Too late...

Increased maternal mortality is multi-factorial

 The photo shows a national newspaper article published earlier this year.  It discussed the many issues that may increase the risk of mothers dying associated with pregnancy and childbirth.

Sadly we experienced a local incident recently. Last Wednesday evening we had a tragedy where a mother in labour was brought to Kisiizi but was dead on arrival at the hospital at around 11pm.

The story behind this sad event is that she had had a previous Caesarean section in one of her nine previous pregnancies.  She went into labour in the village where she lived.  She was taken to a local drug shop / clinic we think at around 3pm and it seems that there was then a long delay before she was put in a vehicle to come here at her own request.


From the description given by the attendants, we suspect she developed a rupture of the uterus through the old scar.

This is the sort of patient who should always deliver in hospital. Most mothers want to deliver at home if possible, partly for cultural reasons, partly economic as it costs a lot in local terms to arrange transport as well as hospital costs, food etc.

One response in Kisiizi is the construction of the Mothers' Waiting Home sponsored by Kisiizi Partners.  This will allow mothers at risk to wait here so when they go into labour they can be moved to the Maternity Ward easily and quickly.
We are following up the case with the District Health Officer and will continue to try and improve health education of both public and community professionals to try and avoid such cases in the future.

Cuisine extraordinaire!

Okay, those of you in Europe will know that the French are encouraging high-end restaurants to include various insects on their menus... but Kisiizi have been doing it for years!  Only problem is they are seasonal...

Here is the extent to which villagers will go to catch grasshoppers at the right time of year - with lights, long pieces of corrugated iron [usually used as roof sheets] and old oil type drums to catch the insects disorientated by a smoky fire.

The result, after removal of heads and wings and frying in oil is as shown below.... brought for us today by a kind neighbour... tastes like shrimps [if you have a good imagination like my wife!]

maybe could do with a few chips?!

"Her tummy's so big, Doctor..."

This little girl presented with a history of significant abdominal distension and discomfort for some time.


Her case illustrates the value of appropriate technology, in this case ultrasound.

The scan demonstrated a cystic lesion thought to be a pancreatic pseudocyst and this proved to be the case at operation when it was removed.

She bounced back really well and her parents were delighted.

 Our only imaging modalities at present are ultrasound and a static x-ray machine.

Our friends in Chester have very kindly donated an image intensifier which will allow real-time imaging and this would be especially useful in procedures in theatre such as orthopaedic manipulations to assure correct re-allignment of fractures etc.  However, our estimate for transporting the equipment here is between five and six thousand pounds sterling.... ummm!

Sun day...

A group of us made a day trip on Sunday to visit Bwindi Community Hospital which is quite remote and very close to the location of some of the groups of gorillas.  It took us about 3 hours with breaks to reach Bwindi but we had a very warm welcome from the staff.

One reason for the trip was to visit a former member of our nurse training school now working in the hospital in Bwindi who unfortunately was burnt by a paraffin stove and is in the ward having treatment.  She was much encouraged by the group.
We enjoyed the tour of the hospital and time to catch up a bit with Kieran & Sarah, two UK doctors we had met before they came out to Uganda when they did the Developing Health course with us.

On the way back we kept watching the sky which was rather cloudy but happily it cleared a bit and we were able to see a partial solar eclipse.  Once more it makes us marvel as we enjoy the heavens...