Day 17

Our last day in Uganda (can't believe it). Even Christopher says the time has gone fast.
We have the most incredible and amazing morning. We have attended the Easter Sunday service on Condemned (death row). This is probably the best experience any of us have ever had. We were given the opportunity to speak and it was a great honour to be able to do so. We have really been embraced into the 'condemned family'. These men consider themselves to be our brothers and treat us with such respect that we feel so very humbled.
This morning I was greeted by a 19 year old called Nicholas who had made me a present. He spoke no english and everything he said had to be translated through an interpreter. Anyway, he presented me with a leather wallet that he had made and decorated himself (last night), on it he had embroidered 'Catherine you mean so much to us' - so, yes you guessed it - I cried.
Then Ambrose, who I had spoken to yesterday came and presented a card that he had made from the Fine Art Club, to say thank you for all we had done. Oh dear - I cried again!
Honestly, I feel so small compared to these men who are so inspiring and motivated.
The service was just fantastic we sang 4 songs with them and were able to harmonise with their brilliant harmonies. The hymns were:
Man of Sorrows
What a Friend
Amen (Just like we sing it in choir)
This is the day
There was clapping and jumping and dancing - what I find amazing is how these men, condemned to die can be so full of praise and thanks to God. Wow!

So, we have achieved a lot in our time here and also learnt a lot. Its been inspiring and incredibly motivating for all of us.
At times we have been frustrated because we haven't been able to do all we wanted but then doors have opened that have given us different opportunities.
We have spoken to many people about palliative care, their needs and experiences. We have trained prison guards and prisoners in order that they may now spread their knowledge to others.
We have spent time doing art and music.
We have visited health establishments, large prisons, small prisons, mens and womens.
We have travelled to the north of this beautiful country, to the east and to central regions.

All of feel us privileged to have this opportunity and cannot wait to come back to see our friends. Thank you to all of you who have communicated with us while we have been away or who have prayed for us and given us encouragement and resources and equipment to bring with us. We shall see you all in the UK very soon and apologise in advance if we bore you with our stories.

Lots of love

Catherine and Christopher xx (Sorry about the hair - it is rather breezy!)

Day 16

Amazing and completely humbling morning.
We have spent some hours today in the Condemned Section (Death Row) at Luzira Prison. Completely humbling because the inmates had been told we were coming and were waiting to greet us with real excitement. Something that obviously doesn't happen all that often!!
So, Jackson, Patrick, Ambrose, Stanley, Christopher, Julius and  Francis have just topped our stay in Uganda with their welcome and enthusiasm at seeing us again. Since we last visited them, several of their number have been released or transferred to other prisons, which, of course, is the most incredible thing. They have also undertaken several courses of study including business studies, book binding and law. Its incredible how they do not sit around even though they have been condemned to die. This morning there was group counselling where the inmates were being encouraged to talk about their feelings and what could be done to help them. I was fortunate enough to have the time to advise and give information to Francis regarding nutrition in HIV/Aids patients. Plus, I had a long discussion with Stanley who, before he entered prison, had been plagued with migraines. Interestingly, since he has been in condemned, he has had no migraines at all. He puts this down to the family atmosphere and having time and encouragement to complete studies and activities that he didn't have the opportunity to undertake before. Its hard to believe, if you haven't been there, the atmosphere and the camaraderie that exists in such a place. Their living conditions are very difficult, so cramped, 3 toilets to 300 men, the washing facilities are a tap on the wall and there is only one meal a day. But this is the most genuinely friendly and welcoming place that I have ever been to. It a place that stays with all of us in our hearts wherever we are.
In the words of Ambrose - condemned for military underperformance - 'Every cloud has a silver lining and I have found my silver lining here. Learning new skills and being given opportunities that I didn't know existed.' - Wow - how fantastic to see the positive in such a situation.

I am now getting a little worried that some of the people I have spoken to here have the gift of prophesy. I had sort of forgotten that the Rev Fred had suggested I buy land here and become a banana farmer, until this morning when one of the condemned prisoners suggested the same thing. Now strangely, for the first time ever, I have managed to get a tan - the prisoners suggested that because I was looking more Ugandan, I should move here and buy land and farm it - WHAT IS GOING ON!!!!!!!!! It looks like I am destined for great curved yellow things in life!

Tomorrow - Easter Sunday - and we will again be on death row to celebrate with them at the morning worship service. This is so poignant and will be a truly blessed day for us.

I am not so sure how blessed the goats and the chickens are feeling though. Tomorrow they will be accompanying us and will be facing the death penalty! I am just hoping that we are not the ones to perform the execution. We are also taking with us sacks of onions, tomatoes, millet flour, rice and
pineapples - I feel like some sort of derranged Delia Smith!

                                          Mmmmmm - Stew!

Tomorrow is our last day here. I cannot believe how fast the time is going. I hate to declare this but we are all, already, really looking forward to coming back again!

One more blog tomorrow.

Lots of love

Catherine and Christopher xx

Day 15

Yesterday we met some really interesting people. Professor Jenny Hamilton was here from the International Distance Learning programme at the University of London. When we were here in Uganda last August we brought with us application forms for distance learning programmes from all sorts of places. Since then one of the condemned prisoners has signed up to do a law degree via the University of London and Jenny had come out here to meet him, bring some books and generally offer some support. I so admire this mans determination. In the evening we had dinner with his wife who has been supporting him and trying to get his case to appeal for the last 10 years. His story is awful - having been framed for a crime he didn't commit. Even though the authorities are aware of who did it (this other man is on the run) they have little evidence. In the meantime he is studying law in the hope that it will benefit his own case and that of other prisoners - amazing!

The neighbours children yesterday, fascinated by the Muzungus (white people) sitting on the balcony!

Today, we have had a really interesting and productive day (not that all the others haven't been of course!). We again visited Murchison Bay Prison Hospital to carry on our discussions with the medical staff there regarding the provision of palliative care. The staff are very frustrated and, in their own words, stressed. They understand the concepts of palliative and holistic care but just don't have the first idea of how to put it into practice. They have little or no support and find caring for dying patients very stressful. They often have patients who die in a lot of pain as they don't how to help them. Nutrition is non existent - the patients diet consists wholly of beans and millet porridge. One of the nurses explained her frustration at trying to get that down a naso-gastirc tube!!! From my own experience I would say it was practically impossible, yet they water it down to try and get something into the patient. There are little resources yet they are very proud of their hospital. It is neat and tidy and very ordered.
Prisoners die in Murchison Bay Hospital all the time, usually from illnesses such as HIV/Aids and Cancer. Often their symptoms are not addressed and this is basically down to a lack of knowledge.
Today, there were two nurses on duty for the whole hospital (122 patients and an outpatients running) and three doctors.
We spent some time with them going through our workbook and palliative care toolkit and explaining how to undertake a holistic assessment of a patient, for which they were so grateful. Again, it is only a small beginning, but the idea is that they start to impart their knowledge to the carers and attendants on the wards, so that gradually, what is a new concept and way of working, will become 'the norm'.
It makes me so grateful for where I work. We have so much, compared to their so little.
We should be very thankful.

Condemned Section (Death row), Luzira Prison - where we will be spending Saturday and Sunday.

Tomorrow and Sunday we will be spending our time in the Condemned Section of Luzira Prison.
The prisoners have been told we are coming and are excited by the prospect!!!!!
Rather scarily (!) 14 chickens have just been delivered which are dinner for the prisoners on Easter Sunday. Apparently, Christopher, Daphne and I have to take them with us to the prison tomorrow. Oh, did I mention that they are still alive?!!!!!!!

Easter Sunday lunch for the prisoners!!

Lots of love

Catherine and Christopher xx

Day 14

Last night in Kampala - so beautiful.

Another exciting and varied day today!
We had to travel into Central Kampala this morning as we had a meeting with Mrs Nanfuka of the Ugandan Prison Service. She is basically the lady who will allow certain things to happen in the prisons or not. We had to talk with her about why our permission letters had taken so long and the importance of our work here. It was a good meeting and she now recognises and understands the importance of palliative care for prisoners with life limiting illnesses.
On the way there we encountered yet another so called 'peaceful' demonstration. One of the MPs had decided to walk to work in protest of the high cost of transport. He was tear gassed and arrested by the police and has been thrown into prison. Seconds after we had let the area the police let off many tear gas cylinders and two people (we believe them to be police) were killed. Much of kampala has been tear gassed today - but we are still safe and well. It seems we are managing to dodge the trouble spots but only by the skin of our teeth!

Following our meeting with Mrs Nanfuka we went to visit the medical staff at Murchison Bay Prison Hospital. This meeting was to introduce ourselves and to discuss their palliative care training needs. Tomorrow we will be training some of the prisoners who act as Ward Attendants in the care of patients (other prisoners) with end of life needs. We were introduced to a male patient with a suspected brain tumour, who is blind, partially deaf and has a severely misshapen skull due to the enormous mass that is sitting to one side of his brain. The staff are unsure how to care for him and are seeking our support and help. This is just one example of the role of the African Prisons Project in healthcare in prisons, so we will be able to do some theoretical as well as practical training.

This afternoon the APP Palliative Care Committee (Daphne, myself and a british doctor called Hannah) met to plan a needs assessment in prisons across Uganda. This is an exciting opportunity to influence and develop palliative care provision across the country and we are looking forward to developing a robust action plan that can form part of both the Prison and Healthcare strategies for Uganda.

Artwork from Luzira Womens Prison - session co-ordinated by Christopher.

We are still having an absolutely amazing time. But are missing certain things from home - of course friends and family; but we are missing chocolate so much. One of the house staff has just ventured out to buy us some!! We were beginning to dream of chocolate (so sad and just so predictable).

Take care everyone.

Catherine and Christopher xx

Day 13

Well, I cannot believe we are Day 13 already - so much has happened and we have been involved in so many things.
So, this morning we went to the Luzira Womens Prison. Last August we visited there to take the knitting group (!!!) but this time we took an art class which somehow turned into a music class - well you know me, always take an opportunity to start a choir!! It was fabulous - approx 60 women in the class. The prisons here all encourage education at every level, from primary to university standard. The education system here is very different from the UK. For a start you have to pay, so if one year you cannot afford the fees it means that school year is on hold until you can. Of course, some people can never afford to go to school at all. The class we took this morning was at Primary levels 1-6. The women were so receptive, keen to participate and very motivated. Just because they are prisoners doesn't mean that they just sit around all day - they are desperate for things to do and getting an education that they have missed out on can be very important.
Our class was mixed with prisoners of all ages and all levels of conviction from remand, those with short sentences, those in for life and those condemned to death. The art went very well and we have some amazing pictures to bring home for our exhibition in the summer.
If a women has a child under the age of two when she is admitted to Luzira Womens Prison that child is admitted with her. Currently there are 10 children and we met a very gorgeous little girl called Linda who quite happily participated in our class.
Now, I am sure that teachers in the UK do not get asked to sing to their students whilst they are busy working - but we did. Christopher was a bit mortified but soon got into the rhythm! It was amazing to sing with these women whose harmonies are so beautiful.
Daphne and I also managed to spend some time talking to the O.C (Officer in Charge) about Palliative Care and explaining our training manual. This was a very beneficial meeting as this was the first time anyone had gone in specifically to discuss what happens with their dying patients. She was so grateful that she almost grabbed my hand off. So training is now set up there for medical staff, warders and prisoners which is wonderful and a great step forward.

I tried to put a picture in here of a piece of the artwork from the prison but unfortunately it didn't work - sorry!

This afternoon we visited Kigo Womens Prison to deliver art supplies to them. Over the next few days they will also be completing pictures for our exhibition. Kigo is a very small prison with only 46 prisoners, including 4 children. The atmosphere there is very different as most of women also work on the prison farm. This can mean that they are very tired a lot of the time, so it will be interesting to see what their pictures are like.

Hope you are all well.

Catherine and Christopher xx

Day 12

Wow - sometimes we think we are too busy and/or short staffed to cope with the amount of work we have but today we have spent the morning working with 'The Aids Support Organisation' (TASO) in Kampala. One clinic this morning - 250 patients booked in and another 30 who turned up on the off chance of being seen. No-one is turned away so everybody gets an appointment!!
In the early 1980's there were 38% of the Ugandan population suffering from HIV/Aids. That is now down to only 6%, however that percentage hasn't changed for the last 4 years. It seems that Ugandans have become complacent about the disease, not fearing it so much, as treatment is widely available and the stigma of having the virus has largely been eradicated.
TASO is an incredible place, people were absolutely everywhere, waiting for blood tests, then to see the doctor, then to have counselling. People on benches, on beds, on the floor, on the grass. 2 nurses, 2 doctors and 4 counsellors.
But, people were happy to wait as they knew that would be receiving good care and advice and free treatment. This service is set up primarily for the poor. Rich people can get treatment easily in one of the many private clinics.
It was a fascinating morning, we learnt much about the development of the virus in Uganda, its treatment and how treatment can be accessed by people in the remotest tribes. TASO has the main clinic in Kampala and then 10 other satellites around Uganda.
More importantly though we managed to get a good link to the World Food Programme (WFP) and as a result of that contact and in my capacity as a Palliative Care Advisor to APP, I have now applied to WFP for access to food for prisoners who are suffering from HIV/Aids. At the moment the prisoners in the condemned section have just one bowl of food (maize porridge) per day which they then try and spread out across three meals. It is not nutritious and doesn't help in the recovery from illness or wound healing, which as most of us know, requires a good healthy diet. So, hopefully we will get some results/advice from this application. It would be an amazing development and improvement for the prisoners if it were to happen.

Well the good news is that our permission letters have finally arrived. Tomorrow we will be in Women's Prisons all day (Luzira in the morning and Kigo in the afternoon). Christopher will be undertaking art with the Women and Children and Daphne and I will be training and discussing issues around palliative care.

Fortunately for us all, a much more peaceful day (no tear gas or bullets) - Thank You God!

Kampala yesterday evening - a sign of hope and promise.

We have sent many messages to our friends in the UK but it appears we are unable to receive text messages back. If you have texted us - please don't be offended if we haven't replied. We are, however, receiving e-mail, can access facebook and can see comments on the blog - it would be so good to hear from some of you.
We are missing you.

Catherine and Christopher xx

Days 10 and 11

So, how has your day been today? Normally my day is very run of the mill. Most things that happen I am expecting to happen. When the unusual occurs it is really not that unusual.
Yesterday, for example, was exactly as we were expecting it. Fairly relaxed, doing some work on the creation of a set of quality standards for the African Prisons Project - sounds like any normal day at Fair Havens really. Audit, statistics, problem solving, risk assessment - my life!

Apart from the current protests about price rises, Uganda is normally a very peaceful country. It has a real beauty about it. The people are happy and friendly. It's safe.

Today, we set off to go to the Joy Hospice in Mbale near to Jinja. The first 15 minutes of the journey were great ...........
Firstly, we heard people shouting, then vehicles racing in the opposite direction, people running and pouring water over their faces, shots sounding - a tear gas attack had happened in the road literally 10 cars in front of us. Robert, our driver, swung the car around and drove so fast out of the area that we were pinned to our seats.
So, determined not to be put off by a bit of warfare, we decided to try another route .......... same thing again! Another route ........... same thing, more tear gas, more shots. Four times, we tried to get out of Kampala but to no avail.
Our poor driver, desperate not to let us down tried every route he could think of. Although at one point I do believe Christopher was quite excited at the prospect of being tear gassed!! Sad boy - obviously doesn't have enough excitement in his life!
We have driven through slums high in the hills, where women were earning tiny amounts of money by breaking up stones from the quarries. Children had no clothes. People living in mud and cow dung houses, with only a tin roof and a curtain for a door. The smells were awful. There were roads that I wouldn't have risked taking my 4x4 down, yet we drove down them in a small toyota corolla (bit bumpy). Needless to say, we eventually had to make the decision to go back to Kampala
We are very lucky - God has kept us safe today and has shown us how fortunate we are to live where we do. That we have nice, safe homes, clothes and plenty to eat. That we have good jobs / school and lovely people to work with. Wonderful friends. We are so fortunate, we don't deserve to complain about anything and we shall certainly think twice before we do in the future. Whilst we are doing this blog (back at APP house), there is smoke rising in the distance and sirens have started sounding, so it may all be getting closer. Oh well - time to close the windows!!!!

Lots of love

Catherine and Christopher xx

Sorry no piccies today - had to keep the camera safely hidden!