As probably happens with most volunteers to developing countries, this has been a week filled with frustrations.

On Monday, I was drawing blood from patient after patient and I guess I wasn't paying attention like I should have. I ended up squirting an entire syringe of blood on my face and all over myself while drawing blood from a child, for a Malaria test. I sent the child's blood, as well as his mother's blood, to the lab for HIV testing, but as luck would have it, there seems to be no record of the test or the blood and the patient has been discharged. I don't believe I ingested any, but it's still kind of scary. On a good note, I seem to be in an area of Uganda where there isn't much AIDS. I would guestimate that 95% of the children we see are here for Malaria and its complications, so I am crossing my fingers.

On Tuesday, I did a very dumb thing. Power is off here from 7 a.m. until after 7 p.m., but comes on briefly so we can prepare our lunch. I had my stove on when the power shut off and I didn't realize I had left a burner on. When I came home later that evening, my house was filled with smoke and soot, as my kettle had ignited on the stove and caught on fire and then extinguished itself. EVERYTHING was covered with black soot and I had to take the next day off, hire two people to help me and we scrubbed the walls, ceilings, floors of the entire house. The ceiling in the kitchen is still completely black, but it could have been so much worse. There are no smoke detectors, extinguishers or fire departments, so I am so lucky I didn't start the entire house on fire.

Thursday and Friday were incredibly frustrating and I almost packed up and flew back home. The Children's Ward has a patient count right now of about 54 patients and usually there is just one nurse for all these children. Eight of those children are critical, 38 of them are acute, but not life-threatening and the others would be what we in the U.S. might have in a "Step Down Unit". On those two days, we had NO nurses at all, but we did have instead, a young man whom they call a "Nursing Assistant", to take care of all our patients. Because I do not speak Lugandan and very few people here speak more English than "Good Morning Madamme", I can only wait until I am told what I can do to help. So, I wait.

We have a 9 year old boy who was post-op from a gut perforation from untreated Typhoid. He had been writhing and moaning in his bed all morning Thursday and I kept telling the Nursing Assistant that something was wrong with the boy and that we had to get some pain meds for him. I finally kept persisting (as I have been known to do) until finally that afternoon I pitched such a fit that he went to the doctor and retrieved some pain medicine for this child. I later found out that he hadn't had the first bit of pain relief since his surgery the day before! I was appalled! The next day it was more of the same and I knew something wasn't right. By Friday afternoon when I finally found a doctor to check him, he actually had feces leaking out through his incision site and had to be moved back to the surgical unit. I'm certain he's probably septic and his outcome may not be good, but I am hopeful and praying that it is.

The biggest problem is that there isn't a solution at hand. We have only 4 doctors to see all the patients who are hospitalized, all the outpatients, all the HIV/AIDS clinics, all the Outreach Teams and to do all the surgeries. Our doctors are young Ugandan natives that are dedicated to helping their people and do so for very little pay. We don't have enough qualified nurses and I did the conversion yesterday and realized that a nurse with a degree from a University, makes about $1585.00/year here. As the "Matron" or Charge Nurse says, it IS a sacrifice in this country for someone to be a nurse. They are overworked, underpaid and overwhelmed. We don't have enough supplies, because we don't have enough money. We don't have clean water when we turn on the faucets here and we run out of gloves every other day. If we don't have an item or a medicine needed for a patient, they must go to the "store" here and purchase it. The other day, we ran out of IV drips sets and the patient's family had to go to the store to buy it so their family member could get Malarial drugs.

I saw the worst case of Malnutrition I have ever personally seen yesterday. A 5 year old girl and her family were brought in by a Mzungu (white guy) who lives near them and wanted to help them with their plight. This poor little girl maybe weighs 20 kilos, all of her bones showed through her skin and all the fat on her body has wasted away to the point that she looks as if she has permanent wrinkles drawn on her forehead...like a costume mask. The worst is that with severe malnutrition, comes edema of the extremities and the skin can only stretch so far. She had many open seeping wounds between her toes and fingers, on her arms and legs and one on the top of her foot that was so infected, that I am sure once she is stabilized, will require surgical intervention. Her family lacks the education or money to bring her to the hospital for treatment. Unfortunately, I guess they didn't realize that no one is turned away here for the lack of ability to pay. They waited so long and now the child is critically ill. The man who brought them handed me 20,000 Ugandan shillings (about $10) and told me to see that they got food, because if he gives the money to them, he didn't think they would get food. So tragic.

On Monday, I will be in "Theater" (Surgery), which should be very interesting. They have a lot of trauma and surgical cases here, because people don't wear seatbelts or helmets. They drive like maniacs and there are no speed limits. Very few people have cars, so most are on foot, bicycle or boda-boda (motorcycle) and get mowed down pretty often.

Tuesday, I will be accompanying an Outreach Team to some of the surrounding villages. I can't speak to the patients directly, but I can be an observer and hopefully help in some way.

I will try to get some more pictures of the village and so forth posted in the next few days.

Christy