Friday, September 21, 2007

travel in uganda

Come with me on a short trip to Uganda. The main base for Hospice Africa is in Kampala - the capital city; built across 7 seven hills. Uganda is frenetically preparing for the Commonwealth Heads of Government Meeting (CHOGM) with seemingly every road dug up and a forest of shrubs and plants ready for planting - if only it would stop raining. Several Ugandans asked me whether the Queen would be happy with the preparations and I had to confess I am not often chatting with HRH. Getting around is by minibus taxi known as 'mutato' with most journeys culminating in the taxi park. For the more adventurous there are the motorcycle taxis or 'boda bodas'. No helmets and a dusty ride but at least you can weave through the traffic jams. Several hours down the busy highway towards Rwanda and the DRC, in Mbarara, there is a very different model for Hospice Africa. Here a vehicle laden with medicines, antiseptic wash, morphine and children's toys leaves early in the morning. Stops are made along the 74km main road towards the district clinic where patients waited for their monthly review. Clinics under the banyan tree - often with a curious audience. We drove past the daily events of life in Ibanda district; boys dragging their heavy loads of matoke (staple diet of steamed bananas) to market and car mechanics setting up shop in the street. Martha and her team were not only offering a great clinical service but also were concerned with the financial challenges, family support and spiritual care. Holistic care in action. Our last patient was seen up a dirt track in the dark - and a sobering site as a desperately poor mother tries to keep her family together despite her illness. No sign of food or fire for the night - thankfully the team were able to offer practical help, clinical care and compassionate concern.

Did you sense some of the realities of palliative care in Africa? I is amazing to see how much has been achieved across Uganda with the support of the government and many many people who are committed to bringing comfort and care. We are discussing an exciting and challenging project to support the training and teaching in Kampala. Next week I will be at the African Palliative Care conference in Nairobi where the theme is 'keeping it real'; so watch out for the next post.

Meanwhile my favourite portrait of the inspiration and founder of Hospice Africa, Dr Anne Merriman. Surrounded by kittens and puppies as ever!

Monday, September 03, 2007


Greetings from the 'Pearl of Africa' It is good to be back and to have such a warm welcome from Dr Anne Merriman and the staff at hospice Africa Uganda. This was one of the early palliative care services in Africa (1993) and sought to provide a model for cost effective care in this continent, as well as offer care to Ugandans. (see BLOG 11/10/06) One of their objectives is also to support palliative care in other African countries; and this is done by education and training support as well as exchange visits. Here you see Dr Anne with 2 nurse colleagues (Funmi and Kuye) from Ibaden in Nigeria. They have a very new palliative care programme and are receiving support and training from Hospice Africa. It was so encouraging to attend a Palliative Care Association of Uganda update and see how much has been achieved since 1993. I have been doing some teaching at the Hospice as well as exploring future ways Cairdeas can offer support.

Let me take you to meet a lady we visited with the Jinja Hospice team. Perpetua lives in a rural setting with her family. You can see her young grandson outside the 'kitchen'. She has been ill for some time and had a miserable experience of uncontrolled pain and expensive visits to hospital with little benefit. With the support of the Hospice team; who can assess and prescribe free drugs including oral morphine; her pain is under control and she is happy to be at home. She wanted to pray for us as she felt God had sent us to help her and give her family support. Here she is reading some verses from her bible and giving thanks for all the help she has received. It is good to be reminded of our core values and purpose in palliative care and to consider the many many people who are not able to access the help that they need.

I hope to visit one of the other sites for Hospice Africa this week so will tell you more of life in Uganda in my next BLOG.

Highlights so far have been many but include a very African church service led by a famous children's choir, Watoto, who are all orphans (many as a result of HIV/AIDS). Dr's Peter and Trish Kiehlmann were also with me on a visit from Aberdeen - small world?