Category: Uganda

Hello there,

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

Hello everybody,

I just want you all to know that it was very difficult to find internet access to post this blog entry, so you better appreciate it (haha, kidding. I mean, sort of…it was actually very difficult though. I am in a very rural place right now, with only one internet café that opens late, closes early, and has a ridiculously slow connection.) I just wanted to let you all know that I’m still alive and well; I didn’t want to disappear for too long. Anyway, a lot has happened since my last post. The aforementioned nutritionist, Albert, told me last week that he wanted to take me to a training he was doing on Infant and Young Child Feeding in Apac (pronounced “uh-patch”), which is the district just southeast of Gulu. I was pumped about the idea because it is very applicable to my practicum, and it sounded interesting. I found out the next day that the training was a week long, and it was going to make the most sense for me to travel back to Kampala on Saturday and then join him in traveling from there to Apac. It makes absolutely no sense geographically, since Kampala is about five times the distance from Gulu that Apac is, but apparently navigating public transportation between the two is rather difficult, so I opted for the longer but simpler route.

I left for Kampala on Saturday morning, and after sitting on the bus for two hours in the parking lot, we finally departed from Gulu. (Busses here don’t leave at set times; you just show up and get on, and it leaves when then conductor thinks it is full enough.) It was frustrating to sit there and think about how much longer I could have slept, but once we left, I remembered how much fun it is to travel through the Ugandan countryside, watching the endless fields of green pass by the window. I also was reminded of my absolute favorite part of traveling by bus in Uganda: the “rest stops.” Now, I don’t know how many of you have experience traveling by bus in the U.S., but in my experience, I find that most busses there very rarely make stops. Of course, those busses have bathrooms on board, and public transportation operates completely differently in the U.S., but it’s worth comparing. The busses here stop all the time! I think that people can get on and off at many points along the route, and if it stops at certain points in small towns, there are vendors who position themselves along the bus routes and sell things to the bus passengers. But the most convenient thing is that you don’t even have to get off the bus to buy yourself a snack; the vendors essentially charge the bus as it is stopping and shove various items up to the windows to try to entice the passengers. I think one of my favorite memories from this whole trip is the image of about twenty vendors running after my bus and trying to sell bottled water, pieces of meat on sticks, and live chickens through the bus windows. I wasn’t able to take a picture this time, but I definitely will next time. It is just something that needs to be photographed.
So I spent one night in Kampala with my host family and then I met Albert and the rest of the team for the trip at the Ministry of Health. I have to say it was nice to be “home” in Kampala, even if only for a short time. Surprisingly, I even rather enjoyed the addition of matooke (which I have been avoiding like it’s my job since I started controlling my own food intake) to our supper. I felt bad that I only was able to spend one night there, but it was fun anyway.

The next morning, our trip to Apac started off kind of strangely. It was somewhat cool that morning (maybe about 60 degrees F), and Albert showed up to the Ministry of Health wearing a knit winter hat. People here are so funny about the weather. What they define as cold is so entirely different from what I think of as cold. I thought the weather was rather nice that morning, but apparently it was freezing. Anyway, we waited for over an hour and a half for the vehicle that was supposed to take us to come and pick us up to take us “up country”. We kept calling the driver, and he kept giving excuses about why he wasn’t there and saying he would be there very soon, but it took forever. Then it turned out that the vehicle was bringing an extra person up with us and there wasn’t room in the pick-up truck for all of us. We spent about another half an hour trying to figure out how to fit 5 passengers plus the driver into a double cab pick-up. We ended up squeezing four people into the back seat. It was terribly uncomfortable, and it was quite the lengthy and bumpy ride. I kept seeing the signs counting down how far Gulu was, and thinking, “it’s only been 10km??? I’m not going to make it!”

Then we took a shortcut that crosses the Nile River via ferry instead of driving around to a bridge. The “ferry” was the most basic one I have ever seen—it was essentially a largish raft with two motorized propellers attached and a few railings. But they loaded our pickup, another car, many motorcycles, and about 40 people onto it and we crossed without incident. I did take a picture of this one, and I will definitely post it when I get back to Gulu.

The rest of the journey up was rather uneventful, though we did see some monkeys along the road, as well as a creature they called a Monitor Lizard, which looked to me like a small crocodile. Our driver skillfully avoided many cows, goats, and chickens that were hanging out on or crossing the road, and we arrived in Apac safely.

This town is one of the most rural places I’ve been since arriving in Uganda, second only to the place I stayed during the rural homestay. There is one main road, with the center of town marked by a traffic circle. I don’t think they get many mzungus around these parts, because I created quite the stir as I was walking home from the training yesterday. People were staring and children were jumping up and down, pointing, and yelling “mzungu!” I think it’s going to be confusing when I go back home and people don’t completely freak out when I walk by. The anonymity is going to be strange, after standing out so much here. The people I traveled here with keep talking about how Apac is not developing, and how terrible it is. I can definitely see why they would say it’s not developing; it is certainly a simple and rural town that doesn’t seem to be making any effort to change, but I don’t necessarily see anything wrong with that. If people are happy living here as it is, why change it? This is a concept I’ve been thinking about a lot, especially while I’ve been traveling through the countryside and observing rural life. It makes me wonder, “How much do we really need to be happy?” Because on the one hand, it seems wrong to me, as someone who has grown up with the luxuries that I have, that people have to live in these conditions where they don’t have electricity, the whole family lives in a small hut, the schools don’t have windows, etc… But on the other hand, things here are clearly functional. If people can get by in these conditions, why do we need to keep making things bigger and better, you know? I definitely think that things that impede safety should be improved, but at a certain point I think sometimes we just “develop” places for the sake of development, and it isn’t actually entirely necessary.

On a related note, about knowing how much one needs to get by, the hotel that Albert wanted to stay in was full by the time we got here (there is no such thing as making reservations in most of Uganda), so we found a less desirable one near the edge of town (which is, of course, about a 5 minute walk from the center of town). It’s a simple hotel, and we are only paying $2.50 a night for it! This is highly exciting to me, because I have already used up the stipend money that SIT gave us to cover our expenses during the practicum (I largely blame the trip to the hospital, which used nearly a quarter of it in one night), so now I am paying for things out of the pocket money that I brought with me. Obviously, the money that I brought goes a lot farther here than it would in the U.S., but I also brought far less money with me for the semester than I would have used in a semester in the U.S.. Anyway, my companions complain about the hotel, but I think it’s fine. I mean, how much more does one need in a hotel room than a bed and a bed net? It’s not luxurious, but it’s functional.

The only complaint I really have is the shower situation. By now, I am getting used to cold bucket showers, but I’m used to taking them at night, when you’re already hot and sweaty, so a cold shower is somewhat refreshing. Here, it’s so hot at night that you always need to take a shower in the morning, because you basically sweat all night (too much information? Sorry!). So at any rate, the shower situation during this stay is such that it is a freezing cold bucket shower in an outside stall that doesn’t have a door at around 6am, when it’s actually somewhat cold outside. It takes some serious guts to dump a bucket of cold water on yourself in that situation. Try it sometime! I have to say I think it is my worst shower experience. So the next time you are getting into your nice, steamy shower in your own bathroom, take a moment to think of me and say, “thank goodness I’m not as insane as Christina!” All the same, I still have to remember that I am lucky because I know this is temporary. I can complain about it all I want, and yes, I am pretty unhappy at the moment when that cold water is first hitting my body and I’m thinking “Why did I come here again???” but I know it’s temporary, and in a month I’ll be back at home enjoying my nice hot showers again, while people here will still be doing this. And of course, the showers are really the least of most people’s worries here, but the concept applies to everything. All of the things that I am seeing, hearing, feeling, and experiencing here are only temporary for me, whereas for the people I’m meeting, this is their reality. And sometimes that is hard to accept.

Yesterday, during the training we went to the local hospital to practice counseling mothers on infant feeding practices. (Maybe I should stop for a moment to say that the people participating in this training are all health workers from clinics in this district and a neighboring district, so this is a task that they would probably do on a normal day at work.) The woman that my group counseled turned out to be 22 years old (so basically my age). She had brought her 6-week-old baby into the clinic for immunization, and we found out that this was her third child. She was also HIV-positive. Our visit with her really hit me hard, because it was like looking at myself in some sort of a weird mirror. I just kept looking at her and grappling with the fact that though we are so close in age, our lives are so drastically different. I basically realized that the only thing that was separating the two of us was luck of the draw. Had I been born in Uganda instead of in the U.S., my life could easily be exactly like hers at this point. It was hard for me to look at her and visualize what her future would be like because for her, this is basically all there is. I have so much growth and so many opportunities to look forward to in my future, but she won’t have these opportunities, and her life will likely not change that much from today until the day she dies. And that feels very unfair to me.

Sorry to end on a sort of depressing note again, but I think this has become long enough, and I’m out of time. Peace and love from Apac. ~CMK

Greetings all,

Sorry if my last post is sort of a downer.  Good news though: I think things are starting to turn around here, so hopefully the next few posts will be a bit more upbeat.  We have traded our live-in plumbers for live-in tile guys for the week, and the plumbers were nice enough to make one bathroom functional until they come back and fix them all this weekend.  (Granted, there is definitely no hot water, and the floor is flooded from leaking pipes, but it’s functional.) They are making serious progress on renovating the house, which is cool to see even though the workers do have an annoying tendency to start working very early, even on weekends.

My roommates and I spent most of the weekend just hanging out, which was probably good for all of our mental health.  We finally got around to going to the Ethiopian restaurant here, which was delicious.  We also met Gulu’s resident drug dealer. He frequents our favorite bar/internet cafe that is right down the road from our house and we have some mutual friends. He owns a shop near the Ethiopian restaurant, and is a really crazy character. The funny thing is that his shop is pretty normal–we checked it out when we were in the area.  He sells cooking oil, juice, bread–all the things one finds in an average Ugandan grocery shop–but he also sells pot off the books, from the same shop, and sits around and smokes with various customers without much subtlety.  (And smoking marijuana is a crime in Uganda. We’re surprised people don’t complain, but he seems very comfortable in his routine.) Don’t worry, he’s totally safe, and we were careful, but it was quite the interesting experience.

As a culmination to my weekend on Sunday night, I was laying out on our porch and doing a little stargazing.  (It’s so nice to be able to have the free time to do stuff like that, and you can see so many more stars here than at home or in Kampala.)  I was feeling frustrated about my practicum and wondering when the next 3 weeks would be over so I could just be done with it already, and then I saw the coolest shooting star I have ever seen in my life.  It just streaked across the whole sky, steadily and slowly.  I actually had to do a double take to make sure it wasn’t an airplane, but then it disappeared into the darkness, the way shooting stars do, and I knew I was right.  It was beautiful, with the backdrop of the African sky behind it, and it just made me feel a lot more calm about everything.  I made a wish, of course.  I can’t tell you what it was or it won’t come true, but I will say that I think it has started coming true already.

On Monday, I had been promised a meeting with some sort of nutritionist who works in Gulu, who was rumored to be starting up a nutrition outreach program this month.  He had just said we would meet in the morning, so I got to the hospital at 9 as usual and waited around for him to show up.  11:30 rolled around and he still wasn’t there.  That’s the time that I usually start getting impatient and decide to leave (and there are only 3 patients in the ward now, so it’s quieter than ever–which is good of course, but boring. Apparently the “hunger gap” usually occurs in May, so this is the calm before the storm), but I decided to give him a call just in case, and he said he was coming.  He arrived at the ward about 15 minutes later, telling me that he was very sick with malaria, but declined my offer to move our meeting to another day.  (As a sidenote, the doctor in the ward also had malaria that day, and couldn’t work because he had to receive IV treatment for it.  I really can’t believe how endemic malaria is here.  It’s SUCH a problem…something really needs to be done about it.)  Anyway, the nutritionist made a little bit of small talk and then cut right to the chase and asked me what exactly it was I wanted, anyway.  I was surprised at his directness (Ugandans are usually pretty roundabout with their conversations), and tried to recover quickly and said something along the lines of wanting to see if there was anything I could do to help with his outreach program.  To my surprise (again), he said “oh, very much!” and basically took off at a run from there.  (His name is Albert, by the way.  Uganda is full of quirky, old-school names like that.)  That afternoon, he took me to a meeting that he was having with the head nutritionist for a very well-known international agency in Uganda, which was pretty cool.  They talked about the plan for rolling out this new framework for monitoring nutrition and preventing malnutrition in children, and outlined indicators for measuring their progress, as well as how they were going to expand it to surrounding towns and districts.  It was a really efficient and fast-moving meeting, which was very refreshing after dealing with so much bureaucracy in Uganda and in non-profit things in general, and it made me really excited about possibly being part of it.

Then I spent yesterday and today attending other meetings with him, which were attended by a combination of NGOs, funders, and the government.  They are trying to recover from the haphazard way that aid was distributed during the war and set up a system that actually makes sense, where NGO services are coordinated with government and Ministry of Health services, and overlap is eliminated.  I think it’s a really good idea, though the meetings were less productive than I would have liked. (Yesterday it went from 9AM to 5:30PM and they still agreed on almost nothing concrete. So much for the efficiency of the day before.) That was slightly frustrating, but I think it was 1) the first step towards something that could be really cool, and 2) a good learning experience for me, as someone who thinks she wants to work in a capacity similar to this later in life.  I also got some good information that is relevant to my research, which might mean that I have a chance of doing well on the paper I have to write at the end of this all.  And I just think it’s really cool that I was actually at the headquarters of such a well-known international agency! 🙂

I’ve decided that Albert is a pretty crazy guy–he moves at lightning speed and doesn’t ever sit still.  I think he’s one of those people that takes on way more than he should (yes, I admit, kind of like me), but he’s trying to take me along with him as he does all this stuff, which promises to be very interesting.  I think there should be plenty of things I can help with, but so far he hasn’t really utilized me in doing any tasks.  He did promise to bring me along on one of the trainings he is doing in a neighboring district next week, though, which I’m really excited about.  I’m thinking about it this way: if I end up being able to help him, that will be great, and it will make me feel better about taking up his time as he teaches me stuff; but if it turns out that he doesn’t have a job for me to do, at least this stuff is way more relevant to my research and is a lot more uplifting than my hospital work.

Anyway, sorry… I think the stuff about the research is probably pretty boring for you all, even though it’s super interesting to me, so I will try to cut back on that from here on out.  I just wanted to let you all know that I was doing a lot better than I was when I wrote the last post.  And truth be told, I haven’t been doing too much outside of research/work, if you want to call it that.  So as far as posts in the near future go: I think I’ll try to post more pictures in the next couple of days, and I am formulating a post about language/linguistics in my head, so that should be coming soon.  Also, I promise there is a gender post coming eventually.  It’s just such a massive topic, I’m having trouble tackling it.  If anyone reading has a request about something you want me to write about, feel free to leave a comment and let me know.  It’s starting to rain and get really windy now, so I’m afraid we might lose power (and as a result, internet) soon, so I’m going to post this now.  Peace and love from Uganda. ~CMK

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