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An outreach clinic for eyes and children with disabilities today in Tubur which is north of Soroti and about a two hour drive from Kumi. We set off in good time and drove through a remote region of parched grass and almost starving cows as there is no lush green vegetation for them to chew. Out of nowhere we found ourselves in Tubur, a settlement with a Health Clinic where parents had gathered to be seen in our clinic.

The warm winds swept through the compound with dust rising and depositing itself in every nook and cranny available. Sometimes, an instant whirl seemingly coming from nowhere appeared and rose only for the wind to blow it onwards. My first choice for outreach clinics is outside in the shade of a tree but this was impossible today as our papers would disperse and our eyes would fill with dust, even more than had entered them already. The eyes were sore, the nose and ears were packed with dust, even my throat and lungs had been better. Could this phenomenon herald the oncoming rainy season? Let’s hope so!

So we sat in a relatively pleasant consulting room with our mobiliser for the day keeping an orderly queue in the corridor and, one by one, the mothers or guardians brought in their children. The wind passed through the open window to send our papers flying but at least their flight was restricted by the four walls. The plight of these children is pitiful with us seeing them but for a short time but the parents have them all day and every day. One such boy with abnormal behaviour was ranting and raving in the father’s arms so much so that we could not hear his story but, no need, as the picture told all and all we had to offer was for him to be taken to see the child psychiatrist who I have met in Soroti Hospital. Not much consolation if the parents had come hoping for a reprieve from this torment. A 14 year old girl came hoping we could help with her burn contractures which she had had since she was one month old. She had been in the family mud hut with her brother and both the parents were not present. He had found a box of matches to play with and the rest followed. You may not recognise the photo as being one of a hand due to its deformity. Her other hand was also burnt but less so and she managed to write. I have forwarded the photos to our plastic surgeon back in Teesside who has replied that he will operate in October. I also sent a photo of a boy with Dacian deformity of the face, a condition causing so much disfigurement, to be told that this condition requires a bone scan to see the situation with the boy’s skull. I shall try to arrange this and, who knows, any slight improvement will be better than nothing. No photo of this boy as it is too graphic. Youngsters came with osteomyelitis (causing dead and infected bone with pain and pus) who needed surgery but, without money, there was little hope, others with severe gluteal and quadriceps fibrosis, scoliosis of the spine; some in need of surgery, others investigations and we could at least try to help them by funding their surgeries. The day continued until the last child had been seen and then it was on to the adults who had been waiting patiently in the hope of being seen.

The children all need serious consideration and decision making but the adults have a lighter note to them as they need advice and comforting as their bodies are worn out completely and I can only hope that our placebo plans are effective. One mother brought her adult Downe’s Syndrome daughter who had cracked soles of her feet for which we could give solid advice. As to the skin condition on her legs and chest, I gave her a hotel-size bottle of Wild Musk body lotion which raised much singing and dancing with joy! They pranced out of the room and along the path from the clinic like happy children. Another old lady came with aches and pains in her neck, round her body and abdomen, down her legs; there was little of her body without complaint. Then she went quiet and whispered that she had a urinary/genital problem and her husband, also afflicted, was waiting outside. I am no doctor but all I had to do was to refer them both to the appropriate clinic at the local hospital and my job was done. This is so satisfying knowing you have helped someone in spite of lack of knowledge. Two sisters of18 and 19 years came in giggling and too shy to tell us that they had a problem with their buttocks. This turned out to be mild gluteal fibrosis which could easily be kept in check with exercise. They were unhappy about the state of their teeth so we referred them to Sam, our new resident dentist. I doubt they will come as Tubur is so far away. We could now drive away but, in the Health Clinic, there was a child of around 8 years who had fallen out of a mango tree at midday and his head was swelling. We waited for the necessary documents and then the mother carried the boy to the vehicle to sit in the back which gives the least comfortable and most bumpy ride. It took an hour to reach Soroti Hospital where we left the family to cope with the situation.

Another evening of heat with little refreshment from the warm shower. Few photos as our concentration on the job in hand was high.1. and 2. Burns 3. Gluteal Fibrosis 4. Challenging boy


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