Friday, October 25, 2013

FRESH Committee

For all my RUSH friends the FRESH committee is coming to Uganda. We are planning on making a wall of workers by posting the clinic workers pictures, names, and titles on the wall. The staff seem to enjoy their job and there is good camaraderie, however, there is a higher turnover rate for clinical officers due to the higher pay and better location of government clinics. In order to combat this the clinic offers housing at the clinic. However, we have found that that staff don’t necessarily “hang out” after work. Therefore, we are making monthly “fun” days at work. So far we have plans for a movie night, a futbol game of teachers vs. health care staff, and a potluck picnic. On another note our first CME (medical education) for the clinic staff is next week on neonatal resuscitation. I will be using the Helping Babies Breathe doll and kit as a guideline. Here’s hoping all goes well!

My Address

I love mail!

My address is…
Sisters of the Holy Cross
Kyarusozi House
PO Box 372
Fort Portal, Uganda, AFRICA

Wednesday, October 23, 2013

What's your name again?

So depending on where we go Anne and I have answered too many different names. We are actually Megan or Anne about 50% of the time, the other half we are...

Uganda: mzungo (white person)
Called by our pet (nicknames) names, which is a sign or respect in the town we live in
Anne: Atwooki
Megan: Abwooli 

Anne: called Ian by the kids
Megan: called Magi by the kids

Ethiopia: faringe (white person)
With a large group of tourists it became hard to remember other people's names in a short period of time so if we were not referred to by our real names then we were called...
-the girls
-the young girls
-the nurses
-Saint Mary's
-the young nuns (note- we are not nuns)

Sunday, October 20, 2013

Race Day

This past week Anne and I have spent traveling around Ethiopia to Addis, Arsella, and Hawassa. At each spot we would train with some super fast Ethiopians (ie: 1:04 half marathoners) and meet Olympians. On Friday we took a 5 hour bus ride to Hawassa- the race site. We stayed in the beautiful Haile Resort- bathrobes and slippers in the closet, a nice workout room with American machines, a grand piano, fast wifi, bathroooms in the hotel lobby, and an elevator- great for post race. Anne and I were in heaven.

On Saturday Anne and I ventured into town. We were offered a ride on the tour bus with a group of other tourists, but we decided to take a tuk tuk (small taxi 3 seater car.) It's only been about three weeks, but we already feel more comfortable around the Africans then the Americans. The driver had a good laugh at our bargaining skills, but we were succesful and even took turns driving the tuk tuk on our way to town- a bit scary at first! It's a good thing we went on our own, because the tour group showed up at the same store as us about twenty minutes later and the prices for things they were interested were raised quiet a bit from what we had paid.

Later that night we attended the "expo"/cultural fair and our names were announced as our bibs were handed to us by yet another famous Ethiopian runner. We enjoyed the cultural dancing and  music that was performed for and I poorly attempted to learn how to dance like an Ethiopian. Fyi, it is a lot harder then it looks. Traditional Ethiopian food was provieded to us on a "plate" of bananna leaves. Anne tried what i thought was red sauce, but we later found out was raw meat- the pre-race food that Haile likes to eat. Despite a lot of worrying Anne luckily did not get sick before her first marathon. Later that night we attended the pasta party and enjoyed a pep talk and Q&A session with Haile himself.

RACE DAY! We had a 5am wake up call for race day. As we gathered up our belongings and headed to the lobby to catch our bus we ran into Haile and got a pre-race picture with him- what great luck! 

We were then off to the start. The elite men and women went off and then Haile blew the horn for the mass start. The course was a two loop course with four out and back sections. It took me a few miles to adjust my breathing to the 7000 foot altitude and find a good pace to run without the help of pace groups or mile markers. The course was marked every 5K, but only in kilometers, which I am not used to. Thank God for my GPS watch that notified me each mile. For part of the course I was able to see the elites run during the out-and-back segments, which was pretty cool. The course was lined with Ethiopians cheering good job, bravo, and good, good repeatedly. The course was entirely on asphalt which was as nice change from the red, dirt, rocky village road I am used to. Although it was nice not to have to watch my footing so much you did have to watch out for the cows and sheep on the road. Warning, they don't always move! At the water stops we were given plastic pouches of 300cc water. It wasn't easy to get used to. I would poke a hole with my finger and get a spray of water in my face, which was fine, but everytime I would drink I would end up gulping too much at once and start choking. The Ethiopian chilcren would run next to me at the water stops hoping to be the lucky recipient of a bag with some water left in it.
At around the 13 mile mark I moved into first place for female non-elites and held that position until the finish. With about two miles left a motorcycle came up beside me and started talking to me. Aft first I ignored it as I was exhausted and figured it was a typical African boda driver. However, he kept talking to me and wouldn't leave my side. One of the men said, "we take you to the finish." Too exhausted to respond I just kind of nodded my head and gave him a look. He then said, "you do realize you are the champion." At that point it clicked. He was the motorcade. Wow, I thought, I've never had that before. The men escorted me to the finish showing me the way, honking the horn, and made sure no one and no animals blocked my path. They had tape at the finish that I broke and then cameras surrounded me taking pictures- it was pretty surreal. The smell of local food combined with a sip of Gatorade at the finish made me feel extremely queasy- thankfully I did not puke, that would not have made for a pretty picture! My time was 3:36- not my PR by a long shot, but given the heat, altitude, and some quality longer runs with the Ethiopans during race week I was happy. I became a celebrity for the day and was asked for a lot of pictures with people. Haile handed me my winner's trophy (cup) on a stage, which was pretty neat. Additionally, Anne finished her first marathon with a smile on her face. All in all, it was a great day. She doesn't know it yet, but I am on the look out for African marathon #2 now! :)

Friday, October 18, 2013

Marathon Week

Anne and I signed up for the inagural Haile Gebreselassie Marathon and Run Ethiopia tour. This will be Anne's first marathon, and my tenth.

We have spent the week traveling around Ethiopia and running with and meeting some amazing Ethiopian Olympians and world champion runners. Running in Ethiopia is very different from running on the flat roads of Chicago and the red dusty trails of Uganda. The Ethiopians train in forests and pastures, and on random dirt trails. The views of cows grazing next to you and beautiful grassland surronding you on the run were impressive, but I still cannot figure out how they knew where to run. We would make lots of twists and turns on our runs, and then out of nowhere a random Ethiopian would sprint past you barely making a sound. It really was like out of a movie.

Our hotels have had better internet connection then Uganda, which Anne and I took full advantage of as we were able to make our first skype calls home in 3 weeks. It was good to see our family's faces. Right now we are in a beautiful American type resort that Haile built. It has a beautiful pool, pillows that are not filled with straw(!), and fast internet. It's going to be hard to adjust back into a simpler lifestyle after being here for three days.

Tomorrow is the marathon! I am excited to run, but still don't know exactly what to expect. It will be the smallest race I have done in a long time with about 300 or so runners- foreginers and Ethiopians, and I have heard the water will be in plastic bags. It could take a few tries to get the drinking down.

On another note, there is a high security alert for Kampala, Uganda right now- the capitol city we have to travel through on our way back to Kyarusozi. Apparently, there is a threat for another Nairobi like attack in the imminent future. So please keep us in our prayers as we prepare to travel home!

Travel in Africa

Travel in Africa is always an adventure. 

If you plan on coming to visit me (which I hope you do) plan to add on an extra two or three hours to the time you think it will take you to get there. 

The roads of Kyarusozi- buckle up!
Tuesday we planned to travel from Kyarusozi to Kampala and then on to Entebbe airport for our 5:30pm flight to Ethiopia for the marathon. So Tuesday we woke up at 5:30am to get a 6am ride from Kyarusozi to Rugombe- the trading center closest to the main road, and the place where we were planning on catching the bus to Kampala, the capitol city. We had the Brothers of the Holy Cross driver take us to what we thought would be Rugombe, but once we reached the town he continued to drive right on past for another half hour to Fort Portal- the area where the bus office was. We were told the bus would be arriving shortly so after thirty minutes and the first of several pit latrine stops (think smelly, dirty hole in the ground) for the day we boarded the bus and were on our way to Kampala- the scariest city in Uganda. As mzungo girls we were quickly bombarded by several Ugandan taxi drivers who climbed onto our bus curious to know our final destination and offered to give us a ride or carry our bags for a large fee. 

When we got off the bus more taxi drivers and random people came up to us offering to carry our bags. We tried to ask for directions to Kampala taxi park, but no one would help us without us paying them- even the bus park workers. So with our arms and backs loaded with luggage (we both have a bad problem of overpacking) we set out for what we hoped was the right direction. After a few stops and a couple hundred mzungo calls we made it to the outside of the bus park where we stopped for a minute to rest our sore arms and wipe our dripping faces. It was there we found our bus park angel who escorted us to the bus marked for Entebbe stage. It's not easy to find the right bus when there are about 80 or so buses of the exact same color crammed into one small square. 

The matatu (bus) was packed with about fifteen passangers and dropped us off at the Entebbe stage where we then found a taxi (private hire) to take us to the airport. Upon seeing two young, white female mzungos the driver told us it would cost 45,000 shillings to drive 4 miles. Now keep in mind we just drove around 30 miles from Kampala to Entebbe for 4,0000 shillings and paid 20,000 shillings for a drive from Fort Portal to Kampala. So there was no way i was going to pay him that much for 4 miles. After doing some bargaining and telling him that we were his fellow Ugandans we were able to bring the price down to 20,000. With all the driving behind us we thought the rest of the day would run smoothly- boy were we wrong!

We arrived at the airport ticket counter for Ethiopian airlines and the lady told us she needed a copy of our credit cards. Now we had already paid for our flights and were hesitant to give her our cards due to the risk of identity theft. So the lady said I could follow her as she made a copy. Well, the first copier was down because the power was out, the second copier was locked and the key was lost, so off we went to the main office where we waited half an hour to get a copy, and then subsequently were able to cross out our credit card numbers on the paper.

Okay, done we thought. We now had access to a "real" toilet, could wash the red dust off our faces, and surprisingly access wifi! After browsing throught the gift shops the flight attendant found us and told us the plane would be leaving an hour earlier. Okay, great. We walked out onto the tarmac and boarded a beautfilul plane. The flight went smoothly and we arrived in Addis Adaba around 7pm and met up with our tour group dirver. Unfortunatley, we ended up waiting for over an hour because 3 other members of the tour group failed to show up, and we did not know what happened to their flight. By the time we left the airport it was dark outside, but immediatly we could tell this city was way bigger then the capitol of Uganda.

We arrived at Yaya Village in the mountains of Ethiopia and immediatly Anne and I could tell that there was a problem. Althought the men only spoke Ahmaric their panicked faces and constant phone calls had us suspicious. Turns out they had overbooked the hotel, and there were no rooms left. Apparently, their solution was going to be to knock on the rooms of some other visitors staying and kick them out. Way to go Africa. Luckily (for them) they did not do that and instead put us up at another runner hotel down the road. After a broken shower and another room change in that hotel we made it to bed exhaused but grateful we had arrived. 

All in all, nothing's easy in Africa! But, hey we did get a free meal and a massage out of the situation!

Wednesday, October 9, 2013

Marathons and Races in all different places....

My legs after a typical muddy run on the African dirt roads
Next week I will be running my tenth marathon in Ethiopia! This will be the inaugural Haile Marathon and will have an international field of runners. Training went well over the summer, and I completed my final 20 miler run before leaving for Uganda. However, the hills and altitude of Uganda have made even short runs tough! Let's just say I will be well tapered for the race! Here's to hoping I finish the 26.2 African miles with a smile on my face!

Clinic Life

Anne and I have spent the first week observing things in the clinic and assessing, comparing, and contrasting situations in the clinic to how things are done at Rush and Anne’s hospital in Indy. Infection control here is a huge issue, and it definitely feels odd starting my day without scrubbing in. I constantly am searching for stat foam, and have to remember it is not at any patient’s bedside. There have been days even when the sinks are out, and we have to walk outside to wash. We have created a survey to assess the needs and perceptions of the staff, and hope to implement a plan to make infection control a priority.
The pace of life here in Uganda is a lot slower then the U.S., and things are often run on African time (add an extra hour or so to the time when you were told to show up for something.) As a NICU nurse I was accustomed to getting tasks done as soon as an order was put in, calling pharmacy for a new medication, and working 12+ hour shifts with little time to sit down and eat. Things in Uganda are much more relaxed, and there is little rush in getting tasks done, rather more time is spent greeting others and taking time to talk to them and find out how they are doing.

The health unit here is a level three unit and does not have an operating theatre or the ability to administer blood transfusions. if these are needed patients are referred to a higher level clinic or hospital, which can take anywhere from 15 minutes ts to over an hour to reach. The ambulance does not run to this private clinic so often it is up to the patient themselves to find their own way there. One such patient who was referred this week was a septic newborn with extreme respiratory difficulty. The patient was extremely sick, and I don’t know if they would make it to another clinic in time. It’s very difficult to see a patient like this sent away when I know the baby could be treated immediately in the U.S.

People here are grateful for the simplest things, whether it be a new shelf to arrange medications on or something as simple as a pen. Sister Angelica, Anne, and I brought three large suitcases full of supplies along with us. Included in that was a fetal Doppler. Previously the midwives had been using a small wooden instrument to listen to fetal heart tones. The Doppler made the heart tones much louder, clearer, and an extra stethoscope attached to the Doppler also allowed the mother to hear the babies heart rate. Seeing the smile on the mother’s face when she heard her child was pretty special.

To all my NICU girls here’s a top five list of what we lack….
1. Stat foam and scrub brushes
2. Isolettes
3. Bottles, formula, lactation consultants
4. I.V. pumps and syringes
5. Monitors

What Uganda does have…
1. No beeping monitors
2. Babies who immediately latch on- we are a “baby friendly” hospital by default
3. No babies with a high comma in their name (as of yet J)
4. Mothers who care for their baby 24/7 during their hospital stay
5. Stoic moms- no epidurals are given, and yet the mother still leaves the hospital on foot with a baby tied to her back

(oh and by the way NICU friends there are no roaches here, but there are lizards!)

A lack of resources, the language barrier, different healthcare protocols, and caring for patients older then 6 months will be a challenge for me, but I hope that by the time I am ready to head home I will have found my niche at the clinic, and made some sort of impact along the way.

Saturday, October 5, 2013

We have arrived in Kyarusozi!

It is great to be able to see many old friends again, whether it be the Sisters, the village kids, or our clinic co-workers. Everyone here is so welcoming and loving.

Adjusting back into a lifestyle without fresh running water, fast internet, and a grocery store stocked with lots of cereal and fresh bread has been easier then one would imagine. The food here is fresh from the garden and the other things, well you just begin to realize it's not all necessary. Although it does make life easier, this lifestyle makes me more grateful.

So what is our day-to-day life like?

Anne and I begin our day by going for a run. It feels like I am in a parade every morning as just about every child comes running out from their home or the bush yelling "mzungu, mzungu," and then go on to ask you how you are doing. This happens pretty much the entire length of the run. It is nice to have some entertainment along the way, but greeting every person along the way is hard when I am just struggling to run up the road as it is. Altitude and hills everywhere make for some tough runs! I had done a twenty mile run the day before I left for Uganda in preparation for my marathon in Ethiopia in October, thus I thought I was in pretty good shape- however, Uganda is whole new territory!

After our run we head to the clinic. This week we have spent observing and trying to find our "niche."
....sorry all, I am about to run out of internet minutes, this blog will have to be continued post is for you NICU nurses!

From the beginning...

Hello from Kyrusozi!

All is well in Uganda, but let me first start from the beginning.

I went to Uganda in 2009 for the first time, and fell in love. I was able to return in 2012, but only for about three weeks due to my job, and enjoyed my time, but felt it was just too short. To me this place became a second home, and one I could not easily forget. Thus I made the decision to leave a job I loved and the comfort of my home to embark on a new adventure in Uganda. A lot of people thought I was crazy to not only leave a  job I loved (in this economy none the less,) but to go to a place that to them was full of unknowns. Yes, it is a risk- will I get sick, what will I do without clean running water and working electricity and a paycheck every two weeks, and will I be able to get a job when I return? To me it was an easy decision. I said yes! I had been praying that I would be able to return to Uganda some day for an extended period of time, and the day has finally arrived. As Phil McGraw once said, "go find your passion and embrace it. When you do you will spring out of bed in the morning, and sleep fast at night because you love what you are doing. There are many kinds of currency in life, not just monetary. I promise you will never regret this work for a moment, because life is not a dress rehersal. This is your life- you're one shot."

I have found my passion, and I am ready to live it out.