Safety Briefing: Ebola Outbreak in Western Uganda

Those who follow the news from Uganda have likely been concerned by the reports of an outbreak of the viral hemorrhagic fever known as the Ebola virus which was first reported as resurgent in western Uganda about three weeks ago, but the outbreak was not confirmed until July 27th. (1,2) There have been about 20 cases and 14 confirmed deaths from this outbreak, most of these cases were from the same household in a village in the Kibaale district in Western Uganda, which is about 125 miles west of Kampala, a day's travel from the Uganda Village Project offices in Iganga District. Uganda has had three major outbreaks of Ebola virus in the past 12 years, the largest one in 2000 was associated with several hundred deaths. (1)

The Ebola virus is a dangerous infection that can cause symptoms of headache, vomiting, and fever, and the mortality rate for those infected by the virus is high. Because the early symptoms are quite similar to other common infections such as influenza and malaria, fear levels can be high during an outbreak. however, transmission of the virus is through direct contact with bodily fluids such as saliva or blood. Therefore, risk of transmission without close contact is low. (3)

There are no travel restrictions in effect for Uganda because of this outbreak, and we are not planning to modify any of the internship activities for Uganda Village Project based on the outbreak. Although a case has been reported in Kampala and several others are being watched there, these are patients who traveled from western Uganda to seek treatment at Mulago, the nation's largest public hospital. The infections did not occur in Kampala. Travel through Kampala for departure at the end of the internship program is not risky. The Ugandan government has encouraged people to limit contact such as handshakes, even though these are unlikely to spread the disease - Uganda Village Project also supports that stance as a good way to prevent transmission of many different types of infectious diseases.

Any friend of Uganda Village Project or the internship program is welcome to contact me at any time regarding the Ebola outbreak with any questions.

- Alison Hayward, MD
Executive Director
Uganda Village Project

__________________
Resources:
1) BBC News: Museveni Warns of Ebola Threat. 30 July 2012.
2) Reuters: Ebola Outbreak Kills 13 in Uganda. 28 July 2012.
3) U.S. Embassy. Confirmed Case of Ebola Virus in Uganda. 28 July 2012.
For those interested in syndromic surveillance:
Searches for "ebola" on Google Insights in the past 30 days

Stories from the Field: Final Weeks in Kazigo A

By Naomi Muyanga

Sara and I finished the baseline surveys on Monday. Then Tuesday was the eye care and WASH sensitizations and it so happened that the VHTs did not mobilize and we had to walk around the village home to home mobilizing (I even rolled a piece of paper to act like a microphone and moved around at the last minute), but irrespective of our efforts, not more than 50 people turned up for the sensitization which was so irritating, but we had to bear it.

Wednesday and Thursday were sanitation pushes – hands on at VHTs homes from Kazigo A and B respectively. Both teams worked together to accomplish the last though it rained heavily on Wednesday and it seemed like we won’t work, as UVP staff also just dropped the materials and left but later in the evening, we started vigorously and managed to complete the task.

The community meeting where the survey results were released was a success, but still after an intensive mobilization on that very day. Titus and Patrick did a demo on safe water which was so fun where they put cow dung to mean faces into drinking water and asked whether any of the community members could take it!

Crazy, but true! - “What fun was in the blog this week?” I asked Derek, but he responded with “time’s new roman? Calibri?” I said, “What language are you speaking?” “The font was times new roman, that’s what I said!” He repeated only to realize it was a misperception of the word fun for font, everyone in the house giggled for over a minute.

Stories from the Field: Borehole Improvement Day

By Lauren Smith 


Friday morning kicked off bright and early with the first Kazigo B borehole improvement day.  Approaching the borehole, shovels, pick-axes, hammer, and sunscreen in hand, we were pleasantly surprised to find the caretaker there and ready for action.  First task: dig trenches to drain the nasty puddle at the end of the borehole and clear away the brush.  Armed with enthusiasm and total confidence in our tool wielding abilities, all four of us mzungu ladies stepped up to the borehole for the first swing.  Shovel digging skills, Gloria and Emily, check.  Hoe swinging skills…well, Lauren found those could use some work.  Turns out that while the caretaker (who is most likely twice our age) could effortlessly dig a trench in a few graceful strokes, us mzungus were in need of some serious practice.  After a few amusing swings, resulting in laughter and raised eyebrows from the Ugandans present, the Ugandans took over trench digging duty.  But, while we may be in need of some lessons in the art of swinging a hoe, we can collect and place rocks like pros, shovel and swing a machete with the best of them.  SP took on fence building, and Dan played paparazzi, documenting the event with four cameras dangling from his arms at a time.  We had a great turnout. Three of our VHTs came to help, and in total, about 15 community members participated in the improvement day.  In a few short hours we’d successfully transformed a dirty and overgrown borehole into a model borehole.  Trenches dug and lined with stones, brush cleared, pedestal cleaned and fence constructed, everyone was in good spirits, proud of the results, and covered in mud.  He who is the dirtiest had the most fun!

Lauren is interning in Kazigo B village this summer. 

From Iganga to Arkansas: Former UVP intern brings Ugandan health into the high school biology classroom

By Jennifer Jehnsen

I was a Team Leader for the Uganda Village Project’s Healthy Villages Initiative in summer 2009. In Nabitovu village, we focused on education outreach about insecticide treated mosquito nets and Waterguard as well as distribution of these at a subsidized price. We also focused on training the Village Health Team with knowledge about First Aid, HIV/AIDS, obstetric fistula, and malaria. These would become the leaders of the village in terms of health. Our day to day involved planning community meetings with village, district, and church leaders and doing community outreach at health centers and at schools. My biggest challenge was getting community members to come to outreach meetings. It was hard to have any sort of advertising in terms of when these were going to take place, so we really had to rely on word of mouth for the location and times of these community events. 

UVP solidified my interest in global health, particularly in rural health, because I witnessed the lack of resources for healthcare in rural areas, specifically for primary care. I saw the health centers without medicine or doctors, the clinics with one nurse and thirty people waiting in line. I've seen similar issues in rural areas in the U.S. and believe that the lack of adequate access to primary healthcare in rural areas needs to be addressed.

Currently, I am a high school biology teacher in McGehee, Arkansas. This summer, I am teaching at the Arkansas Governor’s School, a 4-week gifted and talented program that provides students an incredible opportunity for intellectual growth and social interaction while living on a college campus. I am using the knowledge and skills that I gained from being a Team Leader to educate my students about the public health approach toward tackling neglected diseases found in the developing world. I love talking about my experience in Uganda with my students. They usually have a lot of questions about what the people are like, what the buildings are like, and what the schools are like. I like to incorporate the health issues that I worked with in Uganda into my lessons so that my students can make real life connections about the relationship between biology and health.  I share with them challenges and successes our team encountered while setting up programs to prevent malaria, HIV, and waterborne diseases in Uganda. We also discussed the importance of community educational outreach and sustainability when implementing public health programs. 

 The students created skits for educating people about malaria prevention, and designed prototypes of sand filters that will not only filter pathogens out of the water but also provide a way to dispense water without recontamination. We had discussions about the stigma attached to HIV/AIDS and its affects on prevention, treatment, and testing. The final project will involve the students designing a budget and project proposal for a public health initiative that will address a tropical disease found in a developing nation. 

The main focus of my class is that epidemics of neglected diseases are not caused solely by the virus, bacteria, or protist; economic, social, and cultural factors also contribute greatly to the spread of the disease. My goal for the students is to understand the complexity of the issues in international health and that the spread of these diseases cannot be stopped simply by distributing free medications. I hope that my students will spread awareness about the issues people are facing in Uganda and like a chain reaction, more and more people will become advocates for people living in the developing world.

Jennifer Jehnsen interned with UVP in 2009 and was a team leader. She currently serves on UVP's internship task force. Since attaining a BS in Environmental Sciences and minor in Global Poverty & Practice from UC Berkeley, she has been working as a high school biology teacher in McGehee, Arkansas. 

HIV and UVP: Healthy Village Teams work to combat HIV in Iganga

By Gwendolyn Wernersbach 

HIV rates in sub Saharan African remain a major public health concern globally.  Uganda in particular is considered by many to be among the world's earliest and most compelling national success stories when it comes to combating the spread of HIV.  In recent years, Uganda experienced a decline in HIV prevalence, however, new reports show that the HIV prevalence rate has increased slightly, and that women are disproportionately affected compared to men.    

The HIV prevalence rate in Iganga is estimated to be higher than the national average by about eight percent.  Rural populations are most affected, as access to HIV testing, counseling and treatment are more difficult to come by in remote areas.  According to the Ugandan Ministry of Health, 85% of the population of Uganda does not know their HIV status, which demonstrates the impact and importance of these services.  Access to HIV counseling and testing is compounded by the fact that AIDS-related stigma and discrimination remains the single most important barrier when it comes to behavior change and public action. 

The Uganda Village Project (UVP) is helping to combat rates of HIV in rural areas of the Iganga district by providing HIV counseling and testing services through our Healthy Villages Team program.  The Village Health Teams work with local partners, including St. Mary’s, to conduct culturally appropriate outreach activities to educate communities about basic HIV prevention methods, and often incorporate dance, drama and music performances in to their messaging.  Additionally, UVP is actively involved with distributing condoms in collaboration with partner NGOs, and also administers voluntary HIV testing for villagers as a way to eliminate fear, stigma, or costs associated with travel to a clinic. 

Meet our friend Naigaga Sarah of the Nabitovu village.  Naigaga Sarah is a 34-year old mother of three children, and a proud member of the UVP Nabitovu Village Health team.  She is pictured below holding her youngest child as she waits to speak with the counselor about her results following a routine HIV test. 

Naigaga Sarah comes from a polygamous marriage, she is wife number three and the youngest wife in the home.  "We all came to test today," she said smiling.

"Since Uganda Village Project came into the village, my co-wives, my husband and myself have been testing for HIV at least once and sometimes twice every year.  As a Village Health Team member I encourage others to come for testing and mobilize the village for the HIV education sessions as well. I am happy for the opportunity Uganda Village Project and their donors have given us, by bringing testing right to the village level.  They test at the health centre as well, but it is far and walking there can sometimes be tiresome, therefore bringing testing to us is good and we are grateful."

In 2011, 1,421 HIV tests were administered in nine villages.  So far this year, as of July 2012, 1,623 HIV tests have been administered in eleven villages.  For those that test positive, they are referred to The AIDS Support Organization (TASO), their closest health center, or Iganga district hospital for follow up care and treatment.    

In these ways and many more, UVP is helping to reverse the trend of HIV in Iganga district.  We can only continue to do this important work through your help, generosity and support.  Learn more about how you can make a difference by supporting UVP’s HIV prevention efforts in Iganga here.   

Gwen is passionate about global public health and humanitarian relief efforts, both domestically and internationally. She has worked in the areas of HIV prevention, refugee health, nutrition, fitness, water and sanitation projects, and public health emergency preparedness. Gwen has served as a Peace Corps Volunteer in Lesotho, and holds an MPH from Emory University in Atlanta. She currently works with the American Red Cross and serves on the board as a Member At Large for UVP. 

Stories from the Field: Baseline Surveys, WASH Sensitizations, and HIV Drama Group

By Lindsey Anderson

On Monday, after the team leader meeting, Derek, Felix, and I arrived home and Naomi and I left for a few baseline surveys on the complete opposite side of the village. Our goal was to get as many as possible and then head home to help with our group dinner with Kazigo B before dark. We ran into one of our VHTs and he kept taking us to more houses… As dusk began to arrive, he said we only had 10 more houses for this side of the village, so we thought: why not? By the time we finished the last house, it was almost completely dark and we had no phone and no light, and our VHT left us…so we had to start the 25-30 minute walk back home. After about 5 minutes, it was pitch black. Naomi kept trying to scare me because she was saying there was someone following us and she kept grabbing my arm. Finally, we ran into Dan and Simon Peter from the Kazigo B village and they helped guide us the rest of the way home.


On Tuesday, we had our WASH sensitization at the secondary school in Nabitende. It was not as successful as some of our other sensitizations. High school kids in Uganda are very similar to high school kids in the United States. If they decided they already know the information (or just don’t want to listen), they aren’t going to hear anything that we tell them. But, I’m sure the information came across to a select few...


On Wednesday, we had our HIV sensitization with the God’s Messengers drama group, who arrived 5 hours late because of a diver mishap. When they finally arrived, Sara and I got into the back of the pickup truck (with about 20 other people crammed back there) and drove around the village mobilizing. It was a crazy experience!! We were shouting, dancing, and I even beat on a drum for a few minutes. It was a lot of fun. Once we got back, we all got together to entertain the audience by participating in the local dance! Every single one of us got the chance to tie a scarf around our waists and shake our hips to the beating drums. The audience had a lot of fun watching us, and we had a lot of fun dancing for them! 


Lindsey Anderson is interning and living in Kazigo A village this summer. 

Family Planning Success Stories

By Maureen Nakalinzi

The following are four success stories about UVP's family planning services. 

For Our Children

Forty-eight year old Nabirye Alizikyi lives in Nakamini village in Iganga District. She is a mother to 10 children and she recently decided with her husband’s support to have a tubal ligation procedure done. When asked for the reasons why she had this procedure, she said, “I am disabled so I am afraid I won’t be able to look after my children very well if I continue having more children and my husband doesn’t make enough money. We also want our children to get an education hence we will concentrate on the children we have now." She was grateful for the support given by Uganda Village Project towards this accomplishment.

The Breadwinner

"I am called Naibira Zabina and I am 30 years old. I live in Nabukone Village in Iganga District.  Although I am married, I am the breadwinner of my home because my husband has three wives and he doesn’t earn enough to provide for all our basic needs. I have also always had difficulties with all my pregnancies hence the doctor counseled me and my husband to not have children any more. At first my husband did not support my choice of method, however after we were counseled by a UVP family planning services provider about the benefits of family planning, my husband gave me permission to go and have a tubal ligation procedure done. I feel happy because I will be able to plan for my family efficiently as I will not be worried of getting pregnant again." 

Spacing Our Children Out

"I am called Nakanda Jenny and I live in Nawansega village in Iganga District. I am a mother to five children. My husband and I are both farmers and we both understand that much as we want to have more children, we need to be able to plan for them and properly care for them. After we were counseled by a UVP family planning service provider, we both agreed to use the Norplant and we are both happy that we will be able to space our children very well and also meet their needs without the risk of unintended pregnancies."

Making an Informed Decision Together

Nabirye Loy is 30 years old and lives in Nakamini Village in Iganga District. Although she had planned to have six children, she now has nine children, a factor she attributes to not being able to access correct knowledge about family planning. As a result, she became afraid of using any method. But recently, thanks to the presence of UVP in her village, she was taught about family planning methods and later together with her husband; they made an informed decision to have a tubal ligation procedure done. 

Maureen Nakalinzi works as UVP's Health Villages Program Coordinator on the ground in the Iganga District.

Stories from the Field: A Most Awe-Inspiring Week

By Alicia Majeau


Although I have already written two blogs about the happenings in Kidaago B, I asked my team if I could usurp the right to reflect upon life in the village once again.  This was, in no way, due to any particular affinity for writing on my part, but simply because this past week is the one I feel has been the most awe-inspiring for me, and likely the most impactful for our community.  The week of July 9 was the sanitation week for Kidaago B.  During this period of time, we shared the results of our sanitation baseline survey with the community, trained the Village Health Team members in building basic sanitation structures, and went compound-to-compound, trying to improve individual households’ sanitation.  Over the course of the three days of the actual sanitation push, my team (working in cooperation with our awesome housemates from Kidaago A) built a total of 38 tippy-taps (hand-washing devices), built or improved 27 trash pits, built or improved 15 plate stands, built 12 latrine covers, created drainage for two washrooms, and helped begin or improve 10 latrines.  While many of these terms may seem arbitrary and their impact vague to those who are unfamiliar with sanitation in a village setting, they are all hugely important, yet fairly simple, devices or steps that can be taken to protect water sources, reduce disease, and generally improve health.

My awe at this week does not, however, come from these numbers that reflect sanitation improvement, or even from the incredible tenacity of my teammates and housemates, facing long hours in the field laboring under a hot sun.  Instead, my awe is inspired by the eagerness of the villagers to improve their community’s health.  To begin with, Kidaago B has some incredible Village Health Team members.  One man in particular, always eager to serve his community, spent all three days of the sanitation push working with us to assist his neighbors.  Even after we had finished working hours at the end of the day on Friday, this VHT, Awali, requested that we leave him materials to continue the work for a couple more hours independently.

The three days also resulted in story after story of people putting in more effort to improve sanitation than I ever expected.  In order to convey a sense of ownership, we charge 500 shillings (a subsidized price) for materials in order to build a tippy-tap.  One man, in particular, claimed he did not have the money necessary for such a hand-washing device.  Upon witnessing us build his neighbor one and teach both the adults and children the proper method of hand washing, he eagerly asked us if we could build him one as well, suddenly finding a way to afford it.  My team also found family after family who had chopped wood prior to our arrival for use in building a tippy-tap or plate stand.  Word spread like wildfire throughout the village that we were moving around doing this push, and the response was overwhelming.  The appreciation of the villagers, when I, myself, was appreciating them and their efforts so much, made every bead of sweat and muscle ache entirely worth it.  It is difficult to say whether this effort will continue once my team has left, but I truly believe that with the help and guidance of the VHT that I cannot say enough good things about, Kidaago B will soon be a village to be rivaled in sanitation levels.

Alicia Majeau is an incoming graduate student in the Molecular Microbiology and Immunology Department at Johns Hopkins Bloomberg School of Public Health. She interned with UVP in 2011 and returned this summer to serve as an Administrative Team Leader in Kidaago B village. 

Stories from the Field: Eating in Uganda

By Hannah Hennessy


One of the best parts about traveling to a foreign country is getting to try all of the local food.  Before I embarked on my trip to Uganda, I wasn't quite sure what to expect of African food. It's not a type of cuisine that I had previously tasted, but I made a commitment to try everything, just as my mom taught me.

So far, I have loved the food in Uganda. All of the different kinds of rice and beans and vegetables covered in amazing sauces and full of strong flavors. Overall, there have been only a few foods that aren't too popular. In Nakamini, we have basically outlawed posho (cornmeal and water, basically a less flavorful polenta) and matoke (the Ugandan equivalent of mashed potatoes made with flavorless bananas). However, everything else is free game.

Some of our team favorites are fish stew and okra, chapati with guacamole, pizza on chapati crust, French toast, sukumiwiki, and basically anything with g-nut paste and honey.

Our best meal, however, coincided with our team Fourth of July celebration. Preparation began with the slaughtering of two mzungu (or GMO white) chickens in our backyard (slaughtered by myself and Modest). The meal continued with the boiling of fresh maize and sukumiwiki cooked with Jane's special sauce. Finally, Berna made us authentic Ugandan fried chicken. Basically, it was the best meal ever!!!

All of my culinary worries are long gone because (almost) all of my experiences have been amazing.

For the remainder of the summer, I plan on continuing to explore my food options and improve cooking my favorite Ugandan dishes (so far my small repertoire consists of chapati, fresh passion fruit juice, and charcoal stove pizzas).

Hannah is an intern working in Nakamini Village this summer. 

Stories from the Field: A flushing toilet, a shower, or a washing machine?

If you could only have one, which would it be? A flushing toilet, a shower, or a washing machine.


Gloria: “The toilet to avoid having to walk at night with possible snakes, ants, or dogs on the way to the latrine.”


Corrie: “I would take the shower because it makes me feel good on the inside and clean on the outside.”


Lauren: “The shower because I like hot water sprinkling on me from above.  However, I don’t mind being outside in an open shower as long as there aren’t any kids spying on me from the trees.”


Emily: “The toilet, because once at night I witnessed our neighbor kill a poisonous snake.  I like having a flushing toilet in the house.”


Simon-Peter: “The toilet because it stays clean.”


Daniel: “The toilet because I don’t mind the other two.”

And if you had to give up only one for a lifetime, which would it be?

Gloria: “The shower, because I think the basin showers can be refreshing sometimes.”

Corrie: “I would give up the toilet because I dislike washing my own clothes and appreciate my showers.”

Lauren: “I would give up the toilet because I like the convenience of washing machines and would keep the shower.”

Emily: “The shower because I still feel clean after my basin showers.”

Simon-Peter: “The washing machine because I like washing my clothes.”

Daniel: “The washing machine because I can wash my own clothes!  I would feel lazy if I didn’t.”

Gloria, Corrie, Lauren, Emily, Simon-Peter, and Daniel are all interns working in Kazigo B this summer. 

Stories from the Field: Slaughtering Chickens & Meeting "Mr. Mayor"

By Sara Jenks

The past week has proven to be the most low key thus far.  Naomi and I continued to conduct baseline surveys while the others were in town on Monday.  Unfortunately only about half of the residents were home and another portion ran at the sight of us. One woman hid in her shower but her talkative grandson gave her away.  On Tuesday, just after Felix and Derek had set out to conduct surveys, the neighbor alerted us that someone from Kazigo A had passed away.  At that point, we were to stop working until the burial.  For that reason, I don't have any further work-related updates.  We canceled Wednesday's village-wide sanitation sensitization to attend the burial -- also no villagers would have shown up!  On Wednesday afternoon we attended the funeral with our UVP neighbors from Kazigo B.  Titus, a UVP staff member, gave a condolence speech on behalf of UVP.  He was also able to inform everyone of our upcoming HIV testing day next week.

I, of course, have to relay the Kazigo A chicken update.  Two weeks ago I slaughtered our dinner.  Naomi told me I performed it the quickest of the three internationals, but Lindsey said it seemed like I was the most affected by the act.  It's true, I felt uncomfortable ending a being's life with my own hands, feeling its last breath.  But we all agreed that it was the tastiest chicken we had eaten by that point.  This past Wednesday, we had two chickens for dinner, as we hosted the folks from Kazigo B for an American Independence Day feast.  We ended up grossly underestimating their cooking times and didn't eat until 10:45 pm!  Surprisingly, Naomi, a native from a village in the Busoga region, had never slaughtered a chicken!  She took care of both chickens, but announced that she doesn't intend to do it ever again.

Of all of the children who visit us everyday, we have grown closest with a fourteen year old boy named Waiswa.  His father is no longer living, so he is wise beyond his years.  He seems to know everyone and acts in a most diplomatic manner, so we have nicknamed him "Mr. Mayor".  For example, he made Derek an extensive Lusoga-to-English guide, including such phrases as "I am going to the borehole" and "Big is beautiful."  He without a doubt speaks English the best of anyone his age and is clearly sharp in other realms.  One morning he sat with us at breakfast, after school had started.  When we asked him why he wasn't at school, he looked away, ashamed.  Every day he goes to school and every day is turned away for not wearing acceptable shoes.  We have decided that since Waiswa does so much for us, and since we know his future is bright, we will do what we can to find him a pair of black shoes so he can go back to school.

The team is now heading back to Kazigo A after our midsummer break in Sipi Falls.  There is a lot to be done in the second half of the internship, and we are feeling the pressure.  Luckily we all feel rejuvenated after being inundated by negative ions at Sipi's many sites of crashing water (thanks Theresa Gauvert of Namunkasu for that interesting tidbit)!

Sara Jenks is interning with UVP this summer in Kazigo A village. 

Stories from the Field: WaterGuard and Behavior Change: The Mzungus and their strange American water

By Stephanie Ullrich

We have now been told multiple times that people in this community do not believe that we are drinking the same water as them from the borehole or shallow well. Apparently they have been observing our reusable water bottles and thought that we brought our own special water from the United States with us.

When this happened again today, Douglas- one of our Ugandan team members- ensured the woman that we were indeed drinking the same water as her, but also using WaterGuard to treat it. Waterguard is a water purification tablet used in 20L of water for 30 minutes to kill the bacteria in the water. After we fetch water from the borehole, we put one tablet into our Jerry can labeled “drinking water” and let it sit before its ready to drink or use for brushing our teeth. WaterGuard is sold locally at all village trading posts, and it’s the water purification technique that UVP promotes in the villages.

When the women insisted that the water treated with WaterGuard tasted and smelled funny, Douglas even went so far as to prove to her that there was no difference. He emptied the woman’s mug and took Andre’s water from his water bottle to pour it into her mug. After she tasted it she said she could not tell the difference between her old water and Andre’s treated water.

We anticipate that promoting WaterGuard is going to be one of the hardest challenges we face because it centers on sustained behavior change. Not only are we asking the village members to buy WaterGuard on a regular basis, we are asking them to treat water that they perceive as already ok to drink straight from the borehole. It is hard to prove to them that the water is not fit for drinking before treatment because they have been drinking it for years. We will struggle to prove to them this because no one can physically see the bacteria in the water. And we will struggle to prove to them that using WaterGuard could save them money in the long run because it clean water can prevent child diarrhea (aka advanced charges for medicine and treatment) and taking away productive work days because of sickness.

Stories from the Field: Hello from the Nutrition Team

By Nishant Pandya

Monday, June 18th marked the start of what I considered the Nutrition Team's first work week. Our first week had been a transitional period in order for us to get used to our new home, a new lifestyle, and to orient ourselves. The major project of the week was the information session we were going to hold at the village health clinic, and the focus group with the savings club. Both of these events were to be held on Wednesday. 

After spending Monday outlining how these events would go, Tuesday was spent practicing and rehearsing them to ensure they went smoothly. After feeling sufficiently confident during run throughs, we considered ourselves ready for the actual sessions on Wednesday.

The information session in the morning focused on child and maternal health. We talked about breastfeeding, complimentary feedings, and opened the floor to questions. Despite not understanding much of what was being said, I could tell when a message had stuck. Not being able to understand Lusoga, the verbal language, gave me the ability to focus more on body language. I could tell who was engaged, when people checked out, and if a message had hit home. Later that day, we held a focus group to introduce ourselves to the village. We talked about beliefs they held on nutrition, figured out what foods could be found, and played a game to where we would recite statements and the villagers would say if they agreed or disagreed. Once again, I barely understood what was being said by the villagers, but Caroline and Alex would always fill me in on when something important was said. I spent the time reading body language, helping out however I could, and most importantly, thinking how the Nutrition team could get better for the next session we hold.

By Matt Cognetti

Working with the UVP will make you smarter.

Hello my name is Matt Cognetti and I am one-fourth of the nutrition team, here is part of my UVP story.

Nishant and I started researching a nutrition project to implement into the Uganda Village Project since November 2011, during this time we have went through many revisions, but it has been one of the best learning experiences I’ve had at Penn State... mostly due to an increase in motivation.


While some of my classmates were struggling with the last semester push of senior year, I regarded myself as very fortunate. I could see the importance of my public health, health behavior, and epidemiology classes. I was lucky I had found a reason to care. UVP had made concepts such as ecological model, theory of planned behavior, and household sampling methods relevant to me, and crucial to the work we do everyday.

This has also been a rewarding experience because fresh from my formative undergrad years. I get to work with very smart master of public health candidates, and insanely intelligent and competent Ugandan interns. I could not have asked for a better growth experience as I go to apply for a future career as a doctor and research scientist.

Nishant and Matt are both interning with UVP this summer as part of the Nutrition team. 

Video from the Field: Malaria Skit in Namkesu Village

Interns living in Namkesu put on a play for the community on malaria prevention, integrating local methods to protect  against mosquito bites that cause malaria.

Stories from the Field: Lots of Teaching, Lots of Learning

By Emily Maheux

We had many sensitizations this week in Kazigo B with four sensitization in three days.  We learned a lot about how to work with our community and approaches to teaching young kids.  We performed skits on malaria for the community with paper mosquitos hanging from sticks (thank you Kazigo A) and the community members loved it.  One of our VHT members played the role of “VHT” in the skits and surprised us all with his superb acting ability.  He stole the hearts of the crowd when he pretended to slap the paper mosquitos away.  Any community members nearby who were not already watching the skits became curious.  All fifty of the mosquito nets that we started with were sold after the sensitization. 

We held our sanitation sensitization at Kazigo Junior School on Wednesday, which went smoothly but I noticed that students started losing interest in the demonstrations and discussion on germs.  Luckily, we had another chance to capture the attention of young children on Thursday morning at Toka Primary School, the local government school, during another sanitation sensitization.  For this sensitization, we teamed up with the Kazigo A team to teach about 700 students.  With the hopes of exciting the kids, we invited all of the students to participate in a warm-up this time.  Lauren and I had all the students stand up and follow us in one of our favorite games.  Together we would clap, dance, jump, etc. and have the kids mimic our movements and repeat our declaration of whatever we were doing: “I am jumping!”, “I am twirling!” and so on.  We started slow and then got faster and faster until at the end of it all, we slowed down again with some stretches and finished with “I am sitting quietly.”  After that, we split them into groups for each activity, where we also tried to make each demonstration more interactive.  In the afternoon, when we sensitized on HIV and STIs, we had the older kids spell the word “mango” with their hips (many thanks for the warm-up, Rashad).  This was also a huge hit and the activities that followed went well also.  We had the students play a game to test their knowledge on STIs and another to show the spread of HIV.  A third group discussed the ABC prevention strategy (A – Abstinence, B – Be faithful, C – Condom use). 

We were fortunate to have a very full and fulfilling week in Kazigo.  We certainly hope our audiences learned a lot from us and undoubtedly, we have also learned a lot from them.  I have learned from this exciting week that if we want to get our message across, we must also remember to have fun in the process.

Emily is the Administrative Team Leader of Kazigo B. Her teammates include Simon-Peter (Implementation Team Leader), Daniel, Corrie, Gloria, and Lauren.

Stories from the Field: Visiting Iganga Hospital & Impromptu Drama

By Lindsey Anderson


We are now getting into the rhythm of things in Kazigo A. The focus this week was pretty much on Baseline Surveys and sensitizations. I, however, got to visit Iganga Hospital on Monday. It was definitely a memorable experience. Lauren and Gloria (both from Kazigo B) and I got to tour a few of the wards in the hospital. The first we went to was the surgical theatre, where we witnessed 2 complete C-sections. The sanitation was definitely eye-opening. We even saw one of the doctors take off his glove to answer his phone and then put it back on. It was crazy!

On Tuesday and Wednesday we focused mostly on Baseline Surveys, so we got to travel around the village for a little while and see a lot of the houses. When Felix and I were traveling around with one of our VHTs, we came a small house with an old woman, who, apparently, loved to talk. When we asked her when malaria mosquitos bite, she answered “oooh, mosquito bites hurt so much!” and just went on and on about the bites. Our VHT finally had to get her back on track.

On Friday, we had our second Malaria sensitization at the primary school, but our drama group never showed up! So, we had to make everything up on the spot! I guess it ended up going well, because with significantly less people, we still sold all 50 nets! After the sensitization, the drama group showed up, finally, and asked if they could still do their drama…hopefully it will go more smoothly next time.

Stories from the Field: "There's no place like home..." -- Second post by returning intern, Alicia Majeau

By Alicia Majeau


There’s no place like home… even when that home means battling rats, disagreeing with your neighbors over the toilet, and fending off giant hornets as they nightly try to join you under your mosquito net. After three weeks in Kidaago, our house is definitely feeling like a home. Although there have certainly been some less-than- ideal happenings, such is village life, and facing the challenges that arise is part of what helps this experience change your perspective. And for every rat getting into the food in the pantry, there’s been a wonderful family dinner; for every insult muttered by a disgruntled teacher, a wonderful conversation. We have seen some difficult things, another child in the village passing away last week and the body being laid out for all to see, but we have also seen some beautiful things, village children inviting us to join in their impromptu song and dance session at our house. The people of Kidaago B have also been hospitable to an extreme. This previous week alone, we received three large bags of ground nuts, several mangos, beans, eggs, and ears of maize.


Being so well received overall has made our work in the village a pleasant experience. This past week saw the beginning of our baseline surveys about household sanitation and mosquito net use. Asking to inspect someone’s toilet and enter their house to see a net hanging where they sleep allows for some potential awkwardness, and when people are unwilling, it makes one all the more uncomfortable. We have been very fortunate in Kidaago B, and as yet have met very little resistance. Our first sensitization was also well attended and our HIV and syphilis testing day, which occurred this past Thursday, was a huge success, with 230 villagers coming out to get tested. It is hard to believe that our time in Kidaago B is almost halfway through, but I prefer looking at as still having a little more than half of our time left. Looking forward, my team has a lot of great work still to come, and I am just as excited about our work now as I was at the onset of our program.


This is the second blog post by Alicia Majeau. Read her first post here. Alicia is an incoming graduate student in Molecular Microbiology & Immunology at the Johns Hopkins Bloomberg School of Public Health. She interned with UVP in 2011 and returned this summer to serve as a team leader. 

Stories from the Field: Understanding Village Needs

By Michelle Parks

Uganda is truly a beautiful country. Our house is surrounded by crops of maize and Irish potatoes, mango trees, jackfruit trees, and other green vegetation. Because we live in a house on the Kidaago Primary School compound, there are always welcoming children around, excited to see the “muzungus.” The villagers have been very kind and hospitable to us as well. Although they usually giggle, they appreciate our attempted Lusoga greetings.

This is my second week in Kidaago B. I am slowly learning more Lusoga and adapting to living in the village. I am getting used to wearing my long skirts out in the field, hand washing my clothes, taking bucket showers, using the latrine :-P, and learning to tolerate lots of bugs! Big bugs! But as Jake says… “Beautiful bugs!”

On Wednesday a group of children came to the house in the evening. They offered us maize and began to perform and sing while we watched on the front porch. The singing attracted other village children, and some began drumming on empty jerry cans. One of the girls (she was probably 8 or 9) was an amazing dancer! I need lessons. Alicia and Julius even joined in on the dancing for a little bit.

On Tuesday, we had our second community meeting with Zone 2 of Kidaago B. I was able to successfully introduce myself to the audience in Lusoga! Many of the village needs brought up in the Zone 2 meeting were similar to the issues that were brought up at the Zone 1 meeting. Several villagers addressed that there is only one source of water in Zone 2, so villagers who live on the far side of the village must travel several kilometers to fill their jerry cans each day. As a result, children retrieving water for their families often miss part of school because their journey to the borehole is so far. People also expressed concern about the prevalence of HIV/ STI’s in the village. Others raised questions about UVP’s Eye Care and Family Planning programs. After the meeting was over, a woman approached us and gave us the contact information for a fistula case. It was obvious after a short meeting with this group of villagers that there is a need for all of UVP’s programs here.

Later in the week, the team mobilized for the upcoming HIV sensitization. At several households, we met villagers that complained a member of the household was sick. When we advised the family that the sick individual should go to the health center, they had complaints about the health center and were reluctant to go and get treatment. “There are no available drugs,” “I wont be attended to,” and “the health center is far” were common complaints. At one home, a man had been feeling sick for six years and had never visited a health center!

We had a good turnout for our HIV/STI sensitization on Friday. The villagers were pleased that there was an upcoming HIV/syphilis testing day; they reported that there were many people in the village who had never been tested for HIV. They also requested a female condom demonstration, most people in the audience had most likely not used one before.

Next week we will begin doing our baseline surveys in the village and have the St. Marys HIV/syphilis testing day. Each day in Kidaago B, I learn more about the culture, interact with new smiling children, and take part in activities that will eventually benefit the community.  I am excited for my upcoming adventures in Kidaago B. 

Michelle Parks is a Master's student studying Tropical Medicine at Tulane University. She is from Spokane, Washington.