Day 3 Uganda - Pride and Passion

 I woke reasonably early and we went out to stand in the sunshine before breakfast. No shower for me and Sam as our side of the accomodation had no running water. It was already overwarm (sorry uk friends). As we stood there we saw several kids hovering a little way away... obviously really interested in us but a little wary of coming closer (that didn't last long). We ran back into the accomodation and grabbed some bubbles and stickers. We beckoned the children over and Sam stuck a sticker on each one and I started blowing bubbles... they loved it and began chasing the bubbles all over. Suddenly it was if there was a silent signal. and kids started appearing from around the corner of the house and began to chase the bubbles around. Soon we had a crowd of children laughing and running around us. A good start to the day.

We had to go into breakfast so I gave the bubbles to one of the bigger children and we joined Claire and Gillian around the table for a slice of toast and peanut butter, a couple of bananas and a very welcome cup of coffee.

We weren't sure what our day was going to hold so we packed our rucksacks and prepared to head off to the hospital a short walk away. Whilst I was waiting for the others I spotted some kids playing football... or more like garbage ball... with the ball being some plastic bags bundled up and wrapped with twine. So with my rucksack on, I went and joined in, playing keep ball with one of the older kids. The rucksack was a mistake and although it was early it was already really warm so I was soon panting and gasping like the mad dogs and Englishmen out in the midday sun. The kid got tye ball off me, I got it off him and he won it back as quickly... good fun. I was however glad when the others came out and it was time to go over to the hospital because I think I might have been the one being resuscitated rather than teaching it. 

We walked over to the hospital and were greeted by a very impressive sign for the Freda Carr hospital and a wrapped up statue... 

We had been invited along to the hospitals 100th anniversary on Sunday and the statue was to be unveiled then. We tried to guess who the statue was but had no one to confirn or deny our guesses at that point so we were left wondering. 

We walked onwards to the entrance where we were greeted with smiles and directed to the Hospital directors office. Dr Amos was there to greet us and welcome us to the hospital and he introduced us to Grace, the head nurse who looked exceptionally smart in her nursing uniform. Grace then commenced showing us around a little. (More about Grace later). 

She took us back to the entrance where a baby had been placed into a sling hooked to some weighing scales and inforned us that this was the triage area (outside). Iff the triage area was the Emergency Department... a single room. We were then taken through into the main building __and shown the pharmacy (which appeared to be pretty well stocked) and then down the corridoor to the paediatric ward. Of course my ears pricked up when she said she had a 1.4kg baby, who had been born at 1kg. She showed us to a bed where the mother was lying  with the small baby tucked up against the mother's chest, strapped to mum and covered with blankets. We could just see a small head with a knitted hat poking out. I could also see that he was breathing fairly hard and fast. 

I couldn't ascertain what gestation he had been but regardless I was impressed that they had managed to keep such a small baby alive when they had very little equipment. Grace showed us a non working incubator (waiting for a spare part) a resuscitaire which was new to them and the oxygen condensor, which worked when there was electricity. 

We then went through an adult ward and over to the nursing school.  We could see a large group of people sitting down and as we approached they started singing and clapping. Our welcome commitee! It was quite embarrassing to be fair. They ushered us around and to some chairs facing this crowd of students who were still singing  and gestured for us to sit down. When the welcome song was finished Grace stood up. and addressed the students, introdicing us and the purpose of our visit. She then handed the microphone to each of us in turn to say a little bit about our job at home. 

I basically said that I looked after the small babies, preterm babies and taught doctors and thanked them for having us  and then sat down as quick as poss! 

Once the introductions were over, one of the girls was hassled to stand up and sing an 'english song' so she stood up and started and was soon joined in by everyone. She had a lovely voice... no idea what the song was. Once the song was finished we escaoed from the attention and went over to the classrooms. It seemed we were going to start some teaching today!

So we threw our bags into a corner and started to gather whatever equipment in the room. Sam and Gillian set up next door to teach theor bit about birthh emergencies and me and Claire in the other room to teach resus. There was a line of resus dolls to choose from though one or two looked to be beyond help!

We found 2 trolleys, some sheets, some bag and masks, a suction 'penguin' called that because it looks like a plastic penguin and a couple of stethoscopes. We set up a separate resus station on each and then the students began to file in. We had the nursing students first off and they came in looking a bit shy. We broke the ice a bit by attempting to say hello (Yoga) in their language which made them giggle. I then took one of the trolleys and gave a demonstration of a full resus... then again another including CPR. They were quiet, paid attention. I then went through it again with a bit of participation as I asked them what came next. They started answering questions and became more animated.

We split up into 2 groups then, as there were about 30 of them, maybe more.  We then got them up in twos to go through it themselves with scenarios given by us... a mini NLS test (for those that don't know, Newborn Life Support is a course we have to do at home every 4 years to keep updated, I have just done mine before I came here)

It was going well when I decided to change it up after a couple of run throughs... mums did not always give birth in a delivery room next to the resus equipment.... especially here!

I grabbed the doll and ran outside a little way and placed the baby on the ground near some bushes. I looked into the classroom grinning.... there was a bit of stunned silence as the student ls who were doing that particular scenario were sure what to do... I beckoned and then laughter erupted from all of them as the girl ran out, picked up the baby and raced back in the classroom and started the resus process...

As we went through the students I did tgis a couple more times, which was greeted by laughter, only now the students had cottoned on to it and chased me out so as to grab the baby as quick as possible.

A great fun. By the end of the class, they were counting the inflation breaths along with me, crying like a baby when a resus was successful and cheering whenever anyone had to run to get the baby from outside.

It was really fun, but tiring so I was quite glad when all had had a go and Claire gave a quick talk about baby feeding... unfortunately she hadn't got her knitted boob with her as we weren't expecting to teach today so was forced to use her own  for demonstration purposes. I dont think she minded but it was funny.

Once that finished, it was time for lunch so we wondered back to our accommodation to grab a quick bite to eat.

The afternoon... round 2

This time me and Claire had the midwifery students. This lot were a bit quieter than the first lot and it took a bit more time to get them out of tgeir shells and participating...  the birth of a baby in the bushes started the process... with one of them cottoning on quick and charging after me!

I have never had so much fun teaching resus!

It was hard work though, thinking up different scenarios to showcase the whole gammet of situations they might encounter and whilst remembering that they don't have the equipment or teams of people to help that we are so lucky to have. It was resus at its most basic but that made it a purer process almost.

It breaks my heart that they don't have the possibility to have the equipment we have... no CPAP, no High Flow, No ventilators, no guarranteed oxygen or electric for that matter.

Grace has done a fantastic job in securing some equipment and clearly has big ambitions for a proper neonatal unit... I only hope that I can help her in some small way during my time here.

After the training we headed back and then walked around a little, down to the village of Ngora, where we had a look at some of the stalls. One of the stalls was selling  small dried complete fish, a little snack... so I bought some, closed my eyes and chucked it in my mouth whole... not bad at all!

Further on a woman was preparing fruit so we asked what it was... Jackfruit. We had seen that growing in a tree at our first hotel so we bought a bag... really good. Liked that!

The village feel was vibrant and alive... it was a shame to go back but food was calling!

That night myself and Sam took ourselves off for a night walk.. me hoping to see a snake, Sam kinda hoping not to! No snakes but we found quite a few toads, not sure what type and saw what may have been an owl flying over the roof of our accomodation. The stars were out, the night was warm and peaceful and it felt like we were in the best place in the world!