Uganda Love This

On Thursday morning the nurses and I piled into the car in Kampala and made the what ended up being 8 hour trek, back to Gulu. I swear every time I drive those roads they somehow get worse and worse. I’m hoping that if I return to Uganda in about 3 years then maybe, just maybe, they will be done. On Thursday night we had a “4^th of July tailgate” to celebrate one last time before Sophie and Lucy’s departure. Most of my friends left or are leaving in the next couple of days and knew how bummed I was that they wouldn’t be here on the 4^th of July. Most of them are from Europe so when Jess and I used the word “tailgate” for the first time, they just starred at us and decided for the 4^th of July they wanted the “full American experience”. When Jess and I showed up they were completely dressed in clothes that they viewed to be “American”. It was a mix between lacrosse bro and straight up gangster. They continued the stereotype by screaming (very obnoxiously I might add)-OH MY GOD all night long. Still not sure how I feel about this….. Our “tailgate” ended having about 20 people; a great mix of ex-pats and Ugandans that I have befriended over the past couple of months.

Not your average 4th of July

We had grilled chicken, maize and roasted cassava (kind of like a potato) and then headed to quiz night one last time as a group. AND GUESS WHAT? We actually won! It could have been that we had a very large team but either way we were pretty excited about our victory. We celebrated with a free beer and then danced all night. It was probably one of my favorite nights in Gulu thus far but it definitely made me sad that most of them will be leaving me. I know I know -I can make new friends but these people will definitely be hard to top.

On Friday I spent the morning at the hospital doing some administrative tasks and then relaxed in the afternoon. Jess and I took advantage of the Game of Thrones DVDs that the couples whose house we are staying in left behind and watched a few episodes while enjoying some Indian food. We called it an early night since we were getting up early to head to Murchison Falls National Park for a safari!

Can’t believe I had to say goodbye to this girl this weekend. Probably one of the sweetest people I have ever met

Matt and Frankie arranged a safari trip for their last weekend here and we were more than happy to tag along. Aaron (England) and Rhoda (Ireland), two new volunteers at the hospital, joined our group as well. We all loaded up into the car and made the 3-hour drive to Murchison (and only got stuck and had to push the car once!!) It honestly still amazes me how close I am to a safari park and that I can simply spend my weekends with lions and elephants if I choose. We went on a late afternoon/early evening game drive and saw every animal imaginable, including a lion. The vehicle we took had a cage on the roof so you could sit on the top and just take in the breathtaking views.

The whole safari squad

My roommate Jess and I

On Sunday morning we woke up at 5am and headed back into the park for an early morning game drive because the big cats are more active at that time. Halfway through our drive we saw a leopard in a tree, which was such an amazing experience. It stared at us for about 2 minutes then jumped down from the tree so we could see it run away. Towards the end of our drive most of the group went back inside the vehicle but Rhoda and I stayed on top. Soon after, we ran into a huge herd of elephants that were a little less pleased to see us than we were to see them. They were about 10 feet away when one of the elephants started charging our vehicle and we sped away with it chasing after us for a couple seconds- probably the coolest, scariest, most exhilarating safari experience. I probably Go Pro (ed) every moment of our safari BUT this one. I was just too excited to even pick it up so you’ll have to paint yourself a picture.

After our amazing weekend we headed back to Gulu and spent the evening with some pizza and not too much else. The nurses and I will be spending the day getting everything ready for our extremely full patient schedule and the launch of the registry this week!

Sunset at Murchison!

PS-For those that have asked, I officially have a P.O box to receive mail! Let me know if you want the address.

Sorry for the delay- the last few days have been jam-packed and I have not had WiFi to be able to post this.

On Sunday night half of the team arrived in Gulu and we had a wonderful dinner at the Pagoda. The following morning Twalib and I toured Liesl (Rheach-South Africa) and Renae (Touch Foundation-Tanzania) around the hospital so they could get a feel for what the clinic is like and what resources we have here. We had a couple of RHD patients come in, in addition to a few of Twalib’s more serious cases. There were probably about 20 people that showed up without an appointment simply because they heard that he was back-unfortunately we had to tell most of them to come back next week. One of his serious patients is an 11-year-old boy with constrictive pericarditis. He needs a pericardiectomy  to save his life but unfortunately his family cannot afford it. His father has been saving all year but only has about 1/8 of what the total would be. Twalib has been reaching out to the director at the Heart Institute so hopefully we can get the fees waived. It’s hard to realize that sometimes life or death situations can revolve around money. Sadly fees cannot be waived for everyone because it is not sustainable.

Fluid build up in the 11 year old boy. Honestly heartbreaking to see how much pain he was in and how upset he was that he could not go to school anymore

After seeing some patients we met with the director of the hospital and then went to the records office so that we could see how cardiac cases, as well as other cases, are documented. As you can see I think sometimes we take technology for granted.

After touring the hospital the rest of the team showed up and we all headed out to St. Mauritz. They were so welcoming (as always) and couldn’t wait to show us around the property. They took us to their health center, which I had never seen before, and it was absolutely wonderful. They mostly focus on maternal health and it was awesome to see that a clean health center that is not overcrowded exists for women of this community.

Health Center at St. Mauritz- built with funds donated by a German group

 On Tuesday morning we all loaded up into a passenger van and headed to Aber and Lira for site visits. The purpose of these visits was to help solidify some of the details for our upcoming handheld echo project. In my opinion the two sites were very different. Aber was a lot smaller and well organized while Lira reminded me a lot of Gulu Referral Hospital-overcrowded and a bit chaotic at times. I think a lot of the details for this project will begin to come together over the next couple of weeks so I will make sure that I keep you updated.

 After visiting the sites, I headed back to Kampala with the team. After roughly 10 hours of sitting in the back seat of a van I was very excited by the prospect of a hot shower, dinner and a bed. Unfortunately I learned a very hard lesson upon my arrival-NEVER BOOK ANYTHING IN UGANDA ONLINE. Most of the team was staying at the Sheraton in Kampala (which was full) so I decided to book a room at a nearby hotel. The hotel had trip advisor reviews, a very detailed website and one of the doctors had told me she had even gone on a run by the place earlier in the week. When I arrived the whole place was completely deserted and apparently had been abandoned for almost 2 years. So there I was homeless and feeling like an idiot in front of some very intelligent people (with a lot of letters after their names). Luckily one of the project investigators, whom I met in DC in May, was staying at the Case Western Project house and offered me a room. I’d like to take this moment to apologize to my mom…sorry for causing you stress from 7,000 miles away. All in all I think it happened for a reason. There was a Case Western resident staying at the house and we had such a great conversation about Global Health and Medical School and the interview/application process-so thankful for her good company and great advice.

That’s all for now!

On Thursday morning, I walked into the office and asked to see the list of appointments the nurses had made while Twalib and I were away. As I mentioned before, it is only realistic for Twalib to see a max of 20 patients in a day by himself so we tell the nurses to book around 15 (to leave room for emergencies etc.) When I asked to see the book, I was handed a list with THIRTY patients each for both the 31st of June and 1st of July. Now for those of you that think this looks weird…that’s because its does. We now have 30 patients (which is too many anyway) booked for a day that doesn’t exist. These patients also do not have phone numbers so we cannot call and give them a new date. Needless to say the week of “June 31st” is going to be a chaotic one.

Minus the little scheduling “mishap”, everything has gone relatively smooth this past week. We were able to schedule all of the necessary meetings for the incoming team. In addition, I was able to practice the RHD registry consent forms with the nurses and acted as the patient while the nurses asked me the 14 pages of questions. I use to absolutely hate when teachers would say, “don’t just memorize this but make sure you understand” and I found myself saying it over and over. This whole process will definitely require some learning as we go along but hopefully the first week of enrollment will go smoothly, or as smoothly as things go here in Gulu.

On Thursday night, we had the whole gang over (Matt, Frankie, Lucy and Sophie) for dinner so that they could see our new house. We ordered Indian because Jess and I were both too lazy to prepare something. As we were sitting around chatting we noticed the biggest spider I have probably ever seen in my life. Instinctually, Frankie grabbed a broom and took a whack at it…Apparently this spider was so large because it was carrying all of its babies on its back…so when she made contact there were HUNDREDS of baby spiders scattering around our house. To make matters worse, she didn’t even kill the mom. I honestly wish I were making this up because I can’t get the image out of my head. I’m sure that the screams coming from our house were probably heard from a mile away. We were able to drown the babies with some cockroach killing spray (don’t even ask) but I probably woke up 5 times that night convinced that I was covered in spiders.

Managed to finally celebrate one of my favorite holidays

After our traumatic dinner, we decided to head to BJz for quiz night. Upon our arrival we were surprised to find that they made the executive decision to make June 18th St Patricks day. Every worker was wearing a large green Guinness hat and they had “tubes” of Guinness on sale. I’m pretty sure that Guinness sponsored this by sending their leftovers from actual St. Patricks Day to Uganda but nonetheless it was hysterical. We were once again stumped by some extremely challenging questions in quiz. My favorite was probably “which of these colors is a shade of blue?- beige, indigo or maroon. Challenging but we managed to come up with the right answer. I wont mention the details of the US government question that Jess and I got wrong. We are still a little ashamed. We managed to get 3rd place out of about 20 teams but are planning to head back this Thursday to redeem ourselves.

On Friday evening, Jess and I headed to the TAKS center for an art festival that was hosted by a group of Canadians in partnership with UYE (Ugandan Youth Entertainment), which is a local organization. Unfortunately the weather put a damper on some of the festivities that were originally planned such as dancing but nonetheless it was a very interesting evening. They had extremely talented locals doing live paintings and showed a bunch of short films that were produced locally. The whole group was so passionate about their work and you could definitely see the potential for growth within this organization. They ended by saying they hope to help inspire the creation of“ Africawood”, just like Hollywood, one day.

One of the extremely talented locals

Awesome sunset from TAKS

On Saturday, we all headed to Chobe Lodge one last time as a group. Sophie, Lucy, Matt and Frankie will all be leaving next weekend so we wanted to do something special for our last full weekend together. The Chobe Lodge is about 2.5 hours away from Gulu and will let you use the pool for a small fee. We laid by the pool almost all day and went on a few walks to observe some of the wildlife. It was honestly the perfect day and it made me so sad that some of the first friends I made here will be leaving.

The whole gang (minus Matt) at Chobe 

I am currently waiting on the arrival of the RHD/research team that is on their way to Gulu. Tomorrow we will be showing them an RHD clinic, giving them a tour of the hospitals, attending a few meetings and taking them to St. Mauritz. I am super excited for their visit and can’t wait for more details of our upcoming projects to take shape. 

PS- Happy Father’s Day to my favorite guy- wish I could be there to celebrate! I love you!

Well, its official. Even after a month and a half long hiatus, I cannot escape the name Emmy. I moved into my new house yesterday (which is absolutely fantastic) and hired a taxi to move my luggage from Sophie’s. When I got in the car, my driver asked me my name and I obviously said Amy (seriously Scheel? C’mon). After asking multiple times if it was Emmy for Emmanuel, I tried explaining that Amy is different and is not spelled the same way. I think he may have been a little confused because he then replied with “that’s weird, that’s a boys name in Africa. “ I think at this point it is what it is.

When I arrived at my new place I was honestly stunned. Our house is absolutely AMAZING. I am so lucky that Jessamy happened to run into this family and mention that she would need a place to stay. A British family of 4 headed back to the UK for summer break and offered us their completely furnished house with things I didn’t even know existed here such as a freezer, water filter, and a washing machine. They are letting us live here until September for next to nothing just so that someone is here to watch the house. We are located extremely close to town, the hospital (which is a huge bonus) and next to the hotel that has a pool. I don’t even want to think about having to find somewhere else to live come September because I’m pretty sure nothing close to this exists.

Not our chicken…but it waits at the front door like a dog.

side of the house

Every night, women come in to town and line up on the street for “the night market” with all the fruit/vegetables they tended to during the day. Sophie and her cousin Lucy decided that they wanted to fundraise for their good friend Denis, who has a learning disability, so that he can have enough money to enter a soccer league. They made jackfruit pie and mango passion fruit pie from scratch and just plopped themselves down next to some Acholi women selling bananas and went for it. If I thought people stared a lot before…you should have seen the puzzled faces for this spectacle. So many locals walked by asking what was going on. Luckily one of our friends, who is fluent in Acholi, was there to help communicate with them. No one here has ever heard of pie so lets just say they were very confused. Nonetheless they sold almost 8 pies and raised about $35 (which is a ton of money here).

Sophie and her cousin Lucy selling pie

Over the last 3 days, the nurses and I have continued to prepare for the upcoming visit in addition to preparing the schedule of patients for when Twalib returns to the clinic. It is honestly heartbreaking seeing patients come in, extremely sick, asking for an appointment and told to come back in the middle of July. The nurses told me that people had been coming in Twalib’s absence saying that they were going to die if he didn’t come back. This is absolutely nothing against Twalib for he was offered an amazing opportunity for training in India, which will ultimately make him a better physician. We have 12+ cardiologists in some of our hospitals in the U.S. while here they have ONE for an entire region. It’s like having 1 cardiologist for all of Maryland. I can only imagine the line that is going to form when we see our first patients on the 30^th of June. Everything spreads by word of mouth like wildfire here; once one person knows Twalib will be back, everyone will. Sadly it is just unrealistic to see more than ~20 patients a day.

Happy Wednesday everyone!

Before I go any further, I would like to thank my parents for their constant support. Without them none of this (including the ability to type this blog post) would be possible. Now if you ask any of my friends, they will tell you that if something strange and unlucky is going to happen to someone its going to happen to me (like that time I got pulled over by a bike cop). Upon my arrival in the States in April my computer started to work very slowly and then suddenly stopped working all together. When I brought it to the Apple store they were both amused and quite frankly disgusted to find that my computer had bugs. Not a virus, but actual, physical bugs that had eaten away at my hard drive. I am currently typing on a new computer, which I have successfully (hopefully) bug-proofed this time around.

Now, on to my trip back to Uganda. My travel experience was long, but very uneventful-only one 30minute delay. I also couldn’t help but laugh when my extremely white, British pilot stood at the door and said “ welcome home” to every African appearing person as they exited the plane. Side note: half of these people live in London. Probably one the most politically incorrect things I have witnessed but he was such an upbeat and happy person that I couldn’t hold it against him.

Just me and some equipment doubling as a pack mule. Don’t worry-Paul had me put all of it on in the parking lot and waddle around to make sure I could handle it

Its funny how familiarity can make a seemingly hard transition that much easier. When I arrived in January I remember going through all the what ifs in my head- “what if no one is there to pick me up?” “who do I call and where do I go?” “What if my bags don’t show up?” This time around these things didn’t even cross my mind. Would they have been inconvenient? Absolutely-but I am now in a country that I feel relatively safe in, know my way around in and know who to call if something doesn’t go as planned. The drive from the airport to Kampala felt just like a drive home from BWI would feel.

By the time I arrived to my hotel in Kampala it was almost 2:00am on Saturday morning. Seeing as though it was only 7pm on the East Coast, I was wide-awake. I took advantage of the decent Wi-Fi at the hotel and streamed the Women’s world cup game that was on at 3am local time; since it is the only game I will probably be able to see while over here. I know people always say that when changing time zones you should get up at a decent hour to make the transition easier. I had plans to wake up at 9:30…but may have accidently slept until 2:30. Needless to say my internal clock is still a bit messed up after that. My Saturday included a trip to the phone store so that I could buy a Ugandan SIM card. This means that I will be unreachable on my US number/through iMessage like I was last time. The plus side is that I have a data plan and should be well connected throughout my time here (PS- WhatsApp is probably the best way to reach me) .

On Sunday morning I began the 6.5hr trek up to Gulu. It usually takes between 5.5-6hours but for some reason the construction delays were worse than usual. To put this into prospective, the drive is only about 215 miles, a trip that would take 3.5 hours in the States (or 4 if my mom is driving). This just shows how horrible the road conditions are.

I am currently crashing at Sophie’s place (which is conveniently located next to the hospital) until Tuesday when I get to move into my new house (more details to come)! Literally could not have been more excited to see her! Its so comforting seeing a familiar face.

This morning I will be meeting up with the nurses to plan for the arrival of some very important, key players in our upcoming research. The arriving team consists of research and RHD experts from all over the world including South Africa, the U.S, Switzerland, Tanzania and Uganda. Super excited to see what my first week back has in store!

PS- Happy Anniversary to these cool kids- lucky to call them my parents!

*while I have internet access on my phone, I am no longer living in a place with WiFi access. I will do my very best to post 3 times a week like last time.

My Dad does this thing where if its an important day in my life or its Christmas or I simply wont get out of bed…he comes into my room blaring “ Let’s get it started” By Pink (secrets out dad). Seeing as though I spent my last night up in NJ without him, I would like to thank my brother for stepping in and waking me up with “Africa” by TOTO. Although I may have wanted to hit you at the time, it really did put me in the right mindset for the adventure I am about to embark on.

When I originally found out that I would have 7 weeks home instead of 2, I could have never imagined how fast my time in the States would fly. During this time I got to spend a week at the beach with college friends, go on a wonderful family vacation and attend an absolutely beautiful wedding ceremony for an old friend. I want to take a second to thank all of my family and friends who took the time to meet up with me during this time and everyone that saw me off for the second time.

Time to answer your questions-

1. Why are you going back?

To be honest- I’m sure I will question this decision once or twice during the next, less than comfortable, 25 hours of travel. However, as hard as it is for some of you to believe (hi Meg), I truly did enjoy my first 3 months in Uganda and I wouldn’t trade the experience I had for the world. Of course there were some challenging days but overall each day was rewarding in its own way and I made some amazing friends along the way. I am returning to continue RHD work and it makes everything worth it knowing, and truly believing, that this will save someone’s life.

2. What are you doing this time?

Well, this question is not as straightforward as last time. Over the next 6 months I will be facilitating multiple small projects as well as helping start one huge project come September. First and foremost, we will be launching an RHD registry for Gulu and the surrounding area. By enrolling current RHD patients, as well as future ones into this database, we will be able to track their symptoms, penicillin adherence and their location. In addition to the registry, I will be helping perform a needs assessment of district hospitals in Northern Uganda. This will assess current protocol surrounding RHD diagnosis, treatment and referrals. After the assessment is completed, we will then train non-experts in handheld echocardiography to improve the accuracy of diagnosis and efficiency of referrals. 

That’s all I’ve got-next update will be from 7,000 miles away!

See you all at Christmas time!

xoxo

Emmy