The two men strolled through the paediatric ward arms interlocked and laughing at each others little witticisms. They dropped their arms in unison to grasp others hands and jauntily walk outside together. This isn't one of Uganda's first bi-fathered family units visiting an ill child. One of them is married to a woman with a child nuzzled at her breast and the other is a close family friend. This is cultural. A culture that makes the average Brit a tad uneasy, at least at first (Paul shep tells a good tale of getting into the UG mindset so much that when he went home he tried to hold a mate's hand after greeting and got a less than warm reaction) and would have JM Dyer throwing a hissy-fit on the floor. (Iain MacIver on the other hand, these are your people, in terms of personal space, out here you can have the kind of man-man platonic friendship you've been dreaming of all these long years). If you are friends you shake one-anther's hands for an protracted amount of time letting the sweaty palms of mutual respect mingle and then if your walking in the same direction why not synchronise your arm-swing with your pal by staying interlocked. Another cultural difference that is blindingly obvious (literally in some fundamentalist doctrine) is that ladies will whip out their mammarys at a moments notice. This makes performing a full thoracic and abdo exam a little easier than normal as the are already 'adequately exposed'...if not a little too exposed. Breast feeding is also it seems meant as a spectator sport. Everyone on paediatrics is at. Even to the extent that you examine some of the kids still latched on.
The only option is to choke down your western taboos and be thankful that it's this half of the patient that it is a cultural norm to reveal at moments notice.
I spent a few more days in Paediatrics main; the largest single ward in the hospital with up to about 50 patients at a time. 6 on high-high care (as in very sick, not those palliated with mind altering substances) 10 in high care, 10 in medium care and the rest on the low care (being teed up for the booting out the door) and diarrhoea regions (which sounds like a really unattractive tourist destination). The patients are mainly two to a bed, with the family member looking after them sleeping on the floor, and siblings may accompany the kids (this occasionally leads to the thorough examination of a patient on a bed, finding there is nothing wrong with them...at all...and then once a nursing student translator discovering this is the second cousin of a patient that decided to take a kip.)
I've moved on after two weeks on the kids-chaos zone (although I still join for the start of ward rounds and help with emergency admissions) to NICU the neonatal intensive care unite to those not acronymically gifted. Here is is calm and incredibly warm, as tiny little babies, cry with tiny voices while shedding tiny tears and spike tiny fevers. It's a game of 'when to feed that baby' (available from all good board game merchants) and 'slam that baby full of Abx' (not yet licenced as not everyone can agree on the rules). It's a fascinating branch of medicine but means starting again with a lot of concepts as 'little adults' these certainly aren't (as far as I can tell).
Friday afternoon till Saturday evening i headed to Mbrara, it was the AIM social and prayer breakfast out there, which happened to coincide with James (aka Dr Lovely) leaving Kegando for the journey home (via white water rafting). The journey back was an opportunity to see all the country I'd admired on the way through in reverse through the national park, woods and tea+ Banana plantations. The heat was almost unbearable that day, although a breeze through the cab of the taxi gave some reprieve, I dropped a water bottle on the floor and only picked it up an hour later to find that the water inside had near-enough boiled. The heat was even more intense at two further points. The park authorities burn over the dried grass of the park and felled trees to make way for fresh growth. This was one of those days when the flames had been lit. as we drove down the near-straight road in the national park (it isn't a straight drive however due to the occasional swerve to avoid potholes or lorry drivers on mobile phones) out path was flanked by a wall of flame devouring the already crisp countryside and on the far side lay a charred wasteland. We drove through this for a few minuted before hitting a second wave of heat driving by the flames travelling in the opposite direction. The surprising part was how much was spared, green trees stood proudly in the midst of the ashes of less fortunate plants. On the reverse journey, fresh green shoots could be seen amongst the dead. For new growth, the old must die. (Budding sermon architects: You can make an analogy for humanity spiritually with that. We must die with Christ to live for Christ. Take it, it's a gift)
The rest of the weekend was spent with a the rest of the AIM team, a meal on the Friday evening (burger and chips people!!!! mzungu food, sweet nectar of the Gods). I was hosted by a couple from the UK that have recently started teaching at MUST (Mbrara University of science and technology), Him: an A&E consultant and Her: a Molecular Biochemist. They had hot running water (a shower you can stand in...I'm not joking, you don't have to do the cold water hokey-kokey with this one) and real brown bread. Amazing. The Saturday was a great morning of prayer and encouragement and then a journey back in the car with the Team Shep.
Beyond Dr Lovely, there have been a few further transfers.
Ben has left as well, but the two open spaces have been filled by two new MEers. Possibly in some cruel way of twisting the knife marked 'Bayern Munich 3 Arsenal 1' they are both Germans. I've yet to ask them if they are Bayern fans....maybe some things are best left unsaid and unasked.
In personal news, the FPAS (Foundation school applications to put it simpler or 'dem people wot tell me wot job i got next year' to put is even simpler still) results have come in. Looks like I'm of to South Thames. It's an occasion for Praise and sadness. I did put it first, and I do want to go on to this exciting new chapter (I had to slip in a cliche or two like that) of life; but I'm not looking forward to leaving all the great friends I've found in Manc behind. Who knows though, the Southern drift may bring you back to me again.
For those that pray:
-For health, it's been a but dodge here and there. Mine and the other MEs as well as Helen, who is frequently afflicted
-Ben and James as they head on home that they will be able to re-adjust to the West and contemplate all they have learnt spiritually and medically
-For the hospital administration and wisdom in all it does
-For furthering of friendships with Ugandans
-For wisdom in my choosing of jobs within the Foundation school (there's at least two more stages to complete...)
Yours In Christ. Tom
SDG
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