Thursday 22nd November 2012
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| Haley's Birthday |
I go back up to the Finance Office and hand over my English currency and am told to come back in the afternoon as all the paperwork to authorise the exchange needs to be signed by various people. This is clearly not going to be quite as simple a process as I had imagined. Back at Rose Cottage I spend about 45 minutes on my blog and then decide that it might be useful to type up an alphabetical list of all the place names so that whoever is entering patient data in future will have a document to refer to. Sarah arrives about 11am to check off the Excel spreadsheet with me. Two hours later we finally get to the end and it is a huge relief that I won’t have to look at these sheets ever again. This has been my least favourite experience of the trip so far! It has probably taken me a lot longer to complete the task than it would have done for somebody who has medical knowledge, but Sarah assures me it really has been a big help. Normally Sam would be sitting up until 1am one evening processing all this information. It is now lunchtime and I am definitely ready for something to eat. Chips sausage and beans are on offer today which looks very appetising. Unfortunately, although crispy on the outside, the sausages are bright pink inside and even though they actually taste ok, they don’t look very appealing, so Tom and I both leave ours and get some extra chips and beans instead.
I decide to try the Finance Office again to get my money so that I can settle my debts and also to make sure I have enough money to pay Joselyne in case she arrives early with the dresses. A guy has set up a stall on the grass verge opposite the Guest House, outside the school gates, and is selling shoes. He has quite a crowd around him but I resist the temptation to have a look. At the Finance office I am told the paperwork still hasn’t been signed and am asked to come back in the morning. This is now cutting things really fine but I am assured I will definitely get my money on Friday. I go down the Round House so that I can finalise the number of mattresses with Sarah as she is going to place the order tomorrow to buy 117 new mattresses in total which will be shared between the Children’s ward, one section of the Surgical ward, the Isolation Unit, Maternity Unit and the Medical Ward. These mattresses have been sponsored at £25 each from donations made to the Kisiizi Fund at the Countess. The order represents just under half the total number that need replacing and we hope that the remaining mattresses can be replaced before too long. Sam downloads the Excel spreadsheet on to her memory stick as she needs to incorporate the data into her report that she is finalising for the Management meeting tomorrow. I ask her how she feels the Programme overall has gone, and what the main achievements of this 2 week visit have been. It is a really useful 20 minute conversation and I learn a lot more about the Infection Control Programme at Kisiizi and the positive outcomes that have been achieved. I hadn’t realised but the partnership between the Countess and Kisiizi Hospital was one of only three African partnerships in the first wave of the African Programme for Patient Safety (APPS) that started in 2009 funded by the World Health Organisation (WHO). One big achievement at Kisiizi has been the increased awareness of the Programme and the improvements that have been made to patient safety as a result of the systems and processes that have been introduced. These have helped to reduce the risks around Healthcare Associated infections. There has also been a process implemented around Medication Safety where Sam has been working in partnership with the Haley and Beccy, our Countess Pharmacists on this trip, and Kisiizi Pharmacy staff, who have together been looking at prescribing standards and use of antibiotics. I know from conversations and various comments made by Haley and Beccy that there have been some challenges surrounding this issue over the past two weeks , in particular with one member of the Kisiizi Pharmacy team. However, more on that subject later, or perhaps tomorrow. Some of the data I had been entering on the spreadsheet was related to the Medical Safety Process, so although it was painful at the time, I can now start to see how everything links up. In fact that has been one of the really good things for me about this trip. Although back in the UK when we have been fundraising for Kisiizi, we tell people the partnership is based on 3 current programmes, Nursing, Pharmacy and Radiology, until I arrived last week I didn’t really have much of an idea what was involved. This trip has given me a much better insight into the work we are doing and why it is so important. Apart from the mattresses, most of the other money raised is to cover the cost of sending out staff out to deliver the Programmes. Sometimes it has been seen that we are fundraising to send our staff out here for a holiday, which as I have mentioned in a previous blog is not the case. If our staff don’t come over here and work in partnership to help improve conditions and suggest new, or different, systems of working, then the partnership would fail. Just for the record, I have self funded my trip and used two weeks of annual leave, it has not been paid for from our fundraising efforts. I am impressed to learn from Sam that Kisiizi Hospital was the first hospital in Uganda to appoint an Infection Control nurse and Sister Moreen is the nurse with this responsibility. Sam has introduced audit and surveillance systems and has seen a steady improvement on outcomes over the past three years. I leave Sam to her report and accompany Sarah on a visit to the Neonatal Unit as I am interested to see this area given the fact that we are soon to launch a major appeal at the Countess to build a new Neonatal Unit. The ‘Unit’ is a room, measuring not more that 10’ x 8’ with 5 incubators. Sarah asked the Sister in charge where the little boy who was in the incubator in the left is. We learn sadly that he died late yesterday evening. There is another little girl, very surprisingly wearing a Pampers nappy – that is rare in Uganda as babies normally don’t wear anything, nappies are too expensive. The mother is happy to have her photo taken but is insistent I send a copy to her. I am just thinking how on earth it will be possible to get a photo to her when she tells me she is a nurse at the hospital. So that is another one to add to my list of photos where I need to get extra copies printed, Max Spielman are going to get a big order from me when I get back!
A surprise party has been organised for Haley at 6pm so I help to blow up a few balloons before walking back up to Rose Cottage. I’m just about to leave with a bag full of assorted sodas when Joselyne arrives with my skirt for a first fitting. It is not great timing! Unfortunately it is a bit too long and quite tight on the waist but she assures me she is happy to take the waistband off, redo it, and that will correct both issues. She brings one of the girls’ pinafores and it is lovely but just a bit on the large size. However better that, than being too small – the children can always grow into them. I arrange to meet her at 3pm on Friday as she plans to have everything finished by then.
I collect a basketful of cold sodas as my contribution to the party and walk down to the Round Houses. Sam has done us proud and the table has bowls of various crisps, chocolates and sweets on offer, and she has decorated inside and outside the building with balloons, banners and tinsel. We have plenty of wine left from our initial visit to the Supermarket in Kampala the day after we arrived, and Beccy has organised and paid for a fabulous iced Birthday Cake proudly baked by Amozaic. The seven of us are ready so before the rest of the guests arrive, Beccy presents Haley with a ‘Birthday Banana’ complete with lighted candles. Why a Birthday Banana you will be thinking? Well this morning Haley opened a card from husband James which said something along the lines of : “As you can’t have a Birthday cake you should put some candles on a banana (particularly appropriate as the staple diet of Uganda is bananas!) So we all sing Happy Birthday to Haley whilst she holds her special banana, making a wish as she blows the candles out. The other guests start arriving. Alia, an American IT specialist, who is at Kisiizi for six months as a VSO volunteer, Peter and Angus our Australian housemates and Sister Moreen with her boys Elijah and Bethan, and three year old Michelle, who is the cutest little thing you can imagine. Her hair is tied up into 2twofluffy bunches with another at the back. She is so lovely and everybody wants a photo. Although I’m sure Haley is disappointed at not being at home with James and her family on her Birthday, we do our best to make this Birthday a memorable one for her and then she can have a second celebration at home on Sunday.
Sam has gifts for the children, sticker books, bubbles and toy cars for the boys – as you can imagine they are very well received, as are the balloons that we all start playing with about 10 minutes later. We play ’keeping the balloon from touching the floor’ which really brings the children out of their shells and everybody joins in providing a great source of entertainment and amusement for at least fifteen minutes. Balloons are such a simple thing and yet they brought so much pleasure to the children and to all of us as we watch them having fun. I must remember to include some balloons when I send my next letter to orphans Shivau and Precious. I think Sampson is probably too old for balloons so will have to think of something different for him. The party has to end at 7.30pm as Philip is expecting us at Rose Cottage for supper. Bethan, Elijah and Michelle fill carrier bags with their gifts and some balloons and set off for home.
We have vegetable curry and rice followed by crumble – a lovely Birthday meal which was enjoyed by us all. We are sharing memories and photos of the past two weeks and I must be getting brave in my old age as I look at a photo of a huge Wilms tumour that was removed from the stomach of a 3 year boy during an operation the previous week. Tom spent last week in theatre with Dr John Sloan from the Countess who was over for a couple of weeks with Myra, and found the experience invaluable as he was able to take lots of photos during several operations and surgical procedures that he would not have been allowed to do in the UK. As part of his work here Tom has also been doing an audit of the WHO checklist – a procedure that is undertaken with the whole theatre team prior to surgery taking place to ensure that everything is correct – patient details, type of surgery, ensuring patient understand the procedure and consent forms are signed etc. The WHO checklist is acknowledged to have reduced incidences of wrong site surgery – not just in Uganda but throughout the world. As with any change management process it is not always a smooth ride, people need to see the benefits of changing what they currently do. Tom is undertaking an audit to look at levels of compliance in usage of the checklist and will present his findings at the Management meeting tomorrow.
We adjourn to Round House afterwards for a glass of wine and play several game of Bananagrams . It’s a game that Haley has brought with her – a bit like Scrabble and good fun, although Tom finds it a bit frustrating when he can’t make some words quickly enough before having to pick up more letters.
Later as we all head off to bed, I contemplate the past 14 days. Tomorrow is our final day and it really has been an amazing experience. I have tried to capture as much as I can on the blog but I know there will be lots of things I have forgotten to include. It will probably mean long blogs to read tomorrow and Saturday!
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