I had a 8.15am pickup from the hotel this morning. Rosco, Chris and myself were taking the 30-minute drive to Butabika Psychiatric hospital. The hospital sits on an elevated site that commends great views of the swampland that sweeps down to the shores of Lake Victoria. We met with David who is the Senior Nursing Attendant at the hospital. The hospital has 450 beds for psychiatric inpatients and a further 100 additional beds for forensic inpatients. The hospital is operating well above its capacity. There are approximately 700 inpatients (some having to double-up in beds, others sleeping on the floor. This overcrowding stems from the fact that referrals are often made direct to the hospital rather than the 13 smaller, up-country units that are intended to meet some of the demand. In terms of staff profile, there are 8 Psychiatrists, 2 Clinical Psychologists, 2 Occupational Therapists, 3 Social Workers, 135 nurses that are spread across 13 units that make up the hospital site. Due to staff shortages there can be high levels of work-related stress. In addition to the mental health services, there is also a range of physical health out-patient services available on the hospital sight including those addressing, stroke, HIV, minor surgery, and dentistry.
We were given a tour of the hospital site, this provided an opportunity to visit a number of units including the Child unit (where I met Cecilia who attended the workshop yesterday), the Alcohol and Substance Abuse unit and the Female Rehabilitation Ward. The hospital site was well organized and clean. The staff were friendly and neatly presented in their immaculate uniforms. Chris accompanied me on the tour. He is going to be at the hospital site on placement for the coming years. He was well acquainted with, and well received by staff members that we met. After the tour I met with the two psychologists that are working at the hospital (James and Dorothy). We spoke about their heavy workloads and the challenge of working with such large numbers of inpatients and outpatients.
It was then time to return to Kampala for a final meeting with Dr Nambi. She kindly presented me with a gift to commemorate my visit to Uganda. We spoke about future steps for helping to build our collaboration. It was then time to leave for the airport. There was just about enough time to stop off at the market to purchase some souvenirs of my time in Uganda. My purchases included a Ugandan football top – the Ugandan football team is affectionately known as the ‘Cranes’ and they play at Namboole in the Mandela National Football Stadium.
It took over two hours to make the 35 miles journey by car to Entebbe airport. This provided some time for some laughs with Rosco and Chris, but also some time to reflect on the abiding memories of the trip to Uganda: the chaos of the traffic in Kampala; the thunderstorms; the fantastic welcome that I received; the warm ‘Hmmm’ sound that people would make as they shake your hand and bid you farewell. Most of all though, I will always remember the incredible generosity of Rosco, Chris, Peter and John and the warm welcome that they afforded me. They provided great energy, chat, and the gift of their time to make the visit the success that it was.
The trip to Kigali, Rwanda took place over two legs. There was a brief stop off in Nairobi, Kenya before catching the connecting flight on to Kigali. The staff at the airport were very alert to the outbreak of Ebola in nearby Congo, sand were assessing the body temperature of new-arrivals. Prof Phil Cotton met me at the airport in Kigali. Phil is the Principal of the College of Medicine and Health Sciences in Kigali. He is filing this role whilst being on an unpaid secondment from the University of Glasgow. You can read more about Phil and his work in a recent article in The Lancet (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60553-5/fulltext). Phil has kindly offered to put me up at his home. This gesture is very much appreciated. Driving through Kigali I was immediately struck by how clean and orderly things were. Plastic bags are forbidden in Rwanda and littering is strictly prohibited. The city is also officially the safest city for women in Africa.
Phil and I went to a nearby Indian restaurant for dinner. This provided a great opportunity for me to avail of Phil’s local knowledge and get up to speed on how things are progressing in Rwanda. Kigali has a population of 1.1 million people (a tenth of the overall population of Rwanda). The country is the fastest growing economy in Africa. The system of government in Rwanda has the 2nd highest level of transparency in Africa.
Phil explained that there are over 120 visiting faculty from the United States over to teach in the seven Rwandan colleges that now constitute the University of Rwanda. Phil informed me that people from the US actually constitute the largest expatriate community in the country. Phil is clearly a busy man with much work that to do. He reports to the Minister for Health and other high-profile people within government.