REPORT LIRA APRIL 2026 – Antoinette McAulay

LOGISTICS

PREPARING FOR OUR VISIT 

Gary Cumberbatch led the team and arranged two planning meetings before the trip. Julia Hall and I had an additional meeting to plan paediatric teaching.

We liaised with staff at the hospital and University. I was able to arrange flights via Trailfinders and dollars for the trip. We arranged to bring small items of equipment as requested by Dr Florence, Consultant Paediatrician. I also loaned a resuscitation infant for teaching (as water filled models are not so easy to use in the referral hospital).

TRANSPORT

Flights to and from Entebbe were on time. The return journey however was long and tiring due to flight times

Our driver Arnold looked after us extremely well during the entire visit. We had safe journeys to and from Lira. There has been a marked improvement in the journey as virtually all roads to Lira are now tarred

HOTEL

We stayed at the familiar Hotel Kanberra. Our accommodation was clean and comfortable as usual. Apart from Bonnie, all staff were new, but were extremely helpful. The new chef produced high quality food! We all paid for laundry service midway through the visit which was very helpful.

ORIENTATION  

On the first day we had a planning meeting at the University with Joel, a lecturer (who was our coordinator instead of Samson Udho), Felista (Lead for Midwifery) and Brenda (Nursing lead) to discuss a timetable for teaching over the next two weeks. We also met Anna Grace (Dean) and Arach Anna Agnes (Deputy Dean). 

Joel gave us a tour of the hospital and faculty buildings, and arranged for us to meet Prof Tom Okello (lead for medical school) and Dr Frances Olwa (Dean of medical school) and also Prof Okaka Dokotum the deputy vice chancellor of the University

In the afternoon we visited Lira Regional Referral Hospital (LRRH). We met Dr William (deputy Medical Director and consultant paediatrician) and the new Director of Nursing, and had a tour including neonatal Unit, paediatric ward and the Emergency Department. There are continuing improvements in facilities. In particular there is now piped oxygen in all areas. The neonatal unit is in new premises and now has 12 CPAP machines (of varying complexity) and syringe pumps to deliver IV fluids

A SUMMARY OF MY TEACHING RECORD 

PERSONAL REFLECTION

This is my eighth and final visit to Lira with Poole Africa Link. Each time that I visit I can see improvements both at the University and LRRH. As a team we had a wonderful welcome on both sites and enthusiasm for our teaching. We were invited to lead the CME meetings both weeks at the University hospital and also for the paediatric and emergency departments at the referral hospital.

We were able to tailor our teaching to the requests from the host teams. In particular we were requested to do teaching on birth asphyxia and to try and teach as many clinical staff as we could on neonatal resuscitation. Following a paediatric meeting where a child with a convulsion was discussed, I was asked and gave a talk at the paediatric CME meeting on coma and convulsions. We also prepared draft posters for the delivery suite to alert staff which deliveries required paediatric input after discussion at the perinatal mortality meeting. These still need to be ratified by senior staff, contact details added. I have also been asked to draft guidelines for DKA management for the University paediatric department.

The Children’s ward at LRRH continues to be exceptionally busy. Ward rounds were mainly carried out by Interns, with one supervising permanent doctor (Dr Jimmy). Dr Florence was on annual leave but came back to help with a PDA camp (team from Kampala cardiac institute). Dr Juliet (consultant paediatrician) is currently undertaking a further Masters qualification in neonatology. Nursing staff are still mainly student nurses and volunteers. We spent less time doing ward rounds than previously this year, but I was delighted to see observations recorded on all patients prior to the ward round on one morning. The NICU had very dedicated nursing staff who alongside Dr Florence have a vision of progressing the unit to a level 3, with ventilation facility.

All patients are now recorded on computer and there are computerised patient notes that contain drug chart, observation chart and laboratory results. I met a data entry clerk on a couple of occasions but still patient held notebooks are being predominately used and transfer of information to the computerised system is scanty.

As always it was so sad to see the lack of resources affecting patient care. For instance, a child with Fallot’s tetralogy; whose parents were unable to afford either the journey or hospital costs for the cardiac surgery. As on previous years we saw children who had had village tonsillectomies and skin cuts over their abdomens, carried out before coming to LRRH. We heard the case history of a child who had died following such a tonsillectomy.

We took out small pieces of equipment for the children’s ward and NICU including feeding cups, saturation monitors, thermometers, nasogastric tubes and bag and masks. We also gave a large bag of knitted baby goods, made by a Dorset lady. These were formally presented to Dr Williams and Sr Sarah and much appreciated.

The senior sister on NICU requested to keep the resuscitation doll for staff training. Following agreement from staff at Poole hospital we presented this, with resuscitation equipment and teaching resources, to the NICU on our last day. We also delivered laminated resuscitation guides to the delivery suits.

The team were a cohesive and supportive group, ably led by Gary Cumberbatch. I was happy to be able to support him as this is only his second visit to Lira and first time to lead. Three of us did have a bout of gastroenteritis, but fortunately this did not significantly impact our teaching. Overall, I felt we had made a useful contribution and this was a very rewarding teaching visit.

Antoinette McAulay

April 2026