We Get Schooled

by Alena Pauley

Hi again!
Okay, so to set some background, this year the Nutrition project has expanded its involvement in the Naigobya community to include two nearby primary schools, Naigobya Primary School and St. Paul’s Learning Center. We visited them in our very first week. Our very first day, actually. I remember Moses coming over to Sakura and I, clasping our palms in his now comforting–but at the time a little disconcerting–manner, smiling and saying, “I think it would be good to visit these schools, is it fine?” We said “it is very fine,” but with some hesitation. We wanted to help in any way we could, but it was not clear to us exactly what we were going to be doing at these schools. Moses’s energetically would exclaim that we needed to encourage the schools to implement a model garden and health club. I did not even know what a “health club” was. But we went anyways. We talked to the teachers, telling them to implement a model garden and health club, we listened to their concerns and hesitations, and I left with a bit of uncertainty that any actual change would manifest. I had this uncertainty because, from an culturally American perspective, it would be surprising for any school to implement such change just because four strangers, unannounced and with nothing to recommend them, told them to. I soon learned though that things are very different on the other side of the world.
Fast forward to the end of week seven when the Naigobya team conducted follow-up visits to both schools. St. Paul’s was first. We arrived in the UDHA van and asked the headmaster if they had a model garden to show us or health club to tell us about. And, without further ado, the headmaster quietly led us to a field behind their classrooms where we saw nursery beds brimming with blooming greens, rows of still-green tomatoes, and baby avocado, papaya and mango trees. The students are the primary caretakers of the gardens. Through the garden they learn skills necessary to implement model gardens in their households. The headmaster told us that once the school harvests the plants, they plan to give the crops to the students to supplement their school lunches, which alternates between maize meal, or maize meal and beans, both thrilling options for sure.
Then he told us about their health club. Here, the senior man teacher gathers students he observes with poor personal hygiene practices for a large weekly meeting where he instructs them on proper sanitation procedures. He also makes sure to talk to them one-on-one so that they are able to voice any concerns they may be uncomfortable saying in public. The teachers say that they have already noticed an improvement in students personal hygiene in just a month and a half! However, change has not happened without challenges. Students’ poverty continues to be an issue. It is hard to expect a student to bathe more if they do not have money to buy soap, just like they cannot brush their teeth without a toothbrush or toothbrush, or comb without a hairbrush. These are issues that I have been wrestling with since our meeting and still am at a loss of how exactly to fix them.
Next we visited Naigobya Primary School. I have a special soft spot for Naigobya Primary School. This is largely because I think those kids are crazy-cute little goobers. I have attempted to give them hugs on multiple occasions and every time they run away from me screaming. Not just screaming, but screaming with some arm flailing thrown in as well. At this school, we have had similar results regarding the model gardens and health club. Both have already been implemented, except here the format of the health club is slightly different. The senior man teacher chooses model students who assist him at school-wide health parades to identify students with poor hygiene. He then pulls those students aside to instruct them on proper methods. The results and challenges this school faced are similar to those cited at St. Paul’s, showing that there are not problems unique to one school but are endemic to the entire community.
What I have learned from this experience is that change is possible and that people are willing to change. Not just that, but they want to change. They were so thankful that we came, so gracious and welcoming, and so eager to continue a partnership in the future. The entire experience was one of the most gratifying and rewarding that I have been lucky enough to be a part of in my time here and I am thankful to the schools for the education they have given me.
Lastly, please appreciate my punny title, because I thought that was very clever of myself. Thank you.

Advertisements
We Get Schooled

The Adventure Continues

by Alena Pauley
Hello everyone!
Naigobya team here. So, we are about a month and a half into our African Adventure. It has been chock full of fun, full of ups and down, challenges and successes, of trying new foods and then throwing them back up again. One of my biggest accomplishments is that I can now eat an entire mango, including the peel. And each time I do it, my stomach dies a little bit less than it did the time before. I am training my stomach to be indestructible. All in all I have learned so much–more than I even imagined I could. The culture difference was a bit of a shock at first but now Sakura and I have become well tuned to the daily routine, down to the littlest details and rigors, of living in a typical Ugandan village.
One of the many cultural niches is that when walking through the villages you are supposed to greet every person you encounter, even if you have never met and are just passing through. You say “webale,” which is an all purpose word, whose meaning is sort of like thank you but more. When is doubt, just throw in a good ol’ webale. The person will then respond “Kalae,” which means okay. Then, what really took me a while to get used to, is that you and the person you are greeting both take turns making a high-pitched “hmmm” sound, an exchange that can go on for a while. I think the longest successive “hmmm” exchange I have witnessed was about seven “hmmms” long.  That was particularly intense. What I have been able to gether is that these sounds are not words so much as a recognition that you have been heard and are appreciated.
A part of Ugandan culture that I especially admire is how welcoming and generous so everyone is. In Uganda, your door is always open and you are always welcome. Everyday we come home from the field we find someone new in our front yard. And it goes both ways. Sakura and I have been conducting a large survey that evaluates the Community Health Worker project  in the new regions it has recently expanded to. We have visited over sixty houses, always coming unannounced, always making intrusive requests like asking how often a day they breastfeed or if we can see their latrines, and there has not been a single time where we have been turned away or have not been given an answer. There was one particular instance  that I will forever remember. We were interviewing a potential CHW named Robert. He was so happy that we visited that as we were about to leave, he shyly walked over to us and pulled out from under his arm a pretty, red and brown chicken. We were gifted a chicken. Not a dead chicken. A real live one. I have never, ever been gifted with a chicken before and I am not sure if I ever will be again. It was such a huge gesture. These people that we are visiting are peasant farmers. Most of them make less than a dollar a day and meat is something you only get on Christmas, if then, and for this man to give us his chicken when we had only just met him is one of the most generous acts I have ever seen.
Something that Sakura and I have had especial exposure to is maternal health. Some of the local health practices blew my mind when I heard them. Here are some of the more interesting practices that we were told about. One practice is for women to burn special herbs in a pot and then squat over that pot while naked, essentially burning themselves, because they believe it will give them a safe birth. Another is that women will gather chicken feces, mix it with herbs, leave it the mixture to dry, and then smear the final product on themselves because they think that this will transfer the chiken’s ability to pass its’ stool to the mother so that she can pass her child quickly. While these may be (relatively) harmless, there are some practices that can leave lasting harm on the unborn child. I was taken aback when I was told that pregnant women drink the locally made alcohol because they believe that doing so will help them to produce a clean child with clear, white eyes. One of the most important resources that communities like Naigobya need are not shoes or food–things that I would typically have pictured when I would think ‘aid’– but education. For example, it is well known that pregnant women should take extra iron supplements to ensure a healthy mother and child. But here, a mother will crave iron but not know that it is iron that she is craving. In an effort to curb this craving, women will eat dirt because it has a metallic smell. In local health clinics there are free iron supplements that pregnant women have access to if they know how find it, but the broken link lies in the lack of knowledge. In some of the most secluded parts of the village some women do not recognize labor pains as a sign of birth, so they will not seek medical help and will end up delivering their child in a problematic way that many times this leads to brain defects. Thus many children here are born both physically and mentally stunted, will not perform well in school, and will be doomed to repeat the same cycle as their parents did before them.
As we approach the final quarter of our time here it feels like it will be harder and harder to leave. Because also, how in the world am I supposed to have access to such great pineapple, mango and avocado. Those I think I will yearn for every day. That, and all the wonderful people,  amazing experiences and beautiful culture of Naigobya, Uganda.
Naigobya Team take the front seat on the taxi ride.
Naigobya Team take the front seat on the taxi ride.
The other half of the Naigobya Team, Moses and Tom, goof around after completing a long day in the field.
The other half of the Naigobya Team, Moses and Tom, goof around after completing a long day in the field.

The Adventure Continues

Posters! Posters! Posters! x9

Two weeks ago, the Youth Resource Center team meet with our outgoing class of Peer Health Educators for exit interviews and asked them about their experiences, success, and challenges. When asked what additional support and resources UDHA could provide them, the PHEs overwhelmingly said that their schools need more health materials like posters and educational books. Based on the questions that PHEs said they receive the most, we made nine health posters. These posters will be distributed to our 12 partner schools in Iganga and Naigobiya, local Health Centers, and the Youth Resource Center. Here they are:

Condom Use by Niara
Condom Use by Niara
STDs by Niara
STDs by Niara
HIV/AIDS by Shyamolee
HIV/AIDS by Shyamolee
Common Diseases by Shyamolee
Common Diseases by Shyamolee
Menstruation by Marina
Menstruation by Marina
How to Use a Pad by Marina
How to Use a Pad by Marina
Nutrition by Niara
Nutrition by Niara
Healthy Relationships by Shyamolee
Healthy Relationships by Shyamolee
Referrals by Shyamolee
Referrals by Shyamolee
Posters! Posters! Posters! x9

Busaino Farms

We spent our Saturday at Busaino Farms,  which was owned by one of UDHA staff member Michael's friends and ranked the 2nd best farm in all of Uganda.
We spent our Saturday at Busaino Farms, which was owned by one of UDHA staff member Michael’s friends and ranked the 2nd best farm in all of Uganda. It spans over 1600 acres.
We got to sample fresh produce from the farm, including ground nuts and mangos. Here are Niara and Sakura, lovingly known as the Mango Noobs because they generally dislike the fruit, trying their luck with some Busaino mangos.
We got to sample fresh produce from the farm. Here are Niara and Sakura, lovingly known as the Mango Noobs because they generally dislike the fruit, trying their luck with some Busaino mangos. They were great!
We took a tour of the farm house, from which you could see the Kenyan border just 6 km away.
We took a tour of the farm house, from which you could see the Kenyan border just 6 km away.
Then, we went on a hike around the farm, stopping to see the range of fruits and medicinal herbs they grew.
Then, we went on a hike around the farm, stopping to see the range of fruits and medicinal herbs they grew.
We ended the day with a delicious, farm fresh lunch.
We ended the day with a delicious, farm fresh lunch.
Busaino Farms

Jinja Photo Story

Shyamolee and Marina enjoying our first taxi ride!
Shyamolee and Marina enjoying our first taxi ride!
The taxi was completely packed by the time we got to Jinja!
The taxi was completely packed by the time we got to Jinja!
One of our favorite buildings in Jinja
One of our favorite buildings in Jinja
The river boat we used to explore the Nile
The river boat we used to explore the Nile
The Source of the Nile River!
A spring in Lake Victoria is the source for the longest river in the world: The Nile!
The girls on our boat cruise on the Nile.
The girls on our boat cruise on the Nile.
Niara and Shyamolee after doing some shopping!
Niara and Shyamolee after doing some shopping!
Jinja Photo Story

Our Experiences with Ugandan Health Care

Although a goal of mine was to understand the workings of Ugandan healthcare on a deeper level, I had been hoping not to be able speak from personal experience. This past week has marked my second visit to Mercy Clinic (right across from UDHA). The reasons for my going are funny I suppose…ask me again in a few months. It happened like this…

Sumaiyah and I were walking through town after making a deposit at the bank. The sun was shining, goats were bleating and all was as it should be. A mere mud field away from UDHA, it hit us. Literally. A bag full of garbage, dirt and sewer stuff launched right at us! The marksman was a mentally ill man who hangs out at the corner of the supermarket we always frequent to buy water (and the occasional chocolate bar –well not as occasional as we’d maybe like to admit). We were covered head to toe with dirt so we went back to the house to change and shower before returning to work. It was so unexpected and out of the blue. We spent the next hour laughing at how wacky the event was because hey, what else were we going to do about it! Unfortunately, I had swallowed some of the dirt bomb which meant that that night was not pleasant for me or my digestive tract… I went to the clinic the next morning and found out I had procured a bacterial infection from whatever I had swallowed. Sumaiyah experienced only a bit of stomach pain, but was otherwise fine. I on the other hand hadn’t spend my childhood playing in (aka eating) Ugandan dirt so was badly affected. If only it had been a bag of good old Bay Area Berkeley dirt that had been hurled at me! I was given lots of medicine though and am back to normal now.

It was interesting to note that I was given more than six different types of medicine (I even got a bonus de-worming pill) whereas in the US I probably would have been given only one. To see the doctor was not at all like back home. If you wanted to see the doctor, you walked over to his room, checked if he was free. If so, you’re in luck! Walk in and get treated.

What with Shyamolee’s sprained ankle and Sakura’s skin rash, Dr. Chris Isiko (with whom we live) gets to see us at work almost as much as he does at the house. We’re crossing our fingers that Niara and Alena won’t have any medical emergencies on the trip!

-Marina

I was the first casualty of the war and boy was it a confronting experience. Let’s set the stage: it was week 2 of our internship and we were pumped to climb Mirembe Mountain in Naigobya, the view from which all of the former interns had told us not to miss. Little did we know, that mountain hates GROW interns. It’s where Haley (Naigobya intern from 2014) first discovered that she had a stomach parasite and incidentally, it’s where I sprained my ankle.

This part is just for my parents- Hi guys. You might notice that I downplayed this story when I broke the news to you. Don’t freak out! I’m all better now and this is what actually happened:

The mountain is pretty steep and I had only managed to get up half of it. I chilled out on a rock at the half way point while the rest of the team and guides climbed to the top. Right after they left, I realized what a pickle I was in. I didn’t know how to get back down, the team was too far ahead for me to catch up, and storm clouds had started rolling in. To add fuel to the fire, a local pastoralist who had been herding his cattle on the mountain kept pestering me for food (which I had none of and surely would have eaten already if I did), as vultures began circling on a nearby hill. It was like the first scene of a low budget adventure movie. Once the team came back, we made our descent downwards. My legs were feeling a little shaky and the slippery mud patches made the return all the more risky. I ended up slipping in a section that Marina had warned me about; it was inevitable. With an loud pop, my ankle was sprained.

My healthcare began right at that spot, as one of the interns from Naigobya, Tom, moved my foot around to gauge the pain and possible pop it back in. This freaked the team out, seeing as one wrong move could make the injury worse. They eventually got me up and we limped down the hill together as fast as we could to avoid the rain.

This was a common injury here and it didn’t merit too much attention, just a passing bambi (that means “sorry, poor thing” in Lusoga). Over the next two days my ankle had swollen to the size of a mid range mango and walking was a struggle. It garnered the attention of many a celebrity, like UDHA board member Dr. Iskio, who insisted that I use an anti-inflammatory cream on it.

I eventually made it to Mercy Health Center on Monday after work, where I sat alone in the corridor waiting for an hour for the orthopedic physician to return. The wait wasn’t as scary as the doctor who waited with me, Edmund, and told (lied to) me that he had seen 3 past GROW interns incur the same injury and go through surgery to fix it. In my already vulnerable state, I started crying. Eventually I saw the doctor who told me it was nothing to worry about, upon which I cried again, and was handed a gamut of pain killers, muscle relaxants, anti-inflammatory tablets, and a crepe bandage and sent on my way. I’ve never been on more medication in my life. As Marina said, prescriptions are given out extensively here and seem to be the norm as far as care goes. My visit cost me a total of 30,000 shillings, or less than $10. I wasn’t asked to come in for a follow up or physio. It was that simple.

And it worked perfectly. While I did spend the first week limping and really thinking about the under appreciated privilege of being physically able, I got back to normal within a few weeks just as the physician had expected. Thank you, Ugandan health care!

– Shyamolee Desai

Our Experiences with Ugandan Health Care

The exchange rate is what? Negotiable.

The start of this week was a whirlwind: we had created a 15 page FAQ book addressing the most common questions students ask via our health boxes and an extended 50 page training manual for the peer health educators tasked with counseling these students. We had also realized that there way no way we could convey 50 pages of information to our new PHEs in just one day, which is all we planned for in the initial budget. We needed at least 3 days and the budget had not a shilling of breathing room.
We had to find a way to make it happen. The pressure was on.

After a lot of coordination with our amazing GlobeMed staff back home (shoutout to Rhea, Laura, and Haley!), we had managed to wire the funds we raised for this partnership year five days early. Aisha, UDHA’s resident accountant, got the transaction approved by the board and all we had to do was convert them from dollars to shillings.

We had promised Aisha that we would dress more “adult” today, in hopes that that would give us a modicum of credibility with the fat cats a the bank. It’s too bad the only clothes we brought look like they were made for prairie children, unusually taken with the Woodstock aesthetic. Side note: Everyone dresses so well here! It’s the middle of Ramadan and I have never seen more elegantly dressed ladies in my life. We look like idiots in comparison.

Back to the story!

We walked to Crane Bank at 9 A.M. sharp for our appointment. The place perpetually and intensely smells like enkwawa (armpits), regardless of the number of people in the room. It was unusually empty today, but the enkwawa stench was strong.

We were ushered into a back room, which was a lot less creepy than it sounds. The bank manager, Satish, asked us whether we were in Iganga for a project. The prarie children/Woodstock garb had understandably given us away. After a few calls to his international broker buddies he made an initial offer of 3280 shillings/dollar. He was speaking in Hindi and repeated something his friend had said: the exchange rate was expected to go down in the next week. Years of hanging out at my dad’s office during the summer vacations and listening to the posturing that went behind business negotiations told me that he was trying to down sell us.

Aisha played hard ball though and out of the gate said “You’re going to give us 3300 today.” We did our part too, with a strong emotional appeal along the lines of “Don’t be stingy! It’s for an NGO. The people in this area need health services. Who will provide sexual education, HIV screenings, and help mothers with antenatal care?” all strung together in my broken Hindi. Satish blinked. We were in business!

Ultimately we ended up settling on a 3290 shillings/dollar rate and a small transaction fee. While this wasn’t the going market rate for the day, it was way more than the 2800 shillings/dollar rate we budgeted for. We could not be more happy and down right excited over our end result: our budget had virtually increased by 18%, meaning an extra $3,000 for this partnership year.

And the best part for last: With this money, we were able to hire 11 new community health workers for the Nutrition Project, extend both patron and peer health educator training to 3 days each, expand Youth Resource Center projects like the health boxes and the patron program to Naigobya, and develop new manuals for all of our volunteers.

So we’ll leave our chapter and next year’s GROW team with the following lessons:
  • Election years have been historically good for the strength of the dollar. Don’t waste them!
  • Banks are incredibly “adult,” but so are you.
  • Watch the exchange rate like a hawk. Getting a better deal only by a few shillings could mean the difference between a crisis time budget and one where you just have a few million shillings laying around, waiting to be used. Context for fellow foreigners: a few million is a lot.
  • The exchange rate is what? Negotiable.

– Shyamolee Desai

The exchange rate is what? Negotiable.