Window on Kisiizi

Window on Kisiizi

Monday, 25 May 2015

change in arrangements for FRIENDS OF KISIIZI DAY

We have deleted the previous post advertising Friends of Kisiizi day for 27th June as it has been decided it will work better later in the year so we will circulate the new date as soon as it is confirmed.  Apologies for any inconvenience caused.

Friday, 1 May 2015

Hanna's dad in hospital

Thanks to all of you who have been praying for Hanna and her dad... he has been in Intensive Care in a hospital in Utrecht, Holland.  Hanna flew back to be with the family and its not yet sure when she will return.  Thanks for the messages of support which are much appreciated.

Time flies!

Our son Mark has just been out to visit us, his first trip to Kisiizi for 10 years!  Yet so many people remembered him (though wouldn’t necessarily have recognized him!) and it brought back a lot of memories.It was a real treat to have him with us in Kisiizi...

Mark completed his PhD just before Christmas and is now teaching undergraduates chemistry in the University of Reading.  He could only come for a short time but we were able to pack a great deal in and really enjoyed having time with him.   

Straight after Ian had spoken at the Good Friday service and we had had lunch we set off for a 24 hour visit to Ishasha, the closest section of the Queen Elizabeth National Park, and were blessed to see herds of elephants, buffalo and many antelope types as well as a hyena, warthog, baboons etc plus hippos in the river that is the border between Uganda and Democratic Republic of Congo.  

But the highlight was the animals in the trees.  Ishasha is famous for its tree-climbing lions, the only place this occurs other than a location in Tanzania.  We found 3 lions up in a fig tree, mostly quite sleepy but one lioness then woke up and sat up looking fairly fierce!  


 Then, as we started driving back towards the park information centre, our ranger spotted a leopard in a tree… this was a real thrill as we have never previously seen a leopard in the wild as they are often nocturnal and quite shy so difficult to find.

No TV for us in Kisiizi but we enjoyed one night of the power cut to look at the stars and planets with a small telescope and followed in Galileo’s footsteps as we gazed at the moons of Jupiter, and then looked at the nebula in Orion… another breath-taking experience.

Finally we went with Mark to Lake Bunyonyi, the lake of the little birds, for 24 hours, and had a swim, watched some of the birds and relaxed together before taking him down to Kigali for his plane home.

Wednesday, 29 April 2015

Clinical developments and visitors


Our new Accident and Emergency area is proving valuable as it gives us much better space and facilities for stabilizing very sick patients arriving day and night in Kisiizi.   It did require a bit of structural change to make doorways wide enough for trolleys to use.

 For example Ian was called to an unconscious 4 year old who had been hit by a boda-boda (motor-bike) and knocked down.  She needed a collar to stabilize her neck and medication to reduce brain swelling.  She had a fit needing anti-convulsants.  Her mother arrived and promptly collapsed on the floor due to her distress as she thought her daughter would never recover.   

However, thankfully, the child was transferred safely to children’s ward on a trolley, using the new paths that connect the A&E/Out-Patient building to the wards.  The next day she was sitting up and eating and has now been discharged well much to the delight of staff and family.



The laboratory is also upgrading.  We have been able to create a new phlebotomy room so patients no longer need to come into the lab itself for blood tests.  We have put in new hatches for samples and new benches and we are re-configuring the layout of test equipment to make space for the new analysers that have been installed.  Our new In-Charge, Francis Orishaba, is settling in very well and demonstrating much initiative and enthusiasm so our lab services are definitely going up a gear (or two!)
new CD4 machine to monitor HIV patients
Clinical Staff training session with visiting colleagues
With this support plus input from Dr. Charlie Martin-Bates, a recently retired GP from Reading, we have been updating our Diabetic Clinic arrangements and hope to run a much more comprehensive service.  This is appropriate as the incidence of diabetes continues to rise and has hitherto been poorly provided for so many patients have developed complications that might have been avoided.
Dr. Ian Kemp also came and has worked with our surgeons Dr. Gabriel and Dr. Robert to develop our upper-gastro-intestinal endoscopy service.  This is also very opportune as we have a high incidence of stomach cancer in our community and diagnosing it earlier may avoid much suffering.
We also enjoyed a fortnight’s visit from Jonathan Jones an Orthopaedic Surgeon from Stamford who kindly brought out some very useful equipment and hopes to support the development of orthopaedic services here.  This tied in very well with a further team from Dublin.  As well as physiotherapists we were pleased to have an Occupational Therapist and, for the first time in Kisiizi, three dietitians who looked at our malnutrition programme for children and the work on improving diabetic control.
Dublin team running an Audit session
Currently we have a 6 day visit from Dr. Jim Hansen, with his wife Suzanne from USA.  They visit Kiwoko Hospital once or twice a year and kindly agreed to come down to Kisiizi to help as Jim is an Adult Cardiologist.  So we have run a Cardiac Clinic and been able to get an opinion and echocardiogram on many patients which has been valuable. 

So we are really grateful for all the support and encouragement and practical help our visitors bring with them

Monday, 27 April 2015

In all weathers...

dust trail from a passing vehicle
A month or so ago and the problem was dust in the dry season, any vehicle driving along on the murram (gravel) roads leaving a long cloud in the wake… not so pleasant for any pedestrians…  It also meant our river water levels were lower and so we had some power cuts in the evenings at peak demand time.  

But on a positive note the sun reveals some breathtakingly beautiful colours in the world around such as these flowers…
Now we are into the wet season.  We are about 5,500 feet above sea-level here in the Kigezi highlands so not surprisingly we are sometimes in cloud and can have quite violent thunderstorms as happened last week… unfortunately a lightning bolt must have connected to our high-tension wires and resulted in the burning out of a control circuit board.  As a result our main 300kW hydro-electricity generator was out of action for a couple of days but the hospital ran without problem on our back-up 60kW hydro-electricity turbine.  We are grateful to the Kisiizi Hospital Power Limited staff and  supporters who worked to get everything back to normal.

 The photo below was taken in the late evening when it was pitch black - yes, its a flash photo, but in this case the flash did not come from the camera but from lightning...

 But most of the time we are blessed with beautiful weather patterns, changing lighting and skies...

Saturday, 21 February 2015

WHO programme developments

Kisiizi has a number of links with the World Health Organization and recently WHO published a report on Universal Health Coverage and Patient Safety & Quality.  Only five institutions from around the world had been invited to form a "Learning Laboratory" and Kisiizi is one of them.  This led to this initial report which should be the foundation of some important developments.

We also enjoyed a visit from the WHO Country Representative, Dr.Wondimagegnehu Alemu who toured the hospital and was interested to discuss updates on our Africa Partnerships for Patient Safety (APPS) programme and our progress with the Surgical Unit-based Safety Programme (SUSP).  We also reviewed the Universal Health Coverage work and various plans for the future.  Dr. Wondimagegnehu was accompanied by the District Health Officer from Kabale who is keen for Kisiizi to support further development of Patient Safety in the region.

Click here to see Kisiizi Hospital Website page on WHO Links for more information

Click here to see Kisiizi Hospital Website list of publications including the report mentioned above

Dr. Wondimagegnehu visiting the Special Care Baby Unit

Focus on Africa

This is the title of a regular BBC World Service programme and a suitable theme as we welcome pupils and staff from a primary school in Holloway, north London, who are having a special focus on Africa in the next few weeks. 

We do hope you enjoy this blog and it helps you as you discuss the differences for children growing up in a busy city in England with the very poor rural community around Kisiizi...

Saturday, 14 February 2015

All change...

It doesn't take too much in Kisiizi to be an excuse for a party or at least a cake to share... but recently we have had a lot of comings and goings...


We were sorry to say goodbye to Dr. Lynne Speirs, a paediatric registrar who worked with us for a number of months as part of the Royal College of Paediatrics and Child Health Global Links scheme.  This link has now been in place for a couple of years and has proved very valuable for Kisiizi and has given these doctors valuable and varied experience.
Ian, Lynne & Dr. Paul, our intern
 Other interns have completed their rotations including Dr. Treasure who was in the first group able to do the full year as Dr. Dwight McLeod joined us in August as Consultant Physician allowing us to add General Medicine to the existing specialties of General Surgery, Obstetrics & Gynaecology and Paediatrics.  We also said goodbye to Godwin who has been in-charge of our laboratory for some years.
Dr Treasure (right) saying goodbye in Chapel

Dr. Charlie, Consultant Psychiatrist from New Zealand with his wife Cecelia

 Charlie & Cecelia said goodbye after a couple of months with us. Charlie provided valuable input to Psychiatry working with Sister Nancy and her team whilst Cecelia took many photographs and will be putting together a "coffee table" book illustrating aspects of Kisiizi which will be called A World of Difference -the design is still to be put together and we look forward to the finished item.

Rev. Patrick & Karen

However, the biggest change was to say farewell to Rev. Patrick Bagorogo and his wife Karen who have served in Kisiizi as Hospital Chaplain and Mothers' Union lead for many years.  As well as his principal role as Hospital Chaplain, Patrick also acted as Finance Manager for a period of time when there was a vacancy.  Karen was involved in many roles providing spiritual input to Children's Ward, and supporting the goat project which helps very poor families to have a better chance of feeding their children.

Sr. Nancy presents a gift at the big Farewell Party
Student Nurse presents gift in Chapel farewell for all the Staff

Final goodbyes before driving off (with Moses Mugume, left)


Sister Ruth has returned to Kisiizi after six months in Kampala having successfully completed training in Ultrasonography.  This will greatly improve the imaging department services as for a while Proscovia was the only full time sonographer.  

We are also training Bedad, previously our Orthopaedic Assistant, in a degree in Imaging which lasts four years but will mean in the end we will have a highly trained lead for the department.

Drs. Dash and Emily, Anaesthetic Registrar and GP respectively, join us with the Uganda Maternal and Newborn Hub link.  We are grateful for their support in theatre, developing high dependency care and maternity department support as well as helping with the introduction of more comprehensive triage as we open up the new Accident and Emergency area in our Out-Patient department.

We are delighted to welcome Francis Orishaba, a graduate Biomedical Scientist, to be our new In-Charge of the Laboratory services.  

This comes at a good time as we have just installed a range of new equipment to go up a gear in the support services offered to clinicians and improve our diagnostic and monitoring capabilities.
see    Lab Upgrade post on hospital website

We also look forward to another USA Peace Corps volunteer, Jennifer, joining us in March as a Pharmacist to work with Barbara and Sandra, our Pharmacy Technicians.  This is also excellent timing as we are re-configuring our stores and introducing a new IT system called Stre@mline.

The new Staff Room is in the old bank building
We were excited to receive our new chaplain, Reverend Joshua Bwebale with his wife Jocelyn.  She is working with Radio Rukungiri whilst Joshua has a range of experience having worked as a teacher, pastor and more recently as a specialist counsellor for patients with HIV.

We had an initial welcome cup of tea in our new staff room and then a welcome lunch party on Saturday as they arrived.

Welcome Tea in new Staff Room
Rev. Joshua and Jocelyn Bwebale

Come... all who are heavy laden...

Living here in Kisiizi we see all sorts of burdens being carried by individuals and vehicles... 
Jack fruit....


too much!

and if that is not enough, here is real People Trafficking!

Monday, 22 December 2014

Doctor, Doctor!

Yes, two doctors in the house now Mark has successfully completed his PhD at University of Reading. 

He had his oral examination on 18th December and passed with flying colours so he can now relax for Christmas.

He is working teaching undergraduate students Chemistry and seems to be enjoying this role greatly.  He has been asked to help write a textbook so that is a new venture for him.

Teacher, Teacher!

We are also very proud of Ruth who has survived another term teaching in a school in Islington while at the same time working for a Masters with Homerton College, Cambridge.  So life is busy for her but she has done very well.

All together now...

We are very happy to have been able to arrange a brief trip back to UK for Christmas so will be with Mark and Ruth and then we all go for a 3-night visit to Holland to see the family there before we return to Kisiizi flying out on 3rd January for a further six months.  After that we are not sure how things will work out.... so watch this space!

Ends of the earth...

It seems that more and more countries are hearing about Kisiizi!  We have just had our first application for an elective attachment from a medical student in Iceland!

Kiwi Invasion:

We have enjoyed a good New Zealand contingent with two trainee midwives, Natasha and Katy, joining us for five weeks and then Nadia, an experienced neonatal nurse, coming up from Kisoro to help us for a month or so.  Then Charlie, a psychiatrist from New Zealand with his wife Cecelia, originally from Chile, have joined us for a couple of months - she is a photo-journalist and psychologist.  We also welcomed Lesley, a manager with CMS New Zealand, for a brief visit.

Beth, a trainee phyiotherapy student, joined us from USA and we had medical students from Germany as well as UK so a really nice international mix.  Add to this Ugandans coming from different parts of the country, some unable to speak the local Rukiga dialect, and you will appreciate the richness of the mix of people working together.


We also enjoyed a visit by our World Health Organization country director and his team plus the District Health Officer from Kabale.  They were impressed by what Kisiizi is  doing and we hope the visit will lead to more interaction in future and the spread of our patient safety programmes.

Importantly we also welcomed members of our Board of Governors and were happy to have the externally audited accounts available up to the 30th June 2014 that were duly approved.  There will be some follow-up meetings to look at our 5-year Strategic Plan and the Terms & Conditions of Service and  Constitution so these are important bits of work to finalise.
One way Kisiizi has received publicity is to be included in a Cultural Museum near to Mbarara


Ian is working with Rimpscom, an IT company in Mbarara, on the Stre@mline computer software programme that he had developed in Macclesfield.  This is because the existing IT package in Kisiizi has proved frustrating as it does not have the functionality we need and has proved impossible to upgrade or edit.  Stre@mline is an integrated programme that follows the patient journey and incorporates important patient safety principles.  Management have now given approval for Stre@mline to be piloted in out-patients and if this goes well we will extend it systematically to the wards.  If we achieve good functionality we will install it in a sister hospital in Kabale and if both units have a successful outcome then we will aim to write it up and make it more widely available at a low price appropriate for places like Kisiizi.  If it works out well, it could be used "to the ends of the earth"....
The programme will provide much more accurate data as all the information is stored in an underlying SQL database.  The programme uses a browser front-end interface so its easy to learn how to use the system.