Kitgum Town

Kitgum Town
Kitgum Town

Thursday, October 17, 2013

Continuing medical education

Doc Laurel has taken a couple of training seminars on the topic of Palliative Care and Pain relief. This is an important topic here as many patients present with advanced disease  which may not always be amenable to cure. Many suffer in considerable pain and discomfort and one of the primary goals of good health care is to assist in alleviating this by appropriate nursing care and use of available medications, including Morphine.
Laurel spoke to a group of doctors at the St Josephs Hospital and then later to some clinical officers and doctors who work in the community in medical clinics. This little group gathered in our house and it was really good to see them sharing together .WE were able to identify in the community some impediments to delivery of best medical practice and talked about some solutions which might help people receive better pain relief and management of end of life symptoms, assisting people to die in dignity.
On the medical front, Andrew has been sitting in with the clinical officers at Bregma , observing, giving feedback and mentoring . We saw a lady with Diabetes today who is on medication but has no blood glucose monitoring available and many of the tests we do in Australia to check on control are not available here, so it is a matter of modifying many of the protocols we use back home to this particular place.
Malcolm today was able to help Lois Ford raise her used shipping container off the ground to stop the termites eating the floor away. A local mechanic, Samuel was able to help, providing a car jack and other assistance.
The generator Malcolm helped repair at Bregma is working well . Power is off 50% of the time and having a generator means the XRay machine can be used. Solar Power keeps the other parts of the clinic going.
Anne spent this morning at Bregma talking to staff and patients and just listening to their stories. Many of the stories involve suffering and loss and hardship. It is quite humbling and overwhelming.
Shirley is spending a considerable amount of time in the YOTKOM office, at the back of the drug  shop, sifting through receipts and invoices and using MYOB to get the bookwork for the drug shop and the yotkom project up todate. This is a great help to us in improving transparency and accountability within the Yotkom Project. Things will be set in place which will be ongoing.

Shirley slugs it out in Yotkom office with a packed lunch!
Andrew is  meeting with some key people in the next few days to further secure the land title on the proposed site of the purpose built clinic in Kitgum.
Today,Andrew sat down with Lucy, the  Bregma practice manager and looked at the last few months expenses, income and profit and loss for this important Primary Health Clinic. There are very many challenges to the successful operation of a private medical practice in this setting. Every day brings new set backs, disappointments, frustrations and unexpected  black holes!  Despite this, the medical practice overseen by Dr vincent is continuing to operate and deliver good health care. Without the boost given by Yotkom in the way of clinical officer salaries and capital input this clinic may not have been able to continue running. Dr Vincent may well have chosen to leave town and he is a great asset to this community.
Most of the Kitgum community regard the Yotkom sponsored Bregma Clinic as the best in the town and vote with their feet. WE can see some visible improvements since our last visit.
Laurel, Lynnette and Hannah left at 730am on the homeland bus this morning to make the arduous journey to Kampala. It took them 4 hours to make the first 100km due to a truck being bogged and needing to be dug out of the mud. We are going to miss them.
Yesterday Andrew and Anne went to out to the village to visit Cyclops, one of the laboratory technicians who was working at Bregma. Recently he had been so depressed he took an overdose of diabetic tablets and BP tablets, resulting in a severe low blood sugar and low Blood pressure. It took some hours for him to be brought to medical help and by then he was having seizures and sustained permanent brain damage. He has been discharged from hospital but is unable to speak more than a couple of words. There has been some slow improvement. Please pray for his continued healing and for the pastoral care needs of our Yotkom team and the patients who visit the clinic. We are looking at some ideas to address this issue.

Cyclops with his mother who is currently caring for him

Hello from Africa - this is Anne reporting of some of my african experiences.
Well everyday brings new challenges and stories of peoples lives.  Today we have finally got our toilet fixed which we had to repair with a stick until today.  Power is off again.  Making our way along african roads full of pot holes - and may I say Big Pot Holes - roads washed away which have had not maintenance for years.  Avoiding human traffic, bicycles and boda boda's is a constant challenge, and very time consuming - in this hot dusty environement.  But it is the people who make this place.  Though so poor they are welcoming and happy and we have had the privelege of visiting both our clinical officer's homes and their families for soda and biscuits.  Our watchman John is a lovely man and speaks good english.  He is protecting us with his bow and arrow.  He sleeps in his little hut at the gate on a cement floor with cardboard.  I couldnt have that so gave him the money to buy a matress so he is now sleeping better at night.  He also had a bicycle but couldn't ride it because it had no seat.  So we fixed that too.  One of our team found him some reading glasses which he said is a miracle and a bible is on the way - He is so excited and thankful.  Sarah our cleaner is a widow who has two children to care for - she is struggling to pay school fees as so many are here.  The government schools have 90 to 100 students in each class and are not teaching much from what I can tell.  So everyone wants to send their children to a private school to get a better education as a way out of poverty.  We have had so many request for school fees.
I have sat down with a number of people and asked them to tell me about their lives - and out it comes.  Stories of poverty, war, family members lost, children lost - there seem to be so many funerals here.  The lady who is cooking for us was shot through the arm by the rebels when she was sitting on the floor of the hospital with her baby in her arms.  You can see the scar where the bullet went through. The rebels also killed her first born son who was eight years old.  And so the stories go on.  One mother at the clinic I was talking to this morning lost her son who was 19 months old when he inhaled a nut and even though he had surgery died in theatre.  Last night at the clinic in the night a 2 year old boy was admitted with a temp. of 39.5 and put on a quinine drip and by this morning temp. was down to 36.5 and patient sleeping peacefully.
Well bye for now - need to go and get the dinner on - the lady who has been cooking for us has gone to a funeral today - so lucky I brought some packets of dry food from Australia.  As the kitchens here are very basic - but we do have 2 gas plates.