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Sunday, June 29, 2014

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

Friday, June 27, 2014

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!

Wednesday, June 25, 2014

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

Monday, June 23, 2014

Constructing the Illness Experience

Meet Tiger. He is one of the guard dogs at the KIHEFO compound,
and one of the sweetest animals you will ever meet.
He doesn't have anything to do with this post,
but I wanted to put him on the blog.

Today we went to visit a traditional healer who KIHEFO has partnered with, who has his clinic on Lake Bunyonyi. The title of this post is taken from the title of a lecture of my medical anthropology class last semester, during which we spent a lot of time talking about the culture of biomedicine in relation to other medical cultures. It was amazing to be able to talk to a traditional healer here in Uganda and hear his perspective on medicine and the illness narrative. I got to apply all of what I learned last semester firsthand, which was such a memorable experience.

 Lake Bunyonyi is 65 feet deep, and is the second deepest lake in Uganda. It is a 15 minute drive from Kabale town. Once we got to the lake, we took a motor boat across to the side of the lake where Sam Maurice (or Morris, I’m not sure how to spell his name) has his clinic and his home. We got to spend some time with him, and he told us about his life and what he does, through our translater Lilian.

Maurice was baptised as a child but still believes in traditional religion and healing. He has four wives, and more than 16 children. Three of his wives act as assistants in his healing process. His first two wives are traditional birth attendants. His third wife travels to volcanoes and to a nearby National Park (roughly two hours by car, so actually relatively far) to get the supplies he needs for healing.

We visited Maurice in his home, which is a traditional hut made out of bamboo and mud with a thatched roof. His house does not have a permanent door; he believes he is protected by his gods from any harm, and in 60 years no one has ever attempted to enter his home without permission. This hut also functions as the healer’s clinic. There is papyrus on the floor which functions as a mat, and we sat on tree stump stools inside as Maurice told us about his way of healing. He wore a traditional healing uniform, which consisted of a the skins of rare animals. This showed his power and gift of the gods. On his head he wore the skin of a black and white colobus monkey, on his chest he wore the skin of a lion, and on his legs he wore the skin of a waterbuck.

The Modernization of Ugandan Culture

Traditional religion, which was common in Africa before it was colonized, has become taboo in recent years. While many Ugandans do in fact still believe in traditional religion, most will not admit that they do. The same goes for traditional medicine, which has its roots in the same area as traditional African religion. The statistics that I have been given say that while most Ugandans will not admit to using a traditional healer, 80% of Ugandans actually do still use them. Because traditional medicine has become taboo, many clients go to Maurice at night so they will not be seen by others when they seek his help.
The following story really struck me. Our translator, Lilian, was telling us about a woman who decided that she wanted to be baptised in the church. When she said this, the reverend at the church told her she had to burn her house because she had practiced traditional religion and traditional medicine, and the church believed there were still spirits in the house. The church came and burned down her hut so she could be baptised, which meant that the woman no longer had a place to live. This happened last weekend.

It is amazing to me that in order to become a part of the church, this woman had to give up her home and move in with her son. She had a perfectly good hut of her own to live in before, but the church burned it and all of her possessions so that there would be no remnents of her history as a believer in traditional religion.

Community Partnerships in Action

Anyway, the healer explained to us that his powers are a gift passed down through the generations of his family; the gods decide who will retain the gift. This is where the visit got really interesting for me. Maurice told us that he acknowledges that there are different types of ailments; for the purposes of this post I will call one illness and one disease. He acknowledges that illnesses, which are usually psychological, spiritual, or other problems that can be treated with herbs, potions, and spiritual healing, are within his area of expertise. He also acknowledges that there are diseases that have a much more scientific basis that are out of his realm of knowledge, such as HIV and malnutrition. He refers cases of these diseases, which he diagnoses, to Dr. Anguyo at KIHEFO. This is one way that KIHEFO works with the community to foster positive relationships and trust with community members and community leaders.  Maurice said that he is the chief of a group of 30 traditional healers in Kabale district who meet each month to discuss cases they have had and what they have learned. They also put together seminars for doctors so that doctors can learn what they do. In addition, Maurice said many of the other healers feel as he does that there are certain diseases that are not within their capacity to treat, and they refer these cases to doctors. I honestly think that this type of partnership is a brilliant way of gaining the trust of the community and of learning to understand and support other cultural beliefs. Today was an eye opening experience, and an extension of an education I started in my anthropology class at Michigan last semester. Below are some pictures.


Lake Bunyonyi

The docks. Today was market day.

From right: Amanda, Adrienne, and me on the boat.

Casie and Uncle on the boat on the way to the healer.

The rubble from the hut that the church burned down

Panorama of Lake Bunyonyi
the traditional healer in uniform with
some of his instruments
Lillian translating for the healer 
the healer playing a song/prayer for us before we left.


A Picture Is Worth 1000 Words

More pictures from this weekend's safari!

Amanda, Marti, and Marni on the front of the safari van at Lake Mburo

View from the back of the safari van at Lake Mburo

Two warthogs relaxing under a tree

Female impala standing under a tree at Lake Mburo

A baboon and a bushbuck at Lake Mburo

Sunset at viewing point above Queen Elizabeth National Park

Panorama of the Kazinga Channel

That time our van almost got attacked by baboons
(the car behind us actually did)!

Panorama of a crater lake on the way back to Kabale

A hot spring we stopped at thought to have healing powers.
People come from all over the country to bathe in it.

Sunday, June 22, 2014

Take Nothing But Pictures, Leave Nothing But Footprints


The title of this post is a phrase written on the signs from the Ugandan Wildlife Authority (UWA) at Lake Mburo. This weekend, several of the other KIHEFO interns and I went on a 3 day safari to Lake Mburo and Queen Elizabeth Park. We left Kabale at 6AM on Friday morning, and got back at 4PM this afternoon. Queen Elizabeth Park is about 7 hours from Kabale, and Lake Mburo is on the way. After having breakfast in Mbarara, we did a three hour safari through Lake Mburo National Park We then continued to Queen Elizabeth National Park, where we did a morning game drive on Saturday. then visited the Queen’s Mile, where Queen Elizabeth II had breakfast when she toured what was then Kazinga National Park when she visited Uganda before being crowned queen in 1954.  The park was later renamed in her honor. While we didn’t see any lions or other cats, we saw lots of animals: baboons, vervet monkeys, zebras, impalas, Ugandan kob, hartebeasts, elephants, bushbuck, waterbuck, and several others. In the afternoon we took a boat ride down the Kazinga Channel, which connects Lake George to Lake Edward, which drains into Lake Albert, which ultimately joins with water draining from Lake Victoria to form the Nile River. On the boat ride we saw lots of hippos, buffalo, crocadiles, Monitor lizards, and birds. Another cool thing about this weekend was that Queen Elizabeth Park happens to lie in the part of Uganda that is right on the equator. Because of this, there is a place in the park where you can stand in the north and south hemispheres at the same time. This landmark happened to be right near the lodge we were staying at (the appropriately named Simba Safari Camp—Simba means lion in Swahili) so we crossed the equator several times, and of course stopped on Saturday to take pictures on the equator. For those of you who were wondering, the Coriolis effect is real—water spins in different directions in the Northern and Souhern hemispheres! Below are some pictures of our adventures.


Lauren and me on safari
Zebras at Lake Mburo National Park!


Warthog at Lake Mburo National Park

Safari selfie.


Elephants at Queen Elizabeth National Park.

The Queen's Pavilion

Hippos on the Kazinga Channel

Buffalo and birds on the Kazinga Channel

Me at the equator! (photo credit to Marni Jacobson)

The whole gang divided by hemispheres. (photo credit to Marni Jacobson)

PS, if you are reading this, feel free to leave a comment, send me a facebook message, or an email, keeping in touch with those of you who have been sending me messages has meant a lot while I've been here!