We had another interesting day at Mulago Hospital.  Here is a picture of the students outside one of the side sections of the hospital. It really is quite large. The total number of inpatients every day is about 2000 but if you include the outpatients that flow through those clinics it can be up to 10,000 patients a day. Two of the students spent time on the pediatrics ward today and it turns out that it doesn’t even fit in the main hospital- it is up the hill.  One of the most interesting things I’ve learned about Hospital Care in Uganda and Tanzania (the only 2 African countries I’ve experienced but I think all countries may be the same) is that patients need to bring a caregiver or “carer” with them to provide food and daily care like washing and cleaning the beds.  The hospital doesn’t provide food for the patient and instead carers either purchase food for the patient or they bring the supplies and cook over campfires in the courtyards.  They also wash the bed linens and you can see them drying all over the courtyard lawns.  The nurses are so few and so busy that they are primarily responsible for taking vitals, changing wound dressings, and administering injection medications. This means that the pharmacy dispenses full prescriptions of oral meds (usually a week’s supply) to the patient’s caregiver in little baggies and they are the one responsible for giving them to the patient.  I have wondered what we would do if this were the case in the US (in terms of having to bring a caregiver) because so many people aren’t close to their families and aren’t married.  In Uganda, family and marriage is very important as is caring for your family at-large – “the community”.  Having a caregiver with each patient has many benefits in that as a healthcare professional, we could always have someone to talk to about the patient to provide instructions or answer our questions, the patient always has an advocate, and basically both the patient and caregiver are getting training on the patient’s illness and treatments during the hospital stay and patient education doesn’t need to be saved for the day of discharge.

On another topic: Food.  Food has been really delicious here. I’ve already described the daily breakfast provided by the guesthouse (I’ve included a picture of the eating area). And for lunch we’ve been eating at the hospital canteen- rice and chicken or fish or meat- as previously described.  Dinner has been non-African food so far but tonight we are going to the Ndere Troupe Show where I believe traditional Ugandan fare will be available, including Matoke- boiled, mashed banana.  The show is an African dance and music show.  I’ll talk more about that another day.