Ugandan Medicine

After almost 8 weeks in Uganda my view on medicine has shifted drastically. Through our research we have had the opportunity to spend time in a variety of clinics around Kabale and in the Kigezi region. Upon coming to Uganda I had the idea that we could improve Ugandan healthcare by implementing systems similar to ours in the U.S. However, I have witnessed there is no “right” way to practice medicine, and we have a lot to learn from the rest of the world. There are many diverse ways to practice medicine depending on the circumstances. The key is then to find the best practice in the place where you are.

In Uganda I have noticed many unique forms of medicine from the herbalists to the regional referral hospitals to the small, rural clinics. In the referral hospital we visited they had the capability to treat trauma cases, take x-rays, and perform surgeries using anesthesia. This hospital was similar to the type you would see in the U.S. On the other hand, the rural clinic headed by a nurse could provide simple out-patient curative services. Despite the amount of supplies or staff available, I have noticed a common theme among all of the healthcare settings in Uganda- the personal care is wonderful. Each health worker strives to help in the best way they can with what they have. They work long hours and rest very little (if at all) to ensure that each patient receives the best possible care. For example, one of the clinicians we met tirelessly works in the clinic six days each week for at least 12 hours each day. In addition, he is on call when he isn’t on site. I look at the Ugandan healthcare workers, and I admire them hoping to one day be just as hard working and compassionate as they are. They put their heart and soul into their work and are constantly battling obstacles of limited supplies, electricity, or funding. I can say with confidence we have a lot to learn from them and the selfless care they provide.

The beautiful view from one of the clinics looking onto Lake Bunyonyi

 

 

A Much Needed Break

The nature of our research is exhausting. Both the process of data collection and the substance of those data we obtain can, over time, leave a physical and emotional toll. Our trips to the field require long drives along dirt roads peppered with bumps and ditches. The in-depth interviews are long and conducted under the unrelenting Ugandan sun. And the stories people share - their experiences during the war, the lingering suffering felt in the community, and the sense of abandonment so prevalent - are impossible to hear without feeling at least part of their pain. So last weekend we took a welcome trip to Murchison Falls National Park, the largest one in Uganda.

The park's namesake is a beautiful waterfall formed by the Nile bursting through the rocks of a cliff face just east of Lake Albert. The beauty of the falls is only rivaled by the diverse wildlife found in the enormous reserve surrounding the river. Below are a few of the scenes from our brief and much needed retreat.

Sunrise over the game reserve

Two elephants munching on some grass

Two giraffes posing in the midday sun

Lions...doing lion things

The beautiful Murchison Falls

View from the top

Obligatory waterfall selfie

Obligatory warthog-trying-to-eat-my-lunch selfie

Sao Paulo, NYC

Six weeks in and homesickness is a feeling I've yet to experience. Since we arrived in Sao Paulo it never truly felt like I left home. More like I sat on a plane for 12 hours and when I woke up they just changed the main language to Portuguese. We still had to sit through heavy traffic and reckless driving to get to our house. The buses are never on time, especially when you're in a rush. There's a Starbucks on almost every corner and dolce de leite frappucinos are not to be slept on. Love yourself and get one.  I'm just waiting on the news that Ibirapuera Park has been overrun by Pokemon Go players.

Sao Paulo has managed to one up New York in two places though. The food, if you missed that from my last two blog posts, is just as abundant in options but excels us easily in quality. The creamy texture of cheese in each bite of your bacon and brie burger, the tender but almost overwhelming flavor of a churrasco sandwich with bacon and egg that could only be enhanced by their homemade hot sauce (because hot sauce makes everything better) and the light fluffy crunch of a few coxinhas after a lot of drinking. Sao Paulo has my stomach under lock and key and I can't say I'm ever going to be ready to leave.

As much as I've enjoyed the food here I must give credit where credit is due. The people I've met so far have shaped this experience into something truly unforgettable. They are thoughtful, friendly and always ready to have a good time.  Lizzy's coworkers invite us to bars, parks, festivals and even to their friends houses to make sure we feel welcome and that we get to enjoy all that Brazil has to offer.  Just last weekend Lizzy and I spent Sunday with our coworker Guido and his friend, Silvia, cooking and eating an array of Brazilian dishes before heading to a Festa Junina party across town but not before stopping for milkshakes. We tried to order two small milkshakes but the guy told us to just order a single large and he would split it into two cups for us. The night before we went on a bar hopping adventure to find some fried mandioca (think upgraded french fries). A few places we went to didn't have it and when we found one that did the waiter was honest and told us that their mandioca wasn't that good today and pointed us to a place that might have some better stuff. Something like that wouldn't happen in NYC, not on a Saturday night, not a chance.

Brazilians try to make every moment of life enjoyable and their efforts to share that mindset with us have not gone unnoticed. You start to take the small victories and value them more. Bus came on time today? Beleza, now your day is gonna be great. Taking time to yourself and appreciating life is a concept I think New York could take a few notes on.

Opposites in Harmony

Many people who have visited Brazil speak of this welcoming nature of the population and the amazing food and the busy streets. These are all very true observations, but they all lack something even truer – the many contradictions within the culture. Every Brazilian I’ve met has spoken of the lax nature of everyone and how little is achieved in the workplace, but I’ve personally experienced how hard an entire workplace works just to welcome a foreign stranger. The people in my lab speak of coming into work late, but also quietly stay late to obtain better scientific results. They joke around and laugh often, while simultaneously editing their articles to send in later that afternoon.

Outside of the lab, you’d never expect your coworkers who stayed up late reading more into their respective fields to have such smiling and carefree attitudes or to invite you to every park and bar and event to get to know you better. I remember working on my own one day and a coworker walked up to me and confessed with a very upset face that he hadn’t put forth any effort to welcome me to Brazil….except, he and every other member in my lab has consistently invited me and my roommates out to different places every weekend since my arrival.

Another comforting surprise that I face daily in São Paulo includes the immense amount of greenery and effort put towards nature in the most populous city in the entire southern hemisphere; skyscrapers and office buildings commonly have plants growing up their steep slopes, either through intention or just by nature governing its own path. Residential areas use various plants that are either tall and/or thorny as crime deterrents (our own house has roses lining the path to our house), and sidewalks are never alone with their tree friends breaking up the monotonous grey cement.

These contradictions exist outside the lab and throughout the entire country: everyone eats fast and walks slow, speaks quietly but laughs loudly, the houses are cold without heaters but warm with love and color; the list could go on for an eternity. It’s no wonder, then, that my small and trivial problems are overshadowed by the large and dominating culture surrounding me in this wonderful city of São Paulo.

So, what happens when we are not working?

So, what happens when we are not working?

After a day or week of work, you can find us either sitting around a bonfire at the compound where we live, exploring Kabale Town, or on the road to various parts of Uganda.

Nights by the fire are a time when everyone living and working at the compound get a chance to come together to learn more about each other, laugh, joke, and just relax under the stars. It's honestly one of my favorite things to do while here. There is never any topic off limits and laughs are a guarantee. The only thing we are missing are marshmallows - but we've replaced them with home grown maize! We "harvest" or pick the maize from the garden, peel it, and then place it by the fire for roasting. Within minutes, there is a sweet/crunchy treat ready to be devoured.

Exploring Kabale Town is also something we do quite frequently. Whether it be running errands to the supermarket to get some snacks, popping in to Cafe Barista to get the best Samosas in the country, buying fabrics at the local fabric store, or hogging the internet at local restaurants, these are places where you may typically find us when not around the compound. When passing through town we get the chance to practice our language skills; so in the morning when we are passing someone we say, Oraire ota - meaning 'Good morning. How are you?'. And if we pass someone during the day or evening we say, Osiibire ota - meaning 'Good afternoon. How are you?'. Everyone gets so excited when we attempt the language, so we are sure to get a reply. They get so tickled that it makes them chuckle! The only thing about these trips to town is that no matter the route you take, you are sure to encounter some hills that will definitely work your calf muscles. But hey, what's a little exercise when you reach the top and see the beauty below?

During this trip we have been no stranger to traveling and exploring all that Uganda has to offer. From mini trips to Lake Bunyonyi and Ssese Islands, to extended trips to Kampala, Jinja, Fort Portal and Queen Elizabeth, we have explored quite a bit of territory. We have passed the equator, seen animals (yes, including lions), relaxed at Lake Victoria, tubbed down the famous Nile River, and had some much needed city life in Kampala. All in 7 short weeks. All while working!

I am now off to get some much needed rest so that tomorrow I can enjoy a day of not working. Well, at least not work that is too hard. ;P