Dry season??

It rained again last night. Apparently, this is still considered dryish. I have gotten used to sleeping through it now and am getting great sleep. It makes a world of difference.

We are a few hours away from the 2011 in Uganda and I’m reflecting on what a wonderful life I have and how lucky I am to have a great family (and marrying into a wonderful family), a good job and great friends. There’s no time like the present to give thanks for the amazing opportunities and wonderful people in our lives. Thank you to each one of you for making my life such a joy.

Happy New Year and I’ll see you in a couple of weeks!!!

Pit latrines

In Uganda, especially in the villages, flushing toilets are rare. Instead, many people use pit latrines. “Pit latrine?” you might ask. Well let me paint you a picture. It is essentially a deep hole in the ground with a wood or cement slab on top with space for you to put your feet on either side of the hole. You squat and do your business in the hole. There are varying levels of pit latrines and pit latrine houses that range from one made out of sticks and banana leaves to brick buildings. Fortunately for us, we have a flushing toilet where we’re staying but I’d guess we’re at the only home within about 25 kilometers that has one. What we’ve discovered through talking with the villagers, is probably about half of the homes don’t have a pit latrine at all. They just walk around and do their business wherever.

So today I had a teaching session with the Women’s Rotary Community Corps (which is actually 10 men and 10 women) and the Youth Corps (they just randomly showed up). We discussed all of the reasons why latrines are important (mostly disease prevention) and how it only takes one person without a latrine to get others sick. As a group, they decided that they wanted to go door to door and talk to families about the importance of pit latrines so I told them that we should role play the visit. I played the part of the resistant villager and a woman from the group set out to convince me. She did a great job and everyone had a good laugh as I tried to get out of making a pit latrine. I used every excuse I could think of including that my husband was very busy and had several other wives that he spent time with so he wasn’t going to be very helpful. Hahaha.

After the latrine talk we also discussed basic hygiene like washing hands, making sure your goats don’t poop near your house and things like that. We ended the talk with some information on nutrition. Most people really don’t have much of a concept of the importance of eating food from various sources. The majority of people here subsist on mostly carbohydrates like cassava, sweet potatoes and mangoes. Vegetables and meat are pretty few and far between. I’m not sure that we made much of an impact in the nutrition area but the seed has been planted I guess. 🙂

On a separate note, I’m beginning to feel much better today. I think the antibiotics in my system are starting to work so I’m on my way to ringing in a healthy 2011!

Almost out of water

This post is from yesterday, December 29th.

It seems that we have nearly depleted the water that our host has in his catchment. Thusly, I am going on 4 days without washing my hair. Yuck. Thankfully, we have plenty of drinking water so that’s good.

There are benefits to travelling with medical people. Unfortunately, it looks like I have developed some strep throat. Boooo. Amongst everyone, we rallied some initial does of Amoxicillin and we’ll hopefully be able to scrounge up some more in the village this afternoon. I initially thought I just had the flu but my throat started feeling strep-ish last night and Joanna- our doctor, confirmed that it looked like the beginnings of strep that probably developed since my immunity was low due to a virus that I’ve had for several days. On the bright side, at least it’s not malaria!

Our visit to the clinic yesterday was a good opportunity to have some perspective on my minor illness. I am so lucky to have medical care provided by trained professionals. At the Health Centre-II, the workers are called community health workers and seem to essentially be equivalent to a medical assistant in the States. They are responsible for providing emergency first aid, basic medical care (giving out pills for common conditions like malaria and sexually transmitted infections) and emergency deliveries for those women who are unable to make it to the Health Centre-III to have their babies. I can’t even imagine having the majority of my care provided by someone with such little training. Joanna was observing and stopped a few instances where the health worker was attempting to give unusually high doses of medication to babies. They have a chart that goes by age but the children here are usually so underweight, the dosing should be modified but the health workers had no idea. One of our team members introduced us to a saying- T.I.A. This Is Africa. When we see the kind of medical care they provide- TIA. When the lights go out during dinner- TIA. When you see a little boy reach on to the ground and eat an ant- TIA. It’s been quite a learning experience.

Last night, we got another driving rain. We are staying in a guest house that has a tin, corrugated roof, so you can imagine the racket. It was coming down so hard that it seemed that if we were to go outside the rain would hurt. It was in the middle of the night so I didn’t get to test my theory. There was some really intense lightening that would light up our room and be followed by very loud booming thunder. I has some ear plugs that one of our team members, Amanda, gave to me. The ear plugs and the Tylenol PM helped so that I actually got some sleep last night. The night before it rained also and I barely slept so I really needed the rest.

Today we are hopefully going to be meeting with a nurse from the Kampala North Rotary club to discuss what she’d like for us to do in our remaining time. Yesterday, we found two health workers who are interested in working at the clinic when we open it and they visited the Health Centre-II in Iringa with us yesterday. They seemed enthusiastic and relatively well versed in the basics. We’re thinking that our time might best be spent doing some training with these women on health outreach, emergency delivery and nutrition. We’re also hoping to meet with the Women’s Rotary Community Corps this morning. The RCCs are collaborative in the village that are informal groups who come together to work on specific issues. There is also a youth farming collaborative and an disabled corps who are working on trying to expand their bee keeping business.

We did some testing at the well and determined that because the people are not using a funnel to fill their jerry cans, it is taking the 2 minutes and 30 seconds per can whereas if they use a funnel, they can cut that time by 1 minute. For people who spend 4 hours of their day getting water, the time savings is a big deal. We’re hoping the Women’s RCC will help us to spread the use of funnels so that everyone at the bore holes will start using them. It’s hard to get people here to do anything new even if it is a simple change. We need to explicitly explain to them why spending less time at the bore hole is a good thing and give them tangible examples of how they can use their time towards other activities. It seems that Ugandans have a totally different way of thinking than Americans so it can be tricky when you’re trying to explain you logic to them. Years and years of poverty and oppression color their motivation and really their hope that things can change and get better. Risk taking in Uganda has high stakes. If you decide to try new things and they don’t work, it can mean that your family has even less to eat. This has been especially true in areas such as farming where Chuck, our farming and water guy, has been trying to encourage farmers to plant different crops and/or try to raise different kinds of animals. New things can be scary for anyone but particularly scary when you’re worried about your pride, reputation and feeding your family- men here sometimes have more than one wife and set of kids so the consequences are harsh for failure. A man here was devastated by an African swine sickness that wiped out ¾ of his pig farm and Chuck said he was very discouraged and had nearly given up. Chuck and Annslie, our animal husbandry person, gave him a pep talk and provided some feedback on how he can make things better.

While we’re here, we’re hoping that we can get a microcredit program off the ground. This would help the village considerably if they can utilize it effectively. We’re supposed to have a representative from the microcredit lending institution arrive today. We’ll keep our fingers crossed that the rains haven’t washed out any of the roads!! TIA 🙂

Off to the clinic

Our last team member Annslie finally arrived yesterday in the village. She was delayed and rerouted in Burssels and finally made it to Kampala after 54 hours!!! I’m thanking my lucky starts that we didn’t have any complications on our way out.

Some of the Kampala North Rotary members came with Annslie yesterday and had a meeting with us. We discussed some of the action items that we had identified after meeting with the villagers and tried to get some more feedback from the regarding what they think will work.

Procuring necessary supplies has been a challenge and in case I haven’t mentioned it before, things here are SLOW!!! There is also a sense that we dont’ want to just be giving things away left and right so we are also being careful to have the community members become a part of what we are doing since ultimately, these things that we are doing will be turned over to them for management.

Today, the health team is headed out to the Health Centre-II in Iringa. We will be opening a Health Center-II closer to where we are staying, so we are going to go observe at the operational clinic today to get a feel for how they do business and see if we have any suggestions for improvement.

When we visited the HC-II a few days ago, it is a very interesting place. There are boxes and boxes of birth control pills that women don’t want to use because, according to the worker there, they think they don’t work. Judging by the feedback we received during one of our meetings, they don’t really have a good grasp of how the women’s reproductive cycle works and don’t understand the importance of consistency when taking oral contraceptives. There are lots of opportunities for education on that and several other topics, but it’s hard to figure out where to start since health outreach on an individual basis isn’t really a great use of our time. We are thinking that we may work with the community health workers to help THEM better understand so they can spread the word but as is always the case, the message is only as good as the delivery and we’re really not sure how much people trust some of the workers.

The Health Centre-III is where babies are born. Unfortunately, it is too far for most people to travel. The government has been giving pregnant women here 4 travel vouchers to pay for their transportation for pre-natal care but in the meeting we had with the community, we found out that the Health Centre-III is stealing the voucher and not reimbursing the women. It’s somewhat amusing because no one in Uganda says anything directly. I believe the term that our host used was “pocketing the money” or “the money disappears.” You can imagine how difficult it is to communicate and how long conversations are when people don’t direclty answer questions! There is no such thing as “yes” or “no”. If you ask a simple question like- “Are we going to get the paint today?” You will get an answer like- “I have contacted a Rotarian who is coming from Kampala to stop and get some paint on the way.” And then you say- “Ok. Today?” “He is coming from Kampala and will get the paint on his way.” “OK, will the paint arrive at the house today?” “Mmmm. Today.” This “mmm” business is very funny. We have all picked up this habit. “Mmm” is a response for just about everything. It’s an acknowledgement. It’s sometimes a “yes” or if done in the right intonation, it can also be disapproving.

With that, I am headed off to the clinic. Hopefully, I will have another good internet connection later and report back on our experience there while it is still fresh in my mind.

Merry Christmas!!

Merry Christmas from Uganda! Technically, it’s the morning after. All of our computers ran out of charge yesterday so we had to wait until someone turned on a generator to get them back up and running. It has been unusually cloudy here so the solar panels that are used for electricity haven’t been collecting enough energy to keep up with all of us!

Yesterday we went to our first Ugandan church service. I asked what denomination it is and they said that it is Church of Uganda which I think is Anglican. It was a particularly exciting day because not only was it Christmas, it was also this church’s first service! Our host Patrick donated money to put a roof on the brick frame that had been constructed so a few hundred people showed up to dedicated the church and have the first service. Apparently, when you dedicate a church in Uganda, you have the whole congregation go outside, sing and walk around the church three times clockwise to cast the devil out. I got a ton of great pictures but I guess you’ll have to take my word for it because it seems unlikely I’m going to be uploading them anytime soon :). An interesting element of the service was the offering. They took a collection and I noticed that a few people put in some sweet potatoes, corn and eggs. They didn’t have any money so they brought some food which is quite a sacrifice here especially in the dry months. So in that case, the minister holds up the items to the congregation and basically has a mini auction. The church needs the money so rather than take the food items, they sell them off! Very clever I thought.

After church we got a taste of our own medicine. People were inundating us for photos. We were reluctant celebrities but patiently posed for photo after photo. A man with a film camera was snapping photos and Patrick said that “he will make a kill” by selling all the printed photos to the villagers. I got a cute picture of a little boy in a red, white and blue jersey with Obama on it. Africans love Obama!

After church we came home and had a big feast and played some games. A nice relaxing time was had by all. I hope everyone had a wonderful Christmas!

School in Uganda

Today has been a relatively relaxing day. We got moving by lunch and the health team met to start discussing some possible strategies to address some of the concerns of the villagers while the others went to the school to meet with people to discuss irrigation. The locals are eager to have their clinic reopened. They want access to emergency child birth facilities, access to water, more pit latrines and help with illnesses that are common here like malaria and worms. The children here are a hoot. They follow us around everywhere and stare at us. It’s like have 25 miniature body guards with you all the time!

We visited a school where our host family’s mother went to school. The headmaster and his wife decided to give us all African nicknames. Mine was Namacosay (phonetically spelled). I asked what it meant and they said it means from the Macosay tribe. Hopefully, that’s not an insult!

Primary school education in Uganda is free and they have either just made secondary school free or are working in that direction. The problem is that the school makes a policy that the parents have to send their children to school with grain so the school can cook them lunch. The parents are willing to do that because they don’t have very much to spare so many children end up not going to school. Getting water at the boreholes can take at least 4 hours out of the day and it’s mostly the women and children who do it so they spend most of their day just getting water. Sometimes it takes so long that they drink water from swamps which leads to a lot of water-related illnesses. It has certainly made me thankful for the water that magically comes from the faucet in my apartment and that flushes my toilet. As can be expected, there aren’t a lot of easy answers here but we keep plugging away.

Sorry for the disjointed writing. I have to write outside around a table where lots of people are working/talking so my writing skills are a little compromised.

Thanks for all your well wishes!