I arrived in Kisiizi September 3^rd 12:30 am and began my first day at the hospital chapel at 8am promptly. I was nervous as I realised that I had come here alone and did not know who to speak to about my visit but all the members of Kisiizi hospital are very friendly and lots of people said I was very welcome which was so nice to hear on my first day.

Throughout my 4 weeks I went to a different area of the hospital every day as well as going of a couple of outreach days to the community around Kisiizi, including a trip to a Nursery and Primary school in Rubabo. Before my trip I thought I would spend most of my time in the pharmacy but after my first day I knew that I wanted to go around the hospital as much as possible to see all that is happening and really take every opportunity. The hospital does so much. Even on my last day I was finding out about specialist clinics that happen every week!

I got involved in some of the dispensing in the pharmacy and observed the checking system. The nursing students count out the tablets into clear plastic sealable bags and then, for example, for a dose of two tablets once a day they would write 2 X 1 on the bag. I was surprised at this method of dispensing and not requiring a PIL to be given, as I was used to having to input details into the computer and then have a label printed out with patient details and specific instructions and counselling point but as I mention later, most of the patients cancx’t read so are counselled when the collect the medication.

I had thought that I wouldn’t really have much to do with the theatre block of the hospital and thought it might be a bit too much for me, but my second day was the last day of the urology camp that was doing surgeries with doctors from England so I spent the day in theatre. I surprised myself that I really like talking to the anaesthetists and observing the procedure -if I wasn’t feeling too light-headed. Across a few days in theatre I saw a partial thyroidectomy, a TURP, a total hysterectomy and I found it really special to pray with them before the procedure and hold their hand.

I enjoyed many of the wards but one of my favourites was the maternity ward and I was fortunate enough to see two caesarean sections. I have no previous experience in operating rooms or that much experience on wards and I just loved everyone’s willingness to show me how things worked and to observe the amazing procedures. The nurses were often shocked when I said that I didn’t know how to put a cannular or catheter in, but I kept saying to them: ‘in pharmacy we don’t really touch our patients’, but they wouldn’t allow it so on the maternity ward that I learn how to take a catheter out. On the antenatal outreach I was also taught how to ‘palpate’ (a term I had never even heard before) a pregnant stomach to feel that baby’s head and find where the heartbeat could be found and it was just amazing to hear all the healthy heart beats.

The clinics I went to e.g. diabetes, surgery, gynae, physician and mental health were again so beneficial. To listen to the patients (and translators) and seeing the medications being prescribed depending on what was in stock in our local pharmacy, what medications are actually cheaper so the patients can afford them, and which ones need storing in a fridge and checking with the patient if this is possible. The patients in Kisiizi are very patient and did not complain about having to wait 3-6 hours to see a clinician which I think is a contrast to the majority of patients in the UK, it is something that I admire and have learnt to slow down and not always be in a rush for the next thing I have planned.

Another thing I found interesting was the as quite a few of the patients cannot read and they might miss their appointment as they cannot remember that date the clinician told them, and they cannot read it on the paperwork. This also meant that during their last clinic the prescriber may have increased or changed the dose but at the next clinic the patient tells the prescriber that are still taking the dose from a few months ago as they have not been able to read the correct updated dose and may not have been counselled sufficiently. This meant that, for example, patient’s blood glucose levels were still higher than the normal range as the were not taking the amended dose.

In my final week I went to the paediatric ward and learnt about the nutrition and poultry project that has been set up for several years which gives a chicken to a child who gets admitted with malnutrition so that when the child leaves the hospital, they can still get an egg a day for their protein. The nutrition project also has a garden that grows ‘greens’ for the malnourished children and they sell plantains they grow to raise money for outreach events to go house to house. I also gave the ward a book of ‘A Germs Journey’ by my university tutor for them to give to the children to practice reading and learning about germs on our hands and in some water sources.

The Ahumuza mental health centre is another ward doing amazing work and has a medical clinical officer who takes a team out every Thursday for outreach rotating the area each week. This is extremely beneficial for newly diagnosed patients but also for discharged patients who might still need some monitoring or just want another month of medication (‘refills’). As can be expected mental health is not just local to the Kisiizi hospital area but is far around the surrounding ‘parishes’ and the Thursday clinics massively improve access to patients and allow them to speak to a medical professional and be listened to. It also gives education about mental health as there is sometimes the believe that mental health illnesses are caused by witchcraft which means that people will not be seen by a clinician but will be taken to a pastor or priest. Unfortunately, this can cause even more distress to the individual and ultimately will not help their condition, but having the clinics as mentioned bring medicine and counselling to these areas. The medical officer has also recently done radio broadcasts to the Rubabo area and had really encouraging results where families have brought in their ill family members to the hospital as they now understand that their symptoms are of a mental health illness and can be treated in the hospital.

Being fortunate enough to spend time in such a different part of the world, and feel so welcomed to the weekend events, fitness classes and the ward round was such a blessing. During my time in Kisiizi I was encouraged to try lots of new foods and explore the local area and was even invited round to the Reverend’s house for dinner on a Sunday! Another thing I love about Kisiizi is the Rwchegan dance with the amazing music and jumping so high that your heart is really pounding in your chest- I love it! The Wednesday fellowship is also very special as there is something so powerful about sitting a group of 3 or 4 and singing worship songs and praising God together after the day everyone has had. Everyone is struggling with something and by sharing and praying for one another I was able to see a glimpse into the sometimes-difficult life in Kisiizi. I am already missing my friends at the fellowship with the singing and sharing.

I had thought that attending chapel at 8am every day might get tiring, but the songs, a drum made of cow leather, clapping, lots of prayer and a devotional is a really good way to start the day and see your friends. I am proud to call myself a Friend of Kisiizi and look forward to the many ways I can support the hospital and my friends there. Thank you everyone who supported me before my trip and during I am extremely grateful, I couldn’t have done it without you!