How a late change of plan saved our lives

SUNDAY, July 11, 2010, and World Cup fever grips the globe. Football fans gather in front of TVs in houses and bars, and before large screens in parks and squares, to witness the final showdown between Spain and the Netherlands. Among them is Stacey-Anne Penny, a nurse from Suffolk who’s been in Uganda as a VSO volunteer for a little over a year. Truth be told, she’s not that keen on soccer, but the passion for football there runs deep. “Everyone said ‘You’re in Africa. You’ve got to come out to watch the World Cup Final,” she remembers. Her friends make their plans to view the game on a huge screen at The Ethiopian Village, a restaurant/club in Kampala, the Ugandan capital. In the afternoon, however, there’s a change of plan. The party includes some Dutch friends and, with the Iguana Bar across town being Dutch-owned, someone suggests congregating there instead, as the atmosphere will be rocking. The Iguana it is.

Stacey and one other person find themselves the only two supporting Spain. “All of a sudden the lights go on and a very calm person asks us all to leave. We get outside and then have a phonecall from a friend, saying bombs had gone off. One of the bombs was in the bar we were supposed to be going to . . .”

The suicide attacks on The Ethiopian Village and a Kampala rugby club, where crowds are also watching the game on TV, leave over 70 people dead and 70 more injured. Responsibility for the bombings is claimed by Al-Shabaab, an Islamist group striving to bring down the government of Somalia. The attacks are said to be retaliation for Uganda’s support of an African peacekeeping initiative in Somalia.

The immediate aftermath sees Kampala vibrate to the sound of sirens. A chaotic place at the best of times, moving around is difficult.

One of Stacey’s friends works at the International Hospital in Kampala, reports that it’s inundated with casualties, and says she is going in to help. Stacey volunteers to go too, “but not before sending emails home (to Britain) to say ‘When you wake up tomorrow, you might hear there have been some bombs . . . I’m fine . . .’”

They reach the hospital at about 1am. Intensive care is the section under most pressure, Stacey is told, so she reports there. She’s never been in this hospital and doesn’t know where anything is – and, in any case, equipment is limited. But, in an emergency, it’s a case of doing the best one can.

“There were people everywhere,” she says. “The car park was full of relatives wailing. It was an unbelievable environment.”

Stacey found herself looking after a casualty called Francis, a 28-year-old Ugandan, who wasn’t breathing well at all. “I won’t go into lots of detail in case you’re squeamish but I kept suctioning out things from his throat. He was rattling. His saturations – the oxygen in his blood – were dropping and he was in a pretty bad way. But then everybody was in a bad way.

“When an ENT (ear, nose and throat) doctor got round to him I said ‘Something is seriously wrong here.’ He said ‘Yeah, we need to do a tracheotomy; we need to open his windpipe, and open up his chest a little bit.’ He was going before my eyes. I said ‘I’ll prepare him for theatre.’ ‘Well, the theatres we’ve got are completely overflowing; we’ll do it here.’

“So we did open-chest surgery at the bedside. Halfway through, the oxygen cylinder ran out and his oxygen levels plummeted. ‘Where’s some more oxygen?’ ‘There isn’t any.’ OK . . . which are the two most stable patients? Give me one of theirs and they can share the other between them.’

“It was probably one of the longest nights of my life; but I’m very glad I went.”

Francis survived those dark hours, though he was left a paraplegic because of his injuries and spent three months in intensive care. Stacey visited him regularly and they formed a close bond. When she flew back to England last November, leaving him was the hardest thing.

Sadly, he died in December.

Stacey had long been interested in a placement with VSO, the independent international organisation that deploys volunteers to fight poverty in developing countries, but the then need for a two-year commitment was a barrier.

After the rule was relaxed, meaning volunteers could go abroad for a year, she applied. “When my husband and I separated I thought ‘OK, this is my time to do what I’ve wanted to do.’”

What was the appeal?

“I love to travel. I love adventure. I love to see how people live – and push the boundaries a little bit with my own skills and comfort zone. I’d mainly travelled within holidays, but I did take six months off about eight years ago and did a world trip.

“At that time I did think I’d like to do a bit more than just visit places; I’d like to be immersed in a place for a while and take time out of my culture, my space, my life, and appreciate somebody else’s. And if I could do something worthwhile, then that would be a bonus.”

There is a rigorous interview process, to make sure potential volunteers can cope with the environments and situations they’re likely to encounter.

Stacey, 44, also knew what she needed: other volunteers within reach, for support, and a place where English would be widely spoken in a nursing setting.

“It’s not like going to the shops for a pint of milk,” she smiles. “You’ve got to get things across like ethics – quite involved things.”

For that reason she declined places in Cambodia, Indonesia and Malawi. Then in February, 2009, VSO suggested Uganda from that June – which gave enough time to rent out her home, farm out the dog and organise 1,001 other essentials.

Stacey manages the community nursing team in the Woodbridge area and was granted a year’s sabbatical by employer Suffolk Community Healthcare – an arm of the NHS. It said she could return to her old job. “I wasn’t expecting that, so I was very grateful. They’ve been fantastic – really, really supportive.”

Deciding to go “was exciting, but it was quite frightening to leave everything behind: my dog, my car, my house, my friends, my job”.

There was a nightmare journey. Someone tried to steal her luggage, seeking a bribe to give it back, and at Kampala Airport she couldn’t find anyone to meet her . . . until realising there was just herself and a man left waiting. He was looking for three girls: Stacey, Anne and Penny!

She initially spent time with other new volunteers on an induction programme, and at the end of the week was picked up by representatives of the 80-bed private hospital where she’d work.

The traffic was chaotic, obeying no obvious rules, the potholes deep and the red dust and pollution choking.

There was an early indication of how different life could be compared to IP12 when the car was stopped by a “quite aggressive” police officer seeking a sweetener. Stacey was shocked by this taste of corruption, but the general manager from the hospital dealt with it and laughed it off.

“In the end I learned it was part of society there. The police are not paid very much, and they’re not paid very often, and they have to eat. So I didn’t come to resent it. I just kept bribe money in my car – and paid. But I felt very uncomfortable about that at first.”

The apartment to which Stacey was taken was nice – with a balcony overlooking banana groves – but contained nothing apart from a bed, chair and table. No sheets, blankets, cups, knives or forks . . . So off they went to a supermarket to fill a big trolley with the essentials!

Back to the flat at 11pm. “I just sat in the middle of this apartment with all this stuff around me. I did feel a bit overwhelmed, and I phoned my best friend, who’s been tremendous. I said ‘I’m here and I’m all right . . .’ And my friend said ‘You are all right. I can hear it in your voice. You’ll be fine.’”

The following day Stacey was shown how to reach the hospital by public transport. “Now that was a nightmare! You had to get three little minibuses. They wouldn’t be roadworthy here. They’re called matatus and they cram people in, there are no proper seats, and the whole of humanity is stuffed into these matatus!

“I felt I had to be quite smart at the hospital. They’re very image-conscious (Ugandan people). The girls were living in slum housing, with no water and no electricity, and they would turn up for work immaculate. How they managed it I will never know. So right from day one I wanted to present a smart image: ‘If I want to increase these women’s (nursing) professionalism, it has to start with me.’

“I remember, the first day, getting into the matatu in this white linen dress – ‘Girl in Africa! Yes!’ – and getting there like a damp dishcloth with smears of red earth all over it! This person had a chicken that had been on my lap . . . Nightmare!”

At the hospital, the forward-looking owner wanted to improve the nursing department by drafting in a volunteer who would introduce proven management techniques from the West.

Stacey wasn’t quite sure what was expected of her at first – the hospital saw her as director of nursing! – and there were some very moments of soul-searching as discussions went on to define her role. (More about this in Part Two next week.)

They included a heart-stopping moment when a senior member of staff warned “It’s me or her” . . . and lost!

Fortunately, life settled down and Stacey has an overwhelming store of positive memories to look back on, as a real team effort saw nursing care and management improve no end.

Those first three months were tough, however: trying to find her niche within the hospital and going home to an empty apartment. “You have to be quite strong and self-motivating.”

After a month she was invited across town for a weekend with another volunteer, and from that point her social circle grew. Things improved further when she moved closer – to a house on the edge of a slum. (Volunteers enjoyed teaching the locals to play netball!)

When it rained, sewage flowed through the streets and disease was a real danger. “The first week I was there, three people died of cholera in the area, so I had to be pretty careful . . .” With the dust in the air proving an irritant, Stacey picked up lots of sickness bugs, flu and chest infections – but, thankfully, nothing more serious. Back in England for nearly 12 weeks now, she reflects on her 16 months in Uganda – the initial year was extended to pursue a research project – as “such an adventure”.

“I don’t want to come across as altruistic,” she stresses. “I did this for me. I wanted an adventure, and I had one.” Of course, she also was keen to use her skills to help people, and is happy she achieved that.

Stacey met a man in Uganda who is a trustee of a charity helping to give children an education. He’s become her boyfriend and they’ll be visiting Africa in the spring.

She’s nearly settled back into her former life, though Uganda is frequently in her thoughts – “and then sometimes you can get caught up in stuff here and think ‘Did I really do that? It seems like a dream . . .’”

She admits missing the spontaneity of life in Africa, its less-materialistic values and preoccupations, the warmth of the local people and the easy camaraderie of a volunteer community.

“In Uganda, however bad it is, people smile and laugh. That doesn’t mean they’re not hurting inside – it doesn’t mean they’re not cold or hungry or upset – but they’re able to look beyond their circumstances, often, and still smile.

“I think people here are often just very miserable, and they don’t need to be very miserable! We don’t need four televisions – one in each room for all the children. We don’t need three cars in the drive, and we don’t need 17 kinds of pasta. We really don’t.

“I’m a bit of a princess. I like my frocks; I like nice bubble-baths and things. Friends said ‘You’ll be back by Christmas.’ But it was fine. Put your mind to anything and you can do it. You don’t have to wear khaki to save the world. You can do it in a pretty dress!”

Stuff about Stacey

Stacey-Anne Penny lived in London until the age of eight

She went to school mostly in Wiltshire and trained as a nurse in Swindon in the late 1980s

She’s lived in Suffolk for the past 16 or 17 years

For a while she worked at Ipswich Hospital, in intensive care and recovery

For the past 15 years she’s been in community nursing

Stacey manages Suffolk Community Healthcare’s NHS service for the Woodbridge, Kesgrave, Martlesham, Orford and Wickham Market areas

There are 28 people in the team, including nurses, physiotherapists and occupational therapists

Community nursuing care involves looking after patients in places such as their own home or a residential home, or a community hospital

In the East Anglian Daily Times on Saturday, February 5:

I couldn’t let little Brian lie dying

Why I had to sack some nurses

A key decision after a day in tears