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Saturday, November 1, 2024 Hello from Entebbe! This afternoon I will fly to Dubai, where I plan to spend a few days reuniting with friends, before flying home on the 6th.  Monday, Tuesday, and Wednesday were spent training. We had a couple of patients with dramatically low fluid. They were all treated at the birth center for dehydration with IV fluids and rescanned the following day. So many of the women that come in are dehydrated and have often been leaking fluid for quite some time before coming in for assessment. As I mentioned (ad nauseum), the women in Uganda do most of the labor of daily living, including carrying all of the water in large 20L jerry cans. As their pregnancy progresses, they are often exhausted and in physical pain, so they stop drinking water. Drinking less water means carrying less water. They also may be leaking fluid, but they may not have anyone to help take care of their other children, so they stay at home. 2 of the mothers had a mild increase in fluid aft
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Sunday, October 26, 2024 It’s a cool, slightly overcast morning here, a nice change from the increasing heat during the day. It’s wild to think that my trip here is almost finished! I will have three more days of scanning, Thursday will be hands-on evaluation day, then Friday I will take a small plane from Gulu to Entebbe. I will spend the night in Entebbe and fly to Dubai on Saturday afternoon. Rachel will be leaving tomorrow, for a conference in Kampala, then another conference in Kenya. It’s been great having her here and we have had continuous conversations about past, current, and future trainings. We spend a lot of time talking about how to optimize the training, problem solving, and how to best support the midwife community in Northern Uganda. It’s great to work with someone who is so supportive and appreciative, and flexible. It’s counterproductive to be too rigid here, which is why I am continuously working on my curriculum materials and adding necessary lectures. Sister
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Monday, October 21, 2024 Happy Monday! Friday morning, the midwives wrapped up the lectures with a written exam. I wrote the exam to focus on clinical cases and relevancy, ultrasound image identification, and just enough physics to be useful. I do not time my exams, which eliminates a lot of unnecessary anxiety, and everyone was done within the hour. The lowest score was 87%, each of them doing very well, although they are all still struggling with critical thinking and problem-solving skills. I graded the exams during the lunch break, we reviewed the exam after lunch, and they were able to take off early for the weekend. Three of the midwives went back to their homes in Gulu for the weekend, one of them is a midwife here at the birth center and lives here with her children when she is scheduled to work.  Rachel arrived mid-afternoon, which made everyone happy at the birth center. She flew into Gulu on a very small plane, and sent her luggage by bus, which arrived on Saturday. For thos
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 Wednesday, Oct 16, 2024 Good afternoon (for me)! I hope everyone is doing well as I approach the end of my 2 nd week here. Let’s play catch-up…Late Sunday morning, a box arrived at the birth center from a boda currier. The 2 nd half of my bound lecture notes arrived from the printer! I went through each of the 10 copies, one page at a time, to find everything done correctly. Imagine that. I had already given a lecture on Friday that was in the 2 nd notebook, and I was worried that I would have to continue lectures on Monday without the rest. WHEW! Usually, I wake sometime between 5 and 6am, with the sun rising around 6:30. The lovely kitchen staff usually have the hot water and tea set-up ready by 7am, breakfast is usually served by 9am. I make myself oatmeal for breakfast, along with a large mug of tea, and am settled in the classroom by 7:30am. Class typically starts at 9:30am, giving the trainees time for breakfast, before joining me. As much as I prepare my curriculum and
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 Saturday morning, October 11, 2024 Good morning! (Brenda, Monika, Beatrice, Me, Coletta) What a first week it's been! I'll start from Tuesday, the first official day of class. My trainees arrived early, unusual, but welcome. We started class in the typical Ugandan fashion, without power for the first 3 hours. 😁This made the overhead projector obsolete and made for a challenging morning, reading through the lectures and looking at photos on my computer. The first day of class is when I teach Ultrasound Physics and the principles and concepts of ultrasound. It's a brain buster, especially for anyone who has never had a physics class, so I try to balance the day with some hands-on practice with the machine. Along with a curriculum of 19 lectures, I have also created a user manual for the Ultrasound machines that were donated. Edan machines are very common here, mostly due to their affordability and durability, and my manual is complete with photos to make it clear for anyone
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