Day 1: Kitansa (Monday)

We got up bright and early to eat breakfast, pack the car, and head out to our first village.  All of our outreach has been organized through schools, we were heading to the local primary school to set up.  When we arrived we were greeted by a school full of children ready to meet us!  They helped us unload our car, clear their classroom out and move our stuff in.  After about an hour of hard work – we were finally set up and ready to go!

Katie and her favorite, learning to floss.

Dan getting his first patient comfortable with some OHI.

Marc teaching a group of kids how to brush.



We left the house this morning thinking that our goal of seeing 75 patients was outlandish and insane, atleast Dan, Katie and Marc did – for whatever reason, Dr. Farmer was confident in us.  We were able to see 70 patients, send one patient to the hospital for a large growth in the back of her throat, and provide oral hygiene education for almost everyone that we encountered.  In addition to this – the patients we were forced to turn away got toothbrushes, health education, antibiotics for infection or medication for pain and were told to come to Wednesday’s outreach early to be seen if possible.  Overall – we felt really great about everything we were able to do today, and saw some people with very severe conditions.

Marc and Dr. Farmer suturing after an extraction.

"Walumi??" means something like..."where do you have pain?"

Katie was in pediatric heaven with all of the children from the school; the kids loved her oral hygiene puppet and got a kick out of her trying to use Lugandan to instruct them.  She even taught them some English words with her little talks.  Dan was a rockstar helping Dr. Farmer with “the African molar” and was eager to help with anything thrown his way – and everyone else’s way when they needed a break – and got very comfortable with assisting in extractions and anesthesia.  Marc got incredibly comfortable in his diagnostic skills and was able to get through a ton of patients and despite the language barrier was able to make everyone – even a kid with one of the worst infections we have ever seen – comfortable in our presence.



Uncle John doing some sterilization for us



We had so much help from local English speakers – the village heads – and the friars, especially Robert and Ronnie who are the up-coming friars we mentioned yesterday.  Even the man we hired to drive us for the week (Sandy) jumped in and became an amazing dental assistant and a key translator!  We solidified the little Lugandan we know and learned a few more words <please ignore the ridiculous spelling of these words if you are a Luganda speaker>– yasama noi (open more), wanda (spit), luma (bite), and of course bunira (close), and also learned some really helpful body language. 



Sandy (our driver) and Robert ( a friar) doing some translation.

We are looking forward to tomorrow, and are expecting more patients to show up at tomorrow’s village.  Hopefully we will be able to get our process down a little tighter and be able to add a few more patients and rounds of oral hygiene instruction into the mix!

Thank You for Loving Us! (Sunday)

We all got a great night sleep at the friary on Saturday; the boys were woken up by children letting them know it was “TIME TO GO TO CHURCH!” for the friars and Katie got an earlier wake-up call from the compounds German Shepard.  We were told the dog barks when it sees snakes or intruders, so you can imagine the things going through her head J.  After some amazing showers (the showers here are incredible compared to our Kampala showers), we got together to separate out our supplies and come up with a game plan. Our unpacking was accompanied by some local music a few of the school’s children played for us while they hung out outside the door, eager to meet all of us.  We were able to play for a little bit and get some pictures before we had to eat breakfast and get set up for the day!

Posing with our new friends, they wanted to "Greet the Lady"

Dan & Katie doing a composite fllling


We saw a total of 17 patients over the course of the afternoon – and it was definitely a learning experience.  With an amazing amount of help from all of the friars and people from the village who acted as translators, we all got the chance to do some work.  Marc, Katie and Dan all jumped right in and were all able to get the concept of extractions down, make sure that we had some of the basic language (yasama is open your mouth, bunira is close your mouth), place some fluoride releasing restorations, make sure that our oral hygiene presentations were up to par and most importantly – get some people out of pain and educate them to be able to care for themselves in the future.  For many of the children and even adults we met today, we were their first experience with a dentist.  Everyone was incredibly grateful for our presence and even for the small amount of help we were able to offer them - a common phrase used here is “thank you for loving us.” 

Dan & Dr. Farmer doing a filling

Tomorrow we will head out into “the bush” as Marian calls it, and go to our first village outreach.  We are all bracing ourselves for a long day – as Dan, Marc, and Katie felt like they got hit by a bus after just 17 patients today – but are incredibly excited to meet everyone and be able to make some small impact on their lives and are hopeful that with growth of the project we will be able to make a lasting change.  We are so thankful to Dr. Farmer for coming along with us and teaching us and again – thanks so much to everyone who donated supplies, this could NOT have happened without you!

Welcome to Kakooge!!!! (Saturday)

First things first - all of the patients we saw at Makerere and in the villages have consented to us taking their photos and them being used/posted by us, and if they did not...we didn't take pictures! :)





Now back to Uganda: Leaving Kampala on Saturday afternoon – we had no idea what to expect.  We had heard that Kakooge was various distances and that it would take anywhere between 1 and 30 hours to get there.  Father Marian, one of the friars who works at the Greyfriars Mission Uganda and Marc’s Uncle Johnny, who is also a friar, were meeting us in Kampala so that we could caravan with our minibus and our driver, Sande.  They were only meeting us because they needed to go to a grocery store….which made us think if they have to drive ALL THE WAY to Kampala for groceries – what were we in for!

Playing in Kampala before heading out to Kakooge

We met the friars at Garden City after having lunch and checking out the craft market and buying souvenirs – including Muzungu T-shirts of course.  Father Marian told us to expect simplicity, which is something that we had very much gotten used to at The Edge House in Kampala.  When we arrived, about an hour or so later, at the Friars’ compound, we could not believe how nice of a set up they have!  It is right outside the heart of Kakooge and living inside the compound are three friars, a few up-coming friars, and a cook.  The children that the friary supports live on the adjacent land belonging to the school in dormitories and we got to take a tour and meet all of the children!  The friary has set up multiple side projects to get income for some of the families in their villages – they grow bananas, pine trees for wood, and many other healthy fruits and vegetables.  They also have a well with clean water that they allow village members to use, since children and women are responsible for supplying water to their families. 

The group meeting some kids from the school!

Expecting that we were missing American cuisine, Marian and Johnny asked the cook to make us spaghetti and got us treats like Oreos and Snickers and then….they asked us to eat ants, a Ugandan treat. Marc, Dan and Dr. Farmer say they taste like sunflower seeds – Katie and Uncle Johnny ate theirs more like a pill, so they may not be sure how they taste.  After a delicious snack, we settled our plans for the rest of the week and heard from the Uganda Dental Association that they would send SIX dentists and supplies to help us with our outreach in Wednesday’s village!!! THIS WAS GREAT NEWS! We had been warned about the multitudes of people who will show up this week and are incredibly excited to have help and support as well as to be able to see as many patients as physically possible with so many hands to help!  We also decided that we would see 15 patients on Sunday to have a run through of what would be happening the rest of the week and make sure that we were all up to speed on all of our skills. 




Uncle John savoring his ant, and Katie grabbing a chaser



The men being really manly and enjoying their ants.





THE LUGGAGE CAME!!!! (so did dr. Farmer)

After our awesome night with our housemates, we got up nice and early for Oral Surgery Theatre (which is the OR). It was really cool to see the prep, anesthesia, how they manage the operating room.  It was all very similar to things that we had seen in the States with a Ugandan twist; we particularly enjoyed the wardrobe.  When you enter the surgery ward, you take your shoes off and leave them at the door, change into hospital scrubs, and once you enter the surgery side you select boots to wear. 



Katie, Marc & Dan in our OR outfits!


Marc and Katie had to leave before the surgery started to meet Dr. Farmer and get him to campus for his lecture, but Dan got to stay and see an amazing jaw resection and reconstruction due to an ameloblastoma - there is a picture of the resected section of the mandible at the VERY bottom of this post for those medically/dentally oriented folks. Marc and Katie took Dr. Farmer to get some Indian food for lunch, which was AMAZING, and then made the trek to campus where he gave two lectures on Oral and Systemic health and Local anesthesia techniques.

After Dr. Farmer's lecture with students, the dean, and the president of the Uganda Dental Association.

The students and faculty really enjoyed the lecture and we discussed future collaborations in which we will hopefully be able to assist some Ugandan students in coming to visit UNC, as well as having our students spend more time at Makerere! When we came back to the guest house - WE GOT OUR BAGS!!!! We are all super excited to have clothes that we haven't worn for 5 days straight. We celebrated with a nice dinner at Mamba Point, and came back to hang out with Ellie, Deria, Ben and Nasa (he lives at the house, works there and keeps us all entertained) for the girls' last night. We said goodbye to the staff at Edge House today, and were sad to leave our little home.  We are heading out to the villages and our internet connection here is slow - we will add more pictures to this post when we get a better connection!

Posing with Nasa right before we left!

The resected mandible and the wire they were reconstructing it with!

Oral Surgery - Uganda Style!

When we came back from the internet cafe, and blogging, we got a phone call from Ben saying that our bags had FINALLY arrived! WAHOOOO! We ran down to the local grocery store (the designated meeting place), and waited eagerly as our driver opened his trunk to reveal our long awaited luggage......one bag. And it happened to be one with NONE of our clothes in it. -_-

After we finally recovered from our dissapointment, Ben took us, Ellie and Deria (the "white girls") out to a traditional Ugandan meal.  We had beef in a peanut sauce and chicken both slow-cooked in banana leaves since 5AM.  Ben made sure to get us "all the food" (arrow root, plantains, sweet potatoes, casa root, and rice) and even pineapple sodas to go along with.  It was very good but way too much food, we haven't developed an "african appetite" quite yet.

Us wondering WHAT we he was going to unwrap.

Chicken with all the foods.

The next morning we started the day with rounds in the hospital's oral surgery ward.  We checked on several patients recovering from surgery with Dr. Gonzaga and surgical interns.  We got to see some really intense injuries from gun shots, hammers, and dental abcesses as well as some incredibly progressed ameloblastomas and cysts related to dental infection.  When rounds were finished we grabbed coffee and bananas at the medical student Cantina and then headed to the oral surgery clinic. 



Katie drinking TONS of water.





Dan and Marc enjoying sugary Mt. Dew and Coffee



In the clinic, we worked with surgical interns and Dr. Gonzaga to extract teeth and biopsy several lesions. The clinic was very intense for us as it was most of our first encounters with trauma repair, and the lesions that we encountered were severely progressed.  Dr. Gonzaga made sure to explain things very thoroughly to us and let us examine each patient ourselves.  Dan even got to snip some sutures! The one case that stood out for us all, among all of the crazy things we got to see, was a four year old with a golf ball size cell carcinoma lesion on his cheek.  Since this is an invasive condition, they were planning to remove only the external growth and then move onto chemotherapy treatment. We also saw a 15 year old ameloblastoma on an elderly man that was about the size of pineapple!!!



Katie examining the15 y/o ameloblastoma



Marc examining an inflammed saliva gland

Dan & Katie attempting to come up with a diagnosis.

After grabbing fried "Ugandan meatloaf" (as described by the Ugandan dental students) for a quick lunch - not our favorite meal - we got to go to the computer lab and check out facebook while our hosts studied a little bit. We headed home to relax, stopping by the grocery store for some milk and oreos first, and then enjoyed the last night with out "house family" - we even got to see the Ugandan version of karaoke....which was a really awesome M.C,/lip syncing/performance contest and went to sleep....dreaming about the clean laundry in our luggage.

Marc homesick for WING STOP!

Nothing like oreos and a bag o' milk!!

Welcome to Uganda!

We made it!!! We arrived in Uganda around 8 AM on Tuesday morning (it is Wednesday for us now) withOUT our luggage.  We followed an entire FLIGHT who lost all of their luggage, so needless to say we waited at the Luggage Services office for quite some time.  A driver was awaiting our arrival and we took the hour long drive from Entebbe to Kampala and went straight to The Edge Guest House where we are staying.  The Guest House is similar to a hostel and we are staying with some amazing and helpful international students.  They have all been here for at least 2 weeks and are very comfortable getting themselves (and us) around the city.

As soon as we arrived, we changed into scrubs and a medical student came to give us a walking tour of the University.  Heavy scrubs may not have been the best idea, as it was very hot on our first day and Mulago Hospital is about a 25 minute walk from the Guest House - ALSO, people don't really wear scrubs here so we looked pretty ridiculous, a kid told Dan "you look WEIRD".  Kampala is a bustling city full of people - the hospital really reflects the level of need in the area and we are glad to be here to help.  Mulago Hospital is the largest public hospital in the country and patients are referred here from all over the place.

Dan, Katie & Marc in front of the Dental Clinic

We finally got to meet with our contacts - Susan, Annet, and various others and were introduced to a dental student, Ben, who took us for lunch with "the white girls" (the Swedish exchange students staying in our house) at the student cafeteria.  They were serving local foods - rice, beans, and posho-a local cornmeal style starch...for 200 Uganda Shillings, which is about....8 US cents.  We have been called "muzungu" millions of times (which means "white" and/or "someone who roams around aimlessly") and the little girls are loving Katie and her blonde hair. After our tour, we got to take a nap and then decided we needed to wake up and mingle with the housemates.  They took us out to eat at a great Italian restaurant, negotiated our cab fare, and introduced us to Kampala in the evening.



Dan, Dr. Annett Kutesa, & Marc



This morning we got our first taste of the dental clinic.  We sat in on a group-style Perio discussion (very similar to what we had in class this summer but less chaotic and detailed) focused on the effects of nicotine/tobacco.  Then we attended the Perio clinic and each got to see patients - some with mild sensitivity, and some with VERY VERY extreme perio needs who were there for extractions.  We loved the openness of their clinic and the group involvement during presentation and discussion of patients. 

The dental students took us to lunch after clinic at the student cafeteria again, and today we got to try the pineapple and avocado - DELICIOUS!  We are heading back to our house and might explore the city a little on the way back. 



Dan & Katie with 2 Final Year Dental Students in the cafeteria.



The Incredible Journey



Marc, Katie, Dan & a car FULL of luggage.


After much confusion, many delays, lots of layovers, and eating goldfish/pretzels for dinner - we have officially left the country!!! Instead of our original plans to have a layover in Cairo, we ended up coming through London - excited that we would be able to have time to do some sightseeing and check out some of Olympic Park, we welcomed this change!  Unfortunately - our 11PM flight remained on the runway until 3AM and we don't have quite enough time to make it to the city center.  We made the best of the situation, checked into a hotel for some showers and pillows, and stopped by a local pub for some DELICIOUS fish & chips and cider.

Our little corner of London

 We are looking forward to waking up in Uganda tomorrow morning, checking out our hotel there and getting started with a tour of the facilities at Makerere Universty at noon. At this point, our only concern is WILL OUR BAGS (full of dental supplies/socks/bug spray) MAKE IT TO UGANDA!?! Check back later in the week to find out!