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Tuesday 15th October 2019

The second day of the primary trauma course today. Everybody turned up, and things got underway remarkably promptly. Scenarios went well, lots of interaction from the participants. An excellent talk from Sean one of the course participants who is also the university disaster management lead. So many ideas and so much excitement about what this course could lead to.

Professor Moro came down from Gulu to support the course, he has led the course in Gulu so represents important local support.

Professor Jasper who is the vice chancellor of the university, and is an incredibly wise, calm and awe inspiring person. He gave an inspirational speech at the end and highlighted the significance of this inaugural internationally recognised course at Lira University. His vision is for Lira University to be a centre of excellence and this feels like a massive step in the right direction.

I spent the morning at the Regional Referral hospital on the female medical ward. There were 18 nursing students, from 4 different nursing schools on the ward. I offered to do some teaching on the wards, and ended up trying to teach 20 of them around one bed space-they were so enthusiastic. Good baseline knowledge but getting them to link their theoretically knowledge with what they see in practice is still tricky. There is such a steep hierarchy here that no one really challenges anyone else if they are “ above them” in the chain of command as such.

After 2 hours bed side teaching I left them to get on with their morning duties and headed over to find medical outpatients. Am still trying to get myself an overall picture of how the medical system works here. Outpatients is crazy busy. Multiple clinics waiting in the same room.

I went to the weekly hypertension clinic which sees about 100 patients in a morning. It is run by the interns who are f1 equivalents. With heavy supervision from the outpatients sister- who seems to know everything and speak all Ugandan languages.

In my hour there I saw a puerperal sepsis and a 26year old with a pulse of 26. No ecg available and her “notes “ implied that she was known to have 3rd degree heart block and right ventricular hypertrophy. Her atenolol and carvedilol combinations seemed a tad excessive and she was feeling quite exhausted. She stopped her carvedilol and is coming back in two weeks time!!!!!

The patients are expected to come with a hard backed note book which is works as their notes and also prescription. The doctor writes the plan and if the pharmacy has the drugs in stock they are ticked and bought there but if not then they must go and find the drugs in a pharmacy in town. A date is given for their return but no time and it is also open access for any hypertension patients as well.

A long day for the PTC team, who got home only to be greeted with the news that there was no running water in the hotel………. so a beer substituted a shower and we headed of en masse for dinner.

Only 3 days left!!! Still need to get the second side of the drug chart introduced at the university hospital, can’t present it at the hospital grand round as it is cancelled as the PTC is in the board room. Will need to make a plan b!!!

Freyja



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