It's our last day in Uganda! I can't believe how fast this rotation has flown by and how amazing it has been. I've met so many amazing people - everyone at the clinic is so kind and sweet and encouraging I'm definitely going to miss them so much. We were also able to become good friends with the members of the PMI team at the beginning of the month. It takes a certain kind of person to commit their few vacation days a year to a 17 hour flight and a medical mission trip, and I'm so glad I was able to meet a few people like this and join the PMI volunteer community. In Uganda, I was able to see two Caesarians, a wound cleaning, a circumcision, a severely burned patient, a premature death, countless malaria cases, a gasoline ingestion, a leg fracture, an AIDS patient with PCP, a few cases of active tuberculosis, splenomegaly crisis from sickle cell disease, hypercele, a stroke victim, and so many other cases that I am unable to name everything. We became patients ourselves and helped manage patients and give advice in the pharmacy.

As we return home to begin other rotations, it's hard to think how any others can compare to the experience we've had here. We get to prepare for 36 hours of travel including a five hour van ride, two hour flight, seventeen hour flight, and a final two hour flight to Charleston. Once home I know we're going to enjoy some AC and American food, but also get to look forward to taking our deworming pills, with the ever ominous threat of schistoplasmosis developing within the four weeks since the rafting trip. I hope to see you all soon!!

Addendum: I just pulled a bot fly out of the peace corps volunteer!! It was so cool and disgusting at the same time. There's a photo on Facebook :)

Today (Tuesday) we got to stand and watch a c-section, which they call a "Caesar" here. It was twins! I actually got to see another c-section last Friday but forgot to blog about it. It was so cool, but also very bloody. Tomorrow is our last day at clinic, so we have lots to do in just one day!

The most memorable thing about Kampala, the capital of Uganda, is the traffic. Picture Atlanta traffic, without any marked lanes, only half paved roads-and those that are paved have so many potholes, no traffic rules, and then fill all of the empty spaces on the road with boda drivers (motor bikes with a driver and up to three (maybe four with children) passengers. I think the entire time I was there I saw one stop sign, but no one stopped - it must have been decoration. It also has houses and shops much like they are in Masindi, not how I would picture them in a large city, except here and there are taller buildings or a mall. Our favorite part of Kampala was the craft market which isn't labeled at all and is randomly around a corner behind the Ugandan Tourism office (where we met someone from SC who recognized my Erskine t-shirt-small world).

Oh, I forgot to talk about the ride down there! We took a Matatu, which is essentially a skinnier 15 passenger van which they put 16 people in and they have weird jump seats so people can crawl to the back row. Being so short I rarely have a problem with leg room, but even on this vehicle my knees were crammed against the seat in front of me. It took about three and a half hours to get there, and we had to go through construction, a thunder storm, and recover from an episode of being covered in melted chocolate that somehow made it to Uganda in my book bag without my knowledge. We got off that ride and got in to a taxi, which turned out that the driver spoke very poor English and we ended up at a random hotel. I used my amazing race skills and ditched him and then asked the hotel where to how to get to where we were going (turns out it was less than a block away...whoops).

Back to Kampala - so we loved the craft market and wanted to go out to eat Friday night so we called a driver's number that was stored in our phone and told him to meet us in 30 minutes. He said no problem, and proceeded not to show up after an hour and a half. So I called again, he said he was stuck in traffic and would be there soon. Thirty minutes later it's now dark, we've already run in to two citadel cadets from the PMI trip who are traveling around Africa (random!) and were so hungry. I called the driver again, was about to tell him we were just going to take someone else, and he hung up. So long story short, we took a random driver off the street, piled on with our book bags and all of our purchases and made it to the hostel where we were staying with only a minor incident involving Kathryn's hand and another boda (no harm done but she did get hit). We finished off the day with a brick oven pizza and prepared for rafting the next day. The bathrooms may or may not have been so far away that the grass outside of the room became a middle of the night restroom.

Getting to the rafting in Jinja was pretty uneventful, but do you remember me mentioning the thunderstorm? Well it kept raining, and raining, and raining, and soon the dirt roads were becoming rivers but our only way out to get back to Kampala. So we went over a big hole, the engine fell a little, they fixed it, and we kept going. Then we had to stop because another rafting vehicle was stuck and then realized the fan was broken (I offered to blow on the engine, but they looked at me funny). So, we're stuck behind a giant truck, with a broken bus, in the middle of Africa. The main road is about a mile up, so we walked on the extremely sticky clay until we made it there and had to take off our shoes because they got so coated in mud we couldn't pick them up anymore. My feet are still stained from that mud, and it's three days later. We were supposed to get back to the hostel around six and arrived at 8:40pm.

We woke up Sunday morning and decided to get the heck out of Kampala. So we boarded the Link bus (public transportation) and were only able to sit in the back row. It was horrible. We bounced completely off of our seat with every pothole and speed bump, and then they decided to blast Ugandan music so loudly, and the guy next to me was mumbling along with every song. It was dreadfully hot, and we definitely felt like we were in Africa riding that bus. Thankfully, our final mode of transportation is with the God is Able transportation company on Thursday and will be luxurious compared to the Matatu and Link bus.

I have so much more to say but will have to tell you in person! Happy Memorial Day!!

We had so much fun rafting at the start of the Nile in Jinja, Uganda! We had a safety briefing and practiced flipping the boat over and then getting back in and were on our way. Every rapid was a Class IV or higher and paddling towards a rapid that large seems unnatural. We made it over the first one great, and it was such a rush - but the second rapid was a different story (see the picture). We hit this giant rapid (10-15 feet high), and I just knew we were going over. Following our guide's instructions I held on to the rope and was able to get some air under the raft while it was flipped. Once we were out of that rapid, we only had four of the nine members still with the boat and Kathryn was no where to be found. Like literally-she wasn't with the safety raft or any of the kayakers I saw who were rescuing people. There weren't any floating helmets still in the water, so she had to be somewhere. It turns out she was picked up by another raft because she had floated so far away from us. We made it over all the other rapids and stopped for a delicious lunch around two, knowing that only four or five rapids were left. After lunch we did great going over the rapid that has a 50% chance of flipping and was a Class V, but then there was a bonus rapid at the end... And by bonus I think they mean they make the raft flip over. So off Kathryn and I went, neither one of us holding on to the raft and spinning and tossing and floating in the rapids in all directions. Let me also mention that at this point there's a thunderstorm overhead, so it's also raining and getting pretty cold. The kayaker went straight to Kathryn and picked her up. When I finally resurfaced I was pretty far away from everyone but not panicking, so Kathryn's rescuer told me to swim towards him. We then stayed floating/swimming in the water the rest of the trip because it was warmer than being on the raft in the storm. We ended the day with picture viewing, kabobs, and my new favorite Ugandan drink Redd's. I'll have to do a separate post about the happening in Kampala and with all the traffic, but rafting was such a great trip and made up for any of the madness of Kampala. Happy Sunday!

Who knew we would be using knowledge from the poison lecture in pharmacotherapy in Uganda?? A 18 month old came rushing to the clinic in a parent's arms who had just ingested gasoline and was breathing very rapidly!! Kathryn and I followed him to the nursing room and helped to identify the amount ingested, time since the event, and how much charcoal to give the patient. He was doing great when we left - I honestly never thought I would be using those lectures here! We're heading to Kampala tomorrow, so I may be out of Internet range for a bit; but expect an exciting post on Monday!!! Happy weekend everyone!

It's not been super great two days. Yesterday six people at clinic kept telling me I was fat which is a weird compliment here because it means you're healthy, but it still means you're fat... Which depressed me all day. I know I'm not fat, but even the skinniest (American) person doesn't want to hear they're fat.

And then today we finally got to see a birth, which was really cool until the baby came out, and we were told it was 8 weeks premature and then it died an hour later after oxygen and CPR weren't enough to help it breathe. We're looking forward to immunization Friday and hopefully seeing a birth that goes a little better. To lighten the mood, here's a giraffe!!

We did give a great presentation this morning which everyone loved because it gave lifestyle tips and counseling points to empower patients. So that was a good start to the day! We also got a good laugh when someone at lunch asked if we had vampires in the US (seriously) like they have in Twilight. We said no, obviously.

Have I posted these yet? I can't remember so enjoy!

Not much happening today except another day at clinic. We teach CME tomorrow, so I'm off to prepare.

What a weekend!? We spent Saturday trekking for rhinos in the Zima Rhino Sanctuary which turned out to be quite the adventure. Our boda driver switched out his boda for a car and drove us, along with three young children who are his family friends, to the rhinos. All morning we kept wondering what in the world we had gotten ourselves in to. We finally made it to the reception desk at the sanctuary and hired Herbert, a ranger who led us to the rhinos. Apparently the rhinos are usually pretty close to headquarters, in small groups of no more than two or three, and asleep in the daytime. They get up to eat only in the morning before nine and again at night after five. We hopped in the car with Herbert and drove for about thirty minutes through the bumpy dirt roads of the park and finally stumbled upon five rhinos! Not only is it super extraordinary to see so many together, but they were also up walking around grazing. We were so close and followed them around in the fields for about twenty minutes. One rhino is named Obama because his mom was a rhino donated from America and his dad was a rhino donated from Kenya. It was such a cool way to spend the first part of our Saturday!!!

We got back, showered, and then headed over to Newman and Trish's house for some ribs. These weren't just any ribs, but Jeanine (a local missionary) slaughtered one of her pigs just that morning for this occasion. The whole evening was a great way to spend one of our last nights here with them and a few other people from PMI. Not only was the food delicious, but we devoured almost all of the food and had great company to enjoy it with.

I think Saturday night was one of the latest nights we've stayed up since we have been here, so we slept in Sunday and then went for a walk around town. We got some soda, and Kathryn bought a lovely pair of Rey-Becs (an off brand of Ray-Bans). We had a late lunch of fajitas, and then went to cheer on the local MKMC football team. We felt like such a part of the town because we knew everyone on the team, and many other local businesses were there playing in the league. Our team won 4-0, and Wilson had the best goal of the day from center field. I don't know a ton about soccer in the US, but here at halftime all the players get a giant handful of glucose and eat it for energy. Is that normal? We came back to the hotel and enjoyed a relaxing night with a dinner of toasted cheese sandwiches which were SO delicious (cheese is so rare/expensive here)!!

We were back to the normal schedule at clinic today, and not much out of the norm happened. An update on the burn patient... He was discharged this weekend because he didn't want to stay in the hospital any longer (against the doctor's recommendation) but as far as we know he's recovering at home. Although his burns were extensive and all the way around the arm, they were superficial and will hopefully heal without the need of any skin grafts. Have a great Monday!

The past two days have brought in some fun cases at the clinic. We started off Thursday getting to see a woman in labor and then the baby just after delivery. We missed the actual birthing process because we were on rounds, but the baby was super cute! We also met a man on rounds who sells petroleum out of his house. He came in the night before with burns covering 25% of his body, yet he was eating and talking when we met him Thursday. (This is about to get medical so bear with me if you don't understand) At that point the night shift nurses had only run one liter of NS!! We discussed with Dr Dan about running LR and at what rate (it was already past eight hours post burn) and decided to run the correct amount of fluids as fast as possible, since they don't have a pump. We were leaving the ward and noticed nothing was hung yet, so Kathryn and I became patient advocates and insisted they start the fluids ASAP. He seemed to be in the same condition this morning, although his burns weren't drying out, and the IV access fell out. Considering in the US this patient would be in the ICU with around the clock care and probably in a burn center, we are hoping he makes it Monday when we'll be back at the clinic. It's crazy to think the location of your accident can determine whether or not you survive.

Friday at the clinic is also immunization day!! Which of course means tons of super cute babies to play with! We met our preceptor's two month old, and many other cuties that were getting oral, IM, and SubQ vaccines. The babies weren't too happy to get the shots, they got over them very quickly - with the help of lots of breast feeding moms.

After clinic we went to the local grocery store (it resembles what you would find in a gas station in the US) and got some goodies to celebrate the weekend. The snickers here have a weird aftertaste of dish detergent, just FYI. We're going Rhino trekking tomorrow, so we need to rest up and get ready to hike! I'm still sharing from last week so enjoy these!

Today started like any other Wednesday at the clinic until we got the bright idea to watch Dr. Dan perform a few surgeries, Ugandan style. The first surgery made both of us really queasy because they don't use anesthesia nor a significant amount of local pain relievers before they start. The doctor cleaned a wound that was inflicted in a motor vehicle accident, which sounds less gross than it actually is. There was a lot of scrubbing inside the wound under the skin and picking off dead skin, all while the patient was entirely awake and clenching from the pain. Well we recovered after that surgery and decided to tackle one more for the day.

We thought this second surgery was going to involve only minute amounts of blood, but there was more than I care to admit. We actually assisted in a seven month old's circumcision (we held down his legs). He cried throughout the whole procedure but fell fast asleep once it was over. I really hope that baby awakes without the memory of the trauma he just experienced. It got so hot in the operating room we were both profusely sweating when the surgery was complete and went outside to get fresh air and a bottle of water. The baby went home two hours later, still fast asleep.

We ended the day with our first ride with Mustafa on a boda boda. It was super cheap, very stable, and much faster than walking. It may be our preferred method of travel the rest of the time here. We're off to go eat dinner now, but have a great rest of the day USA.