It’s hard to believe I’ve been in Uganda for 2 weeks! This past week and weekend has been full of learning and adventure. Last week I spent some more time in the neurosurgery ward and identified a patient case that I will be using to develop a case presentation. This will allow me to focus on one patient and analyze the care received, the patient’s conditions, and possible other treatment options. I’ll be sharing my findings in a presentation with Dr. Nicol, Joe, and An so that we can discuss and learn more from this together.
On Friday I got to go to Kirruddu Hospital for the first time. This hospital is the site for several research studies, including AMBITION, a trial assessing the efficacy of a single dose liposomal amphotericin for patients newly initiated on antiretroviral therapy (ART) for HIV who also have cryptococcal meningitis (CM). Although CM is relatively rare in the United States, it is one of the leading causes of death in HIV patients in resource limited settings such as Uganda. An and I travelled to Kirruddu in a van with a physician and a nurse involved in the AMBITION study. Before starting rounds, he was told that there was a new patient who might be eligible for the study. The patient had been newly diagnosed with HIV, had just started on ART, and was complaining of headaches, fever, and neck pain (symptoms of meningitis). To diagnose CM, a lumbar puncture is performed. This involves inserting a large needle into the spine to collect a sample of cerebrospinal fluid (CSF). An and I got to assist in this procedure! Once the CSF is collected, a dipstick that detects cryptococcal antigen (CrAg) is placed into the sample. If two lines appear, the test is read as positive. Fortunately for the trial but unfortunately for the patient, the CrAg test was positive, leading to a CM diagnosis. The nurse then described the research study to the patient and went through all the necessary paperwork for enrollment. An and I observed as Dr. Enock randomized the patient into the trial. As students in a health science program we have obviously read papers and interpreted results from many clinical trials so it was very interesting for us to see the process taking place in real life.
This weekend was a different type of exciting! Since Monday was Uganda Martyr’s Day (a national holiday here), we had a three day weekend. We took advantage of this extra day off and went on a safari! We woke up early Saturday morning and hopped in the van for Murchison Falls National Park. Shortly after entering the park we were greeted by dozens of baboons! We thought they were adorable and slowed to take lots of photos. Our opinion of these apes quickly changed. To get to our lodge, we had to take a ferry across the Nile. While waiting for the ferry, we thought it would be good to take out a game (Kingdomino) to play at the picnic table. As we were getting set up we noticed one of the baboons watching us and slowly inching closer. I thought he looked cute and started taking a video. He got closer and closer and then quickly lunged between An and Joe and grabbed the plastic bag that had the game pieces and put it in his mouth. We all screamed and jumped away from the table. Miraculously the baboon quickly realized that the contents of the plastic bag did not include any food and spat it all out. The game was saved but it was still a scary moment for all! Maybe he just wanted to play Kingdomino with us but after that we all kept a close eye on the baboons.
That afternoon we went “looking for cats” in the Jeep. We saw all the animals I had been hoping to see: giraffes, elephants, lions, and more. We even got to see a family of four lion cubs wrestling in the distance which really made my day! We enjoyed a picturesque sunset as we headed back to the lodge for dinner and sleep. The next morning, we did another game drive where we got up close and personal with two lions. It was unreal to see these majestic beasts walking next to the road only about 20 feet away from us. We enjoyed a quick dip in the pool with views of the Nile before leaving for our river cruise. On the boat safari we had views of lots of hippos and even caught sight of a few crocodiles. Seeing these beasts in the river made me a tad bit nervous for our white-water rafting trip we have planned for next weekend!
After a jam-packed couple days, we are now heading back to Kampala for another week of learning. This will be a shorter week since we have today (Monday) off for Uganda Martyr’s Day and will likely have either Tuesday or Wednesday off for Eid. We learned that if the moon is sighted tonight then Eid will be Tuesday and if not it will be on Wednesday. It seems to me like the undetermined nature of this holiday would make it a bit difficult to schedule meetings and other work activities, but hey, we’re on Ugandan time here!
On Friday I got to go to Kirruddu Hospital for the first time. This hospital is the site for several research studies, including AMBITION, a trial assessing the efficacy of a single dose liposomal amphotericin for patients newly initiated on antiretroviral therapy (ART) for HIV who also have cryptococcal meningitis (CM). Although CM is relatively rare in the United States, it is one of the leading causes of death in HIV patients in resource limited settings such as Uganda. An and I travelled to Kirruddu in a van with a physician and a nurse involved in the AMBITION study. Before starting rounds, he was told that there was a new patient who might be eligible for the study. The patient had been newly diagnosed with HIV, had just started on ART, and was complaining of headaches, fever, and neck pain (symptoms of meningitis). To diagnose CM, a lumbar puncture is performed. This involves inserting a large needle into the spine to collect a sample of cerebrospinal fluid (CSF). An and I got to assist in this procedure! Once the CSF is collected, a dipstick that detects cryptococcal antigen (CrAg) is placed into the sample. If two lines appear, the test is read as positive. Fortunately for the trial but unfortunately for the patient, the CrAg test was positive, leading to a CM diagnosis. The nurse then described the research study to the patient and went through all the necessary paperwork for enrollment. An and I observed as Dr. Enock randomized the patient into the trial. As students in a health science program we have obviously read papers and interpreted results from many clinical trials so it was very interesting for us to see the process taking place in real life.
This weekend was a different type of exciting! Since Monday was Uganda Martyr’s Day (a national holiday here), we had a three day weekend. We took advantage of this extra day off and went on a safari! We woke up early Saturday morning and hopped in the van for Murchison Falls National Park. Shortly after entering the park we were greeted by dozens of baboons! We thought they were adorable and slowed to take lots of photos. Our opinion of these apes quickly changed. To get to our lodge, we had to take a ferry across the Nile. While waiting for the ferry, we thought it would be good to take out a game (Kingdomino) to play at the picnic table. As we were getting set up we noticed one of the baboons watching us and slowly inching closer. I thought he looked cute and started taking a video. He got closer and closer and then quickly lunged between An and Joe and grabbed the plastic bag that had the game pieces and put it in his mouth. We all screamed and jumped away from the table. Miraculously the baboon quickly realized that the contents of the plastic bag did not include any food and spat it all out. The game was saved but it was still a scary moment for all! Maybe he just wanted to play Kingdomino with us but after that we all kept a close eye on the baboons.
That afternoon we went “looking for cats” in the Jeep. We saw all the animals I had been hoping to see: giraffes, elephants, lions, and more. We even got to see a family of four lion cubs wrestling in the distance which really made my day! We enjoyed a picturesque sunset as we headed back to the lodge for dinner and sleep. The next morning, we did another game drive where we got up close and personal with two lions. It was unreal to see these majestic beasts walking next to the road only about 20 feet away from us. We enjoyed a quick dip in the pool with views of the Nile before leaving for our river cruise. On the boat safari we had views of lots of hippos and even caught sight of a few crocodiles. Seeing these beasts in the river made me a tad bit nervous for our white-water rafting trip we have planned for next weekend!
After a jam-packed couple days, we are now heading back to Kampala for another week of learning. This will be a shorter week since we have today (Monday) off for Uganda Martyr’s Day and will likely have either Tuesday or Wednesday off for Eid. We learned that if the moon is sighted tonight then Eid will be Tuesday and if not it will be on Wednesday. It seems to me like the undetermined nature of this holiday would make it a bit difficult to schedule meetings and other work activities, but hey, we’re on Ugandan time here!
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