Roller Coaster Gulu

Hey everybody,

Just want to let you know that I am alive and well. Have now fully recovered from my hospital escapade, and am back to 100% health. This has been a bizarre week, and somewhat of an emotional roller coaster.  Since we had a four day weekend, we were able to do a lot of fun things around Easter time. Most notably, on Saturday night we went to a concert that the other SIT group (the people studying with the other program in Uganda) had organized. In their free time, they had decided to put together a free concert where a bunch of local artists would perform. It took place in a stadium just outside of Gulu, and by most estimates there were between 5,000 and 10,000 people attending that night. It was crazy to see so many people in one place (and on the Saturday night right before Easter, no less!) We found out that apparently at Ugandan concerts, the artists don’t actually perform live; instead, they play their pre-recorded tracks and either lip-sync or sing along into the microphone while dancing. The artists were pretty amusing, but obviously the performances weren’t that high-quality. The performances were separated by many dance contests, at which time I had to quite firmly tell many Ugandan men that I would not like to participate. They seemed to think it would be quite hilarious to see a mzungu try to dance (and in fact, it would have been quite hilarious, given my terrible dancing ability, which I was not about to display in front of thousands of people!) I am actually surprised that they were able to find enough Ugandan women to participate in the contests, because the crowd was almost entirely men. This illustrates the basic gender roles that operate day and night in Gulu (and much of Uganda, actually): the men are often seen out and about (usually socializing, sitting around doing nothing, and/or hitting on mzungu women), while the Ugandan women are at home working and taking care of the children. Women rarely go out on weekends here, even though Gulu nightlife is fairly expansive. Then when the man gets home, his wife is expected to wait on him hand and foot, even though he has been out having fun while she has been working. I’m definitely starting to become a little more bitter towards the men when I see them out having fun, because I keep thinking about their families and how they should be helping the family instead of sitting around and talking to their friends.

Anyway, to go back to the original point, the thousands of people in the aforementioned crowd at the concert were mostly men. My friends and I had to fend off quite a number of them who wanted to get our numbers or arrange to meet up again. I’m starting to get really good at giving excuses for why I won’t give them my number: “I don’t have my phone,” “I have a boyfriend in the U.S.,” “My phone was stolen,” “If it’s meant to be, I’ll see you again,” etc etc. Most of the men we meet are harmless, if a bit annoying in their persistence. It really helped at the concert that one of our male friends from SIT was visiting for the weekend, and when we were having trouble shaking any of our suitors, he would come up, put his arm around us, and introduce himself as our boyfriend. That tended to scare them off very quickly.

I have to say, though, aside from the slight amusement I get from wondering at the huge numbers of men who are suddenly interested in me, I am getting a little tired of the way that people try to use my skin color to their advantage. I’m realizing that it is really hard to make friends here, because while everybody is very friendly, when you start talking to almost anyone, you find that behind their friendliness is the hope that you will get them a visa to the U.S., or that you will pay for their school fees, or something like that. It’s hard to tell if anyone likes you for who you are, or if they only are interested because you are white and to them, white skin=money. I can tell them over and over that I am a student who doesn’t have money, but that won’t change their expectations that I have some sort of connection that will help them. I don’t know if it’s happening more often, or if I’m just becoming more aware of it, but here is an example of the odd skin color dynamics: I was walking to work yesterday, and about 5 minutes away from the hospital, a man fell in step with me. He greeted me and introduced himself as the owner of a shop I had just passed. He was probably slightly older than me—maybe in his mid-twenties. He told me he had been looking for a friend like me—a white friend—and thought that maybe today was his lucky day. I was totally blown away by that statement, and tried to ask why he was looking for a white friend, and to share my view that it doesn’t make sense to judge somebody by their skin color, but he didn’t agree with my reasoning. He tried to set up a time for us to meet again, but I declined. I had never felt so much like a collectible object in my life, and the conversation really turned me off from wanting to interact further with him.

It was still better than some conversations I’ve had with people, though. My least favorite is the interaction where I make eye contact with someone, and they immediately say “give me 200 shillings!” or “you give me 200 shillings?” There are many variations on this, but the general meaning is the same. It really depresses me when people don’t even put in enough effort to greet me normally, and instead just revert straight to asking for money. It makes me wonder how many white people here actually do just give out money like that. Because I certainly never do, nor do any of my classmates. Even though 200 shillings is the equivalent to about 10 cents in US dollars, it’s about the deeper meaning of such an act. If I were to give them money, it reinforces a mindset that I think is very dangerous, which is that people here are poor and helpless, and they must depend on the West to support them. I have definitely started to see a little of what some call “dependency syndrome” here, which is essentially the manifestation of the mindset I just described. I think that is partially due to the huge saturation of NGOs here. Since Gulu was one of the places hardest hit by the war between the Lord’s Resistance Army and the Ugandan national army, when the war ended, a massive amount of aid poured in. NGOs set up bases here, and the network of aid organizations has grown very strong. Now a lot of the foreign staff are being pulled out, and the programs are continuing, run by Ugandan staff, which is great in my opinion. I think the aid was necessary, but I don’t like the after effects that it has left. The truth is, Ugandans are totally capable of doing all these things without help. I had the opportunity to visit several rural health centers with the policy person in charge of nutrition for the district on Thursday (this was much like a real roller coaster ride, since the roads are so terrible), and from these visits it was clear that the NGO presence was strong in Gulu, but that it was making a very positive impact on the community, and it was functioning very well without foreign staff. It was actually very encouraging to see the way that the government health offices were coordinating the delivery of health-related services by different NGOs, so people were working together instead of working on several parallel planes. I think that perhaps it is helpful to get funding from outside sources, since Uganda’s economy is struggling, and the corruption in the government prevents a lot of money from getting to where it needs to go, but the staff of these programs needs to be largely local people. Which brings forward a dilemma I’ve been struggling with for awhile: If interventions to improve life quality and health are better/more effective when they are community-run, where does that put me, as an outsider interested in working to improve health in other communities? Because I was lucky enough to be born into a community with relatively fewer problems, does that let me off the hook for problem solving in this lifetime? Or can I still help out, just in a way that takes a back seat to the local community members who can do so much more because they know the people, the traditions, and the language? I hope it’s the second one, because I don’t think I would feel very good about my life if I didn’t use it to help others in some way.

Which might be why I’m feeling so frustrated about the way the practicum period of this program is going for me.  Despite a week of pushing hard to get away from my “work” at the hospital, I have been rather unsuccessful so far.  On Tuesday, I spent the day watching a two and a half year old slowly give up on life.  His name was Kenneth, and though his head was a normal size for a child his age, his body looked closer to that of a newborn.  He was receiving anti-retroviral drugs to control the HIV that had been passed on from his mother, and he was not responding well to the therapy.  The day was brutal; when I got there in the morning, I was informed that he was “very weak” that day, and it only got worse from there.  The nurses spent a lot of the morning trying to get an IV line in his hand to inject drugs, but had to keep re-trying because his veins were so tiny and hard to see.  I felt so bad for him, because I knew how much it must be hurting him, even though he was so weak he was barely crying when they stuck him with the needle.  Then his mother sat with him on one of the beds with the Winnie the Pooh bedspreads and cradled him while he drifted in and out of consciousness.  The head nurse tried to get the pediatrician to come evaluate him as his condition worsened, but it took nearly 2 hours for her to come.  I like to think that it took so long simply because she was so busy with the patients in her own ward, but the nurses also reported that she was receiving a phone call and talking with students, so she may have just been taking her time. When she got there, she promptly announced that the child was “very sick,” (thanks for the news flash) and prescribed oxygen and about four other drugs, 3 of which the hospital didn’t have in stock.  For some reason, the ward was slightly understaffed that day, so I got to help with starting the oxygen (yay for EMT skills coming in handy), and they injected one of the drugs into him, and his mother again sat and held him while his little body tried to fight its way back to life.  This was the scene when I left for the day, but the nurses told me that he might not make it until the night, and when I returned the next day, I found out that he had died minutes after I left.  I know this kind of thing happens, even in the U.S..  Sometimes there really is nothing you can do for someone, and death is a part of life.  I guess it’s always hard to see someone so young die, because that is not part of the natural cycle.  Also, I keep thinking about the circumstances that brought about his death, and it’s maddening because in other circumstances, he might not have HIV (maybe his mother was raped during the war and contracted it then; or maybe she wasn’t able to access pre-natal care where they test for HIV and give the appropriate prophylaxis to reduce the risk of transmitting it to the child), or even if he did have it, he might be able to effectively manage it, or at least he could have made it through this episode of illness if he was being treated at a hospital with more resources.  It’s frustrating, because I know this is actually one of the better hospitals in Uganda, because of the NGO/foreign funding saturation that I mentioned earlier, and yet they still give the very minimum of treatment.  For instance, Kenneth wasn’t even put on an IV drip even though I am positive he was massively dehydrated and unable to eat anything.  When I asked the nurse about it, she just said in this case they really weren’t able to do that.  I wasn’t quite sure what that meant, but I think it might be because they have such limited resources, and they knew that he was probably going to die anyway, so they couldn’t afford to waste resources on him.  It’s a harsh reality to accept, but I guess that is life here.  It just makes me feel really helpless to see these things, and know that there is nothing I can do to help.  I feel like I am wasting my time, and it is just depressing to witness that every day.  The good news is that today we discharged 3 patients who had improved a lot, and it was definitely encouraging to see them interacting like normal babies, in contrast with the very sick ones that are common in the ward.  I’ve started to just visit the hospital for a few hours each day, and then do other things in the afternoons, because it’s simply not worth sitting there all day and doing nothing.

Outside of work, life here is continuing to get even more strange and unpredictable every day.  As much as I am enjoying this experience, I think I will be ready to go back home in about a month.  We are in the midst of a massive cockroach infestation in our house, which has been fun, especially since my mattress is on the floor, not on a bed frame.  (We only have 4 beds, and when our fifth roommate came up from Kampala, she expressed her desire to sleep on a bed.  I realized how drastically my standards had shifted when I deemed this request as “high maintenance” haha. But I agreed to give up my bed for her, since I have no problem with sleeping on a mattress on the floor. I just tuck my bednet in around the mattress, and thus far haven’t woken up sharing the bed with any insects.)  Also, last night, our landlord showed up at our house at 11:30PM with 3 other men in tow, who he told us were plumbers who had journeyed from Kampala to work on the house, and that they would be staying in the house for 3 nights.  That was a surprise, but he didn’t seem to think it was abnormal, and we just rolled with it.  Luckily, the house is so big that we can inhabit one side of it, and they can sleep on the other side, and it has been fine.  The only problem is, they ripped out all of the tile and the pipes in all of our bathrooms today, because they are replacing them, which means that we are without a place to bathe and are back to using the pit latrine in the back yard.  I swear, when I get home I am going to be so appreciative of all the luxuries that are a standard part of life in the U.S., both the small things like running water, and the larger things like paved roads and quality healthcare. All of this is starting to wear me out, and I’m feeling a little homesick for the good old US of A. Solution? My roommates and I made Kraft macoroni and cheese for dinner tonight, and are making pancakes for breakfast. Nothing like some good American food to soothe the soul. Congratulations if you made it all the way through this massive post.  Peace to you all. ~CMK