Extend

The dreaded words “extend mzungu”. I roll my eyes and shoot a dirty look at the conductor who said this. He wants me to move even closer to the person that I am already snuggled up more tightly than lovers would be. We have to try to squeeze one more person into this mini bus (live a mini van with seats for 19 people). Children are sitting on strangers laps, bags are piled high on top of the mini bus and shoved in all free space, people are standing hunched over using up literally any free space possible. I am already sitting in the most awkward position and have been for the past 2 hours. Sure I will try and move closer to my neighbors, I would love to have more parts of a strangers sweaty body on my sweaty body. Why not?

Transport is always an adventure. My absolute favorite form of transport in Uganda is my own legs. No one else can dictate my speed, no one can get to close to me. I do from time to time have to deal with the occasional harassment but that is well worth it for the fresh air, beautiful views that I can actually see and the comfort of having a fairly big “American” sized personal space bubble where most of the time only my friends cross. The exercise as well is awesome, my legs are going to be so strong just from walking to work and back home (you can ask my mom, sometimes we catch each other on the phone while I am walking up the big hill and am panting out of breath).

Then there is the boda boda or boda for short. Its a motorcycle that you can hop on the back of and pay to drive you where ever. This can be wonderful on a hot day. Its a great way to air out your armpits...let that wind blow. But if the weather is to change, which it does often, it isn't such a pleasant ride. As my co-worker calls it the “open roof” doesn't offer much protection during a rain storm. Not to mention, when you are carrying a heavy backpack and on a boda for an hour your back starts to get sore. I also have the tendency to squeeze my legs together the whole way. Like I think this will save me from falling off. Who am I kidding? But it is a great inner thigh workout. The sensation of going quickly over these dirt roads and feeling the wind in your hair (and armpits) is something that I will miss, maybe I will just get my own scooter or motorcycle when I get home. Boda rides, I would say, are much more enjoyable out in the villages. When you get on one in Kampala, the capital city, I fear for my life. Although, I should probably have a similar amount of fear in the village with the sharp turns and quick drop offs and not great roads. Kampala is filled with buses, cars, mini buses, bodas and people everywhere. Bodas are constantly weaving in and out of traffic, disobeying traffic laws, squeezing through spaces I swear aren't big enough to fit the bike, and narrowly escaping accidents. However, you do reach your destination much quicker than when you are stuck in traffic and obeying the stop lights, and in Kampala you can sit in traffic for hours.

Then there are the buses. Think Greyhound buses just the really old buses that we no longer want in America sent to Uganda. The prices to different destinations are “negotiable”. You have to know what it is supposed to cost and refuse to pay more. The conductor always tries to get more out of you, especially when you are a foreigner. Some buses in Uganda are really nice, they run smoothly, they only stop at the major bus stops, they are clean and the conductors are honest, but that would just be too easy. The buses that come all the way out to where I stay only run on certain days of the week, the are old, the conductors just want to get as much money as possible out of the trip. This can come in the form of taking advantage of people who don't know what the price should be. Perhaps, they try to charge insane amounts for putting your luggage under the bus, or they stop for every person standing on the side of the road even when the bus is full and the aisle is filled with bags and standing people. Sometimes, even, they tell you the bus is going all the way to your stop, when in fact it is stopping in the nearest town (1.5 hours away) and not proceeding further and its 8:00pm at night when it is dark when we arrive at there final destination not mine. Not that I am a little bitter about that or anything. Buses do have their advantages. Sometimes they are playing really awesome music that you can get into, other times it is blasting the same 6 gospel songs on repeat for 10 hours. If you get on the bus super early and are one of the first few people to board then you can get the front seat where there is only one seat and no neighbor and you have the whole front window to see out of and don't need to be prepared for territory wars, but that means that you have to wait for the entire bus to fill up before leaving the bus park. If you do get a seat where you control the window then that means that well, you have control of the window which is priceless. Also seats in buses tend to be your seats and although sometimes you have to play territory wars over your space, the amount of space that you get does tend to be much larger than the dreaded MINI BUS.

Mini buses are quite pleasant in Kampala. There is a seat for everyone, you are not packed so tightly, the prices are cheap and they go just about every where. You just need to figure out how the mini bus system works, but each time I go to Kampala I get better and better at it. However, mini buses in Kanungu and I am sure other rural areas where police are easily bribed and traffic rules are more like guidelines aren't quite as nice. Each row is supposed to have seats for 4 people, except in the front with the driver which only has 3 because there needs to be room for the stick shift...So how many people do you think can you fit into a vehicle? That is a question I cannot answer. I am always impressed at the ability to find space for just a few more people. I am also impressed at Ugandans lack of anger for paying for a ride on this mini bus and then being squished in uncomfortable positions for 5 hours while the vehicle stops every 10 minutes to pick people up or drop someone off. As this occurs and the more and more intimate I become with my neighbor and the more times the conductor asks me to 'extend' the more and more the anger and frustration builds up inside of me and the dirtier the looks I give get and the shorter I get with people calling me 'mzungu' or just trying to talk to me. I am pretty sure you could gauge how long I have been traveling for based on these characteristics. Clearly, if you haven't figured it out yet, mini buses in the rural areas are my least favorite form of transport unfortunately, sometimes it is the only means to get from the nearest town to my bus stop.

Although transportation can be a pain in well you know what, I wouldn't change my commute for anything. A 2km walk each way full of beautiful views, fresh air and if I see more than 3 motorcycles along the way I am curious as to what is going on in the village. Luckily this is my commute and I don't have to deal with close quarters, crazy music on repeat, and traffic (what is that again?)

Holistic Health

Global Health Corps is an organization that promotes health equity for all. What does it mean to be well? How does one not contract a disease? Is health just the absence of disease or does it mean more than that? The World Health Organization goes a step further and defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." The WHO definition includes many aspects of one's well being in order to be a healthy person, and rightfully so.

Take the example of Tukahirwa Alice. She is a 54 year old widow. She lives in a small village called Nyakageyzi in southwestern Uganda. In her village, there are few people with access to power or running water. She is a subsistence farmer growing bananas, beans, sweet potatoes and a few other crops to feed her family. She lives in a mud hut and uses a pit latrine. Many of her children have died and she is left caring for 4 of her grandchildren. On top of that she is HIV positive and needs to take ARV's (antiretroviral) treatment to slow the progression of HIV.

This story is not uncommon for this area of Uganda and other parts of the world. So how do we provide grandmothers like Alice with the tools and ability to create a more healthy life? That is where Nyaka AIDS Orphans Project comes in.

Nyaka, believes that it is important to provide a holistic approach to development. The organization believes that in order to create a healthier, thriving community we can't just focus on education or health care or sanitation or any one aspect alone. The approach must be integrated. Fixing one problem won't raise a community up out of poverty we need to continue to address all factors that challenge people from living a healthy and fulfilling life.

Since I am a fellow at Global Health Corps, I am particularly interested in making sure that ones health does not stop someone from living the life they want to live. In order to improve someone's health that person needs access to health care; but not just any health care, quality health care. The individual must be able to access health services and also receive drugs. These basic services must be affordable and available to every person regardless of their income and where they live. Access to doctors, nurses, dentists and medicine though, does not ensure that a person is healthy.

In order to be healthy we all need a safe places to stay. Some place where we don't fear the roof or walls of the house collapsing. We also need a clean place where the surroundings are free from tall grass, garbage and feces. We need a place to go to the bathroom and a place to bathe. We need a place where there is room for all family members to sleep inside. We need to have a house within a sanitary environment to live, in order to prevent diseases in the first place.

We also need water. But not just any water, we need water free from parasites and bacteria. We need water that does not cause diarrhea when drunk. We need safe and clean drinking water. The same goes for food. We need food that is cooked properly so that we don't get sick from eating it. We all need to eat. We can't just eat boiled plantains everyday with a spoonful of beans. We need a variety of foods like mangoes, green vegetables, chicken, milk, nuts, tomatoes, milk, onions. We need to eat foods that will help boost our immune system and keep our bodies healthy and strong. We all need this, whether we are 2 months old or a 102 years old.

We need education. We need to provide children with the ability to attend school. To learn, to gain a better understanding of the world and a chance to succeed. We need to teach guardians how to keep there children healthy and how to keep themselves healthy. We need to teach pregnant women how to take care of themselves before, during and after birth. We need to teach farmers how to produce food more efficiently. Knowledge truly is power.

 

Perhaps, the most important thing that we need is each other. We need friends and family. We need support and the feeling that we belong somewhere. We need someone to help us take care of our children, cook and clean when we are too sick to get out of bed. We sometimes just need someone to complain to. We need someone to celebrate with us during happy times and someone to lean on when the going gets tough. These interactions can influence our physical, mental and social health. We all need human interaction.

There are many things that we need to be healthy which brings me back to Alice and the work that the Nyaka AIDS Foundation does. Before Alice joined a grandmother group affiliated with Nyaka, Alice was struggling. She could not afford the services and drugs offered at the nearest government hospital, her pit latrine and kitchen were in rough shape. She struggled to pay the school fees for the children she was caring for, her HIV was affecting her life.

Alice became involved with the Granny group, where grandmothers take advantage of micro-finance loans and are able to discuss challenges they are having in their life and provide each other with solutions. This support from other grandmothers with experience with similar problems caring for orphans is a great way to spread knowledge and make that one another know that they are not alone. Nyaka also provides new houses, kitchens and pit latrines to grandmothers. Within these groups grandmothers determine who is in the greatest need of one of these structures. Alice was chosen due to the dilapidated state of her own facilities. The knowledge that she now doesn't have to worry about these structures falling down thus reducing some of the stress she feels.

Alice also utilizes the Nyaka clinic for free healthcare and medications. She no longer has to worry about having enough money to pay for health services and drugs. She also attends health talks to learn how to better care for her family. Her use of the clinic has reduced her burden of living with HIV, in fact she now looks strong and healthy while talking her ARVs and accessing the services at the clinic.

Alice's daughter and granddaughter receive sponsorships from Nyaka to attend secondary and primary school, respectively. The students receive two balanced meals a day. The knowledge that she has given her family a chance for a better future is one that she says is keeping her alive.

Nyaka enables individuals to provide a better life for themselves, while securing a better future for their children by providing a holistic approach to health. Imagine if this success could be replicated for all of those women who were living like Alice. By providing individuals and communities with programs and services addressing not one challenges but many that affect their health we could transform communities. After all, many different things effect health.

Remembering How Lucky We Are

I know this may come to a surprise, but sometimes I need to remind myself that not everyone gets to do what I have been able to do and just how lucky I have been in my life. I've grown up with enough food on the table and clothes to wear. I've had access to good schools and have my Masters degree. I have had the opportunity to travel the United States and different parts of the world. I have a family in both Zambia and America. I am a female in a place where gender inequality is slight compared to others. I am white, and with that comes certain privileges whether we like it or not. I have 2 of the best and most supportive parents and 2 of the kind of siblings that I am proud to call my brother and sister. They make me want to be a better person because they have accomplished so much and are so compassionate. I also have an awesome dog, which is pretty great. My family not only puts up with but also encourages all of my crazy dreams. I have the kind of friends that don't mind when I disappear for a few months and welcome me back with open arms (I am so grateful for this because everyone knows how bad I am with long distance friendships). Basically, I am so fortunate. What a life.

In Uganda, you can get bogged down on the difficult things. Oh no we only have tomatoes..what are we going to eat? Yikes that water is cold, this is the most uncomfortable shower ever! My best friend in country is an hour motorcycle ride and four hour squished bus or mini-bus ride away. But hold on look out the window that view is beautiful! I get to walk to work, where if I see more than 7 motorcycles go past me I wonder what the heck is going on. I am surrounded by joyous children and I am in a place where I can learn so much. Lucky, right?

Anyway, this was not at all what I wanted to write this blog about. My inspiration came from something much more superficial, I hate to say. It came from going on 2 safaris. I had the privilege to tag along with Jenny and Grace, 2 amazing girls that came to volunteer at Nyaka for a few days, and go to Queen Elizabeth National Park. We went on a 2 morning game drives and an afternoon boat safari. We saw tons of animals; warthogs, elephants, antelope, birds, crocodiles, hippos, more birds and a tree climbing lion. Apparently, Queen Elizabeth National Park is one of the few places in the world with tree climbing lions.

A few weeks later I had the opportunity to go on a vacation with 3 of my friends here to Murchison Falls National Park and the Ziwa Rhino Reserve. We got to see these beautiful waterfalls, sleep and have a hippo wake us up at night and warthogs roam the camp. We also got to go on safaris both boat and in a car. We saw antelope, giraffes, elephants, hippos, warthogs, birds etc.

Now, I know this may seem crazy but by the end of the safari I found myself thinking things like “oh great, another hippo” or “how much longer do you think this is going to be we've seem all of these animals”. When did seeing these animals become common place. How silly is it that this is what I felt. People in Uganda haven't seen the places that I just have seen within their own country (I suppose the same thing goes for tourists who come to the US). How many people would do just about anything to experience what I just got to experience? Sometimes I can forget just how lucky I am. One thing that I am going to try and work on this year is to be more present and appreciate everything around me. Realize how lucky I am. I think it is something that everyone should do.

The Rain is Coming!

Now that we are nearing the end of August rainy season is beginning in this wonderful land of Kambuga. Apparently, I have no idea what is in store for me. I am just waiting to find out.

With rainy season there comes different sorts of challenges which you may expect. But before I get into this let me tell you a bit about how I think rainy season works. There is no rhyme or reason. It is sunny for 5 days then rains for 3 then partially rains for 1 then sunny, then rainy then sunny then a little rain etc... There are a few different types of rains. The sky being like “look at me. It sounds like I am going to rain and it looks like I will rain as well but...tricked ya not today dude.” The “light” rain that never ends or the wicked hard pouring buckets wind gusting rain coming through the open windows kind of rain. Unfortunately, or fortunately, depending on how you look at it, I think the last one has been the most common so far.

Esther and I decided to start a garden, we dug our beds planted out seeds. A few days later there was a huge down pour, I am pretty sure that the seeds were washed away. This was over a week ago and there is still no signs of little seedlings. Bummer dude. I should have used my Zambian garden knowledge and protected it with grass until they took root. Oh well we will have to try again with the seeds we have left and buy a few more. I want my garden! The rains won't defeat me at that.

come on garden i want veggies

 

Walking. Yes something as simple as walking is a challenge. As I mentioned in the last post, it is hilly here. 

you can sort of see the road in the top of the picture

Going to the library (I usually go during the work week as it has internet and electricity) I must walk down a few very steep hills and up one steep hill. Roads here are made of mud, when mud gets wet it gets slick. Walking down slick mud can be treacherous. For most of the road it is a decision of whether you want to risk going down the slick piece or put your feet in the muddy area covering your feet with mud but knowing that the chances of slipping are much smaller if your foot is surrounded by that much mud (I usually choose the later option). There is also the trouble with the mud getting caked in the soles of your shoes so any traction that was there is gone. However, on another part of the road a different option presents itself. Here rocks are abundant.

 

 By rocks I mean sharp, jagged protrusions that are a nice place to butt your foot up against because falling backwards is not really an option but one misstep and believe me you can feel the rock through the sole of your shoe. I can only imagine what the damage that my shoes will take after the 2 rainy seasons (yes there are 2 per year). Also, so far, I have remained standing and clean after a few close calls.

For me the most frustrating part of rainy season for me, is being trapped somewhere, be that at work, on someone's verandah, under a tree or in a vehicle (although when the vehicle you are in has no windshield wipers I dont seem to mind it so much) waiting for the rain to pass. Sometimes after work all I want to do is go home relax and cook dinner. However, I think that this is the time the skies decide to open and encourage me to enjoy the company I am with. Sometimes this is easier said than done.

 

Waiting for the rain to end while in a vehicle.  Making friends.

its pouring out!

I also feel the urges whenever I hear thunder to get up and start walking home when it is close to leaving time but my co-workers just sit and wait to see if it rains, if it does its no big deal they will just sit and sit until it ends. They are so patient. On the other hand I get all antsy just wanting to leave. I blame the Americaness in me.

Oh and it doesn't help when you're electricity is solar and it begins raining all day. You all can figure out why.

However, the smell, the life that the rain brings, the bonding you get to do while all huddled into a small space not getting wet. The comforting sound when you are safe in your home of the rain hitting your roof while you are all cuddled up. The excuse to do nothing and be in your pajamas on a weekend day is almost irresistible. The candle lit dinners without power and the early bed times because you can. The nice security guard who sees my clothes drying on the line, takes them down, folds them and puts them in a bucket protected from the rain on my verandah. The rain is good.

As much as we all complain about the weather (its to hot, to humid, to cold, where is the sun?, too much rain, not enough rain) I realize that weather like all things in life just needs to be appreciated for what it is. Nothing more or nothing less.

Rain is good.

Some pictures for your enjoyment:

What I see while walking to work.

mmmm i want to eat you

Fresh lettuce and cilantro while visiting a friend in Mbarara.  You have no idea how exciting this is!

New adventure...new fun

Well I guess it is about time for a little update. For those of you who don't know I was lucky enough to be selected as a Global Health Corps Fellow. This means that I am off on another adventure.  Its an opportunity that I am so grateful to have been given.

Global Health Corps (GHC) is an organization that trains young leaders in public health. The goal is health equity for all. I am lucky enough to be part of the 128 fellows selected from all over the world. The way GHC works is that it pairs a national and an international fellow together at a variety of organizations in six different countries around the world (If you really want to learn more about it you can check out ghcorps.org). The fellows are placed at large organizations such as Clinton Health Access Initiative and Partners in Health, as well as small organizations, like mine, Nyaka AIDS Orphans Project.

First GHC brings all of the fellows to Yale for a 2 week training. It is a great opportunity to meet fellows that won't be in your country placement. It is a bit intimidating because people have such impressive resumes. There are amazing speakers that come to speak and wellness information on how to keep yourself from getting burned out. There is so much to learn from your colleagues it is amazing. However, I think my favorite part was getting to know the international folk and introduce them to our culture whether that be the food or the funny sayings we have. One of the activities we did was have a scavenger hunt in New York City. Some pictures below.

Charles and Joan in NYC (both are with me in Uganda)

My group in New York City

A group of us who are going to Uganda

 

Now, however, I have reached Nyaka AIDS Orphans Project in Kambuaga, Kanungu (their website is nyakaschool.org). It is a small village in the south western part of Uganda. It is in a beautiful hilly location, full of pastures for cow grazing and lots of banana plantations. There is no market, there are a few shops, and electricity and running water is far and few between. The challenges that I face here are similar to the ones that I faced in Peace Corps. Where do I buy my vegetables from? How quickly can I learn the local language so that I can communicate with everyone? Will people ever stop calling me mzungu? (mzungu is the word for white person and comes with all sorts of connotations such as being rich, maybe not being as culturally sensitive etc..) Will I ever blend in? What exactly am I doing here? What is my job? How do I fill my free time? To name a few.

Esther my co-fellow and I at the Nyaka School sign

 

But Kambuga just like Nyansonso has so many bright spots and so much to offer. As I get used to my neighbors and the people here they get used to me I can see the joy and happiness that is here. I am so excited to be making these relationships. I was given a local name meaning gift, just a small affirmation of the beginning of my integration into the community. The pineapples are amazing! The food is not bad at all. Children are children and always bring me joy. There is so much that I am going to learn here and I can't wait to discover more.

 

The view from our front porch.  The red roof is the clinic.

So I suppose a little bit about what I am supposed to potentially be doing. My official title is Health Programs Associate. So briefly, what I will be doing, as I understand so far, is working with the clinic staff and doing capacity building, such as teaching them basic computer skills and more information about different health topics and ways to best educate about these. I will also be trying to improve the procedures and reporting at the clinic. I also have the privilege of working with the grandmother project, assisting with health education and in any other way that I can be useful. I think i will have to spend a bit of time trying to figure out how my skills will best fit into the organization so that I can make the greatest impact.

Today I had the privilege of meeting with a group of grandmothers who came thinking that just a lecture was happening. I introduced my self and asked them if they had questions we ended up talking about eye health and cervical and uterine cancer. There was the normal business of meetings...little did they know that they were going to get a big 120 liter water collecting barrel. The wells and places to collect water is far from where they stay so now they will be able to collect rain water.

The joy and happiness when they realized that everyone was going to go home with this barrel was infectious! I feel so privileged to be a part of it. There was dancing and singing and hugs and handshakes. I was even given some groundnuts (like peanuts) from one of the grandmothers. Something so simple as a barrel can make a huge difference in the life of these grannies. This joy is why I am here and doing what I am doing. I know it is natural to question why I chose to move to a place that is completely foregin and having to go through some of the uncomfortableness that comes along with that. Believe me, I definitely question, but moments like this remind me how lucky I am for this experience. I hope that I can give those grannies a fraction of the joy that they have given me today!

The joy and happiness when they realized that everyone was going to go home with this barrel was infectious! I feel so privileged to be a part of it. There was dancing and singing and hugs and handshakes. I was even given some groundnuts (like peanuts) from one of the grandmothers. Something so simple as a barrel can make a huge difference in the life of these grannies. This joy is why I am here and doing what I am doing. I know it is natural to question why I chose to do what I do, and believe me that definitely happens, but moments like this remind me how lucky I am for this experience. I hope that I can give those grannies a fraction of the joy that they have given me today!