Saturday evening 3/2/2024

I am finally back in Kampala, after a long, exhausting (but rewarding) week. Friday was my busiest day of the week, with 35 exams completed, most of which were OB/GYN. I scanned a total of 100 exams in a little over 4 days, having scanned for 3 hours this morning before getting back on the road. Some of the potentially life-threatening exams that I have scanned this week have included three cases of Retained Products of Conception (RPOC; when a placenta or incomplete miscarriage/abortion is retained in the uterus), ovarian torsion, strangulated hernia, perforated bowel, no amniotic fluid with twins, testicular mass that is most likely cancer, and a massive abdominal cystic mass. 

A woman with a case of RPOC had an abortion months earlier and arrived in severe pain. 

An important thing to mention here is that the term abortion is defined as the expulsion of a fetus from the uterus before it has reached the stage of viability. This can occur spontaneously, also called a miscarriage, or be brought on purposefully. This is important because many people in the United States (with little to no medical knowledge) have decided to hijack this medical term, assigning a stigma to a medical condition that is out of the control of the mother. In Uganda, as well as many other countries, the word miscarriage is rarely used medically. Abortion is the medical term used and there is no stigma, the focus is on the medical condition itself and the wellbeing of the mother, regardless of the reason for the abortion. You may have guessed that I feel very strongly about this. 😏 

So, this poor woman had RPOC for months, with subsequent fever, headaches and general decline of health. She had no access to imaging until she was able to attend the surgical camp and I am not exaggerating when I say that she could have easily died without going to surgery for a D&C (Dilation & Curettage; a procedure to remove tissue from inside the uterus).

I scanned 2 cases of strangulated hernias, one was a case where a hernia had been repaired but ruptured, and another case that was within the Canal of Nuck. Yes, the Canal of Nuck! The condition that I have never seen in 12 years of scanning, but I have seen 3 in only 4 days of scanning in Uganda! Now, it's tucked away in the Video Library of my brain. 

This morning, Allan and I attended the wrap-up meeting with most of the Bulamu Healthcare staff. We were both asked to speak on our impression of the Surgical Camp and we, as representatives of ITW, were given accolades during a small pinning ceremony. These types of ceremonies are an important part of the professional culture in Uganda, and it bodes well for a possible continued partnership between Bulamu and ITW.

My favorite thing about this photo is how serious Allan looks, when in reality he is one of the most chill and jovial guys I know!

Once the meeting and ceremony were concluded, Allan and I returned to the exam room where there were a couple more patients waiting. Pauline, a PR rep for Bulamu, stayed to offer assistance because my nurse, Bridget, was needed in Maternity. My last patient was the woman with RPOC and Pauline offered to take her to surgery personally to make sure she would be taken care of. Most of the camp was breaking down at this point, although patients already checked in were still being treated. While we packed up our equipment and were walking preparing to leave, Bridget came back in with another patient, sensing an emergency, and asked us to scan one more. As Allan unpacked my machine, I learned that she had been having severe right-sided abdomen pain since September of last year. Having no access to imaging at her local clinic, doctors kept prescribing pain meds, as her pain increased. About 30 seconds into the exam, I discovered the problem...a massive, loculated, cystic mass, taking up most of her abdominal and pelvic space from her right flank to her midline! Ouch is an understatement! I quickly wrote up the report and Bridget walked both of the patients over to the surgery suite so they could receive care. Whew! What a way to wrap up the week! 

Allan and I finally loaded up into the van, went by the hotel to check out, and were on the road at 12:30pm. After another 3+ hours on the road, we arrived back at headquarters in Kampala. 

I have found after doing this type of volunteer work for so many years (since 2014!), that I really need to focus on the successful cases and the patients we have been able to help. It is all too easy to think about the countless patients I never get the opportunity to scan, the countless women, children and men who never have access to this level of care. It motivates me to work endless hours, standing on concrete floors until my feet and ankles swell, forgetting to eat lunch, and never drinking enough water in sweltering heat, but it can also keep me up at night. When I am here, especially, I have learned to force myself to stop, eat something delicious, watch a movie before I go to sleep, take a breath. Prepare myself for another day and remind myself of the people we ARE able to help...very much thanks to all of you who continue to support me, emotionally and financially. 

Well, I have plenty more to tell you, but I am officially knackered. Tomorrow, Sunday, I will relax a bit and organize some of my notes and thoughts from a week of brainstorming with Allan. I will wrap up this blog with a photo you may have already seen on my Instagram or Facebook...

This young man is Rian, whom I first met in 2018, my very first volunteer trip with ITW. Rian is the son of Eddie, who is in charge of and lives at the ITW Headquarters property. Rian lives with him, and attends school in town, while his mother and younger sister live in a nearby village. When Rian came around the corner of the house and saw me getting out of the van, he yelled my name and ran towards me, leaping into my arms. 😊😍 I could not have asked for a better welcome party! This is one of my original Rian and Jo selfies...

                                                         I sure love this little stinker! 😂

Much love and Good Night!

Jo/MB