Making plans for 2016

By Leslie Stroud-Romero, Executive Director

2015 felt like a great year for Uganda Village Project. You can read more about it in a previous post from our Managing Director, Kelly Child, but we got the chance to do a large survey to determine the effectiveness of our work, we received a record amount of grant funds, and we started dreaming of the future.  

The end of the year is always a good time for reflection, and with all the talk of resolutions, the beginning of the year seems like a great time to think about what’s ahead. We’ve done both over the past few months.

In October, our staff (with special guest Alison, in Uganda for the first time in six years!) met in Iganga to discuss programs, staffing, and other things we want to focus on in the next three years. In November, we did the same thing with the Board of Directors in Portland, Oregon.  As we held both of these meetings, we reviewed what donors and partners have helped us to achieve in the past few years. Every year we become a stronger, more effective organization. That set us up to talk about how we want to continue that growth for the next several years. By combining staff and board feedback, we agreed to focus our efforts on:

• Increasing our income and diversifying our funding sources to be able to grow and reach even more people in the future
• Systematizing our monitoring and evaluation processes so that we can build on project strengths and adjust areas that aren’t as effective
• Getting UVP’s name out to new audiences to grow our donor and partner base
• Continually improving the internship program, especially by offering more options for long-term engagement with intern alumni and adding components to keep our internship a competitive program
• Reviewing our staff and office systems to make sure we have the support we need to run programs efficiently
• Using the large-scale survey to look at where we need to make program improvements and implementing new program areas as needed to offer villages comprehensive support to improve health

These six areas may sound overly administrative and full of nonprofit buzzwords, but at the core of each focus area is the idea that we want to give each community in Iganga the best chance at improving their own health. Increasing our revenue means we can add programs or increase the number of villages we serve each year. Focusing on monitoring and evaluation means we’ll be able to easily share our impact and ensure that each project provides the best outcome for the money spent. Expanding our name recognition means we can partner with other proven organizations or donors to become even more effective. Setting up a well-staffed office in Iganga with strong administrative systems will give each of our programs the support we need to make a difference.

Over the next few months, we’ll be creating action steps for each of these focus areas and they will guide us in our work for the next three years. We’re all excited for what’s in store for UVP. We’re even more excited for the donors and partners who have walked alongside us to help us make a difference in the lives of families and villages in Iganga. It’s a wonderful feeling to receive donations from people who have been faithfully giving for years, as well as welcome new people into the UVP family.

We’re not looking to make drastic changes over the next few years; we’re proud of our work and grateful for the people who have helped us change lives. We simply want to be as effective as possible, and we think focusing on these six areas will help us do that. As we move into 2016, thank you for the support you’ve given to UVP, and we look forward to the year ahead!

2015 year in review: the launch pad

Kelly Child, UVP's Managing
Director, shares about what
we've done in 2015...and
what's next!

By Kelly Child, UVP's Managing Director

Squeezed in to our modest office in Iganga, every staff member of UVP along with Alison, our fearless leader and Board Chair, are sitting focused on Leslie, our Executive Director, while she guides us through the beginning of our strategic planning meeting. This was one of the few moments of quiet during our session. We visited our strengths, explored what was working with our programs, and envisioned our future. 

Although more formal than most, this was only one of many planning meetings that staff held this year. We are laying the framework to make some profound shifts in programming in the coming years with the goal of increasing our efficacy of each of our programs. But these pending adjustments doesn’t mean work doesn’t continue in the meantime. We've done a lot in 2015 -- and the year isn't quite done!

For our fistula program, our partnership with Uganda Childbirth Injuries Foundation is going strong and the Fistula Foundation awarded us a second grant to find, transport, and follow up with fistula patients from Eastern Uganda. This year we provided these services to 46 patients and plan to continue with another camp in February 2016. 

Orrin and Julius, our first cohort of Global Health Corps (GHC) Fellows finished their time with UVP by conducting a follow-up survey in coordination with Iganga District. This survey compared level of education, practice of behaviors, and other public health knowledge areas between intervention villages, ones that UVP had already worked with, and non-intervention villages, ones we have yet to work with. Overall, the level of education and practice of intervention villages was between 10% and 27% higher than non-intervention villages. Our second cohort of GHC Fellows, Ruth and Rachel, will be continuing to refine our monitoring and evaluation processes as well as define and implement communication processes and new elements to our summer internship program. 

Internship this year was very successful! We hosted 40 international and national interns to work in seven villages: 4 launch teams, 1 follow up team, and 2 project teams. One of our launch teams in Nabirere B identified an opportunity to empower young girls in the village by providing a forum to discuss challenges of being a girl in the village, ask questions about health topics, and receive positive support for their future dreams, or just give them permission to dream. Elements such as these are being considered in future programming to provide an even more holistic approach to our Healthy Villages model. 

UVP staff members were not the only ones reviewing and dreaming about the future of our organization. The Board met in Portland, Oregon to review previous versions and draft a new three year strategic plan. From this, we will evaluate the best ways to proceed forward in order to make our programs even more effective. 

All exciting things! 

You see, making changes doesn’t necessarily happen all at once, but then you look back and you see just how far you have gone. We wouldn’t be making the strides we are today without the support of donors like you. Thank you! 

Becoming part of a community

By Rachel Bridge, Global Health Corps Fellow

When we first met Kaudha Nola at a screening before fistula surgery, her eyes and voice told a story of pain and strength. Almost five months ago, Kaudha experienced one of the most painful and emotionally exhausting processes for pregnant women: prolonged labor followed by a stillborn delivery. Kaudha spent hours trying to deliver her third child, but the baby died and the long labor resulted in an obstetric fistula. The condition left Kaudha disempowered and depressed. She became isolated from her community, no longer able to attend church, host guests, or associate with others; Kaudha and her husband even began sleeping in separate beds. Days began to drag on for Kaudha, each one following the same routine of monotony and seclusion.

Kaudha (left) and Loy, UVP's Fistula Coordinator

At the fistula screening Kaudha had a somber strength about her. Over the course of the subsequent camp we witnessed that somberness bloom into hope and, eventually, joy. We visited with Kaudha and her husband, Kiirya Bashir, in the hours before she was taken into surgery. They wore matching shy smiles and seemed surprisingly relaxed. After talking with them it was clear that even before surgery, the camp had already begun to change their lives. This fistula camp gave Kaudha a community of women and caretakers that welcomed her and understood her situation. She and Kiirya spoke with excitement for their future, citing testimonials of successful fistula surgeries and Loy’s support as the sources of their hope. 

We returned to the camp a couple of weeks later to see how clients were recovering. Kaudha and Kiirya were full of warmth and gratitude after a successful surgery and easy recovery. They gushed about Loy’s incredible caretaking and the new life they were excited to begin after discharge.

A few weeks later we followed up with Kaudha at her home. When we reached her village, it took a moment to register that the young, animated woman laughing and waving at us was Kaudha. She was completely transformed: her somber, reserved demeanor replaced with a charismatic, youthful energy. The visit was powerful for so many reasons, but it can be best expressed through Kaudha’s own words.   

“I am so very happy.  I feel like every part of my body is okay now. In the past I would go to the banana plantation with a mat and sit there alone all day and then at night come home and sleep because I didn’t want to associate with people. I even had good clothes and wouldn’t wear them because I feared ruining them. I felt trapped. But even now I can sit anywhere and move around without fear of leaking or smelling or something happening. I go to church, I eat with my friends, I am part of the community again. I feel free.” 

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!

Kasambiika: a VHT with a passion for health

It has been a great summer for every member of the UVP WASH Team in Kasambiika; one that would not have been possible without the help of proactive members in the community. Between mobilizing for events and advocating for UVP’s cause, among other things, the VHTs and other local leaders have been especially valuable to our work. The 10 active VHTs in Kasambiika I & II consisted of motivated men and women, eager to help out our team in any way they could. Naigaga Robinah Kabaale, one of the original two VHTs in Kasambiika II, was one of the most active and valuable to UVP and our team throughout the last two months.

This picture of Naigaga Robinah Kabaale was taken after
our safe water chain sensitization at the Kasambiika II
Catholic Church on 23 July 2015.

Robinah is currently one of six Village Health Team (VHT) members in Kasambiika II, and is 52 years of age. She lives with her husband, Kabaale Edward, and her four children in Kasambiika II -- just down the road from a the Kasambiika Health Center. She is passionate about health and sanitation in her community and throughout Uganda and has always been eager to do work in a health-related field. She began her work in Primary Health Care (PHC) and slowly became one of Kasambiika’s medicine distributors, as well as the government net distributor for the community. In 2013, with the arrival of UVP in the village, the local leader was contacted to hold a meeting with the UVP staff to elect and initiate VHTs to aid in the organization’s work. Robinah was named one of the two VHTs for Kasambiika II, and is now a certified VHT, along with being certified in PHC and Drug Distribution.

She was drawn to the work and mission of UVP because it mirrored her passion for health and sanitation improvement in her village and surrounding areas. This made her very interested in being involved with the interns and staff, seeing UVP as a platform for her to continue working in a field she has come to love. She specifically mentioned Titus and Maureen as two figures in UVP’s staff that were pivotal in her increased presence in the local public’s health. Additionally, Robinah credits UVP for helping her learn a lot more in terms of health -- not just knowledge, but also practical skills she can share with fellow villagers. For example, her knowledge of tippy taps and personal hygiene has grown to the point where she has built household tippy taps for many other homes in Kasambiika. She feels confident in not only helping build, but educating on maintenance and proper usage of this common hand washing facility.

UVP has helped Robinah in meeting new friends and colleagues that share her interests in health, as well as network in health fields throughout the area. She attributes her adept ability to associate and connect with others, a skill we have all witnessed this summer, to her training and experience with UVP. We have all experienced Robinah’s passion, hospitality, and ability to mobilize others to help UVP. Robinah says that the summer interns she has worked with have all been great and she is thankful that they have come to her village to work - despite wanting them all to stay longer.

She has seen increased health in her village since UVP’s Kasambiikan beginnings in 2013, but still sees much more room for improvement in years to come. Despite the fact that UVP will finish the three-year Healthy Village program in Kasambiika next May, she hopes the organization will continue to help out in any way they can.

Robinah has been an integral part of this summer, always attending UVP and other health-related events, as well as her constant efforts to help mobilize for our sensitizations. She is certainly a role model for others! We are very reluctant to leave the village Kasambiika and Robinah, but our experience has not been taken for granted, and we all hope to maintain contact with Robinah and the other members of Kasambiika we have become so close with. We wish Robinah and the rest of Kasambiika all the best with their health and other endeavors.

Kitukiro: The Power of Data and VHTs

A big Jambo (hello) from Kitukiro! We are over half way done and are eager to keep our work rolling. We have completed baseline surveys and were able to survey 98 out of our 160 households. We are very happy we were able to reach so many households in just 8 days of surveying! We were able to analyze the data and pick out myths people had and also realize areas that need further education. We will be using that data to create our sensitizations. We think the data collected shows us a good representation of the education level in Kitukiro.

While we were surveying, we did a lot of mobilization for an upcoming outreach and held our HIV Day on July 21^st. We had a team from St. Mary's join us and were able to have 128 people tested for HIV and 213 people tested for malaria. Many people were able to receive medication and get support. The people of Kitukiro were very happy with our services and we received very positive feedback from the village. We have not held other sensitizations yet and we hope that having a successful health day will help encourage more people to come to our future events. 

Another success for our team has been retraining our VHTs using our own curriculum. Each VHT is responsible for a certain health concern in the village, so it is of utmost importance that our VHT's are informed and help us dispel common misconceptions. Our VHTs were excited about the training. It is our hope that our VHTs are confident in their health knowledge by the time we leave so that they can continue to be valuable assets to the people of Kitukiro.

Also, both our fearless team leaders are ill with malaria causing our team to have to work harder and have better team work to have everything fall into place correctly. We are doing great with that and our team is working very well together!

We are looking forward to further VHT training and sensitizations on sanitation, family planning, and malaria. Lots to do in the next 3 weeks!!

Bukaigo: Community Sensitization

On July 9th we held our first community outreach session in Bukaigo. The focus of this sensitization was on clean water, personal hygiene, and sanitation. In an open forum we taught the community about the importance of the WHO recommended safe water chain, which includes maintaining a clean and sanitary water source, proper transport of water from the water source to the home, and correct treatment and storage of water once at home. We also taught about various common diseases caused by poor sanitation practices such as dysentery, hookworm, typhoid, cholera, and schistosomiasis. We focused on the causes of these diseases, their signs and symptoms, and how to prevent them from spreading. Later in the week we performed a needs assessment in two water scarce zones of the Buvule village. Now that the needs assessments are complete, UVP can assist the community in constructing new shallow wells to make access to clean water easier for community members living in these zones. As we were doing the needs assessment, we realized that because of the far distance to the nearest borehole, many people are drinking untreated water directly from the nearby swamp.

Although our first sensitization in Bukaigo was a success, our first community sensitization in Buvule we had very low attendance by community memebers. It was so disappointing since a lot of effort was put in preparing for it. However, this has helped us plan better for upcoming community outreaches since we learned that the venue we chose was not a good one and that we did not mobilize well enough. We have come up with a better community mobilization technique that will ensure that more members of the community turn up and venues for upcoming outreaches are being chosen carefully. Since learning from our failure in Buvule, our more recent sensitizations have had sufficient audiences.

This past week, we held a meeting with our Bukaigo and Buvule VHTs. We spent part of our time reviewing health information about WASH, malaria, and family planning. Since this is the last summer that these villages have UVP interns, it is especially important that they are well educated on these topics. After clarifying some amusing questions about family planning methods, we collected Most Significant Change Stories from our VHTs and took their photographs. They loved looking at their photographs afterwards! During the meeting, we also planned out our borehole cleanup day and brainstormed some ideas on how the VHTs could continue to promote health in coordination with the health center, including encouraging the health center to start selling WaterGuard and hosting a malaria testing or HIV testing day. Overall, the meeting was a great success and we all left feeling motivated to pursue our new ideas.

Kasambiika: Water Chain Sensitization

         

          Our first sensitization started with ideas from a lantern-lit brainstorming session: Tom would draft an introduction in Lusoga (always a crowd pleaser), our fearless team leaders, Gladys and Debbie, would explain our mission while the rest of us would present on the different components of the water chain. We spent the week perfecting our ricebag masterpieces (a term used very loosely) which illustrated the different stages of the Safe Water Chain: Collection, Transportation, Treatment and Storage.

            With the help of Swaga, the best VHT in the game, we spent all of Monday placing event posters around Kasambiika. Thanks to the hours of mobilization our other VHTs put in, people seemed excited. The night before our sensitization, we stumbled through our translation rehearsal and smoothed out the miscommunications. By our last rehearsal on Tuesday morning, Team Kasambiika was more than ready for our Water Chain sensitization.

           Using information from our surveys from the previous weeks, our main goal was to emphasize maintaining existing water sources, treating drinking water, and keeping transportation/storage containers clean. The only thing we forgot to account for was “Africa Time.” We spent two hours waiting for a crowd to accumulate while enjoying everyone’s favorite game: Twenty Questions. Eventually, there we were, standing in front of 20 women, green UVP shirts glowing, ready to educate on all things water. It was great. Some highlights include Tom’s Lusogan introduction, Sarah and Debbie’s clean water demonstration, and Gladys reminding everyone that “water is your friend.”

            We later found out that our sensitization’s attendance was low because of a death in the community and that the funeral the next day would affect tomorrow’s sensitization as well. Our sensitization for Kasambiika II was rescheduled for the following week. This was unexpected, but nothing we couldn't handle. We paid our respects at the funeral ceremony the next day, which turned out to be more of a celebration of life. People appreciated that we came and we were extremely grateful to have been invited. 

         Despite a couple hiccups here and there, Team Kasambiika held a successful sensitization with a positive response, surely a sign of more good things to come. 

Bukakaire: A busy three weeks

What a busy three weeks we’ve had here in Bukakaire! After finally conquering our bedbug fiasco (“knock on wood”), we finally got the hang of the daily rhythm of village life and our work. Though baselines started off slowly, we quickly picked up speed; we have now surveyed almost three quarters of the households in our village! During our surveys, we also discovered three women with obstetric fistula, whom we will make sure to steer to the appropriate services and our sensitization on obstetric fistula. The villagers have been very welcoming when we visit their homes and have been enthusiastic about responding to our survey. We’ve also collected many spontaneous gifts of groundnuts (a.k.a. peanuts) and jackfruit in the process.

Overall, we’ve found that there is a general lack of sanitation facilities (tippy taps, plate stands, proper latrine structures, garbage pits) and knowledge of and access to family planning/obstetric fistula services. In the next week we will be starting a house-to-house sanitation campaign to tackle these issues. During this campaign we will be helping people build sanitation facilities using subsidized materials. We will also be holding community sensitizations on safe water, sanitation, hygiene, family planning, and obstetric fistula. We are very excited to begin because we feel that we can make a big impact in the community. This week we gave our VHTs a tour of the sanitation facilities we built at our house to provide some visual examples. Their excitement is definitely a good first step!

We also held Water, Sanitation, and Hygiene Sensitizations (WASH) at two primary schools in the community. At first we were overwhelmed by the 500 children sitting in front of us and gathering by the tippy tap. However, at the end of the day, we managed to maintain relative order and were pleasantly surprised by the amount of knowledge they had about WASH. After we installed a tippy tap at the school, a huge crowd of kids formed a line to try to wash their hands with it. We also taught them a handwashing song in the tune of Frère Jacques, and now we are constantly greeted with that song when kids run into us in the community.

We also had our HIV Outreach Day this week. We were presented with a challenge when we discovered that another organization was also hosting a medical camp on the same day and place. Communication with that organization proved to be very difficult; after many efforts we still were still unsure, even on the morning of the event, about what services they would provide, how they would provide them, and how we would work with them throughout the day.

However, we’ve gotten very good at last minute improvisation and flexibility. In the end, everything seemed to click together nicely. We managed to test around 160 people for HIV and 350 people for malaria! We wish we could have done more, because so many people turned up, but, unfortunately, supplies were limited. In the beginning, we were also worried that the medical camp would attract people from other villages and use up our limited supplies. To help prevent this from happening, we and our VHTs worked extra hard at mobilization. We must have done a great job because the people who showed up from Bukakaire far surpassed the people from other villages!

Despite many busy days, we’ve also managed to squeeze in some fun! One weekend our entire team went white water rafting on the River Nile. Anna got thrown into the rapids 3 times, and everyone, except Diane and the Ugandans, got severe sunburns on their thighs. In addition, Said and Joseph had their first cheeseburger. Said said he “had a good time with the cheeseburger.” On Said’s birthday, we also had a bonfire where we roasted vegetables and squishy creamy bright pink hotdogs…”Yum!” Also, we milked a cow! Johnny laughed hysterically the entire time, and the man who owned the cow was very amused with our reactions.

That’s it for now! Tune in later! “Kalee! Mmm…”

Bukakaire Team – Anna, Brittani, Diane, Johnny, Joseph, Said 

Buwoira: HIV Health Day

Hello again from Buwoira! We’re more than halfway through our stay in the village, and time is flying by. So much has happened in these past few weeks, including but not limited to: the implementation of emergency pee buckets, a team trip to Sipi Falls, the sickness and then health of our two lovely team leaders, and the (almost) mastery of our village chores.

But in addition to gaining arm muscle from lifting heavy jerry cans, we’ve also made major progress in completing our work in the villa ge. We’ve finished collecting follow up sanitation surveys and most significant change surveys, hosted a successful HIV day, and have begun focusing on conducting sensitizations in the community, including one at a local primary school.

Our biggest success thus far has definitely been our HIV health day. We were able to test and give results to 162 people for HIV and Malaria, not including children, as well as provide free Malaria treatment, HIV counseling, and immunizations for children. Ainslee and Fiona brought a group of children from our neighborhood to the event so they could get tested for Malaria, and shockingly, 11 out of 12 tested positive. We were heartbroken that these kids we love to play with every day were sick, but we are so glad that they were able to come, get tested, and get treatment. We heard from some of their parents that they have taken their full course of medication, and we’ve all noticed a change in their health as they play on our front porch. The youngest child, called Naka, used to sleep, cry, and lag behind the others, but now she is all smiles, chatty, and full of energy!

Deanna and Ruth watching drama group perform at HIV Day.

 Overall our event was a success. Not only did we test and give treatment to so many people, we also worked with an HIV drama group and completed our first sensitization on HIV. We’re so happy to have reached so many community members!

Ainslee and our neighborhood children, about to get tested at HIV Day.

While our work has been going well, we have also faced our fair share of challenges in the village. For one, we’ve all had trouble dealing with the tragic, sudden passing of our two beloved goat friends: Herbert and Sebastian. The two baby goats and their mother were eaten in the night by a wild dog, and now their brother, Godfrey, runs around the neighborhood alone. Hearing his lonely bleats has taken a toll on us all as we grieve. RIP to our dear friends.

Our VHTs have also brought some other, work related challenges to our attention. In a meeting with the five of them, they told us that they are often not taken seriously or respected by village members during their work. Many villagers are unaware of their purpose and who they are and question their authority when they tell them to make changes in health or sanitation. Our VHTs are essential and help to continue our work when we leave, so we’ve made raising awareness and respect for them a priority. During survey collection and sensitizations, we introduce them to the community and explain their role, making sure people understand their importance. We love our VHTs and continue to be impressed by their knowledge and hard work and hope that we can improve their position in the village!

With only three weeks left, we are all excited to hold more sensitizations and continue to make a difference in Buwoira. Between competitive bouts of Monkey in the Middle, discussions about food, and chapters of our favorite books, we’ll be mobilizing for our next education session, practicing skits, and making sure our local leaders have tippy taps. 

Itanda Primary School sensitization, interns teaching hand washing song.

Toodaloo—Buwoira out! Xoxo

Nabirere A: A successful HIV Outreach Day

         

        This past Wednesday we held our HIV Outreach day in collaboration with St. Mary’s Hospital. While we focused primarily on HIV, there was also de-worming and immunizations for children as well as malaria tests and treatment available for anyone. During these events, UVP provides testing and counseling along with skits performed by a drama group and a sensitization given by our team, The day started slow, “village time” struck again, and the vaccines, de-worming pills and condoms were not available initially. However, everything eventually settled into place and the day picked up when testing began.

            The highlight of the day came in the afternoon when we mobilized with drama group. To drum up extra excitement, we loaded into the back of their pickup truck and danced and chanted, “Nabirere A, awo kumusigiticet!” or “Nabirere A, go to the mosque!” We quickly amassed a small army of children who followed us to the mosque for the skits. The drama group began with traditional dancing and songs about HIV. Some of our team members were pulled into the dance circle, and even though our hip shaking abilities paled in comparison to the drama dancers, the community seemed to really enjoy us and several people have told us they are looking forward to our next show. As much as they liked the dancing, the drama group really captured the crowd’s attention. Despite the “heavy” nature of the topic, the drama group had the crowd laughing a lot. The drunken fool character seemed to be a particular crowd favorite.

            Our team’s sensitization was the last act of the day. We went over the basics; what is HIV, how it is transmitted, signs and symptoms, prevention methods, how to live positively if you’re HIV positive, and a Q&A session. The community asked a lot of good questions, mostly about the routes of transmission. For example, could bed bugs infect people or how long the virus could survive outside the body? Overall, out team really enjoyed the day and we think it was a great success; we tested 148 people for HIV and many others for malaria. We hope the community learned something from the day and our sensitization, but we will be holding other sensitization sessions in the upcoming weeks to reinforce the key messages about HIV.