Cape Town, South Africa

We ended up buying some last minute plane tickets to Cape Town, South Africa following our trip to Zanzibar. We flew in on the 19th of January with a layover in Johannesburg. Maiken met us at the Cape Town airport and we decided to rent a car for the week…a tiny little Hyundai. Ann did all the driving and conquered the whole driving on the wrong side of the road using your left hand to shift thing. We all stayed at the Ashanti Lodge Gardens hostel, which was a nice hostel...although our room was right next to where everyone hung out at night making it difficult to fall asleep. We got settled in and went out to Long Street for dinner and drinks with Justin, who had been in Cape Town working a number of months at a few hospitals. Long St. is very much like Haight St. in San Francisco with lots of bars and interesting places to eat. Not as many head shops, but that’s California for you. Had probably the best burgers since we came to Africa at the Royale Eatery. Afterwards we went to the Dubliner and listened to a brother/sister combo perform covers of American music. I was amazed at this Westernized version of Africa. Cape Town is unlike anything I have seen in Africa (admittedly I haven't seen that much)and it felt like we had gone back to the states or maybe Europe.


It's got a hemi.

We went to the Victoria & Alfred Waterfront our first full day in the city. It’s a functioning port and there were plenty of ships around, however the area with the tourists is full of tour boats including a sweet replica of a pirate ship. We had some very good sushi at Wang Thai…another first in Africa. Unfortunately we were unable to take the ferry to Robben Island, the location of Nelson Mandela’s prison, as it was booked. Had some nice steaks at Nelson’s Eye, an old steakhouse which was conveniently a half a block from our hostel. Ann finally got some of her beloved crème brulee for dessert. It wasn't as good as we've had before, although it's something that we haven’t seen in a while.

The next day consisted of a wine tour to four wineries around Stellenbosch and Paarl in the heart of wine country, just east of Cape Town. The first was Fairview which had wine and cheese tasting. Good cheese is nearly impossible to find in sub-saharan Africa and that was possibly more delicious than the wine! For lunch we stopped at a winery with a restaurant and had some bibooti(sp?), a traditional Afrikaans dish. Also went to Solms, Tokara, and Villiera. At Villiera we were treated to some sparkling wine opened with a sword. Ann and I bought 7 bottles total, 5 of which we took back to Kampala. Also bought some cheese (garlic-parsley camembert and sun dried tomato chevin). Went to Tank in the Cape Quarter for dinner. We both had sushi again…mine was good, however I don’t think Ann was too impressed.


Wine country...


Sleep it off...

The 22nd of January marks the day Ann cut her hair, removing over a foot of length! It was quite a drastic change, but I love it. I almost forget that it used to be much longer. Made our way south to the Cape of Good Hope and Cape Point. Along the way we stopped to eat in Hout Bay at Mariner’s Wharf, which had some great seafood and shockingly good bread. I was introduced to the Grapetiser, a sparkling grape juice. I proceeded to drink these the rest of my time in South Africa. The drive south from Cape Town is quite beautiful. You’re basically driving on the side of the mountains following the coast to the southern most point of the peninsula. We stopped in Simonstown to see the penguins at Boulder Beach. Penguins are strange creatures and quite hilarious. Most of the time they stood there with their eyes closed and beaks open pointing upwards. When they would walk around I could hardly keep from laughing. A few were playing in the water and many were keeping their babies warm. For dinner we went to the the place Justin was staying (Ivor and Shifra, some of Justin’s family) for Shabat dinner. I even got to wear a yamukah. Since we had meat, there were no dairly products, however we had a non-dairy ice cream. It was surprisingly good.


Hout Bay


Absolutely no shaking hands with the penguins.


They used to be called jackass penguins...


...but that hurt their feelings. Please refer to them as African penguins.


You can see the road we were driving...


Random view heading south towards Cape Point.

The following day involved an early morning hike up Table mountain. It was a steep hike up large stone steps, like the ultimate stairmaster workout. Maiken and Ann handled it much better than I did…probably because I’m in much better shape than those two. Or maybe it’s the other way around. We took the cable car down, which was a quick 2 minutes compared to our 1.5 hour hike. Ann and I moved to a nice room in a different building, so the following nights allowed for much easier sleep than right next to the pool in our previous room. We drove to Camps Bay to enjoy Clifton 4th beach. It was very warm out and the water looked so nice. A few people were enjoying diving into the large waves breaking at the beach. Unfortunately, the best we could do was to put our feet in the water...once we did they instantly went numb. The ocean current in Cape Town comes directly from Antarctica, so it’s a tad bit like an ice bath. Saw a lawn bowling club near the beach with a bunch of old, white men in funny uniforms (goofy hats, polos and white trousers) rolling a ball towards other balls. That night we met a friend of a friend for dinner and jazz at the Rainbow Room. Before the show the host gave our group of medical professionals from America a shout out, which was cool and embarrassing. A group of teens from a local school performed first followed by Abigail Peterson, who was a wonderful singer/pianist. We had a good time, but were kind of falling asleep by the end. Apparently we're reaching that age...


On top of Table Mountain.


Cape Town from the top of Table Mountain.


Look at those athletes giving it their all.

The next day Ann and Maiken went for a 10 mile run along the coast and they say it was quite beautiful. We spent the day with Maiken and Justin at Canal Walk, a large shopping mall in a suburb. It was one of the nicer malls I’ve been in. The food court was very interesting with a large selection of things I’ve never seen before and of course McDonald’s and KFC, where everyone seemed to be eating. Had some tasty beef shwarma at a falafel place. When you ordered your meal they hit a button indicating what kind of meat the cooks should prepare…justin ordered the lamb and I had the beef. We both enjoyed the silly baaaa and mooooo recordings for our respective meats. Not sure if others see the humor in that, but we do. After searching all over Africa Ann finally was able to find a pair of basketball shoes. She has been practicing with her team, and their season starts in March. I’m excited to see her out there…I think she’ll be the only white person in the entire league, so she’ll probably have her own fan club! Of course I’ll be president. That night we ate at Arnold's, where I had the game platter containing an ostrich fillet, oryx fillet, crocodile ribs and warthog ribs. The oryx and warthog were especially good. Crocodile is a novelty, but not anything special. We then went to see Goldfish, a musical duo from Cape Town, who play a club night every Sunday at the same place right near the beach we had been to. It was packed and the indoor area was roasting. Luckily we were able to secure a nice spot at a table which allowed us to drink our illegally brought in box of wine. Nothing says classy like sneaking in a box of wine and drinking it with styrofoam cups.


Staying classy.


Dinner at Arnolds's.

The following day we flew back to Entebbe. It was a difficult transition as we both seemed to be a little homesick after being in a city so much like what we are used to back home. Although we're halfway through our time here...I imagine the rest of the time will fly by.

The past few weeks our two bosses from the U of Mn have been here along with the deans of our medical school and the school of public health and other high ranking officials from the U of Mn, so we’ve been involved in a few meetings and meals talking to the officials about our experience here. They’re exploring their connection with Makerere University and the IDI to see how it can be more significant. It was kind of fun to be ambassadors of a sort. Ann has started work on her public health certificate from the U of Mn. Between that, basketball, work and socializing she is quite busy. I don’t know how she does it, but she’s probably the most motivated person I know so I’m not surprised that she does!

We were dreaming of a White Christmas...

But all we had was this...

Sailboat on the Indian Ocean, on our journey to Stone Town, Zanzibar from Dar Es Salaam.

We spent 3 fun days in Dar courtesy of our friend Imee Cambronero. Imee recently finished her Masters in Public Health and is on a fellowship with the Centers for Disease Control (CDC) in Dar Es Salaam. We have known each other since our undergrad days working for Upward Bound. She has an amazing apartment on Masaki Peninsula in the north. We went out for good food, including Korean and Ethiopian, did some shopping and exploring, and lots of relaxing on her balcony and by the pool. Imee and I also attended an oceanside yoga class at the Golden Tulip. I could do that everyday - with the waves crashing below us and a nice Indian Ocean breeze coming in...

View from the Tower Top Restaurant (aka 236 Hurumzi, aka Emerson and Green), second highest point in Stone Town and a great place to relax with a biri biridi or G&T.

Just outside Fordhani Gardens, where you can get fresh seafood and Zanzibari pizza every night at the market, and where we had our Christmas Eve dinner.

On our spice tour with all of our accessories

In the past, spices were Zanzibar's largest export. There is still a large amount of cloves exported, but many others are grown for local use. The farm we visited was used mostly for education and sold spices to the tourists who came through. We saw all kinds of raw spices - turmeric, ginger, clove, nutmeg and mace (same plant), vanilla beans, cinnamon, peppercorn, lemongrass, and many more. Along the way, we were adorned with necklaces, bracelets, rings, ties, hats, and bags made from the long grass. We tried a variety of local fruits and then off to lunch, followed by a visit to a slave cave and some time on the beach. The cave was used by slave traders after the British abolished slavery in their colonies. The traders would hide the slaves in the cave until there were enough to march out to a waiting ship via a tunnel connecting the cave to the sea.

Fishermen cleaning their nets

Brandon, Christine, Grant, Ann, Katie, Ryan, Maiken and Phil on Christmas Day

After coming back from our spice tour, we met up with classmates and friends from MN. Katie, Maiken and Christine are working at Selian Hospital in Arusha, Tanzania and "Professor Brandon" is teaching at a university there. Ryan and Phil came from the frigid homeland, and with Katie and Maiken, had already gone on safari and climbed Kilimanjaro before meeting us in Stone Town on Christmas Eve.

The entire island had been without power for a few weeks before we arrived, and our accomodations in Stone Town, The Karibu Inn, did not run their generator at night. This made for rough sleeping conditions, but encouraged us to get up early everyday, and we started off Christmas Day with a run through town and along the beach. After breakfast and cleaning up we were ready to head to Jambiani when Maiken and Phil came down with exciting news - they were engaged!

Since we had so much to celebrate, we went in search of a dinner venue as soon as we arrived at the Visitors Inn on the Southeast coast in the village of Jambiani. We all shared an amazing meal of salads, soup, fish, lobster, beef, and apple pie with a few bottles of champagne and wine to wash it all down.

View from my oceanside lounge chair in Jambiani

We spent most of the next five days lounging on various hammocks and beach chairs reading, eating, and chatting. It was so nice to catch up, exchange stories, and compare our experiences in East Africa. Once in a while we got motivated and went snorkeling and sailing, or walked up and down the beach, I even played in a very sad game of beach volleyball one day.

Kizimkazi Music Festival

Sadly, we said goodbye to Ryan and Phil on Dec 28 as they began the 24+ hours of travel back to MN and the rest of us had to settle for the white sand beaches of Zanzibar. The next day was the kickoff to a music festival on the southwestern coast of the island in Kizimkazi. We got there early and played poker during all the sound checks, and Grant and Brandon were very patient with us ladies as we pondered whether to check or raise, by rocks and bottlecaps. Then came the good ol' college drinking games - a little P&A, some hockey - and a case each of Redd's and Savannah. We ended the night dancing in front of the stage to a Swedish band called Clockwise and some local bands before catching a ride back to our bungalows.

After 5 days in Jambiani, we packed our bags and moved 6 km up the beach to Paje and stayed at the Paradise Beach Bungalows. Paje is a slightly larger community and even though it was so close, the beach was nicer. We spent a couple nights here, including New Years Eve.

The ladies, Grant, and a Full Moon for NYE

(Brandon is behind the camera)

We had a big buffet dinner at Paradise Beach for NYE, including seafood, salads, sushi, skewers, and a couple fresh barracuda on the grill and then sat on the beach before heading out to find a party. We eventually found some loud music and settled in the ring in 2010. It was a little anticlimactic and it seemed we were forcing ourselves to stay awake, when the DJ announced "okay 3 minutes, 5-7, 5-8, 5-9, Happy New Year" and then went back to the music. There were some fireworks up and down the beach, and then we called it a night.

Sunrise, New Years Day 2010

The New Year came with a beautiful sunrise, but also some GI distress. Five of six got ill at some point that day and poor Brandon got it first and the worst. We got a ride to Stone Town and said goodbye to the Arusha crew as we headed up for a few more days in Nungwi, on the northern tip of the island. I would have to say, though, if I had to be sick somewhere, it was a good place to be.

Nungwi Village Beach Resort

Grant and I decided to splurge on our last few nights in Zanzibar and it was well worth it after a week of beautiful, but very hot accomodations. This place ran their generators 24 hours a day, with A/C, TV, internet and very comfortable digs. Nungwi is also a very happening part of the island, next door to Kendwa, and lots of restaurants, bars, and activity going on - although this did mean much more hassling whenever we left the confines of the resort. We did a lot of laying by the pool, and the ocean, and met some fun and interesting people from all over the world with whom we did our fair share of drinking. We also hung out with a friend from Kampala, Rosie, and her boyfriend Owen, who were staying at a resort just down the beach.

This was a great end to an relaxing vacation, and left me well-rested, newly motivated and ready to get some work done back in Kampala.

Okavango pantomime under a mango tree

Grant is off playing poker tonight, so I am enjoying a free night to myself...and figured we are due for a blog post. He is more creative with his posts, but since he is so "busy"...

Over the last couple weeks a lot has been going on between getting a new roommate, sending people off on their holiday travels, good and bad news at work, and experiencing more and more of life here in Uganda.

Rugby - Our new favorite spectator sport, which our friends here have turned us on to. We are learning the rules and getting better at heckling each time we pack into Bubbles for a game. We watched a heated Ireland vs South Africa game after which our SA friends disappeared and the Irish bought multiple rounds of shots for everyone in the bar and displayed some fine Riverdance and obnoxious acapella Irish ballads.

Holiday desertion - The expat community is slowly dwindling as the holidays get closer, and it seems to be the goal to send each one off to the airport hungover, or better yet, still drunk.

We are out with Gareth for a "quiet beer" the night before he flies home to the Kingdom of Dundee for the holidays. This is also the first foray on Bubbles for our new roomie Allison...and her first flaming Sambuca shot, whoops.

Uganda/MN exchange - Just before we left MN, two Ugandan medical students arrived in Mpls to do clinical rotations at Hennepin County Medical Center. Francis and Joseph came over to my house in NE and out to dinner with us in Cedar-Riverside as they settled in. A few weeks ago, they arrived back in Kampala beaming about their experience in MN. We are grateful to our friends for showing them a good time, and for Dr. Stillman for really making their hospital experience worthwhile (Francis does a spot-on impersonation!). They want our experience in Uganda to be just as rewarding, and they took us out for pork last week where we talked at length about some important topics - health care and beer.

Fembots - Grant did mention last time that we went to an Austin Powers party while he played in a poker tourney. But what he missed was the work Miriam and I put in to make those costumes! We went to THE Owino market, Pioneer Mall, and all the shops down by the taxi park to find each piece - from lingerie (trying them on over our clothes), to fuzzy material aka winter hats (explaining "fuzzy" turned out to be harder than we thought), to formal gloves (wedding shop, obviously), to wigs (no blonde to be found), to tinsel and bulk cotton. After relaxing for a minute with an expensive Cherry Coke from Ranchers, we went home and assembled it all. I wish we had pictures of us cutting and sewing and stuffing and turning Miriam's living room into a sweat shop.

Quiz night - Again. Fortunately, we did not win this time. But...interesting questions answered correctly by us:

Where do Panama hats come from?

Ecuador - still reaping royalties of my previous expat life

Which is the only river in Africa that does not eventually reach the sea?

Okavango - our friend Glen just left Kampala for Botswana and left us with this timely little factoid.

Pantomime - Myself, being so well-versed in forms of theatre, had no idea what a pantomime was before arriving at the Kampala Amateur Dramatic Society's holiday play. It turns out that guy sitting behind us, with his lewd comments and actor-bashing, was more informed than I was. When I figured out what was going on, and had time to read a summary of the plot during intermission, the second act made much more sense. A few friends and their children were involved in the production, so a group of us girls went to support and do something different on a Friday night while our male counterparts were at the casino.

Dinner under a mango tree - Our friends Martin and Mar-Louise Maybergh invited Grant and I out to their house in Bugolobi for dinner on Saturday. It was a beautiful night (I think there was a snowstorm in MN that day) to sit in their yard, under a mango tree, with amazing food, cold drinks, and wonderful conversation.

Luganda - This is a hard language to learn - there are 21 verb classes! We had an "exam" last week and realized just how far I have come in the past couple months...

Work update - Someone once told me they could never be a farmer because so much of your livelihood depends on unpredictable factors, like the weather. Well, 'tis the world of research where everything depends on grant funding. The research team Grant and I work with has a few grants pending with various institutions across the globe, all relating to HIV/AIDS patients and Cryptococcal meningitis (a nasty infection that is quite common in our setting). Good news is that we received a perfect score on a grant application to do neurocognitive testing on these patients! Grant is working on developing the exam and materials to be used in testing these patients. Hopefully, he will be able to start seeing patients as early as March! However, the grant application for the project I have been working on, when to start antiretroviral therapy in the same group of patients, did not get as high of a score and will likely not get funding before we are set to leave in June. What this means is that I will still be working on preparing for this trial - developing forms, revising operations manuals, and piloting the process - but I will not be around when it actually starts. Kind of a bummer that I won't be able to do the patient-care part, which is a great learning experience and the part that I really love about clinical research, but now I am able to devote some time to other projects. I want to finish the project I started the first time I was here - addressing patients' and families' bias against lumbar punctures to improve patient outcomes. And now I am very interested in getting some information on the burden of Cryptococcal meningitis here in Uganda. I actually have a list of 7 or so projects that I may work on, so although things have changed, I will still be contributing to the big picture. And let's face it, do things ever go according to plan? The beauty is in the journey and all the twists and turns that guide us to where we ultimately belong, and I am thankful for every step and every opportunity.

Grant and I in front of Mulago Hospital and the IDI in our short white coats

We have just a few days of work left before our holidays officially begin and we leave for Tanzania on Sunday! We will be visiting our friend Imee in Dar Es Salaam for a few days and then spending the rest of the time in Zanzibar with Maiken, Phil, Katie, Ryan, Christine and Brandon! Before we take off though, celebrations every day this week...Melissa's bday lunch at Javas, Mar-Louise bday dinner at Mamba Point Italian, and IDI end of the year party.

I am rounding up lots of beach books to bring with to Zanzibar because that is what I plan to do for the next 2 weeks! We should come back well-rested and ready to attack those projects in full-force. I am also starting my public health coursework in January, online, and looking forward to some formal training in such an important area of medicine!

Kampala Marathon - November 22, 2009

The IDI, where I work, put together a team for the 2009 MTN Kampala Marathon. Over 100 people signed up and the reception secretary, Connie, put everything together for us. She even set up outside one day to hand us all our "kits," a nice cloth bag with a race brochure and map, visor, race jersey, bib number, and race chip. This was a seriously big deal. Something like 18,000 participants signed up and it was a sight to behold on race day!

Four hours after getting home from the crazy fun of the SAWA ball, I was back up and getting ready to run. All the madness was starting at the Kololo airstrip and my chances of meeting up with friends before the race looked pretty grim. The race program stated the full marathon was going to start at 7:00, the half-marathon at 7:15 and the 10K (which I was running) was slated to take off at 7:30. That seemed a little ambitious for me, so I strolled up the hill to Kololo at 7:10 and to my surprise, the race had already started! There was still a mass of people waiting in line, and I found Sabine, Yuka, and Jen near the gate. Nobody seemed to be organized by race, so everyone just took off at the same time - although taking off is an exaggeration as we had to walk for the first 5 minutes because it was so crowded.

As we approached the starting line, the inflatable gate started collapsing, but did not deter the thousands of people ready to run (or walk, and I saw a couple people with bikes and someone on rollerblades!).

We ran out of Kololo and out onto Acacia Avenue at Bubbles, past Latinos, Khana Kazana, Casablanca, Protea (site of the previous night's escapades), and down toward the golf course.

Here is the mob going past the golf course club house, with the advertisement for the marathon looming above the road. I have to give credit to Ben Ho, who encouraged me to photodocument the whole race. I first thought it would be absurd to try and carry a camera during a race, but his advice was wisely taken and I will post here are a few choice pics.

My running partner Jen Orkis! I was happy to have a friend to run with and we had a blast with the camera. This was probably not the best idea to take our eyes off the road, considering the condition of Kampala's asphalt, to do an action self-portrait.

After climbing the final hill on Acacia, we turned left and went down Yusuf Lule past Garden City Mall and the new Nakumatt Oasis Complex.

At Centenary Park, we turned onto Jinja Road, past Hotel Africana and trekked down to the Lugogo Mall.

Coming up the Lugogo Bypass, I saw my friend Heleen. I sprinted to catch up and get in front of her to take this action shot. I convinced her to move to the lane on the other side of the median which was less crowded, to run with Jen and I. But soon after, we got reprimanded by some officers and had to jump the drainage ditch to get back...whoops.

Just before Kira Road, we turned back into Kololo and made our way back to the airstrip along Prince Charles Drive. The race is almost over, and the road is still packed!

The finish line is in sight!

Post-race was hectic. As you saw how many people were crossing the finish line at the same time, they were having a little trouble with crowd control. Then, they were giving out free water bottles when you turned in your race chip, and it turned into a mob! People were pushing and grabbing - my race bib got torn off as I was trying to make it out alive.

The IDI had a tent, and Connie was serving up samosas, cake, and juice! It was so much fun to see our colleagues out for the race.

Good work Sabine and Jen!

Nice shirt Heleen! And Sanne was sporting some new Ugandan tennis shoes for the event.

More members of the IDI team!

I was honored to have participated in such a uniting event, with thousands of Ugandans running beside myself and each other! The camaraderie after the event was amazing (minus the fighting over bottles), and am thankful to Connie and the IDI for setting it up for all of us.

Attack of the Fembots

The last few weeks have brought some changes as our friends Elena and Sheida have returned to the US. We have spent a lot of time with them, both in Kampala and "up country". We miss them already and want to wish them the best of luck during their residency interviews. Taking Sheida's room in our apartment is Allison (coincidentally from Minnesota) who is here for about 3 months working for a NGO. Our friend Glen, an internist from Winnipeg, also left and is probably back in Canadia by now after spending some time in Botswana.


Ann and Glen his last night in town.

Last week Ann and I got the opportunity to play some basketball, which we have been missing during our stay here. Our friend at the IDI, Sam, has been inviting us to come play so we joined him at Makerere University for the teams he coaches' (one girls, one guys) practice. I assumed we'd be shooting around, maybe play a quick game. I was wrong. On the way there Sam, who is quite soft-spoken, joked "are you ready to run". I laughed. Apparently he was serious. So yeah, we joined the college kids in their practice including all the drills, sprints, etc. I wasn't ready for that. So after a few days of recovering, we joined him on Friday after work for some 3-on-3 and 4-on-4 before his guys team had a game. So before the game was about to start, he handed me his whistle and told me I was refereeing the game. I was hesitant, but he wouldn't take no for an answer. It was tough as I was all alone and really have no experience refereeing basketball. Sure, I've played for many years and know (most of) the rules, but I guess I wasn't sure if I'd do a good enough job. It was controlled chaos, but I think it went pretty well. I ended up doing this past Friday's game as well, which was even more difficult considering it had just rained. Being that the games are played outdoors on a tar court left for some slippery conditions.

Last week was Thanksgiving, and we were fortunate to have a place to go as the head of research at the IDI is American and invited a number of the us at the IDI to her home. Her family had purchased a live turkey that roamed their yard for a few weeks before slaughter...truly free range. A very nice meal and we even got to watch a little football! Of course it was the early game (detroit vs. green bay) as we're 9 hours ahead of Central time. I don't know how I'm going to see the Vikings in the playoffs, but I really hope I can figure out a way. Especially if they get to the Super Bowl!

Last night Ann attended an Austin Powers theme party and I played in another poker tournament. Ann was a fembot and won the prize for best costume. I won the poker tournament and took home just over $1500 (3 million Ugandan shillings). So far I have played in 3 tournaments and have finished in the money in every one. It's a nice source of supplemental income!


Miriam and Ann in their fembot costumes.

Something to show for it?

So it turns out Mulago is going to get a facelift. At least on the surface that is what is supposed to happen. Whether this will ever translate into better patient care is another story.
We had a good conversation at journal club this morning about what people donate and why. It all started with a [fabulous] presentation by our favorite Internal Medicine resident, Ms. Gloria Temu. The article she presented highlighted the deficiencies of a national referral hospital - Mulago - and the even worse conditions in a regional health center - Masaka - for septic (really sick with an infection) patients. One of the authors was at the presentation and happens to be our Ugandan Principal Investigator (aka Boss), David Meya.
The conversation was very detailed with lots of technical terminology that would bore most of the readers of this blog. So in summary, the outcome of the study gave signs that help predict whether people will die when they come into the hospital in severe sepsis, to be used to prioritize patients and their care. But it also showed that if the hospital could get a hold of iv fluids and antibiotics, it would mean less people would die in a setting like this. If you have ever worked, or been a patient, in a hospital in the US or another developed country, you know that iv fluids and antibiotics are given out like candy. I am going to quote part of the article here to highlight how fluids are such a scarcity - "...on a 50-bed ward at Mulago Hospital where the number of patients can approach 100, we observed that the nurse to patient ratio was less than 1:20 and the volume of IV fluids provided to the ward per day was limited to 20 liters." [!]
For those of you who are interested in reading the article, here is a link to get the free article (another issue in itself - publishing to free online journals).
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771355/?tool=pubmed
There is a lot of medicalese going on, but certain parts are very lay-person-friendly, such as the site descriptions and site resource capacity under the methods section, to get an idea of where this study is taking place, the resources available (or lack thereof), the implications and how it could be implemented in poor setting.
At some point, I made a (half-joking) comment about the 60 million USD that will be going to a Mulago renovation, and maybe they should buy iv fluids instead. It seems the Ugandan government, Ministry of Health, is getting a loan from the African Development Bank (www.afdb.org) to improve Mulago. I am not privy to the details of the whole deal, but I heard that they are going to use the money for structural improvements (hopefully aimed at reducing crowding on the wards). Important - yes, but most important - arguable. There are many, many opinions on what should be improved or added and how to go about it. The ultimate goal is to improve patient care, but sometimes that gets lost in the debate.
This brings us to what people donate/loan and why. How are organizations or individuals who donate able to show they did something? Is it easier to showcase a new building, a paint job, new beds, or to find those patients who benefited from an intervention? If you found those patients, how do you prove it was what you did that helped them? Who gets the credit? If five, or a hundred organizations are working on tuberculosis, or HIV/AIDS, how can you say what you did made the difference, or if there truly was any difference in the first place?
Something to ponder.

It's too damn hot for a penguin to be just walkin around here!

It has been another busy week for Ann and I. First and foremost we now have (relatively) fast internet at our apartment! Ann ran into a very nice neighbor who apparently gave us access to his wireless network for the sole reason that we are American. The exchange went something like this. "Are you American?" "Yes." "I have been there. I have internet for you." Strange yet awesome.

We have been busy arranging our holiday trip to Zanzibar. Tickets have been booked for December 20th through January 4th. Fly into Dar es Salaam, Tanzania on the 20th where we will be staying at a friend's place until the 23rd when we will take a ferry to Zanzibar. (And if I hear another utterance of the med school phrase "to zanzibar by motorcar" I may spontaneously combust.) Ann and I will be staying in Stone Town on the 23rd. On the 24th we will be joined by some classmates and their significant others for another night in Stone Town. From there we will be traveling to the SouthEast part of the island (Jambiani and Paje) until January 1st. Not sure where we're going from there as everything cheap in the North, where we had wanted to stay, is booked. So it's either splurge on a nice resort or find something else. We'll see.

Friday night we had a going away "party" for our friends Elena and Sheida who will be returning to the states this week. Went to Mama Ashanti's (West African) for dinner, Emin Pasha (fancy hotel) for jazz and drinks/dessert, Casablanca (bar) for "indie pop" (some white guy from the UK playing indie music, basically so he could posture as the dj) and Bubbles (expat hangout) for more drinks. Ann and I called it a night fairly early (3am) and the others stayed out until 5am. Needless to say they didn't feel so well the next day.


Grant, Elena (contemplating her life post Uganda), Ann, Sheida and Glen (Ann's friend and an internist from Winnipeg) post meal at Mama Ashanti's.

Saturday we met the Dutch medical students we had met in Fort Portal for brunch and afterwards enjoyed the availability of the internets (and the google) from our humble abode. That night we had the Southern African Women's Association Christmas Ball at the Protea Hotel. Good food. Lots of Christmas decorations. We didn't really expect to need formal attire so we are lucky that a few friends were able to borrow us some attire. Ann looked amazing and we had a great time.


Ann having her hair and makeup done by Mar-Louise.


I can't remember the last time I wore a suit.


Half of our table at the ball...Grant, Ann, Glen, Claudia.


Although we had to leave the ball somewhat early (1:30ish) as Ann had a big morning on Sunday running a 10k at the Kampala marathon! She claims that she'll do a separate post regarding the event, so I won't say anything about it which makes sense considering I stayed in bed while she ran. Watching people start and finish a race on 4-5 hours of sleep didn't make much sense to me. Plus having "watched" Ann compete in a half ironman triathlon for 6 hours gives me a pass, right?

It sure is nice to know so many fun people having been here for a somewhat short period of time. We frequently are invited to various functions and honestly it seems like we have something going on every night, especially during the weekends. It becomes quite exhausting and I'm starting to cherish quiet nights at home...


...especially when I get to do laundry!