Wednesday, July 31, 2013

[Kasambiika 1] Tippy-tap problem-solving, broken boreholes, and soccer

Hello Dear Readers! Things are going well in Kasambiika 1. In this post I will cover some of the challenges and successes that we have encountered in our programming.

A Kasambika sunrise

We have conducted four sensitizations so far: nutrition, family planning, malaria, and male family planning. Male family planning was not attended well. And by not attended well, we mean no one showed up.

Nathan and Tina despondent at the turn-out to the male family planning sensitization.

It seemed like everything needed for a successful and productive sensitization was there. There was demonstrated interest: a focus group of villagers had requested the event for men to learn about the side effects and capabilities of family planning for their partners. There was timely mobilization: we held a soccer match the night before and talked to young men on our way to the venue. The venue was centrally located: we were in a compound close to the school, where the soccer match was.

Yet no one showed up. On our walk back to our home a man suggested that the caprices of village life had prevented people from coming, that tending fields took priority over our meeting. Yet we got the sense from questioning our VHTs and talking to other community members that there was a lack of interest in our programming and message. Disheartening, right?

We bounced back with a successful malaria sensitization.

Raphael explaining the proper way to hang a mosquito net.

Over 30 people showed up to the sensitization, and we sold all the mosquito nets we planned to sell. We talked about the symptoms, treatment, and prevention of malaria. We found from baseline surveys that people often misdiagnose other illnesses as malaria, and that they expect malaria treatment for those illnesses. We also emphasized that pregnant women and very small children are the people most susceptible to malaria (because they have weaker or undeveloped immune systems). We made sure that people know the proper way to hang a net, how often to wash them, and for how long they last.

Recording the sale of nets

And after the sensitization, we had some time to hang out with some of the stragglers.

A perfect high five
We plan on doing another family planning information session targeting the entire community, and we’ll report back on the success of that pursuit.

Another challenge that we faced was implementing our school tippy tap project (if you forgot what a tippy tap was, check our previous blog post). We, the Kasambiika 1 and 2 intern teams, were tasked with using a grant from the Baltimore Rotary Club to fund the construction of six tippy taps at the Kasambika Primary School. We first met with the children and worked with them and the school administrators to build tippy taps. We taught the younger kids the song “Naaba Mungalo” (Wash Your Hands, sung in Lusoga to Frere Jacques) which is repeatedly sung by all village children everywhere. But soon the project ran into trouble. The soap was stolen within days, and the tippy taps were often empty, even though a special prefect had been appointed to re-fill them each day.

We identified the problems and started working on solutions, which is part of our goal while implementing this pilot project. Getting water to repeatedly refill the tippy taps was tedious and too difficult for one student. Bigger jerry cans for the tippy taps would help ease the stress of the tippy tap prefect and his new team’s job. Getting water from the borehole throughout the day is tiring and interrupts schooling. Filling two 100 liter water drums early in the morning for filling the tippy taps was more manageable. Soap was not sustainable. Readily-available and effective ash could be used instead. And the 3 liter jerry cans that we are replacing with the 5 liter jerry cans would be apt holders for the soap substitute. 

We bought the drums and 5 liter jerry cans, and we are almost ready for construction. One significant obstacle remains. Recently the school borehole went out of commission. Community leaders have removed the handle until fixes can be made, which will not happen until Kasambika can foot the bill. We are pursuing a resolution to this situation.

A dry, deserted, broken borehole. Not the happiest sight.
 The Soccer Game

We held a soccer game to distribute condoms to young men. Many young men (we found this meant ages 18-30ish, or at least old enough to play in the football match) showed up. During half-time we demonstrated proper condom use using a matooke (unripe plantain), and talked to the guys about avoiding HIV, STI, and unwanted pregnancies. After the game they took the 250 plus condoms we brought with us.

Pre-game hype.
Hanging out by the goal post.
Raphael and I played too. The young men of Kasambika 1 are very good “footballers.” 
Meanwhile, Tina, Josie, Stephanie and Nichole answered questions some of the young women had about family planning.

They also spent time with some of the other onlookers.
We look to conclude our internship by hosting another sensitization on family planning, one on obstetric fistula, one on safe water and hygiene, and a final community event. We hope to leave the school tippy tap project in the best condition possible.

Best wishes until next time!

Monday, July 29, 2013

[Kasambiika 2] Sensitizations, sensitizations, sensitizations!

Jambo again from Kasambiika 2!

Time sure does fly when you’re having fun! We are more than half way through our time here in beautiful Kasambiika 2 and so much has happened!

After having our first village community meeting we hit the ground running! Our focus has been to introduce interventions for five specific public health issues: malaria, HIV/AIDS, obstetric fistula, family planning, and safe water, sanitation & hygiene. So far we’ve conducted sensitizations for malaria, HIV/AIDS and family planning and plan to have our last two in the coming weeks.

A lot goes in to conducting one of these sensitizations – from planning the agenda and preparing a script to creating visual aids and mobilizing people in the village to attend – but it’s all worth it when there’s a great turn out and people are engaged and eager to participate! 

At our malaria sensitization we had a remarkable 82 people in attendance! Men, women and children of all ages came to enjoy the “show” (so to speak, but we did perform a skit illustrating the importance of tucking in your malaria net!). Community members took advantage of the opportunity to ask questions and jumped at the chance to buy the subsidized malaria nets available for sale. By the end of the event we had sold more than half of our stock and the remaining nets were gone by the end of the week!

We had an equally fulfilling experience at our family planning event this past week where 58 people were in attendance. After discussing different family planning methods, women lined up for their check-ups and eagerly waited to get their method of choice. Some women were so excited that they even pushed and shoved each other (playfully, of course) to be first in line! The nurse was able to distribute methods to nearly 20 women and referred 5 for methods that needed to be performed at the health center. It was great to see such a great turn out for the event, especially because family planning was a hot topic among women in our focus groups.

So it probably goes without saying that the overwhelming engagement and participation from village members has made our sensitizations our greatest success. However, life in Kasambiika 2 isn’t without its challenges. Our greatest challenge so far was revealed when we attempted to partner with the local health center to hold an HIV testing day for the community. Because of preexisting tensions between our village and the local health center it has been difficult to encourage people to participate in testing.

Nevertheless, our team is hopeful that this challenge can be overcome. We believe its critical for self-reliance and sustainability that people become comfortable with accessing services at the local health center, especially for health issues as important as HIV testing and treatment.

With only a few weeks left we still have a lot we want to accomplish! We look forward to sharing more in our next post! Stay tuned!

Tuesday, July 23, 2013

[Bukaigo] A Succesful Family Planning Event


During the third week of the internship, our team conducted a baselinesurvey for the village of Bukaigo. The survey gathered data regarding hygiene and sanitation around the home (latrines, plate stands, tippy
taps and shower rooms) as well as malaria. We found that the majority of people in the village lack basic knowledge about the symptoms of malaria and the best way to treat malaria. We have a malaria
sensitization planned in the upcoming week and hope to sell all of our bed nets while educating our community.

Our surveys also showed our team how great the need for better sanitation is in the village. While we enjoyed being able to get to know our community better, conducting the baseline survey was difficult for our team because we saw the areas of our village that were suffering from poverty the most. While at times we may have felt helpless being surrounded by such extreme poverty, we celebrated the success of our family planning day.

On July 17th, 2013, our team conducted a sensitization about family planning in our village. There were over 50 people in attendance! We are thankful to our Village Health Team who helped us mobilize this event.
Our main reason for educating our community about family planning was to encourage families to space their children in order to better provide for the children they already have. At the meeting, both short
and long term methods of family planning were presented. These methods include condoms (male and female,) pills, implants, vasectomies and tubal ligations, IUDs, and Depo shots. Myths and misconceptions the community had about family planning were also addressed. Other questions were answered by a nurse. At the end of the session, people had a chance to get started on methods such as pills and shots and free condoms were given out. Our team was glad to see that all of our hard work and preparation paid off for our first big event!

Thursday, July 18, 2013

Update from the field: Buwurempe

Amakaga Omwezi Mulala

“It takes a village…to raise a child,” is how the saying goes, because the village is one big family. And this family—the people of Buwerempe—has opened its arms wide to us.

We are Uganda Village Project’s launch team to Buwerempe Village—Marva, Ian, Martha, Sneha, and team leaders Jasmine and Keneth. 

From the first afternoon that we arrived here in Buwerempe, each day has been full of new experiences, lessons learned, and perspectives changed. Much of our time this first week has been spent settling into our homes, meeting community members, and getting acquainted with our village.

Settling into village life has definitely been an adjustment process, but it has been full of pleasant surprises as well. As expected, becoming accustomed to pit latrines and bucket showers is challenging, as is sharing our living space with a multitude of animal species, from chickens and goats to rats and bats and every conceivable kind of buzzing insect. One day, we spent nearly three hours between two water-fetching trips because the lines at the borehole were so long. Despite the challenges, by the end of one week in the village, we feel like we’ve been here for much longer. Our neighbor John has become a fast friend—he has been unbelievably generous. On the first day, John brought over several chairs and benches for our house. Later in the week, he took us on a tour of his extensive gardens, and we returned with more maize, oranges, guavas, and mangoes than we could carry. These fruits and vegetables are some of the many things we enjoy for meals, accompanied with rice and potatoes without fail. One woman, whose house we pass by everyday, brought us a plate full of beans. As John explained, these actions show togetherness and are gestures of acceptance into the community.

A good portion of our week was spent in meetings. On our first full day, we had a meeting with Buwerempe’s Village Health Team. This team, comprised of five elected community members, is our main point of contact with the village, as the team supports health services and represents the populations of the village. Our VHT members are very kind and welcoming; at their meeting we discussed UVP’s goals in Buwerempe, their expectations of our group, and our expectations for working together in order to set a tone of open communication. We also had a meeting with some of the teachers at Buwerempe Primary School. We introduced ourselves and also the Handwashing Project that we hope to carry out over the next several weeks, made possible by a grant from the Baltimore Rotary Club. The goals of this project are to encourage handwashing in schools before eating, after using the latrine, and after playtime by building tippy taps around the school. By teaching the importance of handwashing and by demonstrating the construction and use of tippy taps, we hope that students will take these ideas to their homes and spread good hygiene practices to their families.

The highlight of our work week was the Community Meeting held on Thursday. Throughout the week, we had met several community members in passing, at the borehole, through the VHTs, and even at the burial we attended, although those circumstances were very unfortunate. This meeting was our first official introduction to the people of Buwerempe.

The meeting was a bit more sparsely attended than we had hoped, but it was still a very successful introduction of UVP to the community. We explained the goals and focus areas of UVP and asked several questions to gauge the strengths and weaknesses of the village in terms of health. From the responses we received, the important health issues in the village are access to clean water, malaria, family planning, and HIV testing. We were excited that many members had questions for us regarding specifics about UVP’s core projects, including questions from a few young men about male involvement in family planning. Because family planning is regarded by many men as a women’s issue, this interest from young men was very encouraging.

Our week of learning, meeting, and exploring was concluded on Saturday by a special treat. Many village women and children gathered to do traditional dancing, accompanied by singing and drums. Though our hips don’t move nearly as well as these women’s hips do, we had a spectacular time and enjoyed ourselves thoroughly.

We are all looking forward to getting started on projects over the next week, beginning with the task of collecting baseline data on every household in Buwerempe. 

Wednesday, July 10, 2013

Update from the Field: Buvule

Upon arrival in our village (Buvule), we pulled up into a dirt drive in front of a modest-sized house with a small concrete porch.  We had been told that our house was one of the nicest houses of all the teams, and so far it has fit us fairly perfectly.  We have four decently sized bedrooms and a common area that we use for meals and meetings.  We also have a shower area attached to the back of the house, and a well-maintained pit latrine about 30 steps away from the back door.  Our landlord is polygamous and we are living on his compound.  Many neighborhood children hang out around our porch, and Ravi built a goal post in the side yard by the kitchen where we play soccer with the kids.  They love to ask us to “okuzana omupiira,” which means to play soccer, and are always looking for the soccer ball through the front door of the house.
                On our second morning in Buvule, we met our village’s VHTs (Volunteer Health Team).  There are five for each village, and ours are named Harriet, George, Alice, Godfrey, and Yakubu.  They have all proved to be very helpful to us so far, giving us tours of the village, helping us coordinate meetings with the community, and teaching us words in Lusoga.  However, they had some misunderstandings at first about UVP’s relationship to them at first, and one of them even said she expected to be given a stipend because she was working with white people.  It was difficult to tell them that we could not provide many of the things they expected (e.g. money and more t-shirts), but once we had a conversation with them, we became close partners.  We work with them almost every day and they have been extremely helpful, even though most of them do not speak much English, which makes it difficult for the internationals to understand them.
                Our daily routine in the village consists of waking up with the roosters as the sun is rising around 6:30, or if you are lucky enough to be a heavy sleeper, maybe 7:30 at the latest.  Then two people go to the bore hole with the bike and the jerry cans to fetch water, which is about a 15 minute walk each way.  Meanwhile, someone helps the cook prepare breakfast while another person washes the previous night’s dishes, and some people also take a bucket bath in the morning with whatever water has not been used from the previous day.  Then everyone comes together for breakfast.  We eat a lot of starch in our diet here, but chappati is the best.  It is a flat bread, kind of like Indian naan, and it is amazing!  After breakfast, we generally plan out our day and then take naps or do more chores.  We leave for whatever activity we are doing that day around 1:30, and then we are home by 5 so two more people can get water and everyone can shower and eat.  Then we hang out with the neighborhood kids or play games inside for a couple hours and head to bed by around 10:00.
                As far as our work goes, so far this week has been mostly about community needs assessment meetings.  We have been meeting with different groups of people to ask them what they view as their community’s strengths, and what needs to be improved.  Generally people do not really have an answer for strengths, but they also say that before anything else, they need better access to clean water.  We have heard this from every group of people, and have been told multiple times that even if people understand issues like malaria and hygiene, they need clean water in order to start to tackle health-related problems.  While I completely believe that water is the most important issue for them, it is frustrating that as an NGO that is funded almost completely by private donors, we do not have the resources to just start building wells all over the village.  It is hard to realize that the problems faced in Buvule can only begin to be solved if we can improve access to water, and improving access to water is too expensive to be a realistic short-term goal for our organization.  While UVP hopes to implement a shallow well in the village sometime in the next 3 years, it is hard to imagine a short-term plan that will be satisfying to a village that just desperately needs clean water.

Tuesday, July 9, 2013

Update from the field: Kasambika 2

            Jambo from the intern team at Kasambika 2! Our team is made up of 6 wonderful students: Andrew Phinney from New Hampshire, USA, Esther Chung from California, USA, Isaac Kabuye from Kampala, Uganda, Juliana Nalukwago from Kampala, Uganda, Kenzie Scholl from Minnesota, USA, and Trisa Taro from California, USA. We are all extremely excited to work with our village members this summer.
                We have now been in the village for two weeks now and we cannot be happier with the enthusiasm and openness of the people in Kasambika 2. In our first week, during our community meeting, we introduced ourselves, UVP programs, and our mission for the next two months. We even found community members supporting our goals – dispelling the myths that we arrest people or report them to the government. In addition, we have an incredibly strong and passionate group of Village Health Team members who help mobilize the community. They are currently working with us on our baseline surveys where we go house to house collecting initial data on the village’s sanitation facilities and insecticide treated net coverage.
                We have also started to work with the local primary school on a hand-washing program. Last week, we conducted a survey with some students and this upcoming week, we hope to hold an education session on the importance of hand-washing and install some tippy taps, which are contraptions used to wash hands cleanly. Here’s a picture of ours for an idea of what it looks like!

                 Inspired and motivated by the people of Kasambika 2, we aim to work with the community to hold education sessions on various issues. We hope this summer will be an amazing one for this village and for us! 

First Community Meeting

Kasambika 2 Intern Team (From the left: Andrew, Isaac, Esther, Kenzie, Trisa, Juliana)

Survey-Taking at Kasambika Primary School 

Our Tippy Tap

Monday, July 8, 2013

Update from the field: Kazigo A

So much has happened over the last few weeks that it’s a bit difficult to capture completely. To introduce ourselves we are a team of six, with members hailing from California, Iganga, Jinja, Michigan, and New Jersey. Our names are Jill, Sues, Pricilla, Chirs, Soha, and Rebecca, and we’ve all come to live and work in rural East Uganda for the next nine weeks . As the follow-up team our goals are simple, but perhaps more difficult in practice: we seek to evaluate the impact of several programs put in place by the Uganda Village Project in four village communities. Although we will be living in Kazigo A, we will also be working in Kazigo B, Kidago A, and Kidogo B. The following is a snapshot of what we’ve done thus far.

Moving into the village, we were welcomed with warmth and enthusiasm. We spend most of the first week getting to know the Village Health Team members, members of a Ugandan Ministry of health pilot initiative which was set in place to improve the health of rural villages. The main areas of focus include water and sanitation, Malaria, HIV/AIDS, and Family Planning.

Home, Sweet Home

To support our sanitation program, one of our first priorities was to construct a dish rack for sanitary dish drying and a tippy tap, which is a device used to effectively wash one’s hands in settings without running water. Paul, an experienced member of a neighboring team, helped us construct ours and demonstrate its use.

Sues(team leader) working on the dish rack.

Constructing the tippy tap with the guidance of Paul.

The finished product! From left to right: Paul, Sues, Chris, Soha, Pricilla, Rebecca, Jill, and Leah.

As Friday approached we had completed meeting with most of the Village Health Team members in our four communities. This was a critical first step as these members know their communities best, and will be invaluable partners for the rest of the internship.

On Friday, we had quite a treat. We got the opportunity to watch the local village drum team rehearse. Not only was it a spectacle to watch, this group was said to be a great asset to last year’s team. They helped with mobilizing members of the community and getting across health messages in a culturally relevant way. We’re very excited to work with them in the future.

Local Drum Group.

Although it feels like we’ve already done so much, in reality we’ve only scratched the surface. Stay tuned to hear of our work through the summer. 

Wednesday, July 3, 2013

Update from the Field: Kasambiika 1

Jambo! Today marks the end of our first week in the village.

I’m sorry, terribly rude, we didn’t introduce ourselves. We are the Kasimbiika 1 UVP team! Our team consists of four American interns, Tina (our fearless co-leader), Nichole, Stephanie, and Nathan. We also have two Ugandan interns, Raphael (our other, actually fearless—to a fault, co-leader), and Josephine.

Raphael with Monday’s dinner.
(Photo Nichole Reinen)
Tina with two full jerry cans—who needs running water?

Josephine and Nicole stay hydrated. 

Stephanie in the middle, Tina and Josephine on the left and right respectively. They each hold oranges, which are green in Uganda

Nathan, the wasp-vanquisher. Just kidding, Nathan ran away soon after this photo was taken. Raphael got rid of the wasps. (Photo Nichole Reinen) 

But that’s enough about who we are; let’s talk about what we did this past week. We focused on getting settled in our new house, getting acquainted with our new community, and getting acclimated to each other as teammates.

On Wednesday we rolled up our sleeves and got to work constructing a trash pit, a tippy-tap for hand washing, and a dish-stand. Let’s have a look! We first dug a trash-pit. That was messy so we did not take pictures of the process, but here is the fruit of our labor.

Tippy-taps are ingenious contraptions made from local materials that allow for easy hand-washing without running water.

Josephine plans the base structure.

Raphael starts construction

The Tippy-Tap team tests the tensile strength of the timber. 

 Next we made a dish-stand. This is a hygienic and time-saving way to dry our wet dishes.

Nichole brings sticks from our gracious donor; we call her momma (she’s also our cook; we’ll talk about her in the next post).
Stephanie arranges sticks together so she can tie them together with banana leaves for the platform of our dish-stand. 

Construction begins! 

And voila, the finished project, in use.
 These amenities will help us stay healthy and happy and also serve as examples of sanitary and hygienic improvements villagers can make in their own homes.

We spent the rest of our week becoming familiar with our Village Health Team members and the rest of the Kasimbiika 1 community. In a future post we’ll make sure you get to know our Village Health Team members too! Our Village Health Team was tasked with announcing our arrival and first planned meeting: an introduction and question and answer session for everyone in the community. Their efforts were not in vain, we had a turnout of 142 villagers among the 285 households in Kasimbiika 1. 

A lot of people showed up! 

Our VHT chairperson, Swaga, answering some of the questions posed by community members about UVP’s purpose and function. 

Our team (sans photographers Nathan and Nichole), the VHT, and the Local Chairperson (far right) posing for a picture. 
We would be remiss to forget to mention how we spent our free time: intense word games, learning how to play chess, and conversation late into the night.

Tina relaxes with a book.

We were very lucky to find ripe bananagrams growing outside our compound.

Next week we dive into our projects. We start off with our first Tippy Tap sensitization in Kasimbika Primary School. Then we meet with a focus group for needs assessment. Finally, we will start our baseline surveys on sanitation, water access, hygiene, and malaria. Make sure to check in so we can update you with more stories and background about our projects and Kasambiika 1.