God is so good...: December 2007

Friday, December 21, 2007

Uganda, Pictures

Sunday, December 16, 2007

Uganda, Day Ten-Eleven, 8/20-8/21/07

Early to bed, early to rise. This time, we woke up at about 3:30 AM. My alarm clock provided the rude awakening, but the ice-cold shower that greeted me next made it even ruder. Our hotel in the city of Fort Portal had planned for a much smaller group, so myself and a few other comrades ended up bunking in a small bed and breakfast on the outskirts of town the night before. We grabbed some breakfast and were headed back to Kampala in the still-dark morning.

I tried to stay awake to see some of the countryside. Since I had never seen this land before and it was all so new to me, I felt a little like Livingstone out discovering some new African land. I would pinch myself to stay awake and absorb it all, pestering Michael with questions that he's probably heard thousands of times from people like me.

The drive back into Kampala was as nerve-racking as the previous one into town from Entebbe the night we arrived in Africa--probably even more so. There were pedestrians and cars and trucks and buses and mopeds and bikes EVERYWHERE, and no one follows any traffic laws! You just hit the gas, and hope that other people avoid you somehow. There was a round-about with cars going in different directions about two feet apart from each other with a couple of bicycles, a moped, and a guy in a wheelchair trying to fit through the gap! I bit my tongue several times when I felt like snapping at Michael to take it a little easier in traffic.

We picked up our suitcases that we had left at the hotel in Kampala, then embarked for the airport back in Entebbe. Unfortunately, it was now that I finally discovered the video capability of my new camera; in the craziness of the preceeding days, I hadn't even spent much time experimenting with it! I tried to get in a few video shots from my shotgun position, but they ended up being mostly clips of traffic going by our van. I could have gotten some cool footage had I figured this out sooner!

We stopped for a long layover in Nairobi, Kenya, then had an overnight flight into Amsterdam again. Yet another overseas flight had us back stateside in Detroit, where I tried to do as much preening in the airport bathroom as possible...I'm sure we looked like the grungiest bunch of misfits anyone in the terminal had ever seen, but we didn't really care too much. It's funny; while everyone was talking excitedly about the first thing they would do or see when they got back--friends, family, etc., all I could think about was my razor and shaving cream back home...I could hardly wait to clean myself up!

God is so good. I learned this and was reminded of this so many times during my short stay in Uganda. He stayed with me through so many tough situations (like He has all my life) and through so much apprehension and anxiety...A Wonderful Counselor indeed. I saw how little the people have there, how much we as Americans have, and how badly He wants us to rid ourselves of our crutches--the things we have that we worship and idolize and think sustain us when really all we need is His provision. I saw people praising God and rejoicing in the fact that they can know Him and experience Him--even if they didn't have a moped or a car, or a house with a floor, or even shoes. They had no inhibitions and therefore worshiped freely.

Isn't that how it should be? Shouldn't we--who have been given so much more--be that much more grateful? I thank Him for this experience and for the people He provided to team up and do His work. Now that I'm back home, I only hope I don't fall back onto my old crutches--my sources of insulation and security--that keep me from trusting God for every little thing...even a razor and a can of shaving cream...

Uganda, Day Nine, 8/19/07

Off again for another early morning game drive where we saw more of the same animals as the day before. However, we would then leave for Fort Portal and then on to Kibale National Forest to track chimpanzees.

The forest was gorgeous--a true rainforest with very little sunlight reaching the ground. After splitting up into small groups, we finally found some chimps playing together and eating fruit high in a tree. We definitely had to watch out for falling "debris" though (branches, fruit hulls being tossed down, and even urine from the chimps!!!). Thankfully, no one had that close of an encounter.

The hike was awesome...it felt great to finally break a sweat and get some good exercise. Standing for hours on end in the hospital will tire you out, but this kind of rigorous activity was really just what the doctor ordered--and just what I needed to work off all that matoke!...(a traditional Ugandan "mashed plantain" dish). We headed back to Fort Portal, ate some dinner--easily the best meal of the trip so far--and got to bed early.

Uganda, Day Eight, 8/18/07

This morning we woke before dawn (like most mornings on this trip) to head to Queen Elizabeth National Park for a morning "game drive." On the way there, we passed by a horrific traffic accident in which a bus had had a run-in with a hippo...not something I've seen too often in the US.

The game drive was absolutely amazing. These animals are really something to see in their natural habitat. Sorry, Dad, but our "nature shows" don't even come close--no matter how cool I think Marty Stouffer (the guy from "Wild America") is. We watched baboons, impala, water buffalo, water bucks, bush bucks, enormous termite mounds, warthogs, vultures,

and even a pride of lions who had just finished breakfast. We arrived just a little to late to see the kill. By this time, the lions were "fat and happy," very lethargic after gorging themselves on their meal. We took tons of pictures...thanks for the camera Mom and Dad!

After a couple of hours, we made our way to our next stopover, the Mweya Safari Lodge. I've got to say that this may be the most beautiful place on God's Earth. It lay at the end of a game trail and is flanked on almost all sides by Lake Edward to the north and west and The Kazinga Channel to the south. The lodge sits at the top of a huge hill, allowing you to see wild animals and breathtaking scenery for miles in all directions--over land and water.

We had a bite for lunch--complete with the absolute best passion-fruit juice I've never had--then set out for a hippo cruise in the channel. We saw tons (literally) of hippos, rare African fish eagles, more water buffalo, crocodiles, and all kinds of water fowl. The cruise was fantastic, but the slow moving barge with its droning engines made it hard for anyone to stay awake; I even caught Dr. Haglund bobbing his head a few times. We crammed so much activity into our time, and it was starting to catch up with us.

But, again, the best was yet to come. While we were out cruising The Kazinga Channel, our drivers were out scouting those elusive elephants. Upon our arrival back at the docks, we piled back into the vans and headed off into the bush again. A storm was brewing, and just as the heavens opened up with a torrential rain, a mother elephant and her calf showed up from behind a grouping of trees. They were majestic in the rain, basking in it and shaking off the water with those huge ears. What a find!

After taking quick nap and grabbing a shower, we ate dinner and proceeded to the lobby for a little talent show that some of the team had been preparing. We had all grown pretty close having worked so hard together in such close proximity, so now it was time to let our hair down a little. Senthil slayed us with his own breed of stand-up comedy, while Dave Gleason, one of our anesthetists, regaled us with his new rendition of "I Crossed the Line," sung to the tune of Johnny Cash's "I Walk the Line." (To reference, the Mulago theatres had a pronounced red line on the floor at the OR suite entrance where we were required to remove our shoes and put on these rubber-like slippers to maintain a clean environment there. We all thought it was kind of funny considering all the dirt, mildew, and wild critters that were already behind said line). It was a great way to cap off a full day of hanging out together and just enjoying each other's company.

Uganda, Day Seven, 8/17/07

Today would be our last day in the theatres. Each surgeon was to do just one case each. I was planning on scrubbing Dr. Parker's shunt, but I felt my time would be better spent teaching the Ugandan surgeons how to use the implants and instruments I had brought over to stay at the hospital. Since we had only performed one instrumented spine case that week (Dr. Haglund's posterior cervical on Wednesday), we hadn't really had a chance to teach much instrumentation intraoperatively. Plus, I felt that if I had brought all this equipment but didn't show anyone how it worked, I would have done them no favors. It's actually pretty astounding to see so much equipment they already have yet don't use because they either don't know they have it, don't know what it is, or don't know how it works; these things have just been parked here by well-meaning individuals with little to no instructions on their use. So, I inserviced Dr. Michael, who was very pleasant and eager to learn the proper use of the equipment. I really have enjoyed his and all of the Mulago surgeons' company over the course of the week.

Leaving Mulago was bittersweet...mostly bitter. The surgeons, sisters, and attendants were very sad to see us go. Rashid, an attendant who had befriended me earlier in the week, brought me a gift wrapped in a cardboard box that had once held surgical masks. Inside was a picture of him, some Cadbury chocolates, and a small drinking glass from his home--probably one of the only glasses he owned. I felt completely heart-broken and honored at the same time. I had no idea what to do to thank him. We were changing clothes in the locker room at the time, so I just took off my Duke-blue scrubs and gave them to him. He was overjoyed and gave me a big bear-hug. We proceeded to go through all the new "handshakes" we had learned and practiced that week, and we promised to keep in touch. We finally left to cheers from the theatre workers, and we traveled back to the hotel to finish picking up the bags we had packed the night before.

We were now on our way to meet His Excellency General Yoweri Museveni, the President of Uganda, at the Ugandan House of Parliament. (Pastor Senyonga had orchestrated the meeting). We actually had to make more than one trip to the capitol because our meeting was delayed by the President's other meetings that afternoon.

While we waited at the sentry, we used this bus-time to snag a few catnaps and catch up on much-needed sleep. No offense to His Excellency; we were really excited to meet him, but our sleep cycles were pretty scrambled by that point. After all the security screenings, we were shuffled into a meeting room where His Excellency came in to meet us. All of the press were there as we met him and had pictures made. I thought it was a very nice gesture.

From there, we piled into minivans and set off for Queen Elizabeth National Park in southwest Uganda. (We would stay the night in Mbarara en route to the park). We stopped to take pictures at the equator, and one of our vans got stranded with engine trouble. The problem was quickly fixed, but little did we know what this little snag was foreshadowing.

Later that night as we trundled along the pockmarked roads of the bush--last in line of our 4-van convoy--we got a flat tire.

"We've had a puncture!" our driver, Michael, exclaimed. The other vans sped off into the night, oblivious to what was going on. We pulled over to the side of the road, and got out to change it. I noticed the condition of all the tires--bald as a baby's behind with steel belts exposed.

This van would have failed inspection years ago in the states! But, such is life in Uganda. There really is no such thing as preventative maintenance here. When something breaks, you use whatever rudimentary tools you can find to fix it, then fix it again, then fix it again until you finally cannot fix it anymore. At that point, you leave said object where it lies and look for another one. So Michael and I assessed the situation and began to change the tire. However, this task proved much more difficult than first imagined. It was pitch-dark, we had no hazard lights, all kinds of traffic were whizzing by us doing 60+, and we were starting to hear the denizens of the bush rustling beyond the roadside ditch. On top of all that, our tire jack would raise the van high enough to remove the flat tire, but not high enough to put on the fully inflated spare. We pulled the van up to some higher ground, thinking we would have a more optimal place to set up the jack, but this didn't work either. Then, we came to an impasse--should we keep calling the other vans to come back and bring another jack that might raise the van enough, or do we improvise and pull a risky maneuver to get the van higher into the air??? We decided that it might be hours before the vans ever realize we were stranded, so we proceeded with our plan (which I do NOT advise anyone doing unless you are absolutely desperate and have no other way out). Michael and I gathered whatever smallish stones we could find in the ditch and made a little mound. We placed the jack on the precarious pile of rocks to get the van a little higher.

"Ok Michael," I said, "as soon as I take this flat off the hub, we've got to get the spare on as fast as we possibly can...I don't want this van floating up here with no tire on the wheel, just to have it crash down on the two of us when those rocks collapse!"

"Ok," he replied.

Well, it worked. Michael and I looked like a pit crew that would make the good ole boys at Talladega proud. We were slamming on lugnuts left and right, and before we knew it, we were back on the road to Mbarara.

We finally made it to the Lake View Hotel in Mbarara. How would I describe this place? Well, let's just say it would have been a "roach motel," but the roaches had packed up their things and left this place long ago. I kept expecting to see little girls riding tricycles through the halls or blood gushing from elevator doors a la "The Shining." It was truly eerie. Senthil got a chuckle out of my trying to get situated in my bed under the mosquito netting--which happened to be full of mosquitoes. I was sitting there trying to kill the little pests inside the net like Mr. Miyagi in "The Karate Kid!" What good was this thing?!?

Wow, what a day! I don't want to toot my own horn here, but how many people can say they've been in surgery, met the President of a country, walked across the equator, and changed a flat tire all in one day?

Uganda, Day Six, 8/16/07

Another day of scrubbing and circulating theatres, and another day of firsts. Senthil (my roomate and our fearless PA) got to do his first bilateral temporal artery resection. He was so pumped that he had done a great job and the case had gone well, and we were all so proud of him! Both vessels were almost totally occluded, or blocked.

We finished up at a more reasonable time today because Dr. Mallenga, the Ugandan Minister of Health, was holding a reception for us back at the hotel. The event was an all-out gala, with many hospital workers as well as Ugandan dignitaries there to meet us. We were all quite dingy and ragged looking in comparison to our hosts, but no one cared. They recognized us, gave gifts, and fed us a wonderful dinner.

The highlight of this evening was the acknowledgment of Robbie Diggs (pictured here on the far left), for whom the entire hall gave a standing ovation for his efforts. Let me tell you about this humble hero from Anson County, NC. Robbie had agreed to go on the trip in support of another biomedical engineer from Duke. When his counterpart was forced to withdraw from the mission days before leaving, Robbie stepped up in a big way. He was constantly seen running around in circles, fixing light sources that had blown out bulbs from power surges, getting taxied around Kampala, hunting down any available transformers with whatever money he had in his pockets, teaching the resident technicians at Mulago how to operate and maintain these machines...He even had to repair our OR microscope--intraoperatively--that had shut down during one of Dr. Zomorodi's complicated brain surgeries. He would never tell you how many impossible challenges he faced and had to overcome, so allow me...this guy is a stud.

God is so good...