Sorry it has kind of been awhile since my last post. The whole internet thing was much too difficult to deal with more than once while I was in Apac, and it has been quite the eventful few days since I returned to Gulu, so I’m just now getting around to writing an update. (Though, I really should be writing my paper instead. I just would rather write this. I just wish I were getting graded on my blog instead of on the paper!)
I really enjoyed the rest of the time that I spent in Apac last week. I definitely like small towns…at least in small doses. I loved just walking around there, talking to people, and taking in the sights. The training was pretty useful; I got a lot of information that I can use in my paper, and also learned a lot that I think will just be useful in my life in general, if I really want to do this international public health thing. I also ended up making a lot of friends and having quite a bit of fun. I was told before I went to Apac that people there were somewhat “hostile,” which was not really a comforting thing to hear. (Similarly, I found out on the drive there that it is the place with the highest incidence of malaria infection in the country…also not comforting!) I do have to admit that the hostility thing was somewhat true: at least in comparison to other places I have been in Uganda—notably Gulu—the people were less friendly. I wouldn’t call them hostile, but it did take them a few days to warm up to me, an outsider. I just tried to be patient, and to do little things to show them that I was on the same level they were, such as waiting in line to get lunch instead of jumping to the front of the line with the facilitators who I had come with, and sitting at the table with them even though I couldn’t understand their conversations since they were in the local language.
After a few days went by, I started making friends. It was an interesting dynamic, because I was the only one there who was not married, and one of the few who didn’t have children. They found a lot of amusement in poking fun at me because I was still a “baby” by their standards. I found out that in the Langese culture (the Langese are the ethnic group that mostly live in that area), you are considered a “girl” until you have delivered a baby, at which time you are seen as a “woman.”
It’s so interesting how ridiculously important it is here to be married and to have children to fit into the community, especially for women. Well, actually, for both sexes, in different ways. For women, it’s very important because otherwise they are completely disenfranchised from decision-making in the community. When they are married, they are allowed to attend community meetings, though I get the feeling that their opinions are still not taken into account that much. For men, the idea of masculinity is very much tied to one’s ability to “produce.” A man with many children is considered quite manly in most communities, though this conception is starting to shift a little bit. There is a growing emphasis on family planning by health workers, but many politicians are still guilty of encouraging people to produce as many children as they can. This is somewhat dangerous, because Uganda is currently experiencing what is called a “population explosion.” It’s what happens when the birth rate surpasses the death rate, and is often linked to an improvement of living standards. The improvement means that people are not dying as quickly, but the mindset is still aligned with the previous situation where death was much more common. So for example, people will still plan to have 6 children, so that if two die, they will still be left with enough to help them with household duties. But then, since living conditions have improved, maybe only one child will die, and the family ends up with one more child than they bargained for. Multiply this by all the households in the country, and you get a population explosion.
Having children has just become embedded in this culture; everyone who is married has at least 2 children, but most have more than that. If your marriage doesn’t produce children, it’s considered quite unlucky, and a man can leave his wife if she isn’t becoming pregnant within a reasonable amount of time. Here, divorce is fairly uncommon, and you must present a “good reason” or the divorce will not be granted. Failure to bear children is considered grounds for divorce, as is cheating with another man. But I’m fairly sure that a woman would never be granted a divorce if she accused her husband of cheating. It’s sad, but apparently men’s cheating on their wives is extremely widespread here. The rates of HIV infection are increasing faster among married couples than any other group of people, and cheating behavior is kind of just accepted in the culture. People still consider it wrong, but they also consider it reality.
There was one segment during the training in which one of the male facilitators was lecturing on a topic called “maternal health and family planning,” and he was talking about condoms as a method of family planning and preventing the spread of HIV and other STIs, then somehow it shifted. I guess he was trying to be funny by asking everyone there if they had a condom on them, and they said “for what?” because none of their spouses were there. Then he started saying something along the lines of, “well what are your husbands doing right now? You’re gone for a whole week, and you expect them to just sit at home by themselves?” That made me really angry, because of course I’ve heard talk about men cheating, but for him to say it so blatantly and to sort of taunt them like that just seemed very wrong. Especially since he is actually on the progressive side of the spectrum in terms of stuff like this.
Wow. Anyway, that was a total tangent. The point is, even though we were coming from totally different places, I managed to make friends with a lot of the other participants. They even gave me a Ugandan name: Akello Christine. The Christine is unofficial, but it really does feel like my Ugandan name…people seem to always shorten Christina to Christine. But even though I hate being called Christine in the U.S., I don’t mind it here, maybe because they pronounce it differently and it sounds less pretentious. They put the emphasis on the first syllable: “CHRIS-tine.” I’m really fond of Akello as a surname though. One of my friends here in Gulu has the same name and he said that it means that I’m his sister. Cute. In hindsight, I’m realizing that week was the longest period of time that I have spent here without seeing any other Americans (or any foreigners, actually). It was a solid week of hanging out with only Ugandans, and it was really fun.
The training ended on Friday, and I was supposed to get a ride back to Gulu with the person who was scheduled to give the closing remarks from the funding organization, which is based in Gulu. Unfortunately, he didn’t end up coming—apparently he had another meeting at the same time and so he remained in Gulu. It’s really funny, because this type of thing happens kind of frequently, where someone has a conflict that they clearly knew about in advance, but still agreed to do something else at the same time. Then they end up flaking out on the agreement, and I just wonder, why didn’t they turn it down in the first place? I don’t really get it.
Anyway, so I was left without a way to get back and had to navigate the public transportation system, which was a little daunting at first. Luckily, two other women from the training were traveling in the same direction and they helped me figure it out. We ended up riding most of the way in a pick-up truck that was delivering some building materials to a town sort of midway between Apac and Gulu. This is an unofficial method of transportation—it’s usually cheaper than a taxi, and in my opinion, more fun. I really wanted to ride in the back of the truck (they load the back too so they can make more money), but since we were women, and some of the first passengers, we got to sit in the cab with the driver. He dropped us off at some town I had never heard of and from there, one of my new friends found me another form of unofficial taxi that was going to Gulu. This one seemed to be just some guy’s car, which was about the size of a Subaru, and he was cramming as many people as he possibly could into it. At one point there were 8 people plus the driver in the car, with people even sitting in the trunk area. It was quite the experience. I actually really enjoyed the trip back and found it really fun to use these unconventional methods of transportation, the sardine-like cramming notwithstanding. As we were passing through the bright green Ugandan countryside, bouncing up and down as we chose the smallest potholes to drive through, and I was being given lessons about which crops were which, I was feeling so ecstatic. I realized I was actually really happy in that moment, even though we weren’t doing anything too incredible. I was just fantastically content. Combined with the good experience I had at the conference, I was in great spirits when I got home.
Unfortunately I found some bad news when I arrived back in Gulu. One of my roommates is working at a school here, and one of the students at the school had just died the night before. It’s a little unclear to us all of the factors that contributed to his death, but I think it was mostly the poor healthcare that I’ve been talking about so much. He had some sort of a lung condition and didn’t have a lot of money, so when he was feeling sick he had to go to the government hospital (the one where I work). Apparently they weren’t able to do much to help him, and he passed away 2 days later. He was the same age as I am, and apparently was a really great person, though I had never met him. It was just kind of a slap in the face/a harsh dose of reality. I think that what made it even harder to take was to see the way other people reacted to his death. The director of the school seemed to take it very lightly and was disapproving when my roommate was crying when she heard the news. I guess maybe people here need to develop sort of a thick skin about this kind of stuff to continue to function in their world, but it’s kind of disconcerting to see people barely taking note of a major event like this. I feel like Uganda has been kind of like that—just when I start having a lot of fun and almost forgetting about all of the massive problems that exist here, a reality check that I can’t ignore pops up. Then they just keep coming. Isn’t it weird how things like that seem to happen in groups?
Another sort of reality check happened right after that. The aforementioned roommate had not been feeling well for awhile, but didn’t think there was anything seriously wrong. Then the other night, she woke me up at 3AM because she was suddenly feeling a lot worse. We decided to go to the hospital to get it checked out. Though there are several hospitals that are open 24 hours here, we opted for a private, not-for-profit hospital in the neighboring town that has a very good reputation for providing good care at a reasonable price (still too expensive for some Ugandans, but definitely affordable for us). I had been wanting to check it out for research purposes, because I hear that is where many people from this area go for treatment if they can afford to pay a little and want to get good care, so I was sort of glad to have an opportunity to go. However, our experience there wasn’t great. We waited around for over an hour, just to find out that the lab technician wasn’t there (even though he was supposed to be), so they couldn’t do any tests on her until 6AM.
As I was standing outside making phone calls to try to figure out where else we could go, I saw the pediatric ward across the street. Through the windows I could see that there were tons of people crammed into the ward—I guess it looked kind of like one of those “typical” African hospitals that I have seen on TV, where people are just lined up on beds down the wall, with little space between them and no privacy at all. I could hear babies crying, and then I noticed people sleeping on the sidewalks outside of almost every ward. I just looked at it and felt so disgusted, thinking “And this is the GOOD hospital??” From there we went to another health clinic that was about 15 minutes away by car (we were lucky, because one of the guys we know here, our landlord/friend, actually answered his phone and came to pick us up and drive us around in the middle of the night. I don’t know what we would have done without him.), and they did have a lab technician, though it also took forever. I guess if you want speedy care, 4AM isn’t the time to go to the doctor… The doctor found that she had severe malaria, and he gave her treatment for it. By the time we got home, it was around 8AM, and we were all exhausted. She’s doing better now, but it was kind of jarring to realize how difficult it was for us to get her treatment, considering that we have access to a lot of things that the average Ugandan doesn’t. Also, I just kept imagining how much easier the process would have been in the U.S., and it made me really frustrated that we weren’t there.
Anyway, now I’m basically just spending my days working on my paper. I’m mostly done with “work” at the hospital, and my nutritionist friend is in Kampala for the week, so I don’t have much on the agenda for now. Today we almost got our electricity taken away—that was eventful. Before we lived in this house, a very respected international organization used it as its headquarters. Apparently they just didn’t pay their electric bill for a long time (what an upstanding organization!), and racked up a major tab. Our landlord negotiated for us at the beginning of our stay and got the electric company to turn it back on for a month for a set amount of money, but today two guys showed up at our house saying they were there to turn off the electricity. We pleaded with them to wait until our landlord came, and he eventually convinced them not to do it today, and he is going to go to the main office tomorrow and negotiate. So we’re safe for now, but keep your fingers crossed for us! Power is out in all of Gulu tonight anyway, so I guess it doesn’t matter that much, but at least there’s a possibility that it will come back now. It’s kind of annoying that power goes out all the time, but I’m actually getting kind of fond of the unpredictability. It keeps things interesting. I was just thinking about when I go back home and suddenly power works all the time, and I was thinking it’s actually going to be kind of boring. Where’s the excitement in that, anyway? Peace and love guys. ~CMK