Sitting in a delightful guest house in Entebbe, Dave and Alison's.  Heartily recommend.  Waiting for pickup for the airport. Neither the time nor inclination for any brilliant thoughts or expositions, but picked out some of the more interesting pictures to satisfy the curious till I get home.  Enjoy!!

Irony and some other stuff

Obviously, everyone here is talking about the results of the election. One of my students put it oddly but very succinctly. "Everyone knows that the president of the US is the president of the world. Of course we are interested in your election!"  There is considerable dismay here in Africa, and astonishment that it happened. Enough.

Thought it might be fun to show a couple of pix.  The first is my PG-1 residency group. I couldn't ask for a better crew. Smart, dedicated, making every second of learning count. It's really inspiring, and I'm genuinely so glad that I came and had a chance to work with them.

My crew

The second picture is a bit more complicated.  So, Africa is very poor and some of the clothes and other items you see here are just jaw-droppers. Lots of commercial castoffs. As an example, when the world series gets down to the two final teams, T-shirt makers make a run of T-shirts for BOTH teams so they can come to market the second the results are available.  The losing team, well, they are sold for a pittance in Africa and you'll see people walking around in the loser's T-shirt. One really weird thing I saw was obviously an overrun of T-shirts made for some celebration in Sanford, Maine.

Anyway, talking about stuff that doesn't sell and ending up in Africa... This one isn't so much weird as utterly ironic-- a throw blanket that if you don't recognize it, is a Confederate battle flag.  I asked my residents if they recognized it and they said no-- they thought maybe it was the US flag or the Union Jack. When I explained, they just laughed and laughed.

Saturday morning I leave Mbarara and go traveling. Posting will depend upon my energy and physical connectivity.  Home in a week.

Gorillas, Birds, and Breathtaking Scenery

This was gorilla weekend. We left Mbarara on Friday and drove about 4 hours to the gorilla trek lodge. 

Barbecued goat on a skewer

Had dinner with a delightful Dutch couple, then went to my room. Spectacular view

Wow

Next morning we drove to the briefing, got our packs on, and got going.  There were about 30-35 of us. We were split into groups of 8 and each group visited a different habituated group. On the way we saw volcanoes on the Rwanda/Congo/Uganda border:

Volcanoes, one in the clouds

After 3 hours of strenuous, muddy hiking (I mean Very Strenuous, Very Muddy. Thank you LL Bean and Gore-Tex) we got to the gorilla family. It was really pretty spectacular. Pictures below, which don’t do the experience justice. I must confess, despite my enjoyment of the activity, some ambivalence about the contact. We were charged three times by adult males—screaming, baring teeth, running toward us—when we inadvertently got in their space somehow. (Fortunately, it’s a show—they never actually attack. They are just showing displeasure.) It’s pretty clear that although we were tolerated, they really weren’t thrilled to have us there. On the other hand, a gorilla visit permit in off season (which we were) was $450 USD, and in-season $600 USD. That’s anywhere between 12,000 and 18,000 USD per day, which is a small fortune in Uganda. Hopefully that helps maintain the population and the habitat.

About 2 minutes after I took this picture, he charged me and the guide

Silverback. Old male. The gray on the back is real, not just light

Juvenile fooling around

Juvenile not fooling around

I regret to say that I had quite a bit of difficulty getting back, and had to hand off my pack to a guide and slowed my group down terribly. I didn’t realize I was that out of shape. Apparently walking on a treadmill at age 63 does not prepare one for such a venture. No permanent injury except my pride, which was grievously wounded. I really felt kinda bad about the whole thing.

We had travelled through what is called the Uganda Highlands. All the farming is done on terraces

In mountainous country, there are no taxis or buses. People and goods simply ride in the back of trucks.

We got to Lake Bunyoni, where we stayed the second night. An eccentric eco place, solar energy, solar hot water, room was a freestanding geodesic dome.  The view out the front from in bed was spectacular.  The lake itself has multiple islands and is quite spectacular.

Dugout canoe

Another wow

Finally, Bunyoni is known for birding and I was able to get some pictures

Cormorants

Crested eagle sitting on a phone pole

Black headed weaver

On the way back, we stopped for vegetables. There’s a group of shacks on the side of the road and if you stop, vendors run up to your car window with wicker platters of vegetables. I got a cauliflower and carrots. The cauliflower, I found when I got home, had the added attraction of a gecko. We got him out of the fridge and into the garden.

Well that’s it from Uganda for today.

Town, apartment, and hospital

I deliberately stayed in town one weekend to be able to see Mbarara and to take a few pictures around the place. Documenting stuff for the blog is particularly good in that it makes me take the pictures, and I have a record for myself as well.

Home and food:

I live in a cinder block/concrete two bedroom house. The other bedroom is occupied by my Ugandan roommate, one of three astrophysicists in Uganda. Very nice man. We have a living room, dining room, and kitchen. The bathroom has two toilets separated by a partial wall. One of the toilets has a bath in it as well. The sink (just one) is separate, so potentially three people could use the bathroom simultaneously.

The kitchen has a strange stove with two electric elements and two gas burners. Only the electric elements work. The fridge is not good at all; weak. Anything that really needs to stay cold I need to freeze. For that reason, I buy milk in little 500 ml (slightly over a pint) containers so that I use it up before it can spoil.  Milk by the way, is sold in plastic/paper containers that are sealed. Sterilization is achieved, I believe, with radiation.

Food is, well, not so great. None of the restaurants here are anything to crow about, so I cook for myself. There is a limited array of vegetables (tomatoes, onions, potatoes, sometimes eggplant, sometimes green peppers and I end up making various egg, pasta, and rice concoctions. The Ugandan rice is actually quite tasty. Pasta comes from Egypt.

Water is sometimes sporadic. It has a pretty high particulate content. I put it through a particulate filter, and then I put it through my trusty First Need microbiological filter. (The First Need could get rid of particles too, but this way I don’t shorten the life of the filter.) Electricity is also sporadic. It’s generally on, but occasionally isn’t.

As you can see below, I sleep under a mosquito net.  Pictures are below.

 

Kitchen

My bedroom

Living Room

Town

I walked into town this morning. It is an absolute madhouse. The primary means of transportation is the boda boda. This is a motorcycle with an engine displacement usually between 100-200cc. The driver drives, and the passenger sits on the back. Women in dresses ride side-saddle. Some people hold onto the driver. Some people hold onto a handle that is behind them. Some people don’t hold onto anything. Some people, including me, don’t ride them.  Anyway, they are everywhere. Almost all the motorbikes you see in the pictures that follow are not for personal use, they are boda bodas.  The streets are lined with shops and stalls. The side streets have little stalls and shops as well. I must say that I felt sufficiently different and uncomfortable that I didn’t venture down the side streets, just stayed on the main drag.  I don’t know if any of you get solicited by Finca, the microfinance NGO, but I have a picture of their Mbarara office below.

This is the town center. The bull is the "famous" Mbarara cow statue, commemorating the famous Ankole cattle in the region.

Yup, Finca really does more than just solicit funds.

Typical street scene

What a great picture. Asleep on your wheelbarrow.

View into residential areas

This is actually quite typical. Folks will ride their bikes to where they need to pick up whatever, and then walk their bike back, piled full of bananas, milk cans, whatever.

Costs vary widely. A 500 ml bottle of Tusker beer (4.2%, not terribly high), is 3000 Ugandan shillings, slightly under 1 USD. The exchange rate is approximately 1 USD = 3300 Ugx. I can buy two small eggplants, 4 tomatoes, and 4 purple onions for about 2000 Ugx. However, breakfast cereal made in Kenya under British license is about 15000 Ugx, which is quite a bit. Toilet paper is about 1300 Ugx per roll. An albuterol inhaler made in India is 45000 Ugx.  A CT scan of the chest is about 200000 Ugx.

Hospital and University

The hospital and university are a sprawl of primarily one story buildings, many dating from the colonial era. There is some newer construction as well. For a person from a resource rich environment, it is very jarring to walk around. The hospital provides sinks for patients and families to do laundry, and every morning the lawns are covered with drying sheets and clothing. Wards are long, narrow affairs with no privacy, and they tend to smell. Handwashing is very difficult to achieve, and everyone carries alcohol gel. Attendants (family) either sleep on the floor next to the patient or outside. People here were not nearly as interested in posing for pictures as they were in Bhutan, so I shot a couple of quick pix of a part of the emergency room and the female medical ward with my tablet, so it looked like I was looking something up.  Sorry, everyone.

What’s really interesting to me and somewhat puzzling is all the global development stuff here. Mbarara and environs are funky enough to be decidely classed as resource poor, but ultimately it’s actually pretty safe and sane here. A bunch of universities and hospitals in the U.S. have partnered with the hospital here; Mass General even maintains a “guest house” here and they send residents here. University of Virginia sends their internal medicine resident with a global health concentration here one a year. All kinds of HIV related initiatives are here, funded by private sources and WHO. Everyone’s nipping and chipping off little pieces of the problems here and it’s not clear to me that systemically things change. Certainly, there is a boost in AIDS care—patients get medications because the US and others pay for it. There’s a TB program, and all kinds of meds, but there is no program for directly observed therapy. Some folks come here clearly thinking they have “the answer” but that usually fizzles out pretty quickly. There’s also people who come here with an academic agenda. Collect research data, punch your global development overseas ticket, and go home and write about it. Whether this has any direct benefit for local people is not clear, nor is it the purpose of the visit. To be honest, I worry about that. So, it feels hit or miss. All these people just churning away, but does it really improve life. I don’t know.

The local docs are very smart. I mean, very smart. The residents know far more about physical diagnosis than I do, to the point that it is embarrassing sometimes. They are not taught good critical thinking and presentation skills, but they catch on very, very fast.  Working with the residents has been wonderful. We really have learned a lot from each other.

Anyway, enough sociopolitical and economic philosophizing. Here are pictures of the hospital.

Typical morning scene outside the wards. Laundry drying, and you can just barely make out a group of ladies sitting and chatting at about 2-3 o'clock.

I love this. Everything is free, except for the stuff that isn't. Unfortunately, the stuff that isn't is the good stuff.

View of  a portion of the ED

View down middle of female medical ward.