After a very brief stay in Tororo, I was transferred to Kapchorwa Hospital. Kapchorwa is in the eastern part of Uganda and is located at a height of 6,000 feet above sea level. The beauty of the lush green mountains is breathtaking. The air is cool and crisp almost all the year around. I still remember vividly the red earth that stood in stark contrast with the lush green mountain slopes. Kapchorwa is in the Mount Elgon region of Uganda, a massive volcanic mountain that borders Kenya. Kapchorwa is home to many indigenous tribes, most notably the Bugisu tribe, that were still very traditional in those days.
It was here in Kapchorwa that I saw the beginning of the biggest upheaval in the history of Uganda. The brutal dictator Idi Amin took over the reins of Uganda on 25 January, 1971, in a sensational coup that took place while President Milton Obote was attending the Commonwealth Heads of State conference in Singapore.
On the same day, I was summoned to attend court in Tororo in a medico-legal case concerning a patient I had treated while I worked there. The matron of the hospital dissuaded me from traveling to Tororo as it might not be safe. She was quite careful in using the words of caution regarding the events unfolding there in Kampala at that point of time. Somehow I was made to understand the gravity of the ground situation.
Eventually I sent a radio message (these were the days when you used Ham radios for long-distance communication) through the kind (and understanding) police there regarding my inability to attend the court on some vague pretext.
Over the next few months I had the chance to meet Uganda's most brutal dictator (some call him butcher) in person. Idi Amin visited Kapchorwa a few months later. He was traveling around Uganda telling people his reasons behind the coup. I had a close look at him, while I sat a few feet away from him with other town functionaries on the dias. He and his reasons seemed so genuine at that time.
Kapchorwa had a salubrious climate, which I enjoyed for a year. In those days there was no electricity in the town, but it didn't bother us much. The hospital did have a generator but we had to use paraffin lamps at home. Here I was completely on my own, the only doctor in a 60-bedded hospital. There was no one like Dr Gosavi to turn to in an emergency. I had to manage everything alone with my little acumen for almost one year, June, 1970 to May, 1971. There was no radiological facility, so for X Rays I had to send patients to Mbale Hospital, 32 miles away almost once a week. Referrals were also made to Mbale Hospital.
One morning I received a patient and one look at him left me dumbfounded. None of my textbooks in medical college had prepared me to handle arrows. The patient had an arrow piercing through the epigastric region (upper abdomen). As the patient was lying on the stretcher, the arrow stood stuck vertically. It was the kind of thing you'd probably see only in movies.
My first reaction was that perhaps it could be pulled out. But then it dawned on me that the structure of the arrow could do more harm on its way out. I asked the anesthetist in the theater to explain the structure to me. He illustrated with a diagram that the arrow had a set of fangs on two sides, hence pulling out would mean more damage to the tissues or organs. It was illuminating to me and I patted myself on the back for not taking quick action without understanding the full import of the situation.
Eventually I had to make an incision at the entry point of the arrow in the epigastric region just to widen the approach and visualise the fangs directly and gently remove the arrow without hurting tissues or internal organs any further. I inspected the inner tissues and stomach which were okay. Then I sutured the wound, and kept the patient on intravenous fluids and nil food by mouth for two or three days. He recovered well and was later discharged from the hospital in a satisfactory condition.
This patient also taught me something -- something I couldn't have learnt if I was working in a big city hospital -- and I felt hugely rewarded when he recovered.
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