Sea Chef Cook Off

April 28th, 2015 No comments

Now it was a bit of a challenge today – was this entry supposed to be a starter or a main? The required ingredients were: smoked turkey, caviar, hard boiled eggs, cranberry sauce and blue cheese.

Traditional Pairings

Traditional Pairings

everything inside a lettuce roll

everything inside a lettuce roll

compare, contrast and find the cranberry

compare, contrast and find the cranberry

out of the world sauces carrying flavors across

out of the world sauces carrying flavors across

 

To add a bit to the fun – the top contestant from yesterday was able to chose an additional ingredient and add it to the list of another contestant of his choice.  (No foreshadowing here -it rebounded on him big time).

Lucky me, as well as not appreciating being on stage, I wound up with the camera down at my end. Just what I want – everyone on the ship watching me handle knife/fork and eat in public. Comment? At least I managed without spilling all over myself or sounding too much like an idiot.

Clare, Dennis and I

Clare, Dennis and I

How do I know? I got to watch it on TV this evening.

Categories: Travel Tags:

Master Sea Chef

April 26th, 2015 1 comment

for those of you who have ever sailed on a Royal Caribbean Ship – there is usually, 1000 in the morning on a sea day, a cake decorating contest. Mostly the Master of the vessel vs the Cruise Director/Hotel Director; the goal is to put together and serve a Blackforest cake.  Dark chocolate layers, cream frosting, cherries, some shaved chocolate.  Did I mention the Kirschwasser?  At least one of the cakes will be swimming in so much alcohol that it almost floats off the plate.

Carly (one each Welsh Cruise Director) came up with a new spin. A la Iron Chef, they are having a cook off in the Centrum, 1100 each day.  The contestants, all staff officers, were dressed in traditional chefs jackets and aprons. Presented with a surprise box of ingredients, today’s task was to create a salad in 15 minutes or less.  The tables for the contestaants were in the centrum. The bar counter behind them had a full range of garnishes, condiments and dishes.  The judges platform was on the steps facing the action.

Describing the action shouldn’t be difficult since I had a “ringside” seat.  Surprised? As I normally will do just about anything to stay out of the spotlight I still don’t understand why I agreed to be part of this insanity. No. I am not cooking. Most know better than to suggest that.  Married over 36 years to a wonderful guy who still honours the agreement: I don’t do kitchens or bathrooms.

Nope, I am one of the three idiots sitting on the judges platform with the opportunity to taste the offerings and render judgement.  Not quite the “fit/not fit for human consumption” comedy routine that one of the vets and I pulled off in Kuwait for the command BBQ but still….  Based on the points awarded collectively by the three of us, one contestant a day will have to “Hit the Road Jack”   Today it was Paul, the Refridgeration Engineer.  It was a case of ooppps.  Forgetting an ingredient doesn’t do much for your score.

I will try and have pix in the morning.  Meanwhile, this is turning out to be a lot more fun than drunken cake! 

Categories: Travel Tags:

ANZAC

April 25th, 2015 No comments

For those of you who don’t remember from the last two springs – 25 April is ANZAC day – standing for Australian-New Zealand Army Corps.

This year is the 100th anniversary of the landing at Gallipoli in WWI. The casualties on both sides were horrendous. What was supposed to be a preemptive strike turned into 8 months of hard fighting with little to no progress.

The significance of today (25 April) hit me a few days ago which should not be surprising considering that I was on the Mariner two years ago when there was standing room only in the upper lounge for the memorial service complete with New Zealander bugler from the crew. Last year was the Legend. With a bit of nudging from Val, Ian and a few others the CD managed to get together what turned out to be an impressive service with ANZAC biscuits at the end.

This year I asked the Cruise Director about a service and mentioned that I still had the documents and audio clips I had pulled last year. We also have a larger Australian contingent on the ship one of whom came equipped with flag, readings and the audio for the Last Call.

So there we were, a small group of 15 this morning at 0600. On the pool deck with the wind blasting and the temperatures barely over freezing. There is the Aussie who has the readings, the Padre (Catholic, USAF (ret)), passengers, cruise director and two Yanks (Cheré and I, and she is from Oklahoma).

A second service was held at 1100, up in the Vortex Lounge. Much better attended.

Meanwhile, it is first formal night and we have already started the time jumps ahead. So need to change clothes, wander to dinner and then go back to reading #NewHugoAwards and #NewHugoCategories…

Categories: Books & Tapes, Travel Tags:

And across the Atlantic

April 24th, 2015 No comments

15138_140417160913683

DAY DATE PORT ARRIVE   DEPART
Fri Apr 24 Boston, MA 5:00pm
Sat Apr 25 At Sea
Sun Apr 26 At Sea
Mon Apr 27 At Sea
Tue Apr 28 At Sea
Wed Apr 29 At Sea
Thu Apr 30 At Sea
Fri May 1 Cork (Cobh), Ireland 9:00am 5:00pm
Sat May 2 Portland, England 11:00am 9:00pm
Sun May 3 Paris (Le Havre), France 7:00am 11:00pm
Mon May 4 Cherbourg, France 7:00am 5:00pm
Tue May 5 Brussels, Belgium 9:00am 7:00pm
Wed May 6 Amsterdam, Holland 10:00am 9:00pm
Thu May 7 At Sea
Fri May 8 Gothenborg, Sweden 8:00am 5:00pm
Sat May 9 Copenhagen, Denmark 6:00am

Admittedly the map is a bit weird. From what I know, Amsterdam is on the Atlantic Side…

Any way – Cheré and I are on our way across the ocean in a fancy cabin, no less.

Categories: Travel Tags:

Russell

April 23rd, 2015 2 comments

When I met him last fall, he was quietly perched in his blue easy chair. Surveying his kingdom and content to observe. He had been there for a while, none of the bridge officers knew exactly how long. I gave him a transatlantic pin for his efforts and more or less forgot about him.

Well, apparently one must be cool to cruise the Caribbean and that means sunglasses. Add to that a home port of New Orleans and you start to see the problem. No longer content to sit quietly, both his and others feathers are ruffled and he has to have his beads. Both in addition to his pin.

The bird of the bridge

The bird of the bridge

Do you think giving him a pin on the upcoming crossing might restore some order?

Categories: Travel Tags:

went to St Maarten

April 19th, 2015 No comments

and stayed in Phillipsburg. Didn’t go to the airport and get pummeled by planes. Didn’t go snorkeling (although I probably should have since the camera battery is recharged), but I didn’t want a lot more sun exposure till I recover from Bonaire.

Forget my sunblock? Who me?

Anyway, it is Sunday in St Maarten. The stores that are going to open do so at about 1000. The streets are not blocked off and the merchants seem a bit desperate. There is only one ship in port today not the five to six which has been my usual experience here. Additionally, according to multiple shop keepers – there has been more looking this year and less buying.

The good thing about all of this for me is that the streets are not so swamped with people that I can’t walk.  So I visited my favorite camera store and picked up the last thing I am going to need/want for a long time.  Then we hiked back toward the ship and made a stop at the Leathergoods store. Over the years I have purchased belts and the occasional jacket here.  I love leather jackets and have no guilt in wearing them, so I always go looking. The manager recognized me and, among other suggestions, pointed me to the really bargain rack.

That was nothing compared to Cheré greeting him in Turkish and receiving the red carpet treatment. It was fun to watch.

We hiked back to the ship with bags, not all that much poorer. The Art Box (jewelry store) wasn’t open so the credit cards were spared.

Categories: Travel Tags:

Too few days -

April 18th, 2015 1 comment

and too much OBC.

Not a problem one often has. Most cruises anymore don’t provide a lot of On Board Credit. Further, many have limitations on how you can spend it. For some reason, I wound up with a bunch on this cruise. In an effort to avoid dealing with the main dining room, Cheré and I both prepaid the gratuities leaving us with monopoly money to spend. Since almost all of it is non-cash, it vanishes into the coffers of RCCL without a trace if we don’t spend it. And as far as the shops on board – forget it! The last thing I need is either junk or more t-shirts.

What my kids will appreciate even more is that I am not even buying magnets this go round. No postcards either because they already have them from these ports.

Not sure either of those have anything to do with OBC but I get distracted quite easily.

OBC – one can eat in specialty restaurants. Cheré and I hit Giovanni’s the first night. It was excellent. We went there for lunch once. We tried the sushi – it was ok but not fabulous and certainly not worth a trip back.

Will have to figure it out, but meanwhile, knitting proceeds

Octavia's Garden in the middle of the melody

Octavia’s Garden in the middle of the melody

Categories: Travel Tags:

Name that Fish!

April 17th, 2015 3 comments

The location is Bonaire, the snorkeling trip put on by Woodwind Tours. If you are ever here, book with them – fabulous people, extremely knowledgeable, excellent equipment for everyone from beginner to experienced. They are more than reasonably priced (book the five hours, drinks, 3 snorkeling locations and food!)

The water is crystal clear. You can’t touch anything, feed anything or walk on the coral. Some areas are really shallow and you have to be extremely careful as well as along the drop off where you can’t see the bottom, just reflections off fish as they come and go from the depths. The photos were taken with my CanonD20. I don’t have names for most of these critters – so if you know any, please leave me a comment and I will fix the caption!

Fish #1

Fish #1 – parrotfish

Fish #2

Fish #2

Fish #1 again with friends

Fish #1 again with friends parrotfish

juvenile green turtle

juvenile green turtle

Fish #3

Fish #3 – French Angel Fish (thanks Stu)

Fish #4

Fish #4

Fish #5

Fish #5 – parrotfish

#5's buddy

#5’s buddy? juvenile parrotfish

Fish #6

Fish #6 – Blue Tang (thanks Linda)

a school of #6

a school of #6 – more Blue Tang

Fishes #7

Fishes #7

fish #8

fish #8

larger turtle - really deep

larger turtle – really deep

Fish #9

Fish #9

and last - Fish #10

and last – Fish #10

And then there are sponges…. and coral

sponge

sponge

staghorn

staghorn

Categories: Travel Tags:

Aruba – take 2

April 16th, 2015 No comments

At least I think it is take two. I was here in Jan 2014 certainly (which I figured out simply by doing a search on the blog).

the tourist shopping area

the tourist shopping area

We waited till the first of the crush made it off the ship before stepping out into the heat and humidity. It isn’t a far walk to either the Archeological Museum or the Fort (which is now a local history museum). The first is free, the second a whopping $5/US.

The Archeological Museum is signed in both the local language (which reads like a combination of original amerindian, dutch and spanish smashed up together) and English. At one time a private residence; grants enabled the board to convert, update and maintain. It is open, bright and easy to navigate with steps, ramps, elevators so that anyone can get around. The descriptions are no more than a sixth grade reading level and many are pointedly directed toward school age children. The story is told of the original inhabitants (probably ~1000 CE), various European exploring groups and subsequent conquerors. Although not really stressed, it seems obvious that the closest mainland links are Venezuela. There was information on local archeology, pottery, house construction and use of shells. Domestic animals, long a part of the European household did not appear until the Spanish in the 1500s.

pre-ceramic era house

pre-ceramic era house

Lastly there was a lovely exhibit of local art.

Back out in the heat and trekking along looking for shade Cheré and I avoided all the high end name stores on our way to the old Fort. Not large, most but not all of the wall has been maintained. In case you have any difficulty in finding it – tall square clock tower and two canons out in front (pretty broad hint). Inside, it is a local history museum with friendly staff, a lot of rusted shop and farm implements and a building focusing on “then and now.” So showcased are furniture, old household implements, music making and musical instruments and dolls (one looks definitely like E II).

1800's outdoor kitchen

1800’s outdoor kitchen

yes, a real telephone

yes, a real telephone

sewing basket

sewing basket

Most interesting was an oral history project involving young people on the island.
Their instructions were to find the oldest possession in their family and track down its history through relatives, written documents. Posters gave the information and a video ran with each one of the 20 telling their story in turn. The objects ranged from a gold watch to a cactus soup recipe to cookie iron.

Outdoors we noted birds and iguanas…while confirming that there were a lot of shops with the purpose of separating the tourists from their money. Assume the presence of everyone of the awful cruise ship jewelry shops, most brand name stores, and a lot of bars. When you leave the ships (We and the Adventure of the Seas were in port today) if you turn left and walk down the main street you will find stores more attuned to the local populations (groceries) which is where I imagine most of the crew went.

Linda - what bird is this

Linda – what bird is this

Other things to do – the troll ride looks to be short but might be fun. Water sports are certainly an option. Lots of food and drink.

Post Box

Post Box

It was a nice time, warm. We found no tacky Santa shirts, bought no magnets. At 1000 this morning which was well before we docked the Serenade had held its “Milestone Recognition” so I have my crystal paperweight. Don’t need to add anything else to the suitcase…

(photos to follow)

Categories: Travel Tags:

Sliding

April 15th, 2015 No comments

I did mention that there are almost no children on the ship, right? In fact there are only two, teens both, who do not belong to the crew. Lovely young Canadians, met them on shore in Grand Cayman.

Apparently the water slide still is open, even when there are no takers.

I went sliding this afternoon. The sun was bright, the humidity up and even with the wind blowing it seemed like the thing to do. I was their first customer this cruise. Day 5, third sea day. Only person sliding.

Climb the stairs

Climb the stairs

down the shute, around the 360 and into the water

down the chute, around the 360 and into the water

I even took my underwater Canon and made a couple of videos. From this I can assure you that it is a long walk for a very short (15 seconds) slide.

Categories: Travel Tags:

Grand Cayman

April 14th, 2015 No comments

Georgetown is a tender port which occasionally makes the choice of what to do for the day quite easy.

Do I want to shop (no, not me). Do I want to see the local museum (exhibits haven’t changed since I went through it in 2013 – I asked the guide), do I want to play with Stingrays. The last is a big time actively for a lot of people. Did the brush and bump with stingrays in Papeete so that left me the wander around option.

It was possible to walk around on the sidewalks without pushing and shoving since the only other ship at anchor today is the Carnival Freedom. The last time I was here it 4-5 ships which is more shoppers than I want to see. Wandering around, it was easy to guess who was off which ship: the Serenade passengers were a bit older, a bit better dressed and sober. The Carnival passengers were living up to the stereotype.

The Pirate is still defending the rum –

IMG_1839

The Creature locally is the “blue dragon” which looks somewhere between an iguana and a komodo dragon.

Supposedly a dragon

Supposedly a dragon

I don’t remember the fountain –

Stingray is king

Stingray is king

But there are still numbers and variety

But the Roosters are still ruling the local craft area

But the Roosters are still ruling the local craft area

Categories: Travel Tags:

Knit Needle & Hook

April 13th, 2015 No comments

It is now the second sea day. Yesterday was tied up in many of the first day activities mostly related to Cruise Critic and making sure that I actually can find everything on the ship (and teaching myself the correct turning direction from the stairway. Walking to the back of the ship and starboard instead of port is not my brightest move).

Anyway, Chere and I wound up hanging out that first afternoon near the 5th Deck coffee shop with needles in our hands. We found a few other crafters and had a great conversation with the cruise director who offered to place a note in the Cruise Compass.

This morning we wandered down to Deck 5 and commandeered the couches. Over the morning we were joined by a number of really nice people. A crocheter from Australia (Brisbane), and friend from a previous cruise (from Duluth), a guy stitching incredibly beautiful & intricate Christmas ornaments, five other knitters and a woman hand appliquéing flowers on quilt squares.

The time passed briskly. I wandered back in the afternoon after lunch (fancy reception – excellent food and a large number of the staff who I remember from last fall).

Part of the group wandered back.

I finished a bias knit scarf that has been  on hold for so long that I don’t remember when I started it. I will not mention my poor planning, the previous snarled yarn or failing to estimate when I has used the first half of the yarn. It is asymmetrical and I am just going to call it a design element.

so it is not going to be worn with the large point down the back

so it is not going to be worn with the large point down the back

and no clue how big it might be once blocked...

and no clue how big it might be once blocked…

one skein of 100% merino sock yarn on 4mm needles…

Categories: Knitting, Travel Tags:

The China Star

April 12th, 2015 No comments

at some point last night I realised that it was awfully quiet. The engines were making little noise, the fog horn was no longer blowing and I didn’t sense any forward motion. Obviously I decided it wasn’t my problem and went back to sleep.  It was just after 0600 when Cheré and I looked out the balcony and verified that we were going nowhere in a great hurry.  Ok. We are sitting still, why?  It obviously wasn’t an emergency or we would have heard.

It was 0700 when the Captain came on the speakers to say that there was a ship broken down in the river ahead of us.  Until the tugs stablized it and moved it out of the channel, we were going to be remaining where we were. Looking out over water, Quonset huts, a few houses and land so flat that you could imagine it vanishing under a one meter wave.  Several cups of coffee, the discovery that my access code to the internet worked on both my laptop and iPad at the same time and it was time to find knitters.

Next announcement – bulk hauler still blocking the channel. Bit of research turned up the information that both the Carnival Dream and NCL Dawn had made it up river last night. I have to admire the pragmatism of the Coast Guard and pilots: ship outbound can wait; two that are headed in with passenger loads disembarking this morning were given priority.

Final announcement: ship is stabilized and we will be starting out. It is now lunch time and over 12 hours since we stopped. At least we managed to get turned back around and are now headed downstream.  We creep the China Star being held in place by six tugs. Even so you can see the wake and its effect. Chere reports seeing crew members on deck with small grills. The ship had a major engine failure. No power. No lights, no refrigeration and obviously no internal means of cooking.

I don’t know what they are hauling, but I just hope it is not flammable….

Categories: Travel Tags:

From NOLA to Boston

April 11th, 2015 No comments

After all this time – you would think I would plan these posts ahead of time. Which mostly I do so that I can grab the nice table of the itinerary. Seems like the last remaining cabins might be for sale on the RCCL site, but VTG doesn’t have them any more.

MSY_GCM_AUA_BON_SXM_STT_BOS

Any way – it sort of goes –

Ship Name: Serenade Of The Seas
Departure Port: New Orleans, Louisiana
Ports of Call: New Orleans, Louisiana; (2 days at sea) George Town, Grand Cayman; (day at sea) Oranjestad, Aruba; Kralendijk, Bonaire; (Day at Sea) Philipsburg, St. Maarten; Charlotte Amalie, St. Thomas; (3 Days at sea) Boston, Massachusetts

It is Cheré Harper and I this time around. Around the Caribbean and across the ocean. I have snorkling planned for Aruba and Bonaire and visiting one of the docs from the Uganda course while in St Maarten.

Categories: Travel Tags:

No surprise

April 10th, 2015 No comments

of course but this note is coming to you from the Frankfurt Airport, Senator Lounge in Terminal Z. With a flight after 1200 I had more than my usual amount of time this morning. Being already packed I could do useful things like take out garbage and lock up the house prior to taking the train to the airport.

Never mind about the train – I took the 0750 train connection in Mannheim which arrived before the 0737 (running more than 30 minutes late). Since it didn’t matter to me whether the end destination was Dusseldorf or Hamburg I grabbed a seat in the first available car.

Checking in turned into a small challenge. Since my first flight is Lufthansa, I had to check in through Lufthansa. My connector is United. Lufthansa couldn’t check me through and United kept sending me back to Lufthansa for check in. Given that I have five hours between flights I am not too worried. Even if it takes hours to get through security I should still be able to get some help from the United Service counter before attempting to drop off my suitcase.

1600 – update. Lovely flight with a great purser who entertained me with stories of his grandparents house near Bonn. And his mother used to knit for him; he would really, really appreciate socks (more than a hat or scarf). I am thinking about it. The main draw back? He has size 47 feet…..

Cleared immigration, picked up my bag. Went to the service counter where absolutely no one was waiting and received a new luggage tag. This one has the actual flight number on it, rather than the code share. I am hoping it means that my bag will arrive on the same flight as me.

Now hanging out in the over crowded and under served United Club. At least they have coffee and wifi….

Categories: Travel Tags:

It might be spring

April 9th, 2015 No comments

It was warm and the sun is shining.

The birds have been up and voicing their opinions since early this morning. Buds on the plants and all sorts of new growth.

IMG_0718 IMG_0719 IMG_0721

What you can also see is the children’s playground across the street from my wonderful jungle. During the day it is the source of cheerfulness and happy shouts. At night, when the sun goes down it seems the Goths and vampires come out. The good thing is a lot of police presence in driving them out and keeping the noise and drinking down to a minimum. The bad thing is that it has become necessary in what used to be a quiet neighborhood.

Categories: home Tags:

Foiled again

April 8th, 2015 No comments

You would think that I would understand WP software by now. There is a mandatory re-log in every 24 hours.  So explain to me why, when it had been over a day, I happily typed in a post then was upset when it wasn’t saved. Sentence after sentence, paragraphs just flowing from my fingers onto the screen; it even sounded coherent for a change.G

Did I bother to copy it to a document? No. How about just a screen capture? Nope, didn’t go there either. Just blissfully hit the “publish” button and watched the screen cycle to the log in page.  Gone in the blink of the cursor and not recoverable. Been there, failed this bit of editing before…

It seemed like time to take a break. Ok, I have all these coupons for various amounts off on photo books. Why not try it, especially since they are all willing to give me free photos.

What am I going to do with photos? Who carries around photos? iPads, smart phones – of course. But hard copy photos?  Maybe I can make business cards and cut them up?

Never mind.  I settled on trying SnapFish and Shutterfly. One gave me good information about what I needed to do, the other gave me generalities. One let me enter a lot of text, the other made it practically impossible.  Discount coupons are good; I just wish California didn’t want its share of sales tax.

Now to see if it is worth doing again…..

Categories: Photos Tags:

more than 100

April 7th, 2015 No comments

miles or km for prescription refills. It really doesn’t make any difference which it is really since it means time, distance and diesel burned round trip.  If mail order pharmacy was a reality I might just indulge, but Germany is not exactly friendly on drug imports and I would have to get an APO box again. Instead, I get to drive to LRMC. I could take the train – minimum of 90 minutes each way followed by 20-30 minutes up hill from the train station.

That is right – put the hospital on top of the highest mountain in the area just to make sure that it is totally and completely off the beaten track. Add in paranoia on the part of the military which resulted in what used to be the front gate being redesigned into heavy metal most closely resembling a river lock followed by closing it to vehicular traffic. Why? I can speculate but it does keep incoming traffic away from the ER. Never mind patient transfer time from the Ramstein Flight Line has significantly increased…..  There is a pedestrian gate which I know to be open at shift change and is usually but not always open at other random times.

I thought about the train for about five minutes. That is about how long it took me to decide that half a day spent collecting refills was enough. If the pedestrian gate is not open then it is back down the hill, 5 km around the mountain and back up to the nearest gate which is as far away from the pharmacy as you can get and still be on post.  I drove the 115 km according to Google maps from my house to find that Gate 3 was closed. Gate 4 was now the entrance and Gate 2 the exit. None of this makes any difference to you unless you know the place.

The nice tech at the pharmacy pulled my refills and filled my new script on one counter trip which I really appreciated. Yes, I understand my refills – coming up on 20 years now. Yes, I am fine with Doxycycline – no I don’t need Primaquin, this will do me just fine.  Since I hadn’t had quite enough pain for the day I stopped at the immunization clinic. One needle (Zostavax) in the left arm, updated shot record and I was on the road to home.

 

 

Categories: Medicine, military, Travel Tags:

Key?

April 4th, 2015 No comments

My flight left Entebbe around 0400 in the morning. I changed planes in Istanbul and arrived at Frankfurt Airport by 1445. Ignoring strange goings on with the train (Worms is not exactly on the way to Mannheim), I managed to arrive in Heidelberg and get home.

Then the fun began.

The Wifi was working which was good. The key was not where it was supposed to be. Multiple exchanges back and forth between me and George in California who swore that a key had been left for me. Before screaming, crying or throwing a complete temper tantrum I decided to look at alternative locations. Lo and behold, there – tucked inside a small bit of paper under a cover in what both us think of as trash (not a currently functioning item) was the key.

Sleep sounds really good right about now.

Categories: home Tags:

Leaving Uganda

April 3rd, 2015 No comments

It is after dark and there are some lights shining out between the Cassia Lodge and Lake Victoria. It means that Shabbat has arrived. For that matter – it means that the first night of Passover has arrived as well.

 

We had finished by noon today, both with lectures and a session in Mengo Hospital Lab. I will not readily  admit how many years it has been since I personally prepared thick&thin slides for malaria diagnosis.  Since the flight times for our group varied from 1830 onwards we had a couple members leave from the lab directly to the airport. The remaining four of us came back to the hotel for the afternoon. Given that there were a number of hours, Silke, Sarah and I split a room so that we could rest, lounge and shower before getting stuck in the lobby for the last couple of hours.

Did I mention that I am returning home on Turkish Airlines via Istanbul?

No?

Well, anyway that is the plan. Lufthansa doesn’t fly directly from here. Nor does Austrian or Swiss Air. So my choice was Ethiopian or Turkish. Having flown on the latter, it was excellent plus I would rather change planes in Istanbul.

But I have not been able to check in on line. As it turns out, they have only the one flight per day coming through on a loop – Istanbul-Kigali-Entebbe-Istanbul which means that the counter might not be open for a while. I will update you….

(Right about midnight – give or take)

We left the hotel about 2030 and hit an insane amount of traffic immediately. So instead of taking 50-55 minutes it turned into almost 100 minutes. It was about when we were at the airport that the trip organizer mentioned about he was glad KLM didn’t leave till midnight. No, the time has been changed to 2330. Ooops. We get to the terminal to hit screening (everything through a huge x-ray that I am not sure had anyone watching the screen. The two on the KLM flight dashed for the counter which was about to close.  Counter->Gate->boarding.

It was about then I found that Turkish Airlines doesn’t open their counters till around midnight…

But I managed to get checked in as soon as they opened, through immigration and to the “one lounge for everyone.”  And everything to eat, other than fruit and chips is either on bread, wrapped in dough or is bakery products.  Fruit is good, and chips are a vegetable, right?

 

Categories: Jewish Life, Travel Tags:

Walk through a village

April 2nd, 2015 No comments

We went for a walk today with one of the district health workers. He was following up on the use of bednets which were provided to all the households for free. Well, all the households that were registered and to those members of the household who were known. Numbers are a guestimate at absolute best and a SWAG at worst.  About every four months on top of every other method they have (social media, church, village elders) one of the workers tries to do a follow up.

We were lead by the Village Elder. Originally in wellies and tattered pants, he vanished for a few minutes only to return in flip-flops and nice pants which apparently constitutes visiting clothes in these parts.

We headed past the houses lining the road and up the hill on a one person wide beaten down dirt path. I don’ think any of us really had recognized just how many people are living back off the roads connected to schools and neighbors only by foot paths. What it is also means that every single bit of building materials or personal possessions is carried in by hand. This is probably not as complicated as it seems since there are no wells, no running water, no plumbing and certainly neither power lines or generators at even the wealthiest house in this village.

If you have money, you build of brick often making your own. If you don’t – well then it is wood with filling (cement, dirt and cow dung mixture)). Windows are an uncommon luxury and the floors are dirt. There is only natural light, what little makes it through either windows covered with cloth or through cracks in the joins. The house is really for sleeping and storage of the minimal clothing the family might have. Cooking is down outside. I did not see a candle, but in any case, each of the tiny rooms inside the houses only had a bed and cords for hanging possessions. The chickens went where ever they want – the goats not as much simply because most of them were staked out.

Obviously bed nets are critical to keeping especially the young children free of mosquitos and thus malaria. The nets were there (some are white, some are blue) unfortunately, less than 1 in 4 are actually being used properly in this village which is still better than it used to be.

I will just leave you with the photos – from the most expensive (brick) to least (dab & wattle) house and a couple of outside cooking areas. Then compare it to your life. There is nothing nobel about living like this; people are not happier than westerners. What they are is exhausted from the effort it takes, literally sunup to sundown just to care for children, house, animals, fields. The children who walk km to school as well as those who don’t go because they can’t afford the uniform. Time spent every day hauling water in. And it is not living in harmony with nature. It is wresting a living from the land, slash and burn clearing because it is the easiest. It is dumbing trash because there is no where to take it.

The area

The area

The Crops: (along with the more prosaic sweet potatoes, peppers, potatoes, cassava, maize, etc

paw-paw

paw-paw

jack Fruit

jack Fruit

coffee

coffee

The Houses – outsides:

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And inside:

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Two Kitchens:

 

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It is a land of poverty, natural beauty and people doing their best.

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I shudder to think where Uganda is going to be in 20 years. The population pressure is enormous. The rainforest is being rapidly encroached by people who need those trees to build their houses.

 

 

Categories: Travel Tags:

Botany, no fooling

April 1st, 2015 No comments

Never mind it is April Fool’s Day. What happens if you are a German traveling and fall in love with Uganda? You work hard, buy 72 acres of land near Fort Port and set up a guest farm. You employ people, you accommodate visitors. You can even provide German style salads with the meals (although better because everything is locally grown). Kluge’s Guest Farm is more fun to think about that River Blindness so I am not going there for the moment. Rather, if I could get any of the black and white col0bus to hold still for a photo I would be really happy. Otherwise it is like seeing a plumy tail striped like a skunk go flashing by in the canopy. I have hope…

a black and white blur, the best I ever got....

a black and white blur, the best I ever got….

Our program today ran well in spite of the two people with onchocerciasis thinking that there could not be a group of white doctors coming especially to see them. After all, it is the first of April.  Once we had that sorted out, the day went well.

the guilty fly

the guilty fly

But let me just leave it with: you do not want River Blindness. You do not want worm filaria traveling around your body, accumulating under the skin and seeking a home which they may well decide to find in your eyeballs. More cases every year than Ebola (but same with measles, malaria and a number of other miserable diseases).  But then there are those who have taken the mosquito netting and turned it into fish-netting to feed their families. The Health District is trying to get them to stop. My thought is it might be better to find an organization to get them fish netting so they have an ability to use bed nets for their intended purpose.

The rest of the day we spent on medical and herbal botany. I have been entertaining you with animals and birds. Now on to plants, flowers and strange looking seeds…

on to the plants!

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The Tooro Botanical Gardens grow plants and herbs  representative of that which is found in the Albertine Rift. They dry, process and sell herbs to supplement their income and run a nursery of plants for sale.  Our guide today specialized in these plants and explained the use of all. Some of it makes sense, some it pretty far fetched.  It just makes me wish that pharmaceutical companies spent a bit more time looking at the army of botanical compounds and a bit less time running panels of chemicals “almost but not quite identical” to known drugs. That is not how you discover something new…

Artemesia

Artemesia

two monkeys - would have been nice to have my zoom lens

two monkeys – would have been nice to have my zoom lens

organic lawn mower

organic lawn mower

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seeds on the bottle brush

seeds on the bottle brush

bottle brush - actually pretty soft

bottle brush – actually pretty soft

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passion fruit

passion fruit

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tree house

tree house

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Artesema dried and chopped. ready to be made into tea

Artesema dried and chopped. ready to be made into tea

Categories: Medicine, Travel Tags:

Fort Portal

March 31st, 2015 No comments

We are still fairly near the DRC border along the Western of Uganda which means we are right near the mountains. Not small hills although there are plenty of foothills, real mountains with the largest topping 5000 meters which is a significant height. Unlike other area of the world that are well known with good base sites and guides the area here is a bit more wild which means there is a real opportunity for western climbers to be stupid and get themselves killed. Hiking and climbing during the rainy season are not advised.  In fact a couple of climbers died just a few weeks before we arrived in country not that it made the news anywhere.  The population allegedly is around 55K, 

The hills are green, the roads are red and packed reddish dirt and clay. When it rains they are extremely slippery; those parts which are not ruts deep enough to lose a bicycle or small child walking to schol of which the roads are littered with in the morning.

Remember the joke about “walks to school 6 miles each way barefoot uphill in the snow?”  Well, these kids are walking 1-7 km in the mud each way in their bare feet for the most part.  Since sunrise is about 0700 this close to the border it means that schools don’t start till closer to 0900 or a bit after in order to give the children a chance to walk when it is light.

Across the countryside the land is lush and fertile. The people are fertile but not lush. I am starting to believe much like we can predict who has diabetes in the west and far east based on BMI (body mass index) you can make a good guess at HIV status by the skeleton appearance of many of the patients.

It is like Baron Samedi of Voodoo fame strides through the countryside with his cane and polished skull head harvesting souls. The ancient patient smaller than a 40kg shadow curled in bed suffering from malaria turns out to be barely 50 and newly diagnoses. Malaria, coccidiomycosis, TB, are the major weapons he wields to bring his subjects low. ART (anti-retroviral treatment is provided by the government free of charge. Women get diagnosed in pregnancy if they get prenatal care. Men only when they show up with secondary infections. So where we see people for years on ARTs, here there are all too many who are first diagnosed when they have already progressed to AIDS. It feels like the 1980s all over again.

Like all other regions, there is a government hospital here. Fort Portal is big and bustling. There is a copper mine in the area. There are banana plantations and tea plantations. For that matter, there is as much of a population explosion here as anywhere else. You can buy health insurance: it will cover injuries, maternity, the occasional chronic illness. It doesn’t cover family planning, ART, anything even remotely resembling a voluntary pregnancy termination (to include complications), or dental, or eye care or immunizations or……. In fact, other than maternity it really doesn’t cover much of anything….

We made rounds at the hospital, talked to several patients in depth and the doctors on staff. The nurses seem to operate at a dead run. The head nurse stopped to talk for a few minutes. White dress, traditional nurses cap.

This afternoon we joined a couple of local public health workers conducting surveillance at one of the schools. Schistosomiasis affected 57% of the children at this school not that long ago. With a control program and treatment it is now down to 11%.  I skipped the slide down to the crater lake on the snail catching expedition in the rain.

pictures to follow.

Categories: Travel Tags:

Kazinga Channel

March 30th, 2015 4 comments

The Wiki reference in case you hadn’t looked it up…  Out on a small boat – the nine of us and a Danish couple also staying at the lodge. You have seen most of these birds and animals before but still…. and we got off the water before the rain really hit.

 

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Categories: Travel Tags:

Through the park and out on the water

March 29th, 2015 3 comments

There is Lake Edward, and then there is Lake George. Since I am currently in Queen Elizabeth Park, I really don’t think that the names need any further explanation.  We are staying at Mwenga Lodge

More from 28 March –

There were lions last night as well as other animals

another hammerkopf

another hammerkopf

those pink dots? Flamingos down in a crater lake

those pink dots? Flamingos down in a crater lake

The Elephant has the right of way

The Elephant has the right of way

the more usual view

the more usual view

see all the weaver nests?

see all the weaver nests?

HEY! I am prettier than smart

HEY! I am prettier than smart

Lions

"me" & my cape buffalo

“me” & my cape buffalo

Lioness & 2 cubs

Lioness & 2 cubs

yes, it is a lion

yes, it is a lion

welcome to the Lion Tree

welcome to the Lion Tree

look more closely

look more closely

see the paws and tails hanging down?

see the paws and tails hanging down?

and the faces

and the faces

Rest of the critters

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This morning we left the lodge at 0630. It was starting to lighten up, but the sun had not cleared the horizon when we passed the crater lake.

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The lions were not at the previous location. Instead they were making a pile ‘o beasts. Sleeping but occasionally rolling over or batting at each other.

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Otherwise – we saw a nice collection of everyone else as well. River tomorrow….

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There was a second pride on the road to the salt lake.

Individual plots for salt gathering

Individual plots for salt gathering

The one male stalked off. One of the  females was sitting at the side of the road. It was almost like she had shrugged her shoulders and decided that this pride was a pain to deal with and the guy had gone off in a huff.

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Categories: Travel Tags:

Queen Elizabeth National Park

March 28th, 2015 No comments

Wiki here as I wasn’t able to find any local site/reference. The Park is located 375 km westerly from Kampala as the Jeep travels. It is noted for serious numbers of mammalian species and lots of birds.

I’m holding out for a leopard…..

Meanwhile

Flame tree with locally believed medicinal properties

Flame tree with locally believed medicinal properties

As you drive along the roads in Uganda in those rare areas where there are no houses you could be almost anywhere in the world. Anywhere that British driving rules apply. For the most part the roads are two lanes with a yellow painted line down the middle to suggest that keeping to your side might just be a good idea. There are ditches on both sides, green grass, occasional wire fences, trees and bushes. It is raining this morning leading to fogged windshields, huge puddles and a significant decrease in traffic.

The cars, trucks and buses are still on the roads. What is missing is the rest. The Bodas are not on the roads nor are the taxis. It is raining, no one wants to stand out looking for a ride; no one certainly wants to ride exposed on the back of a motorbike. I keep mentioning them – the Bodas. If you haven’t wiki’d them – here is the information. A number of years ago at one on the inter-African borders you cleared one side then faced a significant distance of no-mans to get to the other country’s border. People got a ride to one side and had someone waiting on the other. To get between, you had to walk. Carrying packages, suitcases, small children that .5-2km could be a difficult challenge in the mid-day sun. Enter the bicycle owners. For a small fee, they would toke your “stuff’ or you from “border to border.” This became shortened to border-border and then to boda-boda. Just let the accent roll in your head. Spreading beyond the border, personal transportation is a major business. From bicycles to motor bikes to motorcycles, over the years the Bodas have become integral in a country with dense traffic.

There are a few long distance bus routes between the major cities, but city routes are non-existent . A Boda does point to point service, even door to door just for you. Share with a friend and it will cost you a bit less than going by yourself. Unlike the Taxis which run along the main roads, the Bodas seem to go just about everywhere. Some routes are individually negotiated; others have fixed prices. The 70,000 registered Bodas also contribute heavily to the goods transportation equation. Want to carry your pig to market or have it transported?  Pack several dozen kilos of green bananas on your head or have someone with a bicycle move them for your?

It is extremely expensive to have a car or truck. Most families will never have that kind of money in a country where the annual family income is 1350$/US. Even with oil assets, the fuels are refined in Kenya and trucked back in order the road. At more than the = of 1$/E a liter, it is not as expensive as all of us assume but well more than most can afford.  Remember, this is a country where most everyone does laundry by hand and hangs it out on the roof/a fence/a line/trees.

Where was I? Oh yes, riding shotgun in a bus along the Mbarara-Kasese Road in the rain.

The leading edge of the Tea "Estate"

The leading edge of the Tea “Estate”

The rain effectively stopped as we headed deeper into the mountains. This is a volcanic area studied with crater lakes (well stocked often with both hippos and schistosomiasis) and heavily agriculture plantings of banana and tea. There are huge tea plantations covering extensive tracts and the mountain sides with terraced plantings much where I would expect to see vineyards at home.

acres and acres of tea

acres and acres of tea

All of which is being harvested by hand

All of which is being harvested by hand

Winding through the mountains we stopped and looked down

The Rift Valley

The Rift Valley

The main road runs through park of Queen Elizabeth Park – we entered at the Katunguru Gate. Along the drive to the Mweya Safari Lodge some of the usual suspects presented themselves: Hippo, Elephant & Striped Mongoose to be specific.

Baboon

Baboon

Waiting for a ride?

Waiting for a ride?

I didn’t take any pictures of Fisheagles since I have seen more than a few of those before. We are going to do a drive late this afternoon which should prove to be interested. The roads are fairly decent; rules are that you stay on the road so why not go in your comfortable bus where everyone is at a decent height and can take photos out the window?

Candelabra Tree

Candelabra Tree

Hippo out grazing

Hippo out grazing

And if you don't believe they are around...

And if you don’t believe they are around…

May I present a striped Mongoose...

May I present a striped Mongoose…

Categories: Travel Tags:

Mixed Challenges

March 27th, 2015 No comments

aka – poop, rashes and break bone fever.

Diarrheal disease is a fact of life. Not restricted to the third world, it is a major component of most potluck food poisoning, cruise ship Norovirus outbreaks, and numerous other infectious diseases. For the moment in the Kampala area, there could be typhoid involved (outbreak is well into its third month).

Two things can make a serious difference to whether you shrub off the illness, lose a day of your holiday to hang out near a toilet but other wise recover or potentially are headed to life threatening illness. The particular disease you have been unfortunate enough to acquire is the first and the individual is the second. Extremes of age, marginal to poor nutrition, intercurrent disease, immune compromise can turn what should be mild discomfort and a need for an extra roll of toilet paper into potential death.

Not to be too morbid, from that discussion we are going to be moving on to rashes. Now, rashes are not my favorite thing. I can identify the simple infectious diseases (measles, chickenpox) because I grew up while they were still prevalent. Poison Ivy is obvious as is acne and warts. But for the rest of it? Hey, it is dermatitis (skin irritation, eruption…) and there are the standards (if it is wet -> dry it; if it is dry -> wet it, etc). Since I know so little (and remember even less – it is a great opportunity to learn.

The last disease of the day is Dengue which comes in four major flavors (I mean serotypes). It is viral. There is no immunization. There is only supportive treatment. Many call it “the worst case of flu” they have ever had. Just in case you are feeling comfortable about being “there” while I am “here” may I simply remind you that the mosquitos are well established in the New World as well as the Mediterranean Basin.  It has been around for a while.

In the last several years (not seen here that I am aware)  Chikungunya (viral) is now an issue.  Given that people travel, even sick people travel it shouldn’t be surprising to note that the disease is rapidly spreading across the Caribbean and Central America. Whether hitch hiking mosquito or human vector – this is another disease which has escaped its original habitat. Packed its suitcase and is off to see new countries and infect new populations.

Anyway – morning was dermatology, afternoon was adult ward rounds divided in the middle by lunch.  The less said about luncheon challenges the better. Mine was excellent, but it took a bit of an effort to get the staff to understand that we didn’t have the whole day for lunch.

Hanging out with the Marabou Storks (but not one)

Hanging out with the Marabou Storks (but not one)

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Hospital Laundry - as managed by patients families

Hospital Laundry – as managed by patients families

and no clue why a batch of pelicans. Mbarara is not exactly on water

and no clue why a batch of pelicans. Mbarara is not exactly on water

Categories: Medicine, Travel Tags:

Crossing the Equator

March 26th, 2015 2 comments

Which reminds me – I picked up The Sugar Barons on the most recent Tantor Audio Book sale. For $4.99 I can listen to non-fiction and learn something about the sugar trade and the Caribbean from the 1650s on ward.

Leaving infectious disease behind for the day, a discussion about occupational health and safety is in order. As it turned out – no tour was on offer at  Kakira Sugar (the largest manufacture here in Uganda).  The photos are from outside the compound as picture taking is not allowed on the compound much less in the clinic or on the wards. The fields are easy – the alternative hauling (dude on the bike is blurry – sorry about that).
Sugar Cane in the fields, areas of cut and ares just planted a few months ago

Sugar Cane in the fields, areas of cut and ares just planted a few months ago

man on a boda loaded with sugar cane

man on a boda loaded with sugar cane

We left Jinja at a relatively early time in order to avoid traffic, if that might ever be even remotely possible. The field trip this morning (starting to feel like a happy elementary school child without the burden of parent chaperone.  Kakira is one of the major sugar producers in the country. Not only do they have plantations and factories – they have an incredibly huge compound with all the amenities of your average overseas military post.

Besides the headquarters and administrative areas there are shops, post office, barber shop, schools, clinic and hospital. Extensive housing is on the ground for workers of a certain level. Housing is also supplied for the contract workers: cane cutters, truck drivers. Given the geographical location in the world (see today’s subject line) growing and harvesting sugar is a year around proposition. Unlike a long time ago when I lived in the neighborhood of Crystal Sugar which ran shifts around the clock for the few weeks after harvest of the sugar beets. 

Since I  mentioned cane cutters – you have probably already figured  that the cane is cut by hand, loaded into the trucks by hand and, for that matter, sorted off the trucks by application of significant amounts of human labor. It is a good job in a country where employment is difficult to find, especially that which includes the provision of free medical care. The downside for the cane cutters – besides the risk of injury is living in extremely crowded barrack type situations away from their families for extended periods of time. 

And then we got on the bus to start our 320 km trip to Mbarara. Not that the traffic was horrible or the roads a challenge. Our driver said we did well to make it back to the North Kampala by-pass in about three hours (100km).  

Once past Kampala our pace picked up and the traffic decreased.

2 Bodas, five passengers, multiple packages but no chickens

2 Bodas, five passengers, multiple packages but no chickens

Our rest stop was at the equator (see photo) and consider this probably the only pix of me that you will see for this trip. My partner in crime is Canadian. In fact, I am not sure that I mentioned it – but we have four Germans (usually living in Germany), one Canadian and me living in Germany, one Ugandan living in the Caribbean for greater than 30 years and a Canadian living and working in Hong Kong.

standing at the monument

standing at the monument

Apparently end of the month is low economy for the Police; I counted over 25 radar stops along the way. Usually located about .5 km out from town or a few hundred meters after where everyone is hitting the accelerator it seemed at least that they were not interfering with commerce. I missed catching the fish and fish standards but there were plenty of opportunities for anyone to buy vegetables, chick-on-a-stick, catch a Boda or buy any number of things in town.

Stands in town

Stands in town

Bodas for hire

Bodas for hire

typical main street in the many, many towns we drove through

typical main street in the many, many towns we drove through

fruits and vegetables

fruits and vegetables

houses, animals and kids line all the roads

houses, animals and kids line all the roads

sun headed down before we arrived

sun headed down before we arrived

Categories: Medicine, Travel Tags:

Fever is/

March 25th, 2015 No comments

aka – it isn’t alway Malaria. Although when you are in Africa for more than 8 days it could be a good guess.

This morning we went to the Buikwe Subdivision Hospital where fever was the symotom under consideration. There was an excellent lecture about Ebola (last outbreak in Uganda was 2012 and not the same variant as in West Africa). This is also an areas where Trypanosomiasis (sleeping sickness) is endemic. Ward rounds: in a room about this size

yes, exactly this crowded and no better furnished

yes, exactly this crowded and no better furnished

(except with bright animals painted on the wall) where we saw several older mothers caring for their babies on the pediatric ward. Older means 18 with your first child or 26 with your fourth/fifth and most with a child over the age of 12 months were visibly pregnant. We saw sickle cell and cerebral malaria. Unhappy babies and ones that could peak out a smile.

To Build a House

To start – the room I currently have. Please note the frame on the bed. It makes it easier to drape the mosquito netting and have it work while leaving enough space to turn over.

#21 Upstairs

#21 Upstairs

 

The population density in the rural areas is amazing. If you live in North America, Western Europe or Australia, you know that few people leave outside of the major areas. In North American, rural areas are characterized by long stretches of empty, a few scattered towns and houses surrounded by out buildings and land. In Europe it is most often small tows surrounded by extensive fields under cultivation. In Australia, you are either along the coast or literally “outback” somewhere that no one usually goes.

Uganda has 85% of its population in rural areas. It isn’t just the houses and shops lining both sides of the road at what are probably towns even tho there are no town names, road signs or route numbers. I can understand the concept of “Plot Number” but do not appreciate at all what it might tell me about location. People are continually in motion. There are children all over the place: in school yards, walking along the roads, playing in front of the house, working in the fields, sitting with their mother as she sells vegetables from a road side stand. There is absolutely no question that children form half of the population.

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From the Buikwe Subdivision Hospital where we saw babies, discussed African Trypanosomiasis and Ebola we took a drive to both have lunch near Lake Victoria and see one of the local fishing villages (small smelly fish which require drying….). While we were at it, we set a TseTse fly trap to see what we could capture. These critters are first cousins to horse flies and we all know how great it feels to be bitten…

simple and effective trap. the flies come to the dark colors, then always fly "up" when they take off, becoming trapped in the netting

simple and effective trap. the flies come to the dark colors, then always fly “up” when they take off, becoming trapped in the netting

For those of you who haven’t met them – tsetse flies are nasty biting flies capable of happily transmitting parasites from infected mammal to uninfected in pursuit of blood – a favorite food. Since they are so effective in disease transmission, they have been well studies in the lab, as well as extensive vector control programs. (Trapping, release of irradiated males…..)

One wonders about their place in the food chain. Effective disease vectors, still something else had to have been eating them. I couldn’t find any information at all about what species, a bird perhaps, used to find this fly a nice juicy treat. Not that I want disease back. The effect on humans, livestock and wild animal populations was devastating but some critter somewhere has lost their lunch.

I started thinking about where all these children and their relatives live. You may have a landlord who owns the land, most of the time you are responsible for your own shelter. Round houses with mud dabbed walls and thatched roofs are out. Not only are they impossible to live it, but they provide an absolutely wonderful vector habitat.

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So you want to build a house. First you either make your own bricks or buy them from someone who is in the business. Made from the local iron rich red clay they are stacked in a standard form and the outside is coated. A fire is then started inside and is maintained until the bricks are hard enough to build with. Age them a bit along the side of the road.

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When you have time/money, draw out the walls, then start the layers after leveling your dirt floor.

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Maybe sometime in the future you will be able to afford to pour cement inside to have a solid floor.  If you have money, you can buy supplies – including your bricks and mortar from a commercial store –

 

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Continue building your walls, leaving space on one side for doors and windows. Make one side of the roof higher than the other so it slants and the water will run off and away.  (Gutter could collect rain water, but then still water could also provide a breeding place for insects).  If you don’t have money for the roof right now, you can always start raising crops inside the buiing. (which means that like Death Valley in the Balkans – trees inside a currently unoccupied house doesn’t mean war, someone died or the house was bombed.)

When you have a bit more money add the tin roof. Even better, you can have windows and a door rather than cloth curtains.

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The white X you see on some of the buildings is from the Transportation/Highway Department. Sometime in the future this is going to become a paved road and probably two lanes. The houses in question are going to have to be taken out to build the road….

and ending with birds

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Categories: Medicine, Travel Tags:

Leprosy

March 24th, 2015 1 comment

Doesn’t that stir up thoughts of Gothic castles, strange asylums and nuns nursing the damned in the slums of Calcutta?

Otherwise known as Hansen’s Disease, it is caused by one of the mycobacterium family (TB ring a bell for anyone?)  Similar to TB, causes granulomas and can be treated with a long course of a couple of particular antibiotics. It doesn’t cause parts of the body to fall off, but does severely damage nerves which results in the patient having decreased ability to feel pain. Recent research in genetics has lead to the assumption that about 95% of the population is naturally immune.
The other five percent? They can become infected.

We drove along between klick after klick of sugar cane fields between Jinja where we are staying and Buluba where the St Frances  Hospital is located. Founded in the 1930s and mostly funded out of Europe (esp Germany and UK) it was initially solely dedicated to the care and treatment of Leprosy. It’s role has evolved over the years as antibiotic regimes have proven to stop the progress of the disease. Unfortunately, neurological loss is normally permanent. In a culture that values village and family times, most patients are not welcome back home. Even though the treatment is outpatient now, occasional medication reactions but mostly lack of support have a significant number of patients remaining for an extended period of time. No matter how much education you provide, some superstition remains. Medication is provided by the government free of charge and it also pays for care.  There are a handful of patients who consider St Francis home and the nuns who run the hospital their home (all over 75 years old).  M. leprosae is not an opportunistic infection, so there has not been any increase with the spread of HIV. 

The infra structure needs help, the generator only supplies those area which require power. We saw a number of patients with leprosy as well as babies with malaria, a toddler with tetanus and several other diseases not routinely found in North American or Western Europe practices.

When you think about it – the characteristics of leprosy with all the associated myths might well have played into nightmare, fantasy, fear and the belief that the living dead really exist.
Zombies anyone?

Water Birds and Sacred Ibis

On a much lighter note, the weather held without rain so we went ahead the planned short boat exploration of Lake Victoria. What follows are pictures of water birds, shore birds and, of course – the source of the Nile (which is the longest river in the world. Yangtze is the third and the Mississippi is the 4th. Blanking on the thirds – but thinking it is the Amazon…) a couple of lizards and one monkey determined to ignore us.  With the skyrocketing population, this area has been extensively fished. Fish farms are now in operation along the shore. Each “container” is stocked with small fish which are fed and will yield about 1000 fish at full growth. What is obvious is that several of the bird species think this is just a special version of “fish in a barrel” created especially for them.

We ate dinner before returning to Jinja.  Since it was too early in the day for the fruit bats I am afraid that I can’t provide you photos of them. 

The origin of the Nile

The origin of the Nile

headed OUT

Source of the Nile

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I'm ignoring you

I’m ignoring you

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Vegetarian Kebab Platter

Vegetarian Kebab Platter

Categories: Medicine, Travel Tags:

Starting with HIV

March 23rd, 2015 1 comment

As you might guess, HIV is a major issue in Uganda as it is in other sub-Saharan countries. The plan for the morning is a review lecture followed by ward rounds at the Joint Clinical Research Center in Kampala.

Established by the Ugandan Government, the Center works in collaboration with UCSF, Johns Hopkins, NIH, ITM (Antwerp & Hamburg). Much of the funding comes from PEPFAR & EDCTP.

 

forget your standard thoughts of US or Ger man hospitals.  There are two wards where we made rounds: one for the men, one for women. The windows are open with light and fresh air coming in. The nurses here know how to manage IV medications as there are no fancy electronic pumps.  The ward is squeaky clean.  Some family are present helping.  Opportunistic infections are the reason every is here. Malnutrition is a fact of life.

Currently (WHO statistics) – HIV disease accounts for 17% of the annual mortality over all and about 7% in those under the age of 5. Life expectancy at birth is 57 years. If you make it to age 60, you have on the average another 16 years ahead of you. The death rate/100,000 population from HIV/AIDS has dropped from 440 in 1990 to 169 in 2013. The accuracy of either statistic is in serious question. 85% of the population is rural. Death registration is no more accurate I suspect than birth registration and cause of death is going to be as much political as medical.

Our early afternoon has a lab and discussion of opportunistic infections. We drive to Mobria for a field trip on medical botany. Pictures will be forth coming, but the 2 hour hike through the forest was a blast. The plants are blurring in my mind, the red tail monkeys were a hoot and there was something called a blue ttracto ??? flying from tree to tree and expressing extreme displeasure at our presence

road construction delayed out arrival to Jinja till about 2000.  The rain kept most vehicles and people off our interesting back route alternative

 

 

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