Month: March 2010

Greetings from Mbale, Uganda!

Surprisingly, we have found very functional internet in the middle of rural Uganda.  On Sunday we spent most of the day driving east from Kampala to a very rural village whose name escapes me right now.  The scenery was absolutely breathtaking–actually somewhat similar to Colorado, but with an added tropically lush element.  We spent two nights at a hotel unlike any other I have experienced.  It was structured somewhat similarly to a summer camp, in that there were “dormitories” that were spread out, and we slept on bunk beds, with 4-6 people per room.  It was built on the side of a hill/small mountain, and beneath us the land sloped down into a valley.  On the other side, there were several waterfalls that I could see when I stepped out the door from my room.  It was calm, quiet, and beautiful–a nice break from the hustle and bustle of the city, for sure.  It was somewhat like camping in that there were no real bathrooms–only latrines, and taps with running water for brushing teeth, etc.  There actually were showers (something many of us don’t even have in Kampala) with hot water (a big thing for us!), which was amazing, even if the water was a little overly hot [read: scalding].

We went on several hikes in the valley, and up to the base of two different, and large waterfalls.  We actually got to “shower” under one of the waterfalls, which was really cold, but so exhilarating and fun.  I didn’t believe that we would be able to stand under the water without getting knocked down, but it was really possible. I loved it because I kept looking up and thinking “Wow, how many times in my life am I going to be able to look up and see THAT?”  It was awesome.

We also did some work in the past few days (we are at school, after all).  We had several lectures on research methods, and then we went out into the local community and used the various research methods we had been taught.  (SIT has amazing resources/connections and they were able to set up groups of people who were willing to talk to us, so that was majorly helpful.)  The people my team interviewed were really interesting–they were part of a small “merry-go-round” group, where about 20 of them decided to come together and pool some of their money monthly, then give the sum to a different person each month, based on a pre-determined schedule.  That way, they were all able to make large purchases such as livestock, supplies of crops, parts for their houses, etc, that they wouldn’t have been able to afford otherwise.  It was a really cool way to see people working together.

We have a free night in Mbale tonight, but we are staying at a church-run guest house which has a curfew of 10PM so it probably won’t be too eventful.  Then tomorrow we move into our rural homestays, where we will be for 3 days.  During those three days, the only other SIT person we will see is the other student we have been paired with for the trip.  Intense!  But I like my partner so I think it will be fine.  We’re also supposed to bring them gifts, and our coordinators told us that livestock are very popular gifts, so we’re bringing a hen!  (They said since it will lay eggs, the family probably won’t kill it, so I hope they’re right!)  But again with one of those rare opportunities…how many times am I going to be able to bring someone a live chicken as a gift?  Out of time!  Hope all is well. Peace and love!

Sometimes I almost forget that I’m not in the U.S..  I’m starting to feel really comfortable here, and maybe I’m kind of getting sensitized to a different way of life.  In general, things aren’t as nice/fancy here as they are at home, but they serve their purpose.  I stop being surprised when I see dilapidated buildings and when I hear people shouting, “Mzungu, I love you!” at me.  I’m getting good at crossing the street and weaving in and out of taxis that are stuck in “the jam,” and I’m starting to know my way around the city.  Sometimes it starts to feel like home.

But then there is always an immediate reality check.  Today was like that.  We have now split up into electives for our classes, and my elective is Public Health.  We went to visit a health clinic in a village on the outskirts of the city.  We conducted focus group discussions about family planning with some people from the community, and we got a tour of the facilities.  The FGD went really well—we split into two groups, each talking to one gender group.  My group talked to the men, and it was actually a lot of fun.  They really loosened up and started joking with us, and it became a dialogue about culture and gender roles.  I’m going to write a whole blog about gender issues later, so I won’t go into that right now, but it was a really interesting/fun experience.

The mood got more sober really quickly, though, when we started getting a tour of the clinic.  The healthcare system in Uganda is supposed to be universal; people can go to any government health center and receive care free of charge.  There are 5 levels of health center, with the lower levels treating very few conditions and the higher levels treating everything.  This was a level 4 health center, which is supposed to be able to do everything except complex surgeries.  The grounds were extensive and in decent condition, but it became clear very quickly that there were major problems with the clinic.  They were drastically understaffed and didn’t have the most basic supplies/drugs.  There were around 35 patients waiting in the hallway to see one clinic officer, who I think is basically the equivalent of a Physician’s Assistant in the U.S. (and this was around 2pm in the afternoon).  In the maternity ward, the facilities for delivering a baby were really sparse.  There were two delivery tables, and that was pretty much all.  They didn’t have any blankets to wrap the babies in (the mothers have to bring those, along with sheets for their hospital bed when they come to deliver), no oxygen to jumpstart a baby’s breathing, not even anything to suction the nose/mouth (the first thing you’re supposed to do when delivering a baby).  And painkillers for the mom?  Forget it.

So basically, if the delivery is abnormal in any way, they are not equipped to deal with it.  They have a surgery wing, but they don’t have a surgeon; they have a blood bank but no blood.  They can supposedly refer to the main hospital if they are unable to handle a patient, but it takes so long to get between the two places (due to the roads and the traffic) that it seems unlikely to me that a patient with a severe health emergency would survive.  The only time-effective way to get between the two places would be to take a motorcycle taxi, called a boda boda.  I forgot to include those in my post about transportation, but they’re not that complicated.  Basically, some men have motorcycles that they drive around the city, and you can pay to get a ride almost anywhere on one.  They’re more expensive than regular taxis (from what I’ve heard it’s usually between 5000 and 6000 shillings to go across town, when it’s never more than 2000 on a conventional taxi), but they are a lot more maneuverable than the taxis, meaning you arrive much more quickly when you travel by boda.  We are forbidden to use them while we’re on the program because they are deemed unsafe.  I think this is a legitimate stipulation, because the boda bodas weave through traffic, sometimes driving on the wrong side of the road or the sidewalk to get around traffic jams, and the passengers never wear helmets.  (Surprisingly, the government just passed a law saying that all boda boda drivers have to wear helmets, and they are actually wearing them.  I say I’m surprised because laws really seem to have little legitimacy here…).  But back to the original point, a lot of the people we talked to at the clinic said it was already a struggle for them to pay enough to get there, so they certainly wouldn’t have enough to pay for more transport.

Also, there is the fact that they are unsafe.  While we were at the clinic, there was a car accident on the road right outside where a boda boda crashed into a taxi.  At first I thought it wasn’t a big deal since we were right outside of a clinic, and because people didn’t seem to be too worried about it.  But then as they were talking about it more, people were saying that the passenger who was on the boda was probably going to die.  That hit me pretty hard—she was a young woman, probably about my age, hadn’t been wearing a helmet, and sustained a pretty serious head injury.  Since I have training as an EMT, I was thinking about all the things that should be done for someone with a head injury, but then I realized that they had none of the resources to do any of those things.  It just made me so mad—I was thinking “What do you mean she’s going to DIE?!”  It’s just absurd that this happened right outside of a “high level” health center, and they couldn’t do anything for her.  They couldn’t even treat the driver, who was injured less severely.  They had to send them both to the main hospital (which we visited a few weeks ago, and it’s really not that much better equipped).

The whole trip just brought me sharply back to the reality of the situation, which is that I am in a resource-limited country, and when something goes wrong here, people usually aren’t able to deal with it.  It would probably be different if something like that happened to me, because I would be able to pay to go to a private clinic that would be better equipped.  But for the majority of the population, that’s not an option, and that is a sobering fact to remember.  For all the bad things people say about the U.S. (myself included), at least you know that if someone is having a health emergency, they will be taken to the hospital which will treat them to the best of their ability.  Like I said, this is just one of those sharp reminders that this setting is quite different.

This weekend we are leaving for a week-long trip to rural parts of Eastern Uganda, where I’m sure I’ll experience a lot of other things that are really different and difficult to comprehend.  So I’ll definitely come back with at least one blog entry, but I may not post for awhile because we won’t have internet access.  So until then, don’t worry about me, and take care everybody.  Peace.

Greetings all,

I feel as if the last post may have come off a little more negatively than I had planned. I really am OK, and this experience has a lot of positive aspects as well as the difficult ones. Uganda is kind of reminding me of that scene from Lord of the Rings (yes, I am pulling out the LOTR reference, sorry to be a nerd) where Elrond is trying to convince Arwen to join the rest of the elves in leaving Middle Earth, and he says he has looked into her future and “there is only death” there (because he sees that Aragorn will die and she will be left mourning). But then she has her own vision and sees her future child, and says to her father “But there is also life.”

That’s how I feel about this experience so far. Yes, I have already seen a lot of pain and suffering, and yes it has been hard… But truly, I think coming here was one of the best decisions I have made. There really is a lot of life and joy here. Despite all the problems they have, people here seem so happy. When you walk down the street in downtown Kampala, you pass hundreds of vendors, selling out of storefronts, stands, or off of blankets spread on the ground. They report that they don’t make much money (probably about the equivalent of $1-2 on an average day), and on some days they won’t sell anything. Some of them sleep in the same place where they operate their business, which may mean on the sidewalk, covered with a tarp. But when you pass them in the middle of day, you would never know. People are constantly laughing, joking, and generally having fun while they work. That’s something that is really difficult to find in the U.S.. In my mind I compare the high-powered, suited, business men working in Wall Street-type places with the business men here (who also wear suits, by the way), and it just amazes me, because I feel like the U.S. business world exists in greyscale, whereas here business takes place in vivid color.

The atmosphere in general is just so different. The U.S. is so rooted in capitalistic ideology, and everyone is trying to get ahead, no matter how many people they have to push down to achieve that goal. Here, though people are also trying to succeed because it’s a matter of survival, it’s more laid back and there is a much stronger sense of community. People help each other, which is really refreshing to see. But it also extends beyond economics, into family life and just life in general.

I find the family relations and personal space conceptions especially interesting. Family lines are much less clearly defined than they are in the U.S.. Parents treat many children as their sons and daughters, not just those who are biologically related. People who are considered cousins in the U.S. are brothers and sisters here. Maternal aunts and uncles are considered other sets of parents, and these people consider their brother’s/sister’s children to be their own children. In some families, it’s hard to tell how many people actually live there because friends, relatives, and neighbors are continually flowing in and out.

People are just friendlier here. I have never walked down any street here without being greeted by multiple people along the way, and the few times I’ve been lost in the city, people have been amazing in helping me find my way back to where I’m supposed to be. Maybe part of that friendliness has something to do with my skin color—being white definitely has its advantages here. (I hereby correct the language I used in a previous post, where I wrote that being white automatically put me at a disadvantage. I’ve thought about it a lot since posting that and it has bothered me, because it’s definitely not true. It does make me stand out, and sometimes that makes me a target for getting ripped off, but sometimes it opens me up to opportunities that might not be available to other people.) But the friendliness also just pervades Ugandan society in general. I hear it in the pleasant chatter in the taxis, when busses in the U.S. can be completely silent; I see it in the way people always have time to stop on the streets and say hi, when I’m often guilty of walking past friends at home because I’m in too much of a hurry to stop; I feel it in the touch of the smiling children who run to hold my hand as I’m walking through their neighborhood, though they have such a difficult life compared to American children. You know what I mean? It’s really refreshing, and I just admire it so much, because even though life is hard, people here have their priorities straight and are enjoying the life they have been given.

I think this is illustrated well in one last anecdote. I met my host grandmother recently, and I had barely stepped through the door when I was greeted by a massive smile and excited exclamations in Luganda, and enveloped in one of the most enthusiastic hugs I have ever received. She, like the rest of my host family, has accepted me into her life as a true family member. She remained in my thoughts for the rest of the night after we left, and I marveled over the love and acceptance that she had shown for me immediately. It really speaks volumes about a culture based on love, because she had no reason to accept me into her family. She is an old woman who has few material resources, but a lot of power in the family. She is not in the best of health, and she lives in a remote area that makes contact with the rest of the city difficult. If she had decided that she didn’t want to bother with meeting this mzungu (I’m the 5th student my family has hosted), no one would have faulted her. But she truly thinks of me as a granddaughter, and insisted on seeing me as soon as possible, and that is really amazing to me. It touches my heart that the family has accepted me so readily, when most people I know would keep a stranger at some distance from intimate family life.

That is the life and the joy that I have been writing about. It stretches from the rural villages to the center of the capital; from the children in my neighborhood to the vendors on the street. It is in the tea that is constantly offered to you and in people’s eyes when they greet you; it’s in the voice of the taxi driver trying to convince you to get in his taxi, and in the aroma that fills the house when you cook homemade food each night. It’s the feeling of knowing what is important in life and knowing not to waste your time with the things that don’t make you happy. Perhaps it’s partially related to the pain that people experience too; knowing all too well that tomorrow is guaranteed to no one sometimes helps to put priorities in order. That’s the life that makes me love this place, and makes me want to get out of bed each day despite the painful things I see. I can only hope to bring back some of that outlook on life when I return to the U.S..