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Report Lira Uganda Objectives and Findings Physio Sandy Lynn

Lira Uganda Objectives and Findings
A report for a two week visit to Lira University and Lira Referral Hospital.

Objectives

  1. To establish a link with the CP clinic to determine any needs that they have for future visits.
  2. To discover what manual handling techniques are taught and used in the hospital and university and teach the students and nurses appropriate manual handling techniques as required.
  3. To reinforce the dangers of bedrest and encourage a ‘why can’t we get them out of bed’ philosophy to the nursing staff.
  4. To test the haemoglobin levels of patients pre and post C-Section

After a slow start to being in Lira and trying to find a place on the wards things took off. The first stumbling block was that there was 1 nurse per ward with 20 students and 27 patients to look after. The majority of the students were not proactive and standing or sitting about waiting to be told what to do. The nurses and students did very little hands on with patients as this was left to the family.

When patients were transfers from one bed to another or moved up the bed by the student nurses they were generally picked up and moved by 3 or 4 students using poor posture, even a patient with a C2 fracture.

2: I spent a lot of my time on the wards training the students how to use the tarp they put under patients as a slide sheet. How to log roll a patient, the importance of supporting limbs of a stroke patient with a dense hemiplegia. Unfortunately the lecture for the Lira University students did not happen due to confusion by the lecturers about timings and the students not being made aware it was happening.

3: On the post C-section ward patients were not expected out of bed for the first 24 hours post operation. I taught the students the importance of early mobilisation and the risks of bed rest. The students were taught LL exercises to teach the patients to help prevent DVTs and thoracic expansion exercises to help prevent any chest infections and I watched on with pride as the students taught these to the patients.
1: Each Tuesday and Thursday I visited the CP clinic based in a small room in a mental health facility. This service was run by a Ugandan OT. She saw patients on a Tuesday and performed stretches and muscle rubs for the patients and taught the parents how to do this at home. On the Thursdays she made specialist seating for the patients out of cardboard and newspaper from the hospital and wheat flour and water for glue. These were then painted. The parents were taught how to do this so that they could make new ones one the patient had outgrown their first one. The parents were provided with cardboard and newspaper to do this. There was another OT who performed home visits to the children who were issued equipment to ensure that they were suitable and no further adaptations were needed. Furthermore she taught the residents of the mental health facility how to make stools, trays and bins in a similar fashion so they could sell them to make money to buy their medications.

4: Unfortunately I was unable to complete this task and it has been handed over to a Ugandan anaesthetist to carry out.

Overall I feel this was a very successful visit and was pleased with the achievements. It will be very interesting to see if any of the manual handling and bed exercises are continued when I next return.

On my next visit I will come armed with large posters to place on the walls about manual handling and post-operative bed exercises and the importance of early mobilisation. I will also look to start a teaching session in the hospital for the students to attend to teach them the basics of manual handling with a certificate for them if they come (as this seems to be very important to them).

I will also hopefully continue to develop my link with the CP clinic and bring along either a paediatric or neuro physio as I feel that their skills will be very useful on the wards and in the clinic.

Sandy Lynn
Physiotherapist Poole Africa Link



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