In the end, College Inn (the hotel on top of the nightclub) became a bit of a barrier to study and sleep, and so we decided to leave, in search of greener pastures. And boy, didn't we do well.
361 Golf Course Apartments is my new address for now, everyone...
Sunday, 20 November 2011
Kampala, HIV and TB
First and foremost, I love Kampala. And I love Mulago hospital.
We have had two weeks of teaching on HIV and TB and I couldn't have wished for a more up to date, cutting edge set of talks, from world leaders.
Some highlights for me were:
- Hearing Barre-Sinoussi herself, give the opening address to the HIV symposium at Makere University
- Seeing patients on the wards and having to think how differently we need to act in resource poor settings compared to at Chelsea and Westminster
- Going to Africa's only Persian Restaurant in Kampala
- Meeting one of Kampala's six female taxi drivers
- Having quite interesting talks about what has caused HIV to spread in Africa like nowhere else (and yes, the issue of sexual networks / polygamy / beliefs about the acceptability of sex outside a relationship)
- Going to see Kampala's free circumcision program
- Arguing with colleagues about the appropriateness of research and trials in Africa, and the ethical considerations
I really should have written this bit contemporaneously, as its not easy to do it justice this way. Needless to say it has been amazing, especially as someone who wants to pursue a career in HIV and Infectious Diseases.
What, if any are my take home points?
1) women, once again have a raw deal, and will continue to do so unless more investment goes into prevention of HIV that they can be in control of (eg PrEP and microbicide gels)
2) behaviour is hard to change, but if we are going to try, it shouldn't just be a medical model, but a complete sociological one that looks at self-esteem, stigma, disclosure, and an overall sense of being well with HIV
3) as a UK trained physician, i've really only seen a fraction of what this epidemic means to the world
4) TB will hopefully, be picked up more readily with the help of technology such as GeneXpert, but we need ideally a version that is less reliant on electrical power and cheaper, before it can be a true point-of-care, rapid diagnostic test
5) Africa needs a plan for the future in terms of getting more people on treatment - currently there is a massive deficit in terms of those who need treatment and those who are getting it. The problems aren't just financial or supply related. Ideally, we need to follow in the footsteps of Kenya, who has just had one of its local drug companies approved by WHO to produce ARV's, which will account for a significant cost saving compared to having to source external products.
Once again, I quote Paul Farmer, who stated that we do not just need an equal option, but "a preferential option for the poor".
We have had two weeks of teaching on HIV and TB and I couldn't have wished for a more up to date, cutting edge set of talks, from world leaders.
Some highlights for me were:
- Hearing Barre-Sinoussi herself, give the opening address to the HIV symposium at Makere University
- Seeing patients on the wards and having to think how differently we need to act in resource poor settings compared to at Chelsea and Westminster
- Going to Africa's only Persian Restaurant in Kampala
- Meeting one of Kampala's six female taxi drivers
- Having quite interesting talks about what has caused HIV to spread in Africa like nowhere else (and yes, the issue of sexual networks / polygamy / beliefs about the acceptability of sex outside a relationship)
- Going to see Kampala's free circumcision program
- Arguing with colleagues about the appropriateness of research and trials in Africa, and the ethical considerations
I really should have written this bit contemporaneously, as its not easy to do it justice this way. Needless to say it has been amazing, especially as someone who wants to pursue a career in HIV and Infectious Diseases.
What, if any are my take home points?
1) women, once again have a raw deal, and will continue to do so unless more investment goes into prevention of HIV that they can be in control of (eg PrEP and microbicide gels)
2) behaviour is hard to change, but if we are going to try, it shouldn't just be a medical model, but a complete sociological one that looks at self-esteem, stigma, disclosure, and an overall sense of being well with HIV
3) as a UK trained physician, i've really only seen a fraction of what this epidemic means to the world
4) TB will hopefully, be picked up more readily with the help of technology such as GeneXpert, but we need ideally a version that is less reliant on electrical power and cheaper, before it can be a true point-of-care, rapid diagnostic test
5) Africa needs a plan for the future in terms of getting more people on treatment - currently there is a massive deficit in terms of those who need treatment and those who are getting it. The problems aren't just financial or supply related. Ideally, we need to follow in the footsteps of Kenya, who has just had one of its local drug companies approved by WHO to produce ARV's, which will account for a significant cost saving compared to having to source external products.
Once again, I quote Paul Farmer, who stated that we do not just need an equal option, but "a preferential option for the poor".
Uganda
The journey from Nairobi to Kampala was a painful 16 hours in a bus, with minimal breaks. We all felt rather beaten up, especially as we had to be in lectures from 8am the following morning.
The scenery is stunning and the border crossing was a unique experience, under the cover of almost complete darkness! My only memory is of how we queued in the rain and the dark, and the free condom dispensers (yes) next to each counter. Still haven't quite worked that one out.
Sadly we arrived at our hotel which was on top of a nightclub, and at 1am, it wasn't the best combination.
The scenery is stunning and the border crossing was a unique experience, under the cover of almost complete darkness! My only memory is of how we queued in the rain and the dark, and the free condom dispensers (yes) next to each counter. Still haven't quite worked that one out.
Sadly we arrived at our hotel which was on top of a nightclub, and at 1am, it wasn't the best combination.
Nairobi
Nairobi, not that I saw much of it in between work, was a very different place to Tanzania. Much more of a big city, like any other, with malls and highways. We had a fairly low-profile week given that Kenya was officially at war with Somalia that week. We were hosted by Kenyata hospital, where we took the ETAT+ (Paediatric life support) course, which was super. I also had the chance to meet up with mum and dad, who did the Masai Mara and were staying with their friends.
Most notably though, I camped for the first time and loved every minute! Definitely up for doing it lots in the future!
Zanzibar
So, I spent my week off in Zanzibar, which was a really welcome break from the mainline. Zanzibar has an interesting history, and the slave trade played a large part in it. As an outsider, it felt like another world. Its winding streets make you feel like time has stood still.
Mum and dad joined me in Zanzibar, and we spent the first few days in a charming converted mansion in the centre of town, which had the best view of Stonetown I'd ever seen. We then went to the loveliest resort, which was out of this world.
One of the highlights for me was meeting the last Zoroastrian family to remain in Zanzibar - Bomi and Diana Darukhanawala. Another example of the dynamic nature of communities. The Tembo hotel was actually the office of Cawasji Dinshaw and Brothers, and still bare's their name over the entrance.
One of the highlights for me was meeting the last Zoroastrian family to remain in Zanzibar - Bomi and Diana Darukhanawala. Another example of the dynamic nature of communities. The Tembo hotel was actually the office of Cawasji Dinshaw and Brothers, and still bare's their name over the entrance.
No excuses...
So it's been an extremely long time since I last wrote for a number of reasons. I've had my parents over and then we went to Nairobi and finally arrived in Uganda. I'm going to try and blog somewhat chronologically, if that helps. It has been an amazing time and there may well be some areas that are glossed over.
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