Thanksgiving week highlights

Happy belated Thanksgiving! We are so thankful for you all. Here are some highlights from our Thanksgiving week:

We got two packages in the mail!! What a treat! For this pic, I asked everyone to hold their favorite item :-). For the record, Gid chose mac and cheese, Levi - gummy bears, Silas - a pickup truck for his birthday, Josiah - Lego magazine, and Mark - choco chips.

Another, umm, highlight (for the boys at least) was slaughtering our turkey. Here are some pics of the event. I've left out the most graphic ones, but they're still kind of gross. Really makes me appreciate Butterball!

De-feathering

I'll stop there. You can thank me later :-). Obviously, after some more work, we were able to enjoy eating Mr. Turkey the next day. Even more, we enjoyed great fellowship with new friends. 

This is a terrible pic with all the glowing eyes. I didn't take as many pics as I should have, so this is all I've got :-).

Tomorrow, we are heading to a Ugandan wedding, so I'm sure there will be more pics to come in the near future.

More November Pics

Here are some more pics from the last couple weeks:

We've started hosting football (aka soccer) games at our house on Saturday nights, and have been drawing a pretty good crowd. The only thing that scares me is about half of the group wears cleats and the other half is bare foot :-//.

Donah and Maureen - our two brave lady players this past week

Spectators!

Another favorite activity at our house...jumping on the trampoline. Totally worth the space it took up in the container!

On Monday, to celebrate Mark's completion of his time at the hospital, we took a trip to Jinja (about 2 hours away). We enjoyed some fun times, including:

Milkshakes!!! (When it comes to milkshakes, absence really does make the heart grow fonder :-).

We also played tourists and took a boat to see the source of the Nile. Pretty cool

This is the place where Lake Victoria joins up with the Nile river...our kids were ready to jump in, but we had to restrain them...not the cleanest water for swimming.

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Some November Pics

This is Christine here, so no pics of people's guts coming your way today. Sorry. Here are some shots from November.

Digging a hole in the mud, filling it with water, and putting toys in it...doesn't get much better than that!

Watercolors with Levi

What are these, you ask? White ants - caught by Gideon, of course. Cooked in the top pic and uncooked in the bottom. Did he eat them? Sure did.

Here, our friend Donah is pointing out that he should have taken off the wings first :-).

Celebrating the birthday of a particularly nice boy who turned four this month...

We have some newly hatched chicks scampering around after their mother in our yard these days. I couldn't resist throwing in a shot of them in all their cuteness.

Final weeks at the hospital

My last two weeks at Mbale Regional were in the Pediatric Acute Care Ward and the Theatre (Operating Room - for those from the other side of the pond)

                                     ***** Warning- may be a bit gory for some ******

These last two weeks ended well. With my background being in pediatric critical care I enjoyed working in the Peds Acute Ward. They have strong leadership in the unit that shows in the way they approach and organize patient management. Just outside the ward on the veranda is a desk where two of the providers sit. They gather a quick history and physical exam and determine the patient's treatment. If they are really ill they slide into the 4-6 bed high acuity side. If not so ill the get in line for an IV placement. After their IV is placed they get in line for their first dose of antibiotics or any other treatment that is indicated. From there they find a bed and continue with their treatments.

It was nice to see the organization and the benefits of it. As I mentioned earlier the unit has a strong leadership base as well. The nursing staff is great and the physicians are involved in a fair bit of research. One past multicenter study was published in the New England Journal of Medicine. A current study is assessing the effectiveness of fluid resuscitation in children, and for this study the use of bedside ultrasound is used to assess their cardiac function. (For those who know me I was pretty excited about that!)

My following week was in the Theatre. There was a surgical team from western Uganda that was doing a cleft lip/ palate camp for 18 children. I was able to help out in the OR and get a feel for the anesthetic practices in Uganda.

One of the cleft lip cases. 

When the 3 day camp was complete I spent the rest of the time just hanging out in the OR seeing other cases. Thursday started out with an intestinal obstruction- a hernia with about 1 meter of necrotic bowel. The patient was quite ill and hypotensive throughout the case but pulled through after some work. 

Couldn't resist adding in the picture. 

I was able to have some good talks with the folks there. Resources are limited but they make do with what they have. For instance... there was a 1 month old that needed and exploratory laparotomy. Cutting into his abdomen, pulling out his intestines to look for any damaged spots and placing them all back inside his body.  This is a pretty big case for a small kid. They were out of oxygen so had to do the case with the child spontaneously breathing under ketamine with face mask oxygen from an O2 concentrator. The only monitoring that is available is a hand held pulse oximeter that shows you oxygen saturations and intermittent heart rate. (And I would complain when I could not see the ETCO2 waveform) If the child stopped breathing during the case they would just manually bag him up for a bit. I talked with the anesthetist  about this and the final conclusion was that you have to do the best work you can with what is at hand or else the child would have died in 12 hours if you never went forward with the case. 

I was glad that the last two weeks went well. I was thankful to the Lord for this as it was good to leave on a positive note. I was also thankful for the good relationships that I was able to start there. I plan to keep in the loop with how things are going there at MRRH.