Another Kampala weekend...
on Random Uganda (Uganda), 25/Jan/2010 09:29, 34 days ago
Sunday morning… January 24th…Two weeks have escaped me again. My seven-month anniversary in Uganda has come and gone in a whoosh of imaginary candles.This morning I awoke, as is my Sunday usual, to the sound of emphatic Christianity.‘Praise him… Prraaisse himm…. PRAISE HIM…” (and you hungover pagans behind the wall, this means you too!) Although I did stagger in about 0330 this morning (story to follow… or precede… somewhere… maybe), I am actually not hungover. But I could make serious use of another goodhour of undisturbed snoozing.Stacey spent the night in our guest room. She is hungover. She assures me that our church is not nearly as obnoxious as the one near her house.‘Hardly noticed them,’ she said. ‘Almost soothing, really.’ We set about planning the next kampala vso cluster fundraiser: Battle of the Obnoxious Ministerial Bombasts. We are quite sure we could fill a large venue with volunteers and expats. Nearly everyone we know has a horror story of Sunday morning torture. Judging could be done with a decibel meter and a panel to assess the quality of the rant. The revenue from rotten vegetable sales alone could roof a couple of schools.So I dig out a pair of shorts and go for a run.One of my buddies is waiting for me at the bottom of Tank Hill (the large hill near our house crowned with water tanks). Moses is an aspiring boxer (if I had to hazard a guess, somewhere between the fly and the flea weight category). As I drag my sweaty hypoglycemic carcass up the hill he shadow boxes circles around me in an elaborate dance, as he tells me how I should sponsor his career and take him to Las Vegas, and we could make millions. I contemplate kicking off one of his kneecaps and dropping as one perspiring mass onto his chest, but instead I put on what passes (at my age and fitness level) for a burst of speed. He doesn’t stop dancing, but at least I make him breathe hard enough to cease with the banter.I run down through the gravel pits and into the flats of Bukasa and Namuwongo. On one stretch as I pick my way through the back streets back to Kironde road, I notice a gentleman peeing into the ditch. Taking a short call (elimination here is divided into short calls and long drops, I’ll let you work that our for yourselves) on the unprotected verge of a busy street is perfectly acceptable here—and taking a long drop not that unusual either. As I run up the road I think he may have a prostate issue as he seems to be making an inordinately long time of it. But no, he’s masturbating. He smiles at me as I slog past.I guess we all have our own ways of worship on a Sunday morning.Friday. January 22ndThree Belgian medical students doing an elective rotation in Rwanda are visiting Queen Elizabeth Park. Their driver makes a stop at one of the crater lakes. He pulls the van to the side of the road that runs along the rim of the crater. And misjudges the slope and stability of the shoulder. And the van rolls down the hill into the crater. One of the students says she lost track of the rotations at seven. Fortunately the lake is much receded.Later FridayAt the Centenary Park (it is unclear to me which centenary the park celebrates—independence was in 1963. Maybe the centenary of 100 years of being a slightly underenthusiastic part of the British Empire in its heyday?) We, however, are celebrating the new gentler, kinder, happier VSO Kampala Cluster—monthly Friday night gatherings: less whinging, more drinking. It isalso graduation night in Kampala, so there are 4 parties within earshot, each with a speaker system larger than the space your average kampala family of 8 sleeps in. Needless to say, conversation is difficult, and they are charging 4000 shillings for beer (robbery, out and out highway robbery), somostly we are milling around.Modified phone log:2130h: (loud music and giggling in the background)‘Hello, Robert, its Ian, there’s three Belgian girls in a traffic accident out of Kadongo. One of them has a vertebral fracture. The Belgian embassy wants to fly them from Kasese to Nairobi. Can you do it?’‘Tonight?’ (trying to calculate time for complete metabolism of two 500cc Nile Specials at 5.4% ethanol by volume)‘No, in the morning.’‘Are we flying the helicopter?’‘No, the Belgians are arranging a plane.’(against better judgment)‘Sure, no problem.’‘Good. I’ll give you the number of the guy from the Belgian embassy.’ (side conversation with someone who actually understands the workings of a blackberry) ‘uh yeah, I’ll text it to you.’2140h: I call Bart, first secretary of the Belgian consul (later, when impatient with the fueling process he will be self-promoted to deputy ambassador). Once again I have forgotten to purchase airtime for my phone (most of the phones here are pay as you go, and you have to purchase little cards from the airtime shops and enter the code numbers to keep your ability to phone out—you can still receive calls when you have no airtime), but I figure I have a few minutes left.(loud music and giggling in the background)I’m trying to keep the conversation brief while trying to find a less than deafening corner of the park to hide in. He’s trying to give me minute details. Finally we agree that he will pick me and my gear up at the hospital about 11am.‘Good. I’ll give you the number of the doctor in Kadongo.’ (side conversation with someone about the workings of his blackberry) ‘uh. Yeah. I’ll text it to you.’2150h: I call the doctor in kadongo. He can’t hear me. ‘(slighltly incredulous tone) Are you in a bar, doctor?’My phone runs out of airtime and the call ends.2155h: He calls me back. Maybe slightly irate. Says his phone is almost out of airtime. We agree that I will call him in the morning to reassess the status of his patients.0030h: Tom from IHK transport/ambulance wakes me up with a call to reiterate all of the information in the above conversations.Saturday morning.I wander into the hospital and start scrounging for equipment. One of the patients reportedly has an unstable cervical spine fracture. I grab the only spine board and the only two stiff neck collars in the entire IHK complex. Both of the collars are size regular and dirty (in the states, we would consider these single use items). I hope she has a regular size neck. I choose the cleaner of the two. I also manage to put together a few straps, a pad for the board, and a folding stretcher.One of the nurses grabs me and says my patient is here. I had thought my patient was in Kasese, but she explains that an ambulance has just arrived from Jinja with a drowning victim. Okay, she has my interest.In the‘trauma room’ is an asian man involved in a camping accident that had something to do with a barbeque and a tent. Apparently he ran and jumped in the lake to put out the flames. The rescuers who fished him out of the lake decided that they had saved him from drowning and pronounced it so. Myambulance team stuck with the story. His lungs were clear and his oxygenation and ventilation intact, but he did have burns to maybe 30% of his body surface. We admitted him to our plastic surgeon. (in the states at a good burn center his prognosis would be excellent, here, well, we can always hope for the best).Bart picks me up in the Belgian Consulate’s Prado edition Landcruiser and we make a quick stop by VSO to pick up my passport (VSO has been hanging on to my passport for the better part of 6 months in an ongoing, as yet unsuccessful, effort to get me a 1 year work permit/multiple entry visa). I am hoping that this jaunt into Kenya doesn’t result in me being forced to purchase yet another temporary single entry ($50) visa. Bart assures me he will handle it.I was expecting that we could drive to the hangar of the chartered aircraft, load my gear, and be off in a matter of minutes. But that, it turns out, would have been just silly.Imagine yourself in a line at airport security. You are already late for your flight to Addis (or Amsterdam, wherever), and then you notice that the people in front of you are trying to thread a folding stretcher and a spine board (not even to mention the medi-bag with the scalpel, scissors and oxygen tank) through the x-ray machine… Imagine your impatience as the security team decides they want to stop the flow of traffic through the only functioning check point in an international airport so that they can go through a medical bag that contains just about every device that a potential terrorist would want to carry onto a plane—if the plane were headed somewhere other than Kasese.But, surprisingly enough, we manage to clear security a few milliseconds before the several hundred people behind us explode into a frenzied riot of exasperation. And we find the twin turbo prop Eagle Air plane the Belgians have chartered. And I have an interesting conversation with their engineer (Vlad) about how I’m going to secure a stretcher to the floor of the aircraft (Vlad ties the stretcher down to 4 disparate points in the plane, making it impossible to walk around and still allowing the stretcher the latitude to leave the floor by a good eighteen inches in the possibility of turbulence—I make himleave me a wrench so that I can remove 4 sets of seatbelts, and, screwing the anchor bolts for the belts into the holes in the floor from the removed seats, manage to secure the stretcher.)Modified Flight Log:1400h: take off for Kasese an hour and a half behind schedule. Spend the entire flight securing the stretcher and making plans for securing spine board to stretcher.1445h: land in Kasese. Meet and examine patient. Look at x-rays—some subluxation of c4 on c5—might be a unilateral jumped facet, could be a normal, hard to tell as x-rays are crap (but, in the defense of the hospital in kadongo, no worse than I would have gotten at IHK). Fortunately the patient has full strength and sensation in her hands and feet. As welike to say in the business: she is neurologically intact. For someone who has suffered a potential cervical spine injury, this is a good thing. Load patient in plane and make her as comfortable as one can be while strapped to a board in a stiff collar (fortunately, the tiny hospital in Kadongo had a pediatric stiff collar to fit her tiny neck).1545h: take off for Nairobi after a long wait for Ugandan immigration to come and stamp an exit stamp in the Belgian girls’ passports. Spend an anxious 2 ½ hours wondering if the spine immobilization is adequate to keep the turbulence and impact of landing from paralyzing the patient. During the flight, the patient’s two friends decide that instead of getting off in Nairobi, they are going to fly back to Kampala. Bart’s hair starts to go gray.1815: land at Nairobi’s commuter airport. Wait for ambulance that was supposed to meet us on the tarmac.1830h: communicate with ambulance. They were waiting on the tarmac at the main airport.1845: ambulance arrives. Transfer patient to ambulance. Examine patient. Patient can still move fingers and toes. Relax sphincter tone for first time in four hours.1900: pilot announces we have to take off. It is getting dark and if we don’t take off immediately, Eagle Air will have to pay extra to have the runway lights turned on.1905: land at the main Nairobi airport. Pilot explains that in his hurry to take off before having to pay for the lights he made the command decision to refuel at the main airport (where the lights are free). Because the airport is quite busy, though, we are directed to a taxiway out in the cargo zone, closer to Tanzania than Nairobi.2000: waiting for fuel truck.2100: still waiting for fuel truck.2200: fuel truck arrives. Long discussion with pilot. Apparently the fuel guys can’t accept cash at night. Ugandans don’t carry credit cards. (Unless they’re shopping at the gift shop at the Sheraton, they really have no place to use them) The pilot wants to use my credit card. In the interest of getting the plane the heck off the ground, I think about it. Hmmm… even if Visa security did approve a purchase in Africa for a 1000 liters of Grade A jet fuel (at 67 cents a liter, in case you’re wondering), would I really want the number of my credit card floating around a runway in Kenya in the middle of the night? Uhhh. No.2230: two remaining Belgian girls change minds, again. Want to get off plane and go stay with friend who has just texted to say she’s not going to get a CT scan until Monday. Bart’s bruxism is definitely getting worse. He makes a few phone calls. It won’t be happening.2245h: pilot somehow solves payment issue. Fuel guy puts rickety ladder into bed of pickup and balances there putting 200 liters of fuel into left wing tank. Bart gets up into pick-up to steady rickety ladder so that we don’t wind up with our second cervical spine injury of the night.2330h: finished refueling. Take off for Entebbe.0005: flying over Lake Victoria. Come to the realization that all of the pouches under the seats are devoid of life vests. Look around for the life raft. Nope.0030: flying over Lake Victoria at 10000 feet in an unpressurized, unheated plane. Freezing my heinie off. Look for the overhead bins to see if there might be a blanket. There are no overhead bins. No blankets either. And, according to the pilot, Vlad never fixed the heater, because 'why would you need a heater in Africa?' Why indeed. Continue shivering for remainder of flight.0130h: land at Entebbe. Taxi to spot a good half kilometer from terminal. Walk to the terminal and get a luggage cart. Push cart back to plane. Precariously load a spine board and stretcher onto a cart designed to hold a suitcase. Carefully push gear through doors of terminal into immigration area. Lone officer is sleeping. Push on through. The customs officer looks at me suspiciously.‘Did you clear immigration?’I tell the truth.‘Yep, just passed right on through.’‘Do you have anything to declare?’I’m standing there with a luggage cart that has a seven foot long spine board extending off the front like a diving board and is otherwise heaped with medical crap. It is very difficult for me to pass up a straight line like this. But I do. ‘Nope, not a thing.’0230h: drive Entebbe to Kampala. Unload Bart and the girls at the Belgian embassy. The Belgian ambassador is going to put the girls up at his residence. Ask yourself: If I got into trouble in a foreign land, even during business hours, let alone at 2 in the freakin’ morning, would my country’s ambassador offer to put me up? (speaking from experience, if you are American, I can tell you that your answer would be no) One point for Belgium.0330h: Moses, the driver for the Belgian embassy, drives me back to the hospital to unload the gear, and then drives me home.