Thursday, April 15, 2010

Week 2 - Video

Week 2 - Video from PublicHealth Uganda on Vimeo.

Jay and Rachel demonstrate Ugandan dance moves in this humorous instructional video.

Week 2 - Photo Slideshow

Week 2 - Photo Slideshow from PublicHealth Uganda on Vimeo.

A look at our second week in pictures.

Week 2 - Interview with Olivia

Week 2 - Interview with Olivia from PublicHealth Uganda on Vimeo.

This video consists of an interview with Olivia in which we discuss her interests in music, dance, and drama.

week two: the friendliness of the ugandan

Location: Kampala, Makerere

When I first arrived in Uganda, I was immediately struck by how kind so many Ugandans seemed to be. Not only were those Ugandans who were affiliated with us so welcoming and kind (the first Ugandan I met here, Dan, welcomed me so warmly, even though he had to come pick me up at the airport at four in the morning, facing rain, thunder, and lightening in a car with very poor windshield wipers), but even those people who we have met on the street or at restaurants have been so friendly to us as well. When we go out someplace, people seem to want an excuse to speak and interact with us, and on several occasions, a simple request for directions has led to good conversation.

To and degree, I suppose, I was expecting this. My Lonely Planet mentioned Ugandans’ friendliness several times, as did my other guidebook, and everybody who had gone before us attested to this. Yet experiencing this friendliness through personal interaction is different than hearing about it from outside the Ugandan context. In experiencing the friendliness characteristic of so many Ugandans, it is difficult not to think about their lives relative to what we are used to living with in the United States. It is true that many of the people we have interacted with have been better off, and although I appreciate these peoples’ friendliness, it is not this group of people whose friendliness I am taken by; rather, it is my interactions with people selling sausages on the street, with the person cleaning for me, or my interactions with street children living in the slums of Kampala, that force me to evaluate my situation relative to theirs.

Meeting with the street children, I think, was what really made me appreciate the resources that I have had available throughout my life. I have had a quality education, I have access to quality healthcare, and I have never been without food, housing, clothing, and family. Many of these street children have never had any education, come from abusive households or are orphaned due to accidents or diseases such as HIV/AIDS. They sleep in the slum, sometimes under a roof and sometimes not, and they eat whatever they can get their hands on. One child who I spoke with, who attempted to tell me about his life in very broken English, had a large festering wound on his leg, probably the result of a run-in with a piece of scrap metal. Yet, despite all this – despite having almost nothing relative to what I have – these were some of the kindest most welcoming children I have ever met. I truly could not understand how they could be so kind, welcoming, and courageous, and how they could have such a positive outlook on life, when they were living on the streets with barely enough food, without family or resources. The problems I face in my life seem insignificant, almost petty, compared to theirs, yet I do not see myself as being as positive and kind as they were, and I am definitely not as courageous.

It is very impressive really. Despite our position as college students visiting them from the United States, I think there is a lot more that we could learn from them than that they could learn from us.

Wednesday, April 14, 2010

Week 2: Music Man! Let’s Take a Walk Down Memory Lane

Location: Makerere University, Kampala, Uganda

I initially applied to this program for three main reasons: 1) The Public Health Research portion seemed like a great opportunity to expand my capacity in qualitative and social research. I embraced the idea of encountering research in a new field and understanding the methodology. 2) HIV/AIDS has always been a huge issue in Africa. I wanted to understand the programs that the government and NGOs implant to prevent and limit the spread of HIV/AIDS. And 3) was purely exotic reasons. I imagined this as a rare chance to go somewhere unknown and culturally different to get away from the very routine and stress-filled life back at home. I had the impression that this Public Health Program in Uganda was solely a prospect to recognize how social research is conducted in a developing country, and why Uganda has been relatively successful in decreasing the amount of HIV/AIDS in the country. Little did I recognize that so much of the education and socioeconomic aspects of Ugandan culture is dependent upon music, dance and drama.

Mulago Bright Primary School:
One of the NGOs we visited was Mulago Bright. This primary school is one of the poorer primary schools in Kampala. They have many orhphaned children and can only provide enough financial aid for a handful of students to move past the primary level into secondary level of schooling. It was amazing how despite their financial situation, they have brought back awards for best dance, poem, and music in the nation. After performing for us, I was amazed at how well rehearsed the students were in sing song and dance in reference to sanitation and health concepts. I had no idea how much Ugandans have learned through song and dance. The children listen very well through their interpretations of healthy living through music, dance and drama.

MDD Training:
The past week, we have been training for an upcoming performance at Basibi/Nabisiogi, in which we perform in front of the village with local dances and music we learn in the previous two weeks. This has provided us. The most compelling aspect of this training involves a drama play in which medical experts (some of the students) explain the reason behind good sanitation such as using toilets, mosquito nets, and sleeping away from animals. Even the dances have interpretations, in which undervalued parts of the body seem to take precedence in some dances.

The significant difference in how music and dance interpreted in the states and in Uganda is astounding. MDD is used as an educational experience for health, among other issues in this developing country, while the states usually seem to use music and dance to interpret feelings and emotions. The use of MDD is great, but it makes me wonder how the time is allocated among educational experiences. MDD seems to take a significant amount of their time, so where does the time for classroom education go? The government, since the 1900s have implemented many programs to increase education. For example, Universal Primary Education (UPE) was introduced in 1997, allowing all children to attend primary school for free. Public schools increased and in just one year, the number of attendees in primary school increased by 70%. MDD is great in teaching students basic health, but it makes me wonder if the students are still given enough education time for other topics, such as math, language, science, etc. Would it better to allocate the time and money elsewhere, or is the primary health education still necessary for Uganda?

Week 2 - Blogging by Candlelight

Location:Kampala

I'm writing this blog by candlelight. This the second time in the past 24 hours that we have lost power. Oddly I find this all very exciting and begin to comprehend the true meaning of immersion. When we arrived over two weeks ago, we discovered our apartments shared many of the same amenities that we are used to and have become reliant on back home. For example, we have standard toilets that flush, plumbing (although lately there's been a water shortage especially in the guys' apartment), electricity (except in this case), television, internet, and a balcony (which I don't even have at my apartment in Evanston). This is all to say that aside from the lack of air-conditioning and having to adjust to sleeping under a malaria net, our domestic lifestyles have not been interrupted. Compared with living conditions in the rest of the country, our situation is quite luxurious. These power outages, though far from modeling the true circumstances of many Ugandan people, have at least moderately demonstrated the type of domestic challenges and inequities that many people face daily. As I eagerly light the candles and collect the flashlights, delighted by the challenge and naively nostalgic for the days before electricity, I realize to most others, a loss of power would render feelings of hopelessness and frustration. So while for us it may be fun and games --temporary and exciting, for others it's certainly an uncomfortable way of life to say the least.

This week we visited a number of NGOs ranging from HIV clinics to hospitals to homeless and orphaned children's homes and schools. One of the most striking visits was to Mulago Bright. A primary school located near Mulago hospital which functions as both a home and school for children who are orphaned, homeless and/or otherwise affected by HIV/AIDS. The school offers first through seventh grade education as well as an MDD program. The living conditions at the school were astoundingly squalid, yet even despite this adversity, the students had developed an extraordinarily talent in music and dance, winning an impressive number of awards and honors. The entire experience was very touching and hopeful.

Another impressive aspect of many of these NGOs is their intense social responsibility and reintegration programs. A majority of the NGOs we've visited, cater towards individuals marginalized from society due to HIV, mental illness, or immense poverty. A common denominator between a number of these NGOs however, has been a focus on reintegrating these people back into the community after their respective treatments, recuperation or re-stabilization processes. This reintegration is catalyzed through the creative enterprise of craft-making. Many of these NGOs train these people in crafts such as jewelry making, carving, weaving etc, building a self-sufficiency that will benefit them once they reenter society. This demonstrates a deep social consciousness and consideration that I've seldom seen elsewhere.

Week 2- Kirabo

Location: Kampala, Uganda
Some thoughts/points of interest:

Most people dress really nicely in Kampala and especially at our university. A lot nicer than I dress at home. Women are often in stylish dresses, skinny jeans, and leggings and men wear khakis and long sleeved button downs. I don’t know how they handle the heat! Apparently they find it “cold” at night when in fact it’s beautiful weather. In the rural villages people don’t dress so fancily, but as we’ve seen, they take out long colorful dresses for holidays like Easter. In the slums they obviously do not dress fancily either, but it is a lot more common than I had imagined.

This week we visited a mental health facility. One of the girls on my group is a psych major and is aiming to conduct research there. Unlike Mulago, it was a really nice place exactly as you would see in the U.S. But like Mulago, we were taken all around the facility, into patient wards and even a private room.

There is an outdoor area for the patients to enjoy, yet most of them were laying on either the concrete or the grass and sleeping. My understanding was that patients were kept out of the bedroom as much as possible to keep them from sleeping all day, but that could be wrong. I found it kind of disturbing that some people were curled up on the concrete instead, but again, I may have misinterpreted and maybe they enjoy sleeping there because it’s cooler. Another odd thing about the facility was that they treat drug and alcohol abuse as if it was a mental illness; they have a special ward for it. Additionally, there is a ward for individuals who were previous gunmen; so, all the staff members are trained to shoot a gun “just in case”.

This facility had 100 nurses, about 750 patients, and 10 DOCTORS. (Calling all Psych majors! You are needed!!) Psychiatric treatment is extremely limited in Uganda and is highly associated with stigma. Many patients do not want to go home at all after treatment for fear of being ostracized and abused due to their past illness. Some patients do not have a home to go back to at all. Many of the patients were there due to war trauma. The woman who presented to us described vividly how they feared being “cut”, had their families lost or murdered, and couldn’t sleep at night.

All in all, another disturbing hospital visit that made me extremely grateful to be a U.S. citizen. However, those facilities were much nicer than many of the shack homes of Kampala. Minus the lack of freedom, it almost seems as it would be much more comfortable to reside there.

…The longer I am here, the more I realize how much I love home. Motonony just seems more and more enticing…


Week 2-All Good Things Come in Threes

This week seems to have embodied the idea that all good things come in threes--water, electricity, and internet--but no one is allowed to have all three working at any one time. The guys' building has been without water probably 3 times this week, the girls' building is without electricity so we've been running on a generator or going without, and the darn green door apartment is still without internet (along with the classroom). But, aside from the pesky, never-ending list of housing grievances, it has been a hugely eventful week of NGO visits, classes, and exploring the city.


We went to visit different NGOs to get a sense of the different organizations that work here in Uganda and so that students could link up with the group they'll work with this quarter. One of the most interesting visits was to the national referral mental hospital called Butabika. It was simultaneously fascinating and a bit disturbing to learn about the Uganda perception of persons with mental illness. The general belief is that people in mental hospitals are crazy, dirty, and don't deserve to be treated well or with respect. There is a huge amount of stigma surrounding mental illness in this country--far more so than in the US--which often means that patients who receive treatment at Butabika are unwilling to return home because their family and their community doesn't want to deal with them and the negative connotations. At Butabika, some patients have chosen to simply stay and live there for many years--a few patients have been there for close to 20 years.


We were able to tour the facility and actually go into patient wards. All of the patients are required to wear green gowns so that they can be easily identified by hospital personnel as well as civilians in the event that someone escapes. The wards were extremely simple with just a large room completely full of beds. They clearly have a large and ever-growing number of patients, so they have trouble with housing and enough staff to take care of the patients. Although the average stay is 2 months, many patients stay longer than that or are readmitted after family members refuse to take care of them. Although there was some evidence of talk therapy and other approaches to treatment, it seemed that a huge emphasis was placed on drug therapy. Perhaps in a facility in which doctors are extremely! limited, the easiest way to control someone is through medication.


Another part of the tour that I found extremely interesting was the fact that people being treated for drug and alcohol abuse are treated at the same facility. The Ugandan perception seems to be that addiction is another form of mental illness and that those people are crazy as well. While I'm not familiar with the exact definition of addiction and whether it does fall under mental illness, I was still surprised to find rehab patients in the place as people with serious mental disorders, such as schizophrenia or bipolar disorder. Perhaps I'm focusing on the US model where most rehab programs are privately run, but I was still taken a bit aback at the understanding of mental illness in this country.


Probably the most memorable experience of the week was our visit on Friday to an organization called Peace for Children Africa. PCA is a group that works to help street children achieve a better life. They provide food, housing, and education for a huge number of kids who live on the streets, left to beg, steal, and get by on their own. They first took us to the slum where they find most of these kids and we saw the terrible conditions that people are forced to live in. For the children that they can't accommodate at their permanent house, PCA runs an outreach program in the slum every Friday. In a community hall they provide basic education, first aid, and socialization for a group of street kids. We were able to interact with the kids, hear their stories about why they live on the streets, and came to realize that these are kids who are in a terrible situation and deserve a better life.


Once we had seen the slums, we went back to the PCA house where the street kids that they're currently rehabilitating live. There were lots of triple bunks with mosquito nets, a large living room with tables where kids do homework, and a workshop in the backyard where some of the older boys make wooden carvings and other crafts to sell at markets to earn a little extra money for PCA. We spent a good chunk of time--probably an hour--just meeting the kids and playing with them outside. One of the girls, Aisha, brought out some traditional grass dance skirts and tried to teach the girls how to do a traditional Ugandan dance. Once the boys got back from school, they brought out drums and started doing some cool acrobatics like back flips, round offs, etc. It was a really great way to spend the afternoon and it showed me that once these kids are given the resources they need and a safe environment to live in they behave just like a typical kid, despite their history.


After visiting the different organizations this week I wish I had even more time to spend here. We always seem to be over-programmed with activities and there's never enough time to see and spend time at all of the different places. Hopefully things calm down a bit in the next week and we can settle into our respective NGOs. Since we all attend Northwestern, where power, water, and internet are taken for granted, this week of seeing the different situations that people must live in has helped me gain a bit of perspective about my own life. It's hard to completely change our expectations, but at least we can be a bit more patient when things don't go exactly as we expect.


Location: Kampala, Makerere

Week 2 - Mulago Bright

Location: Kampala, Uganda

On Tuesday, April 6, we visited Mulago Bright Standard Nursery and Primary School as part of our last NGO site visit of the day. As we had just arrived from Joint Clinic Research Center and Nsambya Home Clinic, I was hopeful that Mulago Bright would present me with the opportunity to volunteer at an organization in a less “hospital like” environment. Focusing on supporting HIV/AIDS infected and affected orphans, training students in the arts to develop their talents, and providing basic needs to needy children, MBSNS has served its community since 1998.

Soon after we arrived, the director of Mulago Bright proudly informed the group that his institution had been declared the best school in Kampala for music, dance, and drama in 2009. Though his expression made it clear that this accomplishment had brought him great joy, this was one of the few positive things that the director had to say about his school. One of the first places we were taken to on our tour of the facility was a small room where several children shared a cramped living space. In what sounded like a thoroughly rehearsed speech, the director informed our group that each bed in this cramped space was used by at least three bodies.

As our tour progressed, the director made fewer and fewer mentions of Mulago Bright’s strengths and potential; rather, he insisted on highlighting the deficiencies of his facility. While it would be erroneous to suggest that the problems outlined by our guide were entirely illusionary, the degree to which he outlined these problems was shocking.

The next stop on our tour of Mulago Bright was a larger room characterized by a high ceiling and a corrugated iron roof. In addition to acting as a classroom, the director explained, this room served as a sort of storm shelter for the MBSNPS community. At Mulago Bright, water leakages represent much more than a minor nuisance; they present a serious inhibition to learning. Indeed, whenever the rains come the entire Mulago Bright family—students and faculty alike—must crowd into this room in order to keep dry, and as there is very little space in this room to move let alone conduct classes, learning in such an environment is impossible.

I recognize that Mulago Bright’s director cannot be faulted completely. Perhaps I misinterpreted the director’s words entirely. Perhaps he only intended to make the point that, in spite of such adverse conditions, the students of Mulago Bright have remained steadfast in their commitment to education. However, if this was indeed his point, it could have been much more clear.

Though I certainly felt uncomfortable with the director’s instance upon highlighting Mulago Bright’s weaknesses, I understand that there may have indeed been a method to his madness. Through pointing out the shortcomings of his school, the director undoubtedly had the intention of drawing much needed financial assistance. When we visited Peace for Children Africa (PCA), the impact that financial security became more than apparent. With a strong base of governmental and foreign assistance, PCA can afford to provide its residents with school supplies and healthy meals. Without this same economic security, the director of Mulago Bright may have to try everything possible to support his students. Donors may not feel pressed to help Mulago Bright unless its deficiencies are sufficiently marketed. Money goes a long way when invested in an NGO, and, though disappointing, this may just be how aid works.

Tuesday, April 13, 2010

Week 2 - First week of classes!!

Location: Kampala



Week 2 in Uganda and things are going pretty well. Easter Monday was pretty laid back which was great because it gave me a chance to slow down and get things ready for classes the next day. I woke up bright and early the next day ready to go!! We were introduced to our Luganda teachers and they both seemed pretty cool. My teacher was a bit intimidating at first, but in a good way. He knew exactly what he wanted to do and wasn't going to waste any time. The rest of the week was good as we got more acquainted with the campus and teachers. The lectures are very interesting. Just imagine someone talking at you for two hours straight!! Strangely enough, I'm alright with it. The subject matter is pretty interesting so it's not boring at all. It might get a little old eventually but for right now everything is good. We started visiting NGOs and that brought up a whirlwind of emotions. Everywhere we went was so different and significant. I wanted to become involved with all of them but of course there is no time for that. The most striking organizations we visited were Mulago Bright and Children for Peace. Mulago Bright is a primary school that is basically operating on nothing. It is located in a slum and was unbelievable. These children were lucky to be there but the conditions were horrible. They didn't have any clean water, there were holes in the rooftops which sometimes prevented them from studying when it rained and all they really had was music, dance, and drama. They won an award for the best school of the arts but they were lacking in so many other areas. It was heartbreaking to see how they lived but it was also inspiring because in spite of their situation, they were happy and thankful for what they had. Children for Peace was also striking on both ends of the spectrum. They had wonderful facilities for the children and were able to get them to school. They all had their own beds with mosquito nets!! All of the children were trained in the arts and they used this knowledge to create revenue for the program. After we visited the home, we went to the see where the street children lived and it was horrifying. Just imagine living in a huge dumpster. The smell was horrible and is was disgustingly crowded. I met a young girl who I connected with immediately. I was so drawn to her in as a mentor and an older sister. I couldn't fight back the tears when she told me the story of how she ended up on the streets and all I could do was hug her. I couldn't imagine going through what she has had to. That was a very humbling experience and made me appreciate my life and all of the opportunities I've been given. I can't wait to get more involved and hopefully have a positive impact on whoever I decide to work with.

Monday, April 12, 2010

Week 2 - Meeting People, Dancing, and Getting around the City

This week we started classes, began our dance training, visited the NGOs and other organizations where we will be interning, and took our first ride on a matatu. Needless to say, it has been a full week. I know last week a lot of us were feeling like tourists, and I think this week we have started to find our place in Kampala. We are not experts by any means, but we have met some new people and visited some new places.

In meeting people, I have noticed differences in the ways that Ugandans (versus Americans) greet people. Although variable, handshakes here tend to be longer than those in the United States. Usually, you clasp hands, rotate them so that your still grabbing hands but your thumb is pointed toward your own body, then rotate your hand back to the customary hand shake position. And don't be surprised when the other person continues to hold onto your hand for a prolonged period. This seemed strange at first, as I am most familiar with the brief, firm handshake that most people use in the United States, but I have become accustomed to this greeting now. This is not to say that this is the only way that people greet you in Uganda. I have also received quick handshakes and hugs, as well as handshakes accompanied by "Hello" and "Praise be to God." The commonality in all of these greetings, however, comes in the form of warmth. Everyone has been so kind and welcoming.

Dance training has been fun but frustrating at times. The traditional dances of the Buganda region involve a lot of hip movements and footwork. Olivia (our dance instructor) started us out with the footwork (step left - one, step right - two, step left - one, etc.). Then she added leg lifting (step left, raise right leg from the waist - one; step right, raise left leg from the waist - two; repeat). And then she added the "shake it." (I think that one is self-explanatory.) Some in our group caught on right away, but I would say the majority of us tried with occasional interjections of, "My body just doesn't move that way." Olivia has been supportive, and I am sure with practice we will get it before our performance next weekend.
When we haven't been doing traditional Ugandan dances ourselves, we have seen many performances. Last weekend we saw an amazing performance by the Ndere Dance Troupe. This week some students at Mulago Bright Standard performed for us, and so did some children at Peace for Children Africa. The integration of music and dance in Ugandan culture is really cool. It serves as a means of communicating cultural and social messages, and it seems to bring joy as well as a source of income to many dancers. It's truly amazing to see children who do not have parents or any possessions or who have come from the streets embracing performance and using it to explain their situations to other people.

Getting around on mutatus has not been too bad so far, but then again, Centurio and Olivia have either been accompanying or organizing most of these rides for us. I have learned a few things about riding in matatus, though. 1. Be prepared to get very close to the person sitting next to you. 2. Pay around the time you are about to get off. 3. Watch your head upon exiting the matatu. I have hit mine several times now. 4. Make sure that a matatu driver who has been hired to take you to a specific place actually knows where that place is located. He will get you there eventually, but expect some pauses for directions. 5. Sometimes matatus get pulled over by police for inspections. I'm not exactly sure what these inspections are about, but again your ride might take a little bit longer than you originally expected. (Believe it or not numbers 4 and 5 happened on the same matatu ride.)

Overall, it has been a busy and enjoyable week. Remembering to have a sense of humor and to stay open-minded has made everything easier. Plus, it doesn't hurt that everyone has been so welcoming and helpful.

Location: Kampala

Sunday, April 11, 2010

PCA's work with Current and Former Street Children

Background Info:
Throughout the week we have been touring NGOs with Centurio to look for potential sites to volunteer at. As part of our program, we're required to conduct research usually by working with an NGO. The project I designed is independent of NGO work because I'm investigating the current status of bioethical issues in Uganda through a series of interviews and conversations with Makerere University Medical School faculty and students along with other leading Ugandan bioethicists. So, while the NGO visits have been really interesting, I went to each one with the mindset that I was just visiting and not looking to volunteer there.

The Story:
After classes on Friday we went to Peace for Children Africa (PCA)- an NGO that works directly with current and former street children from the slums in Kampala. To explain our experience with PCA as amazing would be an understatement. The kids we met and the people that are dedicated to helping them are unlike anyone I've met yet here in Uganda.

We toured their home, where 23 former street children live. Some of the children are orphans and others ran away from abusive or otherwise broken homes. They mainly came from the largest slum in Kampala called Kisenyi. At the home, they are provided food and funding to go to primary and secondary school. They have a garden where they can learn to grow fruits and vegetables, a wood working shop where they learn how to make crafts to raise money, and various instruments and props to perform music, dance, and drama.

After touring the house we went to Kisenyi, where PCA performs outreach every week to provide basic medical care, education, and socializing with current street children. We toured some of the slum, saw where they live and what kinds of things they do to raise money for themselves. We then went to a community hall where we interacted with current street children. Some spoke a lot of english (meaning they probably went to school for several years) while others only spoke a slang version of Luganda. I got to sit with several kids and ask why they left home while Paul, a PCA leader, helped translate. It was heart-breaking to hear stories of their parents, some of whom were abusive and/or drug dealers or drug users. Other parents simply abandoned their children or sent them off to find another parent with instructions that they were somewhere in Kampala. So, these kids live on the street. They don't go to school and perform odd jobs like collecting plastic bottle or metal for minimal pay to survive. PCA works with these kids to try to get them to go to the PCA house or an orphanage if they don't have space. According to Paul many of them don't want to leave the streets because they would rather make money than go to school. So, PCA works with them to help them as best as they can to provide services for them in hopes that eventually they'll want to move off the streets and have the right mind set to get an education.

We headed out of the slum to go back to the PCA house to meet all the children that live there as they were coming home from school. As soon as we drove up, the kids came up to introduce themselves and wanted to interact with us. Some of them taught us how to play traditional drums, others tried to teach us some dance moves (I'm admittedly an awful dancer), and others just hung out with us. It was an amazing experience just spending an afternoon with these kids. They were so loving and welcoming despite not really knowing us and coming from such difficult pasts. I think we all walked away from that experience smiling and trying to plan the next time we could come back. For me, having planned a purely academic project, I decided to downsize my project so I can be at PCA as much as possible.

Location: Kampala, Uganda