Day 3 Bwindi

Day #3 Monday

My first day of work was today.  Each day at Bwindi Community Hospital starts at 0800 in the area outside the outpatient department with a prayer and meeting of all staff who can attend.  Reverend Bernard read scripture about Jesus and the Last Supper, and then chastised those who had found other things to do than attend the services Sunday afternoon, telling them that as part oft the community, it was their obligation.  There of course was singing and clapping. I felt righteous, having done my part.

The Hospital Administrator, Charles, introduced himself and again welcomed me.  He and a group from the hospital were spending the day going out to one of the nearby communities--"visiting their stakeholders".  During these visits, they discuss the upcoming nursing program and also recruit participants to the health plan that the hospital has.  Patients pay monthly for the ability to use the hospital services when they need them--sounds kind of like insurance.

Jane and I attended a "Learning", held each Monday and Wednesday in the Dining Hall--all interested staff may attend.  The presentation today was provided by the HIV Outreach Team who travels to surrounding communities to educate and provide testing services for HIV.  The raw data was presented by a volunteer from the community who is part of the team and HIV positive.  She said: "I'm the advertisement for the reason to get tested, I live a full rich life with HIV."  The numbers tested had declined slightly over the previous year and the team felt it was due to a lack of funds.  They have not been able to visit the villages the day before to promote the next day's testing, relying on radio advertising instead.  There was a lively debate which it was a pleasure to watch.  Gently, and without blame, the group questioned the conclusions and discussed other ways to recruit, as well as point out different ways to determine success.  The dentist told a story about traveling to a village to provide dental care and, finding no one waiting, going to the school and asking the teacher to send all of the students home for a visit to remind their parents.  He got 10 patients.  Another asked whether they were looking at the right data...he wanted to know why they were not tracking those who tested positive to ensure that they had received follow up care, asking "Isn't that why we want to test?--in order to treat?"  There was no defensiveness, and no animosity among the group, only love and support.  They elevated their practice, and provided ongoing quality improvement by their actions.

Jane and I have been charged with developing the budget for supplies, equipment and other costs associated with the school and we are already late.  We organized the data and were pleasantly surprised to find much of the work already done, just needing to be combined into a presentable form.  We worked on that today, tomorrow will take the plans and go over to the school, taking pictures of progress, and placing furniture where it will be needed.  If we get that job done, we'll travel to one of the local schools to get an understanding of what it takes to outfit a kitchen for 3 meals a day....that's what the schools provide.

Jane and Charles (the administrator) have gotten a quote for a BioGas generator in order to fuel cooking. The BioGas generator will produce methane from the septic system.  There has been some discussion about whether the location of the septic was close enough to the kitchen to be economical to transport the gas, but evidently so.  We'll include that quote in the proposal for funding to Rotary International.   The electricity to the school may be able to be provided by the process which the hospital uses, a small hydroelectric company that is locally run.  Rain water caught in barrels will provide drinking water.

I had a surprise when I visited the restroom, for which I wasn't prepared.  The toilet was the eastern variety--within the floor.  I've used them before, but it takes thinking and practice, as well as strong leg muscles and a sense of balance.  I'm not always good at all of those things at once, so also need a potential hand hold.  I was only moderately successful.  Happily there are hand-washing stations everywhere.

Breakfast:  Scrambled eggs, toast, water, fruit, Nescafe.
Lunch: Beans, rice, plantains
Dinner:  Fried fish (probably perch), rice, mashed potatoes.  Oh what I'd give for a salad...

Monkey Guest House

I sleep at night in the back bedroom, which has two bunks.  Happily, I'm the only one in there.  I have a mosquito that wraps around the bed, and there's an open window with bars and hard screening attached.  There is a communal bathroom, but it has a real toilet, and a shower with a trickle of hot water.  Meals are served at the big dining room table in a great room.  My home for the next month.