Hospitals and Food in Uganda

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.

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Settling In & Pharmacy Meetings

It is now Tuesday, Sept 11 at 6:30pm and we are now settling in and getting used to life in Uganda.  There are so many different things to experience here that initially it is easy to be overwhelmed with the new scenery, new smells, new noises (loud birds and monkeys) not to mention new people and languages. Although English is one of the National languages, and it is the “medical” language here, many people speak normally in non-English native dialects.  It hasn’t been hard to communicate at all with the healthcare professionals we’ve met, but when it comes time to talk to patients, we may need to translators or defer the the Mulago staff for those interactions.  Monday morning started off with a delicious breakfast provided by the Mulago Hospital Guest House consisting of fresh pineapple, eggs to order, toast, tea, and passion fruit juice.  The Makerere Professor picked us up and brought us to the Pharmacy School where we were able to meet with two other faculty members and discuss plans for our time in Kampala.  We also gave them the 200lbs of books that we had brought all the way from Wilkes University, which they were very happy to accept as shown in the picture above with Professor Odoi.  Later that morning, we went to Mulago Hospital and met with the Principle Pharmacist (Pharmacy Director) and the Training Coordinator Pharmacist and were given an in-depth tour of the hospital campus.  Later in the afternoon, we walked to the Mobile Cell Phone store to get my USB Modem re-activated.  It turns out that WiFi isn’t readily available but that the use of portable modems is very common. Luckily, I had bought one last summer which just needed to be re-activated and airtime added (which of course involved a fee, albeit quite reasonable for the benefit I will get from it.) Now, walking anywhere on the very busy roads here is a feat in and of itself and I am quite proud to say that we were able to navigate the crazy Kampala traffic to get to the store and the pharmacy school when last year I was really scared to cross the street.  Finally we ended the day with a delicious italian meal at a place that was lit with small candles on the tables that were on a wooden platform with a small roof, but basically the restaurant was out in the open- not in a closed room.  Sitting there in the glow of the candle light eating a leisurely meal, it was hard to believe that this was the same Kampala that during the day time was filled with lots of traffic, noise, and so many, many people.

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London

Just a quick post before I go to breakfast and head to Mulago Hospital for the day-  London was great! We had the 11 hour layover so one of the students did some research prior to the trip and found a 2 & 1/2 hour bus tour we could take. It turned out to be the perfect thing. Since we all had a bunch of carry on luggage, it was nice to get a good survey of London from the top of a double-decker bus without having to be weighed down by our backpacks.  The city was full of excitement as the paraolympics were still going on. We didn’t go to any of the venues but there were people talking about it and it was interesting to see some of the special artwork around the city in honor of the paraolympians.  We did take time for a great lunch at a traditional pub- fish and chips all around.  Here are 2 pictures- one of the students on the bus and the other of Big Ben. As you can see, it was a lovely day with beautiful weather!

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Safe Arrival in Kampala, Uganda

Hi all! Sorry for the delay in posting but wifi isn’t as available as I’d hoped. But I did just get my USB Modem reactivated so I should be up and going now. After a very long trip- 7 hr to London, a 11hr layover, then 8 hr to Entebbe Uganda we finally arrived yesterday morning (Sunday at 7:30am). Today was our first day at Makerere University school of pharmacy. We spoke at length with the faculty and planned the rest of our activities. We had a long tour of the hospital by the head pharmacist. Tomorrow morning we will go back to the hospital and start our volunteer work.

20120910-202810.jpg

Posted in My Safari (My Journey/Adventure) | 2 Comments

Safe Arrival in Kampala, Uganda

Hi all! Sorry for the delay in posting but wifi isn’t as available as I’d hoped. But I did just get my USB Modem reactivated so I should be up and going now. After a very long trip- 7 hr to London, a 11hr layover, then 8 hr to Entebbe Uganda we finally arrived yesterday morning (Sunday at 7:30am). Today was our first day at Makerere University school of pharmacy. We spoke at length with the faculty and planned the rest of our activities. We had a long tour of the hospital by the head pharmacist. Tomorrow morning we will go back to the hospital and start our volunteer work.

20120910-202810.jpg

Posted in My Safari (My Journey/Adventure) | 2 Comments

Off on Our Ugandan Adventure!

Well, we are finally at the airport awaiting our flight to London- Heathrow Airport for the first leg of our journey to Uganda.  15 bags are packed and have successfully been checked through to Uganda and carry the following:

  • 33 Pharmacy Textbooks (weighing about 200lb total) for Makerere University School of Pharmacy in Kampala
  • 12 beautiful handmade quilts by the T-Rail Quilt Guild of Danville, PA. (I’ll post a picture of these later)
  • 64 Little Dresses for Africa made by women in Florida and Pennsylvania
  • 50 knit and crocheted hats for infants and toddles (yes, Africa is actually cool in the morning and evening and babies still need to keep their heads warm, especially right after birth)
  • A whole bunch of miscellaneous toys for the children we meet through working in the rural clinics

Stayed tuned to this blog as our safari progresses (remember, Safari means “journey”).

Update about the prior post on Travel Medicine:  I was not able to video interview my colleague who contracted Malaria recently in Uganda due to his not feeling well on the day of the interview, but… he did tell me his whole story by email and has said I may share it with you on this blog. I will get to that in the next few days.)

 

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Travel Medicine: How to Stay Healthy When in Africa

When I tell someone I am traveling to Africa, one of the first things that come to their minds is concern for my health and safety.  Certainly there are many diseases in Africa that aren’t common in the USA but most are preventable with the appropriate precautions.  First of all, my students and I had to make sure we are up to date on our regular childhood vaccines, and especially be current with our Tetanus immunization.  Then there are 2 tropical illnesses that are preventable with vaccines:  Yellow Fever and Typhoid.  The Yellow Fever vaccine is required for entry into Uganda.  It is a viral illness that is carried by mosquitos and up to 50% of the people who get Yellow Fever die from it.  Typhoid Fever is a bacterial illness obtained by ingesting contaminated food or drink (a food-bourne illness).

Malaria and Diarrheal illnesses, though, are very, very common in Africa but neither is prevented by a vaccine.  Malaria is a parasitic disease carried by a specific type of mosquito- the Anopheles Mosquito- can be prevented by taking an anti-malarial drug routinely before, during, and after exposure in Africa.  If you are bitten by an infected mosquito and you have not been taking an anti-malarial, it will usually take about 10-14 days for the symptoms of fever, muscle aches, vomiting, diarrhea to start.  Taking your anti-malarial drug on schedule and without missing any doses, is extremely effective in preventing illness.  Other things you should do to reduce your risk are to sleep under mosquito nets and to use insect spray with at least 30% DEET from dusk to dawn. This is when the Anopheles mosquito comes out.  But, I always recommend and use bug spray myself at all times because there are other diseases that can be caused by the daytime mosquitos. Please click on the World Health Organization links below to learn more about Malaria and Yellow Fever.

Stay Tuned for a SPECIAL SURPRISE:  I have a friend who has recently been in Uganda and unfortunately he got sick.  Tomorrow I am interviewing him on video, and if all goes well, I will post this within the next couple of days.  You will be able to hear a first hand account of Malaria and Amoebic Dysentery.

WHO | Malaria.

WHO | Yellow fever.

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Pharmacy Students Ready to Travel Part 4

Read on to learn about the 4th and final student who is accompanying me to Uganda in just 1 week. I can’t wait!

In Australia, Summer 2011Hello, my name is Ben and I will also be traveling to Uganda with the Wilkes University Global APPE.  I saw this as a great opportunity to travel and interact with another culture and be able to take a good look at our profession.  It is my hope that I gain a real appreciation for the work that we do, but also gain experience that will help me in the future.  While in school at Wilkes University, I have been active in Student Government, E-mentoring, APhA (American Pharmacists Association), and focused research on the cost/benefit analysis of placing a pharmacist in a primary care setting.  I have a great deal of passion in improving quality and reducing costs in not only pharmacy but health care as a whole.  Like Melissa, after pharmacy school I will serve as a pharmacist and Captain in the United States Air Force.
In my spare time, I enjoy traveling, working with my hands, and am exploring my abilities in barbecue having built my own meat smoker.  I have traveled through all but 13 of the United States (Alaska has been my favorite thus far), I have participated in study abroad programs in Australia and Europe.  I look forward to our upcoming safari and hope to share our experience with future students to go on this experience.

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Pharmacy Students Ready to Travel Part 3

Read on to learn more about the 3rd Pharmacy student who is accompanying me on this journey.

My name is Stephanie and I am 23 years old.  I grew up in Western Pennsylvania, about 1 hour outside the city of Pittsburgh.  I have an older sister, Lindsay who also attended Wilkes University.  Pharmacy has always been a huge part of my life as my father, uncle, and sister are all pharmacists.  Throughout pharmacy school, I have been involved in Kappa Psi Pharmaceutical Fraternity and American Pharmacists Association.  Upon graduation, I would like to work in a retail setting.  In my free time, I enjoy running, cooking, traveling, and spending time with family and friends.  Previously, I have had the opportunity to travel to Mexico, Dominican Republic, Aruba, and Jamaica.  I wanted to travel to Uganda to experience a different culture as well as learn about medical and pharmacy practices in Uganda.  I know this will be a once in a lifetime experience, and I am very excited to embark on the journey.

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Pharmacy Students Ready to Travel Part 2

I’d like to introduce, Mike, the second pharmacy student who is joining me for the safari to Uganda.

My name is Michael and I am 23 years old from Point Pleasant, New Jersey. My home is located about 3 miles from the Atlantic Ocean, where I live with my mom, dad, younger sister, and our golden doodle (dog). In my free time, I enjoy playing golf and tennis. I also like to watch football and baseball in which my favorite teams are the New York Giants and New York Yankees. I do enjoy to travel, but in the past I have not travelled far outside the United States. I have went to many different states, including California, Arizona, Florida, and also the Bahamas, Dominican Republic, Belize, Mexico, and Puerto Rico, outside of the continental US. I think this trip is a once in a lifetime opportunity where it will be a great chance to meet people from and learn a different culture. I know I can learn a lot from the people I will meet while visiting Uganda, including about their healthcare system. I hope to use what I learn on this trip throughout my career to help make me a better pharmacist. For the past 2 years in school, I was a teaching assistant for Anatomy & Physiology lab. This past year, I also performed research at a local free clinic to see the affect the clinic had on people’s diabetes. After graduating, I hope to be accepted into a residency in a hospital to one day become a clinical pharmacist and possibly a professor at a pharmacy school.

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