Uganda, the first of hopefully many visits.

DSC_1170With four weeks down and four to go, I can confidently say I love this country. After a 33 hour trip, I landed in Uganda for the first time. While Kampala is one of the most crowded and busy cities I’ve ever seen and there seems to be a frightening lack of enforced traffic laws, it was the beautiful nature and extremely friendly people that first caught my attention. The city and countryside are covered in lush greenery from banana trees to pineapple plants. Below the vegetation, most of the dirt has a red tint to it due to the high iron concentration. Needless to say, the landscapes here have been an enjoyable contrast to the beautiful beige expanse known as my home in Southern California. The first few days I was also struck by how warm everyone is in Uganda. Both the people I met for research purposes and the strangers I ran into were all very kind, welcoming, and willing to teach me Luganda.

My main purpose this summer is to help evaluate the appropriateness of an alcohol and intimate partner violence screening and brief intervention within the setting of a large HIV counseling program. Since this is a pretty big topic, however, I’ll save most of the details for a later blog post. Here, I’ll talk about my initial experiences traveling in Uganda, visiting local hospitals, and working with a large HIV research program.

DSC_0531While I have spent multiple weekends in Kampala, most of my time has been within a one hour radius of Kalisizo, a town in the southern district of Rakai. I live in a guesthouse with seven other mzungus (foreigners). There is a house mother who lives with us, makes us amazing food, and should be thanked for keeping us all alive. Most mornings I wake up early, eat some breakfast, take my malaria pill, and head to the Rakai Health Science Program’s headquarters a block away. I pile into a bus or Land Cruiser with a large group of Ugandan researchers, healthcare workers, and counselors. We then drive for about an hour on rather bumpy but (thankfully) dry dirt roads. Our destinations are usually small villages where we conduct surveys, offer HIV testing, counseling, and a free mobile clinic. The days are generally long and tiring but I always come home happy. The RHSP workers are a tight knit and very fun team to work with and the communities that we visit are all very welcoming and seem to really appreciate the services being offered.

DSC_0542I spend most of the day either taking blood pressure measurements, working on rapid HIV tests, or helping in the mobile clinic. While I can’t quite claim mastery of Luganda, the local language, everyone seems to think it’s quite amazing and hilarious when a mzungu greets them in their own language. Even though my interactions with these community members is limited to (very) small-talk or speaking through a translator, meeting so many friendly people and learning about their lives while hopefully being somewhat helpful to them, has been a very fun and rewarding experience.

Beyond work, I have also had the opportunity to visit Masaka Regional Referral Hospital and shadow physicians at UroCare Hospital in Kampala and Kalisizo Hospital. It’s been very inspiring to see how hardworking and compassionate healthcare workers are in this area despite the low pay and high volume of very challenging medical cases. Many lab tests and imaging services we consider necessities in the US are either lacking or are located four hours and too many Ugandan Shillings away. While much of my medical education in the US has been geared towards learning what imaging and labs to order, watching the physicians here has helped teach me how to use a good physical exam and patient history to narrow down the diagnosis. Because healthcare workers in this area must rely heavily on their experience and clinical reasoning, I’ve been able to gain a lot more experience with the empiric treatment of diseases.

DSC_1303My time here has been very beneficial to my growth as a future physician, but it has also provided the opportunity for an amazing summer break. I’ve been to Masaka and Kampala multiple times to have fun with friends, attend a birthday party, and eat lots of delicious foods. Additionally, a group of us mzungus took a trip to Murchison Falls where we enjoyed an incredible safari seeing elephants, giraffes, and lions. We took a long boat ride up the Nile river featuring, crocodiles, hippos, birds, waterfall, and a beautiful hike. Since this park is about a nine hour drive from Kalisizo it allowed us to see a lot of the country and appreciate the huge natural diversity that the region offers. This weekend, four of us (including Lawrence, another UCSD SoM student) will be heading to Mt. Sabyinyo and Lake Bunyoni to explore the south west corner of the country.

Thanks for reading and ‘see you Mzungu!’ (as yelled by almost every adorable child that I walk past)

Eric Arnold

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