The Finale Finally

I'm not sure about reverse culture shock, but I feel I might be suffering from reverse climate frostbite. I left for Uganda at the end of January; a perfectly natural time for snow. As I drove South from Manchester to Herts the falling snow blurred past the car in white streaks, that the slightly more childish side of myself really enjoyed as it looked just like hyperspace (a Star Wars reference for those unenlightened)...sometimes the childish side is the dominant force, and I may or may not have made some sound effects to accompany it. Sufficed to say the snow was a few inches thick when I left. As I said: perfectly acceptable for January. The big shock was that after enjoying temperatures in the mid twenties to mid thirties I returned to find the weather in the UK almost unchanged. As though to spite my absence it had stubbornly kept the thermostat the same to punish me on return. This meant that despite a 2 month gap, both the trail South and the return journey North were snow covered affairs.
 This blog is intending to cover three weeks so brace yourselves: verbage is coming.

 I asked a Ugandan man how parents came up with the names for their children in their country. He responded, straight faced, that they look through the dictionary for words they like...then use them as names. If that is the case.... it definitely shows. This particular gent had named his eldest children Innocent (the guy of course) and Immaculate (the girl), which aren't exactly the easiest names to live up to, even with the best school record. His name selection isn't exceptional, I made good friends with at least two Innocents and an Immaculate in my time out there.
(As an aside -you must be getting used to my style by now right-  I could help but imagining a future court room scene involving one of these ambitiously named kids. Something along the lines of:
 Judge: So who is the accused
 Barrister: The accused is Innocent sir
 Judge: Are they now?
 Barrister: They are Innocent sir.
 Judge: I think we'll be the judge of that. The cheek of the man.
 Barrister: No sir I don't think you understand, Their name is innocent.
 Judge: Ah, I see. How do they plead
 Barrister: Innocent?
 Judge: Innocent is it? Even with all those witnesses. Very well.
 Barrister: No guilty
 Judge: Is that their middle name?....... )
Other names Include Blessing, Happy and Dopey (that one isn't true). There's also a great trend towards choosing names that would have been incredibly popular at the turn of the Century: Doris, Geoffrey, Edmund and Doreen to name but a few. I'm partly tempted to return to Uganda for the birth of my children call them Salacity, Plethora and Englebert (two girls and a boy if you're wondering, the second one had some weight issues) and watch them coast through school without even a moments bullying.
 In the Buconzu region there's a second part to the naming process where instead of having family name (there is no surname), your first name would be your position in the family i.e. 'firstborndaughter' and all the following children named in respect to their order of emergence from their mothers womb. There's also names specific to twins and the order that they make their escape. The honour associated with childbirth also bestows a new name on the mother of said twins, triplets gets you even more kudos...the more womb-mates, the more respect. (So Tom Breckers, your mother is a woman of great honour is seems)
 
 Once the Oxford lads had left there was a respite in comings and goings. A paediatric Intermediate life support (ILS) course took place over the next two days so we were busily distracted from the 'gaping hole' the boys had left (I'm only being mostly sarcastic R and K). So to a degree, I can now save the life of children....although with the over 5s I'm only used to resuscitating them if they are quadruple amputees and have permanently closed eyes (I'm referring to the slightly creepy 'little-annie' dolls that are used for resus training that in order to save material and space have nothing but the portions vital for practice. They also allow the over-zealous play-actor to shout 'Holy Cow! It's been a massacre in here, their arms and legs are gone!..I'm going to check breathing while you search for their limbs, they may still be viable' but who would be that absurd?)

 Friday afternoon I finally managed to visit the local market to pick up some local fruit and sugar cane. Trying to get the cane to give up it's sweet goods demonstrated why everyone over the age of 4 seems to walk around with a machete, my knife and fork skills were useless here.

 On friday evening before you could say 'ze Germans are coming' er...the Germans had come, four more. Two fourth year medical students there for a fortnight, a sixth year student on a 5 month elective (they have a lot of elective on the germanic degrees it seems) and a radiology assistant coming out for a year. All hope of a British majority being re-established were crushed a few days later. Before you could say 'Waffles, Ice tea and war memorials' four Belgian nursing students and their overseer had arrived.
 So I was finally a plucky Brit amongst Europeans and Ugandans.

Saturday evening was Dr Chris's leaving do. The best thing to do when confronted with grief and the impending departure of friends is to burn some animals (having killed them first) and then eat them. So this was done. Succulent pork and surprisingly tender goat supported the speeches and heartfelt goodbyes that evening as the sun set behind the Rwenzoris.

 The final week then went too quickly:
 On monday I taught a gathering of nations (Germany, Belgium, Britain, Ethiopia, Kenya and Uganda all represented) about the basic management of congenital malformations (having only read up on it that day).
 Tuesday we headed to the Congolese border for Epilepsy outreach clinics, we didn't cross into Congo; but we were situated on a hillside the river in the valley at the bottom of which marked the border and the hill rising up directly in front of us was Congo. It looked greener, but grass always does.
 Wednesday and Thurs were busy. The ILS course was being rerun again, and a lot of the paediatrics team teaching or learning on it, so I went ahead and looked after paediatrics (it wasn't actually just me...but it felt that way) and attempted to do some teaching in the process. Weirdly enough, I occasionally thought that the nurses calling me doctor was justified. Reality returned quite quickly however.
 Then all of a sudden It was the final fellowship with my international brothers and sisters on thursday evening. Then Friday morning arrived and I hit the road.

 My Travels from there in summary:
 Friday night: Kingfisher lodge, great food, swimming pool, pretty much abandoned except for my good self.
 Saturday: Traveled to Mbrara for debrief and to start the process of ranking 274 (that's right 274!!) jobs on FPAS.
 Sunday: Church at MUST (the university in Mbrara) and journeying to Kampala.
 Monday: 'Relaxing' by finishing FPAS ranking.....this took hours.
 Tues: White water rafting on the source of the nile in Jinja with Some Ozzies, Germans (these guys get literally everywhere) som czechs, british JWs, Japanese soldiers that spoke no english and some 'Gap-Yahr' students nursing hang-overs having 'experienced' some Ugandan culture last night.
 Weds: Traveled back to Kampala and watched Django Unchained in a Ugandan cinema as part of my world cinema tourism program.
 Thurs: Packed, actually relaxed....at last.
 Friday: 1am returned to the UK......followed by sleep.
 Sunday: Return to Manc.
 Monday: Placement re-commences....

Part of my farewells involved food. Food is an important social occasion out here as it is in many cultures. There are two particularly distinctive foods that were staples for the nursing students. Posho and Bundu (TP will no doubt correct me on the spelling here). They are both dining experiences. Posho is a lump of maize flour (or something like it) that looks not unlike porridge that has been cooked and then abandoned in it's bowl overnight. Except that it doesn't have any of those distracting features of porridge...like flavour. Paul Shep would have it that it tastes like 'white' but I think that that does a disservice to white. Sugar, salt, icing, mayonnaise all are the flavour of white....this was more like the taste version of beige, it definitely has a flavour but it's one that makes very little effort and doesn't really care if you notice it or not. Either way, it's function is to leave you full and this it does quite well, as long as you load your fork with beans and sauce the lack of flavour isn't really an issue. The other is bundu. This one your not supposed to taste, and if you do your doing it wrong. A friend of mine when asked which was their favourite food said 'Bundu, because you don't have to chew it. It just goes down'. Just like an inexpensive, vegan friendly version of the oyster you just put it straight in; bypassing the mouth into the food pipe. Bundu is good, if you approach your food like a performance art or a sport..... and have no teeth. Again sauce is where you get the flavour from. You make a ball by rolling a chunk of bundu in you palm, you then plunge your thumb into it to make a hole scoop up some soup-sauce-stuff and throw back your head. Simple right. Don't make the mistake of chewing, then you'll find that it has the consistency of play-do and wants to cling to the roof of your mouth with the tenacity of an alien face-hugger.

 So I dined with my Ugandan friends and said my multitude of farewells. It seems like I was only arriving yesterday, but already the time had gone. Friendships between brothers are eternal however, and there is no such thing as a missed opportunity amoungst Christians as we will hang-out in eternity. As sad as parting may be, it will be the briefest of breaks in contact in the light of eternity. Maybe I will return there some day, there's still Murchison falls to visit and a number of things to do that an impoverished student couldn't afford. Who knows? the future is written but I will not be privy to it until I walk into it.
 I've had great times, made some fascinating friends from vastly different backgrounds, been pushed professionally and learnt much about myself, God and the nature of poverty. Will I work in Uganda in the future, maybe. Will I take this experience with me whatever the future holds: of course.


Prayer:
 -The Shepherds are still out there and on their final stretch. Pray for their work, health and walk with the LORD.
-Matt Craggs is out there now as the Manc representative on the ME program. He's not got quite the ego I do to keep a blog....but I promise he is there, but pray that it'll be a great experience for him.
-For my final two months or so in Manchester before I move on to the great unknown of a job in South England.

Thanks for reading this, the gramma and spelling must have been gruelling. But I appreciate the effort.

A Tale of Orphans and Kingfishers

'Well done Doctor'. I looked around for a moment before realising this was aimed at me.
'Er....thank you sister,' what had I done? granted I'd woken up, showered, dressed myself and fed myself all without much prompting which could all be perceived as quite impressive; but I wasn't sure which part of my morning routine had invited the adulation of the ward nurse. It took at least two further mornings to realise, that it was more of a welcome than a comment on my performance. But every ones confidence takes a nice boost when praised for turning up.
 This joins the list of the Ugandan turns of phrase that have in turn first bemused, then amused me before becoming part of my dialect (the ones that don't leave me feeling like a traitor to the English language that is).
 Here are a series of examples:
'Yes [insert name here]' -a common greeting. This one was relatively easy to understand.
'You are lost' - not a phrase used when I accidentally find myself in the women's bathroom because of being unable to interpret the symbols on the outside, but a phrase meaning 'I have not seen you for a while'.
 'They are more likely to WHAT?....to have an ectopic, which is WHAT?....life threatening, which is WHAT?....a very serious situation.' This is an example (loosely based on life) of Ugandan rhetoric, which is very confusing at first because you think that the speaker is shouting a question at you and before you can marshal your muddled thoughts they have answered their own question and may have moved onto another. Another WHAT?....another question. Rather than helping matters it tends to jar the old train of thought.
 'They have ever had vomiting' - This is not a claim to eternal vomiting that began when time was made or saying never but dropping the 'n' but in fact the positive form of never which can lead to such a situation:
 Doc 'Have they had vomiting'
 Brief discussion with patient...
 Nursing student 'They have ever had vomiting.'
 Doc 'So they have not vomited'
 Nursing student 'they have ever had vomiting'
 Doc 'They have never vomited then?'
 NS 'No, they have ever vomited'
 Doc 'Have they, or have they not had vomiting?'
 NS 'Yes'
 Doc 'Yes they have or yes they have never vomited?'
 NS 'Yes....they have ever vomited
 Doc 'Ah......'

There are a few others, many of which are more pronunciation based, that can't be done full justice here...

The rainy season has dutifully begun. It's timetabled to turn up in early March, and unlike many things working on Africa time, it has done exactly that. Rain has been pounding us in the morning for the last two days demonstrating one thing. Heavy rain is as much a nemesis of productivity (and life in general) in Uganda as Snow is in the UK. Like we look out the window, see a layer of white and start acting like it's a nuclear winter here they look out the window see rain and the walk from the nursing school accommodation to the chapel becomes untenable. Sufficed to say, yesterday there was hardly a soul in chapel and work only began once the rain had died back. Despite the deluge of rain, it switches back to blistering sunshine in the space of an hour and by the afternoon all signs of the rain have almost completely disappeared.

 On Thursday I strayed from the wards to a local school/orphanage combo. The place is run by a local man Isaac who has set up a number of such projects the school has a roughly 50% orphan student body whose fees are paid for via the fees of the children with means and from donations. The definition of orphan out here can mean someone with no parents at all (or a full orphan as one of the teachers described it) or someone who has lost there mother and their father can no longer care for them (a 'half orphan'). Here as part of the project they get both accommodation and schooling. 'Education' is definitely the big buzz word out here, and loaded with the promise of success and escape from poverty. Rita (the Maltese -or is it Malteser - nurse that is the driving force behind quite a number of community outreaches) has been a long term collaborator and supporter of the project and invited me along with her. It took some essentially off-road driving on tracks that weren't made with cars in mind to get there navigating some 45 degree inclines and pot holes that goats could comfortably shelter in. The school was in a isolated spot on the hillside across the valley and around the corner from Kegando. The drive when as smoothly as could be expected from the terrain (bar Rita forgetting to bring Isaac's sister with us) and we pulled up in the village 'high-street' to be greeted by a crowd of school children. There is detail if this scene that I have left out and will return to in a moment...
 The day proceeded with me and Rita sitting in on a school board meeting (my contribution was to smile an nod appropriately), visiting the site that was being prepared for the new classrooms; being welcomed at great-great-great length in front of the gathered school by various members of staff; making a speech myself...i made something up about the value of education (although the only applause I got was when I mentioned i was an arsenal fan); having the school choir sing some self composed songs for us (including the classic: 'Well-e-come, Well-e-com our vistas, well-e-com Thom-omu'); having photos with various people and finally having lunch with the Staff in which I had the distinct honour of eating the chickens stomach (which is preferable to kidney and having your eye removed with a spoon, but not quite as good as a drum-stick). It was an amazing and surreal day.

 The detail from our arrival at the school that I neglected to mention and it's later consequences can be told here almost in full with the aid of retrospect. When we drove into the town 'plaza' not all the children were on their feet waving or jumping to greet our arrival. In the crowd of kids scattered away from the approaching car to reveal what could have passed as a bundle of rags if it wasn't for the limbs sticking out from it. A child was lying in the road oblivious to what was happening around. As we passed the spot again on foot we were told that the child had just had an epileptic fit moments before our arrival. Children and adults were milling around, but no one had helped. There is a belief, it seems, that epilepsy is contagious (even to the degree that epilepsy that develops in someone after their marriage is immediately blamed on the family that they have married into and the social reprocussions can be severe). The child therefore had been left to fit and then lie in the blazing heat of the morning sun. Rita carried the boy inside to recover and gave hims some water and food. On our return from the school we checked up on him again and his father was found. He had suffered probable birth trauma as a child and had been suffering epilpesy ever since until this his 9th year of life. He was lucky to not have befallen any accidents, but a combination of the initial insult and multiple seizures had left him mentally slowed. It was locally believed that there is nothing that can be done for seizures and therefore nothing was done. The father was talked to and encouraged to seek medical help. It was an incredible joy to see him on monday attending the epilepsy clinic in kegando, where the consultation and medications are free. It may be overly melodramatic to say that this could turn his life around, but with the right management and and medications a degree of normality can be restored to his childhood and the social ostrosization may be removed. It is sheer providence of God that we arrived when we did to witness it.

Friday was a day off. The day off took us to a place called kindfisher lodge. The lodge is home to almost 'infinity pool' (would that be a billion pool?) that overlooks Queen Elizabeth national park from atop one of the neighbouring hills. You can swim with a vast expance of beautiful horizon stretching 180 degrees in front of you. This is added to by the great food they slap on your plate and fine cups of tea that the place in front of you.

Saturday took me to the Rwenzori high-school for focus fellowship, a scripture union event for teaching and outreach. The subject that was being covered was 'sex' rather suprisingly. It was a fun event to attend and definitly lent a lot of cultural insite as to how it was approached biblically. Not sure i agreed with -or in fact understood- everything said, but it was enjoyable none the less. Favourite quote: '10% of people are what is know as very sexy' after which the speaker wrote the words '10% -sexy' on the board (I gathered that he meant 10% of people have an  extremely high sex-drive not to do with how great a percent of the population he personally found attractive).

 Sunday afternoon Rob, Keelan, The two German electivites and I headed to the waterfall again. This time armed with swimming gear. We were originally going to head into the rewenzori mountains for trekking, but our guide pulled on us at the last minute....planning anything out here is a little foolish to attempt, but still us mzungus try. The swimming in the waterfall was a very good substitue, especially after discovering that you can swim around the back of the falling water throuch the channel of erroded rock, position yourself behind the thundering water and then throw yourself into it's stream. Having seen how forcefully it tried to relieve you of your swimming shorts, the girls descided (wisely) to pass up on the experience to avoid any wardrobe malfunctions.

 Monday and today were back to wards for malaria, malaria and a slice of prematurity.

 The medical elective scene is ever changing. Two German third years have arrived Mareika and julia, neither of which are Bayern Munich fans, so we can safely be friends for now. And who knows the entire situation may be redeemed next week if BM oblige and loose by say 4-0...that would be nice (and very realistic). A new American has arrived to inhabit the star-spangled (non-literally) American room at clay house in the form of a final year called Erin. Plus tomorrow morning the oxfordians are heading off to South Africa, so farewell to Keelan and Rob. The unfortunate fall out of this is that I will be the only Brit left on the medical elective program here...I hope to survive the assault of foreign cultures unperterbed.

 I could mention FPAS here, and the shambles that has been afflicting the medical students of the uK. But the only comment I'll make is....It looks like for now my future is again unknown in terms of location in the country. God has a plan however, he just has delayed the part where I discover what it is, which he has a perfect right to do.

Prayer points, for those that pray:

-For safe travel onwards for Rob and Keelan and protection from flying bullets and other mishaps in South Africa.
-For UK medical students as they await their results...again.
-That I will be able to make the most of my last week and a half in kegando
-As always for health
-For wisdom in care and descision making for me and the other doctors.

Yours faithfully Tom
 SDG