Back to auld claes an' matooke

Sunday 10th January 2010

After a great Christmas break, we are back to focusing on what we came to do here. It was good seeing everyone at Reach Out again. Most had gone back to “the village” for Christmas. Everyone seems to have a village of origin, no-one admits to being from Kampala, but while most people still have some relatives there, with the move to urbanisation, there is a gradual loss of connection with their roots and it may be that the next generation will seen themselves as city born and bred with no relatives to visit up-country. Kampala is still quite quiet and the traffic in the morning is very light, it may be because the schools are on holiday until 2nd February. Reach Out cut down its services more over Christmas than before, although there were still clinics for the acutely ill and very sick clients. Surprisingly, the clinics have been quiet this week, the nurses think some people may have travelled to their villages for Christmas and not have the money to travel back.
Bobby is back to being busy working with the IT consultant and the Monitoring and Evaluation Team to get the new HMIS completed and has started generating reports from the considerable volume of data that has been entered over the last six months. He is enjoying exploring and learning about SQL Server while depending on his MS Access to provide users with a more familiar front end to the data.I have been working on analysing data for a study evaluating the effectiveness of an intervention for discordant couples (one HIV+ve the other –ve)  so that I can work with clinical staff to submit an abstract for a big HIV/AIDS conference in July in Vienna. I am also working with another member of staff on another abstract for the same conference about the Prevention of Transmission from Mother to Child Programme. It would be great if they can go. They are all very good and confident at talking and have a charm and grace that I can only admire but writing is more difficult.
My main goal is to set up a collaboration between Reach Out, a local university and a Scottish University, which would provide the long-tern academic support needed to allow Reach Out to take a lead in setting the research agenda. The staff are very keen to use and do research to be able to show the effectiveness of their nurse-led model of care and all the other aspects which makes Reach Out so special. From an academic perspective, Reach Out is very dynamic and ready for change and innovation.
We are also making the research governance more streamlined, and this is particularly important because of the constant stream of students, some local and other from overseas (overseas from Uganda!)  who want to come to Reach Out to carry out research for their dissertations. I am preparing guidance for prospective researchers which we will put on the website to make it easier for them to understand the process involved before they can have access to staff and clients.
We also now have weekly meetings of the Research Capacity Group, and overall there is a lot of research being done, mainly by using data which is collected routinely for the reports which donors require quarterly. With the new Health Management System which Bobby is helping to design and implement, extracting this data should be easier than before.  Given the problems we have had in extracting and interpreting routine data in two recent community nursing studies I think Bobby could maybe show NHS boards how to do things the Reach Out way when he comes back to Scotland.
At the end of the week three members of staff left and we had a very African send-off - they just do these things so nicely. 

One was a long-serving nurse, and the nurses are a great team who recently won a Best Practice Award, so it was a very emotional send-off for Lynn. Towards the end of the ceremony, we were each served a soda (Coke, Fanta etc are collectively referred to as soda here) and a brown paper bag with a vegetable samosa and a bun, to finish off the party in style.
We have had lots of e-mails over Christmas, which we have appreciated, and some have included photos of the snow at home. We realise that the UK is having the worst winter for 50 years and  that the cold spell is far more prolonged than usual. We also read that the UK is importing salt from Africa for the roads - we certainly don’t need it here except for our rehydration therapy. By way of contrast I decided on Friday morning to work outside to get some space to spread out some questionnaires which needed checking before the data was entered. I started out on the bench outside the office but soon became too hot and had to move under the shade of a  large tree in the compound. I did think about the photos and reports in the Scotsman online as I worked – and I know we will dream of this climate next winter. 
It also seems strange sitting on our verandah in the evening with a waragi (gin at £4 a bottle and very acceptable) and tonic watching the birds as the sun goes down and knowing that we will not be doing that next January.