Intervention and Reflection

Intervention…this is where we are at now. Some has been good, some has been frustrating, but all of it has been worth it. Some fears were confirmed, some stereotypes were reinforced, but on the whole, people were grateful for the time we took to share with them what we learned from interacting with their communities. There is a lack of education and information and some communities almost get stuck, unable to move forward because nothing has come along to challenge the status quo. When you present the problems you’ve found to people, they know. They want better. Holding it up to the light, bringing it to eye level…you can see the recognition in their faces. And you can see a guilty sense of grief in some of the faces because they know that they could be doing more, but have given in to the status quo. The challenges they face are real and significant, however, I truly believe that if you can strike a cord in just a few people who know deep down that they could do better, that a huge ripple effect is possible if they choose to take action.

All of the interventions we did were a direct result of the needs assessments we had conducted previously in each place. So we went to share with them our results from those meetings. The information that we had to share came from the mouths of their own community members.

First, we went back to the fishing village. We decided to have separate meetings with four groups: the fisherman, the mothers, the primary school children, and the youth not in school. I was present for the fishermen and the mothers. The fishermen are like a sub-culture within themselves. Once they are in from the water, it is common to engage with prostitutes, drugs and alcohol. Everyone likes to relax after a hard days (or night’s) work, but lets get real. This community has a much higher prevalence of HIV. If the nurse’s estimate was right, close to 30% of people are infected. Also, men like to go for the younger girls, thinking that they are innocent and don’t have HIV. Well, after they have their go with her, she is now infected. Most people don’t use protection and a lot of girls have their first child at about 16 to 17 years old. Then you have transmission from the mother to the child. Also, a lot of these fishermen have families outside of the village. After working for a length of time in the village, they return home. From one generation to the next. You can connect the dots. It is not the greatest legacy to leave behind you.

With both the fishermen and the mothers, one specific topic was a focal point: 50% of the children that we interviewed had witnessed sex in their community. It is no surprise that those children were more likely to go on and engage in sex at an earlier age. Of course experimenting with sex is a normal part of life. But experimenting in an environment such as this carries far greater consequences. A lot of the kids growing up here fail to think that there is life outside of the fishing village. Most do not get more than a primary school level of education. It is almost like people are just waiting around to die. The fishermen themselves said that they expect they might die every time they go out into the water. There is no planning for the future. That mindset, when shared on a village level is like a death sentence. However, I have to say…after talking bluntly with these groups of people, especially the mothers, you could see some people just hungry for this kind of talk. They wanted to learn more about what we had to share. Talking about sex, talking about HIV, cervical cancer, family planning and parenting, education…these topics seem like no brainers to a lot of us. We take a lot for granted. All in all, it was a successful visit and many people thanked us and said that when we come back, we will find their community in better condition.

Today we went to meet with Commercial Sex Workers on the Uganda/Congo border. This area is a perfect storm for prostitution: the border, the highway, businessmen, truckers, traders…there is a lot of movement and a lot of men coming through on a temporary basis.

There is an organized group of women that are all sex workers, so that is how we have been meeting with them. When we did our needs assessment, it became very clear that most of them had no idea what Cervical Cancer was…but they thought they did. About 50% of them were HIV positive and condom use was a problem. The majority of the women said that if they could find other work, they would leave the streets. They expressed interest in sewing or having a salon. They also said that they have no one to offer them support. So we brainstormed as a group. What could we offer these women for advice? We knew that we could give them useful information about Cervical Cancer, but what about the desire to start a business? We decided to think what they could do united as a group. If every member (around 70) saved 500 shillings a week (this is about 20 cents), they would have enough to buy a sewing machine in two months. One step at a time, they could grow.

We were a bit hesitant about the meeting in the first place. This group of women tends to be a bit feisty and are often looking for handouts of some kind. Every time we have visited them, they have asked for money. I am not saying this as a generalization of all sex workers all over the world. I am talking about this specific group of women and I have confirmed these suspicions with my own eyes and ears. Especially being a white person. They see you stepping into the room and they immediately think that you have money. With every suggestion that we had, they had an excuse for why it wouldn’t work. They did have a savings circle, but they only lend small amounts to individuals. They had never pooled their money and made an investment or a purchase as a group. I reminded them that they told us that they have no one to give them support and right now this group of women is their largest asset. No one is going to come along and solve their problems. It is up to them to solve their own problems. It sounds harsh, but it is true. There is this lack of planning for the future. It is as if every day stands alone and tomorrow is something that happens tomorrow. So, it was a frustrating meeting. I think that we did leave an impact. They at least got to learn about Cervical Cancer and, yes, we did give them some condoms. For free.

Another group did an intervention in a pastoralist community about disease transmission and risks involved when people live close to animals. This community deals with brucellosis, which comes from drinking raw milk. Of course if the animal is healthy and the milk is dealt with in a hygienic way, raw milk is fine. I drank raw goats milk until I was 13 and I only turned out a little weird. Anyways, they also have issues of rabies, anthrax and tuberculosis. I want to share one story that we heard, and this was through translation so I may have some of the details wrong. Apparently a cow had fallen sick and died. I think from tuberculosis or some other disease that infected the lungs. Well, the farmer buried it and then later someone from a neighboring village came and exhumed the body for the meat. To this day, those people have a persistent cough and are quite sick. Again, there is just a lack of understanding about these things. Some people sleep in the same room as their chickens. The animals just roam around the home and defecate wherever and it is common for people to go without shoes.

I want to end on a bright note. When my colleagues went to share our information with this community, they were well organized, showed up in large number and were eager to hear from us, eager to learn. If you don’t have access to information, how can you learn? All you can do is observe what is happening around you and draw the most well educated conclusions from what you are dealing with. They can’t just “Google it”.

So, my time here is almost done. We are going to start writing the final report. We head back to Kampala on Thursday and then I fly home on Sunday. How fast this month has gone. I don’t expect that I will write any more posts…access to internet is really hard to come by. That is why I made this post so long. Whoever is reading this, ‘thanks’. I hope I was able to hold your attention and share my experiences with you in a thoughtful way.

The Dust is Everywhere

It takes the lowered, sun kissed light of dusk to illuminate the swirls of dust that hang and move through the streets like invisible cloaks of our daily activities. As the sky quiets and darkens, the surrounding activity explodes with sounds of people and vehicles and horns and competing amplifiers of music; smells of roasting meat and corn and chapatti and warm milk. Once again, the dust is captured, suspended in the headlights of the countless motorcycle taxis. As I walk through this night scene, unable to hide behind my whiteness which glows in the dark here, I collect the dust on my skin, my clothes, my hair and I become a bit more a part of the environment that surrounds me. This place is not my own. The history here is not mine. The hills and streets and people do not know me. My only connection or sense of belonging comes from the fact that I am also a human being whose skin collects dust just like everyone else around me.

What I love about traveling to a place that is so unfamiliar from what you know is that fleeting moment when you feel as if you have actually touched on the pulse, gotten to the heart of what it means to know a place on an intimate level; to understand the way of life. Not superficially, but on a deeper level. Even if it is just fro a brief moment before you slip back into the confusion of being a stranger…to just feel what is happening around you and understand that at every moment of every day people are living their lives with the means that they have to do so. To walk down a street at night and understand the sounds that you hear and the smells that are all around you. For that brief moment, you feel as if you belong and you understand the undercurrent that flows beneath it all; a connecting force. It is as if you have to drop your guard, let down your defenses to actually let this sensation in. Once you get there, a whole new world opens up and you are no longer on the defensive with every step you take. You are on the receiving end and you get to choose what you receive only to an extent…and that is the beauty of vulnerability. Sometimes the outcome is greater than you could ever hope to imagine. Just that moment of understanding is worth weeks of uncomfortable uncertainty, exhaustion and oversaturation. Like a balloon that has been filled with so much air to the point which it can’t remain within its own confined boundaries so it has to burst open to join a larger body of air. That, to me, is the beauty of putting yourself into a completely unfamiliar environment.

The Discovery Process

Discovery is an arduous, exhausting process. Part of this field attachment is to take in as much as we can and learn about certain key communities and the issues that they face, then determine an appropriate intervention. We have been to some communities that have such large-scale problems; you would have to change the mindset and social dynamics to have any effect on the health and economic issues faced by the community, not to mention political issues concerning the relation with the border to the Congo. It also feels weird to come in as an outsider and try to solve issues of a community that is not my own. However, I am so grateful that we are traveling with Ugandans. While none of them are from the area we are in, it is so useful to be able to compare my reactions with theirs and realize that just because I am from a more developed country a lot of what we are seeing is a shock to them as well and they really want to do something about it.  They are all very intelligent and passionate. Here we are at the equator.

I think that it is common for people to become so accustomed to their surroundings that they may no longer see just how many problems there are. It can take an outsiders perspective. Also, we are being guided by local people from the communities that we are working with. They are our educators and they know what their challenges are. We are also being taken to projects that have been very successful and are operating well. It is nice to see successful projects and it is necessary for generating the momentum and the energy for tackling larger issues. There is never one single solution. Issues of poverty, HIV/AIDs, mal-nutrition and food insecurity are multi-faceted problems.  People keep working so hard to simply treat the problem that they are unable to work on the root cause of the issues.

I am going to throw in a picture of me with some African Children just for the fun of it here to break up the text...This is at the fishing village. No sign of any guardians. They just followed us around. 

Our team keeps coming back to the concept of ownership. In some situations, it seems as if people have become too used to being given services for free. In a way it takes away from the value of the service and also the magnitude and implications of the problem. I’ll give you an example. HIV. The community that we all felt the most overwhelmed by was a fishing village called Kyanga. There are a number of factors that contribute to the state of this village. For one, it is fairly isolated with only one road in and one road out. Also, they are in Queen Elizabeth National Park, so there are issues surrounding land use. The Congo is on the other side of the lake and also relatively close by land. The village nurse’s best estimate was that roughly 30% of the population is HIV positive and there is a large issue with sex workers, both local women and women coming in from the Congo. Testing and ARV pills for HIV are given out free. The nurse stated that the general mood around HIV seems to be that it is just something that a lot of people have and that there is free treatment for it, so why worry about preventing it. Obviously this attitude will solve nothing. We are wondering if the level of free services provided for it is having a negative consequence of taking away from the magnitude of the disease.  

Amidst all of the heaviness, there is good. Today we visited a project called Give a Goat. Essentially they identify households in need and give them a goat. There is mandatory training provided before a household gets a goat and they are required to give the first offspring of their goat back to the center so that they can give it to another family. Up to this point they are working with 380 households, the majority of them headed by women. The families are also able to bring their goats to the center for breeding. The center also has a primary school for a small fee and a health clinic as well through which they enroll their members in a communal health insurance program. They also treat their water on site so there is clean drinking water. All of their electricity is generated with solar panels. They raise chickens, goats and pigs and cultivate maize, bananas, pineapple, coffee and eucalyptus. It was a really wonderful place that is making a noticeable impact on the rural community. 

This is the view from the property:

Here is one of their billy goats. Pretty cool lookin' dude. I think he posed for me. 

Annnndd.....I was in goat heaven. I grew up with goats and I absolutely adore them. It was so nice to be around them. Such neat creatures. He gave me a kiss!

I am going to leave it here for the sake of ending on a positive note. We have ended the discovery phase of the project and are going to move into figuring out what possible interventions would be for various communities that we have visited. I am excited to see what we come up with. 

Cheers from Uganda!

Love, Sadie

Photo Album Link!

The weekend has come and we have been able to have some down time.
Here is a link to my photo album on facebook:

Bwera, Uganda

Getting to know Bwera

One correction from the previous blog: We are not in the area of the mountain gorilla. Aside from that disappointment, everything else has been really wonderful. Our days are really busy from morning until night and I have been trying to reflect on all that I have been experiencing and learning.

The human is an extremely adaptable animal. However, we can also become so accustomed to our environment that we no longer fully realize our surroundings. Certain things that used to shock us no longer do. Problems that seemed insurmountable get integrated into the everyday way of life as something to deal with rather than something to solve.  While these statements can be applied to any country of varying levels of development, I am reflecting on what I have experienced of Africa. In the past week, we have visited a pastoralist community, an independent farmer who has worked hard and built up an impressive operation, a commercial mango farm, a market at the Congo/Uganda border, a district hospital, a water treatment facility, a public school and a private school. Not to mention countless meetings with local Community Development Officers, Micro-Finance Lender, security forces and meeting amongst our own team. We have been busy!!! I will not summarize every activity due to time, but I will share some. Here is a picture of our team.

Most of these things I got to experience on my first trip to Tanzania…so the initial shock has already been dealt with. However, I am still left with this overwhelming sensation of hopelessness. Even when I think I have a good idea of how to implement a possible solution, how? There is a lack of infrastructure, resources and money…always a lack of money. However, people here are hard working and good spirited. They appear to be so much more grateful for the little that they do have than many people that I have met that have more than they need. Myself included at times. So...I have to quit complaining, get off my butt and do something!

So, on that note, let me share some of the issues faced by the people we have visited so far. I’ll start from the beginning:

The pastoralist community: 

The livelihood of this community is cattle. They practice open grazing of their herd and face issues of land and water scarcity as well as disease such as Foot and Mouth Disease. These communities are surrounded by Queen Elizabeth National Park and have come to depend on grazing their animals in the park among other wildlife. Cattle are subject to being killed by lions and in turn the livestock keepers kill the lions. There is also a concern about the mixing of cattle and wildlife from a disease perspective. Another issue surrounding disease is the fact that this area of Uganda is very close to the Congo border. Animals are brought across the border and bring diseases with them. 

While visiting the pastoralist community, we got to observe the vaccination of a herd of cattle for Foot and Mouth Disease.

After Vaccinations, the cattle are set out for open grazing. Available land for grazing and water are scarce. Cows can go up to 70 km in a day in search of both....if I understood that right.

From there we moved on to the farm of Dorothy Police. This is a truly remarkable woman who has built up an extremely productive and impressive farm of both livestock and crops. She was widowed at the age of 32 and is now 74. She has committed her life’s work to her farm and helping others.

She raises pigs, chickens and other livestock. The pig pens are off the ground for sanitation. 

On the left are the pig pens and then one of the chicken coops is on the right. The mountains in the background are the border to the Congo. It is absolutely beautiful country.

Shade grown coffee

                      She was especially proud of the women in the group for getting their education.

From there we visited a large-scale commercial farm. The owner of the farm most likely had resources to begin with so it is not a rags to riches story. The scale of it is impressive and who doesn’t love a good mango? However, there were many problems. For one, they do use pesticides and they are near a water source but do not monitor for contamination. Also, the workers have no protective equipment when spraying other than overalls. The workers work 6 days a week from 8-noon and receive 2,000 shillings a day or 60,000 shillings a month. There are roughly 2500 shillings to a US Dollar, so that is just over $20 a month. Plus they have no housing provided for them and no health care.  

I guess that is ending on sort of a negative note. That was not my intention, but I am tired of writing and you are probably at the end of your attention span for my ramblings. I will write more later. 

We have done much much more since then, but it takes a very long time to upload pictures and I am sharing a modem with my fellow students, so I will wrap this up for now. 

Thanks for reading!

From Kampala to Kasese--A Ugandan Overview

Who would have thought that a year after returning from Tanzania, I would be writing a new blog post from Uganda? Not me. Funny how opportunities present themselves if you are open to seeing them.

After 3 airplanes and about 24 hours of travel, I arrived around midnight...and it was a 40 minute taxi ride from the airport to the hotel. I could not see much but I was immediately transported to the Africa I remembered from the smells of the dirt and diesel and food and every indescribable smell that just hangs in the warm, humid night air. I loved it. I opened my window and let the wind just blow over my face. So lush and vibrant. It was good to be back.
Enough of the romantic stuff. I suppose you want to know some more useful details.

So, what I am doing here? It is not an entirely simple answer. It is sort of a two-parter. This opportunity all started with a class that I took during my last semester at the U of M focusing on using social entrepreneurship to address sustainable development in Uganda, Africa. Our group decided to focus on the issue of Child-Headed Households, which is any household that is run by a child 18 years of age or younger. From the research that we did, it appears as if around 50% of households in Uganda are headed by children. Additionally, about 46% of the population is under the age of 15. These are shocking numbers and really hard to imagine. So, our group decided to explore the idea of setting up a vocational type school that would offer more trade oriented training to the heads of these households who are unable to obtain a formal education. Activities such as beekeeping and shade-grown coffee were explored, with the idea that we could adapt to the local needs. However, at this point, all we have are assumptions based on internet research. Seeing what the reality is on the ground with our own eyes was the obvious next step.

Over the course of the semester, we were paired with Ugandan students at Makarere University in the capitol city of Kampala. There are a total of 8 Ugandan students in areas of Veterinary Medicine, Public Health/Nursing and Environmental Studies. They are part of an inter-disciplinary program called "One Health Initiative". This approach looks at the inter-relationships of humans, animals and the environment and works to bring together multiple disciplines to improve on the health and well-being of all three areas with a specific focus on the issue of infectious diseases.

Myself and two other U of M students are fortunate enough to be able to go with these students on their 4 week field attachment in Western Uganda!!!!!! We will be traveling with the 8 Ugandan students and a few faculty members. Our home base will be in Bwera, which is located close to Lake George, Lake Edward, Queen Elizabeth National Park (they were colonized by the British in case you couldn't tell) and Rwenzori National Park. I have been told that this area is incredibly lush and mountainous and is also the home to the Mountain Gorillas!!!!! I would absolutely love to see a gorilla in person, in the wild. My favorite trip in Tanzania was when I traveled to Gombe National Park where Jane Goodall studied Chimpanzees. I still need to do a blog post about that...oops!
Anyways. I am really excited to go to this area.

While in the field, we will be visiting with local farmers, households, health clinics and community leaders to learn about their way of doing things and the issues that they face. We will hopefully be able to get a clearer picture, also, on the issues and needs surrounding child headed households. Essentially, I am just going to go with an open mind and observe.

So, that is the gist of it. I arrived on the 12th with my fellow student Jordan. We have been getting ready for our departure to the field, which is tomorrow morning, the 15th of June. I will have internet while out there, however, I am not sure how reliable it will be or how much time I will have for writing. I will update as I am able.

As of now, I just have a few pictures. I feel like this trip will be treated like the "second child". On my first trip to Africa, I took pictures of EVERYTHING. Now, I walk around and I am not shocked by anything. It just feels normal. So, I will probably take far less pictures this time around, but I promise that they will be really good pictures. Quality, not quantity this time.

Here is a picture of some of the students we will be traveling with...hopefully next time we will be with a real gorilla. May this find you all in good health. Love, Sadie