Monday, July 20, 2009

Featured Summer Intern Team: Bugabula B


Bugabula B Village, Bulongo Sub-County

Matt Moy (Team leader) – MPH at Benedictine 2007, first year medical student at Chicago Medical School

Mumbe Lawrence (Ugandan leader) – Public Administration and Communication at Makerere University 2008

Amanda Hibbard - Undergraduate at Suny Upstate Medical University 2010, Biomedical Science, Psychology

Kate Werringer – Undergraduate at Berkeley 2011, Molecular and Cell Biology, Psychology

Chrystal Shen (who left Uganda before this interview was conducted) – second year medical student at Mayo Clinic Medical School

We sit around a small wooden table in the shade of a low-down jackfruit tree, waiting for Kiyunga Health Center staff to arrive and begin the day’s HIV testing. 

“Tell me about your village,” I say.

Matt, the team leader, launches into a Scottish accent: “We reside in a sweet little village, where the day begins with the crowing of the cock, and the sunset lights the sky afire o’er the bonny hills…”

I laugh. “Seriously now."

The team pauses.  “Well, we live in the middle of nowhere,” says Matt.  (Its true – Bugabula is an hour from Iganga town by motorcycle, down small, winding, dusty roads.  Of our five Healthy Villages this summer, it is certainly the most isolated.)

“And the crow does really wake us every morning, around 7,” chimes in Amanda. (The kids in the village call her Charcoal, because that’s what ‘manda’ means in Lusoga.) 

“The villagers ask us about our lives at home at lot,” says Matt.  “About the roads, the houses, if we have goats wandering around everywhere like they do…. “

“Children,” Katie interjects, “are the main inhabitants of the village.  Everywhere you go, you hear ‘Jambo, jambo! ‘” (Jambo means hello, originally a Swahili word, now used widely in Uganda.) 

Amanda agrees.  “ Where you walk, they follow.”

“Sometimes, when you can’t see any adults around, its like the kids have taken over.  Like they own the village,” says Katie in a fake-ominous voice.

“Like Lord of the Flies,” Matt jokes, and the whole team laughs.

“The young adult population gambles and plays cards a lot,” says Matt after a moment. “And pool! I play pool with them sometimes, and then feel guilty about it, because I ought to be working.” 

Lawrence, the team’s Ugandan volunteer, interjects. “When Matt came, he used to plan out every minute of every day… no, every second!  But now, he’s stopped that – or at least it’s less.”

“Being here helps to chill me out,” Matt agrees.

“What do you guys do in the village, for fun?” I ask.

“Play with babies,” Amanda replies immediately, a zealous gleam in her eye. 

The others simultaneously groan or make faces at her.  “We call her baby-snatcher,“ says Katie.  “She’s always got one in her arms… we’re afraid she’ll end up taking one home!”  A second later Katie adds, “We also play jump-rope, limbo, we play soccer.  We have conversations about where AIDS came from, America or Africa.” 

“Oh, and we sing a song, with the kids, about slavery in the US!” says Amanda.

I ask them to sing a verse for me, and it’s horrible – all about slaves in America, working all day growing sugar and tea.  One of the lines runs, “See my back, its is broken.” 

“That’s terrible!” I exclaim, and we wander off on a tangent about slavery and colonialism.

“So,” I say finally, bringing the conversation back to potential blogging material, “What were the major challenges to your work here?”

“Adjusting to Uganda time,” replies Matt immediately. “And the language, of course… though once I figured out that conjugation goes at the beginning of words, picking it up was much easier.”

“Yeah, and I really think that Matt learning the language so well has opened up doors for us,” says Katie.

“It shows people that you are not isolating yourself,” agrees Lawrence. Despite his generally jolly demeanor, Lawrence’s words always come out sounding thoughtful, and particularly significant.  “That you want to be part of the community.  It’s one of the most important things here – learning the greetings, at least.” 

Returning to my last question, Amanda responds, “The latrines, too, it took a while to get used to them.”  The rest of the team agrees. 

“Also,” Katie comments more seriously, “our village had very little experience with outreaches, so I think they might have had even less idea than other village about what we were here to do.”

“Yeah, it took a while just to communicate our goals here,” says Matt, and the rest all nod in agreement.

“And,” says Amanda, “I think one of the hardest aspects was the emotional side of things.  UVP should maybe warn people… however you might try to keep a distance, you’ll end up getting attached.  And you should, you know, its important. You need to get attached to do really good work here.  But its hard, then, when people die, or get sick.” 

The rest of the group agrees.  “There’s been four burials while we were here,” says Matt.  “A four year old, an eight year old, a one and a half year old, and a man that was supposedly over one hundred.  But we’ve also been here for happy events – like a man ‘picking up’ his wife from her house, with a whole procession, and dancing, and ceremony, and music.  That was really cool.” 

“What were your major accomplishments, so far?” I ask, thinking I should lead the team to happier grounds.

“Integrating ourselves into the village,” says Amanda.

Matt agrees.  “Definitely.  Its like we’ve removed the disconnect between us and them.”

“And I think a lot of that came from playing with the little kids around the house,” Amanda comments.  “We know all their names; they teach us Lusoga and we teach them English; we show them how to use WaterGuard… stuff like that.”

“What she says is actually right,” agrees Lawrence. “These guys, the children, are a connection to their community.  We play with them, and they go home and tell their parents.  ‘The mzungu let me come into their house,’ or ‘the mzungu was playing soccer with me in the yard.’  And then the parents think, ‘well, ok, these people cannot be bad.’  Its like a form of mobilization on its own."

“Besides that,” Matt continues, “I think we’ve done really well following up with WaterGuard and mosquito nets – we’ve maybe gotten to about half of our buyers. They seem to be using the products well, and remember our instructions. Which really shows, you know, the outreaches are working. “

“Also,” he says after a pause, “we’ve made so many good connections and contacts in our community.  Partly because of the LC1, he’s so great – really interested in what’s good for the village, not just himself. “  (The LC1 is the elected leader of the village.) 

“There’s so many amazing people in our village,” says Katie.  “People who are really active, and care about their neighbors, and are interested in volunteering and doing whatever they can to help us, and to help their community.”

Amanda nods.  “Perhaps,” she says, “the most important part of our work here has been just finding those people.  You find them, and you do what you can to help them out, and then they do what they can to help the rest of their village out. You know, we’ve been lucky… maybe its just our village, or maybe not, but we’ve got some amazing, inspiring people living here. Some really incredible people.”  

Tuesday, July 7, 2009

Obstetric fistula article published in Yale Journal

We are proud to report that an article detailing some of UVP's experience with obstetric fistula has been published in the Yale Journal of Biology and Medicine:

Experiences with Obstetric Fistula in Rural Uganda, by Will Murk, YJBM June 2009.

Sunday, July 5, 2009

Featured Summer Intern Team: Bulumwaki

Village: Bulumwaki
Ronita Nath (Team Leader) - NYU, Masters in International & Public Health, 2nd year
Christine Poquiz - Law School (Undecided), entering 1st year
Teneille Dzuba - University of Regina, International Studies With Concentration in Development, 5th year
Ce Zhang - Penn State, PreMed, 2nd year
Julius (Ugandan Counterpart) - Masters, 2nd year

We would like to feature some of the work of our summer interns on this blog. They have been passionate, enthusiastic, and dedicated in spite of facing numerous challenges in doing fieldwork in the rural villages. We have five Healthy Villages teams this summer stationed in our pilot 5 villages for the program.

The first team we are featuring is the team stationed in Bulumwaki. This village is nearest to Namungalwe Health Center, where UVP worked intensively last year to establish a referral system for obstetric fistula. The team is made up of interns Ce, Teneille, Christine, and Ugandan intern Julius. The team leader is Ronita.

This team has been working on several initiatives since their initial interviews in the village. In addition, because of their location, they have been working on follow-up for patients who were sent to Kamuli Mission Hospital for obstetric fistula repair surgery in 2008.
- Malaria: net sales and sensitizations
- Family planning: outreaches and working to strengthen condom supply chain
- Sanitation: sensitizations at primary schools
- HIV/AIDS: testing and outreach in conjunction with partner organization

The team's accomplishments so far include setting up a point of sales in the village for WaterGuard, creating a song with primary school students about hand washing, and holding a malaria and safe water drama performance in the village. Team members have helped school students to form clubs at the students' request that focus on health issues in the community such as HIV/AIDS. They have been taking the time to search out and perform followup on patients seen for fistula treatment who had been referred from Namungalwe Health Center. The team has also been intensively seeking qualitative input from community members by performing home visits to discuss sanitation issues, malaria prevention, and other public health needs. Congratulations on all your hard work, Bulumwaki team!

Below are some quotations directly from the team about their work in Bulumwaki:

What village are you in and how do you like it?

- We are in Bulumwaki, I like it a lot! I was surprised at how welcoming the village is. We feel very safe and protected by the community. - Christine
- Our host family is very nice and our host mom calls us her "children", which is very endearing. - Teneille
- The village is very good at mobilizing for our outreaches. The five UVP volunteers are all staying at a house in the village. The house is very nice and we are extremely lucky to have a solar panel! - Ronita
- Our village is good, except there are a lot of spiders in the house and the girls are always screaming about them! - Ce

What have you been doing in the village?

- We've been talking to the primary schools about sanitation, safe water, and malaria. We started a safe water club at Wagodo Primary School to encourage them to practice sanitation. They built a tip tap (a hands-free handwashing device) last week under our guidance. - Teneille
- At the secondary schools, we talked about HIV and encourage the students to be tested. While many of them would like to be tested, one of the main barriers to testing is that the free testing is usually offered during school hours. We are working on setting up a testing date/time while they are not in school. At one school, they are starting an HIV club, which we have been invited to speak at. We would like to talk to them about infection, family planning, and safe motherhood. Additionally, we're following up with the fistula patients from last year. Though we have been conducting various small outreaches, we are holding our big bonanza outreach today! - Teneille, Christine

How does the community feel about the implementation of HVI?

- This village has been very receptive towards us and the programs that we're bringing to Bulumwaki. They are always so willing to mobilize for outreaches, it seems like they all want to have us here. - Ce
- Sometimes, I think they think "why are we here", but other times, they are very excited. Some think that we are there to sell products like mosquito nets and waterguard. -Ronita
- The community is extremely excited about the well, for which we broke ground recently. -Christine

What do you consider to be your major accomplishments so far?

- The "Big Bonanza" held today was a success because we were able to sensitize a large number of people on WaterGuard usage and malaria net usage. We also had the Safe Water Team at our bonanza and they introduced the community to the modified clay pot to gauge interest in this new technolgy. We've done four house outreaches and all of the households that have participated have been very receptive. - Ce
- The community was able to decide upon the location of the shallow well very quickly, within a 30 minute meeting period. This shows that the community works well together and is very enthusiastic about getting a well. -Teneille
- We created a fun sanitation song, which we've taught to primary students. Now instead of the kids yelling out "Mzungu, how are you?", we can hear them singing the song when we walk by. This is possibly one of the more sustainable things we are leaving with the community. -Teneille


O'kunhaaba munghaalo
N'aa amandhi n'e ssaabuni
O'kunhaaba munghaalo
Essawa yoo'nha yoonha.

O'kunhaaba munghaalo
ngonva mu'tooi
o'kunhaaba munghaalo
n'aa amandhi n'e ssaabuni

O'kunhaaba munghaalo
ngo'okhali o'kulya
o'kunhaaba munghaalo
n'aa amandhi n'e ssaabuni

O'kunhaaba munghaalo
nga'omazze okuzhaana
o'kunhaaba munghaalo
n'aa amandhi n'e ssaabuni


Wash your hands with water and soap
Wash your hands always

Wash your hands with water and soap
wash your hands after using the bathroom

Wash your hands with water and soap
Wash your hands before you eat

Wash your hands with water and soap
Wash your hands after you play

Major Challenges:

- It's difficult to figure out how to make things sustainable. For instance, we have a tip tap at the school now, and there are a few students responsible for fetching water, but we don't know how long this will last for. I can imagine them getting tired of fetching water, then leaving the tip tap dry. -Christine

Saturday, July 4, 2009

A heartfelt thank you to Kristen, and introducing our newest members

It's been a while since our last blog update, but things have been busy with UVP and there's a great deal of news!

Kristen Shuken, our program manager for 2008-2009, has completed her "tour of duty" in Iganga and will be starting graduate school in the U.S. this fall. Responsible for managing all of UVP's projects on the ground, Kristen did an incredible and singular job. Among her many accomplishments, she oversaw construction of more than ten shallow wells, helped over 40 women receive treatment for obstetric fistula, implemented our "Healthy Villages" baseline survey at 1000 households in 70 villages throughout the district, set up and supervised our summer volunteer programs, and managed our orphan support scholarship program. Kristen helped UVP grow tremendously during her tenure, and she will be deeply missed in Uganda. On behalf of the executive board, thank you, Kristen, for your service to UVP; we wish you the very best of luck as you start graduate school!

We would also like to give a very warm welcome to the newest members of UVP's family: Mariam Khokhar and Leah Bevis. Mariam will be succeeding Kristen as our Program Manager for 2009-2010, and Leah will be assuming our new position of Healthy Villages Coordinator, in charge of implementation and monitoring of our Healthy Villages interventions. Mariam and Leah are already in Iganga and have gotten off to a great start in overseeing our 2009 summer volunteer teams. They will be contributing updates to this blog as time (and electricity!) permits. Welcome, Mariam and Leah!!