Western Uganda may be the most beautiful place I have ever seen!

The view from my guest house in Kilembe

I wish my photos could do even an element of justice to the scenery of Western Uganda. From Sunday evening until last night, I have been traveling along the Rwenzori Mountain range, exploring its valleys, plains, gorges and foothills. I have yet to see anywhere else so lush and so expansive. As the area is still relatively untouched by man, it is home to such exotic life, from flowers to animals, which some photos will show further on.

Nestled in pockets of this incredible environment are a few towns I have visited since Sunday. Fort Portal is the only English-named town in Uganda. It house 3 missionary private hospitals and a government regional referral hospital, called Buhinga. As there are no orthopaedic surgeons here, I met with one general surgeon, an orthopaedics resident in his final year, and a medical officer (a post-internship year obligatorily stationed upcountry). Sadly, orthopaedic care here can consist of little more than closed reductions, some casting and splinting, and the occasional debridement or pinning. As no orthopaedic specialist works here, they do not have any tools for even the general surgeons to manage basic fractures. Most people end up referred to Mbarara or Kampala.

The ortho resident here has voluntarily come back to his home town to provide orthopaedic care before starting his own practice. He ended up personally buying some basic tools (drills, a few pins etc) in order to provide at least some kind of care for patients. He will have to wait 2-3 more weeks before the government even considers his request for equipment. And as he tells me this, we are sitting in the nicest of ORs I have seen since arriving here. It is empty. There are not even enough doctors here to staff the OR on a daily basis, despite the pile up of patients on the ward. Where are the surgeons? Making a living in the private system or other endeavours. Government salaries for doctors here are not even enough to feed and family and put kids into school.

Fort Portal, across from Virika Hospital

The private protestant mission hospital. There are only medical officers working here. A specialist can be called in, if available.

After an hour of pounding rain, I met my driver for the rest of the trip, Fred. He is from Fort Portal also. We throw my bag into his car and begin the most beautiful road trip of my life. As we head southwest, we are driving along and eventually into, the Rwenzori Mountains. There is also an unnamed mountain range to the east, and in between them lie lakes. The largest one is Lake George.

Two hours later, we meander a two-lane road into the town of Kilembe. It is a gated town; a security guard mans a road block 24/7. The town is small and sits in the heart of a small valley, completely secluded from the rest of the world and, as I am told, the bad weather. In the 1950s and 60s, this was a copper mining town overrun by Muzungos. When the mines closed in the 1970s, the white people left, except for the occasional visiting doctor.  Kilembe is incredibly tiny and quaint. It has a gas station, a few local markets and a school. Somehow it also has a general hospital. Kilembe Mines Hospital, once the point of care for the miners, is a collection of tiny buildings on the foothill of one of the mountains. It includes the guest house where I was staying.

My guest house! Nestled under a half dozen mango trees!

Across the street from the hospital

This hospital is particularly interesting, and it probably the best run hospital I have been to in Uganda. It is considered a private not-for-profit hospital. This means it receives some money from the government, some from the catholic church, and a little from the patients. Although patients do have to pay a small sum for care, it is nothing compared to the costs of a private for-profit hospital. There is only one specialist doctor here, everyone else is a medical officer or allied health care worker, such as physiotherapists and orthopaedic officers (cast techs). The specialist is the only orthopaedic surgeon in the district, Dr. Wefula. He is also the hospital Superintendant. When he came here as a medical officer, they told him they would pay for his orthopaedic post-graduate training if he came back to work permanently. He did.

Dr. Wefula and I outside the "Major Theater"

Unlike any other doctor I have met so far, Dr. Wefula seems to enjoy his job. His team, as he is, is so motivated. Compared to the Kampala teaching hospital where length of stay for orthopaedic patients averaged 33 days, his average is 7-10 days. His wards are always full, but he operates 7 days a week, with his medical officers managing the obstetric and general surgery cases. He doesn't have a lot of equipment, but some was donated when he arrived, other things he has bought himself, and he receives a small supply from the government. As he said, "I don't have much, but I make it work with what I do have." Patients come here from all over the South and West of the country, and generally leave with a solid chance of full recovery.

Sample spread of local food. The hospital kitchen supplies lunch on OR days for the staff in their tea room. Far left in the pot are local sweet potatoes (they are whitish-yellow), in the leaves are Matoke (steamed plaintain, mashed), the second pot is rice, and the thermos pot, top-right, is a beef stew. The bottom left basket contains a meal of maize and cassava, the open pot is a bean-tomato stew, and the bottom right is an eggplant dish. Believe it or not, as locals tend to have only one big mean a day, everyone eats a lot of ALL of these dishes!!! It is delicious though!

I hated to have to leave so soon. The staff here were so welcoming. I hope to stop by in December when I come back this way. The next destination is Mbarara. To get there, the safest road is through Queen Elizabeth National Park. This is one of the most popular game parks here. The main road goes only through the periphery of the park, but sightings of animals are frequent, as you can see by the pictures below. Within 30minutes, I saw two elephants, 6 or so African Buffalo, two kinds of antelope, of which the Uganda Kob were in groups of hundreds (no pictures as there were far away), and a family baboons having a pow-wow on the road. I can't imagine what you see when you pay to go in!

A group of African Buffalo

Olive baboons. The little baby kept hiding from my camera!

Daddy Baboon

African elephant

The second elephant

 As we exited the park area, we started climbing along this gorge. Lakes and rivers were everywhere, but once we got to the top, suddenly you could see for miles to the south and west. It reminded me of that opening scene of the Disney Lion King movie where the lions are perched on a cliff and look over their kingdom. I could probably see into Tanzania one way, and the Congo, the other! Again, my camera died just before I could get a good picture of this view, but I promise - It was breathtaking!!!!

Richard (my drivers switched due to scheduling conflicts!) didn't know what the name of this tree is called, but it is deadly. It's hard to tell with this photo, but although the trunk looks like a normal tree, the branches are like a cactus. If you break the branches, out comes a milk that is apparently deadly to the touch!!! I will most definitely be staying away from those!

Lake George

A different lake...

And this is looking south from my Lion King perch. To the right, I could see about three lakes and the mountains behind.

The rest of the drive was equally beautiful, but I will spare you the details. I arrived to Mbarara after dark. I checked into the University Inn for my meeting tomorrow with Dr. Bitarho, the only orthopaedic surgeon in the city. This city, which I have yet to see, is supposed to be one of the most modern in Uganda. It has a University of Science and Technology, which includes a medical school. I am looking forward to my time here, though tonight (Thursday) I head off to a nearby lake for a day off tomorrow. This lake is one of the only bilharzia-free in the area and so I plan to swim, tan, and do some computer work outside! That said, you probably won't hear from me again until after my interviews in Masaka and I am back in Kampala.

Hope all is well at home,
Love,
Maryse