Nakaseke Hospital 6/20/18

Today we visited the local public hospital in the community where we received a tour and had a discussion pertaining to the needs of the hospital and the healthcare system here in Uganda. Upon first observations, I felt the hospital was larger than I imagined it would be, but still much smaller than a hospital I would be used to seeing at home. The main focus of the hospital is Primary Health Care which reminds me of how the U.S. focuses on primary care and acquiring primary care physicians. One thing that was mentioned as an issue is the long wait times that patients face which is also very reflective of the healthcare system in the U.S. except for the fact that the hospitals here often have outdated equipment and also a disproportionate amount of medical staff compared to the average 2 million clients that it serves. There are 192 staff, and of those only 13 are doctors. We were also told that the maximum allowance of staff for the hospital is currently 190 so that means they are “technically” in excess of 2 staff members. Even though they are understaffed, it isn’t as simple as hiring more people. They would have to go through a lengthy process of appeal with the government and they would likely not be approved. The facility is meant to serve a much smaller population, but people come there to get care because it is free. I thought it was very interesting that a patient could avoid wait times and be served right away in a private area but only if the agreed to pay for their services. The cost was equivalent to about $1-2 in the U.S., but for many people here that is not affordable. When we went to that area of the hospital, there wasn’t a single person there despite the fact that many people were waiting elsewhere for free care. I feel we have a similar problem in the U.S. Many people can not afford health care or insurance and then to make matters worse, they get penalized for being uninsured. It’s especially troublesome when they don’t receive the care they desperately need. In the U.S. it is often difficult to receive services if you are not able to pay. Recently, before coming to Uganda, I had to go to the emergency room and as soon as I finished getting my “treatment ” which truly was only taking my vitals and giving me an ice pack to take home, I was being charged a $150 co-pay plus any charges that would be associated with the doctors fees for literally sitting in a room for 5 minutes, unbelievable right? Ultimately there are many ways the healthcare systems here and at home at very similar. The only real differences I could think of is the availability of hospitals and care, however it is similar because it is not accessible to a large portion of the population.

Some surprising statistics that we were informed of:

70% of all births are done through c-section

72% of residents are over an hour away from a public hospital

55% of individuals with chronic illness don’t have the proper medications

Only 33% of needed drugs are actually available

77% of drugs in peoples homes are not labeled correctly or at all

It was very interesting to compare our healthcare systems and to think about how the U.S. is advanced in some ways, yet there is still so much we could do to improve.

Clash of the Cultures 6/19/18

For this blog assignment, we were asked to talk about a cultural difference between the Ugandan students and ourselves that has played either a positive or negative role in our interactions.

The first thing that comes to my mind is punctuality, or the lack there of. I feel like being on time is something that has always been stressed for us. Being on time for work, school, meetings, etc. In our culture the saying goes “if you’re early you’re on time, if you’re on time you’re late”, however since we have been here, there has rarely been an occasion where people have been on time. There have even been several occasions where we have had to wait nearly an hour after we were suppose to start something or be somewhere for everyone to be in attendance. This has been frustrating especially because we don’t have a lot of free time and we have so much to get done, so the time that we spend waiting can be spent working or doing other things we need to get done. Being punctual isn’t something that is stressed very heavily here so it has just taken some time to adjust, especially coming from a culture where “time is money”. I can say that we have not been the best about expressing our frustration about this issue. We throw in subtle hints here and there that it bothers us, but we are never really serious about it. We have never tried to sit down and have a conversation about it. I can say that personally I hate conflict of any type, even when something gets under my skin I just grin and bear it, but that shouldn’t be how we approach things. We can do better about being more open and expressive of our feelings.

Another thing that has caused a bit of tension within our interaction as a group has been lack of communication. For example whenever we plan to have meetings or need to communicate something with the group we use our group chat on WhatsApp, but often times, we don’t get any type of response back from a single one of our group members. This can be frustrating because we feel in the dark, or we can’t be assured that everyone is on the same page if people don’t respond (and it really bothers us because everyone always has their phone in their hand). Fortunately, we usually see our group members throughout the day at meal times, or just walking around on campus. Once again I reiterate that we haven’t done a very good job at communicating this and that isn’t very fair to them. A lot of the time, I think I allow my frustration to take over and influence my attitude. As an example we were supposed to have a meeting after lunch, which everyone knew about, however when the time came, no one was there besides myself and Haley. Almost immediately the first thing that came to my mind was “fine we will just get it done without them” but what does that solve? I’ll tell you, absolutely nothing.

Overall I think we struggle with communicating our frustrations because we don’t want to come off as rude. We also do a bad job at making assumptions that everyone understands, or is on the same page and then we get upset whenever things don’t go as we thought they would. This has been a learning process for us all and I feel the Ugandan students extending a lot of patience to us and we need start doing a better job of reciprocating that.

Field Work and an Impromptu Photoshoot 6/18/18

Today was my first actual day doing interviews with the members of our community and it was quite interesting. I missed the other two interview days because I was sick the first day, and the second day Haley and I stayed on campus to plan our HIV program. Today as a team we were able to interview 6 homes. We split into two groups and each group completed 3 interviews. We are finding that many of the residents have similar responses and yet they each explain their experiences in different ways. Everyone that we saw today seemed very open and willing to speak with us. One woman even showed us an ultrasound and notes from her doctor when we asked about her health and her opinion on availability of medical care in the community. When we first started field work, I thought that we would not encounter many people that would want to talk with us, especially since we are different and we don’t come from this community, however people have been working with us and I am very grateful to them. Sometime this week we will finish up our data collection and then we can begin to focus on planning something that will hopefully help to support and uplift the community.

After our work, we had a little fun and played around with the camera on my phone. We took a few (well maybe more than a few) pictures. I think I said this before, but my group members love to take pictures!

I also tasted pure sugar cane today thanks to Monica, a member of Arné and Cheyenne’s group.

Sunday Dinner 6/17/18

After all the excitement of yesterday, today was a pretty chill day. The highlight of the day, as with every other Sunday, was our dinner at Dr. Brady and Dr. Cathorall’s house. I didn’t mention it, but last week we had a feast of spaghetti, cabbage salad, pineapples, and perfectly buttered toast compliments of Chef Brady. This week we had pizza pasta, cabbage, toast, and banana pudding for dessert! I can’t tell you how spoiled I feel this weekend with all the tasty foods.

We are about to enter our third week of field work. Both Dr. Cathorall and I will be celebrating our birthdays this week (mine on Thursday and hers on Friday). We also have our woodball tournament on Saturday in Kampala where we will see the First Lady of Uganda.

I’m sure we are in for quite an eventful week!

P.S. I stole Haley’s pictures because once again, I was too excited to eat my food and I forgot!

Behold the Beauty of Jinja!!!6/16/18

We waited all week for today, waterfalls, a peaceful walk through the forest, and the pièce de résistance,the source of the River Nile in Jinja!

The day was truly filled with so much wonder and beauty that to try and describe it only with words would be a disservice.

Our first stop of the day was Sseziwa Falls. I have never seen a waterfall up close but it is truly a sight to be seen. We took a walk around the park, to the top of the falls, and back down again. We even got close enough to feel the spray of cool mist coming from the water!

The next stop was our rain forest walk. Our tour guide led us on our journey through the forest where 300 year old trees stood tall and strong towering over us. He informed us of the many species of trees, insects, and animals that reside there. We caught glimpses of beautiful butterflies and red tailed monkeys. A few of us were unlucky and suffered some fire ant bites, but that wasn’t enough to spoil the moment.

We stopped off to have lunch at a restaurant called The Source Cafe and I am very happy to report that I was lucky enough to be able to indulge in a bacon cheeseburger with fries accompanied by a side of chapati chips and guac (yum)! Unfortunately I don’t have a photo for evidence because I was that excited to eat it.

Last, but certainly not least, we traveled to the source of the Nile. We were able to see the exact point where Lake Victoria turns into the White Nile. The day and the weather could not have been more perfect for our tour. We were able to get off the boat and take photos on the rocks. I was so scared I was going to fall in, but you’d never be able to tell from the smile on my face!

Today was a day that I will never forget. Before this trip, I had only seen such beautiful places in photographs, but now that I have witnessed it with my own eyes, I will forever cherish these moments.

Thank you to Dr. Cathorall and Dr. Brady for making this trip one to remember for us all!

Talk of Sustainability with a “Snack” 6/14/18

Today the PH and speech path students, Dr. Cathorall and Dr. Brady, and Mr. Mathias took a walk to visit the beautiful home of Mr. Patrick. Mr. Patrick has done extensive research in using fecal matter as a sustainable energy source. Now I know what you may be thinking, because honestly I thought it too at first, but he explained to us how the whole process works. After giving us a tour of his property, he invited us into his home to have a conversation about his work. He told us that he has traveled to the UK, Dubai, Switzerland, Tanzania, and various other countries to spread his knowledge and market his research. He explained to us that here in Uganda, it is quite difficult to get people on board with his research, but he has done years of testing and he is working diligently to change that. In addition to his research, he also spoke about how he hopes to help the people here in the community. As a philanthropist at heart, he wants to assist those in need and help the community to flourish. Mr. Patrick showed us so much hospitality. He was so kind to us, and he even had a “snack” prepared just for us, and by “snack” I mean an entire meal and it was absolutely delicious. We had Irish potatoes, milk tea, chapati, and fried chicken! It was literally a taste of home and much appreciated by everyone. I am excited to see Mr. Patrick’s success in the future.

Lights, Camera, Implementation!!! 6/13/18

Today was the day!

We implemented our HIV prevention education program and I think it was a success! It’s hard to imagine that we spent a whole year of school to do what we essentially just did in a single day here. Just as with our senior projects, we had some unexpected things happen that we had to adjust for, but we made it work. We were so worried about not having anyone show up, but we had an entire class of kids plus a group of about 8 community members. We planned on having only or mostly adults, so we decided to do the entire program with the kids and then just talk about condoms as a prevention method rather than doing the demonstration. Once the kids left then, we did still do the demonstration for the adults. From start to finish our program lasted almost 2 hours! The kids were having a good time with the activities, and they also asked a lot more questions than we had anticipated, but we were happy to be there with them educating them and having fun at the same time. I’m grateful that the kids came because I feel we got a lot more energy from them than we would have with adults, especially when it came to the activities. I feel kids are also less fearful to ask questions and so the conversations we had with them flowed well with little hesitation. The TV cameras got there about halfway through our program and although I thought it would make things awkward, everything continued on as normal. Dr. Cathorall told us that we did well and everyone on our team was very happy with how the day went. I think today has been our best day thus far!

I forgot to mention this, but the day I was sick we got a new team member and his name is Jeans!

24 hour Health Education Program! 6/12/18

This morning we had a meeting with Dr. Cathorall and she told us that tomorrow the local TV station will be coming to film us and we need to create some sort of program or activity to put on for our community. The Chairman of our community had already expressed that he would like us to educate the community on HIV, so we decided we would base our program around it. Given the short prep time, Haley and I stayed on main campus to do research while the rest of the group went into the field ( I was secretly thankful because I had just barely finished recovering from my stomach bug, as mentioned in my last blog).

One of the most frustrating things I have faced on this trip is dealing with my computer. While trying to do research, not only was my computer refusing to keep connection to the WiFi, but it was also operating painfully slow. Even my phone wasn’t really useful, and it really had me worked up because I didn’t want to be a let down to my team. Despite the struggles, we were able to create a lesson plan for a 4 phase program. The program included providing education about HIV through facts and statistics, demonstrating how quickly the disease spreads through a fun activity, testing the knowledge of our community with another game, and finally educating our community on the correct way to use a condom through demonstration. Haley and I paid a visit to the health clinic to ask if they offered free testing and also to see if they would donate some condoms for us to pass out at our program. Being that we weren’t expecting very high numbers of participants, we asked for 20 condoms, but we were ecstatic when the clinic gave us 4 full boxes with 144 condoms each, that’s 576 condoms! After supper, we met with the rest of our team to run through the lesson plan all together a few times just to make sure we were prepared. Chelsea and Mikayla were also there because they are going to be joining our group tomorrow to help with the program. We had a bit of confusion and hesitation from the group when we were explaining everything, but by the end of the night, ultimately everyone was on the same page. The only thing we are concerned about is the amount of people that we will actually get to come to the program. Hopefully everything will work out!

Kampala 6/9/18

Today we traveled to the Kampala campus which is about an hour away. We were put into groups and then each of us went to visit a different slum community. Haley and I were grouped together and the people we were with were completing their field work in that community. It was very interesting to see how people in the community interacted. Mr. Chaney, who was supervising our group, encouraged that we take notes and photographs to document our experiences. From a public health standpoint, I have seen many things here that I have never been exposed to in the US, and I don’t mention this to sound negative, but rather to point out that people don’t often think about things that they feel are beyond them, the things that they don’t see everyday, or experience personally. It is so easy not to think about issues in other parts of the world that don’t exist in our neighborhoods or towns, and often times it is hard to imagine solutions for problems that seem so large, however that is why we are here, to see things from a different perspective and to challenge ourselves to apply everything that we have learned only on a much larger more impactful way.

On a lighter note, after we returned from the field, we gathered together with Ndejje faculty for a celebration. Today I am happy to say that I expanded my palate and tried goat and fried grasshoppers ( I can finally cross eating an insect off my bucket list whooo!). We ate, talked with the faculty members, and a few of us even danced the night away (even without the Beyoncé song we requested). It was a very fun evening and we were all definitely exhausted by the time we got back. Although it has only been a week I have already met so many people and had so many new and exciting experiences. I am so glad that I am here in Uganda!