Health Fair

As my final project here at SOVHEN, I came up with the idea to do a community health fair. All the neighboring villages would be invited to the fair, where they could get information and counseling, testing, and some refreshments. My idea was to supply knowledge about preventing diseases and other ways to treat conditions other than using medicine. I wanted to have about 5 tables that addressed the most pressing issues in the community: malaria, dental health, HIV/AIDS, nutrition, and family planning. I wanted to tach the community what these diseases are, how they spread, and how they can avoid getting them. I also wanted to have some free testing available, but I didn't want that to be the main point of the fair because I think it's more important to understand rather than just rely on a test being positive or negative. 

I was really really excited about my health fair idea. I thought it would be fun, easy, and cheap! The only thing we would need to spend money on would be to buy some water, pop, small snacks, and maybe a few testing strips. We would use the medical officials and supplies we have here and rely on other volunteers to advertise the fair. I even wanted to make a flier to pass around the community to remind people about the services we would be offering. 

If you're wondering why I keep saying "I wanted..." or "my idea was..." it's because most of my ideas were shut down by the other SOVHEN members. When I first brought up the idea, they all seemed skeptical about it and I wasn't quite sure why. I have been involved in planning health fairs back in the states and they all turn out well.  They said if we just offered information, no one would come. They said if we decide to test, we have to give them free medication. They said if we tell them we have refreshments, people will just come for the food and leave. They told me we can't teach about dental hygiene if we can't give them a toothbrush and we can't tell them about malaria unless we have a net to give them.

What I took from our meeting is that knowledge means nothing here.. People don't want to know how to avoid getting HIV, they just want free condoms and free medication when they finally do get it. When I brought up the fact that most cases of hypertension can be treated by just eating better and exercising, they told me the only way to treat it is to give medication. They don't want to learn about eating a balanced healthy diet unless you can give them the food to eat. Basically, I was told that sharing health education knowledge is useless.

I was honestly so struck and saddened by this thought that I almost decided to give up the idea of the health fair completely. I was very frustrated by the people I was working with. I understand that the culture here says "free" is the most convincing argument, but I really thought it was worthwhile to try something different. I get it that the villagers don't have the money to pay for most of the medication they need, but we are trying to offer FREE knowledge about the diseases they can stop harming their community. The culture here calls for medical officials to treat, rather than prevent, but I wanted to do my small part to change that. 

In the end, we came to an agreement that best suits the villages. We decided to draw people to the fair by having a soccer tournament. We are planning to set up a few tables on the sidelines that address HIV, malaria, general health, and deworming. A big part of the fair will be administering free HIV and malaria testing, but I have also convinced them that we can also give information about the diseases. I know that what I'm trying to do is very different here, but I don't think they brought an American volunteer here just so that they could continue doing things the African way. I am still very excited about the health fair and I hope that we can do our small part in preventing the most common diseases. 

Week 10!

Let me tell you a little bit about what I have been doing in Africa for the last 10 weeks. For the first half of the summer,  I was very involved in the medical center. I organized medical records, took patient testimonies, made a video, and even helped give immunizations. It was thrilling and really interesting to be involved in the medical system on this side of the world. After awhile, though, the work at the medical center really slowed.. I suppose July just isn't a busy month because its not high time for malaria or many other common diseases. I was really disappointed by this because I really enjoyed what I was doing.

Luckily, I had the 3other FSU students here to keep me busy when I wasn't working. They had come in the beginning of June and were teaching at the local primary school.  We traveled a bit and just had a good time exploring together. When Kate, Ashley, and Tyler left in the beginning of July, I was left with not much to do at all. 

Finally, I decided to take up their position as an English teacher at the school down the road and I have been LOVING it so far! I never ever ever thought that I was enjoy teaching but these kids make it really fun. I teach primary 5 (5th grade) at Bukibira (pronounced like buchibida) Primary School. Recently, the government decided to relocate 5 of their teachers to other schools and decided not to replace them.  Bukibira was left with just 5 teachers for the entire school of about 200 children. When I offered to come and teach after Kate, Tyler, and Ashley left, they practically kissed my feet they were so happy. 

I have been teaching "tenses" for the past month and it has been going pretty well. They have a hard time understanding my accent so I am lucky to have Sandra helping out and translating in my classroom. We just spent the last week going over irregular past participles (eat..ate..eaten) which was pretty difficult. Once they finally understood the irregulars, I asked them what the past participle of "dance" is and they told me "dancen".....

I have really come to love these kids. I want to do a small fundraiser for them when I get home. I think I will ask people to just donate their loose change to help the kids afford their school fees and school supplies. All of their book cost about $3 and an entire year at school only costs $20. If I can get different groups of people to "sponsor" one of these children, I think it would make a big difference in their lives. 

Anyway, that pretty much sums up what I have been doing for the last 5 weeks.  I only have a week and a half to go until I come back to the states!

Sarah

The very first time I took the short walk through the village to Lake Victoria, I was bombarded by little kids screaming "mzungu" (of course). There was one little girl, though, that stuck on my hip the whole way down to the lake. She held my hand firmly the whole time, although she never looked up at me or spoke a word. I noticed that she, like many of the other village kids, had a white fungus all over her head. I was so charmed by this little girl that I decided I would take her to get treatment for her fungus. (The fungus is caused by drinking unclean water, most likely from the lake). Little did I know, it would be the beginning of a great friendship. 

Sarah is a 4 year old beautiful little girl. She has the most radiant smile and contagious laugh I have ever heard. She is the second oldest of 4 sisters and her mom is 21, like me! She has scars all over her head and often has cuts on her face because her mom beats her and her sisters a lot. She lives in a one room dirt house with her mom, dad, 6 month old sister, Nulu (2 year old sister), and Kadijah (5 year old sister). 

Although Sarah only speaks about 5 words in English, and I the same in Luganda, we don't have any trouble communicating. I spend a few hours with Sarah everyday and give her a lot of attention that she doesn't receive from her parents. The first time I ever gave her a hug, she didn't even know how to react. Many people here consider children to be a burden and thus don't give them any affection. I find it ironic that most people don't like kids yet almost all of them have 5-10 children of their own. For example, when I got here 2 months ago, I noticed that Sarah's little sister Nulu had a terrible respiratory infection. I was waiting for it to either go away or for her parents to take her to the clinic, but neither happened. I finally brought her to the hospital this week and got her treatment, despite the fact that everyone told me that her parents would weather neglect to give her the medicine or sell it somewhere. I guess I'll have to see. 

HIV/AIDS outreach

A few weeks ago, my organization decided to go out into the field and conduct HIV/AIDS testing and counseling. At around 1 in the afternoon, we arrived at a nearby village to find about 40 people waiting in line to be tested. The majority of the people there were women, which isn't too surprising considering that culturally, many men don't really care if they have HIV or if they spread it. We immediately began to set up our makeshift clinic under a tree, which consisted of a few benches and the testing supplies, and began testing. 

I was considering taking part in the HIV testing until I saw how the other nurses were doing it. To begin with, the whole process was completely disorganized.  The people were in no particular order and were getting very frustrated that the process wasn't going faster. To compensate, our nurses decided to take multiple people's blood at one time... Without gloves. Quite frankly, it was terrifying to watch my coworkers do their work. They would take blood from a patients arm, (again, without gloves......), set the syringe  down on the table without a cap, and then move onto the next patient. Finally, they would put some drops of blood on the test strip, but 9 times out of 10 they couldn't remember whose blood it was. I was so nervous about the situation I decided to remain recording the data on another bench. 

Although the outreach was a little scary, I would like to think that it was worthwhile. At the end of our 8 hour day, we had tested 65 patients for HIV and found 8 to be positive, or 8%. This is a little higher than the national average of people with HIV, which is 7%. 

Unfortunately, after all that work, we were not able to supply those who were HIV positive with the Antiretroviral therapy (ARV) drugs. There are certain organizations, who with the Ugandan government, supply these ARVs to public hospitals for free. Our clinic is private, and thus we don't have access to these drugs, which creates big problems in our community. Historically, villages that lie close to Lake Victoria have higher rates of HIV/AIDS, which holds true to our village. Because we don't have these drugs, we have to refer our patients to alternate hospitals that are about 8 miles away. Most of our patients don't have the means to get to this hospital and thus are forced to suffer with their disease. 

African Time

In the one month I have been in Uganda, I have learned so much about the culture, American culture, and about myself. There have been many times that I was so frustrated by the way things work here, but these were countered by instances that made me love Uganda more. 

It is said here that everyone runs on "African time" meaning that nothing and nobody runs on a strict schedule. For the first few weeks, I truly enjoyed working on African time, waking up late, taking naps in the afternoon, and never being in a hurry to do anything. After about the third week, I realized how frustrated I was by this whole "African time" mindset. I came to Uganda to work hard everyday in hopes to make an actual difference in the community, not to sit back and enjoy the scenery everyday.

Another thing I have become acutely aware of is the difference between American work ethic and Ugandan work ethic. The people I work with at SOVHEN are very brilliant and inspiring, but they don't have the drive and determination that I see in many Americans. For example, they have developed a way to create sanitary pads out of banana plants and have even developed a business plan to circulate their product. The idea is genius, yet there are thousands of unfinished pads sitting in the warehouse without plans to do anything with them. Also, many people here are perfectly content to work 2 or 3 hours a day, while I am stuck going stir crazy because I don't have enough work to do.

 It has taken a lot of wasted days for me to realize that I need to take matters into my own hands, instead of relying on others, if I really want to make a difference. One of my colleagues and myself have identified a serious problem in our village in that many people don't have latrenes and must resort to open deification. This can cause major health complications because it is not sanitary and also pollutes the nearby Lake Victoria, the peoples main water source. We have begun to research and identify possible solutions for this problem and I have high hopes that we will be able to make progress before I leave. 

Although there have been very many times that I have been frustrated by work here, I truly am enjoying my time in Uganda! The people here are very warm, welcoming, and kind. I live in one of the most beautiful places I have ever seen. I walk down a dirt path for 5 minutes and find myself on the banks of Lake Victoria.  I eat fruits and veggies that have never been touched by a chemical and com from my front yard. Life is complicated, but life is also good. 

Malnutrition Outreach

This week I began to work on a new government outreach program that was aimed at treating malnutrition. The program is helping malnourished children ages 5 and below, HIV positive people, and pregnant mothers by identifying those that need help and supplying supplemental food.  I was so excited about the project because I thought I could help make a real difference around our community. Like many of you, I figured malnutrition would be a serious issue in the impoverished village in which I live. The first day, Rogers, a colleague of mine, Nalong (a woman who is 8 months pregnant and expecting twins), and myself went out into the village to find those people who were malnourished. We went house to house, weighing and taking the Mid-Upper Arm Circumference (MUAC) of everyone we thought needed our help. We then told all of the mothers to bring their children to our medical clinic later in the day to receive free supplement food from the government.My first day doing malnutrition outreach shocked me in many ways and also taught me some very valuable lessons. First of all, I was totally wrong about thinking everyone in our village was malnourished and needed our help. On the contrary, most of the kids were perfectly healthy, even though they are skiiiiiiiiiiinny compared to American children. I found this shocking, but then realized that because we live near the lake, the people are able to meet their very basic needs. They can get semiclean water from the lake to drink, bathe, and water crops. Additionally, they can find almost all their food in the ground in the form of potatoes, eggplants, and corn. These people have not survived thousands of years without being able to properly feed themselves, yet there are certainly other places in Uganda that struggle to find food.
Second of all, I grew to highly respect our neighbor Nalong. She is pregnant with her THIRD set of twins and is still willing to put a lot of time and effort into this program. She must have been absolutely exhausted after walking in the village all morning and helping in the clinic in the afternoon but she always remained positive and composed. Lastly, I learned how to deal in a very high stress environment when I  volunteered to man the clinic as the physician and nurse took their lunch break. They left me to take the name, height, weight, and MUAC of all of the 30 toddlers in the clinic. There were mothers throwing their babies into my arms, children peeing on the floor, and others screaming because they are afraid of the white lady. On top of that, I speak only a few words in Luganda and thus could not communicate to them that I couldn't physically take care of all their children at the same time!I feel so lucky that I am able to live in a place that teaches me a new lesson everyday. Whether it is how to  take the MUAC of a screaming baby or shower using less than a gallon of water, I am constantly being challenged. I can't wait to see how the next 9 weeks go!

Mzungu

One of the most surprising and hilarious aspects of living in Africa is being one of the only white people around. I didn't realize how different my skin color would make me from the rest of the population. Whether you are driving in a car or walking down the road, people will almost always stop to stare at the white person, especially in small villages. The first time I walked down the dirt path to where most of the villagers live, I was BOMBARDED with about 20 little kids holding onto my arms and yelled "mzungu, mzungu!!!!!!!!" (mzungu is the Lugandan word for white person). It was so shocking and hysterical that I had no idea how to react! They love to touch my skin, feel my hair, and listen to my foreign voice. Some of the elders in the village are even afraid of white people because they have never seen anyone with my skin color before. The funniest part is that it still happens every time I walk down that little dirt path to the village! It really makes you feel like a celebrity, but it also makes you realize how much you stand out. I would like to think that by the end of my 3 months in Uganda I will have really meshed into the culture, but my skin color is preventing me from doing that. No matter how "African" I act, people will always be staring and wondering what silly thing the mzungu will do next.