Rambling comments without a picture

It's Wednesday morning here and I'm downtown to pick up a chicken that I "reserved" at the market yesterday afternoon. It was still living and moving when I left it. Hopefully today it is de-feathered and at quartered. The plan is to make chicken curry tonight in our little kitchen.

So far most of my medical activities have been spent on the ward rounds of the general medical ward. The ward has about 60 beds total - though people will sometimes be on the floor if it is crowded. There is a male and female side. There are four teams that split up the patients, each consisting of an attending, a post-graduate, and intern, and a bunch of medical students. For the intern and students, scutwork consumes most of their lives, usually to detriment of learning. The attending formally rounds on M-W-F and I try to join one of the teams on those days. I have minimal practical input to provide but try to add someting useful. Unfortunately many of the best cases (sick patients where we don't know what's going on) have often died by the time I round again.

I spent yesterday in the general medical clinic, which was interesting. It's a combination of "our" diseases - hypertension, diabetes, etc, and "their" diseases - TB and HIV. It's good to see that low back strain is ubiquitous in the world. A younger woman had fairly severe rheumatic heart disease, which is uncommon in the U.S. these days. In some ways this is similar to the UW hospital, in that many patients are referred, often from private practitioners, because they can't figure out what's going on or they need tests done. The hospital itself is connected to MUST - Mbarara University of Science and Technology, so there's a lot of other students here. Mbarara generally is a well-off area. Most students are relatively economically advantaged, and there is a fair amount of economic activity here, including a Coke bottling plant.

Tomorrow I hope to round on the pediatric ward with a pediatrician from the UK. Otherwise at the hospital there is a TB ward, an OB ward, surgery ward, diabetes clinic, HIV clinic, ER, ICU (3 beds). There is also a hospice organization that comes to the hospital and does home visits. It's funded externally and so is sometimes the only source of morphine. Ironically, we referred a gentleman to hospice so they could pay for chemotherapy for his Burkitt's lymphoma. Of course most people still die here before they even come to get medical attention, much less a referral to hospice. I'm hoping to visit the hospice office next week.

Have you stopped reading yet? If not, then I'l continue with one more factoid. I bought local wine yesterday, made from fermented banana and pineapple. And to tchris : No, I haven't found a wine store yet.
Bye!

Weekend in QENP

I’ve included some photos from the weekend spent at Queen Elizabeth National Park in Uganda. Reportedly the queen will visit that park as part of her visit to Uganda for Chogm which is upcoming (www.chogm2007.ug). The country has a well-organized park system, though I think it’s less visited than Kenya or Tanzania. We stayed at a hostel - which was cheap - but spent dinner and evenings at the Mweya Lodge - which charges over $300 per night. They serve western food, but the highlight of the dinner was a hippo that walked up next to the dinner patio to eat grass – not a rare event according to our guide.

The dark thing in a tree is a chimp that we found after 3.5 hours tracking through the mud. These chimps are habituated to humans from years of being studied by researchers, otherwise they would be nearly impossible for a guide to track with a bunch of tourists in tow. Otherwise there’s a caveful of bats and an elephant, of course. It’s a beautiful park. Since we frequently see images of these animals on TV and in books, the photos don’t come close to conveying the experience.

It's Thursday evening and I've headed downtown to find an internet cafe. Above are some sights from around the city. Motors here seem to run on equal parts petroleum and oil. The above cloud was created by a petroleum tanker. I think I may include that photo in my upcoming lecture on asthma. The other picture shows a street scene. In the background is a statue of a bull at the entrance to the city. In the foreground is meat, no doubt someone's supper tonight.

Arrival

So I've safely arrived and I'm a couple of days into my trip. I had some doubts as the plane landed when it rolled by the wreckage of a small plane next to the landing strip. It was also raining. Apparently the crash happened a few weeks ago and there was still some investigation going on.

Mbarara is the name of the town I'm staying in. I have a bungalow in near the hospital where other visiting students, lecturers, etc also stay. Most of my time has been spent on the inpatient medical ward. The illnesses are dominated by HIV and TB. There is quite a bit of meningitis - bacterial and cryptococcal, also TB. Today I saw a case of rabies, which I will probably never see in the states. Diagnostics are limited to basic blood tests and plain xrays. Antibiotics are available but of a limited assortment.

Departure

So I'm sitting and writing this during my 10 hour layover at Heathrow Airport in London. For some reason the german version of blogger.com came up so I'm not sure how this will come out. Here is a photo of me and Liana, saying goodbye at the Madison airport.