A typical day

(Ellen's home)

Ellen lives on a hill several miles from the middle of the city. It is a nice home with running water and electricity half the time--a lot nicer than we were used to in Kenya. Traffic in Kampala is crazy, so it takes a while to get to the “Better Living Resource Center” which was set up by the church in Kampala. Behind the grounds is a crate that’s been converted into a clinic. Medical records consist of a notecard with a name, estimated date of birth, the date they are seen and what they are treated for. Documentation is obviously not as big of a deal. Ellen makes the diagnosis mostly by taking a thorough history and basic exams. Her drug cabinet is mostly antibiotics, pain killers, asthma medicine, antifungals, anti-malaria meds, antacids and vitamins and ect. Our special tests include urine dips, using a fetoscope for pregnant women, and, well, that's about it. We have to refer out for malaria blood smears, X-rays, ect. Drugs are given out without payment to those she sees. It seems that many are lost in the shuffle. Even though the hospitals are apparently free, patients are often pushed for a bribe (because the government doctors don't get paid by the government and have to get money from bribes) or get lost in the shuffle. One patient from the village had osteomyelitis for 15 years. He had a gaping wound and come to Kampala for treatment. Ellen has referred him to the hospital repeatedly because it now requires amputation; however, we’re not sure why he hasn’t gone yet.

Most patients are members of the church. There is a large refugee population. I thought it was interesting that she also had a stock of antidepressants. Many refugees have been through so much trauma that they suffer Post-traumatic Stress Syndrome. Ellen gets them involved in the church’s bible study groups, and amytriptilene has a sedative side effect so it helps them get some sleep.

Patients are seen daily, with Ellen’s only day off on Monday. A lot of time is also spent ordering medicines and taking care of church business—and answering all my questions! I come home and do a lot of reading. Ellen has a small library of books on infectious diseases that I pour through. My favorite one is the book on African dermatology. I fall asleep looking at pictures of nasty skin lesions. I miss visiting homes, so at least once a week I try to stay the night with someone from the church. This past Monday I had a really good time staying with some girls who live in a nice slum near the clinic. They took me to a "Gospel Club" where we got to do some dancing. They were great and I can't imagine coming here without experiences like those.

Tomorrow we'll visit an Orthopedic hospital, one of the odd jobs for Ellen. Then, in about a week, two doctors and some others from Texas are coming for a medical mission in the Jinja and Ft. Portal areas. Patients will walk miles to be seen and spend the whole day waiting. We will see as many patients a day as possible. Today was spent getting medicines, going over the formulary, and getting acquainted with the African names of antibiotics.

This weekend Ellen is going with a team to do a survey of the north for a church plant, so I’ll take off to visit my old school in Kenya and do lectures and give out medicines there. I was able to purchase a stockpile to take them for only 20 USD. Visiting my old students and home will the highlight of my stay here.