The Last One

I again apologize for the sparce postings this week. As I said earlier in the week, things have been slow in the clinic, and we have not gone on as many excursions. On Wednesday we went to Rugarama Hospital to do a garden workshop with some mothers of children in the malnutrition ward. We got to show them how to more efficiently grow vegetables at home so they can provide more balanced meals for their children. The technique we showed them allows between 20 and 30 cabbages to be planted in very little space, along with other local vegetables such as dodo (wild spinach). Below is a picture of the demonstration garden. This was a nice way to end the nutrition portion of the program; we got to see how some simple education could really help these women—and be a good garden project in the states as well!

Yesterday morning was our last day in the clinic. We got to see some patients, and later in the morning, we finally got to see KIHEFO’s new Maternal and Child Health Hospital, Kirigime Health Center. It has been ten years in the making, and just opened for out patient antenatal clinics this month. When it is finished, it will have over 100 beds—a HUGE achievement, as the local government hospital has only 3 beds, a pediatric wing, and out patient clinics. It will be the first Maternal and Child Health Hospital in Uganda. We got to see some of the mothers who were there for the antenatal clinic. The way KIHEFO has convinced mothers to get antenatal care is to provide free ultrasounds of the babies. It has worked well so far, and news is spreading fast around Kabale about the new facility. While we were there, we got to give a nutrition seminar to the mothers about providing balanced meals for their chidren. While I am sad that I will not be able to stay to see the continued progress towards a full opening of this ground-breaking facility, I hope that I will get to come back one day to see it in its full glory. Below are some pictures of Kirigime Health Center.

Labor Room of Kirigime Health Centre

Future Main Wards of Kirigime Health Centre

Another ward of Kirigime Health Centre

Today, to celebrate July 4^th here in Uganda, the other interns and I took a last trip to Lake Bunyonyi. We relaxed by the water, sang patriotic songs, and just sat and talked. We ended up running into some students who had left KIHEFO last week and were on safari, so we got to catch up with them. In the late afternoon, I finally decided to jump in the lake. It was beautiful and not to cold. Lake Bunyonyi is the deepest lake in Uganda, and the second deepest lake in Africa—it is 65 feet deep! All in all, it was a wonderful day. Below are a few pictures.

Rob, Amanda, Casie, Marnie, Adrien, and me
at Lake Bunyonyi 

Repping Michigan Kinesiology at
Lake Bunyonyi 

Panorama of the lake 

Casie, Adrien, and me at the lake.

It is hard for me to believe that my month here in Uganda has come to an end. While I know that this internship has been a very impactful learning experience, I also know that I will continue to learn from my time here in Kabale and my time with KIHEFO long after I leave tomorrow. There are things that I will not realize I learned here for a long time, but for now, I will give a list of 7 (my favorite number) important lessons I will take from my time here, both for my benefit and yours:

1.     Slow down. Really embrace every moment, and don’t worry too much about what’s past or what is coming. Live in the present, because otherwise you will miss so much of what life has to offer.

2.     Advocating for yourself is not selfish. In the real world, you have to go after what you want. If you ask the answer may be no, but if you don’t ask, the answer will never be yes.

3.     Passion isn't always easy. Just loving a subject or being passionate about a cause does not mean I will wake up every morning and love what I have to do that day. Some days are hard. Yet those are usually the days that you can learn the most from, so remember them.

4.     See work in progress everywhere. The hard workers, the doers, the hopers, the dreamers. They can be found anywhere and everywhere, and will inspire you when you need it most.

5.     Carpe Diem. This has become a motto of mine in the second half of my time here. Sieze the day. Live life to the fullest. Leave wherever you are with no regrets. You never know when-or if-you will be back.

6.     It is ok to look forward to going home. This is one that I struggled with at the end of last week. I have been away from home a lot, but this is the first time I ever actively looked forward to leaving where I was and going home. After reflecting on it I realized that I think it means this: if you look forward to going home, you know how much you love your family and friends,and are excited to be closer to them again. Remember this feeling when they are near so you don’t take them for granted, but until then don’t focus on missing them so much that you miss out on everything where you are.

7.     Be positive. Don’t let anything consume you except the power of positive thinking. Life is too short for that, and it is a waste of energy. Take the time to appreciate the positives in every day.

Thank you to everyone who has followed my adventures for the past month, and to everyone who has contacted me while I have been here. It means the world to me. I’ll be stateside in roughly 48 hours, and I look forward to catching up with everyone then. I started with a quote back in May, and I think I’ll end with one, because I like them so much. You all have seen this one already, but I  think it is the best one for the end of my time with KIHEFO, so I’m going to repeat it:

Go to the people: 

Live with them, 

Learn from them

Love them

Start with what they know

Build with what they have.

But of the best leaders,

when the job is done,

the task accomplished,

the people will say: 

“We have done it ourselves.”. –Lao Tzu

A parting gift from KIHEFO at our
farewell dinner on Thursday.

Canada Day

Today was my last outreach here in Uganda. KIHEFO does a monthly HIV outreach to a community group about a half hour’s drive from Kabale town, where we see HIV+ patients, see how they are doing on their medications, and provide them with a month’s worth of ARV therapy. There are almost 200 patients in this group, although today no more than 30 came to the outreach. We learned that one of the barriers to coming is hygiene. Many people feel ashamed that they do not have soap and water to bathe, and feel embarassed coming to pick up their medications. While there are many other barriers to healthcare here, this one seemed so simple to me that it really struck me. If soap were provided, or, better-yet, if people were taught how to make their own soap cheaply so that the soap could be more easily accessible, maybe more people would get their ARVs. In addition, they would have better hygiene, and wouldn’t get sick as often. This was a very concrete example of how interconnected so many issues are here. You cannot solve one without affecting several others.

Adrienne and I hard at work at the HIV outreach.

Anywho, this post is called Canada Day because, well, today is Canada Day. Our local coordinator here, as well as her two roommates, are Canadian, so we had a celebration at the KIHEFO compound. We had pancakes, hashbrowns, and bacon with maple syrup for dinner. It was all delicious, and a nice change of pace. Now I am going to watch the USA vs. Belgium game (or at least some of it, as it is after 11PM here) and tomorrow, we are going to do a nutrition workshop at a local missionary hospital.

Breakfast for dinner!

Sustainable Agriculture in Uganda

This week has started out much more slowly than the last three. While the days are going by fast, they are not quite as jam-packed as last week was, which is a nice way to end my time here in Uganda. However, it also means that my blog posts are likely to get less exciting. In any case, we started off the week with a day focused on sustainable agriculture in the developing world. We had a seminar in the morning, and in the afternoon we visited KIHEFO’s rabbit breeding project and a nearby mushroom project. Agriculture is something I didn’t know much about before I came here, and something that is definitely a huge part of Ugandan life. Many Ugandans are subsistance farmers, which has caused a lot of challenges as a cash economy has become more and more prevalent throughout the country. One thing I learned a lot about yesterday, and throughout this month, is the role of gender in agriculture. Here in Uganda, women do the majority of the agricultural work, but have little control over what crops they can plant and what they can do with the crops they harvest. All of the responsibilities of the farm are broken down by gender. One example of this is that all perennial crops are controlled by men. Women cannot choose to buy and plant those crops; they must wait for their husbands to make that decision.

In addition to the traditional fruit and vegetable farms, throughout this month we have learned about different ways to help find local, sustainable solutions to malnutrition in southwestern Uganda. Yesterday we got to visit KIHEFO’s rabbit breeding project, which is still starting up but has a lot of potential. Earlier this month, I helped revise and administer nutrition surveys in Rubira, a nearby village. Future volunteers will continue to administer these surveys in Rubira and in other villages to identify families with malnourished children. The goal of this is to be able to provide qualifying families with one male rabbit and two female rabbits to start their own breeding project so the family will be able to have protein to eat and have a more balanced diet. Eventually, the family could sell some of their rabbits back to KIHEFO, and KIHEFO could sell rabbit meat in town, which would help cover costs of the program. We got to see a program similar to this in the mushroom project that we visited yesterday. This project gives mushroom spawn to farmers, and the farmers grow the mushrooms. After the farmers grow the mushrooms, they can sell them back to the mushroom training center, where they can be packaged and sold. The profit from the sales of the mushrooms goes back towards funding the project. These two projects are local, innovative solutions to the malnutrition problem in Uganda that involve sustainable agriculture. Below are some pictures.

The future administration building for the rabbit project.

Some of the rabbits at the rabbit farm.

Kale in the garden used as rabbit food.

Solar dryers at the mushroom training center.

Mushrooms growing at the the training center.

Weekend Recap

Saturday

I couldn’t come up with a creative title for this blog post, my apologies.This last week has been a busy one, but it has been great. Yesterday was the monthly nutrition assessment at the KIHEFO nutrition clinic. This event is held on the last Saturday of every month. Those children that are brought back are assessed (weight, height, arm and head circumference) to see their progress. KIHEFO cooks a meal with meat and rice to entice the caretakers to make the journey back so we can check up on these former patients.  I got to help weigh the babies, and I got to give the presentation that I gave to the students at Rubira Primary School on Friday to the mothers. It was a great lesson, and very interactive. The volunteers even offered their own advice to the other mothers on how to make balanced meals to keep the children healthy. It was great to see this community so interested and willing to learn, and willing to make such a long walk back to the clinic.

In the afternoon, I got to go to another health camp that KIHEFO volunteered its services for. KIHEFO partners with a pentacostal church in Kabale to encourage the congregation and the preachers to seek medical attention in addition to seeking healing through prayer. This partnership is only one of many ways that KIHEFO has been able to plant seeds in the community to gain trust in biomedicine. This medical camp was specifically for those of the Batwa tribe, also known as Pigmies, who are an indiginous people in Uganda. They speak their own language and are often shorter than other Ugandans. This free health camp was a rare opportunity for these people to get medical attention. I got to see patients with one of KIHEFO’s nurses for the afternoon.

Rob, Adrienne, and I at the Nutrition Clinic

The weighing equipment, provided by UNICEF.

Sunday

Today we took a day trip to Kisiizi, an area around 80km (an hour’s drive) from Kabale town, within Kabale district. Here we got to see a missionary hospital, Kisiizi Hospital, which was originally constructed as a leprosy hospital when Uganda was a British colony. The hospital is now a missionary hospital that receives half of its funding from the Ugandan government, and the other half from churches and other foreign aid groups. The facilities of this hospital were amazing. They had pretty much everything: operating theatres, a maternity ward, a mental health ward, a children’s ward, an HIV/AIDS clinic, and more. They have a system in Kisiizi where for 20,000 Ugandan shillings per year ($8 US) an entire family can be medically insured, meaning that if any member of the family falls ill any number of times, they are completely covered for all medical expenses at Kisiizi hospital. This is a great way to encourage locals to invest in their health so that they don’t have to wait several years to be seen when they fall ill, and is something that many private clinics are trying to implement in the area. In addition to seeing the hospital, we got to see Kisiizi Falls, a waterfall where women who became pregnant out of wedlock were pushed to their death by their own brothers. Legend has it that the last time this happened, the woman pulled her brother with her, and the tradition has not been continued since. While this story is incredibly sad, the waterfall was beautiful, and the entire trip was a great way to spend the last Sunday of my time here in Uganda. When we got back, my friend Adrienne and I went for a beautiful evening run around Makanga Hill, which ended the day nicely. I can’t believe this month has gone by so fast, but I am excited for my last week here in Kabale. Below are some pictures.

On the way to Kisiizi

View of the mountains on the way to Kisiizi

The spot where they used to push women off the falls.

Caution sign at the point where they used to push women off the falls.

Kisiizi Falls.

Marti, Adrienne, Casie, and I at the bottom of the falls.

Amanda, Adrienne, Casey, and I at the bottom of the falls.

Me at Kisiizi Falls

Panorama of the waterfall.

Kisiizi Hospital

Project Healthy Schools

Today, I went to Rubira to work in the clinic there for KIHEFO’s monthly outreach. I got to shadow some of the medical professionals and see patients. In the afternoon, I got to go back to the primary school in Rubira to teach their sixth graders about the different food groups. During the year, I volunteer for the University of Michigan Health System as a Health Ambassador for Project Healthy Schools (you can see their website here: http://www.projecthealthyschools.org/).

For 10 weeks, I get to teach sixth grade students about healthy habits and how to eat well. Lesson three is the “MyPlate” lesson, where we talk about the important food groups and how to make a healthy plate. The other public health student, two of the medical students and I planned the lesson and gave it just like the project healthy schools lesson I give the sixth graders in Ann Arbor. It was amazing to see how the same simple lesson could be used for two vastly different groups of children halfway around the world from each other. Below are some pictures.

Me at the clinic in Rubira

MyPlate Lesson

The P6 and P7 (6th graders) at Rubira Primary School

This Time For Africa

As I’m sure many of you know, last night was a very exciting night in the World Cup Soccer/Football Tournament. USA played Germany, which was exciting for my American friends and me, and Ghana played Portugal. Since Uganda is not in the World Cup, our Ugandan friends are cheering for all the other African teams, so while unfortunately for them Ghana lost last night, the USA made it through to the next round. Last night was also a special night at the KIHEFO compound because it was the last night that another large group of students was here with us. A group of students from Mbarara University has been here for the past month, and they left today.

In honor of them, and in honor of the CFHI students who are leaving next week (which includes me—time has gone by so fast!) Dr. Geoffrey threw a party at the compound. We watched the football games, were treated to a buffet of Ugandan food and soda, and had a DJ and large speakers playing songs to dance for the whole night. I’m pretty sure the entire town of Kabale could hear the interesting choice of songs, which included, but was not limited to: Ludacris, Katy Perry, Carly Rae Jepsen, and African dance music. Waka Waka (This Time For Africa), the song that Shakira did for the 2010 South Africa World Cup, is very popular here, and played on tv before the game. Our DJ also played it as the closing song at our dance party. (You can listen to it here: https://www.youtube.com/watch?v=pRpeEdMmmQ0).

At that point, around 11:30PM, Dr. Geoffrey drove the entire KIHEFO staff into town so we could experience a “night on the town” (read: an hour of standing and watching other people dance) at a dance club in Kabale. It was quite an experience. He stayed with us and then drove us home, at which point we all went to bed exhausted. Enjoy some pictures below.

Adrienne, Casie, Lauren, and Favour
(pronounced Fava-Dr. Geoffrey's daughter)

Some of the group watching the USA vs. Germany game
while the DJ played some music

One of our preceptors, Allen, dancing with Favour

Atayo showing off his dance skills

Lauren and me

Adrienne and me

Rob shows off his dance moves

Conga line!

Health Camp in Kicumbi

Today we went to Kicumbi, a village about 15 minutes outside of Kabale, to work at a free health camp sponsored by KIHEFO. These health camps don’t happen often, so it was exciting to get to be a part of one. We got there at 10AM and worked until 5PM. We set up a general clinic, dental clinic, eye clinic, antenatal and family planning clinic, laboratory, HIV counseling, and a pharmacy. Patients were triaged and sent to the appropriate area to wait to be seen. I worked with one of the KIHEFO  midwives for most of the day, observing her interactions with antenatal patients. In the afternoon I also got to see some of the cases that had been referred to Dr. Anguyo, which means they were the more difficult cases (Dr. Anguyo was the only full-time doctor there, the rest were medical officers, midwives, nurse practitioners, and students). By the end of the day, the camp saw almost 250 patients with a large variety of complaints, which is common for these types of camps. Many people we saw today would never be able to afford to come to the clinic, but because of KIHEFO they were able to be seen in their own village. All in all, it was an amazing experience. Seeing patients and learning about their conditions, as well as seeing the differences between theoretical approaches to counseling and treatment that I have learned at school and on the ground techniques utilized in underdeveloped areas is an experience that I know will be useful to me in the future, both in my coursework and in my career. Below are some pictures.

Inside the church where we held the health camp

Family planning supplies

KIHEFO ambulance

This hut was our pharmacy