AN addiction is defined as physical dependence on a substance or activity. I confess to several. The first is sour milk, either on its own or as an accompaniment to fresh mandazis (a type of Ugandan doughnut) and wild honey (we have a productive hive on the farm). The milk is prepared from a neighbour’s cow and has no additives, being dispensed from a large earthenware container. It is not pasteurised, so bovine tuberculosis is a risk. The farmer’s daughter always giggles when I ask if her father’s herd are well, not coughing and otherwise symptom-free.

The diet of our neighbours, the Dinka tribe of South Sudan, has always been based on fresh or sour milk, together with blood drawn off from the jugular veins of their cattle’s necks. This provided sufficient protein and calories when they were nomadic pastoralists but due to the endless and ongoing civil wars, hundreds of thousands of Dinka have now been herded into refugee camps in East Africa, sans milk, sans blood. Whether the World Food Programmes’s maize, rice and flour will affect their towering heights, protuberant teeth or aggressive egos remains to be seen.

The next is groundnut butter, made by roasting the nuts in a wok-like container over the open fire after adding a handful of river sand, then swirling it round till the red skins peel off. The sandless, huskless nuts are then crushed on a grinding stone – back-breaking work – and stored in a clay pot which is sealed. The end result resembles not at all its commercial relation in First world supermarkets, being a dense, deep brown, highly aromatic sludge; two or three teaspoonfuls added to sweet potatoes will sate the appetite till the next morning. While peanut allergy in its several forms is frequent in Britain and a cause of misery to many, both adults and children, I have yet to see a case in East Africa, probably because no additives or preservatives are added to the peanuts.

Simsim or sesame seed butter is even richer than the groundnut version, with a tart taste and no sweetness but rather a hint of the savoury. The richness is such that it often has to be mixed with its peanut cousin to avoid your liver and gallbladder seizing up in shocked spasm.

My third addiction is trimming all finger nails to the quick. This is not a fetish or an obsession, because it serves a useful function, being a necessity professionally. However after decades of scrubbing up for surgery, major or minor, or for delivering babies, you become uneasy, even irritable, if the nails lengthen beyond a certain limit. Until they are attended to, there is a reluctance to expose them in public. A Nigerian colleague who enjoys one-upmanship often produces a smart nailfile when we talk and smiles knowingly when I at once clasp both hands behind my back.

Finally there is kisra, a very thin pancake, made of sorghum, maize or wheat flour mixed with water. It is cooked on a plate-sized skillet over a charcoal fire, each pancake being peeled off once ready and added to the growing pile.The skillet is lightly wiped with groundnut or sesame oil before the next offering is poured onto the hot surface. They are eaten freshly cooked, rolled up with a variety of spicy fillings or used as dippers for mouthfuls of meat, fish or vegetable stews.

Chapatis are much thicker than their kisra brothers, with oil added to the mix. A popular street food, they have saved the lives of many batchelors, especially the ‘Rollex’ (named after the Swiss watch to indicate luxury and wealth) where a beaten egg is poured over the almost-cooked upper surface at the crucial moment. As a connoisseur educated me while eating one in Gulu’s main market, their makers have a vocation, the resulting chapati having a tensile strength unknown to lesser varieties of pancake and certainly not as effete as a crepe.

Dr David Vost studied medicine at Glasgow University and is currently working at a hospital in Swaziland. He and his family live on a small farm in Northern Uganda near the Albert Nile. davidvostsz@gmail.com