Lion King jokes. All day long.

I don’t even know if there is a point in me trying to convey to you what a safari is like. I mean, don’t get me wrong, I will try, but prepare for my description to fall pathetically short of what the experience is actually like in real life.

Do you know the last place that I saw lions, hippos, elephants, zebras, baboons, warthogs, flamingos, antelope, crocodiles, and water buffalo all in the same place? I’ll tell you. When Simba sang about his excitement about becoming king of all that the light touches. I mean he couldn’t WAIT to be king, and now I understand.

Like most people, I have seen these animals in National Geographic magazines, Disney cartoons, and zoos…but let me tell you- until you ride on top of a van through African plains and see them just….existing… running, playing, fighting, pooping, all in their natural habitat, a picture will never do it justice. But of course I will put pictures up. Because I happen to love you enough to wait 30 minutes per picture to upload.

Side note: I bought a safari shirt at Target before we left, and it may have been the best decision I made for this trip. It enhanced my experience MINIMUM like 6 or 7 times more than it would have been if I had just worn a regular, stupid shirt.

So we left Friday morning at 6am for Lake Mburo and Queen Elizabeth National Park. It took us pretty much all day to get there, but we were definitely not disappointed. We’d been driving through mountains and hills and up and down and around all of the things, and finally we pull around a corner to THIS. Queen Elizabeth National Park. Full of any and every wild animal your sweet little heart can handle.

We slept in a lodge IN the park, which was amazing, and then woke up the next morning at 6 to get a good jump on the day to find some daggum animals. African sunrises, right? 

Also, I pretty much sat on top of our van for the entire day. Like a dog sticking its face in the wind on a car ride. I don’t care. Here are some pics of what we ran in to (lions were too far for an iphone to pick up, there’s no point in posting a picture).

THEN we got on a boat and road all along a channel with MORE animals. Trivia: which African safari animal kills more people than any other animal in Africa per year?

A. Lion

B. Crocodile

C. Leopard

D. Elephant

You are all wrong. The answer is E. Hippos. They kill like over 500 poeple in Africa per year. Super cute, they are huge and yawn like so big you guys. So big. But they will kill you. You can save that little nugget for parties.

I was pretty much in heaven for the entire weekend. After a while everything looked like an animal. Logs. Trees. Ant hills. People. It was by far one of the coolest experiences I have had in my short little life on earth. I hope I can do it again. You have to do it.

Aaaand then this week so far has been great. Monday we were back in the general clinic working with a really great doctor named Allan. He has been so great to teach us treatments, symptoms, making us think and rule out diagnoses, and stretching us to not be dependent on technology but to use the training we have worked so hard for. Here, they are not only the doctor, but they are the radiologist, counselor, and technician. They are awesome.

Lauren sewed up a guy’s lip who was in a motorcycle accident. She didn’t even flinch. She wins the prize for first African operation. Shelby dabbed for her. (photo with permission)

About 80% of Ugandans will go to a “traditional healer” either before or after they try a medical solution their problem. They go to them for everything from joint pain and infections to psychological problems and thinking someone has placed a spell on them and need to get rid of it. Now---we know that when someone is struggling with infertility, there are usually identifiable reasons for it in lab tests, scans, and medical histories. Or if you have auditory hallucinations and paranoia, those are signs of schizophrenia. But here, people may think a jealous neighbor or family member went to a witch doctor to put a curse on them…so they go to the traditional healer to fix it. Or they'll go for pretty much any ailment you could think of.

KIHEFO has decided not to write off these traditional healers as crazy herbalists who sacrifice bulls to shrines and communicate with spirits (which they do), but since so many Ugandans go to them, they have tried to partner with them with work with these communities, so when the problem is out of the traditional healer's hands, they will pass them along to the doctors in Kabale.

We took a boat across Lake Bunyonyi yesterday to visit one.

Shelby.

This was him. Kind of like Rafiki, but in real life.

Two of his 4 wives showing us how they cut people where they are hurting and use a horn to suck out the problem..........

Question and answers. I have many more thoughts about the experience, but that isn't really for this blog...we can grab coffee if you are dying to here more about it. He was definitely one of the most unique individuals I have ever had the chance to meet. Huge cultural experience.

Village kids stomping' it for us outside his house.

We weren't able to do deliveries today, which was kind of disappointing, but we went to the hospital where we will be working for the next two weeks to take a tour and meet the staff and contacts there. They have an amazing maternal ward, operating theatre for obstetric surgeries, and 10 incubators for pre-mature babies. It will hopefully be a really fruitful time. We are all definitely eager to learn more maternal medicine, and it sounds like the remainder of our time here will be full of it, starting tomorrow in the antenatal screening outreach.

Thank you for those who have been following and praying for us as we continue our adventure. We have all been incredibly healthy, safe, and full of life. Thank you guys so much.

Love from Africa,

James

Full-Swing.

Guys. Hey. This is long, but there's lots of pictures.

I am officially writing this from our apartment, because we have internet, because we made 6 trips to the internet store over the span of 5 days to finally get our modem that we paid for on saturday  activated. I wasn't frustrated at all. Patience is what I felt the whole time.

That was a lie, but the important thing is that I burned down 0 Ugandan internet stores and ended up in 0 Ugandan jails, and now we have internet. Today is a good day.

All internet problems aside, the last 3 days have been really busy, and full of new illnesses and experiences and learnings. We are in full-swing.

A recap for you.

On tuesday, we spent our first day in the clinic in town with a couple of the doctors. We started the mornings with some short rounds on patients with the doctor to get an understanding of the inpatient conditions. On top of the run of the mill problems like diabetes and high blood pressure, patients here have all sorts of other things going on like malaria, and typhoid fever, neuro-syphilis, and lots and lots of HIV. It complicates things. The rest of the morning was literally like being on the show House. But in Africa. And realistic. And without adequate access to CT scans, X-rays, lab tests, MRIs, or pretty much anything else outside of each other's brains and a diagnostic manual. We would just sit in the office together with the doctor and patient, hear their symptoms, do an exam, and start going through every differential diagnosis we could think of and treat them the best we could based on their symptoms.

We spent time in their lab, where I had to reach way back to my microbiology knowledge with "gram staining" blood to isolate bacteria/malaria, using a candle as a bunsen burner. It was insane. But I learned how to find malaria in someone's blood using a microscope. So.

You could see the malaria parasites bursting out of the blood cells. Amazing.

The lab.

Wednesday we drove out to a village that KHIEFO has partnered with to build maternal and child health. About 60% of the children here are malnourished, and Uganda has one of the highest maternal and child mortality rates in the world. So we split into 2 groups and hiked all over their little mountain and went house to house surveying the mothers and every child they had under 5. We were checking for malnourishment, sickness, parasites, and the mother's health, diet, and water source if she was pregnant. It was so eye-opening. Not only do the women here AVERAGE having 6-7 children, but they work in the fields doing hard labor all day, walk miles to fetch water every day, watch the kids, make the money, and have food ready for whenever their husbands get home. The men mostly drink. It is actually really hard to watch it happen, but it is the culture here and we are trying to understand it the best we can.

The village school. They danced for us.

Where's Waldo.

Hiking to the next house

Checking height, weight, and arm circumference.

Lauren and Alana doing a survey

Shelby educating, Barnabas translating

It looked neat so I did it

And last but not least, we went to another village today that KIHEFO has adopted for HIV patients who have no way to access anti-retrovirals to keep the virus at bay. They go every single month. We drove way out to their village, did physicals on them and gave them the meds they need to stay healthy. Once again- no access to most drugs, no access to labs, and no access to imaging. We just treated with the antibiotics and pain medicine we had to the best of our ability. For example-- a lady sat down with Lauren and I and told us she was accidentally hit in the head with a metal axe a month ago, she lost consciousness, and is now having terrible headaches a month later. She had a quarter sized indentation in her forehead....

We gave her Ibuprofen. There was literally nothing else we could do.

This was one of about 15 cases today where we just realized how unbelievably blessed and fortunate we are to live in America. Medicine here is another world, and we are learning and applying so much of what we picked up over the last year and a half.

We found a pterygium in her eye.

Juliet and Ben, who helped us translate and treat the patients.

Tomorrow we are going on a 3 day safari.
Monday we work back in the general clinic.
Tuesday we meet with a Ugandan "traditional healer" (80% of Ugandans use them for medical care.)
Wednesday we will be delivering babies in the government hospital.
Thursday we will be learning ultrasounds and antenatal screenings at the new hospital.

This is the best. Thank you for your prayers. We have all been incredibly healthy and strong, and we have been like kids in a candy shop here. We love every single second of each day and opportunity.

African animal pictures on the way soon.

Love from Uganda,

James

This is [definitely] Africa.

I love the internet like, so much you guys. Uganda, however, does not seem to share the same sentiment with it as I do. It has been a bit of a struggle to get consistent internet around here…or water….or power. So I apologize for the delayed update. If I’m being honest with you though, you could cut me a little break. I am in Africa.

But you guys…Kabale, Uganda is amazing. We have become acclimated to this small little town incredibly fast in the 48 hours that we have been here, and Shelby, Lauren, and I have all immediately felt at home. It is a pretty small town tucked away in the rolling hills of southwest Uganda, very close to both Congo and Rwanda. We are about 6,000ft+ above sea level, so it’s super different than I thought it was going to be. It’s REALLY cold at night (you can see your breath and I love it) and because of the elevation all of us have been out of breath after any sort of physical activity…like walking to the bathroom, sitting up in bed, brushing my teeth…things like that. Totally kidding its not that bad. But it’s definitely a struggle. I won’t bore you with a bunch of minute details that you can’t really relate to, but I just wanted to update y’all and share some pictures of what we’ve been up to.

So we got to Rwanda Friday night after dark and stayed at the hostel with a couple of the folks that work here. In the morning we woke up to the smell of open fires, diesel gas fumes, and hearing cars honking and motor bikes zooming around. There was no question after looking out over Kigali that morning- we were definitely in Africa. We spent the morning at the genocide memorial (in the early to mid-90’s about 1,000,000 people were killed in a tribal conflict that devastated the entire country….20 years later Kigali has become the cleanest city in East Africa and they have really turned the country around). It was incredible and sobering. If you have ever seen the movie Hotel Rwanda, that movie is based on what happened here.

We crossed the border that afternoon into Uganda after a beautiful drive through Rwanda, and began to get acclimated to our home for the next month. Here’re a few pictures of the apartments where we live and eat and hammock---pretty amazing view. Not mad that we brought the eno’s.

This is what the drive form Rwanda to Uganda looked like for 3 hours.

Customs crossing into Uganda.

 Our apartments (on Dr. Jeffery's property, who is the founder of KIHEFO Clinic)

Front yard

Lol. Am I right?

Alana learning how to do laundry from Patricia, our Uganda mama.

Home sweet home.

 Since we got here we have just explored the town, tried to turn our time around, and gotten to know the staff, doctors, nurses, the other student living with us (Alana- she is pre-PA and lives in San Francisco and we were all best friends in like 6 minutes). We took a 3-mile drive to Lake Bunyonyi (2^nd deepest lake in Africa)- in a couple weeks we are going to camp on one of those islands for like $20. It’s incredible.

Lake Bunyonyi

 Today we had orientation with the coordinators, getting to know the clinic and status of healthcare, malnutrition, HIV, maternal and infant mortality, marriage and family systems, and the do’s and don’ts while we’re here. Like any new country, there is so much to learn and so much to get used to. It is very hard to truly get a good understanding of such a different culture in such a short amount of time, but we are staying open, humble, and teachable in this new setting. It looks like we are going to get a ton of hands on experience.

Orientation with Trina and Barnabas, the program coordinators

Touring the clinics we will be working in for the next month

Splorin'

Women here do the hard labor and bread winning, cooking, cleaning, and child raising. 

Anyway. I'm tired and that's enough for now. We love it here, we are safe, there is no Ebola, and we start in the clinic tomorrow! This is going to be an incredible learning experience, from delivering babies, to stitching up motorbike accidents, to treating malaria, typhoid, and parasites. We are so excited, and the people here are so welcoming and glad we are here! Stay tuned. More to come.

Love you guys,

James