Day 4 – Quiet Day

After the adrenaline (caffeine?) rush of Kampala, it is a relief when Victoria tells us she needs to go into town, and perhaps I could go over clinic arrangements and procedures with Rose while Alicia helps out in the little ones’ dormitory.

Pauline Greenlick, who is treasurer of the Bright Kids USA Foundation, and her husband Louis Picard  from Pittsburgh, have been very busy networking, and she sent me a couple of emails reporting on her progress and requesting some information.  She asked about the possibility of screening for ocular disease in the children and whether Victoria has plans to support those with disabilities in the surrounding community.

The clinic is named after Gloria Namusoke, a BKU orphan who had multiple disabilities and died while away at boarding school after making great progress under Victoria's care and love.  As in many poor countries, those with significant disabilities are often hidden away by families and not provided with the opportunity of developing their full potential.  It is hoped the clinic will eventually become self-supportive by providing services to members of the surrounding community.  Victoria hopes to encourage families to bring members who suffer disabilities to the clinic, by offering free care to those individuals.

I spend time with Rose going over the clinic supplies and questioning her rather closely about her experience in medical procedures and treatments, and particularly the use of the various medications we procured yesterday.  I am most impressed by her knowledge, reported experience, and overall confidence.  We identify a short list of supplies we wish to add, including eye charts and an ophthalmoscope (magnifier light for examining eyes).  I hope to accomplish vision screening with all the kids during my stay.  I have not seen any of the children with eyeglasses, so I suspect we may detect a few vision acuity issues which may be impeding studies and require assessment by an optometrist.

Rose at work behind her desk

We also review the preparations for the planned vaccination clinic this coming Saturday.  Rose has confirmed with the public health department that they will deliver combination vaccines for measles, mumps, rubella and also diphtheria, tetanus, polio with syringes and needles early Saturday morning.  We remind Victoria that posters still need to be disseminated in the area, although she has been getting the word out through her considerable local network.

Rebecca, Obama in back, Alicia, and Rose standing over Lydia

awaiting lunch in the little ones' dorm

Jovan - a very friendly ham of a guy

Auntie, Rona in Rose's lap and Harriet in behind

Lydia

Sanyu with Alicia behind and left.  I was a bit alarmed by Sanyu's distended abdomen, but Rose advises she was badly malnourished on arrival at BKU with the typical associated abdominal distention, and that she is steadily improving

Auntie, Rose with Rona, Harriet (behind), Becca and Alicia

Elijah Obama

Following a short (and surprisingly calm) visit with Alicia and her charges at the little ones’ dorm, I have lunch and a short nap.  Alicia helps Richard with his various tasks tending the animals, including milking the cow, feeding and watering the hens & chicks, etc.

Victoria surprises us by arriving back by pickup truck laden with a new bunk bed for the little ones’ dorm, a desk, chair, and waiting room bench for the doctor’s office area of the clinic (just nearing completion), and sundry needed general purpose items, all purchased with the funds I had left over from our shopping trip yesterday.

Victoria had many of the kids pose out front of the main building with the new supplies and furniture.

I love photography, particularly people photography, and I hope to contribute to getting more exposure for BKU and perhaps attracting sponsors for the children who are not yet sponsored.  To this end, I spend some time “torturing” a number of the kids (Alicia’s opinion) by getting individual portrait images.  Look for them on page two of this blog (soon to come).

Pastor Wilson arrives and leads us in a prayer service.  Thankfully, the power comes back on in time to finish preparation of the evening meal and settling the kids to bed.  I post my Day 3 report, arrange a Skype date with Sarah, and show some of the kids the BKU short video which is posted on YouTube (see the link on this home page).  Unfortunately, the internet connection is slow enough that the video needs to be coaxed along in 2-5 second bursts, with frequent re-starts.  We have a couple of our own short videos from the first day which I was unable to post to the blog for some reason.  I will try posting them to YouTube and provide links on the blog home page.  Sarah has promised to help me tidy up the visual appearance of the blog when she gets some spare moments, since she is now busily studying graphic design in Vancouver.

The little ones await the start of the prayer meeting

Alicia has Obama glued to her lap

Nights:

Since it’s 4 am, I’ve started adding to this post, and this all is becoming a too-common theme, I thought I may as well comment on the nights at BKU.

Nights are mainly very quiet and there are only a few outdoor lights left on around the compound.  The three dogs who belong to BKU tend to lounge on the front porch, which is just outside the windows of Alicia & my rooms.  When I’m lying awake, the sound of a dog breathing or scratching makes me wonder if it’s in the room with me. Three or 4 times nightly, something sets off a loud chorus of mournful wailing and excited barking which persists for 15 to 60 seconds.

Typically, I’ve been sleeping soundly from 1030 pm to 2 am, then up until about 5 or 6 (usually after the first or second rooster crowing), then I will sleep again until perhaps 8.  Alicia does much better sleeping the night through.  It seems a bit long for jetlag to persist – wonder  if it’s the antimalarial med, the heat, the huge turmoil of emotions I’m sorting through each day, or a combination of all the above.  You, dear reader, are the lucky (or not) beneficiary for, with a full day and a straight 8 hours’ sleep, there would not be much time for blogging.  Sometimes I do get a half hour nap midday, but usually can’t sleep then either.

So, when I get bored of the thoughts and ideas churning around my brain, I get up, grab the laptop and go out to the dining table to set up and worry about my exposure to mosquitos.  Usually I apply a little more DEET spray for good measure.

The first night of this, I was alarmed by scrabbling and scratching in the kitchen.  Finally investigating with my flashlight, I saw a rat was the source of the commotion (smaller than Alicia’s pet rats from a former time).  One night it was very active, even pushing pots and pans out of the cupboard, but usually it’s just scurrying about.  I was at first a bit alarmed, but we now co-exist quite comfortably.

Alicia – the girl who at 5 was famous for handling bugs and snakes – freaked out one evening when she caught a glimpse of the rat in the storeroom off the kitchen, and she had several of the older boys hunting about but stealing looks at her as if to say “what’s all the darned fuss about?”  She’s seen 2 cockroaches since we’ve been here, both mildly large & relatively docile.  She does get over it quite quickly, and is even becoming more comfortable around the cow.  Victoria says she’s occasionally needed to spray for bugs or put out rat poison, but she naturally hesitates to overdo it with little ones crawling about, and the building quite unavoidably has cracks and crevices in the walls.

It’s a bit funny what things do or do not scare people.  Arnold, the incorrigible ham who’s traversing the terrible twos will drive Alicia nuts by tormenting the dogs or cows with a stick, stomping on the dogs’ tails or jamming his hand in their mouths, yet when I walked around front with him this evening to look for his shoes just after dusk, he was terrified when we saw a small frog hopping about.

Arnold in a rare quiet moment

Personally, I'm very leery of snakes in the wild and thankful we have not yet encountered any in Uganda.

Some random unrelated pics follow below.

Dan is thrilled to be given a homework assignment

Rebecca, Sandra & Dan back home from school

Robert is sponsored by a Canadian lady

Rebecca & Sandra

Janat & Brenda check in with "Mama" on arrival back from school

Preparing the evening meal in the kitchen.  The blue box in back is the Biosand water purification device

Ester holding Don, the youngest BKU charge at 10 mos age

Hakim (Victoria's grandson) with Brenda

Robert

A precious cargo for the boda boda captain enroute to school

Rose visits a stand in Kampala

Kampala residents at rest

Day 3 – Kampala

Kampala, Uganda’s seat of government, population approx. 1.8 million, is built on 7 hills. It is a 45-60 minute ride by minibus taxi from BKU, and our destination today when taking Isaiah to his HIV clinic appointment.

The taxis are like a run-down club van back home, with 5 rows of seats, each holding 3 (sometimes 4) persons.  There are flip-up seats along the side of the van with the single sliding door, allowing passengers to enter & exit the rear seats.  The taxis make frequent stops anywhere along the roadside where a pedestrian appears to need a ride.  They operate more in the fashion of a public transit vehicle than a private taxi. The cost is $3000 shillings per adult for the one-way trip.  Isaiah rides for free because he sits on Rose’s lap.  The drivers are rather aggressive, and make generous use of the horn.

Taxis are loaded inside & out

 

We set out about 8:45 am.  Isaiah is an orphan who lives with his grandmother nearby.  Victoria agreed to provide the service of sending him to the clinic because grandmother felt unable or unwilling to do so.  He is a very quiet, polite, withdrawn boy who seems sadly listless the entire day.  There is a mix-up in directions, and we stop first at a clinic funded by the British, whose campus appears like that of a resort hotel.  Isaiah whispers this is the wrong place, and a quick phone call by Rose confirms that we need to catch a ride another few km. along the highway.  I am very pleasantly surprised by the physical infrastructure and efficiency of this second clinic.  HIV treatment for citizens is funded by the government, including the cost of medications.  The grounds are very clean, the clinic area quite spacious with a playground outside the pediatric outpatients, and we complete registration, consult with the HIV “counselor” (probably like a physician assistant in Canada), and pick up the 3-month supply of medication all easily within an hour.  This gives me only a little time to play kickball in the waiting area with an energetic little guy of about 4.

Isaiah is a lovely child

spacious and uncrowded paediatric HIV outpatient clinic

View from the clinic - one of Kampala's 7 hills

We are advised that, although Isaiah’s CD4 (blood cell) count is still acceptable, he has lost a little weight since his last assessment.  Rose expresses concern about the quality of nutrition in his home.

Our next goal of sourcing stock medications takes us into the very heart of the city.  Venturing off the main road, the taxi bus winds through a maze of narrow dirt corridors lined by vendors’ shacks then out to the main thoroughfare of Kampala Rd.  The street is overrun with minibus taxis and motorcycles, and the sidewalks throng with a steady stream of humanity,  with great variations in all features except skin colour.  Alicia remarks she has not seen another Caucasian since we left the airport.  We get more than our share of stares, but mostly friendly smiles, a wave, and rarely a hand reaching out to touch the unfamiliar light skin.

We find the forex shop which Victoria has recommended, and I exchange the bulk of my US$, save a couple of Ben Franklin’s  which the clerk eyes suspiciously.  On the way there I am rather bold, hanging behind our little group to catch the right moment or angle to click the shutter and capture an image, but now with more than 1M shillings in my pocket (not a great sum to North Americans, but several years’ salary to most Ugandans) I feel suddenly wary and hesitant to have the distraction of a camera held up to my eye.  Please understand, there is nothing in the behaviour of any locals that makes me feel the least threatened or in peril, and it makes no sense, since I have no more money than when it was US$ bills in my pocket, but the concept of > 1M cash in any currency on my person seems daunting.  Fortunately, it is only a short walk to the wholesale pharmacy.

two Kampala residents are happy to have the muzumbu snap their picture

The pharmacy is a lively storefront operation run by East Indian pharmacists, one of whom is able to provide a price list per unit of almost all the 15 or 20 items on Rose’s shopping list off the top of his head.  It amazes me that one can purchase Amoxicillin, Ceftriaxone, epi-pens, malaria treatment meds and injectable diazepam without a doctor’s prescription or proof of attachment to a recognized medical centre.  We pay the equivalent of a two-or 3-month supply of birth control pills in Canada, for enough sophisticated meds to stock the clinic for a good year or so.  When we discover they carry the newer type of blood droplet quick malaria test kits, I am happy to double up and obtain 50 kits, probably enough to last Rose a couple of years.

By this time quite hot and thirsty, we find a little café where the waitress does not hesitate to seat us at a table occupied by a single young woman, who takes it all in stride.  While we sip our beverages (Fanta for Rose & the kids, Mountain Dew for this caffeine-starved jet-lagged soul), a street vendor wonders in and tempts me with a kid’s stand-up face mirror.  I have held off shaving until today, mostly due to my natural resentment of the need to shave, but also using the excuse of the lack of a mirror in Victoria’s guest bathroom.  Not sure how those female college interns from the US managed, but I guess they all have make-up mirrors carried 24/7.  Anyhow, heading out to the HIV clinic and a pharmacy outlet as a representative of Ontario’s medical profession, I felt the need to take razor to skin this morning, using only my reflection in the glass cabinet door and cursing the dim light resulting from another untimely power outage.  So, when Alicia rolls her eyes and pleads that I not embarrass her by purchasing the “hello Kitty” mirror, I remind her that it was she who had teased me about the few straggly patches of missed beard on my visage earlier today.  Of course, the first vendor’s success brought a slow stream of follow-up calls, offering various wares but none of which carry the same immediate utility as my newest possession.
 

Refreshed and emboldened, I ask Rose if we can find a shop to purchase some balls for the kids at BKU.  Loving soccer myself, I brought two good quality soccer balls which I deflated for transport.  Unfortunately, I must have damaged the bladder of the kid-size ball, so only one functional ball was available for the enthusiastic attention of all the kids.  I think I would like to pick up a dozen or so balls of different varieties, but we have no luck finding anything in the downtown market after a couple of little circuits, so we decide to head to the minibus stand.  I do find a street vendor with a few overpriced cheap rubbery balls on the edge of the stand, so I grudgingly purchase 4 balls to bring back to BKU.

A sea of minibus taxis at the stand

The minibus stand is a large cul-de-sac with an impossible number of vehicles all crammed together, facing every which direction, and mostly standing still, often honking.  Somehow Rose finds the line headed towards Entebbe, and we secure the back row seat with windows that pull open.  We sit in the heat for some time while the driver and conductor load foam mattresses and trunks onto the roof of the vehicle, then finally edge out into the crawling traffic.

We do manage to Skype Susan (my wife & Alicia’s Mom) in Florida where she is visiting her own Mom, although the connection is a bit poor for the video feed.  Alicia is doing incredibly well, given her extreme closeness to Sue, the distance and the culture shock.  She is maturing into a kind, thoughtful and considerate young woman.  I email a “happy birthday” to Sarah, my middle daughter.  She hasn’t shown as online when I’ve looked on Skype, but hoping we can schedule a connection, mindful of the 11-hour time difference between Entebbe & Vancouver.

I am pleased to see Isaiah eat a full plate of food when we return to BKU.  Victoria ends her day by singing prayers with a few of the older children in the kitchen.  I find it very moving.  She then offers a spoken thanksgiving and prayers for blessings – not sure if she prays this part in English for my benefit – but I am rather surprised to hear her ask the Lord to consider whether Isaiah’s grandmother might see fit that he could receive better care at BKU.  This saint of a lady has such an incredibly big heart that she would willingly take him in if she thought he could fare a little better, knowing full well how terribly stretched her resources are with the number of kids now under her care.  Hers is a capacity for love and a generosity of spirit that is one in a million, or probably even less common.

Day 2

So hard to believe it’s been only 48 hours since we pushed our bags out of the small Entebbe airport doors and scanned the many faces and signs for those of our host.  We have seen and experienced such a multitude of new things and discovered a world both wonderfully and tragically foreign to that we know.

Monday is a school day.  Alicia is already up long before 7:30 am when she has the pleasure of watching the children in their various coloured school uniforms leave for their studies.  Victoria hires a motorcycle taxi (boda boda), whose driver she has carefully and personally screened for safety & caution despite her own morbid fear of riding on motorbikes.  This driver picks up the youngest children to transport them to & from school.  The rest of the kids walk.  “Mama” dreams of purchasing a boda boda, renting it to a driver to give her a weekly income and save on the cost of school transport. 

 

Once I drag my bones out of bed and endure another cold shower, Victoria leads us on a walk to the supermarket.  Alicia pointed out to me that the contraption on the shower wall is a water heater controlled by a switch outside the bathroom, so warm showers are a possibility, provided hydro is working and I remember to flip the switch 20 minutes before bathing.  BKU is on a dirt road in a small township named Kisubi on the edge of Entebbe.  We walk perhaps 1.5 km back towards the main road, frequently moving out of the way for cattle herds, trucks, vans and boda boda who vie for paths around the deep potholes and valleys.  The journey requires enough caution to fear for the safety of the younger schoolkids.  Folks working outside their small shacks or tending vending stalls tend to take a long glance at the “muzungu” (white folk), but usually respond with a friendly “hi” or wave when spoken to.  The children invariably stare openly at us, and shout and wave when we acknowledge them.

Dodging traffic

Bananas stacked at a shop

The supermarket is the size of a moderately large convenience store back home.  Alicia finds the drinking water and milk at the home quite unpalatable, so we pick up some bottled water and Coke for her.   Jam, pasta noodles, a bag of flour, a bottle of wine, some unfamiliar snack chips, 3 newspapers, and a couple of other small items difficult to identify were all to be had for $64000 Ugandan Shillings, for which I traded about $30 USD at the expensive airport foreign exchange.  Inexpensive to us, but terribly dear for a local worker who may be paid $2600 shillings for a day’s work chopping rock for bricks in the hot equatorial sun.  Hence the need for the young man with the rifle sitting outside the supermarket and the many staff, one of whom accompanies us on our rounds through the aisles and carries our basket.

Alicia finds a furry leopard skinned bottle of liqueur which I have to promise to buy from duty free for the trip home.

Victoria purchases 3 pairs of “Croc” type sandals from a vendor on the return journey, replacements for a few children whose footwear is excessively worn.

The last leg of our flight here stopped at Kigali, Rwanda where we lounged on the craft for 45 minutes while passengers disembarked & new ones boarded, headed back to Brussels.  The young man sitting beside me for the last short bit of our journey is a teacher from the UK.  He planned to volunteer for two years training teachers in rural Rwanda, but gave up after 6 months.  The local teachers spoke enough English that he felt he was accomplishing something in his chosen mission, but he found the isolation imposed by the language barrier became unbearable after a while.  Apparently the Rwandan language is terribly complex, and after six months he still could manage no more than a few phrases and superficial greetings, so he had no one with which to converse from the time he returned to his lodgings until the next work morning.  Fortunately for us, one can get by quite comfortably using English in Uganda.

This fellow repeated something I’d heard from another African visitor: the smells are something that will assault your senses and which you may not have expected.  Truly, the road from BKU to the supermarket provides a riot of stimulation to all senses, and smell is not the least of those.  From the ubiquitous wood-burning cooking facilities, to diesel fumes, fresh cattle dung, luxurious vegetation and the occasional throng of humanity, one cannot fail to realize “this is not Kansas, Toto”.  I find it more interesting than unpleasant, but Alicia, who has a vivid sense of smell and hearing, struggles a little more at times, I think.

Once re-hydrated upon our return, we have a little ceremonial presentation of our donated supplies to the clinic and I meet nurse Rosemary.  There is a photo op, of course, and I sit down to review the clinic supplies and needs, some of the screening and preventative care she is currently undertaking, and what assessments and treatment she is allowed to perform.  Her scope of practice is closer to that of a nurse practitioner back home.  Rose is allowed to diagnose illnesses and prescribe and administer medications.  She has some quantity of antibiotics and dressings on hand, but will require more.  An otoscope would appear to be highly desirable.  I ask her to make a list, and we will visit a pharmacy warehouse shop tomorrow when we accompany Isaiah to the HIV clinic in Kampala.

Nurse Rose is pleased with our cache of supplies

This is the clinic building and workers busy completing the second floor.

One of Victoria’s relatives arrives to consult with me in the afternoon.  This elderly (and elegant) lady has been plagued with pain in her left thigh and knee for many months, and lately is feeling the pain in her right leg.  She saw an orthopaedic specialist in the city, was advised the source of the problem was a spinal disorder which I didn’t quite understand in the translation, and she was given some medication and advised to get a firmer bed, which does not seem to have helped much.  I do not find much physical evidence of spinal disease, and her hips and knees have surprisingly good pain-free range of motion, so I have nothing to add to what she had been advised.  She plans to return tomorrow with her X-rays and the name of her medication, which may provide more clues.

An unfamiliar quiet descends on BKU during the school day.  Ten month-old Don and busy toddler Arnold keep us on our toes when they are not napping, but mostly the staff has a welcome chance to rest and catch up on chores that have been waiting, such as hand laundry.  Still suffering jet lag, I take the opportunity to nap for an hour.

Alicia & Sister Immaculate watch over Don

Alicia works on the evening meal while I sleep

At 10 months of age, Don is the youngest BKU kid

Victoria and Sister busy in the kitchen

In the later afternoon, Sister Immaculate takes Alicia and I on a walk in the other direction from the supermarket.  We pass Banana Village, a small resort tucked away in the trees that is popular with Caucasian visitors who head out from there on tourist or business sorties.  Also a quarry where the red rock is hacked out by hand and shaped into bricks.

Our destination is a satellite property of BKU that houses two small barracks, a cookhouse, outdoor washrooms and gardens growing cassava, maize and sweet potatoes.  It is situated on a hillside overlooking a picturesque river and marsh.  We wave and smiled in response to the many lively shouts of “muzungu” from the residents we see on our return walk, and our ears are treated to the strains of evening prayers from a local mosque.

Sister Immaculate leads me on the path to the older kids' compound

All the children’s sleeping quarters are crowded, often six or more to a room and sometimes children sharing beds.  With the numbers of those in care continually growing, there is certainly a need for more accommodations.

The boys at play outside the kitchen hut

One room of the boys' quarters

one room of the older girls' dorm

View of the older kids' compound from the girls' dorm

Janat

Justine

Janat, Olivia & Vicky

The older girls pose with their "Auntie" Matron

Vegetable garden (foreground) and boys' dorm behind

This evening Alicia & I are amused to speak with Richard, one of the older boys, and educate him about Canada.  The concepts of four seasons, snow, leaves changing colour, maple syrup harvesting and McDonalds are all completely foreign to him.  It is fun to bring up Google images to show him what we were speaking about.  Even Victoria, who has traveled to the USA and Israel, has not experienced maple syrup, so we will need to ensure some future visitor brings a sample.