A little more in depth look at things.

I have been crazy busy. The days are long, I come home tired, and it is HOT, which drains the life out of me. Barely have the energy to cook supper much less post a blog. However, quiet afternoon after getting home from Lake Mburo National Park, and I can do some posting

First, really didn’t get a chance to see Dubai. However, my impression was that the culture was relatively intact, the place was clean, you could eat the food, and they were quite tolerant.  Could have been a lot worse, and the free hotel was actually quite nice—clean and comfortable. Meals weren’t bad either. The hotel came as part of my air ticket since I had a long layover.

This place is so different it is hard to create context. I have been treated with utmost courtesy by all the Ugandans. I live in a compound associated with the University. The white people here in the compound are a mix primarily of Brits and German/Scandinavian, with a few Americans thrown in. Whites are called mzungus, which can be endearing or degrading depending upon context. The UgandansI have had conversations with are socially very conservative.  They recently dropped the death penalty for homosexuality. There are several expats here that are simply doing research. They come here to collect information about development in the developing world, medicine in the developing world, social issues in the developing world, AIDS in the developing world, etc.

The medicine is unbelievable. Tremendous amounts of AIDS, TB. We’ve also seen some utterly weird stuff that no one can figure out. This is partly because no testing is done. The patients simply can’t afford it. There’s a strong tendency also to work up problems and then do nothing about it. I’ve been trying to gently argue against that. We also do weird testing. There’s a white lady doctor who sounds from accent like she’s from Canada. Every Tuesday and Thursday she schleps around a hand-held ultrasound machine so any problem that can even remotely be addressed with ultrasound gets ultrasounded, and she happily wanders from patient to patient with her probe. A couple of times it’s been very helpful.

The wards are massive. I have been working on female ward. When it is full, there are patients on mattresses on the floor. Sheets provided by family. There is no effort made to provide privacy for anything except inserting a foley or doing a pelvic. Women routinely sit around topless; there is apparently little or no inhibition about this, at least on the wards.

Had my first chest clinic. 10 X 12 room with a desk, a few chairs, a spirometry station, an exam table, and a bunch of file cabinets. Add the PFT tech, a resident, and Dr. Muyanja (learning to have specialized respiratory knowledge, who’s a nice guy, really nice guy.) the nurse, the patient, the attendant (patient’s family member/friend/translator), and me. Often there is a patient getting a PFT while a patient is being seen, and at one point when we were falling behind, the resident was seeing a patient, the doc was seeing a patient, and the PFT tech was doing spirometry all in the one room. No regard for privacy.  I clearly helped Dr. Muyanja, who soaks it up like a sponge. 

The way medical education works here is that there are students, interns, and post-grads. The medical students are, well, students. The interns are there because they have to be; they can’t get a license without doing an internship and some of them don’t seem to be giving their all. The residents have to pay to do a residency, and because of that they self-select. They are smart, motivated, and a lot of fun to work with. I really enjoy them. They like working with American docs because we are approachable and are accepting of and encouraging of interaction, questions, and letting the residents gently push back when they disagree.  We are much less hierarchical than locals or Europeans/Brits. My lectures are a mixed bag. Some have been good, but I gave one that really came off awful, to the point that I apologized.

I now have an apartment mate. He is one of three Ugandan astrophysicists (honest, I’m not making this up), got his PhD at Cape Town, the real deal. Came down from Kampala to teach physics and astrophysics at Mbarara. He’s a really nice guy and I couldn’t ask for a better roomie. 

I am personally feeling somewhat overwhelmed. I’ve been fighting a cold that I brought from Maine, just about over. I’ve had trouble with the heat—any effort on my part drenches me. I’ve been cooking for myself (got taken out a couple of times) and have gone pretty much vegetarian—vegetables, eggs, cheese. Today I had a small tin of sardines which was wonderful. I don’t plan to cook any meat here for myself. Ugandan beer is acceptable.  The food is not particularly interesting in restaurants, which is what I fully expected.  I am VERY glad I brought my water filter. Bottled water is expensive and I won’t even rinse my toothbrush in the tap. Occasionally the water comes out with yellow/brown particulates—I think it is road dust because the two are the same color. There’s a pre-filter that came with the kitchen, that gets out the particles, and then I filter with my microbiological filter for drinking water. The eggs often have flecks of bird turd on them, so they are getting iodine water treated as well as the veggies. (I am making a dilute iodine solution and soaking my veggies and eggs in it before cooking. Iodine works as well as bleach but is more concentrated, and comes in these teeny tiny little bottles…)

Everyone here, expat, local, the game ranger I walked around with this morning, an Indian on the plane I sat next to, is worried about the US election. They all talked to me about the US election. They really, really worry that Trump will get elected—genuinely fearful of what might happen. The reaction I’ve encountered is clearly worse than when I was travelling during the height of the Iraq war, where showing your face as an American was not such a hot thing to do.

I will put up animal pictures as a separate post.