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!

Grasshoppers, Fort Portal, and more basketball

Yes...I ate a grasshopper. Actually I ate quite a few and they are really not that bad. Mostly they taste like salty, crunchy nothing - but we mzungus managed to make quite the spectacle of it, taking pictures and teasing each other. Miriam, Elena, and I went out for pork (a national pastime in itself, which I may have mentioned before) with Simon, Allen, Jenny, and Sister Immaculate at our favorite joint - Deep Blue in Wandegeya on Thursday night. It seems to be a prime spot for locals to hawk their wares, and happens to be where I bought dresses for Pyper in the past, but this time a man walking around with a large tupperware container caught our eye. Simon called him over and ordered a napkin-full of grasshoppers! At first I gagged when Allen took a handful and stuck them in her mouth, but then I tried it, with my free hand on my Nile Special as a chaser, but it went down fine, with more to follow.
After pork, we went to meet our friends at Quiz Night. This was our third night, winning the first time, hosting the second, and now participating once again. Unfortunately, we won again. It is bittersweet, because the competitive side of you wants to win, but the practical side does not want the responsibility of hosting it. However, our team members had not hosted before and thus still felt the urge to take it all the way (and get their own Bubbles t-shirts).

And this week were the final games of the Falcons' season. They were playing the Warriors and lost the first 2 games of a best of 5 series. However, games 3 and 4 went their way and they played particularly spectacular on Wednesday night - with all their fans, including a handful of mzungus, cheering them on. Saturday night was the final game, we were in Fort Portal and missed the loss that ended their season :( We look forward to next season, though, and I hope to be playing on a women's team by then!

This weekend we took a trip to Fort Portal, in western Uganda. Preparing for the trip, Grant and I made a trip down to the bus park to figure out the bus schedule.

This was quite the adventure in itself, and after asking multiple locals where the Link office was - and many polite but completely wrong answers - we found out there is no office. You just show up to the bus park, find a bus going to your destination, and wait until the bus is full and leaves. The bus ride was uncomfortable with the three of us squished together on a packed bus, but the 4.5 hour ride was much more enjoyable on the way home when we bought five tickets for the three of us.
We stayed at a very nice guest house just outside of town (and around the corner from the prison) that had comfy rooms, a relaxing atmosphere, and amazing food! We met a pair of Dutch medical students, Heleen and Sanne, and joined them on a tour on Saturday. The tour included some hiking...up to a vantage point to view the beautiful crater lakes, through lush agricultural land (matoke, banana, papaya, guava, avocado, maize, g-nut, yams, cassava, coffee) with community members, down to (and back up from) a beautiful waterfall, and through the forest to see monkeys, birds, and more flora.

Mahoma Falls

One of the deep, beautiful crater lakes

Some of the pretty flowers

Avocado Tree

Paw-paw (papaya)

Black and white Colobus Monkeys

Red-tailed monkey

At our final stop, out of the forest and at another crater lake

It was a fabulous weekend, and nice to get out of Kampala. Ironic that we sleep so much better when we leave home! Our friend Elena, who has joined us on many adventures (including Jinja, Murchison Falls, and Fort Portal) is leaving soon :( She also has a blog with more pictures and stories, www.ebyhoff.blogspot.com, check it out.

Lions and Tigers and Bears, Oh My!

(Ok, so there weren't any tigers or bears but I did see a Lion!)

This past week has found us continually busy. Ann has been perfecting her role as study coordinator while Grant has been doing some grunt work - the always exciting data entry. Honestly, I am just happy to be useful. Tomorrow I will start sitting in with a group that does neuro-cognitive exams so that I might learn how to perform them on the patients enrolled in our study. Once I figure them out I'll be tasked with figuring out the specifics including time, place and interpretation. Nice to finally get things moving though.

Wednesday night we attended another basketball game at the YMCA. It is now the playoffs and the top 4 teams have advanced into two best of 5 series. Our team is the Falcons as a friend of ours at the IDI plays for them. It was an exciting game involving two free throws to put the Falcons up by one with about 10 seconds left. The other team got the ball down the court pretty quickly and one of their players nailed a somewhat ill-advised pull up three to win the game. We believe there was time left on the clock, but fans rushed the court and the refs just kind of said "game over". The clock is only visible to the half of the court that we weren't sitting on, so I guess we'll never know the truth. That has left the Falcons down 0-2 in the series, although they picked up a victory on Saturday night. I love going to basketball games here, although it's too bad they don't have a nice gym (like nearly all high schools in our country) to play in. The outdoor court leaves something to be desired. Anyone ever witnessed a rain delay during a basketball game before? Hopefully we won't have to. Next game is Wednesday night, so hopefully they can pull out another W.

Thursday night Ann and I had a relaxing evening with our friend Miriam, a medical student from Tufts (in Boston) who is here on a Fogerty fellowship. We went over to Miriam's (really nice) apartment and made breakfast for dinner, which included french toast, fresh fruit and omelettes (avocado, tomato and onion). Following that we watched Sunshine Cleaning, which was a pretty good movie. It was nice to have a simple evening where we could just enjoy each others company. Miriam's washing machine was nice too...

Friday I traveled to Murchison Falls National Park while Ann stayed back in Kampala as she had been there previously. The Nile River flows through the park emptying into Lake Albert, which forms a border with the Democratic Republic of Congo (DRC), before continuing on through Uganda to Sudan and Egypt. Friday mainly consisted of traveling North from Kampala with a stop in Masindi for lunch. Once we reached the gates to the park we had to travel quite a ways, which allowed for some enjoyable baboon watching. Their butts are hilarious. Once we reached the camp site we had the rest of the evening to ourselves. So we hung out and had some drinks at the bar/dining area overlooking the river. The next day we had to get up quite early, so it was pretty early to bed.

Saturday morning involved safari through the Nile delta region of the part. We saw all kinds of beautiful scenery and animals. Some of the highlights were giraffes, elephants, baboons, various monkeys, hartebeest, african buffalo, kob, bushbuck, duiker, dik dik, many birds and a lioness. I couldn't believe how many giraffes there were! It is also somewhat difficult to spot big cats, so it was pretty exciting to see the lioness. Unfortunately the leopards were too shy to say hello. After about 4 hours of driving around we headed back to camp and had lunch. The afternoon involved approximately 4 hours of safari via boat as we traveled up the Nile to the actual falls for which the park is named. Basically the entire length of the Nile (at this point) is full of hippos, so we got lots of time with them. Also saw some of the other animals grazing and drinking from the river. The crocodiles were harder to spot as they like to hide in the water, however near the falls we were treated to some very close up crocs lounging under the tree. A couple got into the water right near the boat, which elicited a few gasps from the boat.


Giraffes. I got nothing.


Awwwww, look at the little baby elephants.


Mama says crocodiles are ornery cause they got all them teeth and no toothbrush.



Hungry Hungry Hippos

Sunday involved a hike up to the top of the falls for some amazing views. After a bit we took off back to Masindi for lunch and eventually arrived in Kampala around 4:30pm. It was a long weekend. If the mosquitos (malaria) or tse tse flies (sleeping sickness) don't get you, the african sun will. I am now a certified tse tse fly killer as we had quite the experience riding through the park. If we slowed down the flies caught up so we were constantly opening and closing windows in order to balance the chances of sleeping sickness vs. heat exhaustion. So this was more of an art than a science and some people were very shitty artists. Lucky I was there to terminate the flies.


Murchison Falls from the Nile River.

Ann thought we should include a few pictures of our place...

Emu Omwezi - Mutunda

One month - October
What an experience we have had in our first month together in Uganda. It is funny to think about our hectic, multi-tasking, prioritized days back in Minneapolis and how our lives were changed with a flight across the pond. It is a simpler life here, and tasks take longer, but there is also this laid back attitude that rubs off on us. It is nice to relax and take it all in - the sights, sounds, and smells (some better than others), the people, the culture, the experience. We have learned to conserve, to wait, and to do without. But one thing that I seem acutely aware of this time around, is the necessity to be aggressive. That midwestern passivity does NOT work here. There is no such thing as waiting your turn, if you have an opportunity to get ahead of someone, you take it. This concept is also seen on the road and being a pedestrian is dangerous. Grant was sure I was going to kill him crossing the street when we first arrived, but he has now become an expert at dodging matatus and land cruisers, all the while looking both ways for bodas down a one-way street.
Grant and I have begun Luganda lessons twice a week and have been practicing our greetings and numbers lately, which comes in handy with bodas and taxis. It makes such a difference in the way people perceive this mzungu when a local greeting comes out of my mouth. Although it is frustrating once you get past the words we know and end up smiling and nodding.
Mondays and Wednesday evenings are devoted to our Luganda class, and our other days have been gobbled up by social events. Last week on Tuesday I went out with the girls to a "jazz" event at a club, and it was actually R&B and spoken word. There is a famous (?) Ugandan musician, Maurice Kirya, who puts together these monthly shows and recruits local artists to perform. It was standing room only by the time we got there, but were able to enjoy the acts from the bar. We hosted Quiz Night at Bubbles on Thursday, and it was fun to organize and entertaining to watch teams strategize and concentrate, all the while drinking and trash-talking each other. Friday we went with a large group to the Protea Hotel, to partake in their buffet that our friend Martin has been selling to us with his chef-speak since we met. Needless to say, we were not disappointed.
Even though I brought Halloween costumes from the US, we still ended up walking around all day Saturday looking for final touches. Miriam, Sabine and I then got ready and headed to a great costume party hosted by Sabine's good friends Sybille and Charlie. I had a fabulous time admiring everyone's creations in Kololo while Grant was busy playing poker at Pyramids Casino. He ended up getting 4th and winning $800! I knew I brought him along for something :)
Ouch, Sunday was spent recovering. Grant paid me to go pick up Pavement takeout (even though I felt like death) and we stayed in sleeping and watching movies. Later on, our friend Pete had a gathering at his house in Ntinda where he served his famous chocolate beef and had a surprise birthday celebration for Veronica. He also had a Ugandan Women's Organization there selling bags and beads and I was happy perusing the goodies. Next weekend we are heading to Fort Portal with our roomie Sheida and friend Elena, to do some trekking around the crater lakes and see the chimps.

PICTURES!!!

Nichola, Rosie, Miriam, Sybille, and I


Myself, Tom (aka Billy, aka Jack Sparrow), and Sabine


After the Protea buffet, sipping on Gareth's favorite KLC drink...
Miriam, Grant, me, Sheida, Gareth


Pete, me, Grant at Sunday's soiree


And we do actually work, I swear...
Here we are working on database stuff at the IDI