Saturday 28 February/1 March 2014

Here we go again! Off at the crack of dawn to Teesside Airport in the dark, the rain and the wind but, this time, with Helen Jefferson who is joining me for the trip. Bidding our husbands farewell and promising to be good girls, we got through security with a total of 112 kg without difficulty. We arrived at Entebbe Airport 13 hours later and were greeted, not only by Matthias and Susan, but by thousands of flying insects which we thought were mozzies but, no, they were lake flies and we were reassured that we wouldn’t end up covered in bites.

Helen and I shared a bed and managed better than expected but the night was hot and, in a way, we were too tired to sleep. We woke to sunshine and the sound of the children in the hospital’s hostel over the pathway.

Our cases sat piled up and needed some organisation so they were duly unpacked, re-sorted and zipped up waiting for tomorrow’s trip north. Everything was an effort and it wasn’t long before the sweat was building up into rivulets down the nose. My laptop is the only item which didn’t travel well and it had a big crash which took ages to sort itself out. It’s still not 100% so fingers are crossed that it will last for the next 3 weeks.

I had brought some things for Elizabeth, Sheilagh’s friend and so she called to collect them – comics with toy guns which weren’t picked up on the security xray, sweeties and biscuits and some money. My baggage was reduced but only very slightly. Florence in physio didn’t know I was coming and gave me a warm welcome as did other staff members. The children are delightful; pushing themselves along in their wheelchairs, with their amputations, cleft palates and club feet. It is very special to be back and to be able to witness these children coping so maturely with their disabilities.

Staff lunch was delicious and full of my last dose of salt as Anna in the Guest House insists I have a salt-free diet. My eyes were bigger than my tummy and I couldn't quite down all the beans and rice on my plate but my helping was a good 50% less than the Ugandans! Helen missed her meat!

A siesta was necessary after lunch and I was in a deep slumber when my mobile phone rang to tell me that Christine was back from her outreach work and we could start our meeting. Christine is the physio here who deals with Motivation Africa and my best hope for wheelchairs for Kumi. Our meeting was constructive and we drew up a plan for a pilot group of 5 children who have the potential to attend school if they can be provided with a wheelchair. I hope to get this started whilst here. I also hope to arrange for a Memorandum of Understanding between the two hospitals to be drawn up and agreed so that there is a formal association. Some of the Kumi rehab staff can attend a wheelchair training course at the end of March so there is much news to discuss with the Kumi staff. Not a bad afternoon’s work?

Friday evening and we both needed yet another shower before going out for supper to celebrate Matthias’ birthday at a restaurant near the airport. We enjoyed the balmy warm evening drinking beer and wine and tucking into platefuls of curry. Things were going to change drastically in the next 24 hours so we deserved a treat – a bit like a prisoner’s final meal.

The night’s sleep was an improvement on the previous night but still it was difficult to awaken feeling refreshed and, following a breakfast of omelette made by Matthias, we awaited Alex’ arrival with his small saloon car to take us to Kumi. Would he manage to squeeze our 4 large cases, 2 cabin cases, seemingly numerous bags and ourselves into the small space? He did with little room to spare and we set off towards Kampala and beyond. The traffic to say the least was horrendous and the exit out of the city took more than a few hours. We stopped at Lugogo Shopping Mall where I bought an internet bundle so that I could be on line during my stay and we popped into Banana Boat which has been mentioned in probably every year’s diary as I like to buy cards and little African items made locally. Seemingly, many hours (in fact 5 hours) passed before reaching Jinja which is on the shores of Lake Victoria as is Entebbe so, for me, progress doesn't start until we turn left at Iganga and proceed north. We were surely ready to eat and so lunch was taken at Igar fuel station which has sort of decent toilets…sometimes. Now the final stage of our journey commenced and we passed the papyrus fields many of which were being burnt thus causing dramatic lines of dancing orange flames away into the distance. Once through the last big town, Mbale, the geography changes and all there is to be seen is bush land whichever way you look. There are very few brick houses as in southern Uganda but thatched mud huts and we can feel that Kumi is near. The road had been resurfaced for many miles but there was still a long stretch waiting to be renewed. The dust from the lorries made visibility zero and, with many of them without rear lights, we would suddenly be confronted with their rear ends. Accidents are common and I was alarmed to pass a fuel tanker which had run into the back of a lorry. Was it in imminent danger of exploding? Finally and after more hours than it took to get from Amsterdam to Entebbe, we arrived at the hospital and it is at moments such as this that one wonders why are we doing this? The heat was intense and, tired from the journey, all we wanted was something to eat, take a cold shower and fall into bed. Supper was, unfortunately for Helen, my favourite meal of dodo (not the extinct bird) and Irish potato but a Club beer made a welcome addition.

The night was unbearably HOT and, for the first time in 13 years, I threw open the windows and slept naked under the mozzie net. Sweat poured out of me and I kept rolling over to dry out the lower half. I must be a good few pounds lighter already!