Saturday 4/26/2024

Hello! You might want to get comfortable, grab a snack, and put your feet up. This will be a long one! 😁 I am back from the Ssese Islands, visiting 3 islands and 5 clinics in 3 days. 

Let's back all the way up to last Friday. I went to CHI for the day, but there were no patients. The clinics that I have worked with here do not run as they do back in the states. There are no appointments made, patients just show up, first come first served, or they don't. Gingo has been asked to create SOPs for the clinic, which is not something he is familiar with or has any experience doing, so I helped him with some research and examples, talked about some other resources that I may be able to send him, and then I headed back to the office. 

When Picho and I arrived at the office we were informed that, once again, the trip to the islands might have to be postponed again due to a last-minute request from the US team.  Renny had responded with the requested paperwork, but Friday in the US is Saturday in Uganda, so we would not have an answer until late that evening or the next day. This is one of many times this has happened during my trip, and my frustration was palpable. I wrote an email to my travel agent asking her to let me know what the cost would be to change my flight and spend another week in Istanbul or fly home early. At this point, I have only spent 5.5 weeks actually training or scanning for ITW, the remaining time has been spent looking for projects or problems that I can assist with at the ITWA office. As helpful as that has been for the Uganda team, it has not been my intended purpose for coming here, leading me to question my purpose and effectiveness. I have been planning this trip since I left Uganda last year, with plenty of notice for my arrival. It's been quite disheartening, compounded by my overall exhaustion, increasing allergies from the dust of Kampala, and missing my long, peaceful walks in the woods near my home. Very late in the evening, I was sent a message from Allan that the trip was back on, so I sent a follow-up email to my travel agent and spent the next day packing. 

As I finish writing this last part, I wonder if I am making the right choice in sharing all of these thoughts and frustrating feelings. There is always the risk that it will compromise my relationship with ITW, or that I will lose the financial and emotional support I depend on to continue doing this work. I also don't want to only present the "good parts" of my journey, leaving a false story for my readers and supporters that feels disingenuous. This is the fourth NGO I have worked with in this capacity, and there have been many more that I have worked with (having volunteered in some capacity since my childhood, thanks to my mom) ranging from a standard volunteer to Volunteer Coordinator. Most of these experiences have been wonderful, but like any company or organization, I am a good fit with some of them and not so good with others. This feels like proof that having been told most of my life that I am "different" and not everyone's "cup of tea" is actually true. I have to remind myself that I do believe in the work I am doing, that being different has been a benefit, ignoring the often-overwhelming self-doubt. This type of volunteering isn't easy, but I can't help but feel that it's worth it. So, it all stays in the blog. The good, the bad, and the ugly.

Monday morning, Renny, Allan and I loaded up the van, picked up Samalie, and drove to Entebbe to catch the ferry to Bugala Island.

 Many Ugandans have a complex relationship with water and boats, stemming from a combination of water sanitation and scarcity, and a lack of safe waterways and boats, leading to water related accidents and tragedies. This may serve as at least a partial explanation as to why none of my travel partners were looking forward to our journey on Lake Victoria. 

Many of you may know that I have worked and lived on Whidbey Island many times and it's one of my favorite places. I love being surrounded by water and love riding on boats and ferries, so as opposed to my fellow teammates, I was looking forward to the ride to the island. Trust me when I say that the ferry in Entebbe was the smallest, sketchiest ferry I have ever seen! The Whidbey ferry can hold 120-140 vehicles, and below is a photo of our van, crammed in between a couple of trucks. 

There was an enclosed seating area where most of the passengers crammed in together (no, thank you!), and the rest of us found space along the railing or in a small area up top. There was not nearly enough seating for everyone, and the trip was about 3.5 hours long. The ferry was delayed by a little over an hour, as supplies were loaded onto the ferry. The ferry was going to be out of commission for maintenance, with no replacement, so it was loaded with more supplies and people than usual. We were blessed with a beautiful day, and I managed to find a seat on the top level, finally pulling into Kalangala just in time for a beautiful sunset. 

We settled into our hotel, ordered some dinner, and discussed the plans for the next day. A few years ago, ITWA-CHI trained 9 healthcare workers from 3 government clinics, sponsored by the Uganda Rotary, and this visit would give us a chance to check in with them, bring some much-needed supplies, and check on the equipment. Samalie would spend the day at one of the clinics on Bugala island, while Renny, Allan and I would take a small wooden boat to 2 remote islands to assess their clinics for possible future training. The government Health Centers offer free services and are often staffed with overworked and underpaid health professionals, so offering additional training can sometimes mean more responsibility and time consumption, without additional compensation. Even though ultrasound can be a wonderful diagnostic addition and elevate patient care, it can also be hard to manage for these exhausted workers. This is something I need to remind myself, when I am checking the progress of sonographers that have completed ultrasound training. 

The following morning (Tuesday), we stopped for breakfast, dropped Samalie off at the clinic and drove to the boat docking area to find our ride. When we dropped off Samalie, I took a few moments to deliver some of the supplies I brought for the clinics: towels, headlight beanies and solar lamps. The islands are often without power, so the lamps and beanies were much appreciated. (Thanks, again, to all of you!)

The first leg of our journey was a one-hour ride from Kalangala to Bukasa Island, outrunning the storm that was rolling over the north side of Bugala island. 

This was our boat for the day, a wooden boat with an outboard engine,
designed for passengers and transporting supplies between the islands. 

We arrived in a small cove, climbed out of the boat, and began an uphill hike to the Bukasa Health Clinic at the top of the hill. Keep in mind that when a patient needs emergent care, they must walk or be carried down this hill to an ambulance boat, then transported to Kalanga or the mainland, to receive advanced care. 

We all sat down with the assistant to the clinical director, introduced ourselves, and explained that the Rotary was interested in funding additional ultrasound training to one of the clinics on the remote islands. We were there to make a clinic assessment and help determine which clinic could benefit the most and would have the most success with ultrasound training. Allan and I worked on an ultrasound machine that someone had donated to the clinic, only in use when visiting Sonographers came by to help, while Renny went through the Assessment questionnaire with the Assistant. We gave a short demonstration on our Lumify system, then decided we should move on to the next island to outrun another incoming storm. So, back in the boat for an hour and a half ride to Lulamba island.

Lulamba had already received quite a bit of rain, so we were faced with a flooded path and a short detour to walk up to the clinic. 

With more clouds moving in, we were a bit faster with this assessment and back on the boat for a 45-minute ride back to the Kalangala. 

Yes, I am the only one truly enjoying the ride! 😂

We were lucky we chose to visit the islands on our first day, as the rain continued for the next 3 days. Increased rain means rough road conditions and delays for patients trying to reach the clinic, which means on Wednesday and Thursday we settled into our breakfast spot, watching soccer highlights, and waiting for a break in the weather.

We arrived at the Bumangi Health Center, and I unloaded more towels, hats and solar lamps, to the delight of the midwives. They are often called out in the night and an extra light source is a game-changer for them! Another reminder that this is all worth it.

I took some time to work with one of the sonographers, focusing on areas she felt were most challenging, then Samalie and I took over scanning patients. This served two purposes, giving the staff a much-needed break allowing them to take more time with patient care, and also giving the patients a more thorough ultrasound. 

(Are you still with me?? I warned you this was a long one! 😉)

Thursday was much the same, arriving at the Mugoye Health Center by late morning. While waiting for patients, Allan started to work his IT magic, finding a creative solution to the dilemma of a signal booster that wasn't working. 

About an hour after the rain stopped, mothers began arriving and Samalie and I got to work. We started out with me scanning, while Samalie took the history and Renny wrote their exam into the registry book. At some point we realized that we would be here all night, as more mothers arrived, so we split up and Samalie and I continued scanning patients until late afternoon. I handed out more gifts, received a wonderful hug in return, and we headed back to the hotel for a much-needed cleaning up. 

Another bonus of these solar lamps is that you can use them to
recharge the light from the headlight beanie!

Allan had told me about a beautiful hotel on the island that he wanted me to see before we left, so I treated everyone to a delicious fish dinner with a view of Lake Victoria on our last evening.

Friday morning, we were on the road shortly after 5am. With one ferry down for maintenance, we wanted to get in line for the only ferry leaving the island, docked at the north side of the island and arriving on the mainland about a 3.5-hour drive south of Kampala. The rain had started up again in the early hours and the lake level was rising. The ferry only allows the driver of vehicles boarding to stay in the car, so the rest of us waded through the flooding to board the ferry.

They also do not allow passengers or drivers to sit in their vehicles while on the ferry, but the continued rain forced most people into the small, covered passenger area, leaving the rest of us out in the open, so Allan and I smuggled ourselves back into the van and hid out in the back (tinted windows!).  Always an adventure when I travel with this crew! We finally arrived back at the office in the late afternoon, everyone looking forward to a shower and dry, clean clothes. 

Well, there you go...caught up on the week. Whew! I plan on spending the day in my room, poor Rian isn't feeling well, and I would hate to get sick before I head back to Istanbul and home. I have paid Eddie to catch up on my laundry, so tomorrow I will start packing. Monday, I go to CHI to work with Gingo and also a Dr. whom I worked with last year. The rest of the week I will finish up some projects I have been working on, pack up supplies to be sent to some of the trainees from the birth center, and continue my packing process. Friday I will spend the day and evening in a hotel in Entebbe, because my flight leaves for Istanbul at 4am on Saturday. 

I will check in again at some point, before my flight home, and I have taken off the week after I return. Experience has taught me that the time change on my return trip makes me completely useless for at least that long. Thanks for joining me and a big THANK YOU to everyone who has helped make this trip possible. I would also like to thank the people who have been making donations towards the purchase of more solar lamps, they make an incredible difference in the lives of so many people!

Much love, Jo/MB