Madame Janet visits Mityana

Dr. Ruby Dunlap’s Uganda Fulbright Blog
Uganda’s premier English language newspaper, The New Vision, had this article with the headline, “MEDICAL STAFF ABANDON HOSPITAL IN MITYANA” in the 23 September issue, page 7.

Over 40 medical workers in Mityana Hospital on Monday morning abandoned work, leaving 400 patients unattended to.
The workers went to attend a court session where their four colleagues were charged with manslaughter following the death of a pregnant woman in labor.
Sources in the hospital said workers reportedly agreed not to return to work unless their colleagues were granted bail.
Nurses Jane Nanfuka, Agnes Namirembe, Joy Namutebi and Dorris Nalwanga allegedly refused to attend to Sylvia Nalubowa and her unborn baby last month.
The hospital administrator, Charles Luzira, said the medical workers were not on strike but were only showing solidarity to their colleagues and would return to the hospital after the court session.
The nurses were backed by officials from the national midwives and nurses association.
Chief magistrate Justine Atukwasa granted the accused bail of sh200,000 each which they paid. She then ordered them to return to court on October 6.

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I say “Mattress,” you say “Matt-er-ess.”

Dr. Ruby Dunlap’s Uganda Fulbright Blog
Christine and Eva.JPG “Does the U.S. have a big problem with culture?” asked Eva, her small face full of concern. We had just finished reading and discussing Wellman’s chapter on “The Diverse Learning Needs of Students” in the 2009 Billings’ textbook on Teaching in Nursing. The “problem” in this chapter (pp. 21-22) is expressed partly as a catalogue of failures, failure to recruit sufficient minority nursing students and nursing faculty, failure to adequately support the minority student, etc. “Well, children in the U.S. go to similar schools,” I said, “and almost all of us speak the same language. We do have some cultural issues but I don’t think we have a ‘big problem’ with culture. What about Uganda?”

“Oh, all children in Uganda learn English from the beginning,” she said, taking her cue from me. “We don’t have a big problem with culture in Uganda.” (See photo of Eva, the young woman wearing the black sweater. Christine is busy at the computer in front of Eva who is speaking with Keren.)

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“When were you last de-wormed?”

Dr. Ruby Dunlap’s Uganda Fulbright Blog
While in Kampala on Saturday, I received a frantic text message from Bob: “Come home and look at my stomach.” He was indeed in a pitiable state with an intensely itching rash and welts erupting all over him within a few hours. He was having an obvious allergic reaction to something. We thought at first it might be the laundry detergent. Perhaps Amina hadn’t rinsed his clothing sufficiently? I gave him what I had: topical diphenhydramine and also topical cortisone I had purchased at a Mukono pharmacy on the way home. I also had him take Advil PM which has close to 40 mg of diphenhydramine per tablet. That made him sleep and calmed the itching for a little while. But the rash kept growing and I began to get suspicious of the doxycycline. Antibiotics are notorious for causing rashes like the one Bob was having. I instructed him not to take any more doxy and re-washed all of his clothing, rinsing everything until the water was perfectly clear.

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This Week in Kampala

Dr. Ruby Dunlap’s Uganda Fulbright Blog
Kampala is a city of unknown millions who, from a distance and from a height, has a lush look to it with many red tiled roofs nestled among trees and rolling hills. Marabou storks are its biggest birds, tall, gaunt, bald-headed carnivorous birds that prefer their meat well-aged. When one sees many of them circling, a ballet of exquisite grace for one of the world’s ugliest birds, one can be sure of a butcher shop close by.

Getting into Kampala from Mukono is a laborious drive of around an hour if one is lucky, the vehicle lurching either to avoid or try to beat other occupants of the road to a coveted spot. Lurching, I might add, in a mix of oily black diesel fumes, red Ugandan dust, and the smell of garbage which litters the roadsides. I had to make this trip four times this week. I have decided the experience gives me sensory data with which the better to enter imaginatively into Dante’s Inferno.

The first trip was on Monday for groceries, a weekly hire of driver and vehicle which has become necessarily routine. The next two trips were for a two day meeting of a Duke University sponsored “partnership to improve the Ugandan health system.” Mike Smith, the chair of health sciences at UCU, had been invited and, in turn, invited Jean Chamberlain, a Canadian OB/GYN who has made it her personal life’s mission to reduce maternal mortality in Uganda, and Edward, the Ugandan physician who heads an undergraduate program in health administration which is funded by another Canadian organization. As it turned out, I was the only nurse invited to the group.

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First Class Maps

Dr. Ruby Dunlap’s Uganda Fulbright Blog
“Africans don’t like maps and they don’t use maps,” laughed my Ugandan colleague as he handed Mike Smith’s map to me. Mike wanted me to see the turns in the road, the towns and villages, and the geographical features of the country through which we were traveling from west to east as we headed to Sipi Falls.

“What do you do when you want to get somewhere?” I asked. “Do you just start out in the general direction?” But they laughed as though my question were hardly worth answering. Even without maps, Ugandans are a people on the move and they always seem to end up where they want to be. Ben, our Saturday afternoon speaker for the retreat, told us the chilling story of how Idi Amin had punched him in the face, causing the loss of his eye, and how he had followed the railroad track by foot to escape being murdered by Amin’s henchmen. It took him nine days to walk from Kampala to the Kenyan border to safety, the railroad mapping his path securely.

Ben, at the time the editor of one of Uganda’s English language newspapers, hadn’t caught a typographical error in the headlines. The headline was supposed to read, “Amin Raps Nyerere” or some such other African leader. Someone had inadvertently put an “e” after the “p” in “Raps” and Ben had not caught it before it went to press. Amin was not amused. “Ben is one of the few important people who survived the Amin years,” one of the Ugandans told me later.

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Sipi Falls Retreat

Dr. Ruby Dunlap’s Uganda Fulbright Blog
Sipi Falls.JPG Members who could from UCU’s health sciences department spent the weekend in a retreat at Sipi Falls near the Kenya border. That I survived this experience is testament to a God in heaven. It all began innocently enough with Faith, one of those splendidly capable young women such as Belmont’s school of nursing has in Karen and Heather, telling me “we would do a little walking.” Faith had organized the whole thing, all the meals and the stay at the Crow’s Nest at Sipi Falls. Why that name didn’t make me suspicious I’ll never know.
We loaded up on the school of nursing bus: department head, physician Mike Smith who, besides myself, was the only other expatriate. Faith, Maureen, and Dorothy, department administrative coordinators. Jemimah, the chair of nursing.
Inside our bus.JPG Edward, a physician, who is the administrator of a MBA in healthcare. Francis, one of the instructors for their BS in community health, an important non-nursing health profession in developing countries. Clarissa and Selah (pronounced Sell-ah) from the MPH in maternal-infant health. Mike told me it’s actually an MPHL (MPHLeader) degree, open to anyone with a previous bachelor’s degree and very popular; it has UCU’s largest enrollment for a health profession. Tom was our driver. And finally, Grace and the other Faith, two of my MNS students and also faculty for the RN-BNS program. Here’s a photo of our first meal stop, lunch on Friday. I had beans and rice with greens, all delicious.

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Finding a Rhythm

Dr. Ruby Dunlap’s Uganda Fulbright Blog
Had it been a philosophical chicken, it certainly would have appreciated Thomas Hobbes and his cynical view of things. From the moment it emerged from its shell, wet and tottering, until it was finally dispatched by someone to be eaten by me and mine, it had lived to eat brutishly and avoid being eaten nastily.

It had been marginally successful in its first ambition and finally unsuccessful in its last. Now, to add insult to injury, I was critically gazing at its scrawny, blue-tinged carcass and wondering why I had paid 12,000 Ugandan shillings for it, roughly about 6 USD.
Chicken, I had been told, is more expensive than beef in Uganda. My experience has validated that. A plump fryer-sized chicken in a Kampala grocery store costs about 16,000 shillings or 8 USD. A pound-sized package of minced (ground) lean beef costs about 1.50 USD. The chicken in my kitchen had been purchased, sight unseen, from someone Karen had said raised really extra good chickens. This must have been one of their bad-chicken days.

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Gail Bursch review of new book by Jill Bolte Taylor

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Book Review of My Stroke of Insight by Jill Bolte Taylor, PhD
published in The Art of Teaching
reviewed by Gail Bursch, Belmont University School of Physical Therapy
In the midst of beginning another hectic school year, take a deep breath and a moment to imagine the consequences of suddenly having a stroke or traumatic brain injury. Consider the misfortune of a successful neuroscientist, who taught Harvard medical students and conducted research at the Brain Bank, having a massive stroke at the age of 37. After surviving a massive bleed in the left hemisphere of her brain, Dr. Jill Taylor wondered if she would be able to speak again, to walk again and would they take her PhD away?
The ways in which Jill connected with the outside world for help during the four hours her brain was hemorrhaging is an amazing story. Because the left hemisphere contains the speech and language centers, she could not speak intelligibly nor recognize phone numbers. Each normal function shut down one by one as the bleed progressed. The curious neuroscientist in her monitored the details; overcoming the fear and desire to succumb to a peaceful death. Jill described the loss of her ‘brain chatter’, which refers to the left brain monitoring time and details, categorizing everything so that we can make sense of the world. With the left brain injured, her right brain became dominant resulting in silent euphoria and feeling at one with the universe.

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