Fistula Ambassador Training

Obstetric fistula, a childbirth injury which is a result of prolonged obstructed labor, is common in developing countries where the poor women cannot access proper medical care during pregnancy and labor. Uganda is no exception. Over 200,000 women suffer with fistula throughout the country.

Women with fistula live a life of isolation because the condition causes constant leakage of urine or feces. Sadly, many women suffering with fistula do not know that there is a cure for their condition. Due to a lack of information and education on their condition some even attribute their condition to curses or witchcraft.

The Uganda Village Project works hard to identify patients and giving them access to repair surgeries. However, locating patients proves to be difficult as women with fistula are isolated and marginalized in their communities. Our Fistula Coordinator, Loy, works tirelessly to locate fistula patients across 8 districts in Uganda. She is very successful in communicating about fistula and counseling women suffering with the condition because she herself suffered with the condition and had repair surgery. As one of our former fistula patients said, “I felt more comfortable because the person [fistula coordinator] who came to talk to me about this condition had gone through the same ordeal and was in a position to explain to me what fistula meant and that it could be cured”. Uganda Village Project wants to replicate Loy’s success by identifying other former fistula patients to be ambassadors in their communities.

In November of this year, Uganda Village Project's Fistula Program launched a Fistula Ambassadors project which brought together 18 former fistula patients from the districts of Namayingo, Iganga, Luuka, Budaka, Pallisa, Mayuge and Kaliro. In this two day training, the women were given knowledge on the causes, prevention and treatment of fistula. Additionally, trainees learned how to effectively communicate about fistula in their community and attended a fistula outreach where they could watch our Fistula Coordinator give her presentation and answer the community’s questions.

Now, as fistula ambassadors, these former fistula patients have the skills to actively identify patients in need of treatment, participate and organize outreaches in their communities to educate people about fistula, and create support networks where they can meet and discuss challenges and personal issues prior to or after surgery.

Since 2007, UVP has helped a total of 240 women living with fistula receive fistula surgery by conducting sensitizations, identifying fistula cases and facilitating the process of taking the women for surgery and supporting them while the recover in the hospital.  We hope that with our Fistula Ambassador program, we can help that many more women. UVP’s Fistula Ambassador activities have been funded through a grant from the Fistula Foundation. 

Check out photos from our training below:

Our Fistula Ambassadors

Written by: Kait Maloney
Edited by: Tiffany Hsieh

Dr. Alison Hayward speaks at GlobeMed HillTop Conference 2013

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This month, Dr. Alison Hayward, Uganda Village Project's co-founder and chair of the board, was invited to speak at the GlobeMed Global Health HillTop conference held at Columbia University in New York City. GlobeMed is a student-founded nonprofit with many similarities to UVP in its mission and values. Both organizations focus on grassroots community-based work to improve health and alleviate poverty via partnerships between students and community members.

Dr. Hayward gave an overview of Uganda Village Project's history and its programs to conference attendees, with emphasis on the Healthy Villages program. This lecture was followed by a lively discussion of the challenges of nonprofit work in resource limited settings and of creating behavior change in communities as part of public health initiatives. Thanks to GlobeMed for the invitation to participate and speak at the conference this year!

UVP Fistula Program in the News

Uganda Village Project (UVP) was mentioned in a recent article about obstetric fistula in Uganda. There are approximately 140,000 to 200,000 women living with fistula in Uganda. This devastating childbirth injury can be fixed--and UVP is working to do just that. We send women to fistula repair camps run by the Uganda Childbirth Injury Fund three times a year. Read more in the article here.

Join us at UVP's 10th Anniversary Celebration!

We're only two weeks away from UVP's 10th Anniversary! It's hard to believe we've already been working with Iganga district for so long, but we have a lot to be proud of. If you are in the New York area (or have friends who are!), please join us for a wonderful night on November 8, 2013. Tickets can be bought here (on the upper right hand side) or at the door.

Hope for Asenath

Since 2005, Uganda Village Project has provided direct assistance to over 220 women with fistula in rural eastern Uganda. To empower former fistula patients, raise awareness about the issue, and save more women’s lives, we’re expanding our fistula work by implementing the Fistula Ambassadors Program in 2014. This work is possible due to a generous grant from the Fistula Foundation, an organization committed to raising awareness of and funding for fistula treatment, prevention and educational programs worldwide.  

The Fistula Foundation has funded Uganda
Village Project to expand our fistula work and
implement the Fistula Ambassador's program.

The Fistula Ambassadors program will train former fistula patients to become Ambassadors by utilizing their trusted community networks to increase the impact of our fistula programs and services in local communities in Iganga. Ambassadors will conduct awareness and educational outreaches in communities, reach out to women and girls in their area who suffer from fistula, and support them through the surgery and reintegration process. The first training of Fistula Ambassadors will start next month.

Fistula survivors lend a powerful voice to speak out about fistula, and can play a valuable role in championing the issue by reaching out to their communities to help prevent and treat fistula, thereby saving countless

Asenath helps other fistula patients in her region

numbers of women and girls suffering from fistula. Asenath, a fistula patient Uganda Village Project has worked with, has always been an example of strength and hope. At our most recent camp, Asenath echoed the ideas behind the Fistula Ambassador’s Program:

“Whether I am healed or not, I will continue to tell more women about fistula and identify more patients because someone once told me about fistula surgery.  And I can only repay them back by telling more women about free fistula surgery, for no woman should live like that when there is a chance of getting repaired.”

Asenath has had several unsuccessful surgeries, but she spends two days a week traveling to neighboring villages educating people about fistula. It is with this spirit that Uganda Village Project undertakes the expansion of our fistula work by implementing the Fistula Ambassador’s Program in 2014. Community by community, woman by woman—we hope to make fistula a thing of the past. And thanks to this generous grant from the Fistula Foundation, we’re step closer to that goal.      

A new start for Safina

Uganda Village Project (UVP) is wrapping up one of the thrice-yearly fistula repair camps that happen at Kamuli Mission Hospital. We partner with the UK Childbirth Injuries Fund to run the camps that offer a new start to women with fistula. UVP conducts community outreaches to teach rural areas about fistula and identify women who are in need of repair. The UK Childbirth Injuries Fund sends surgeons to support the local facilities and provide surgeries to heal women with fistula.

Safina recovers in the hospital after her repair surgery

Safina, a 25 year old woman from eastern Uganda, is one of those women. She had heard about how important it was to deliver in a health center during her visits to antenatal clinics during her pregnancy. The nurses at the health centers stressed the risk of delivering at home, so when Safina’s labor pains started she prepared to go to the health center. Her husband, however, refused, and took her instead to a traditional birth attendant. Safina delivered her healthy baby after two days of labor, but immediately after childbirth she began leaking urine. Due to prolonged labor, she had sustained an obstetric fistula and leaked for six months. Although devastating, Safina is one of the lucky ones. She attended one of the repair camps last year and is now fully healed from her injury.

Our fistula activities will increase this next year because of a recent grant from the Fistula Foundation. We’re excited for the opportunity to provide life changing surgeries for women, and conduct outreaches that prevent women from encountering fistula in the first place. Safina is proof of the difference that we are making with your help. Thank you for helping Safina be repaired and start a new life.

[Kasambiika 1] A Musical Farewell

It has now been over a week since we left Kasambiika 1. Most of us have already reverted back to our home environments, but we all still hold warm memories of the village. We left with heavy hearts and full stomachs.  After hosting a dinner for the whole community, our VHTs threw us a surprise party, which happened to coincide with the request of another villager who wanted us to attend his house for a dinner party. The Kasaambiika 1 intern team was not afraid of challenges, especially challenges involving food—it's true, one time Raphael ate 5 bowls of porridge then ate a whole egg in one bite! Just kidding that was me—and we ate at all of them. 

Before we get into the lessons and our closing thoughts, we need to make a quick shout out to Mama, the woman who cooked and housed us. Miss ya mama!

Lessons learned

All of us learned a lot about working with different personalities, both within the group and our village stakeholders. We all put aside differences to work together towards our common goal: improving the health of Kasambiika 1 and empowering its residents to make healthy decisions.

One thing we all had to work together on was leaving Kasambiika Primary School with a new paint job. Most of us had left the village by the time this got finished, but Tina was still around and got this picture.

In Lusoga this says wash your hands every day. Before you eat, after you use the latrine, after you play.

Sometimes there are problems that you have to leave behind. Throughout our entire internship we could tell that there were underlying tensions between the health center and the village population. We could not do anything to fix these problems while we were in the village. We did not want to cause more harm than good, and we did not have the permanent presence to make sure everything was resolved. We hope that the UVP staff is better able to mediate between the two parties and work towards a more harmonious health system in K1.

Closing thoughts for the summer

This was our final project for the UVP staff. For everyone outside of UVP and Uganda village life, annotations follow.

0:00-0:59 to the song “Pretty Boy Swag” by Soulja Boi. This song is about our head VHT, Swaga. Swaga made a huge difference in our outreaches for the village. He was instrumental in mobilizing, planning, presenting, and pretty much everything else we did in the village. This is our tribute to him and the other VHTs.

1:00-1:45 to the song “Ignition (remix)” by R Kelly. This song is about promoting birth control in the village. A laysoo is the traditional Busoga waist covering worn by Josie in our video. Pills, depo, and IUDs are all birth control devices that we promote in our UVP work. We only provided the Depo shot once during the internship (Maureen brought it, as the song suggests), but more options are available at the health center. Also, other NGOs like Marie Stopes work to promote birth control in the villages.

2:00-2:39 to the song “Hot n Cold” by Katy Perry. This song (sung by my sister, thanks Naomi!) is a story of a child getting malaria. A baby child was the subject because children under five (and pregnant women) are more prone to getting malaria. Small children's immune systems are not developed, and for pregnant women's immune systems are weakened by the strain of pregnancy. Towards the end of the song we emphasize the importance of prevention and recommend two methods: sleeping under bed nets and clearing stagnant water. We mention misdiagnosis in the song. During baseline surveys we asked what the symptoms of malaria were and we often got answers that corresponded more with a common cold or virus than malaria. While you can still get these symptoms if you have malaria, sometimes when a child or adult is sick in the village it is just a bacterial or viral infection instead. People, especially children, should not take anti-malarials for illnesses that are not malaria.

2:40-3:25 to the song “Call Me Maybe” by Carly Rae Jepsen. This song is about our shallow well request forms. Kasambiika had two boreholes and one shallow well. Water access was a problem in our village, as in many of the other launch villages. We hope that if adequate shallow well sites are found that UVP can start digging soon.

3:25-6:18 to the song “Thrift Shop” by Macklemore. This song covers the lighter side of village life. The first verse is about getting vaccines to go to Uganda, and complaining about having to take Doxycycline as an anti-malarial every day. We were lucky to have prophylaxis, as the people in our village do not have access to the kind of malarial prevention that we could afford. There are a number of other jokes in this song, so comment on this post or send us a question if you want anything else explained.

Miss you Kasambiika! Warm regards from Kampala and America. 

The K1 team

[Kasambiika 2] "Your work will not end with you. We will continue it"

Jambo again from Kasambiika 2!

The last two months has been a whirlwind! And we can’t believe the time has already come for us to leave our beautiful village!

It has been an amazing journey, filled with a lot of love, laughs and a few tears. We feel blessed to have worked with so many amazing people and to have made memories that will last a lifetime!

As part of our good-bye to the community, we threw a large farewell dinner to show our appreciation for their hard work. We were able to thank all our supporters and recognize those whom without we would not have succeeded. We stressed the need to continue implementing health measures and maintaining the dedication the community has shown during our time together. After the formalities were finished, our guests eagerly hit the dance floor! It was great to see so many of our new friends enjoying the rare treat of stereo music!

In all seriousness, our farewell dinner was symbolic of our last two months: fun, happy, a little stressful but surrounded by love and support! It was the perfect way to end our time here!

Our friends in Kasambiika 2 warmly shared some kind words that have resonated strongly with all of us. While words fail to define the experiences and memories we are taking home with us, these come pretty darn close!

“Your work will not end with you. We will continue it.”

“There is a saying that states ‘out of sight, out of mind’. That is not true for us!”

“You come from such great distances to be with us… that is a sign of true love!”

Muzungu, BYE-EEEEE!!!! (for now!)

[Bukaigo] Farewell surprises

After 8 weeks in Bukaigo, it is hard to believe that we are leaving.  These past few weeks have certainly flown by.  It seems like just a short time ago we were still unpacking our suitcases and learning how to tie jerry cans to the bikes (although, granted, 8 weeks later, we are still trying to learn the latter).

We had successful sensitizations involving malaria, where we sold out of our mosquito nets, and HIV/AIDS and STIs, where we went to the secondary school in the village just south of our village and spoke in front of more than 200 students.  They were extremely rambunctious, but it was understandable: it was the end of the day, and they had been studying for quite some time for exams.  Nevertheless, they asked great questions, and they seemed very interested in learning how to prevent illnesses.

We made a very funny video about our summer here in Bukaigo.  It was a huge hit at final debrief.  We had a reputation for being a quiet group, so other interns (as well as UVP staff) were delightfully surprised to see our quirky side.  It was really fun to have interns come up to us and say “I really liked this part!” or “that part was hilarious!”

We said our goodbyes to our village with a song, and then we said goodbye to our VHTs and other leaders with a very nice dinner.  We had over 30 people attend.  Then, on our final night, our village surprised US with a goodbye dinner!  People from all over the village came.  We ate a ton of our favorite foods – katogo, rice, g-nut sauce, pineapple, cabbage – and danced the night away.  Then, our VHTs presented us with beautiful bouquets of flowers.  It truly was an amazing send-off.  It showed that our village truly did respect our work, and that they are already excited about next summer’s interns.

It is certainly going to be difficult to say goodbye to everyone.  After all, living in a tiny three-room house with five complete strangers, you get to know each other pretty well. Although we are all off to different locations in the morning, we know that we will not be saying goodbye for good (hello, Facebook!).  Our paths will certainly cross again, and we’re all looking forward to the day that it does.

[Kazigo A] Hello, can we see your toilet?

Osiibye Otya to all of our friends and family keeping tabs on us all in Kazigo A!  We all feel incredibly busy, but are learning a lot in our short time here.  We find ourselves often wishing for more time to complete everything we have planned. 

As the follow-up team, we have spent most of our time checking up on UVP’s projects implemented last year.  What this means for us is a LOT of house-to-house surveys and mini-sensitizations based on individual need.  Picture this: we come to your house, say hello, and then ask to see your toilet.  Lucky for us, the villagers here are much more welcoming than anyone back in the States! This work requires many long hours walking in the sun, but we find ourselves spending time learning from and building relationships with the Village Health Teams in our four villages.

Along with the sanitation and hygiene follow-up surveys, we have been working on a hand-washing project at the local primary school.  This project has been a pretty cool experience for our team; its objective is to stop the spread of disease by placing children and youth at the forefront of behavioral change.  We were able to hold educational sessions with both the teachers and kids, spend time to help build tippy-tap hand-washing stations by the latrines, and observe their use.  Our team, along with Kazigo B, also started painting a mural on the wall of the school.  Our challenge now is to find an innovative way to create a sustainable supply of soap for the school, as well as ensuring that the hand-washing message actually gets through to the students and that the tippy taps are well maintained. This is something we are still struggling with, and hope to find the best option for Toka Primary School.

Last week, our team held its first sensitization on Family Planning in the village.  We love Kazigo A, and feel pretty lucky to have been given a village that is so interested in Family Planning.  Both the men and women seem well educated on the programs and methods. We held two different sensitizations- one for the women and another for the men. Although it would have been ideal to combine them, this is what made sense culturally and logistically in our village. Most of the women in attendance received the appropriate method after getting a checkup from the nurse who came out to help us. It was great to see so many women who have been attending the quarterly Family Planning sensitizations return for more methods. Holding a sensitization for the men was also a big success, since one of UVP’s goals is to have men play a larger role in Family Planning through gaining a deeper understanding of its importance and the methods.

In the coming weeks, we will be trying to complete as many follow-up surveys as possible, along with retraining our VHTs and holding sensitizations in the villages on the different programs. Another great success has been having such wonderful VHTs to work with, who are so enthusiastic to gain more skills and have made our work in the villages possible. Sending lots of love from Kazigo A and hope that you stay tuned for our next post!

[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!

[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!

[Bukaigo] A Succesful Family Planning Event

BUKAIGO TEAM- Blog Post 2

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!

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.