Brooke Does Uganda: The Work Begins (and a trip to Bujagali!)

The true work is already beginning and my wheels are turning. I can feel it.

My first week at JCRC consisted mainly of spending a bit of time with people from all areas of JCRC including pediatrics and adult clinics, doctors and their study patients, nurses in various departments, the ward (16-bed hospital), lab with PCR, data, and pharmacy so I can get a good idea of what all the roles are and what challenges everyone faces.

A frequent question of mine was "What is the hardest/most challenging part of your job?"
I learned that many challenges are related to the system and having to manually write things or type things in, but I hear there is a new electronic system in the works that will be implemented within the next few months to help facilitate many of these processes.

My most challenging day this far was in the ward with the nurses this past Wednesday. Nurse to patient ratios are much different from the States, and there is not a separate area for those more acutely ill. Helping to create more of an intensive care unit for the patients is something my supervisor, the head of nursing, mentioned having me do. There is simply no type of electronic MAR (Medication Administration Record) yet, which makes the nurses' work long and tedious and filled with paperwork. My hope is to help streamline these patient care processes for the nurses so they can spend more time with patients. It's a systemic challenge that is passed down to people.

I found myself in an ethical dilemma at times, wanting to provide the best care, but not wanting to be "that person" taking charge and trying to change everything in my first few days with my new place of employment. It's just not feasible or acceptable. I am here to listen, reflect, and learn right now, but that can be hard sometimes. Then I think that perhaps more constant monitoring is not the answer, but maybe one should shift to a model of comfort focused care instead for those patients that are terminally ill, and I am pushing to partner more with Uganda Hospice, and organization that provides pain relief medications and comfort care for those nearing the end of their experiences now on this Earth. And then I think, at minimum, at least these patients have some clinic to go to and some care to receive.

This upcoming week, I will be working with CQI, or the Clinical Quality Initiative, to see what they do and to learn as much as I can in terms of quality control. The beginning of this upcoming week is a bit uncertain. Due to not knowing exactly when the end of Ramadan will fall, I don't know if I have tomorrow or Tuesday off. Depends on the moon, and I will find out soon :)

So, this weekend, I felt I had to leave my bubble of Lubowa and venture off into Kampala and beyond. Friday later on, I went with my co-fellow, Kakeeto, to some of the markets in Kampala and purchased so many things. We met up with his friend Moses, who so kindly drove me home to Lubowa from Kampala after helping me bargain in the market through 1.5 hours of traffic at rush hour. Crazy.

Saturday I took a boda (motorcycle) to the old taxi park in Kampala, got on a bus that I hoped was going to Jinja (and I was right!), and took a car to a very rural area East of Kampala about 2 hours from the border of Kenya called Bujagali to meet up with GHC fellow Orrin, his friend Laurel, GHC fellow Devin, and his co-fellow Violet.

I took the great opportunity to see the "Source of the Nile" and sit on a docked boat on the Nile itself at night chatting with some great people. I loved seeing Devin's cute house (pictures below) and walking through his neighborhood with him as he enthusiastically greeted many people. "Muli mutya!" (not quite sure if that's how it's spelled, but for now it will have to do). I thoroughly enjoyed a "vegan rolex"-yes! It actually said vegan on the menu. Couldn't believe it. It was fantastically relaxing and refreshing to be out there.

In the morning, we saw monkeys in trees and some nice birds. The bird calls are fantastic here.

Also, success: I joined the gym here, B Active, and went to a cardio circuit class which was a blast. Next week, I should be moving to my new home as well a little away from here, but still close enough to walk/boda to work. More to come!