Location: Kampala, Uganda, some in Gaba Outreach Program
Our research project finally had a chance to kick off these last couple of weeks. I have had the great opportunity to conduct questionnaires and interviews with HIV/AIDS patients, analyzing the quality of healthcare at Nsambya Home Care and their important OutReach Program out in Ggaba. This has not only allowed me a chance to meet wonderful people, but provided me with valuable data about Nsambya Home Care.
Nsambya HomeCare was initially created to help PLWA patients afford their medications by subsidization and provide needed counseling to allow patients to cope with the situation. Not only do they provide treatment and counseling for 1000 shillings (50 cents), but they also make sure that patients leave the facility satisfied knowing what they have to deal with. Nsambya HomeCare really is a blessing. They have done so much to provide patients with the care they need to deal with HIV/AIDS, and they even opened an outreach program in Gaba for patients out in that region to have closer access to medication and treatment. Every health worker that I have met has been very welcoming and social, allowing me to research fluidly and quickly. However, as well as this HomeCare has provided treatment, there are nevertheless problems that they need to deal with.
The idea of a problem is related to your point of view on the situation. If you have never experienced a better way of life, you have no idea there is something better out there, so you may have no problem with an experience. However, if a patient is more educated and has gone through countless situations and understand the scenario better, he/she might have more to say in terms of improvement of the quality of care of a situation. Thus, a problem is very relative to what you know and what you have experienced. That was something I clearly saw between the patients at Gaba and Nsambya HomeCare. Gaba patients, who tended to be more rural, have very little problems with the quality of healthcare. The wait time is long, the health workers treat them fine, and they have very little complaints. However, patients at Nsambya HomeCare, though very gracious of the treatment and medication provided, have complaints in which they feel would make the experience more pleasant. For example, if they could provide free water, money for food due to the long wait time, and complaint boxes, they would be able to improve on the quality of healthcare and the patients would be happer with their experiences.
What I also realized is some information that people are willing to share in front of someone other than a health worker or community volunteer. It is in the subconscious to think that the health worker and community volunteers would be biased towards the quality of healthcare at the facility. They would be more likely to say the treatment as positive and the commitment of the health workers to be strong, but the patients would be much more willing to explain their problems to a third party. Interviews and questionnaires provide patients a chance to bring their complaint boxes to the table and share what they have to say, providing a freedom of speech to someone who is willing to listen.
This learning experience of qualitative research has more than helped me understand how patients act and how questions should be asked to not seem harsh and provoking. As one who has not done any previous qualitative research, Nsambya HomeCare has provided a valuable observational experience to perform a pilot study. I would very much like to thank Brian, the counselor, for being my translator and explaining the process of treatment at the Gaba OutReach Program, as well as Sister Irene, Teo, etc. for helping me out on my project. I would also like to thank Dr. Maria Musoke for letting me interview patients at Nsambya HomeCare and Head Nurse Grace for directing patients to me. This experience is more than I could have asked for in a couple of weeks in Uganda.
Friday, May 28, 2010
Week 8 - The War Continues for Former Ugandan Child Soldiers
Location: Kampala, Uganda
This week, our School of Public Health lessons revolved around the subject of mental health in Uganda. By far, the most interesting lecture we received was on the subject of post traumatic stress disorder in former Ugandan child solders. As we learned, the forces of Joseph Kony’s rebellion movement, the Lord’s Resistance Army (LRA), have brought utter chaos and destruction to the region of northern Uganda. Over a period of roughly two decades, the LRA acted with what seemed to be a complete disregard for human life in its effort to overcome the Ugandan military. As explained by Derluyn, Broekaert, Schuyten, and De Temmerman (2004), this conflict had a significant impact on the lives of all the inhabitants of northern Uganda: “Tens of thousands of people have been killed and mutilated, hundreds of thousands displaced, and farming activities and livestock have been totally disrupted” (p. 861).
Though few in northern Uganda were left untouched by the hands of the LRA, perhaps the most detrimentally effected were the child soldiers used to fuel Kony’s campaign of terror; with more than 20,000 youths abducted to date, children comprise roughly 90% of all LRA recruits (Derluyen et. al 861).
Although a great deal of stability has come to northern Uganda in recent years, the conflict lives on in the minds of these child soldiers. Subject to sexual exploitation and abuse and forced to engage in the rape and murder of their loved ones, those children abducted by the LRA are at a monumental risk of developing a multitude of psychiatric disorders (Okello, Onen, and Musisi 225-226). Among the most common and problematic of the psychiatric disorders developed by these youths is posttraumatic stress disorder (PTSD). Defined as “an emotional illness that usually develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience”, those living with PTSD may find it extremely difficult to adjust to life after war (Muhwezi slide 24). In general, PTSD symptoms are grouped into three categories: intrusive memories, avoidance and numbing, and increased anxiety or emotional arousal.
Intrusive memories, or “recurrent re-experiencing” of trauma, represent one of the most troublesome symptoms of PTSD (Muhwezi slide 25). Constantly burdened with the images and sounds of acts that they witnessed and committed during wartime, former Ugandan child soldiers often experience great struggles in their efforts to look toward a new, peaceful future. In a Lancet article entitled “Post-traumatic stress in former Ugandan child soldiers”, Ilse Derluyen and colleagues outline the true prevalence of the intrusive memories symptom in LRA abductees. Out of a total of 71 respondents who completed the impact of event scale-revised (IES-R)—a self-report scale for PTSD— the mean score for the intrusion symptom was found to be 18.2 out of a maximum score of 28 (Derluyen et. al 862). Given their additional findings on the events witnessed by many child soldiers during periods of conflict, this high occurrence of intrusion may come as no surprise; Out of a sample of 301 former child soldiers, 77% had seen someone being killed during their abduction, 6% saw a member of their immediate family being killed, 39% had to kill another person themselves, and 2% had to kill an immediate family member (Derluyen et. al 861). As many former Ugandan child soldiers have had their social support networks disrupted by the very events that caused their PTSD, policy makers in the Ugandan government and humanitarian organizations must continue with their efforts to support a healing process so that former LRA abductees may cope with their painful intrusive memories in a healthy fashion (Muhwezi slide 31).
Thought the symptoms of posttraumatic stress disorder are indeed serious, a great deal of hope exists for former Ugandan child soldiers living with PTSD. One of the most effective tools in overcoming this devastating mental ailment is psychotherapy; by speaking with former child soldiers about their experiences as members of the LRA, mental health professionals can provide them with an outlet for emotions and memories that would otherwise go unexpressed. Additionally, further efforts are necessary to combat the stigmatization of child soldiers in those communities that have been devastated by the LRA. Though it may be difficult for many individuals in northern Uganda to greet the very child soldiers who killed their loved ones with open arms, the Ugandan government and the international community must work to spread awareness that these children were indeed forced to comply with Joseph Kony’s agenda.
References:
Derluyn, I., Broekaert, E., Schuyten, G., & De Temmerman, E. (2004) Post-traumatic stress in former Ugandan child soldiers, Lancet; 363: 861–63
Muhwezi, Wilson W. "Traumatization [Post Traumatic Stress Disorder – PTSD]
in Uganda." Introduction to Public Health: Module 4. Makerere University, Kampala, Uganda. 27 May. 2010. Lecture.
Okello, J., Onen, T, S., & Musisi, S. (2007). Psychiatric disorders among war-abducted and non-abducted adolescents in Gulu district, Uganda: a comparative study. African Journal of Psychiatry. 10:225-231
This week, our School of Public Health lessons revolved around the subject of mental health in Uganda. By far, the most interesting lecture we received was on the subject of post traumatic stress disorder in former Ugandan child solders. As we learned, the forces of Joseph Kony’s rebellion movement, the Lord’s Resistance Army (LRA), have brought utter chaos and destruction to the region of northern Uganda. Over a period of roughly two decades, the LRA acted with what seemed to be a complete disregard for human life in its effort to overcome the Ugandan military. As explained by Derluyn, Broekaert, Schuyten, and De Temmerman (2004), this conflict had a significant impact on the lives of all the inhabitants of northern Uganda: “Tens of thousands of people have been killed and mutilated, hundreds of thousands displaced, and farming activities and livestock have been totally disrupted” (p. 861).
Though few in northern Uganda were left untouched by the hands of the LRA, perhaps the most detrimentally effected were the child soldiers used to fuel Kony’s campaign of terror; with more than 20,000 youths abducted to date, children comprise roughly 90% of all LRA recruits (Derluyen et. al 861).
Although a great deal of stability has come to northern Uganda in recent years, the conflict lives on in the minds of these child soldiers. Subject to sexual exploitation and abuse and forced to engage in the rape and murder of their loved ones, those children abducted by the LRA are at a monumental risk of developing a multitude of psychiatric disorders (Okello, Onen, and Musisi 225-226). Among the most common and problematic of the psychiatric disorders developed by these youths is posttraumatic stress disorder (PTSD). Defined as “an emotional illness that usually develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience”, those living with PTSD may find it extremely difficult to adjust to life after war (Muhwezi slide 24). In general, PTSD symptoms are grouped into three categories: intrusive memories, avoidance and numbing, and increased anxiety or emotional arousal.
Intrusive memories, or “recurrent re-experiencing” of trauma, represent one of the most troublesome symptoms of PTSD (Muhwezi slide 25). Constantly burdened with the images and sounds of acts that they witnessed and committed during wartime, former Ugandan child soldiers often experience great struggles in their efforts to look toward a new, peaceful future. In a Lancet article entitled “Post-traumatic stress in former Ugandan child soldiers”, Ilse Derluyen and colleagues outline the true prevalence of the intrusive memories symptom in LRA abductees. Out of a total of 71 respondents who completed the impact of event scale-revised (IES-R)—a self-report scale for PTSD— the mean score for the intrusion symptom was found to be 18.2 out of a maximum score of 28 (Derluyen et. al 862). Given their additional findings on the events witnessed by many child soldiers during periods of conflict, this high occurrence of intrusion may come as no surprise; Out of a sample of 301 former child soldiers, 77% had seen someone being killed during their abduction, 6% saw a member of their immediate family being killed, 39% had to kill another person themselves, and 2% had to kill an immediate family member (Derluyen et. al 861). As many former Ugandan child soldiers have had their social support networks disrupted by the very events that caused their PTSD, policy makers in the Ugandan government and humanitarian organizations must continue with their efforts to support a healing process so that former LRA abductees may cope with their painful intrusive memories in a healthy fashion (Muhwezi slide 31).
Thought the symptoms of posttraumatic stress disorder are indeed serious, a great deal of hope exists for former Ugandan child soldiers living with PTSD. One of the most effective tools in overcoming this devastating mental ailment is psychotherapy; by speaking with former child soldiers about their experiences as members of the LRA, mental health professionals can provide them with an outlet for emotions and memories that would otherwise go unexpressed. Additionally, further efforts are necessary to combat the stigmatization of child soldiers in those communities that have been devastated by the LRA. Though it may be difficult for many individuals in northern Uganda to greet the very child soldiers who killed their loved ones with open arms, the Ugandan government and the international community must work to spread awareness that these children were indeed forced to comply with Joseph Kony’s agenda.
References:
Derluyn, I., Broekaert, E., Schuyten, G., & De Temmerman, E. (2004) Post-traumatic stress in former Ugandan child soldiers, Lancet; 363: 861–63
Muhwezi, Wilson W. "Traumatization [Post Traumatic Stress Disorder – PTSD]
in Uganda." Introduction to Public Health: Module 4. Makerere University, Kampala, Uganda. 27 May. 2010. Lecture.
Okello, J., Onen, T, S., & Musisi, S. (2007). Psychiatric disorders among war-abducted and non-abducted adolescents in Gulu district, Uganda: a comparative study. African Journal of Psychiatry. 10:225-231
Thursday, May 27, 2010
Week 8 - The 145 ft. Jump
Location: Kampala
One thing I know for sure is that Uganda has emboldened me. This was revealed this weekend when we went to Jinja for white water rafting and bungee jumping. I must preface this post by noting that I am terrified of heights yet somehow I developed enough courage to plunge 145 feet down into the roaring Nile. After an entire afternoon rafting followed by close to ten hours of deep sleep, we woke up to a new day of adventure. The jump was set for 9:30 and I could barely hold down my breakfast in anticipation. After having mounted a daunting set of stairs, I stood at the top of the platform and watched as one by one my classmates made the leap. As it inched towards my turn, panic set in. Creeping towards the chair, at which point the towel/rope combination would be attached, I glanced over the edge which revealed a 44 meter drop. A few weeks back, the morning of Ssese trip, we spent a relaxing day by the pool side. There were three diving platforms of increasing height. Even though the highest couldn't have been more than fifteen feet from the surface of the water, the jump was intimidating and I barely had the courage to do it. Now, staring down into the Nile 145 vertical feet away made the fifteen foot jump look easy. Probably the scariest part of the whole experience was hopping towards the edge with your feet bound, and then edging even closer with nothing to hold onto. In theory, there's a bar above the edge that one should hold to facilitate the process of reaching the edge. However, I was too short to reach it and therefore had nothing to rely on for support. I had hardly enough time to collect myself before the countdown began...3...2...1....it's hard to believe that I actually jumped. Even looking back at on the moment and watching the video over and over again, I still feel jittery and my heart still races. The first twenty feet was a complete blur, and the stomach drop only set in after falling halfway down. I think that's when the realization of falling actually kicked in. Then the rope retracted and I soared up, then down, then up, then down again. The experience was amazing, definitely a moment of my life that I will continue to relive with the solid satisfaction of having had the courage to take the leap.
One thing I know for sure is that Uganda has emboldened me. This was revealed this weekend when we went to Jinja for white water rafting and bungee jumping. I must preface this post by noting that I am terrified of heights yet somehow I developed enough courage to plunge 145 feet down into the roaring Nile. After an entire afternoon rafting followed by close to ten hours of deep sleep, we woke up to a new day of adventure. The jump was set for 9:30 and I could barely hold down my breakfast in anticipation. After having mounted a daunting set of stairs, I stood at the top of the platform and watched as one by one my classmates made the leap. As it inched towards my turn, panic set in. Creeping towards the chair, at which point the towel/rope combination would be attached, I glanced over the edge which revealed a 44 meter drop. A few weeks back, the morning of Ssese trip, we spent a relaxing day by the pool side. There were three diving platforms of increasing height. Even though the highest couldn't have been more than fifteen feet from the surface of the water, the jump was intimidating and I barely had the courage to do it. Now, staring down into the Nile 145 vertical feet away made the fifteen foot jump look easy. Probably the scariest part of the whole experience was hopping towards the edge with your feet bound, and then edging even closer with nothing to hold onto. In theory, there's a bar above the edge that one should hold to facilitate the process of reaching the edge. However, I was too short to reach it and therefore had nothing to rely on for support. I had hardly enough time to collect myself before the countdown began...3...2...1....it's hard to believe that I actually jumped. Even looking back at on the moment and watching the video over and over again, I still feel jittery and my heart still races. The first twenty feet was a complete blur, and the stomach drop only set in after falling halfway down. I think that's when the realization of falling actually kicked in. Then the rope retracted and I soared up, then down, then up, then down again. The experience was amazing, definitely a moment of my life that I will continue to relive with the solid satisfaction of having had the courage to take the leap.
Week 8 - let the fun begin!!!
Location: Kampala and Jinja
This week was sooooooooooooooooo much fun!! On Sunday we went to see the move Imani and it was wonderful. I didn't know what to expect but I a little about the day before and I was amazed. It was so beautiful and so real. After the movie, we met with the director and the writer. I was a bit nervous to conduct an interview but they reminded me of me and my sister which was really nice. They were very down to earth and it was a lot of fun talking to them and seeing how the movie came about. Monday we visited a water treatment plant and the landfill. You can probably guess it wasn't the best smelling experience but it was very informative. Throughout the week, we broke up into groups of threes to work on presentations on our trip to the water treatment plant and the landfill. Because it was our first presentation, we didn't know exactly how to go about it. We only had a few days to prepare on top of our other activities and assignments. We were all a bit stressed out but in the end, everyone did really well and we were nervous for nothing. On Saturday we left for Jinja. Originally I wasn't going to go but I realized that this would be my last trip with the whole group so I went and I'm so glad I did. I pretty much hate water but I went rafting and at times I wish I hadn't. It was really fun but there were times where I thought I was going to flip out of the raft and die. Luckily for me, that never happened but our guide made us get in the water a few times just to get a feel for it. I argued with him a bit because I wasn't comfortable but in the end, it was good practice in case something happened and I fell in. Our bodies were so sore after rafting for 31 km!!! I basically passed out on the bed immediately and had one of the best nights sleep ever!! The next day, though I didn't bungee jump. I enjoyed watching my friends try to fly. Afterwards, I realized how much I'm going to miss this group and how lucky we all are to be here and be able to have fun with each other to create amazing memories.
This week was sooooooooooooooooo much fun!! On Sunday we went to see the move Imani and it was wonderful. I didn't know what to expect but I a little about the day before and I was amazed. It was so beautiful and so real. After the movie, we met with the director and the writer. I was a bit nervous to conduct an interview but they reminded me of me and my sister which was really nice. They were very down to earth and it was a lot of fun talking to them and seeing how the movie came about. Monday we visited a water treatment plant and the landfill. You can probably guess it wasn't the best smelling experience but it was very informative. Throughout the week, we broke up into groups of threes to work on presentations on our trip to the water treatment plant and the landfill. Because it was our first presentation, we didn't know exactly how to go about it. We only had a few days to prepare on top of our other activities and assignments. We were all a bit stressed out but in the end, everyone did really well and we were nervous for nothing. On Saturday we left for Jinja. Originally I wasn't going to go but I realized that this would be my last trip with the whole group so I went and I'm so glad I did. I pretty much hate water but I went rafting and at times I wish I hadn't. It was really fun but there were times where I thought I was going to flip out of the raft and die. Luckily for me, that never happened but our guide made us get in the water a few times just to get a feel for it. I argued with him a bit because I wasn't comfortable but in the end, it was good practice in case something happened and I fell in. Our bodies were so sore after rafting for 31 km!!! I basically passed out on the bed immediately and had one of the best nights sleep ever!! The next day, though I didn't bungee jump. I enjoyed watching my friends try to fly. Afterwards, I realized how much I'm going to miss this group and how lucky we all are to be here and be able to have fun with each other to create amazing memories.
Week 8 - Blisters and Bungee Jumping: A lesson in spontaneity
Well, I don't consider myself an extremely spontaneous person, but lately I have found that sometimes it pays off to do things without thinking about them too much.
On Wednesday, I was about to eat lunch at the small restaurant across the street from our flats when I received a phone call from the director at the Epilepsy Support Association of Uganda (ESAU). That morning, I had contacted him about the possibility of attending a general assembly meeting. I have become interested in studying epilepsy in Uganda, particularly the psychosocial aspects of the disorder, and I thought that attending this meeting might be a good way to show the organization that I was interested in their cause and would like to work with them further.
Now, I received this phone call around 1:40 p.m. The director explained that the best meeting for me to attend was that afternoon at 2:00 p.m. and that it wasn't that far from the university. Of course, I questioned briefly whether or not it was worth it for me to go to this meeting. I wasn't really sure where it was or how useful it would actually be for me to attend. I could have easily said that I was sorry and that I wouldn't be able to make it, eaten my lunch, and worked on my assignment due that evening. Instead, I ran to my room, changed into a nicer outfit, and googled the location of the meeting. I ran back to the restaurant, left money with the others ordering food, and took off to find the meeting.
I let the director know that I would be late and began walking in what I thought was the direction of the hotel where the meeting was being held. Let's just say that I asked at least fifteen people for directions on the way to this meeting, and I certainly walked twice the distance that I actually needed to. This whole time I could feel the blisters forming on the bottoms of my feet, but I kept walking. Eventually, I got to the meeting (about an hour late) and was introduced to everyone in the room as I tried to quietly take a seat in the back. The meeting was informative, but more importantly, I met many of the people involved in the national operations of the organization face-to-face. They were all very nice to me, and I knew that this would be an organization that would want to work with. Since the meeting, I have gone to the national office and found that the impressions I gained at this general assembly meeting were correct.
Overall, I'm glad that I made the split-second decision to go to the meeting. Even though I got terrible blisters (my feet are still recovering), I made great connections with people at ESAU and showed my enthusiasm for working with the organization.
Lesson two in spontaneity is a little less serious. This past weekend, we went to Jinja for white water rafting. We also had the option to go bungee jumping. Now, I have never really had a desire to go bungee jumping. I do love roller coasters, the giant drop and the like, but jumping from a platform with just a rope tied to my feet was never something I felt particularly inclined to do. But I thought, 'Hey, when am I going to get the chance to bungee jump over the Nile River again in my life?' And that pretty much sealed my fate.
Deciding to jump off of a 44 meter-high platform while standing on the ground is a lot easier than actually making that jump off of that 44 meter-high platform, though. I would say I remained pretty calm as I climbed up to the platform, and I was even pretty calm as they tied my feet together. I started to freak out a little bit when they asked me to hop to the side of the platform. I was even more freaked out when they told me to shuffle so that my toes were hanging off of the edge. I looked down when I was told not to, and then all of the guys yelled, "Three, two, one, bungee!" and I just had to jump.
I'll admit, it was pretty amazing, and I'd certainly do it again. I'm glad that I didn't let my fear prevent me from signing up to jump and that it didn't prevent me from jumping when I was standing at the edge of the platform.
So again, I'm glad that I did something spontaneous, something outside of my comfort zone. I'm already planning my next daredevil stunt. Bungee jumping has certainly made me brave.
Location: Kampala, Jinja
On Wednesday, I was about to eat lunch at the small restaurant across the street from our flats when I received a phone call from the director at the Epilepsy Support Association of Uganda (ESAU). That morning, I had contacted him about the possibility of attending a general assembly meeting. I have become interested in studying epilepsy in Uganda, particularly the psychosocial aspects of the disorder, and I thought that attending this meeting might be a good way to show the organization that I was interested in their cause and would like to work with them further.
Now, I received this phone call around 1:40 p.m. The director explained that the best meeting for me to attend was that afternoon at 2:00 p.m. and that it wasn't that far from the university. Of course, I questioned briefly whether or not it was worth it for me to go to this meeting. I wasn't really sure where it was or how useful it would actually be for me to attend. I could have easily said that I was sorry and that I wouldn't be able to make it, eaten my lunch, and worked on my assignment due that evening. Instead, I ran to my room, changed into a nicer outfit, and googled the location of the meeting. I ran back to the restaurant, left money with the others ordering food, and took off to find the meeting.
I let the director know that I would be late and began walking in what I thought was the direction of the hotel where the meeting was being held. Let's just say that I asked at least fifteen people for directions on the way to this meeting, and I certainly walked twice the distance that I actually needed to. This whole time I could feel the blisters forming on the bottoms of my feet, but I kept walking. Eventually, I got to the meeting (about an hour late) and was introduced to everyone in the room as I tried to quietly take a seat in the back. The meeting was informative, but more importantly, I met many of the people involved in the national operations of the organization face-to-face. They were all very nice to me, and I knew that this would be an organization that would want to work with. Since the meeting, I have gone to the national office and found that the impressions I gained at this general assembly meeting were correct.
Overall, I'm glad that I made the split-second decision to go to the meeting. Even though I got terrible blisters (my feet are still recovering), I made great connections with people at ESAU and showed my enthusiasm for working with the organization.
Lesson two in spontaneity is a little less serious. This past weekend, we went to Jinja for white water rafting. We also had the option to go bungee jumping. Now, I have never really had a desire to go bungee jumping. I do love roller coasters, the giant drop and the like, but jumping from a platform with just a rope tied to my feet was never something I felt particularly inclined to do. But I thought, 'Hey, when am I going to get the chance to bungee jump over the Nile River again in my life?' And that pretty much sealed my fate.
Deciding to jump off of a 44 meter-high platform while standing on the ground is a lot easier than actually making that jump off of that 44 meter-high platform, though. I would say I remained pretty calm as I climbed up to the platform, and I was even pretty calm as they tied my feet together. I started to freak out a little bit when they asked me to hop to the side of the platform. I was even more freaked out when they told me to shuffle so that my toes were hanging off of the edge. I looked down when I was told not to, and then all of the guys yelled, "Three, two, one, bungee!" and I just had to jump.
I'll admit, it was pretty amazing, and I'd certainly do it again. I'm glad that I didn't let my fear prevent me from signing up to jump and that it didn't prevent me from jumping when I was standing at the edge of the platform.
So again, I'm glad that I did something spontaneous, something outside of my comfort zone. I'm already planning my next daredevil stunt. Bungee jumping has certainly made me brave.
Location: Kampala, Jinja
week 8 - Kampala's music scene
Location:Kamapala
There is a surprisingly large and Hip Hop community in Kampala, especially when taking into consideration the relatively young popularity of Hip Hop in Uganda. Through my interactions with those involved in the Hip Hop community, there appears to be two distinct groups of artists: those who consider themselves to be “underground” (making music for themselves as opposed to for the money and popular appeal, whether intentionally or unintentionally), and those who consider themselves to be “mainstream,” or whose music is widely liked by the public. The division between underground and mainstream seems to be largely a matter of self-identity. Nearly all of the artists who I interacted with identified as one or the other, and they used this identity largely to shape their music.
The underground Hip Hop community is wide, diverse, and close-knit. It was initially started by Silas Babaluku – a Hip Hop artist who started the Bavubuka All-Stars Organization. Bavubuka is an organization that promotes the arts, but that is mainly known in Uganda as something of a Hip-Hop community center. Nearly every underground artist or group who I met came from Bavubuka, and many of the artists from outside of Kampala still have strong ties to the organization. I found that the underground scene in Uganda and Bavubuka really went hand in hand, which explains why the artists who call themselves underground are so tight and close-knit as a group. It should also be noted that Bavubuka that has quite a strong presence in Kampala. Many people who I spoke with, even though they were not at all involved in the Hip Hop scene, were still familiar with Bavubuka and its mission.
I have had considerably less interaction with the group of artists who consider themselves to be mainstream, but I have still interacted with a number of them. Aside from it being more difficult to access those mainstream artists, it was clear to me that the network of those artists was not nearly as close as the network of underground artists. Although most of the mainstream artists who I met seemed to know each other, they did not speak about one another so much as friends but more as colleagues, and so networking in this context was actually significantly more difficult. For them, it seemed, music was more of a profession – a context in which, as I saw it, they treated their music more like a business as opposed to a medium of artistic expression. Still, the mainstream music scene was still more about the music, and less about the money.
Although these mainstream artists were less accessible, I was still surprised at how accessible they turned out to be, especially compared to what I am used to in the United States. I was able to sit outside and take coffee with GNL – one of the most popular musicians in Uganda – and it seemed not to be a big deal. It was like sitting outside with anybody else – no bodyguards or disguises to go incognito, no lines of fans asking for autographs, and nobody taking pictures. I guess this should not have come as a surprise though: About a month ago, I saw a newspaper headline talking about GNL’s new 30million shilling record deal. I was impressed at first, until I realized that 30million is only about $15,000 USD. It is nice to know that even the popular music scene here is still a relatively down to earth, and compared to the U.S., rather low budget.
There is a surprisingly large and Hip Hop community in Kampala, especially when taking into consideration the relatively young popularity of Hip Hop in Uganda. Through my interactions with those involved in the Hip Hop community, there appears to be two distinct groups of artists: those who consider themselves to be “underground” (making music for themselves as opposed to for the money and popular appeal, whether intentionally or unintentionally), and those who consider themselves to be “mainstream,” or whose music is widely liked by the public. The division between underground and mainstream seems to be largely a matter of self-identity. Nearly all of the artists who I interacted with identified as one or the other, and they used this identity largely to shape their music.
The underground Hip Hop community is wide, diverse, and close-knit. It was initially started by Silas Babaluku – a Hip Hop artist who started the Bavubuka All-Stars Organization. Bavubuka is an organization that promotes the arts, but that is mainly known in Uganda as something of a Hip-Hop community center. Nearly every underground artist or group who I met came from Bavubuka, and many of the artists from outside of Kampala still have strong ties to the organization. I found that the underground scene in Uganda and Bavubuka really went hand in hand, which explains why the artists who call themselves underground are so tight and close-knit as a group. It should also be noted that Bavubuka that has quite a strong presence in Kampala. Many people who I spoke with, even though they were not at all involved in the Hip Hop scene, were still familiar with Bavubuka and its mission.
I have had considerably less interaction with the group of artists who consider themselves to be mainstream, but I have still interacted with a number of them. Aside from it being more difficult to access those mainstream artists, it was clear to me that the network of those artists was not nearly as close as the network of underground artists. Although most of the mainstream artists who I met seemed to know each other, they did not speak about one another so much as friends but more as colleagues, and so networking in this context was actually significantly more difficult. For them, it seemed, music was more of a profession – a context in which, as I saw it, they treated their music more like a business as opposed to a medium of artistic expression. Still, the mainstream music scene was still more about the music, and less about the money.
Although these mainstream artists were less accessible, I was still surprised at how accessible they turned out to be, especially compared to what I am used to in the United States. I was able to sit outside and take coffee with GNL – one of the most popular musicians in Uganda – and it seemed not to be a big deal. It was like sitting outside with anybody else – no bodyguards or disguises to go incognito, no lines of fans asking for autographs, and nobody taking pictures. I guess this should not have come as a surprise though: About a month ago, I saw a newspaper headline talking about GNL’s new 30million shilling record deal. I was impressed at first, until I realized that 30million is only about $15,000 USD. It is nice to know that even the popular music scene here is still a relatively down to earth, and compared to the U.S., rather low budget.
Week 8
Location: Kampala
There is no going back, ever, and if anyone sees me slipping, remind me of where I have been. I am so full of love for the things I have seen and people I have met- intellectually my heart is breaking but I feel next to nothing. Maybe it is a gift from God that I rarely cry, maybe it’s supposed to give me courage to keep going. Today our group had lunch with a community of Congolese refugees, some of whom shared their stories with us. When these men and women talked, you either saw nothing or everything in their eyes- overwhelming sadness or emptiness. One man spoke of how, as a pastor, he was asked by the military to provide children to the army. He refused on the grounds that those children were God’s, not his, and was taken to live for 9 months in the bush as a result. He was tortured and beaten during that time until he could finally escape, where he ran for six months. Ultimately he was rearrested on the charges that he was responsible for the kidnappings of other children. Today he lives with his wife in Uganda as he was kicked out of the country. His wife was raped, and one of his two children is not with them- he/she had gone missing but has recently been found and will be returned to him. It has been about 3 and half years and now he/she is six. Another man discussed how military men would kill people, cut up their bodies, roast the flesh, and then make the villagers eat the body. Finally, a woman spoke- saying that the military came to the house of her husband and children. The children were beaten in front of her while she was tied down and then subsequently raped in front of all of them. She began sobbing and ran to sit down, unable to continue. Do you know why the war in the Congo continues??? It is a war over our CELLPHONES and ELECTRONICS, it is perpetuated by America due to the desperate hunt for profitable minerals and materials to sell!!
Is the world ugly, or is it beautiful?? Is your life just one more life?? Are we supposed to have hope when all this happens? They do- they DO. WHY? If I ever go back to my old life, my old selfish lazy way of thinking, someone hit me over the head with a baseball bat. Even right now, I am listening to my American pop music while typing up a transcription of an interview I did with a ~15 year old girl, Alexa, whose uncle continually asked her to have sex with her until she ultimately ran away to the slum and was finally rescued from her crappy life. Oh, did I mention she was living with her aunt because her father died and her mother was too poor to take care of her?
I hate and love this place. I don’t know how to feel, but I do know that the love I receive from the kids I volunteer with, and the people that share their horrific stories with us, is worth more to me than anything else. How does this all go on when, walking through the streets of Kampala, I see outwardly nothing of the sort?
THIS IS WHY I CAME TO AFRICA. THIS IS WHY. MAY I NEVER, EVER RETURN TO MY IGNORANCE OR LOOK THE OTHER WAY AGAIN.
Week 8- (Un)Qualified
I began part II of my research plan this week. Part I involved interviewing 4th and 5th year medical students at Makerere University to understand the ethical challenges they’ve faced during their clinical rotations at Mulago National Referral Hospital. Part II involved observing wards at Mulago to better understand the context for the stories I had heard and to observe any other ethical issues that students did not address. I decided to focus on pediatrics wards because of the many stories I had already heard about ethical situations involving informed consent, rationing of medicine, and patient autonomy.
So, I addressed up (tie included) and went to a pediatric ward that I had been given permission to observe. I was required to wear a white coat (as all doctors do) on the ward while observing despite the fact that I was only there to observe, not treat. This white coat turned out to be more trouble than I had ever anticipated. I still don’t know whether it was because I was wearing the coat, am a mzungu (white person), or because of severe under-staffing that I was asked to help diagnose and treat patients. It’s probably a combination of all three reasons. From the moment I was introduced to the person I was shadowing I was perceived as having medical skills that I in fact do not. It took 5 minutes and many different attempts before I successfully explained to my guide that I was not qualified to help and that I really only wanted to observe despite the fact that she would allow me, if I had agreed, to help diagnose patients by listening to the heart and lungs, taking medical histories, etc. After talking with many interns and master’s students, it is evident that the idea of “just observing” seems silly and unproductive to them. Why would I not want to learn how to treat patients? Why could I not help them? Why was I there if all I wanted to do was watch? Why should they take the time to talk with me if I couldn’t provide some help in return? These were all the questions that I was directly and indirectly asked throughout the day.
As someone who is interested in ethics, I felt strongly that it would be unethical to try to treat patients without proper training despite the fact that it would have been much easier to simply take basic diagnostics to appease the staff. At the same time, I had to question whether my presence was causing an undo burden on the staff and on the patients. I kept asking myself, “Am I taking away from time the staff could be using to treat patients? Am I indirectly harming the patients?” This was particularly hard when I went to the acute pediatrics ward as I felt even more in the way and less prepared to handle what I saw.
Location: Kampala, Uganda
So, I addressed up (tie included) and went to a pediatric ward that I had been given permission to observe. I was required to wear a white coat (as all doctors do) on the ward while observing despite the fact that I was only there to observe, not treat. This white coat turned out to be more trouble than I had ever anticipated. I still don’t know whether it was because I was wearing the coat, am a mzungu (white person), or because of severe under-staffing that I was asked to help diagnose and treat patients. It’s probably a combination of all three reasons. From the moment I was introduced to the person I was shadowing I was perceived as having medical skills that I in fact do not. It took 5 minutes and many different attempts before I successfully explained to my guide that I was not qualified to help and that I really only wanted to observe despite the fact that she would allow me, if I had agreed, to help diagnose patients by listening to the heart and lungs, taking medical histories, etc. After talking with many interns and master’s students, it is evident that the idea of “just observing” seems silly and unproductive to them. Why would I not want to learn how to treat patients? Why could I not help them? Why was I there if all I wanted to do was watch? Why should they take the time to talk with me if I couldn’t provide some help in return? These were all the questions that I was directly and indirectly asked throughout the day.
As someone who is interested in ethics, I felt strongly that it would be unethical to try to treat patients without proper training despite the fact that it would have been much easier to simply take basic diagnostics to appease the staff. At the same time, I had to question whether my presence was causing an undo burden on the staff and on the patients. I kept asking myself, “Am I taking away from time the staff could be using to treat patients? Am I indirectly harming the patients?” This was particularly hard when I went to the acute pediatrics ward as I felt even more in the way and less prepared to handle what I saw.
Location: Kampala, Uganda
Tuesday, May 25, 2010
Week 8- Our last adventure
This past weekend we went to Jinja on our last trip of the program. The scheduled activities were white water rafting down the Nile and bungee jumping over the Nile. Rafting was good fun for everyone, except two of us who wanted the boat to flip the least each fell out of the boat. My flip happened on the very last rapid of the day and involved a few minor injuries. The experience reinforced just how much I'm not cut out for outdoor activities. I much prefer seeing and experiencing nature from a safe distance, not as up close and personal as being sucked underwater in huge rapids. But that's beside the point. Most of the day was fun and I'll simply be avoiding rafting for the foreseeable future. On Sunday, people had the opportunity to go bungee jumping. As you can probably guess from my previous comments, that's not an activity for me. I have absolutely no desire to leap off of a platform hundreds of feet in the air, feel like I"m going to crash into the water, or be jerked back up by the elastic bungee cable. Instead, I enjoyed watching my friends take this crazy leap from a safe distance. While they all really enjoyed it, my favorite part was hearing the screaming and cursing that occurred as they made their initial fall. One guy even touched the Nile river upside down--and by touch I mean he was dunked up to his waist. All in all, it was a fun weekend, but we all left exhausted.
As much fun as I had, the end of the weekend signaled the very significant reality that our program is almost over. We have been on our last trip with Dan and Centurio, taken our last drive out of Kampala, and are now down to 11 days of exams, papers, and presentations before our program in Uganda officially ends. Thrown into the last week are 3 birthdays which should be great fun! But aside from that, it's hard to believe that we've been in Uganda for 8.5 weeks and our time as a group is quickly coming to an end. It feels like I'm just starting to get the hang of this city and now the program is over. Luckily, most of the group is actually planning to stay for some portion of the summer. I think only 2 of the 9 of us are set on leaving Uganda for good next week. I'm looking forward to having people to spend time with once the summer is upon us. And, as much as I have loved this program, I'm also excited to finally be able to focus on my research. Our lectures and trips have been great, but it's hard to really settle in and get involved in a project when your time and focus are constantly being pulled in multiple directions. As our program comes to a close, I'm sad to see certain experiences end and people leave, but I'm looking forward to what the summer will bring.
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