Here in Kampala it is now the first of December. My computer still thinks it's monday night in san francisco, and I haven't the energy or technical skills to disabuse it of this notion.
I have been working as a vso medical volunteer here in Kampala for slightly more than 5 months of a year-long placement. Over these months I have been sending out long rambling hyperdramatic emails to loved ones, family and friends. A few of whom ( a very few) have chastised me for being too lazy to write a blog such that I finally went to blogspot and discovered that even someone with my limited motivation and understanding of computers can have a blog in a matter of minutes.
So here it is. A blog. Those of you who asked for it, you know who you are, the rest of you probably clicked on a link for male enhancement.
First of all, the opinions expressed herein are the product of a deeply disturbed imagination coupled with a cynical nature and should not be thought to reflect the facts, the truth, reality or the official views of CUSO-VSO or any other person or organization described in the rambling passages that will fill this blog.
I am working as a medical volunteer. Some of the posts here may be on the unsettling side. I suggest at least a glass of red wine before proceeding. Most of the what I will write about, however, will not be of a medical nature. In general I will try to describe random moments of the life of a mzungu in Uganda--things that strike me as funny, ironic, or maybe even educational.
In the next few weeks, I will try to get some pictures up and post some of my previous meanderings through the countryside. But now I have to make a roadtrip to Soroti, and the macbook is not invited.
Monday, November 30, 2009
eid
November 27th
Today is Eid (Eid al-Adha), a Muslim holy day celebrating the willingness of the prophet Ibrahim (Abraham?) to sacrifice his son… If you are one of the faithful, you are probably eating goat tonight. My understanding is that today you are supposed to sacrifice a chicken, or a goat, or, if you are wealthy, a cow or two. You are to share the meat with the poor. About 10% of Ugandans are Muslim. But Eid is still a recognized bank and government holiday. At the Kibuli Muslim hospital, where Jean a VSO midwife works, there was a skeleton staff of infidels working.
Eid is not, however, a recognized IHK holiday, but the place is surprisingly vacant of staff all the same. Even our OPD and emergency areas are frighteningly empty (as I think I mentioned before… our clientele don’t like to waste their time off going to the doctor. Something to be said for that. I was thinking about scoring a 3 day weekend myself, but we had a training team meeting for the clinics this morning and Dr. Andrew, knowing I was already in for the meeting, asked me to cover for him.
Andrew is not Muslim. But it is his wedding anniversary, so I said sure. Andrew is one of the three medical directors here. The first two function so ineffectively at their jobs, they had to appoint Andrew medical director as well…(I don’t have a degree in medical management or anything—as it turns out, neither does Ian, or his buddy Kevin, our new ‘CEO’—but something seems wrong with this management strategy) Part of Andrew’s job is to put out customer care fires as they blaze up around the hospital…
Today’s customer care dilemma was an angry patient in pharmacy: A man suffering from diabetes who had just been told that his health insurance wasn’t going to pay for the insulin his doctor prescribed him. Hmmm. Probably my remark—that I’d be pretty pissed off, too, if I found out that my health plan didn’t cover the medicine that I needed to ward off premature heart disease, renal failure and blindness—did not help things much. And of course, his health coverage is us.
With IAA, and our newly acquired Microcare (finally, an insurance company that tells you right up front exactly how much they care) insurance line, the International Medical group at IHK now has the biggest share of the health insurance market in Uganda. And unfortunately, the folks who sell our policies have taken a page out of the American Insurance industry playbook: Advertise the world, sell the moon, and then given them the 27 page booklet of fine-print exclusions. Things like insulin.
Lorna, the customer care rep for the day, wanted to pin the problem on one of my doctors. ‘She (the doctor) shouldn’t have prescribed insulin. She knows we don’t pay for insulin.’ I tried to explain the concepts of the physician as patient advocate and do no harm. But she wanted me to reprimand Dr. Emma and have her apologize to the patient. Let me think… No. I think Lorna will be happy when Dr. Andrew gets back on Monday.
Today is Eid (Eid al-Adha), a Muslim holy day celebrating the willingness of the prophet Ibrahim (Abraham?) to sacrifice his son… If you are one of the faithful, you are probably eating goat tonight. My understanding is that today you are supposed to sacrifice a chicken, or a goat, or, if you are wealthy, a cow or two. You are to share the meat with the poor. About 10% of Ugandans are Muslim. But Eid is still a recognized bank and government holiday. At the Kibuli Muslim hospital, where Jean a VSO midwife works, there was a skeleton staff of infidels working.
Eid is not, however, a recognized IHK holiday, but the place is surprisingly vacant of staff all the same. Even our OPD and emergency areas are frighteningly empty (as I think I mentioned before… our clientele don’t like to waste their time off going to the doctor. Something to be said for that. I was thinking about scoring a 3 day weekend myself, but we had a training team meeting for the clinics this morning and Dr. Andrew, knowing I was already in for the meeting, asked me to cover for him.
Andrew is not Muslim. But it is his wedding anniversary, so I said sure. Andrew is one of the three medical directors here. The first two function so ineffectively at their jobs, they had to appoint Andrew medical director as well…(I don’t have a degree in medical management or anything—as it turns out, neither does Ian, or his buddy Kevin, our new ‘CEO’—but something seems wrong with this management strategy) Part of Andrew’s job is to put out customer care fires as they blaze up around the hospital…
Today’s customer care dilemma was an angry patient in pharmacy: A man suffering from diabetes who had just been told that his health insurance wasn’t going to pay for the insulin his doctor prescribed him. Hmmm. Probably my remark—that I’d be pretty pissed off, too, if I found out that my health plan didn’t cover the medicine that I needed to ward off premature heart disease, renal failure and blindness—did not help things much. And of course, his health coverage is us.
With IAA, and our newly acquired Microcare (finally, an insurance company that tells you right up front exactly how much they care) insurance line, the International Medical group at IHK now has the biggest share of the health insurance market in Uganda. And unfortunately, the folks who sell our policies have taken a page out of the American Insurance industry playbook: Advertise the world, sell the moon, and then given them the 27 page booklet of fine-print exclusions. Things like insulin.
Lorna, the customer care rep for the day, wanted to pin the problem on one of my doctors. ‘She (the doctor) shouldn’t have prescribed insulin. She knows we don’t pay for insulin.’ I tried to explain the concepts of the physician as patient advocate and do no harm. But she wanted me to reprimand Dr. Emma and have her apologize to the patient. Let me think… No. I think Lorna will be happy when Dr. Andrew gets back on Monday.
a kampala thanksgiving
November 26th
Thanksgiving in Uganda.
The rainy season continues. As I’ve said, I prefer the mud to the dust (‘cuz the dust doesn’t get into your lungs), but the 4am thunder storms that have ruined my sleep for the past week are getting a little old. And the back roads that I walk to work on are getting slowly washed downhill. Some less slowly than others. Occasionally a truck will pull up at the bottom of the washout (on Bukasa road, where the mud hits the pavement) and a group of young men will get out and shovel the silt into the bed where it will get mixed with yard clippings, household waste and the odd brick. The truck will then drive up one of the dirt roads and find a particularly nasty hole or rut to shovel their road fill mixture into. They will gently pat the unstable mass with their instruments or their flip flops and move on to the next highway repair job… two storms later, the disposable diaper that was the lone structural element of the road patch will be back down on Bukasa road.
This morning, on my walk to work, as I made my usual corner-cut up through the housing development (2 ragged lines of rust roofed shacks surrounding a mud courtyard and a row of pit latrines) on the corner of Bukasa and St. Barnabas roads, a large turkey with its tail feathers fully arrayed walked around one of the latrines and blocked my path. (I know it sounds like I’m probably invading the privacy of the 20 or 30 people who live on this sloping scrap of earth roughly the size of your living room, but I have been assured that the path that winds by the latrines is a public right of way). Usually I see chickens and goats and half naked children on this section of my commute, but, in the 3-4 months that I have crossed this yard, I have never seen a turkey. I stood there looking at the turkey. He looked at me. The tail feathers grew ever so slightly more erect. Was it a sign? Was I really supposed to be at home peeling sweet potatoes instead of going to work? Was someone trying to tell me that my excuse (our oven only works on broil, our refrigerator just died, and, for some reason, our hot water taps have run dry) for skipping the traditional American exercise in excess is a lame one?
A small bareassed and barefooted toddler runs over, kicks the turkey in its tail feathers, and runs off squealing before the turkey can mount a defense.
No matter where you are, it sucks to be a turkey on thanksgiving.
So instead of stuffing a turkey, I went off to give a lecture on oxygenation, ventilation and airway management.
For dinner we went to the New York kitchen restaurant. Conveniently located in the parking garage of the Garden City shopping center—with outdoor seating in parking stalls B1-6. I figured that since, surprisingly enough, I hadn’t been invited to thanksgiving at the American embassy (and I don’t belong to the American Recreation Assoc.), it would be my best chance of getting some turkey with stuffing and overly-thickened brown gravy. No such luck. I had a chicken chef’s salad instead. The volunteer sitting next to me, a Norwegian who writes news stories for Mama FM radio (an NGO nonprofit thingy that gets disadvantaged women on the air), kept looking at my dinner. Finally she said, ‘you’re eating a salad?’ Yes, I had to admit, I was. I guess I’ve gotten slightly away from the peel it, boil it or throw it away doctrine.
After dinner we went bowling.
Thanksgiving in Uganda.
The rainy season continues. As I’ve said, I prefer the mud to the dust (‘cuz the dust doesn’t get into your lungs), but the 4am thunder storms that have ruined my sleep for the past week are getting a little old. And the back roads that I walk to work on are getting slowly washed downhill. Some less slowly than others. Occasionally a truck will pull up at the bottom of the washout (on Bukasa road, where the mud hits the pavement) and a group of young men will get out and shovel the silt into the bed where it will get mixed with yard clippings, household waste and the odd brick. The truck will then drive up one of the dirt roads and find a particularly nasty hole or rut to shovel their road fill mixture into. They will gently pat the unstable mass with their instruments or their flip flops and move on to the next highway repair job… two storms later, the disposable diaper that was the lone structural element of the road patch will be back down on Bukasa road.
This morning, on my walk to work, as I made my usual corner-cut up through the housing development (2 ragged lines of rust roofed shacks surrounding a mud courtyard and a row of pit latrines) on the corner of Bukasa and St. Barnabas roads, a large turkey with its tail feathers fully arrayed walked around one of the latrines and blocked my path. (I know it sounds like I’m probably invading the privacy of the 20 or 30 people who live on this sloping scrap of earth roughly the size of your living room, but I have been assured that the path that winds by the latrines is a public right of way). Usually I see chickens and goats and half naked children on this section of my commute, but, in the 3-4 months that I have crossed this yard, I have never seen a turkey. I stood there looking at the turkey. He looked at me. The tail feathers grew ever so slightly more erect. Was it a sign? Was I really supposed to be at home peeling sweet potatoes instead of going to work? Was someone trying to tell me that my excuse (our oven only works on broil, our refrigerator just died, and, for some reason, our hot water taps have run dry) for skipping the traditional American exercise in excess is a lame one?
A small bareassed and barefooted toddler runs over, kicks the turkey in its tail feathers, and runs off squealing before the turkey can mount a defense.
No matter where you are, it sucks to be a turkey on thanksgiving.
So instead of stuffing a turkey, I went off to give a lecture on oxygenation, ventilation and airway management.
For dinner we went to the New York kitchen restaurant. Conveniently located in the parking garage of the Garden City shopping center—with outdoor seating in parking stalls B1-6. I figured that since, surprisingly enough, I hadn’t been invited to thanksgiving at the American embassy (and I don’t belong to the American Recreation Assoc.), it would be my best chance of getting some turkey with stuffing and overly-thickened brown gravy. No such luck. I had a chicken chef’s salad instead. The volunteer sitting next to me, a Norwegian who writes news stories for Mama FM radio (an NGO nonprofit thingy that gets disadvantaged women on the air), kept looking at my dinner. Finally she said, ‘you’re eating a salad?’ Yes, I had to admit, I was. I guess I’ve gotten slightly away from the peel it, boil it or throw it away doctrine.
After dinner we went bowling.
Subscribe to:
Comments (Atom)