stabilisers off….

In a few days, our support system will change. Since we arrived, Zish has been here to look out for us. Zish is a GP from the UK, who spent a year here until September this year with his wife and his two young children. He has shown me ropes in the hospital, given limitless practical advice about essentials such as accessing the internet, and money. He has provided us with a car, and a house ready stocked with the puzzles, children’s books and lego left behind by his own children when they were here. We have been supremely fortunate. For me, the clinical calibration has been the most helpful. When is someone sick enough to need a lumbar puncture? What is the dose for ceftriaxone? What tests can we do in the lab? What is realistic to expect on the wards – can we expect observations on sick patients to be done every four hours?

We’ve also had Marian and Ceri as well. Marian is the RCGP’s lead on adolescent health. She has been coming to the hospital twice a year for the last couple of years to support the hospital’s project called USHAPE. USHAPE is a family planning training progamme based here in Bwindi, funded by the Margaret Pyke trust. USHAPE encourages a ‘whole institution approach’ to family planning. The idea that family planning is integrated into all parts of the hospital provision (so for example, ladies can’t be discharged from hospital without a check that their contraceptive needs are being met.) In this area, women have an average of 6 children, and on average, don’t want more than four. There is a very young average age of first pregnancy, and getting pregnant whilst still of school age puts both the new mum and the baby at significant future financial and social disadvantage. Hence the need for family planning. Anyway, Marian’s particular focus has been the development of Youth Friendly services in the hospital, something I hope to become involved in . But more of that later. Marian has been more than kind. She has listened, provided support, thoughtful reflection and child care (!) during our brief time together.

Ceri was the doctor from the UK doing my current role a few years ago. She stayed for two years and remains actively involved in the work of the hospital, through a UK charity she and other previous volunteers have set up called REACH Bwindi https://reachbwindi.com/blog/ She has also been here to support USHAPE. She has deeply established relationships with many of the staff and a strong and realistic understanding of how the hospital works. And she has been happy and generous in sharing those with me and a huge support also. And after all, it is all her fault that I am here. It was by finding her blog on the internet that I first knew about the  hospital.

Marian and Ceri will be leaving this week also. I’ve had gloomy moments, feeling overwhelmed about how I will cope with the clinical demands mostly, when it all still feels so new. But I have to learn to stand on my own two feet and I have really warmhearted and generous Ugandan colleagues to turn to for advice, and Brian and the girls at home…. Let’s see how this week goes!