Wednesday, February 24, 2010

Let the Sanitation Campaigns Begin!

We have now officially begun our village Sanitation Campaigns.  In both Butongole and Bugabula we have held Safe Water and Sanitation workshops for Village Health Team members, political leaders, and other village leaders.  In Butongole, we have also held a “hands-on day,” and Bugabula’s “hands-on” day is about a week from now.  Next week, we shall begin the workshops in our other three Healthy Villages – Walukuba, Bulumwaki and Nabitovu.


The workshops take a full day (from around 9am until 5 or 6pm), and are very interactive; many of attending individuals (such as our Village Health Team members) have been trained in health or sanitation already, and so the workshops are as much a discussion and brainstorming session as anything else.  We also do some demonstrations, and some activities.  For instance, at one we point we call 2 volunteers up to drink from apparently identical bottles of water.  One bottle of water is pure, and tastes fine, but the other is incredibly salty – the second individual’s facial expression is enough to let the entire group know that something is awry!  The idea here is to demonstrate that even if water appears to be clean, it may be contaminated with things invisible to the eye – and more dangerous than salt!


At another point, we have the villagers draw out a basic map of their village on the ground, and mark with rocks where the households with no latrines are, and where the areas for open defecation are.  Then we have them mark their own houses.  The idea here, of course, is to show that open defecation is a danger to everyone in the village, including themselves.


At the end of the workshops, the villagers draw up an action plan: in Butongole they divided the village into 4 zones, and chose 3 village leaders to work with the villagers of each zone on sanitation implementations.  In Bugabula (a smaller village), they chose to each work with a “cluster” of homes around their own home.  UVP is subsidizing jerry-cans, wire, string, and nails, to help the villagers who may not be able to afford sanitation measures on their own.


After each workshop we hold a “hands-on” day, to demonstrate construction of the various sanitation measures: tippy-taps, plate stands, trash pits, etc.  Our hands-on day in Butongole went very well, with leaders from every zone attending.  We constructed a tippy-tap and a plate stand at the house of one of the village health team members, and we arranged to return in a few days to work at homes in the other zones also.  This way each zone will have a “model household,” a concept promoted by several NGOs in the area besides UVP.


After the hands-on days are complete, we shall be working with workshop “sanitation experts” to do a baseline survey of sanitation in the village, so that we know the starting point for every household in the village.  (This way, we’ll know how much has changed by the end of our Sanitation Campaign.)  After the baselines are complete, we’ll hold massive village meetings, where the workshop experts themselves will present the action plan to the village. 


All this is very exciting, because while we (UVP staff) do the initial training, the majority of the sanitation campaign shall be run, not by staff, but by village leaders!  Not even a year into our work in these villages, we can truly say that we are beginning to take a backseat when it comes to village organizing, allowing the community members themselves to be the agents of change in their villages. 

Monday, February 8, 2010

An Eye Care Story From Butongole

We had our second eye care outreach last Friday, organized for Butongole villagers at Namalemba Health Center. We brought an eye doctor over from Jinja, who was very fatherly and obliging, and the Health Center staff was incredibly helpful in organizing over fifty patients, taking records for the doctor, and generally facilitating the process. The doctor saw, in total, 11 Butongole villagers and 43 villagers from other areas around the Health Center. 

One girl was particularly memorable.  She was perhaps 8 or 9, and the doctor called me over to see her eye. It appeared, at first, like there was a funny shaped hole right next to her pupil. Open closer inspection, however, it wasn’t a hole – it was a large piece of wood, or rock, or some hard thing. Most of it was stuck right into her eye, but a tiny bit rose above the surface, like a splinter in one’s finger but a thousand times more painful.

The girl’s eye was tearing constantly, and she was absolutely silent. Her entire body looked fragile and pained, as if her spirit had been worn down, atom by atom, by ongoing pain. The doctor told me that this “foreign object” had been in her eye for 2 months – if it remained so for much longer, he said, she would have run the risk of permanent damage or blindness.

Luckily for us, the doctor carried numbing solution in his little medicine box.  A nurse tipped the girls’ head back, holding her chin and her forehead, and the doctor splashed a few drops of the solution into her eye.  I had no idea that eye-numbing solution was painful, but I learned that day that it was.  The girl – a skinny little slip of a thing – made not a sound, but clenched her hands to the seat and held her body absolutely rigid with pain, pushing her feet against one another in a sort of desperate motion-cry.

The nurse continued to hold her head, and eventually the girl’s body relaxed – the numbing solution had evidently kicked in, and she was no longer in pain. Then the doctor took a long needle from a sterilized syringe – nothing in it, just a needle – and brought it close to the little girls’ face. I can only imagine how it must have looked to her, held down as she was by the nurse, the needle looming above her face. Tears began to run down her face, from both eyes this time, and she whimpered in fear, clutching her hands again. The doctor murmured something to her, perhaps ‘don’t fear,’ or ‘it will be over soon,’ and lowered the needle down and touched it to her eye to remove the foreign object.

I couldn’t see very well what he was doing, but it looked to me very similar to the process of extracting a splinter out of one’s hand or foot. The entire procedure probably took no more than 15 seconds, but it seemed an eternity. The little girl, her body again rigid and her feet writhing in pain, was silent except to cry out once, and all I could think was “What does that look like to her?” If it had been me, I was quite sure that no doctor could have gotten that needle anywhere near my eye without putting me into a dead faint first. But I suppose this little girl was in so much pain that she was too exhausted to fight –either that, or she just genuinely wanted the pain to end, and figured that any short term pain was worth it in the long run.

A week before our Butongole eye care outreach, we brought an eye doctor right into Bugabula village, and that doctor saw 21 Bugabula villagers. In the coming weeks, we’ll be bringing doctors to see villagers from our three other villages: Bulumwaki, Nabitovu, and Walukuba. Some of these villagers will receive a simple antibiotic, or some other medication or small procedure that will cure them right away. Many of them, however, will require further treatment or surgery – those individuals with mature cataracts or advanced trachoma, for instance. For these individuals we will organize transportation to Iganga Hospital, where we will bring in eye surgeons from Jinja to operate on their eyes, free of charge. By the end of the entire program, UVP will have helped heal hundreds of Iganga villagers with eye problems.  

Tuesday, February 2, 2010

The Season of Heat

These days, Iganga is hot.  Having been previously acquainted with only the cooler, summer months of Uganda, I am every day amazed at the deep, heavy heat of the sun – the incredible, resting weight of the air that presses down on our dusty little town. 


In the afternoon heat, my skin burns red no matter how much sunscreen I put on, and burns in a way that feels less like the result of UV rays and more like the result of standing a few feet away from a roaring fire.  The sensation reminds me of childhood contests, where my cousins and I would sit with our bare backs to the fireplace, right beyond the grate, seeing who could stand the heat for longest before moving forward.  It reminds me, also, of the air that burned my face when I stood, as a 9 year old child, by a river of flowing lava, a river so hot that a stick pushed into it burst into flames at mere contact.  I suppose what I am trying to say is, this heat feels less like the stuff of hazy, ethereal, barely-existent waves and particles, and more like a physical, present layer of something soft and heavy, dry and parched and dusty, laying across one’s skin – invisible, but no less tangible for the fact.


At the house, our conversations revolve around the heat.  All greetings have been replaced by statements about temperature – when one of us leaves the house and returns, we greet the rest with a statement about the heat.  When we wake up in the morning, our first words are about the relative cool of the morning, and our hopes for how long that cool might last.  As we go to bed, we attempt to quantify the heat of the day – was it hotter than the day before? Didn’t this week seem hotter than the last?  We are never successful in such comparisons, for it is so ultimately hot that no further statement can really be made, like attempting to comparing infinity with infinity plus 3.


Perhaps I sound too harsh, in my description of the heat.  Every word is true, but I shouldn’t like to sound as if it is unbearable or hateful, or even a major problem in our day-to-day lives.  The thing is, the heat is tremendous, but it is a dry, heavy, dusty heat – it lays over us, pressing down so that we slow our walking to the pace of a crawl, seek shade whenever possible, drink bottles and bottles of water warmed to the point that they might well be used for tea – it is hot, but it is not a sticky, humid heat, and it is not an oppressive heat.  It is not that heat, from the south of the US, which causes one to sweat while simply sitting in the shade, that damp and blanketing heat which makes one feel like one’s very soul is leaking out of one’s pores.  And it is not absolutely inescapable, as I imagine it might be in South Sudan or even in Northern Uganda; the morning are cool, the shade is always a slight respite from the sun, and late, late in the evening, as the stars shine high in our rural sky, the heat begins to fade and smooth breaths of wind flow through the town, lightening and cooling the air until around 8 or 9 the next morning, when the sun shall begin to warm us again.