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Pictures from Uganda (June 2006)

The first time when I saw this 2 on an outreach I thought they would be twins. But I learned that the girl was 2 years old and the boy 1 year old. Both of them were not able walk because of malnutrition. And to make it worse the mother was about to deliver again. How should she manage to carry 3 children at once. Now you have to imagine that some men have several wifes who all deliver at this terrible speed then you don´t need to wonder any more about the cause for malnutrition. Especially in the rural areas people still have the attitude to produce as many children as possible. One woman may deliver 10 to 15 babies, times 3 women ... sometimes the father doesn´t even know all the names of his children. The 2 on the picture are eating "plumpy-nut", which is a therapeutic food based on groundnut paste which is extremly dense in energy and ideal for kids to gain weight rapidly. As you can see: most children are enjoing it - only that half of it remains on the floor and face instead of in the mouth  .

Elephants   (05.06.2006)

This picture is from the Queen Elisabeth Nationalpark. In February I went there for some days and I really enjoyed the wonderful nature. Before we arrived there I had wondered if I would be able to see elephants und then just some meters after passing the entrance this herd came crossing the road right in front of us! Amazing! Our guide told us that you have to be careful not to end up in the middle of a herd otherwise they may easily kill you in the car.

Malformations  (05.06.2006)

This boy came to one of our outreaches. He had malformations of all his extremities. But still he was able to walk in a more or less normal way and he was going to school. Sometimes it is impressive and also sad to see such "funny" conditions when we visit people deep in the bush. Most of them have never seen a doctor in their life and especially disabled children are growing up just like that without any support. Most of the having a sad and lonely life at home - some of them just lying inside the hut every day because they are seen as a disgrace for the family.

Wedding in church  (05.06.2006)

This was the first church wedding I attended in Africa. I was a bit surprised that most of it was not so much different from a wedding in Germany. On this picture the couple is cutting the cake. Afterwards a tradition follows that we don´t know in Germany: first the woman has to feed her husband with cake and sparkling vine and than the other way round. It is a symbol for their care for each other. Then the woman brings cake to the family of the man and the man to the family of the woman. All this causes a lot of laughter, but I really enjoyed the sybolism of it.

Drums instead of bells   (05.06.2006)

On Sundy morning there are no bells ringing here to call the people to church, but they are reminded by this drum. It is amazing how far the sound can reach. And since most people don´t have any clock at home it is really helpful.

The new NU-team (05.06.2006)

Always after some years the nurses have to alternate in their positions within the hospital. Not all at once, but always some of them. In May this year it was again time for it and also our ward was included. Therefor we now have 2 new nurses. This picture shows our new team: the names are from right to left: Teddy, Rose, Tina, Jeniffer, Florence and myself. Jeniffer is an "enrolled" nurse, which means that she has a 2-years training. Florence and Teddy are nursing aids without any training and Rose is a trained social worker and is assigned as local in-charge of the NU.

Okoth at time of admission   (05.06.2006)

This boy came with a marasmic kwashiorkor to us. The most severe type of malnutrition. You can see very clearly the oedema in the feet and hands. Also the skin change is very typically for this type of malnutrition.

Okoth after rehabilitation   (05.06.2006)

Okoths life is a very sad story: his grandma had 5 children. 2 died because of AIDS, 2 more died as soldiers and the only living daughter got a cerebral malaria and ended up with severe mental disability. Also her husband died some years ago (she didn´t know what he was suffering from). In addition to all this suffering, her disabled daughter became pregnant one day and no one knew who had preganated her. And she delivered Okoth who also seems to have a mental disability. Now the grandma lives alone with them and tries to earn enough money with her little gardening work to feed all of them. No wonder that Okoth was severely malnourished! The grandma didn´t want to come to the NU, because she thought that there was no hope for him, but he made it and now she is so happy about it that she wanted to change Okoths name into "he, who survived death" (I forgot how it was called in Ateso). On the other side: if you think about the future, there is not much hope. The grandma is old and if she dies one day, there will be no one left to take care of Okoth and his mother and most probably they will never be able to manage their own life. We did a small miracle, but what will be in 5 or 10 years?

800g   (05.06.2006)

This is a newborn baby delivered with a weight of 800g. Inspite of this extremely low birth weight it was surprisingly strong and was able to suckle from the beginning on. In Germany such children would never survive without intensive care but here we don´t even have an incubation bed. So we advise the mother to carry the baby throughout with direct skin contact on her breast and if she needs to lay it down, then we heat the room before with hot water vapour. If infants are to weak to suckle, the milk is expressed with the hand and given with a spoon or naso-gastric tube. It is amazing how tough this children are!

Asio und Okot   (05.06.2006)

Okurut   (05.06.2006)

This small boy didn´t make it. But the reason for malnutrition was this time not poverty or poor knowledge of the parents, because they where both teachers. But he was suffering from a huge cycst in his liver, which had to be removed by surgery. Unfortunatly it took long to make the correct diagnose and then again until the parents had saved enough money for the operation. Therefore he was already too weak and the complicated operation had to be interrupted. Afterwards he came to us in order to gain new strengh for a second operation. They had to remove fluid from his stomach every few days but it seemed to work: he became stronger every day. After some weeks the doctor decided to try it again and everything went well - only that he lost too much blood and there was no blood for transfusion available and so he died because of anaemia. This is a very common problem here. Most of the time patients need to travel to the next bigger town with local transport to get a blood transfusion. But it is expensive and takes long. Too many of them die on the way.

Ploughing   (05.06.2006)

Cultivation in Uganda is still pure manual work. Also ploughing is not done with machines, but with bulls. At the beginning of the rainy season you can see and hear everywhere men with their bulls. Also planting, weeding and harvesting is all done by hand work. If someone has a job and some regular earnings, he or she will employ workers on a daily basis to cultivate for him or her. But all the staff in the hospital have their own land where they cultivate for their own family. Sometimes we are e bit irritated when people are not coming for work in time, but if you imagine that they have worked already for several hours in there gardens before they come to the hospital, then it is hard to be really angry with them.

Warthogs   (05.06.2006)

These nice boys here were living directly in front of our lodge. I think no other animal is as ugly as they are, or? But I was surprised how friendly they are.

Rainforest  (05.06.2006)

Next to the Queen Elisabeth National Park is tropical rainforest and a hike in this forest was included in our safari - with an armed guide of course, because you never know which animal you might meet on the way. But except for some foot prints and very many monkeys we didn´t see much. But still the atmosphere and the soundscape was an interesting experience.

Black tea   (05.06.2006)

This is a tea plantation. Cultivation of tea and coffee is common in Uganda. Coffee mainly produced for export, but tea is also used a lot by local people. Especially in the western parts of Uganda you can see huge plantations with this plant. For the tea production only the youngest sprouts are used.

Boat trip  (05.06.2006)

In the Queen Elisabeth National Park we also went for a trip in a boat. Thia lake is the only water source in the area and therefore you can find there very many different animals during the dry season. I was amazed to see how all this animals are living so near to each other without nuch fighting. It seems that they have their own rules and that it works quite well. I tried several times to take a picture of a yawning hippo, but I couldn´t get it.

Watertank   (05.06.2006)

Some weeks ago our water for the shower started to stink terribly. The only thing we could do was to empty the nearly full tank. It was horrible to see the water running out just like that. Water is something so precious here. We hired some young men to remove the tank from the stand and to clean the tank. Thanks be to God that it happend at the beginning of the rainy season - the tank is now full again before we enter the dry season.

Zebras   (05.06.2006)

Wild zebras! A wonderful view such a herd - even at a far distance...