Sunday, May 14, 2017

The Lovell Ladies In Uganda

March 6 - 17, 2017



Note: Photos courtesy of Rebecca Lovell and Nancy Lovell Hess

They're heeeeeere!  March 6th Dennis and I set out before sunrise for the long drive to Kampala and on to Entebbe Airport to pick up the lovely Lovell ladies who would be landing in the early afternoon.  What happened between the end of the last post and now?  The household said a tearful goodbye to Travis, followed by a busy administrative week filled with grading final examinations and log books, writing grants for equipment for the hospital, completing a long overdue chapter for a textbook, writing lectures to be given in the coming weeks, and applying for two state medical licenses, all while solidifying travel plans for the family.  Whew!  Once at the airport, Dennis and I were peering through the final exit point to see when my mom and sister might be coming through.  After an hour we recognized my sister Rebecca, and started making ridiculous waving motions as they finished gathering their luggage and walked toward the sliding doors.  I can't even begin to tell you how excited I was to have them in Uganda, to show them the country where Dennis and I have been living, and to share with them some of the incredible experiences the country and people have to offer.


The family received their first dose of Kampala traffic right away, with our van arriving in the congested capital city at the peak of the evening rush hour.  Fortunately our trusted driver, Fred, was able to navigate through remote roads to keep us moving forward, but still the traffic made the normal five hour trek over eight hours of sitting in the car, this after mom and Rebeck had been traveling for over two days.  We arrived at our home just before 11pm, with just enough time for a quick tour of the apartment before settling in for a short night.

March 7th was an early start for my sister and I, heading to the morning meeting where she was able to meet the wonderful people that I work with.  The meeting included a heart-wrenching story, as one of the intern physicians had returned to work that day after burying his wife, a nurse, who had died the week before.  As he told us of her long battle with the illness, the nurses consoled him through their story of being present at the burial and giving her the customary nursing send-off ceremony.


Once the physician expressed his thanks and turned the meeting to other topics, I had the pleasure of introducing my sister to the group.  In addition to more pulse oximeters requested by students (Yes! Vital signs!!!), my family  also brought two books, Obstetric Intensive Care Manual and Fetal Heart Rate Monitoring, both personally signed by Dr. Thomas Garite.  The staff was full of laughter and smiles as they accepted the books on behalf of the department.  In a country where physical books are often expensive, if even found at all, receiving a signed copy is so appreciated.  With the addition of these books to the Clinical Gynecology Oncology books by Dr. DiSaia that Dr. Emily brought earlier, the students and staff were ecstatic.  A huge thank you to both Dr. DiSaia and Dr. Garite for your contribution and donations!

Rebecca and I had a quick tour of the gynecology ward before Dennis and my mom joined us at the hospital.  Throughout the introductions to the hospital and university staff, one thing became clear: meeting family is an honor.  Even more clear: parents receive an incredible amount of respect.  People were extremely excited when I introduced Rebecca as my sister, and when I would introduce my mom they would gasp and say, "this is your mamma?!?"  An additional cultural fact learned at the end of the day: you never introduce your parents by name.  It is considered rude.  They are simply introduced as your mamma or pappa.  No name needed.

While giving a tour of the school, I received a phone call from an intern physician on the ward regarding a patient who had just died, with a history of fevers and now with blood running from the nose and mouth.  This constellation of symptoms can be concerning for hemorrhagic fever, incorporating the Yellow, Lassa, Marburg, and Ebola viruses.  Less than 12 hours after my family arrived in Mbale and there was suspicion of Ebola!  The most widely known outbreak of Ebola was in 2014 in the west African countries of Guinea, Sierra Leone, and Liberia.  However, Ebola is a zoonotic disease (transmitted from animals such as fruit bats and primates to humans) with occasional small outbreaks in the Democratic Republic of Congo and Uganda.  We quickly made a plan to get in touch with the head of department and head of the hospital, while I promptly notified Peace Corps who got me in touch with the CDC and the Ministry of Health response team.  Within 48 hours results came back showing no evidence of any type of hemorrhagic fever.  Thank goodness!


That afternoon my family received a whirlwind tour of Mbale, including the market where our normal vendors gave us extra food items as gifts to the visitors, meeting Medina - the fabulous tailor who makes beautiful kitenge outfits, and of course sampling local food - matooke, beans, and rice with African tea at Cosmo's.  After some time to relax and adjust to jet lag, we were off to an impromptu meeting with the leaders of Women In The Medical World, planning a celebration for Women's Day.  The leaders were so excited to meet the family and wanted them each to give a small speech.  Much of the planning also revolved around finding a speaker of honor for the following day's celebration, with the ladies instantly agreeing that Rebecca would be the perfect person to fill the position.  As soon as plans were set, we were off to the next destination: dinner at Saleh's house.

Saleh and Fred both work at/own Casa Del Turista.  They are a phenomenal duo, who have taken a small business and expanded rapidly over two years' time, all the while giving back to the community and supporting other entrepreneurs in Mbale.  While most national parks in Uganda are located on the western border with Congo, they are working to build up tourism and ultimately help to bring more business to the eastern side of the country.  Both are incredibly friendly and fascinating people.  When planning out the tour of Uganda for my family, Saleh warmly invited the entire Peace Corps Mbale group to a dinner at his house and with his family, including the whole extended Casa family.  Throughout the year we had been attempting to have a movie night with Fred watching "The Lion King," as he had never seen the film before.  This was the night.  

With Saleh's youngest climbing her way up and sitting firmly in my lap, we were all humming and singing along to the opening song of the movie.  What was the verdict from Fred?  Loved it, including changing his phone ring tone to "Hakuna Matata," which really does mean no worries in Swahili.  Asante sana, Disney!  Dinner was easily the best we have ever had in Uganda, with traditional local dishes including malewa (a dish consisting of boiled bamboo shoots that the Bagisu are most known for and my favorite!), pumpkin, cassava, spiced rice, fish, goat stew, chapati, and many many other delicious dishes.  It was a huge spread of food and a fantastic evening with a wonderful family.



March 8th was a national holiday in Uganda for International Women's Day!  This day was incredibly special, celebrating with all of the Lovell ladies together in Uganda alongside the incredible young women of Busitema University Faculty of Health Sciences.  It was the first Women's Day celebration for mom, and the second that Rebecca and I have celebrated together; the first was when she and one of my best friends, Matthew, came to visit me in Guatemala in 2014.  By 9am we were out the door and heading to Magic Graphics to print booklets of The Inspirational Women Of Uganda Directory as a gift to the young women.  While the printer was making the books look absolutely perfect, we found a delectable cake for the celebration.  Once all was in order we were off to the school to help set up and get the celebration underway!

The leaders were hard at work in the kitchen when we arrived, sitting in chairs arranged in a circle and peeling cabbage, cutting tomato and green peppers, while others were working hard over the coal stoves steaming matooke and rice.  We helped with cutting garlic, onions, and carrots before heading inside to make bows for the decorations.  Festivities were planned to start at 11am.  Around 1:45 pm the DJ was set up and the women were cleaning up for the party.  The ladies came downstairs wearing their finest dresses, high heels, and make-up for the occasion.  Letitia and Claire were the MCs, keeping the event fun and entertaining with games, singing, poems, and speeches from Rebecca, Mamma (who made the entire room teary with her words), as well as visiting midwives and doctors from the hospital. At 4:00 pm it was time for food and cake cutting, followed by the whole room erupting in laughter and dancing.  We were joined by a special guest, Irene Atuhairwe, our GHSP champion at Peace Corps Uganda.  She has been an amazing supporter of the Women In The Medical World club from the beginning, and I'm so thankful she could join the celebration!

By the time we made it home at 5:00 pm, it had been a full day of love, laughter, dancing, and tears of joy.  The whole household including our guests, Irene and Bonaventure Ahaisibwe from Seed, gathered on the oh-so familiar stairwell for the traditional happy hour where we all catch up on successes and challenges of the day, discuss the latest news stories, and review books we are reading or recommend, amongst so many other topics.  With the limited time in Uganda, I am so thankful that the few days in Mbale were so rich and full of life in this city.  After a dinner out on the town, it was time to head home to pack up and prepare for the tour-de-Uganda beginning the following morning.


March 9th we bid adieu to Mbale and set off for Jinja, the town situated at the source of the Nile River.  This marked the start of our tourist adventure, with Fred as our driver and guide, as well as the newest member of the family during the trip.  After a harrowing ride along the highway (ask for details next time you see us 😉), we arrived at our hotel and relaxed by drinking Nile Special beers by the Nile before heading off to a boat ride.  The boat took us up the Nile to the source of the mighty river, then to Lake Victoria where many fishing villages saddled the shores.  Otters played and popped up from the water nearby, birds flew overhead, as countless others were singing in the trees.  Uganda is known for its immense population of birds, with over 1,000 unique species in the small country.  It was nearing sunset as we returned to shore so we enjoyed the magnificent view, along with a tasty meal, at the Jinja Sailing Club. 

We had an early start in the morning, leaving Jinja at 5:00 am to avoid Kampala traffic as we continued south-west, crossing the equator line from the northern to the southern hemisphere, through Mbarara and on to our final destination: Bwindi Impenetrable Forest! Having done the gorilla trekking in January, Dennis and I knew the Rushaga Gorilla Camp was the perfect accommodation and what essentials were needed so my family was well prepped.  Along the narrow and winding road to Bwindi, children were dancing and waving while shouting "mzungu!" to our car as we drove past.  We arrived at 4:30 pm, a mere 11 1/2 hours after embarking on the journey.  That evening Rebeck and I stretched out the long car ride through an hour-long yoga session on the deck overlooking the green forested mountains beyond.  Before dinner the guests at the lodge were entertained by a group of local children, singing traditional tribal songs to raise money for school fees.  One little girl was not officially part of the group, but that didn't stop her and her pink dress from dancing, clapping, and singing along with the rest of the kids.




March 11th was gorilla trekking day for mom and sis!  Dennis and I joined them for breakfast before wishing farewell on the journey; although the trekking fees go towards a great conservation cause, we couldn't justify going again as the cost is prohibitive.  Looking to trek gorillas in Uganda?  Find the tariffs here. Dennis and I enjoyed a morning on the veranda and lunch including a chips omelette - essentially french fries held together by fried eggs - delicious!  At 2pm our trekkers returned, with photos, videos, and stories galore of the fantastic creatures.  The best video was captured by mom of a baby gorilla overestimating the strength of a tree.  The afternoon was spent reading and relaxing (some of us reading a book with a backwards book jacket) and listening to incredible stories from two adventurous travelers who were staying at Rushaga over drinks and dinner.  The gentlemen hailed from the U.S., and had driven to Uganda all the way from South Africa, equipped with a refrigerator and freezer with ice cubes readily available in their souped-up land cruiser.



March 12th was another driving day, from the lush hills of Bwindi to the very hot dry desert landscape of Queen Elizabeth National Park.  Our stomachs were filled with the infamous rolex - chapati with fried eggs rolled up inside - bought from a roadside stand.  Even before entering the park we saw elephants grazing in the distance as we made our way to Simba Safari Camp.  The national park was originally founded as Kazinga National Park but the name was changed to Queen Elizabeth National Park (QENP)in 1954 to commemorate the queen's visit.  The park contains volcanic craters and salt lakes, as well as the Kazinga Channel, connecting Lakes George and Edward, filled with hippos, crocodiles, elephants, and buffalo.  QENP is known for the tree climbing lions, found deep in the south-west of the park in the Ishasha area.  Our stay was in the northern section of the park; if visiting, plan an extra day or two to drive the rocky road south to Ishasha.

The morning of March 13th we were up with the rising sun for a game drive through the park.  The start was delayed, however, as the admission attendant didn't arrive until 7:15am, a full hour after the park was supposed to open.  On the trails we encountered several vehicles of tourists who had seen a pride of lions.  Not long after, Dennis, perched atop the roof of our moving van, spotted a lioness deep in the brush.  She was powerfully moving through the plains, eventually crossing the dirt path we were driving on, passing right by our car in order to find shade in some nearby bushes.  After our encounter we continued on, driving by a salt lake to a fishing village where the locals live amongst the wild animals in the park as they had done for centuries.  As the fishermen were loading up the nets in their boats, hippos were keeping cool in the water not far offshore.  We learned that the fishermen had to strike a very delicate balance between getting their catch for the day to sustain their families and coming back early enough to be safe from the hippos who come to shore for feeding during the cool nights.  Returning late from fishing out on the lake could be fatal.  From the village we cruised the road next to the Kazinga Channel, encountering a large yet skittish herd of elephants.  We enjoyed our packed lunch at the Mweya Institute of Ecology, overlooking a herd of elephants cooling off on the opposite bank of the river below.  As we finished our food, a marabou stork - understandably known as the ugliest bird of East Africa - was looming nearby.  Yikes!  

In the afternoon we explored the Kazinga Channel by boat, getting up close views of the elephants bathing next to herds of buffalo on the banks, and pods of hippopotami deeper in the water.  The refreshing breeze coming from the water was a welcome respite from the heat.  Best of all our guide was able to spout off the names of every bird we came across, flitting through the trees or feeding onshore.  Back at the hotel we had a lovely candlelit dinner out in the cool evening air before heading in for the night.

March 14th we tried our luck at another early game drive, however there were some mysterious fires burning nearby and the park entrance attendant was again significantly late to her post.  Since the animals usually hide from fire as well as the heat of the rising sun, we decided to skip a second visit to QENP and instead grabbed one last cup of coffee at the camp before heading north to Kibale National Park.  Kibale (pronounced Chi-bale in this area) is a beautiful tropical forest, lush and green, home to forest elephants and over 13 species of primates including chimpanzees.  Our new home was the Primate Lodge, a luxurious accommodation within the national park, with secluded cabins each having a large porch looking out onto the forest.  A serious family yoga session in the afternoon was perpetually thwarted by uncontrollable bouts of giggling as well as the site of beautiful birds perched atop the nearby trees and monkeys swinging from branch to branch right before our eyes.  During our fabulous dinner we watched nature putting on its own entertainment, with over 6 geckos scaling the walls in front of us in pursuit of a butterfly.  Nature at its finest!

The Kibale forest and the stay at the Primate Lodge was one of the most amazing places Dennis and I have ever visited.  The lodge itself is comfortable, has fantastic food, and a setting that is serene yet simultaneously stimulating with the number of wild animals and birds nearby.  Highly recommended.

In the morning, all four of us went on a hike through the forest to observe a community of chimpanzees.  In comparison to the large and majestic gorillas, the chimps are crazy.  The communities have upwards of 100 members, with most members present not visible when you encounter them in the forest.  Once the chimps begin to communicate with each other, you quickly realize that there are far more of them than meet the eye.  With male chimps fighting and clamoring through the trees for the few females in heat, you could feel the tension between the males running high.  Perhaps the most harrowing experience was when the community's alpha male was displaying his strength, charging within inches from Rebecca and me.  With a solid hour and a half with the rambunctious animals, we were all ready for the quiet walk back to the lodge to decompress.

Reading, yoga, and more animal watching followed throughout the afternoon, before heading out near sunset for a night walk through the forest.  With only a flashlight to help you see what is immediately in front of you, the forest takes on a completely different feel.  Our lights were scouring the tree tops looking for the tiny bush baby, weighing 150 - 250 grams as an adult.  You can imagine this makes them difficult to see at any time.  Fortunately at night their eyes reflect any light shone at them, making it possible to identify them as they agilely leap through the treetops.  Rebecca was the main spotter, identifying three in the tree tops.  

The next morning we ate breakfast while a family of red tail monkeys played in the trees surrounding the dining area.  With that it was time to leave the forest and head east for the long drive to Entebbe.  In Entebbe we settled into the Lake Victoria View Guesthouse, taking in the large lake and packing up for the next day.  With one last dinner of matooke, rice, beans, pasted greens, and chapati, it was the perfect way to round out the week of touring.  Of note, the guest house charges and exorbitant amount of money for local food - for that reason we would recommend against staying here.

On March 17th Dennis and I dropped off mom and Rebecca back at Entebbe airport for their long journey back to the U.S.  Just as we were leaving the guesthouse we heard through the news that the highest ranking police official had been assassinated just outside of his home - creating some changes in regulations and adding new tensions in the country.  Nevertheless, all was safe where we were. 

Although sad to see them go, Dennis and I were so grateful for the two weeks spent with family and sharing our experience in Uganda with them, alongside new adventures together.  Not bad for a first international family vacation.  Once mom and sis were safely at the airport, Dennis, Fred, and I made our way back to Mbale to resume life as usual in the hospital and university.  



Sunday, May 7, 2017

Physician Educator: Starting Semester II

January 23 - February 24, 2017



Thanks to Dr. Emily Adams-Piper for many of the photographs 


January 23rd marked the start of the second semester for students at Busitema University Faculty of Health Sciences.  Since the medical school was founded in 2013, the fourth year medical students currently on clinical rotations are the inaugural class of the university.  The fifty-two students in the class are divided into four groups of 13 to rotate through the four major fields: general surgery, internal medicine, pediatrics, and obstetrics and gynecology.  The rotations are five weeks each, with three rotations in the first semester, making this second semester block the final major discipline clerkship before the students move on to the subspecialty rotations later in the semester.  This is my last group of students! 


After the subspecialty rotations, the students have a recess term followed by a short break, then begin their fifth and final year of medical school.   During this last year they repeat each of the four major disciplines, rotating for seven-and-a-half weeks each.  The students are then mandated to complete an intern year before being fully granted the right to practice as a physician.  Graduation has its own customs and timing, as on October 3rd, in the midst of their internship, the young physicians will leave their posts for a few days to head back to their medical school and attend the official graduation ceremony as well as to celebrate the day the school was founded.


On the same day the new semester started, newly sworn-in President Trump signed legislation reinstating the global gag rule, this time markedly expanded.  As a women's health care provider, this is terrible for women worldwide, with implications beyond what is written in black and white.  I am a HUGE proponent of contraception: the ability to prevent unwanted pregnancies and increase spacing in between children decreases abortion, maternal mortality, as well as infant and child mortality.  If you want to make the world a healthier place, empower women's reproductive rights.  An excerpt from an essay entitled "Listen to Women", written by Dr. Julie Hein in the American Congress of Obstetrics and Gynecology journal, eloquently states: 
"Being an advocate for women extends beyond the four walls of our clinic or hospital. We must educate ourselves about the various issues affecting women in our communities and our world — laws that threaten reproductive health rights, cultures of sexism, and inequalities that keep women across the globe in poverty — and fight against these problems."

On January 26th a guest lecturer arrived for a few weeks - Dr. Emily!  When I was the Gynecology service chief resident at UCI, Emily was a fantastic urogynecology fellow to work with in the operating room and on the ward.  As soon as she discovered Dennis and I were headed to Uganda for the year, we immediately began planning a way for her to visit.  A huge thank you for the incredible support of my supervisor Professor Wandabwa as well as the Faculty Dean of BUFHS Professor Waako for making her visit happen!

Emily didn't miss a beat in getting settled into life in Mbale or the hectic hospital.  There was no sign of jet lag as we spent the first few days introducing her to all of the hospital and university administration and staff, settling in to the gynecology outpatient clinic looking for patients in need of urogynecology surgery, rounding on the gynecology ward, seeing antepartum / "return OB" patients, or teaching the medical officers and interns in the operating theatre that the key to a successful prolapse surgery is "slow and safe."  Perhaps the most memorable and crazy surgery we had was a utero-cutaneous fistula, where the hysterotomy from a cesarean section and the skin became infected, necrotic, and fused so that when we thought the underlying organ was bowel, it was actually endometrium.  Yikes.

In addition to bringing a box full of pulse oximeters requested by the students, a few Heaney clamps, forty metal speculums, and four copies of Clinical Gynecologic Oncology, personally signed by Dr. DiSaia himself.  The students of the university and staff at the hospital were incredibly thankful for all of these. Two copies of the book were a gift to my counterpart Dr. Stephen Waiswa and my supervisor Professor Julius Wandabwa; Professor was so excited he gave me a hug, lifting me off of the ground!

When not running around the hospital we were up for early morning runs or yoga, shopping for beautifully patterned fabric, enjoying a delicious cup of coffee, or sitting on the stairwell with Dennis, Travis, Bob, and Julia discussing a whole host of books and recent events.  With Emily's undergraduate degree in English literature, she was the perfect match for Bob and Julia's literary knowledge.

February 1st was an exciting day - the founding of the Women In The Medical World club!  Busitema University is progressive, ensuring that at least 30% of the student body is made up of women.  The students cover both medical and nursing disciplines.  BUFHS student organizations are often affiliated with the nearby School Of Clinical Officers, where students are trained in a medical position similar to a physician assistant in the US.  As an undergraduate at UCSD I was a part of the Alpha Chi Omega sorority.  I was privileged to meet incredibly ambitious and inspirational women in both my own undergraduate studies as well as alumni and other women successful in their careers, while also participating in outreaches through the sorority philanthropy: bringing awareness to and providing education about domestic violence.  In medical school I was a member and mentorship chair of the American Medical Women's Association, pairing medical students with an attending physician as a mentor, holding journal clubs, donation drives for underserved women in the community, and attending national conferences.  Each of these organizations had a tremendous impact on me during school, constantly providing inspiration and motivation to continue reaching for the heights.

Currently no student organization or club exists for the empowerment of women studying the various medical disciplines in Uganda.  So the women of Busitema University Faculty of Health Sciences created one.  With a general assembly of ambitious young women, they spoke of the challenges facing women in the medical and nursing fields, as well as what impact they wanted the club to have on the university and the community.  With that the positions of chairperson, secretary, treasurer, community outreach chair, scholarship chair, mentorship chair, and student exchange program chair were created and a group of seven influential leaders elected.  In creating the name, a show of hands showed Women In The Medical World to be far and away the most popular.  A women's empowerment club is born.

If any reader is aware of scholarship opportunities for women in Uganda, or has access to setting up student exchange programs, please message me the info to promote our scholarship and student exchange chairs!

I have the pleasure of being a patron, or advisor, to the club alongside the incredible Dr. Rebecca Nekaka, as one person wrote on the whiteboard at the end of the meeting: "Dr. Nekaka - our Michelle Obama."  As an aside - lesson learned in organizing clubs and meetings: in November I sent out an email to all students a few weeks in advance with a reminder email a few days before and the day of ... no one showed.  Calling one class leader at 2:00pm and asking them to organize a meeting for 5:00pm ... fifty women attended.  Phone and WhatsApp are by far and away the preferred method of communication with the students.


February 3rd was Dennis's 34th birthday so we took a celebratory weekend trip to the Sipi River Lodge, a luxurious retreat an hour away from Mbale with green mountains, flowing waterfalls, cooler temperatures, and fabulous french press coffee.  The evening was filled with good food, laughter, homemade brownies by Julia, and sitting in front of the roaring fireplace with Bob reading "August Heat" by W.F. Harvey, and Dr. Seuss's "Happy Birthday To You!" before heading into our cabin with the sounds of the nearby waterfall soothing us to sleep.  

Saturday and Sunday morning we sat just outside of our cottage, drinking delicious tea and coffee while watching the sun slowly rise over the mountain.  On Saturday, Travis, Emily, Dennis, and I set out to hike the three waterfalls in the Sipi area.  In the midst of the dry season the water was not as thunderous, making it easier to explore the base of the falls without getting pelted by water from above.  Unfortunately the infamous ladder to the lowest falls had recently burned down, meaning we could only admire the waterfall from afar before heading back to the lodge for a luxuriously hot shower and afternoon of reading and relaxing.  That night we were again entertained by Bob's sing-song voice, reading "The Lottery" by Shirley Jackson, and Edgar Allen Poe's "The Tell-Tale Heart". After enjoying more coffee and reading on Sunday morning, we headed back to Mbale.

The following week at the hospital had its frustrations, with the operating theatre not functioning well due to the lack of water, no blood in the blood bank for the many elective 20-week-size fibroid uteri booked for hysterectomy, and on top of it no anesthesia officer available to give anesthesia in the event everything else was functioning.  Thursday February 9th, however, the fourth year students amazed us with their report-back on fibroids.  The university focuses on a problem based learning approach, where in place of traditional lectures, the students create objectives for what they should know about for a given topic on a Monday, then over the course of the week read and prepare their findings.  One student presides over the meeting and each student presents what they were assigned to investigate.  After each presentation, if there are any questions, clarifications, or additions, the rest of the group can add on.  It is amazing to see what each person will find in the course of reading and fun to see learning in process.  That evening we were hosted to a fabulous Punjabi dinner at Jasraj's house, a Peace Corps Volunteer living in Mbale.  There isn't running water or a sink in Jasraj's living quarters, but that didn't stop him and his co-volunteer Mïchäł from making a deliciously spiced meal.

Friday February 10th was another family dinner affair, this time with the infamous muchomo pork alongside saffron rice, paired with more stories from Bob reading aloud "To Build A Fire" by Jack London to a rapt audience being mentally cooled through the Mbale heat.  Saturday February 11th we trekked the nearby Wanale Ridge, with Emily climbing up the wall of sticks like a pro.  This was followed by an afternoon relaxing and reading poolside and a 'family' dinner at Mt. Elgon Hotel on the green outskirts of town.  Sunday the 12th was also an early start, meeting Jasraj early to catch a matatu (local taxi bus) to attend service at the Sikh temple in Tororo.  We had the best guide through the service, practices, and religious customs, followed by meeting several prominent Sikh community members over a communal meal with all comers welcomed.  The rest of the weekend was spent grading midterm examinations and preparing for the upcoming week of lectures.

For some Valentine's Day fun we operated alongside Professor Wandabwa in the morning and then were off to a grand rounds presentation on pelvic organ prolapse.  The topic is typically reserved for the fifth year of medical school, however Professor wanted to capitalize on Dr. Emily's presence and expertise.  The students were engaged and asked thoughtful questions, expanding their knowledge of pelvic anatomy and support.  In the evening we had a family celebration at our favorite Indian food restaurant in town, New Nurali's.  To think that when Dennis and I first began dating in 2004 I was convinced that I didn't like Indian food... :)

Thursday the 16th we sadly bid farewell to Emily as she left for Entebbe and on to Tanzania to meet up with her family for some adventures.

The Mbale crew was also gearing up to say goodbye to our own Dr. Travis, who was leaving after the end of the fourth year clinical rotations.  In addition to preparing for finals, we sent him off with a flurry of family dinners, including a fantastic Polish feast on February 23rd created by Chef Mïchäł, complete with sparklers and shooting heart confetti which we found in our clothing and apartments for days.

I leave you with wonderful photos of the colorful sunrise, and the bubbly theatre nurse Lorna enjoying the theatre shoes left for her by Dr. Emily.  Enjoy!



Up next: The Lovell Ladies in Uganda!