Manafwa Clinic

So today we went to Manafwa for clinic. Manfwa is in a more part of town but ill get back to that.

First the morning routine. 

Obviously things are different in Africa . You adjust , you rest you expectations. 

Let me give you some examples. 

US/Uganda

1. Power goes out, people call LIPA. Lipa people get fired , company completely revamped and becomes PSEG/ Power goes out , you whip out a "torch" (flashlight) and maybe a generator provides some electricity for lighting. 

2. You order food , expect it in maybe 30 mins after appetizers. Pitch a fit if no delivery . / You order food 2-3 hours ahead of time and still give it another hour before asking when lunch will be ready . 

3. You need to take care of business aka number 2. You expect a toilet with toilet paper. / You need to do "long call" ( the word for pooping). You carry your own toilet paper / flashlight / hand sanitizer because you never know what you're gonna get.

4. We say " you're welcome " when someone says thank you. / people say "you're welcome or you're most welcome " when meeting you or welcoming you to a new place. * this is one of my favorite things to hear in Uganda 

So having said all of that. Our group has two vices / habits. Morning showers and coffee. We made arrangements for coffee but little did we know the water tanks would cleaned this very morning and possibly be down for "hours." Long story short , we got one shower working and all took a quick shower..but it's one of those less than subtle reminders of things we take for granted . 

So after figuring the shower business out, we packed into a land cruiser and headed to Manafwa. 

Low head clearance + dirt road = good times. 

 Our destination:

Now the views from this rural clinic are amazing . The air is fresh and foliage green and lush. Between seeing patients we enjoyed the following : 

And finally the clinic 

Clinic was decent paced. My chief complaints were all over the place:

Urinary changes, foot rash, dizziness, fever , leg numbness, leg pain, arthritis pain, worms

Diagnoses that I made : lady with potential hyperthyroidism (nodular thyroid , hypertension, palpitations, hyperreflexia) , older lady with with sbp in 170s who I found a systolic murmur of which I suspect is mild aortic stenosis , lady with hearing loss from hard, impacted cerumen and likely effusion given her uri symptoms 

Had a couple gu / pelvic / "gi" exams 

The rest of the cases weren't as clear cut with many chronic complaints. This coupled with all my information via translator made it a tougher day for me. However , I tried to do right by my patient, write good notes and tried to procure good follow up :) all in all, a productive day . One of my older patients ( the lady with a.s.) told me that if I manage to make her feel better, she hopes I'm blessed for my effort .

A solid end to my day :)