Withers go west....

Hello and welcome to a BUMPER issue of our Uganda blog! Grab yourself a cuppa, get comfy and enjoy. This month we took a 2 week road trip to visit other rehabilitation clinics in rural areas of Uganda.

Our time in Kiwoko has focused on preparations for our trip as well as ongoing physio input. On our weekly Saturday walk to the food market for groceries we found a large army helicopter and a group of very serious looking police and army personnel surrounding the local school field. When we asked one of the police officers (slightly less scary than the soldiers!) what was going on he said the president of Uganda was attending a function with his daughter. As you can imagine this caused quite the stir and the normally deserted field was surrounded by at least 500 people sitting and watching the helicopter! We reassured our visitor from the US that he wasn’t visiting a military hot spot and this was absolutely a one off!

We were also visited by a team from ADARA, a large charity based in Seattle which supports Kiwoko and in particular the NICU (neonatal intensive care unit) and paediatric follow-up in community. 3 NICU nurses from Seattle came to assess the work done with their support and also train staff, including Gemma. Gemma’s training input at Kiwoko has been excellent, and the team from Seattle came with further expertise which has been very helpful. This has increased Gemma’s confidence on NICU which will come in handy when her colleague is on holiday in July and she covers NICU independently. Gemma is looking forward to bearing this responsibility.

Work for Tom has been much more sedate focusing on the practicalities of completing a 1200km road trip! Tom completed duties on the adult wards and outpatients and organised education sessions for A&E in June. He also conducted advice sessions with ward staff on back care and how to avoid back pain.

Work and home life have been very settled and we feel that Kiwoko is now most definitely our home and can really rest properly when we are here. Gemma is still loving her running, and I am still baking bread. Our thoughts are turning to home somewhat, and the things we are looking forward like hot showers! We have also realised that there are somethings we don’t have to wait for, we just have to work slightly harder for them. So, every shower night you will find me standing on a chair with a 5L bottle of heated water and a colander to provide hot showers for Gemma!

And so to the road trip. We set off from Kiwoko southwest to a large town called Fort Portal and then south to a smaller town, Rukunjiri. This 1200km road trip was aimed at learning more about treating children with Cerebral Palsy, Hydrocephalus, Microcephalus, Club Foot, and Down’s Syndome. Most importantly how they are managed and treated in the community, with a view to try and improve the provision of care around Kiwoko. Overall, the travel was pretty smooth, with much of the driving on very good roads. 5 hours were completely miserable on challenging roads!

In Fort Portal where we visited the Kyaninga Child Development Centre (KCDC), originally started by an English physiotherapist, Fiona, 8 years ago who had come to help a family with a son with cerebral palsy. Fiona saw a massive need for physiotherapy. KCDC now covers approximately a 100km radius providing treatment tthrough rural health centres, schools, home visits and clinics held in KCDC in Fort Portal. The team is probably country leading both in level of care and range of treatment provided, it is made up of 4 physiotherapists, 2 occupational therapists, 2 speech and language therapists and 2 special needs teachers.

We spent 3 days with the team at KCDC and visited all the different arms of their care delivery. Gemma and I spent separate days visiting outreach projects where the team aims to provide rehabilitation and education to families who cannot reach the KCD Centre. We were blown away by the level of compassion and care shown by the staff helping families struggling to care for their children, through rehabilitation, encouragement, and validation. One of the massive problems in Uganda is the stigma around children with disabilities and KCDC are doing amazing work to challenge and heal misunderstanding around the causes of disability.

The other focus of KCDC is making sustainable, affordable mobility aids available. They use the locally plentiful bamboo for walking frames and wheelchairs from bamboo and parts from bicycles. This is game changing for physiotherapy in rural Uganda, as walking frames and wheelchairs are both hard to source and very expensive. KCDC is an excellent project and shows what is adequate staff and resources. This project helped us both develop clinically, but is unlikely to be very transferable to Kiwoko as it requires staff and resource levels beyond the capacity of Kiwoko. It was almost too good and the differences were too large.

We travelled on 300km and had a surprise encounter with some elephants just outside of Queen Elizabeth National Park! We arrived in Rukunjri at Chilli Children. This project also aims to support children with disabilities and their families, but with a much smaller team and level of resource. Chilli Children runs a Club Foot clinic, rehabilitation group sessions in their exercise hall, outreach rehabilitation and data collection and financial support for families. Occupational therapist, Evas is an inspirational and very warm woman who has a heart for caring for children and families effected by disabilities, and she cared for us very well. We attended a group rehabilitation session on our first day in Rukunjiri and witnessed amazing warmth and care amongst families and their children. Evas explained that the peer element of the sessions was perhaps the most important aspect - another way of breaking down stigma.

As we carried out physiotherapy care we were able to chat with parents of the children and provide them with encouragement and education on their children’s conditions. Our time in Uganda had equipped us to communicate well with these families and we felt that we added to their care, something that may not have been the case if we had come earlier in our trip.

Chilli Children also supports family income with a chilli farming programme. These chillies are too spicy and small to use in domestic cooking so marketed to a company who make chilli powder, the proceeds supporting the families. These chillies do not take a large amount of care, water or space to farm. The income allows the family to spend time caring for their children’s needs. This is a Christian founded project and we loved how closely the staff at Chilli Children walked with Jesus and prayed with the parents before the clinics.

Chilli Children had much we felt we could take back and suggest to ADARA -especially the benefits of physiotherapy and play in community groups, and the rehabilitation groups providing families with both education and peer support.

The final destination of our journey was a lodge halfway back to Kiwoko, it was a perfect place to relax and reflect on our amazing journey - full of new people, experiences and learning. We also enjoyed some delicious food with lots of vegetables, something we had missed after spending the last week and a half eating chicken and chips or very carb heavy Ugandan meals.

Overall, we’ve had a wonderful May with lots of new experiences and learning. We are enthused about our return to Kiwoko, grateful that we can experience so many new things, and excited for a long quiet June.

Top 3 “I’ve Learnt” from May: -

• I’ve learnt how not to make pretzels

• I’ve learnt that crossing the equator is a definite anti-climax

• I’ve learnt that Tom is very good at off-road driving (thanksGemma!!)

Prayer Requests

• For a smooth month at work, finalising and completing projects at the hospital, good attendance and engagement of staff with the training, and fruitful conversations with colleagues around the progression of physio across the hospital.

• For time and headspace to reflect on our time in Uganda so far, on the lessons we have learnt, and the blessings we have received from people around us and at work.

• For guidance from God in our discernment process of how Kiwoko and Uganda will be part of our lives once we return to the UK