7 May Friday

4 May evening
No Power.
Tuesday evening. No power in my guest house for over 24 hours. Rest of town has power – nobody really know why we don’t. The generator is “spoiled” which meads not even minimal lights…and I won’t be able to boil water for my coffee in the morning. Will have to wait til I get to breakfast for my first cup.

Julius – Surgery
The young man who came to us with a worsening 2-month old leg wound arrived at TSMP clinic early on Monday. He, the driver (Richard) and I went to the private clinic where he had gotten a wound culture done on Saturday. At 9:30 we were rthe first to sign in to see the orthopedic surgeon (who is only here 3 days/week) Julius saw the doc at 11 – not a bad wait (though I was eager to be back to our clinic)! Xray showed no bone involvement, but the tissue needed debridement. About 300,000 shillings ($150) later and at 5 pm, he was waking up. Somehow, Richard had located Julius’s wife and year-old daughter (the 4 orphans of Julius’s brother were left at “home” in the hut in the camp.) Here, a patient’s family has to provide food, water, help with the bathroom…since Julius and his wife actually have NOTHING, we arranged for meals to be brought to them in the evening and tea and donuts to be brought in the morning.. The wife was prepared to spend the night – she had a sheet to sleep on the cement floor.

The surgeon was highly suspicious of the tissue and sent a biopsy to Kampala ($15). He thinks it may be TB. The results will be back when Julius sees the doc on the 14th. Meanwhile, we transported him to TSMP, where he spent one more night in a bed and in a clean environment, with food and clean water. His wife arrived on Wednesday morning and was there fro the first dressing change. The wound looked good – it was dry and the tissue is pink. But it is really big and the tissue around it is extremely fragile. The gellow has at least a month of healing ahead of him. I decided to give money to Richard to pick up beans, posho (like polenta), cooking oil and charcoal for them as he drove them home. Richard is one of those amazing angels – he know the people, is really spiritually connected and is incredibly dedicated to the poor people who were displaced by the civil war and who now have been pushed out of the camps by the government, but still are somewhat homeless. It is not a good scene here.

A bit more about this situation with Julius. Generally, my approach is to focus on community level needs. There is so much need here that helping one person feels a bit like a drop in a very huge bucket. And how does one decide who is meritous and who is not? I crossed over that line with Julius and am feeling quite conflicted. He’s only 21 and lost his ability to earn money with this leg injury. He most surely would have lost his leg, even though he had been to our clinic right after the accident and was treated. At our all-staff meeting on Wednesday morning, I talked about this with the staff. I acknowledged that I had made a mistake and should have consulted with Martin and Dr. Nathan before launching into the wound culture and all that ensued. One of the problems that this could lead to is people in the community expecting that the clinic will be able to provide this for everyone. And of course, we cannot. I both wanted to let the staff know that I had made this mistake and was totally owning it. AND I wanted to demonstrate that making mistakes is quite human. In talking with one of the staff about this later (Esther), she said “when you don’t have open communication with people and they can point out your mistakes, how can you ever learn and avoid doing something wrong?” I totally love these guys and am constantly inspired by their wisdom.

Outreach Day – Thursday
Thursday we packed into a van and drove about 40 minutes north and east of Soroti where we did an outreach clinic. Four doctors saw medical patients (155); a midwife saw antenatal women (30?), a midwife did childhood vaccinations (I have no idea how many) and the lab did some malaria tests (we ran out of test strips) and the dispensary nurses counted out tablets and gave injections! WOW! I helped with registration and was very popular with the docs when I showed them how to change the new thermometers to Centigrade! I also helped with the vaccinations – filling out the cards and escorting sick Moms to the medical docs, when needed. Then I helped in the dispensary, something that is always needed, but not my favorite thing to do.

Friday
How can it be my last day in Soroti? I woke at 4:30, the power is off, again. (It had been on for about 24 hours.) I plan to be at the clinic this morning, will see Julius and change his dressing. I am hoping it will be busy enough that I won’t have time to cry. I am so full of many emotions – gratitude for Charles Steinberg’s invitation to come here 6 years ago, for the “Gails”, for these strong and dedicated staff who provide such loving care for people who have suffered so much and for Jennifer Braun and her willingness to partner with us and then take over the clinic. Without her dedication, none of this would be as it is today.

As I sign off, I will be heading to Kenya tomorrow. I’ll be meeting with a friend there who is teaching at a school of nursing. I’ll try my best to report in about that road trip and the possibility of a job interview! And then actually having some fun.

HOME ON the 15th. I am actually going to be home on May 15, not the 5th. I made a type-o. Sorry for that!