Monthly Archive for April, 2009

Grania: Moving On

We’ve been back two months now. On one hand it feels like we’ve only just arrived, but on the other like we’ve never been away. We’ve moved back into our flat, we got married, and I restarted work – plenty of change! We are now settling back into a routine and finally have some time to take it all in.

Much of our time has been filled with wedding planning, which all came together perfectly on 14th March 2009. It was so much fun having all our close friends and family with us at the wedding, and I hope they enjoyed the day as much as we did. Thankfully the weather didn’t let us down, London shone in the spring sunshine and we were able to show off our home town to our guests. All the Ugandan-made goods we’d brought back with us looked great – including the groom and Best Men in their bark-cloth waistcoats, and me in my one million shilling wedding dress! The day just seemed to go so quickly, and all too soon it was time for the last dance…

Once the high of the wedding was over we bypassed the honeymoon (having been on a three month holiday!) and just enjoyed being back in London and back in our little flat. Thankfully it doesn’t need that much work done to it and we are reacquainting ourselves with life in leafy north London… no more papaya trees and mud huts, now it’s back to grey skies, bare trees and the occasional squirrel! It’s strange but I am already missing the little kids who lived next door to us in Kampala – I wonder if Nagongale has finally grown his new front teeth?

Another major change in my life is that I have now returned to work after three months off. This has been my longest period of time off work since graduating, and predictably it’s taken me a few weeks to get back into the rhythm of working life. And the difference between my working environment in Uganda and the new one in Hampstead has made things even more disorienting!

As part of my training in respiratory medicine, I am now working as an Intensive Care registrar. This is important because respiratory medicine often deals with patients who have been on life support machines as a result of problems with their lungs. What this means for me is that I am going from working in a system where we work without tests and medicines to working in one of the most intense environments in the NHS, where I can prescribe the most expensive test or drug at the drop of a hat. The changes are huge. I am now regularly working 90 hours weeks, and am back working nights and weekends. (Dan has hardly seen his new wife since I restarted work). I have also had to adapt to no longer being the most senior doctor around – I have already corrected one of the consultants, who thankfully thought it was amusing!

Now that I’ve returned to British medicine I’ve been struck by the very different problems encountered here compared to in Uganda. Here there are no longer young people suffering from HIV/AIDS related problems, and in the 11 bed ITU department I am currently on, nearly half of the patients are in hospital with complications from current or ex- drug use. This is something I am really struggling with – in the developed world we spend thousands of pounds to treat just one person’s self-inflicted injuries, whereas if that money was used in Uganda, you could help hundreds.

What I don’t want to happen is to settle back into comfortable western life and forget all that I have learnt in the past eighteen months. I remain in close contact with Bosco in the TB lab and the staff of Hope Ward. The samples are coming in steadily and we should have Phase One of the TB trial complete by the end of May. Then the job of writing it up starts in earnest, and the second phase of the Target TB project – putting the MODS test into everyday use – can begin.

I have established some links with TB scientists and policy developers here in the UK. They are really interested in helping us use the results of our work to add to the growing movement for affordable solutions to TB. Dr Richard (my replacement at IHK) has been doing great work in planning and starting the TB service, and the good news is that one of the junior doctors at IHK has expressed an interest in taking over our job and running the TB service as well as Hope Ward. Dr Edith is an excellent, enthusiastic young Ugandan doctor who Richard and I will support as she takes on the role. This to me is very good news: for Ugandan doctors to see what can be done, take an interest, take it over and develop it for themselves. I have been lucky enough to have had an education in the UK and to benefit from all the opportunities offered to young doctors in Britain, and in Uganda I had the opportunity to share what I had learnt with some very bright and keen doctors who haven’t had the same opportunities. I will continue to support them as much as possible now I am back.

Hope Ward continues to offer treatment to the most vulnerable patients in Uganda. Thank you to everyone who donated to Hope Ward as a wedding gift. Securing funding for Hope Ward is a continuing need, and Dan and I will continue to support Nurse Irene and the team at Hope Ward as much as possible. To that end, if you have enjoyed reading about our exploits on this web site, you may be interested to know that we will shortly be making it into a book, with all profits going to Hope Ward. (Details will be available on the website within the next few weeks.)

This is our last post as we continue to settle back into life without the bleating of goats in the background or the cold bottles of Nile Special beer at sunset. Thank you for all your support throughout the last eighteen months. We hope you’ve enjoyed sharing our adventures as much as we’ve loved sharing them with you.

Webale nyo and welaba! (Thank you very much and goodbye in Luganda.)