“The wild dogs cry out in the night, as they grow restless longing for some solitary company”

Africa by Toto

Haleigh and Amber initially thought that particular song lyric only applied to the Serengeti/Mount Kilimanjaro, but apparently it also applies to the outskirts of Mukono. Between wolf howls, dog barks, jetlag, and a crippling, albeit justified, fear of mosquitoes, neither of us slept well last night in spite of being exhausted.

Haleigh and Amber did not learn from our mistakes yesterday. We thought that for a wifi device, photocopies of our passports would count as valid forms of identification. We were sorely mistaken… but luckily we had Devir to help us out.

After getting connected, we went to visit Hannington at the Mukono Access Clinic. With his help, we started the administration of the Prehospital Emergency Trauma Care Assessment Tool (PETCAT). PETCAT is a survey that Peter and Zach developed for emergency medicine providers in low and middle income countries to assess the current quality of prehospital care. The questionnaire looks at major categories of injuries such as hemorrhages, aspiration, and fractures. Each question is designed to be answered using a 0-10 scale, where 0 means the scenario never occurs and 10 means the scenario always occurs. An example of a question would be, “For externally hemorrhaging patients, how often do patients arrive with pressure and elevation applied?”

We began the process by going to major trauma centers and hospitals in the Mukono District and asking as many healthcare workers as possible to fill it out to establish a baseline of the pre-hospital care here.

In between giving out the surveys, Haleigh and Amber may have discovered a staple restaurant called Bell. Chicken and rice dishes seem to be a very popular food choice, and although Bell didn’t have a menu, the dishes at our table all looked really good, and we are hoping to try them at some point. Our new skill learned today: how to cut chicken with only a fork and spoon, harder than it sounds!Our favorite question we were asked at lunch was whether or not we had boyfriends. For blog purposes we’re pleading the fifth.

Another high point of the day was that we made new friends! One of our VTCA colleagues introduced us to his friend Jackie*, who brought us down the street to meet her aunties within 5 minutes of meeting her. We exchanged whatsapp numbers and received the nickname “Hamber.” Haleigh won’t acknowledge that it’s a combined name and thinks now Amber has a nickname. It’s okay though, in an endeavor to be cordial Amber is letting Haleigh call her “Hamber” for the time being.

Dr. Hannington also graciously gave us a tour of the Mukono Access Clinic. They have a patient intake room and three wards where patients can stay for extended periods of time. We were surprised to learn that one of the current ward residents came in with malaria and that two patients we saw this morning also had malaria symptoms. Hannington made sure we were taking our malaria pills and wearing lots of bug spray (don’t worry mom!).

This afternoon we witnessed rain here for the first time! The streets got very muddy, and this means boda boda accidents are more likely to happen. While administering PETCAT at another nearby clinic, a patient who had been hit by a motorcycle taxi drive came him. His arm was extremely swollen, and we had the opportunity to watch Hannington and another doctor splint his arm. First they ripped cardboard box to about the size of the man’s arm and measured the length on his uninjured arm. Next, they wrapped the cardboard around the injured arm and secured it with wrapped gauze. The doctor asked us if we’d like to administer the intramuscular pain medication and intravenous inflammation medication. We explained we were not trained in these techniques but happily watched. The patient was then sent to a different facility for an X-ray. If the imaging confirmed a fracture, the doctors would then reset the bone and apply a plaster cast.

After our exposure to Ugandan medicine, we continued to administer PETCAT before walking home for a brief but much needed rest. We finished the day with a meeting with Hannington, Jacob, and Devir to recap the day and make a plan for tomorrow.

Personally, our goal is to get to bed before 2am tonight.

*Names have been changed to protect privacy

All images posted with permission of the included parties