14 kids from Buwoira

By Kelly Child, UVP's Managing Director. Kelly joined Uganda Village Project in June 2015.

The first few weeks in a new position are always a little scattered as you acclimate to your new duties and organizational culture. Add the bustle from receiving and placing 40 national and international interns in rural villages in Uganda and the days fly by like a whirlwind. This post was written this summer, and as we’re preparing for the next round of HIV outreaches, it seemed like a good time to revisit it.

Each intern team in villages joining the Healthy Villages program held an HIV outreach where UVP helps to coordinate supplies and health workers to provide testing, counseling, and treatment options for HIV and malaria along with immunizations for children. The first two events were great—a large community turnout and the interns had a great time mobilizing the community and executed entertaining sensitizations and answering questions like the bosses they are.

Buwoira’s HIV outreach resonated with me the most. While driving through the lush, green village, Titus, our HIV Program Manager, grabs the megaphone and starts encouraging villagers to attend the event out the car window. We arrive at the event site and it is clear the interns have been busy this morning as all the event stations are set up: registration, HIV and malaria testing, counseling area, immunization table, etc. 

As the event slowly gets started, Ainslee and Fiona, two members of the Buwoira intern team, leave the event in search of the neighborhood children, the kids who occupy, play, and giggle on the veranda of the interns’ village house. They return with 15 children in tow intending to get them all tested for malaria and immunized. We came to find out that 14 of the 15 children tested positive for malaria. At events like this, our partners supply medication for treatment of malaria along with testing kits for HIV and malaria. Because of our event in the village, all 14 kids were able to receive treatment.

Sometimes I get caught up in trying to Sometimes I get caught up in trying to learn Lusoga (Wasuze otya eyo? Bulungi!), financial spreadsheets, and sweating (a lot). I’m reminded of the importance of our work in moments like this one in Buwoira and am so grateful for this opportunity. Thank you to all of our 2015 interns! We’ll be thinking of you as we hold HIV outreach days in other Healthy Villages this month.

Coming together to stop fistula

Can you imagine 80 visits to Africa in less than 50 years? At Uganda Village Project, we have knowledgeable staff with years of public health and development experience. None of us, however, come close to 46 years of work in Uganda. That honor goes to Dr. Brian Hancock, a talented surgeon

who has been volunteering his time in Uganda helping fistula patients during 50 visits to Uganda (80 total to Africa!) over 46 years.

Not long ago, we were at Kamuli Mission Hospital to meet with everyone involved in the most recent fistula camp. We were pleased to spend time with Dr. Hancock, who graciously invited us to sit down for a cup of tea and talk more about the women who come for surgeries and how things have changed over four decades of fistula treatment. He can remember tiny details of the majority of his patients, and he talks about each one with a genuine appreciation and a sparkle in his eye. During other visits to fistula camps, I’ve been struck by the resiliency and strength of the women. This time, during our conversation with Dr. Hancock I was reminded how important it is to work together to achieve change for women with fistula. It really does take a village, and in this case, the village comes from England, Scotland, Norway, the US, and across eastern Uganda.

Loy, UVP’s Fistula Coordinator, was monitoring patients who had just come out of surgery. Nurses from Scotland were working with nurses from Uganda who had recently been trained in fistula care at another Ugandan hospital. Everyone was really impressed by their skills and excited for the potential of them taking on more duties in the future. There were doctors from the UK being assisted by Ugandan nurses in the surgical theater. When we talked with Dr. Hancock, he said it used to be just him and one nurse attending to fistula patients. Now, there are multiple people from multiple countries all dedicated to healing women.

As we sat with a Scottish nurse waiting to support the next surgery, she acknowledged that it takes a lot of energy to work at the camps, often 12 or more hours a day, in order to meet the demand for surgery. All the international doctors and nurses use their personal vacation days to come here. She deflected our appreciation, though, with a reminder that none of their work would be possible without efforts to identify women suffering from fistula and bring them for the surgery in the first place. It’s not only doctors and nurses from multiple countries who make this happen, it takes Fistula Ambassadors who share their stories with women in their communities to encourage them to come for surgery. It takes UVP staff who support the Ambassadors, organize camps, and make sure the women heal and return home safely. It takes the Fistula Foundation, who provides funding for many of these programs, and it takes donors from around the world who help us support women before and after surgery.

I'm still impressed by the resiliency of the women who come for surgery. They're the entire reason we all do this. But watching this global village come together to help the women was just as inspiring.

Return to Uganda

By Alison Schroth Hayward, UVP co-founder and Board Chair

It had been over 10 years since my first trip to Iganga, when I performed a needs assessment and co-founded Uganda Village Project, and more than five since my most recent one. The last time I walked through our gates on Moses Kintu Road, six years previously, we had just moved in. Walking into the compound felt unreal – I had returned to the office so many times in my mind’s eye, during the intervening years of volunteer work from home, that being there again felt like being present in a daydream.

Not only is the Uganda to which I arrived different from the Uganda of five years ago, now I am different too. No longer do I even consider jumping on the back of a boda boda, letting my hair fly behind us as we zip around the traffic. I stick strictly to cars for transport. There were no crazy mataatu encounters, stacked like sardines in a tin can barreling down the road with chickens at our feet. Although Entebbe is still the same small, sunny airstrip, it now has jetways, security cameras at immigration and fingerprinting machines, and functioning conveyor belts for luggage. Kampala is still a dust bowl of crowds, traffic, and mayhem, but there are traffic lights now. And Iganga is still the same sleepy, agrarian town along the highway – aside from what appears to be a newly flourishing industry in woodworking along the old Kaliro road, it all still looks the same to me as the day I left.

The trip was emotionally different for me as well. In the past, when I witnessed one of the routine tragedies of life in rural Uganda – such as seeing a five year old carrying a toddler on his or her back, far from sight of any parent – I previously just registered how foreign that sight was, then how tragic, and I would momentarily acknowledge to myself that this was something that should not happen and I kept moving. I was able to compartmentalize my horror, file it away mentally under “things that I wish were different.” Something about being a mother has changed this for me. Now, when I see that tiny child bent under the weight of their baby sibling, it carries a much deeper meaning for me. I’ve carried that weight. I know much more about exactly what that tragedy might truly entail, on a daily basis. The situation is no more sad than it always was, but now my sadness is personal, and I struggle to keep my composure and hold back the tears when I see children suffering. – or even now, just writing about it.

This feeling of intense heartsickness made it much easier to feel overwhelmed at the enormity of the need in rural Iganga. I wanted to protect my heart, I tried to push the images and feelings out of my mind because there were too many wrongs I could not right. Ironically, feeling more personally affected by these situations made me want to run further away from them, to surround myself with happier thoughts and put my head in the ground.

Then, on the last day of my stay in Iganga, Maureen arranged for some of the beneficiaries of our programs to come visit with me at the office. I once again met Josephine Nakalimo, then a very quiet and shy secondary school student, now a confident young college graduate who just registered her own nonprofit to help other vulnerable children. She explained to me that she was postponing the idea of marriage and children, because she wanted to secure a job and her financial independence first. She launched into a speech of gratitude that seemed like it had been mentally planned for quite some time. “I want to thank you so much for what you have done for me. If you were not you, then I would not be who I am today,” she repeated to me several times. “You are my mother, because you cared for me like I was your child.” Once again, I was fighting back tears, but this time they were happy ones. I was full of pride at what Josephine had accomplished and who she had become. On a personal level, the experience clarified resoundingly that it was possible to make a difference, to change lives – something I theoretically knew, but had been having trouble accepting as true.

Fighting against poverty and preventable disease in rural eastern Uganda continues to be one of the most rewarding things I’ve done in my life. Revisiting Uganda reminded me that all the work I’ve done, all the dollars I’ve spent – these efforts have not been meaningless gestures in the face of an overwhelming tide of need. Each choice to help has meant something real to a person or a family in Iganga, even if I did not have the opportunity to meet and speak with each of them or to know their names. I returned home with a renewed commitment to improving community health in those places where the need is greatest. I wish I could have taken you with me, but I hope that through this narrative, you’ve been able to see the trip through my eyes.

Sincerely, and with many thanks for all you have done to support Uganda Village Project –

Alison Schroth Hayward

Janet gives great hugs...and hope

By Leslie Stroud-Romero, UVP Executive Director

I’ve lived on the continent of Africa for six years, and this was by far the most enthusiastic greeting I’ve ever received from an adult here. Especially one I’d never met.

Last month, I traveled with two fistula colleagues and Uganda Village Project’s (UVP) Fistula Coordinator to visit one of UVP’s Fistula Ambassadors. We drove up to a traditional Ugandan home: several buildings clustered together, mostly with mud walls and thatch roofs. After our very enthusiastic hugs from Janet, the Fistula Ambassador, as well as multiple members of her family, we were ushered into one of the huts to wait. Family members filed in to greet us, and then Janet appeared with tea, boiled eggs, and groundnuts. A short while later, she showed up again with lunch. We had just finished eating in town, so we politely poured ourselves some tea, snacked on eggs and groundnuts, and Loy (UVP’s Fistula Coordinator) explained for the tenth time that we had already eaten and couldn’t possibly eat more. Janet’s response to our continued amazement about her hospitality was that she had been repaired from fistula for no cost to herself or her family. UVP had literally changed her life, and she wanted to express her gratitude in any way she could.

It was my first time to visit a Fistula Ambassador. UVP started the program two years ago to train peer educators how to spread the word about fistula to their communities. Janet was an easy choice to join the program. She had gotten her fistula in 1975 and was repaired in 2010. She knew the burden of fistula, and she wanted to do what she could to prevent it and to give other women hope. In fact, the day we showed up to visit Janet, there was another woman with fistula at her house. She had been referred to Janet, and so she came over during our trip so she could talk with Loy and make arrangements to travel to the upcoming repair camp this fall.

After a while, we went with Janet for a fistula outreach she was leading. There were many women gathered, and while the number of men attending was sparse, there were some teenage boys who will certainly need these messages when they marry in a few years and make decisions with their wives regarding childbirth. Janet stumbled at first – her in-laws were in the audience and so she was afraid to talk about a few sensitive subjects – but the audience encouraged her, and she plunged ahead. Afterwards, Loy got up to reinforce messages, and then women came up to talk privately with both Janet and Loy.

There is an energy to Janet that she shares with her community. It’s evident in her hugs, in her insistence at feeding us, and in the way she got up in front of her peers and talked about a medical condition that normally is reserved for quiet whispers behind the house. Janet is helping women get over the stigma of fistula, and ensuring that her community stays informed and engaged in preventing this life-changing condition.

Bukakaire: getting caught in a downpour with Mr. Kiti

The last two weeks of the summer have been a blur. We have been so busy wrapping up our work and making sure that the villagers and our VHTs are ready to continue the programs once we leave. As our last project for the summer, we are working on the Bukakaire sanitation push. After finding out through our baseline surveys that good household sanitation was rare, we realized how important our work in improving household sanitation is. To educate the people in Bukakaire about good sanitation practices, we held a sensitization where we taught the importance of washing hands using tippy taps, drying plates on “standard” plate stands, and containing decomposable garbage in fenced trash pits. Attendance at the sensitization was great and people seemed excited to begin improving their household sanitation using UVP techniques and subsidized supplies.

After the initial sanitation push, we began “hands on days” at the houses of our VHTs and village Chairman. It is important that they have exemplary household sanitation, since community members look up to them when improving their own health practices. We spent two full days building trash pits, tippy taps, and plate stands as a team. Once their households were perfected, we were ready to move on to the general community members’ households!

For the past week, we have been moving from household to household in the village, promoting the UVP subsidized supplies (nails, wire, string, and jerry cans), to encourage villagers to begin collecting the wood needed to build these very important sanitation devices. Community members are so grateful to have our help, and we often leave with small gifts of gratitude, such as bags of g-nuts or maize.

Our Interview with Mr. Kiti
After helping Mr. Kiti build his sanitation devices, it began to downpour, so he invited us into his house to wait out the storm. While sitting on mats in his living room with about 10 village children who were also seeking shelter, we had a good conversation about his life and his involvement with UVP in Bukakaire. Mr. Kiti is one of the older members of the village, and he is very enthusiastic about UVP’s work, attending almost every event that we have held throughout the summer. He has a wife and 10 kids, five of whom still live in Bukakaire.

After growing up in Bukakaire, Mr. Kiti moved away from the village to attend Elgon technical school as an engineer and began his career in a coffee factory as part of the Lusoga Growers Cooperative Union. Mr. Kiti first learned of UVP when two staff members came to Bukakaire looking for a sample of 10 households to survey to determine the community’s need for UVP’s programs. He attended a community meeting held by these staff members in which they asked villagers if they wanted UVP to work here. He was enthusiastic to participate in the program because he realized that it would improve his livelihood, make community members healthier, and help the current community members to raise their children knowing the importance of home sanitation.

Mr. Kiti stated that UVP has made him a “people’s person”, since our community meetings connected him to other villagers and encouraged him to interact with others. He says that because UVP has helped him to improve his home sanitation, he will no longer be afraid or embarrassed to host functions at his compound. He realizes the importance of improved standard of living. For example, UVP programs have provided him with subsidized mosquito nets. After explaining how grateful he is that UVP has helped him improve his health, he recommended that UVP help the village improve access to safe water, increasing the number of boreholes and renovating the protected spring. The good news is that Bukakaire has two years left as

part of the Healthy Village Initiative, so it may be possible in the future! Mr. Kiti is “grateful to the governments of USA and Uganda for allowing this partnership targeting community empowerment”. He asked us not to forget about Bukakaire. 

We definitely will never forget!

Nabirere B: bringing men into family planning

Time has absolutely flown by! We’re beginning our last full week in the village this week. We’re all sad that our time here is wrapping up, but we’ve had such a productive few weeks of programming! We held most of our sensitizations in the last two weeks. Safe water, sanitation, malaria, and family planning – we’ve covered it all! We often begin our meetings with a drama, which is fun for us to plan and perform, as well as a more entertaining way to introduce the audience to the topics we are discussing. Then we have about a 30-minute presentation, focusing on how disease can be prevented through realistic behavior changes such as boiling water before drinking it and using mosquito nets every night when they go to sleep. Afterwards, we hold a question and answer session. We’ve been very impressed with how engaged our community is in what we have to say. They seem eager to apply the information we’ve presented and we hope through the rest of UVP’s three-year program in Nabirere B that we see significant improvement in sanitation facility coverage, malaria net coverage, family planning usage, and a significant reduction in preventable death and disease.

Presenting how to build standard sanitation facilities in one community meeting

Essential to all these programs are the members of the Village Health Team (VHTs). Elected by the community, these five individuals work with us to mobilize the community for our events and will be the ones continuing the public health work in the village when we leave. One of our most enthusiastic and active VHTs is Sulaina Mutesi. The original two VHTs in the village recommended her to be a part of the Village Health Team because she was already very active with promoting health in the village. During our time working with her, we’ve seen her enthusiasm in mobilization and condom distribution. She says she was excited to welcome UVP into the community because she knew she could mobilize well for the events and was passionate about the educational sessions we conducted. She was especially excited to receive tippy tap and plate stand supplies, which were provided to her as an incentive to be a role model of sanitation in the community.  Sulaina feels very recognized and important now with in the community because they have started to really respect her as a VHT and ask her to help them check their facilities. She now feels like a highly respected woman in the community and that being a VHT has changed her life for the better. She feels so proud to be a VHT for UVP and she is very happy to be doing what she is doing.

Sulaina at one of our events

 One of the most rewarding programs we’ve conducted so far has been our family planning sensitizations and outreaches. We engaged both men and women on the topic, but had to do so separately and with very different strategies because family planning is such a delicate topic. Many men are resistant to the idea because cultural concepts of masculinity encourage them to have many wives and many, many children. However, after having seven or eight children, many women become interested in obtaining family planning because they are content with the size of their family. However, the culture is pretty patriarchal, meaning the woman is not empowered to make that important of a decision. This leads to conflict – often the woman has to sneak behind the husband’s back to obtain family planning.

So, we decided to have a sensitization for the men on family planning, too. We talked to them about the concept of not having more children than one is capable of catering for economically, the health and economic benefits for mothers and children of spacing out children and having fewer of them, and the various methods they can utilize to do this. The men were extremely receptive to the information, and we’re hopeful that the seeds we planted combined with the work of our male VHTs will slowly change the culture to be more receptive towards family planning.

When we had the sensitization for women, we took more time to explain how each modern family planning method worked and how to use them. Afterwards, we provided birth control pills, shots, male and female condoms, and three or five year implants to the women who were interested in longer-term family planning. It was exciting for us to see their interest and excitement directly translate into action as they took concrete steps to begin a family planning method.

Team members from Nabirere B conducting a family planning sensitization

Although we’re very sad to leave Nabirere B, we’re excited that UVP programming will continue for the next three years! We can’t wait to see Nabirere B transform into a model community for sanitation and health.

Kitukiro: Jamilah shows hard work pays off

Time in the village is flying by and it’s hard to believe that we have been here in Kitukiro for 7 weeks. We are continuing to hold sensitizations and have been having a great turn out for each of our events. We have begun doing more creative, interactive events in order to keep the villagers engaged at the sensitizations. We have added a tippy tap raffle, a mosquito net raffle, and a few short dramas to our sensitizations and have received a positive response from the village. Our VHTs have continued to stay committed to the work we are doing, and we have confidence in the village of Kitukiro to continue to improve their own health and sanitation after we leave!

We recently interviewed a villager in Kitukiro named Jamilah about her experience with UVP. We selected Jamilah because she repeatedly took the initiative to attend all of our sensitizations and improve the sanitation of her home by constructing a plate stand and garbage pit. We asked Jamilah about what she had heard about UVP. She told us that she knew UVP was about improving cleanliness, helping to construct proper plate stands, and about mosquito nets. We then asked what had inspired her to come to UVP events and to take steps to improve her own household. She told us that she wanted to learn all of the things she didn’t know. During our time here, she has learned about boiling her drinking water, using the sun to kill germs on plates and utensils, and different family planning methods. She is more knowledgeable about family planning side effects, how often to wash a mosquito net, the importance of plate stands, and how long boiled water is safe to drink. We are encouraged by all that she has learned, and the steps she has taken to improve the sanitation and hygiene of her own home. We were so happy to hear that she has even educated neighbors about family planning and the importance of household sanitation facilities!        

We are thrilled to know that our work in Kitukiro has paid off. It is sometimes easy to get frustrated by language and cultural barriers, lack of resources, and the abundance of incorrect health beliefs. Speaking to people like Jamilah reminds us that the villagers are invested in UVPs efforts, and are benefiting from the time that we have spent here. We couldn’t ask to leave the village on a better note than that!

Our time here has been both challenging, and educational. We are all leaving Kitukiro more aware, rat-tolerant, appreciative, proud, and hopeful for the future. We are beyond grateful for our time and experiences here in Kitukiro, Uganda, and UVP will always hold a special place in our hearts.

It’s been a great summer, y’all!

Sincerely,                              

Kitukiro Killer Whales

Nabirere A: a young family improves sanitation

Wotali is 21 and has lived in Nabirere A for 11 years. She married when she was 19 and she and her husband live close to the village mosque. They are farmers and she sells chapatti that her husband makes. Wotali was the first person to buy a “sanitation kit” from our team to construct a tippy tap and plate stand, the day after our community WASH sensitization.

How did you first hear about UVP?
Wotali: I had never heard about UVP until some of the team came to conduct a baseline survey at my house.

What UVP events have you attended?
Wotali: I attended the family planning and WASH sensitizations and went to the borehole clean-up day at the mosque.

Why did you attend these events?
Wotali: Curiosity, primarily. I wanted to see what these interns had to say.

What impact, if any, have UVP’s activities had in your life so far?
Wotali: I was inspired into action by each of the sensitizations. I had never heard of family planning until I attended the sensitization and afterwards I started on a family planning method. After I went to the WASH sensitization, I decided to buy the sensitization kit because I wanted my house and my family to have a plate stand and a tippy tap to improve our health. I will continue to attend UVP activities and hope to continue learning.

Bukaigo: interview with a VHT

Godfrey Nadomi is a member of the Village Health Team in Buvule (in Bukaigo, we work with Buvule, too). He is a history teacher in a secondary school. He was a resident of Businduka in Ruwuka district where he also served as a VHT before he moved to Buvule where he has lived for five years. He first heard about UVP from Obbo Titus, one of the UVP staff, who was coordinating the UVP programs at that time.

This is what he says about UVP: “The community members in Buvule are so appreciative of the work Uganda Village Project is doing in the village. Before UVP came into this village, sanitation and hygiene here were really poor but now people have changed their status and uplifted their health; latrines and plate stands have been constructed. There was also indiscriminate disposal of solid waste but due to this project, people have been health educated. Therefore the status of the sanitation and hygiene in Buvule has increased from 32% to 78.2%."

“Working with UVP has positively affected [Buvule] because I am enjoying my life as I have access to safe water which was not the case five years ago before. . . I have gained more knowledge from the UVP training on different health issues and this has enabled me to health educated my fellow community members on issues like malaria which has been a problem and how to prevent it, sanitation and hygiene, water treatment, family planning. Before people used to boycott the family planning program, but UVP has taught them easier sensitization procedures, hence more community members have gained interest in controlling the pregnancies and planning for their children.

“Selling water guard to the community members is a nice idea as people now know the importance of using it. Before people used to say that using water guard makes water taste bad, but now they have been educated on the importance of this method of water treatment. After the WASH team sensitized the Buvule community members on how to correctly use water guard, they have been coming to buy the water guard you left behind with the VHTs.”

Buwoira: Working with Timothy

We recently had the chance to interview a Buwoira Village Health Team (VHT) member, Timothy. Timothy's work as a VHT focuses on HIV. We are so grateful for all of his help this summer in Buwoira; we would not have been able to accomplish so much without his steady presence, punctuality, and passion for improving health in his home village.

Timothy was born in Buwoira and has spent his whole life here, and has worked with many different non-governmental organizations over the years. In addition to being a VHT, Timothy is an engineer in the electricity field, a farmer who raises cattle, as well as a husband and father. Timothy has been a VHT for over 20 years, so when Titus introduced him to UVP, he was happy to be trained on UVP programs.

Timothy has experience with HIV, sanitation, malaria, and family planning, so it made sense for him to continue that work with UVP. Also, UVP helps make villagers more aware of the presence and expertise of VHTs. The VHTs in Buwoira have struggled with villagers not respecting their role, and UVP has helped with that. Timothy said he is excited to continue his work after the interns have gone.

Being involved with UVP has shown him the importance of sanitation and hygiene. In the past, there was not clean water for all villagers, but the addition of a shallow well has improved access to clean water. There was also low latrine coverage, but UVP sensitizations have helped increase coverage and reduce open defecation. Though Timothy’s current focus is HIV, his favorite topic is sanitation and hygiene and he especially likes encouraging villagers to build sanitation facilities to reduce the incidence of jiggers in homes. His least favorite part of being a VHT is that people can’t always differentiate good from bad. He does not like feeling like he has to force people to do things that they should be doing for their own benefit.

Thanks for all the help, Timothy!