Sunday, May 13, 2012

The First 3 Weeks - Outside Mulago

Uganda so far has been the best overall experience. As you probably gathered from my blog about my Ob/Gyn rotation, I am getting incredible hospital experience both in knowledge and practical skills. I also have had a great time with all the wonderful people I met while living here and have had a blast hanging out in Kampala as well as doing some traveling in Uganda.

The Edge House where I live is a busy place. It is usually always full and it doesn't take long after one person leaves before a new one arrives to take their place. Most people tend to stay for anywhere from 4-6 weeks so I will for sure completely switch groups of people in the house once if not twice. The best part is that a few days after I arrived, a girl from the Netherlands (Renee) came and she will be here for the same amount of time that I am. We seem to get along well personality wise and I am excited for the adventures we will have while in Uganda. As I write this, there are 6 people that have already left the house (not including people I met that stayed elsewhere and have left) and another 7+ that will leave at the end of this week. I have had an amazing time with the people I have met the first quarter of my trip and anticipate that each group that comes next will be just as great.

Edge House is definitely the best house. We hang out a lot together and the people that run it - Freddie, Nassa, and Lucy - are fantastic. They even do our dishes for us :) At least a few times a week we go out to dinner together and whenever anyone leaves, the whole house is really good about going out together for a final farewell dinner. Someone always has an idea of a new place to try so I have had Ugandan, Indian, Chinese, Italian, Mexican, and "continental" cuisine. If someone hears about something cool happening on a night in Kampala, they will write a note on a white board that we have and usually there will be a group of people that will go. We went to the contemporary national ballet at the National Theater one night followed by a poetry and hip hop cultural night. I've watched soccer matches on a giant screen at a bar/restaurant called Mish Mash. I've had a massage at the nearby country club and spent two afternoons by the pool. Just last night I went to the Dutch Queen's Party - who knew there were so many Dutch people living in Uganda! I also went to a house party of one of the residents from the UK that I met on rotation with 8 of my housemates. The house party was the coolest house party I think I have ever been to - they had a DJ and a rolex man. Rolexes are great Ugandan street food - a chapati with an omlette rolled up inside (hence the name rolex). We also play games together as a house. We have had a few nights of playing cards, one game of ultimate frisbee, and 2 soccer matches. I don't mind sharing a room and a bathroom and a kitchen and common area with so many people because all the people are really fun to be around. But you can see why I have had a hard time finding time to blog with everything happening around me!

It's nice to know that I have met such great people while living here that in the event that anything bad happened, I know I would have a houseful of people that would be by my side the entire time. I know this because of an incident we had during our ultimate frisbee game. We were having a great time playing. The score was close and so we were all getting a little competitive. One of the girls on my team was going to catch a pass when a girl from the opposing team tried to block it. She ended up sliding into the girl from my team. The game immediately stopped and we all ran over to see my roommate lying on the ground in pain holding her leg with her ankle clearly dislocated and likely broken. Although the hospital is a great experience as a student, it is not a place I would choose to go to as a patient if I could help it. Everyone playing went on a mission - one called our international student coordinator to figure out what hospital to take our friend to, one went to get her money, ID, insurance information, one went to get transport to take her to the hospital, one got some pain medication that she had brought with her. The whole house came together to help one of our own. On the ride to the hospital, there were 4 of us in the van with her trying to get her leg still. Once at the hospital, 3 more of our housemates came to join us bringing more personal items for our injured friend and money in case we didn't have enough to cover the bill. It was really inspiring to see this international group of students who hadn't known each other for that long really rally together to support our friend in need. She ended up staying in the hospital overnight and then saw some Italian orthopedic surgeons in Kampala. The decision was made for her to fly home to have surgery. She has since had her surgery and is doing well at home. We all miss her and wish she was still here with us!

I have had three weekends in Uganda since I arrived and have traveled for two of those weekends. My first full weekend here, I went with a group of British students from Birmingham, Renee from the Netherlands, and Audrey - an American medical student I met on my Ob rotation to Jinja to go white water rafting down the Nile River. The source of the Nile is Lake Victoria and the start of the Nile is full of amazing rapids all the way up to class 6 (the highest class). We rafted 2 class 5 rapids and smaller ones as well. Apparently there used to be a lot more rapids and these rafting trips started closer to the source but in the past few years, a dam was built that has destroyed some of the rapids closer to the source. We were picked up on Satuday morning and drove to Jinja. At Nalubale headquarters, we were fed a breakfast of rolexes, bananas, and juice and were fitted for helmets and lifejackets. We then boarded a truck to head to our launch site. Once we arrived at the launch site, we were separated into two groups - one that was going to have the ultra super extreme rafting trip and another one that was slightly more tame. I, of course, wanting to get the full Ugandan experience immediately walked over to the ultra super extreme raft along with 4 of the 5 guys that were with us and 2 other girls. Our guide was from Zimbabwe and had been rafting for the past 15 years on various rivers throughout Africa and Europe. We entered the Nile at a wide calm spot to learn a few things about rafting before starting our trip down the rapids. Our leader taught us the different commands he would give for paddling forwards and backwards and how to keep in rhythm while paddling. He taught us how to "GET DOWN!" and hold on to the raft when we hit the major rapids. We practiced our short swimmer rescues and how to get ourselves back into the raft. We learned what to do in the event that we became long swimmers (too far from the raft to grab onto the rope on the side) and how to hang on to rescue kayaks properly. We were taught to fold up into a small ball when under the water to facilitate being shot back up to the surface more quickly and then once on the surface to back float with your head looking in the direction you were flowing with the current. Finally we practiced what to do when the raft flipped over. We were told to try our best to hang onto the paddle even when thrown off the raft and given some tips on swimming while holding the paddle. Feeling slightly more prepared, we started off.

The first rapid we hit was a grade 5 and it was a drop down a waterfall. Our leader told us that we really, really didn't want to flip on this rapid. We hit it just right and went over the falls landing with a big splash and paddled our way out of the falls. We watched as the second group went over. They didn't hit it quite as well as we had and ended up partially stuck under the falls and needed the safety boat to throw them a rope and help pull them out from the falls. We continued down the river and the next rapid we hit was a grade 3. We thought we were doing really well paddling through it and then we flipped. We were all a bit suspicious that our raft leader had something to do with our flip. This was confirmed after watching the video and seeing the photos from the rafting trip that indeed we were sabotaged. This set the precedence for the rest of the rafting trip. Except for the very first grade 5 (we had a second one later on in the trip called "The Bad Place") and one other rapid that was only a grade 3 but had some treacherous rocks that the current was directed towards, I was out of the raft on every other rapid...something like 5 or so rapids. Outside of the two where no one fell out, there was only one other rapid that the whole raft didn't turn over on although I was not one of the ones who managed to stay in the raft. It was a blast! I never once felt unsafe. The rescue kayakers were great at getting to you quickly when you became a long swimmer and brought you back to the raft. Even when I was under the rapid, I had a great time being tossed around by the Nile. I folded myself into a ball and got shot up to the surface relatively quickly although at The Bad Place, I was just sucked back under after getting a good breath of air. Our leader definitely lived up to the ultra super extreme rafting experience as he took us down the path of each rapid that would most likely wind up with our raft flipping and if that didn't do it, he flipped us himself. The final rapid called The Nile Special was great fun - I ended up out of the raft near the start and riding it the whole way down. I swam to our raft far downriver.

In between the rapids, we took our time in the slower moving water and swam in the Nile, reapplied sunscreen, and drank some water. We also had a lunch break midday with a delicious sandwich, chips and guacamole, and pineapple. That night we stayed at the Nile River Camp which was a great lodging along the banks of the Nile River. The best part about it was the rope swing that you could swing into the Nile from. That and the hot showers. After a good night of sleep, the next day we went into Jinja and to see the actual source of the Nile. We had heard/read that it wasn't all that impressive, but I thought it was still really cool to see where this famed river originates. The town of Jinja (the second largest in Uganda) was pretty sleepy on that Sunday afternoon but still very pleasant to walk around. After seeing the source and walking around Jinja, we returned to Nile River Camp and took the busy back to Kampala. It was a great first weekend in Uganda.

The following weekend, Renee (my roommate from the Netherlands who is here the entire time I am), Audrey (from Seattle - arrive the same time I did and is staying for 5 weeks) and I took the bus from Kampala to Sipi Falls in eastern Uganda near Mt. Elgon, the highest peak in Uganda and near the Kenyan border. We had heard that the falls were really beautiful and the weekend very relaxing and peaceful. We had a bit of an adventure to get there. We left the hospital early to try and get an early afternoon bus to Mbale but the buses were full until 5:30. The drive to Mbale takes at least 4 hours and sometimes as many as 6 hours and then from there, it is another hour by private hire to the town of Sipi Falls. While waiting for the bus, we had a nice lunch in Kampala City Center. The bus trip took about 5 hours and we arrived in Mbale at 10:30 at night. We had not arranged for any transportation to meet us in Mbale and along the route, the manager of the lodging we were planning to stay at kept calling me to see where we were on our journey. Thankfully, the people from the Mt. Elgon Flyer bus service in Mbale were able to help find us a private hire to take us to Sipi Falls. We finally arrived around 11:30 at the Crow's Nest - a place with supposedly a gorgeous view (which we couldn't see because it was dark) and a bit rustic. They use a generator that they only run for certain hours of the day so we had kerosene lanterns to light our way to our dorm room and for light as we got settled and ready for bed.

The following morning, we were not disappointed seeing the view from outside our dorm. We were on a hill overlooking a valley and Sipi Falls. It was breathtaking and so quiet and peaceful. We ordered our breakfast (it takes a while to get it after you've ordered) and got ready for the day. We arranged for a guide from the Crow's Nest to take us on the long hike through the village, farmlands, and hills to the three waterfalls. Seeing the rural way of life in Uganda was so nice. Most people farm and one of the major crops in this region is coffee. I had no idea that coffee beans on the tree are actually encased in a red shell and look a bit like berries. The hike, despite being at a relatively leisurely pace, still made all of us slightly out of breath due to the altitude. It was nice to take breaks and be able to take in the view from the tops of the hills we were climbing. About halfway through our long hike, it started to rain. Thankfully we all had rain jackets with us as the rain became progressively harder and everything not covered by the rain jacket was soaked. In many ways, this made the hike even more fun. The top waterfall was the smallest of the three but still very nice. There was a "swimming pool" at the base of it but because we were already pretty cold and it didn't look all that inviting, we decided not to get in. The second falls was probably my favorite. We started at the top of it then hiked down to the bottom. There were two parts of this set of falls - the main waterfall and an adjacent one called the "shower." I was glad I had my waterproof/shockproof/freezeproof camera with me to take with us as we stood underneath the shower and got some great pictures of the three of us. Finally we hiked to see Sipi Falls itself - a 99m high waterfall that drops down amongst a background of such lush greenery. It was serene.

After our hike back to the Crow's Nest, we were all glad to change into some dry clothing. We went up to the main lodge to read, relax, and hang out before our dinner (which we had ordered that morning) that we had planned for 6:30. Dinner was delicious and after that we played a card game that Renee taught us - a Dutch game called "Beste" (not sure of the spelling). Renee and I are both quite competitive and especially, I think, with each other when we play games. (It is a friendly, but serious competition between us - we both really like to win). A fourth person staying at the Crow's Nest asked to join in our game so the 4 of us played. To win the game, you have to win 5 rounds. Renee and I were neck and neck the entire evening while Audrey and our new friend were sitting with only having won about 1 round each. I ended up winning the game overall :) We went to bed that night relatively early because without electricity, there is not much to do.

Sunday morning, we got up and met our guide for our planned coffee tour. We went to the home of a local coffee producer and learned the art of making coffee. Starting from the red encased beans, we broke these open to expose the two pale coffee beans inside. These had to be placed in a large mortar and pestle and ground until the coating came off of these beans. Then this was emptied onto a plate and the beans separated from the coating by blowing gently on them. After this, the beans were placed in a pot and put over a fire for roasting. While constantly stirring, we waited to hear the crackle of the beans indicating that they were finished roasting. These were then emptied back onto the plate and we sampled our freshly roasted beans - delicious! The roasted beans went back into the mortar and pestle and were ground up manually in order that we could make coffee. After grinding the beans, the coffee grounds were placed in a pot of boiling water over the fire and boiled for several minutes. Then this was poured through a strainer into a flask for us to drink out of. It was probably the best cup of coffee I have ever had. The flavor was so rich and bold. Coffee lovers everywhere really should go through this process to have the freshest tasting coffee. Amazing.

We went back to the lodge and arrange for a private hire to take us back to Mbale so we could catch the bus back to Kampala. The ride home was much quicker than the ride there and we got back in the early evening ready to start another week at Mulago.

The third weekend (right after my last week on Ob), Renee and I spent in Kampala. A few of our housemates were leaving that weekend to go back home and since we had traveled the previous two weekends and were going to be here for a while still, we decided a quiet weekend was in order. On Friday night, I had been invited to a house party of the the Ob/Gyn resident from the UK that I had been working with on the wards. She told me that all my housemates were welcome to come as well. I wasn't sure what the house party would be like and I was nervous that it would be a total bust especially because I wasn't really sure where it was and it took a while to get a hold of my friend for better directions while we were on the road. We finally made it, and the house was full of people. It was probably the best house party I have ever been to - the house was very nice and they had hired a DJ as well as a rolex man (a rolex is a chapati with an omlette rolled up inside - a Ugandan street food favorite). All the beverages were also provided. We had a blast dancing and making new friends and didn't end up coming back home until the early hours of Saturday morning. Saturday morning, Nicole - one of my roommates returned from her rural rotation. We had a lazy Saturday sitting at the Makerere Guest House using the internet and just relaxing. On Sunday, Nicole, Renee, me, and Sarah (a new arrival to Edge House) went to Kabira Country Club to spend the afternoon at the pool. Although it is a little pricey, it is a great pool to swim in and lounge by and they have really great food. In addition to hanging out by the pool, Nicole and I decided to get hour-long massages (only $10!!). It was a good massage but definitely the most full body massage I have ever experienced. I don't know that I will have another while I am here, but the one time experience was very relaxing.

So that pretty much sums up the first three weeks and as I am writing this and have been in Uganda for 5 weeks, I have a lot more to catch up on in more recent blogs. I hope to write about my experience on the Surgical Casualty ward and my safari to Murchison Falls by the end of this weekend!

Location:Kampala, Jinja, and Sipi Falls

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