“Hot-- brings cold water. Cold-- brings hot water.” Hope reporting from Uganda!

Hope in Mbarara, Uganda!

Mbarara, Uganda 

Mbarara is a large city in Southwestern Uganda, smaller than Kampala, with shorter store hours but bustling and with considerable traffic at times (when there’s a jam).  The refugee resettlement area, Nokivale Camp, has a majority of Somalis but also quite a number of Congolese refugees.  I traveled to Mbarara with Vicky and Ursula (2 IOM nurses), Ken (IT guy), Robert (operations manager), and our driver Isingoma. We loaded the van around noon on Sunday, stopped at a supermarket deli for lunch on the go, and arrived after 4 hrs in Mbarara. We all slept a little while jostling on the road, and I was able to catch a few pictures of the lush green landscape.  Goats and longhorn cows crossed the road in the more rural areas, but the ride was pretty smooth.  As I periodically opened my eyes after a big bump, I often felt my pulse racing in panic when I saw us rounding a curve with a car coming in our direction at full speed in the right lane.  We always comfortably passed by the car while I took a few deep breaths and reminded myself that all was well—it is simply a left-lane country.   Speed bumps are taken very seriously, consisting of 4 in rapid succession within ½ meter followed by another series of 4 after about 1 block.  There were shipping trucks, vans, cars, taxis, and boda-bodas (taxi motos) sharing the roads in an elegant stream of traffic with horns tapped to communicate gently and minimal signs to indicate traffic regulations.

Longhorn cows in Mbarara, Uganda 

On arrival to Mbarara, we unloaded supplies in the hospital and settled in at the Tandem Hotel.  I’m pretty sure I’ve never had such a large bed with such an enormous mosquito net. There is a TV, mini-fridge, double-sided wardrobe, light green plastic table, and 2 chairs framed in metal and padded in pale green with embroidered gold flowers.  The bathroom has a little sink with red mini Imperial Leather soaps and a large plastic bucket under the showerhead.  The sign on the wall reads like a proverb in bold, intricate script, “Hot-- brings cold water. Cold-- brings hot water.”  When we leave for the morning, I hand over my room key with DO 8 etched on a royal blue plastic rectangle the size of a high school hall pass.  They spray the rooms for insects/mosquitoes during the day, and I really have yet to feel many mosquito bites.  In the morning, we walk across the drive to the outdoor breakfast nook.  We have tea or African tea (hot water or hot water with steamed milk) to which we can add dissolvable coffee grains or into which we can dunk a tea bag.  Pineapple, watermelon, and sweet bananas are served while we wait for our eggs to be cooked and the thick slices of salt bread to arrive.  The hotel staff who cook for and serve us sit on the lawn and watch as we eat, so it is easy to wave and smile in appreciation. 

Mayanja Memorial Hospital in Mbarara Uganda 

On arrival to Mayanja Memorial Hospital on Monday morning, we found that the 53 single applicants >15 years of age had bused the 1 hr from Nokivale Camp and were awaiting registration.  Vicky gave an introductory talk regarding the plan for the day and explained why everyone would be signing 2 consent forms.  A chorus of enthusiastic yeses followed her question if they all could understand English.  She asked for someone to come and sit by her to translate her introductory talk, as it was clear that everyone was excited to be chosen by UNHCR for a medical exam and planned to answer yes quite a bit in the coming days.  Each applicant was called into the office and “bled” before sending them for their CXR.  I worked with the lab tech while Vicky began to take their biometrics (height, weight, vitals) and past medical histories.  We traveled to Nokivale to administer TB skin tests to children between 2 and 14 years of age who had not had a positive TB skin test in the past.  The roads were dusty and bumpy en route to Nokivale, and there were police stops occasionally on the road.  The police were hoping to earn a little money by stopping people who were driving a huge carload of bananas.  Our IOM minivan was waved through each stop with a smile and greeting.

We arrived at a youth center near Nokivale where over 150 children had gathered for TB skin tests.  Vicky called names and administered TST while the driver drew a large red circle around the site of administration on the right forearm.  I recorded the time of administration and lined up alcohol swabs after pulling bits of cotton off of a roll and placing alcohol on top of each.  After 2 hrs, we were on the road again, returning to the Mayanja Memorial Hospital.  We regrouped with Ken and Ursula, and we drove to dinner (for me, Matoke and g-nut sauce--- smashed plantains in a patty and pale purple peanut sauce).  This was a full day, and dinner is seldom as satisfying as it was that night. 

Tuesday and Wednesday we return to the hospital to welcome 50-70 more applicants for introduction, bleeding, and xrays (no “jabbing” as no one over 15 is given a TB skin test).  The medical exams begin Thursday, and I will be working with Dr. Saul for 3 days, seeing 30 applicants/day before he returns to Kampala and remain to continue applicant exams. I have studied the CDC’s technical manual on TB screening and treatment for immigration/refugee resettlement applicants as well as the US paper forms to be as helpful as possible.  I will have the opportunity to work with an interpreter as almost all refugees speak Swahili (although English and French are helpful for most).

Hope this finds you warm, safe, and healthy.

~Hope Pogemiller