Sunday, September 29, 2019

Seeing Tears Turn into Smiles

by Loy Tumusiime, Reproductive Health Program Coordinator

It had been a boisterous day filled with stories and camaraderie. The UVP office was filled with all of our Fistula Ambassadors. It’s one of my favorite activities because I get to hear many stories about successes; our Fistula Ambassadors conduct educational outreaches in faraway places. They cover about 4,000 square miles in eastern Uganda. Today, I got to catch up with Aidah who made the trek to Iganga even though she is expecting her baby any day. As a former fistula patient, Aidah has been reflecting on her previous birth experience.

After a prolonged labor, Aidah left the hospital with what turned out to be a very complicated fistula. Her first husband, distraught by the loss of the baby and his wife’s health condition, left. After one year of living with fistula, Aidah attended a UVP fistula camp and received treatment that resulted in the successful closure of the fistula. She was so grateful for the services, she started conducting informal educational outreaches – before UVP established the Fistula Ambassador program. Once UVP partnered with The Fistula Foundation and established the Fistula Ambassador program, Aidah didn’t have to think about the offer to become a Fistula Ambassador. Her passion for educating women on how to avoid fistula shines brightly six years later.

Now remarried, Aidah is expecting her baby any day and she and her husband have prepared very well with a small savings that will provide them transport to the health center and supplies needed to support a healthy and safe delivery. When I asked Aidah what inspired her to keep acting as a Fistula Ambassador, even traveling in the final days of her pregnancy, she had this to say: “When I see a woman leave the village crying only to return with a smile on her face, I know her life has been changed, just like mine was.”

To find out more about UVP’s fistula program, visit our website. You can support Aidah’s work to educate women in remote places by making a contribution to reproductive health programming!

The Connection between Health and Wealth

by Josephine Asio, Program Coordinator

“Having a pit latrine in my village was considered a luxury,” Harriet laments. Based on this comment, it doesn’t surprise me that she scoffs when she tells me that her neighbors used to think that it was witchcraft that made children fall sick. Harriet knows it was the poor health conditions of the village.

But now, three years later, Harriet is pleased with the changes she has seen in Namufuma. She says that seven out of ten neighbors now have latrines and many more people sleep under mosquito nets. These numbers were confirmed by the graduation survey in the village – there was a 20% increase in latrine coverage and a 10% increase in knowledge of how malaria spreads and is prevented during the three years.

One notable thing Harriet shared with me was the difference in how the community members saw the government health workers. Prior to UVP working in Namufuma, the sub-county Health Assistant was known for arresting people who did not have a proper latrine. Although that practice had been outlawed nearly ten years ago, community members still feared a visit from the Health Assistant. The VHTs and UVP staff visited the village many times with the Health Assistant to provide valuable education and slowly debunked the myth that those without proper facilities would be arrested.

She finishes our conversation by making a bold statement: “A healthy community is a wealthy community.” I pondered this statement for a while, wondering why she so clearly understood the relationship between health and poverty, but that others still seemed far away from this revelation. I came to a conclusion I’ve had before: behavior change is a slow process and we must be patient and persistent.

Do you believe that health and wealth are intertwined? Learn more about UVP’s Health Villages program by visiting our website.

Friday, August 30, 2019

The Many Weights of Disease

by Josephine Asio, Program Coordinator

Sarah in Mwendanfuko knows that diseases do not only affect your health; they affect you physically, financially, and emotionally.

I met Sarah while conducting house-to-house education with the sub-county Health Assistant. Sometimes people are afraid for us to visit them because they do not have the proper health facilities in place, but that was not the case with Sarah. When we found her, she was with her six-week-old baby and her mother in law, and she was confident that she had the proper facilities because she had experienced tragedy in her family that she never wanted to experience again. In fact, it was such a traumatic experience, that even years later, Sarah became quite emotional while telling her story.

When Sarah’s sister was three months pregnant, she began to bleed. Because of financial constraints, her sister was not able to be taken to the hospital immediately. The next day when they were able to seek treatment, they learned that Sarah’s sister had malaria; while the health care providers did what they could, they were not able to save her, and her sister passed away while in Sarah’s arms.

Because of her traumatic experience, Sarah sought antenatal care early in each of her four pregnancies and heeded the recommendations of the health care providers. Every member of her household sleeps under an insecticide treated mosquito net and they seek care immediately after symptoms arise. In addition to ensuring preventative measures are in place for her family, Sarah also encourages her neighbors to purchase mosquito nets from UVP to keep their families healthy and to avoid tragedy.

Sarah’s story is being used with her permission. If you would like to learn more about our malaria program, visit our website.

Friday, June 28, 2019

The Realities of Inequity

by Becca Rose, Ryan Blake, and Nikki Johnson, Interns, Naluko Village

On our first full day in Naluko village, we met with our Village Health Team members (VHTs). These five community leaders are tasked with promoting general health within the community, despite access to scarce resources and no formal medical training. About an hour into our meeting, a voice called at the door, “Kodhi!” ‘Knock Knock!’ A man popped in and called one of our VHTs outside.

A couple minutes later, the VHT returned, exchanged words in Lusoga through choked tears, and left. Our Ugandan team leader, Sarah, translated, “Her father has just died.” It’s culturally expected that relevant members of the community attend funeral ceremonies, and so we learned that all of our VHTs would be absent two days that week, traveling to attend the burial. We expressed our condolences to the family and resolved to visit her upon return- as per custom, but then exchanged concerned glances, wondering what this would mean for our work.

The meeting continued and our excitement slowly rekindled. We learned more about our community and began to discuss our ideas. Then, we got to the chairman. The chairman is the head political leader in the village, and holds significant influence with community members. Initially, we planned to make personal contact with the chairman immediately, and request he set up a community meeting for us to introduce ourselves. The VHTs informed us that his wife was sick, but because the nearest health center was in Iganga Town, a far distance from the village, he wouldn’t be available to meet with us. Another obstacle. Yet again, we were called to be flexible, and adapted appropriately, resolving instead to meet with the vice-chair and other prominent leaders.

That evening, the woman we hired to assist with our food informed us that she would not be able to cook for us because her son was sick and she would have to attend to him. For the third time that day, the consequences of the health challenges we were tasked to address were directly inhibiting our ability to make progress.

Just as with most systemic inequity, the cycle begets itself. The lack of public health resources within the community was directly inhibiting our ability to provide public health resources to them. Western powers often adhere to toxic false notions about the realities of life, overlooking the complexity of solutions in low-resource contexts, especially in sub-Saharan Africa. Many people believe that healthy practices, such as washing hands or using hygienic waste management practices, are simple obvious truths with simple obvious solutions. This reductionist thinking fails to account for the cyclical nature of these issues. Interrupting a cycle is tricky business, involving active accounting for the consequences of the issues, while simultaneously preventing their recurrence. With a nuanced and relevant understanding of the issues at play, our team is excited to take on the challenges that lay ahead, regardless of the obstacles along the way. After all, this is what we’re here for.

Learn more about UVP's public health internship by visiting our website.

The Strengths and Weaknesses of Our Village

by Julia Chodyla, Intern. Namunkanaga 2 Village

With broad smiles reaching ear to ear, the children of Namunkanaga 2 walk past our new home singing the song we taught them about washing their hands after using the latrine. This melody is a clear indication that we have started to leave our mark; we have started to inspire healthy living. 

After assessing the strengths and weaknesses of the community through a SWOT analysis with our Village Health Team members (VHTs), we are shocked and impressed with the village’s proactive approach to family planning. From what we are told by our VHTs, girls as young as 13 are getting the implants and are regularly renewing them every three years once they expire. And despite the strong religious devotion in the community, the men are taking their wives and daughters to get contraceptives, actively supporting them every step of the way. That being said, we still find a disconnect between this information and the sea of children that crowds each household and crams into the school benches. Hopefully when we visit house to house the next two weeks conducting our baseline surveys we will be able to investigate the reasons behind this phenomenon. 

This leaves us to assess one of the main challenges of the village: sanitation. Our initial impression is that drinking water is rarely treated or boiled and there is a lack of hand washing after using the latrine. In households without latrines, community members oftentimes urinate or defecate in the bushes or the sugar cane fields, and even if a latrine is available, it is not smoked or scrubbed due to its mud structure allowing an infestation of flies that spread diarrheal diseases. Malaria is another area of concern: although the government distributed nets a few years ago, education surrounding their proper use was not provided and some people are convinced that malaria is contracted by eating mangoes. While it may be a strong statement, we believe it is a true statement- there is a severe lack of education- education about the contraction of diseases, education about the prevention of diseases, and education about the access to treatment. 

According to the VHT’s, one thing that cannot be argued is that the people of Namunkanaga 2 are yearning for information and are ready to make large strides towards healthier lives. We extend our utmost gratitude for the warm welcome, hospitality, and encouragement Namunkanaga 2 has given us. We know that a healthy life can be a reality by working together to create a sustainably healthy village that is given the tools and education to keep independently improving.  

Learn more about UVP's 2019 intern cohort by visiting our website.  

Thursday, May 30, 2019

Your Feedback has Profound Value

Your Feedback has Profound Value

We eat, sleep, and breathe UVP. We know what programs look like on the ground and the names of all the VHTs. We see the same faces when we go to the village and we have relationships with staff members at all the local health centers and the Iganga District offices. We’re embracing UVP all the time, so there are things we take for granted, things we intrinsically know because of our intimacy with the work. It’s called the curse of knowledge – once you learn something, it’s hard to remember how it feels to not know.

The survey that many of you took last month helped to illuminate ways we could talk out the work of UVP, the work you support, to promote better understanding of what exactly is going on in villages in Iganga. Here’s a couple tidbits we received from you.

Yes, you got all the questions right! If you ticked the box indicating that trachoma education is one of UVP’s programs, that tells us that we need to do a better job at highlighting program changes (we used to implement trachoma awareness programming, but began focusing on our other programs in 2009).

Most respondents to the survey know that UVP provides education in clean water (83%) and sanitation & hygiene (77%) and clean water access (75%). What surprised us is that most people don’t know that, in addition to malaria education, we provide malaria testing and treatment (only 35% knew this). And while many people (68%) know UVP provides HIV education, less than half (47%) know that HIV testing and counseling coincide with that education.

We learned that the term ‘public health’ is ambiguous and broad – it can mean many different things to many different people. The largest majority of people categorized it as required, useful, or necessary (23%), followed by a community concern (17%), and finally as general health or non-descript health terms (15%). We could do a better job at painting a picture of what public health means, particularly in rural Ugandan villages.

We also learned that it is difficult to determine what UVP is directly responsible for due to our close ties with other organizations. So, our job is to better communicate those things to you! While we’re making adjustments in our communication, feel free to reach out to us if there is something that you really like, something you learned, or even something that left a bad taste in your mouth (something you didn’t like). Please be gentle, we really do take your comments to heart!

And finally, a heartfelt thank you! Because you took the time to provide us with your input, we can provide better education about what public health looks like and the real impacts it has to rural communities in Iganga.

Kelly Child
Executive Director

Now the Baby is Not Just Her Responsibility

by Maria Gorret Nampiima, VHT Program Coordinator

Sometimes, health education requires tenacity and creativity.

I met Sarah in Ituba A while the VHTs and I were conducting house-to-house visits focusing on reproductive health education. Because of the sensitive nature of reproductive health, these visits are different than our outreaches; community members feel more comfortable to share their personal stories and ask detailed questions. Sarah was no exception.

At five months pregnant, we were astonished to learn that Sarah had not gone for antenatal care yet. It can be easy to make a community member feel ashamed and guilty, so we kept our surprise reactions to minimum; after all, Sarah isn’t the only one responsible for seeking antenatal care. She expressed to us that she knew she needed to go and was worried – she had experienced birth defects in previous pregnancies and wanted to check on this baby, but didn’t have the funds to transport herself to the health center.

Sarah shared her challenge in seeking antenatal care with the VHTs during our visit, and after some discussion, she asked for the VHTs help to encourage her husband to better support her health care in pregnancy.  Although family counseling is not typically a role VHTs embody, they were supportive of her request and our next stop was the trading center.

Upon arrival, the VHTs quickly located Sarah's husband and, after greeting him, asked several questions about his wife’s health. As the VHTs discussed with him the importance of antenatal visits, his face changed from confusion to determination. Since he had not been to any of UVP’s reproductive health outreaches for men because he works outside of the village during the day, he wasn’t aware of the importance of antenatal visits. As the education provided by the VHTs sank in, he became more understanding and accepting of his role in the pregnancy part of raising his child.

Fast forward two weeks: we’re back in Ituba A and visit the trading center again, looking for Sarah’s husband. The moment he sees us, he smiles widely. He is happy to report that Sarah has been to the health center for an antenatal visit and she and the baby are doing fine and growing well. He is proud of his healthy family, and we left him at the trading center sharing his story with his friends.

It’s amazing what a little education can do!

Education and access are a powerful team! Learn more about this influential program and ways you can support life changing education by visiting our websiteWe are sharing Sarah's story with her permission; her husband has asked to remain anonymous.

“I Pondered on Taking Poison”

by Loy Tumusiime, Reproductive Health Program Coordinator

After almost two hours, Jamira realized that labor had started, but her husband and other family encouraged her to wait until morning to go to the health center. After all, these things can take time.

In addition to the family’s influence, “it was the long distance [to the health center] that kept me from seeking treatment early,” Jamira remembers. Unfortunately, the baby did not survive. Upon discharge from the hospital, Jamira went to her grandmother’s home; Jamira did not want to go back to her husband until she figured out why she was uncontrollably leaking urine. After one month, her grandmother couldn’t take the smell and built Jamira a shack made from banana leaves behind the house. In addition to being isolated, Jamira was in pain. “I pondered on taking poison,” Jamira says as she recalls those dark days 12 years ago.

Jamira’s first flicker of hope happened when her sister-in-law heard one of UVP’s Fistula Ambassadors giving an educational talk at the nearby health center. It wasn’t until Jamira reached Kamuli Mission Hospital and saw all the other women in the same condition that she embraced that hopeful feeling. “Fistula is a treatable and preventable disease, but when you are out there you can’t know that.” Living in a rural area limits the education that women are exposed to, making UVP health outreaches by staff and Fistula Ambassadors some of the only education women receive.“When urine flows, it washes away all the brain and stops you from thinking abroad,” she says.

Despite being shunned for 12 years, Jamira’s spirits are high as she readies herself to leave the hospital to participate in UVP’s reintegration program where she will learn a trade and continue to heal in a supportive environment.

A fistula patient today becomes the Fistula Ambassador of tomorrow. One woman at a time, UVP’s Fistula Ambassadors find those who have been neglected for years, suffering in silence - women like Jamira.

You can support our Fistula Ambassadors to reach women like Jamira with life-changing treatment by making a contribution today! We are sharing Jamira’s story with her permission.

Tuesday, April 30, 2019

Beginning a New History with UVP

by Patrick Tulabagenyi, Program Manager

People passing by see us and stop to ask questions. And our group grows with each passerby.

We are in Namunkanaga village holding a community meeting to discuss some of the health challenges facing the village – conducting our due diligence before we commit to working in a community for three years. The community discusses several health concerns and asks many questions about how UVP works. It was at this point that Banuli stands to speak.

Nearly ten years later, UVP’s work in Luuka District still stands out in Banuli’s mind. As a former leader of a village in Luuka District (formerly Iganga District), Banuli worked directly with UVP to improve his village’s health, specifically through safe water. As he spoke, it was clear to me that he was well-respected in this village.

Banuli narrated to his peers about the positive relationships UVP forged in his previous village, relationships that affected many positive changes. He noted the new shallow well and the reduced prevalence of diarrheal disease. He smiled wide when he mentioned seeing many new tippy taps in the village as a result of the education his community received.

Namunkanaga is eight kilometers (five miles) from the nearest health center. Transport costs can keep a family from seeking medical treatment, so preventing illnesses is of utmost importance. Namunkanaga’s chairman stood up and stated that he felt the community would greatly benefit from educational sessions. The crowd nodded. The vote that followed was overwhelmingly in favor of working with UVP.

Following the meeting, the chairman showed us the proposed house the interns could live in. The community is very excited to work with UVP and pulsing with energy to welcome their visitors in June!

The interns are coming! In June, UVP and Namunkanaga will welcome our new intern cohort. Like us on Facebook and Instagram to see their adventures!

Not All Things are Sweetened by Sugar Cane

by Josephine Asio, Program Coordinator

At the time, she didn’t know that sugar cane could be deadly.  

As Ms. Kagoya and I chat on her recently swept veranda, we watch her two year old son playing under the mango tree. I sensed a bitterness arising as we begin to discuss her experiences with malaria more in depth.

Early in 2017, before UVP started working in her village, Kamira, Ms. Kagoya experienced complications during pregnancy. She was about 16 weeks along when she began bleeding. Because it was early in her first pregnancy, she had not yet had her first antenatal visit, so she thought the bleeding was normal, especially because she didn’t feel sick. “It all happened so fast that I didn’t know how I got to Bugono Health Center,” she says. She woke up at the health center to find out she had lost the baby. The nurse told her that she had high levels of the malaria parasite in her blood and that is what caused the miscarriage. The nurse also told her that she could still have more children, but she would have to change her habits.

Upon returning home, Ms. Kagoya and her husband began clearing the space immediately surrounding their compound. Sugar cane had been planted to the edge of the house and closely surrounded the compound, but after talking with the nurse, Ms. Kagoya now knew that sugar cane was a popular breeding ground for malaria. Because sugar cane is a lucrative crop, it is unheard of for a farmer to clear some area of the crop.

In addition to clearing the sugar cane and standing water, Ms. Kagoya and her husband located their mosquito nets and hung them. When the government distributed mosquito nets nationwide, there wasn’t much education to accompany them. It can be hot sleeping under a mosquito net, so Ms. Kagoya hadn’t taken the government distributed nets seriously.

The bitterness I sensed at the beginning of our talk dissipates to hope and passion. She doesn’t want others in her community to experience the tragedy her family did, so she encourages others to take the education UVP provides seriously. She doesn’t want a mother to lose her unborn baby because of a lack of knowledge. “Lack of information can be very fatal,” Ms. Kagoya tells me. And she’s right.

We are sharing Ms. Kagoya’s story with her permission. If you believe that prevention is the key to better health, join us in addressing key program areas in rural communities!