Here's a quick report about today.

Two of my colleagues and I went to a clinic called Alive Medical Services.  It's supported by a variety of sources including the Ugandan government and Alicia Keyes.  It's in a neighborhood where the main road has about 5% of its original pavement and some of the the biggest washed out potholes I've seen in a residential area.  Three blocks away are the slums that are ubiquitous here in Kampala.  To compare the slums here with my only other reference point for slums, the slums of Buenos Aires ('villas de emergencia' or just 'villas') take up relatively small pockets of the city.  In Kampala, the majority of the land is taken up by slums. 

The facility is quite nice in absolute terms, even upscale by Ugandan standards, and the surrounding neighborhood has what I would qualify as upper class homes.  There are about 10 consultation rooms for outpatients and about 5 inpatient beds.  Patients can present to the clinic 24 hours a day.  By far the main focus of the clinic is management of HIV and its associated complications.  To give you an idea, I saw two kids, 5 and 8 year old boys, and their father who are all HIV positive.  The mother is also HIV positive and had active tuberculosis recently and now the 5 year old has a cough and junky-sounding lungs (or crackles and rhonchi to be precise).  According to the doctor I was working with, he should have been on isoniazid prophylaxis as soon as the mother was diagnosed.

One interest thing to note is that here the HIV serostatus is always mentions in the opening line of the history of presenting illness.  And they often refer to HIV as ISS, a euphemism that stands for immunosuppressed syndrome. 

Probably the most memorable event of the day was the trip to the neighboring slums.  Two women who work for the clinic and live in the slums took us there to show us the "neighborhood".  As we walked, the kids often smiled and waved at us and came to shake our hands.  Occasionally we heard the word Mzungo, which referred to us.  We visited a hairdresser's home and got to see firsthand what it's like in one of these homes.  This particular one was made of wood rods tied together with mud or stones filling in the spaces.  Some walls were sheet metal.

There's much more to say, but I'm out of time so I'll have to fill in details later.