Mystery Can Mean Misunderstanding

By Edmund Okiboko, Managing Director

UVP intern Augustine engages with community members at an
HIV outreach in Kamira.

When a woman suddenly died, the mystery sent the community abuzz. The consensus was that she was infected with HIV. Ngobi, the husband she left behind, was distraught and confused, and began to believe their speculations and assumed he was also HIV positive.

Months later, during UVP’s biannual HIV outreach in the village, Nurse Nalwogo learned of this man’s situation and, as a long-time partner with UVP, new she needed to attempt to speak to him. She walked the short distance to his home, less than a 3 minute walk, and said, “kodi” (knock, knock, anyone home?). Ngobi welcomed Nurse Nalwoga hesitantly. After traditional greetings and inquiries of the health of family members and livestock, Nurse Nalwoga gently directed the conversation to the event, visible from Ngobi’s house. With a little more encouragement, Ngobi agreed to go with Nurse Nalwoga to take an HIV test.

To Ngobi’s surprise, he tested negative for HIV. He was not convinced of his status by this one test, so he pursued another one the following week at his local health center. It, too, was negative! Ngobi was so happy that he visited Nurse Nalwoga at her regular health center in Namungalwe to share the news. The two rejoiced.

Fast forward six months: UVP is conducting the second HIV outreach in the village for the year. Ngobi arrives to the event and immediately seeks out Nurse Nalwoga; her brief visit and encouragement to test has changed his life. The extra 10 minutes she spent seeking him out, patiently explaining the benefits of confirming his status, and educating him on ways to prevent new infections of HIV is how UVP strives to be different. Health is a journey and there are many influences in each person’s story.

“When UVP started working closely with our health center, we have also been able to reach out to villages and interact with the people we serve,” Nurse Nalwoga reflects. By building relationships with nurses at nearby health centers, UVP breaks down obstacles keeping rural communities from accessing health services.

Nurse Nalwoga appreciates UVP’s partnership approach noting that “Uganda Village Project effectively engages VHTs in all its programming and empowers them to refer patients to the health center from an informed point of view.”

She adds, “This has also greatly improved on the knowledge base of community members because they now know where to get health care services hence, making a difference.”

Ngobi’s story has been used with his permission, though his name has been changed to protect his privacy.

Safina’s Journey and Victory

By Maria Gorret Nampiima, Alumni, 2016/2017 Intern Cohort, Nabirere and Kamira

An energetic and confident woman, Safiina sits, smiling, during the education portion of our recent family planning outreach in Bufutula. Pursuing family planning services has not been an easy journey for Safiina: she has struggled with complications from contraceptives, battled stigma from her neighbors, and resistance from her own children.

As opposed to other health interventions, family planning causes the most debate among policy makers, religious leaders, and neighbors. Despite the negative perceptions people have towards adopting family planning methods, the prevailing circumstances in most of the developing countries have left many with no other option: in Uganda there has been an upward curve of contraception use of nearly 20% (Andi, Wamala, Ocaya, and Kabagenyi, 2014). But this increase does not come to those who lack strength.

Safiina, a mother of eight children and one of our clients in Bufutula village, shared her story about why she started using contraceptives. Similar to most women in rural villages prior to the implementation of UVP health programming, she did not want to use family planning services. She had been told falsely that contraceptives cause conditions like hemorrhage and infertility because it destroys the ovaries. Since her family depended on subsistence farming as the only source of income, she and her husband lacked enough capacity to provide basic needs to their children; clothing, education, and medical treatment all seemed out of reach. As a result of having very limited resources, she lost a child. After attending a community sensitization held by UVP and considering her personal situation, Safiina began taking contraceptives.

With 47% of people receiving their information primarily by word of mouth (Population and Housing Census, 2014), it’s no wonder rural women in Uganda do not utilize contraceptives more; nearly half of the information they receive is tainted with bias and subjectivity, which allows misconception to run rampant. UVP addresses this gap with a unique, relationship-based approach. But this takes time. And communities need people like Safiina.

Realizing her influence on her children, Safiina urged her eldest daughter to pursue contraceptive methods. At a tender age of 17, Safiina’s first born dropped out of school and is now a mother to a one-year old boy. Safiina now sees that her children’s lives could be different if she had been in a position to space her children. She wants a better life for her grandchildren.

After trying multiple methods to find the most compatible option for her body, Safiina has settled with a quarterly injection of Depo. Having taken on the initiative to utilize the family planning services, she is not worried about having pregnancies she has not planned for. Additionally, she feels energetic enough to work for her children. Although she has benefited from the program, she claims her husband is not supportive, which can make her contraceptive use challenging to continue. Despite this challenge, Safiina acts as an ambassador for the UVP family planning program.

Community members like Safiina greatly appreciate our partners and stakeholders who work hand-in-hand with us to ensure that we increase access of health interventions to people in rural communities of Iganga. On this note, we call upon all social change agents to come on board to support our programs morally and financially to continue to strengthen UVP’s capacity in addressing social inequities and injustices through facilitating health and well-being of rural communities in Uganda through access, prevention, and education.

Want to help us continue to support Safiina and other women in Bufutula? Make a contribution and specify the family planning program. And follow us on Instagram, Twitter, and Facebook to see your UVP family in action in the villages. Safiina's story has been used with her permission.

She Can Be Both: Farmer and “Musawo”

By Tulibagenyi Patrick, Program Manager, WASH

Her hands are dirty, but not because she hasn’t washed them recently. She’s been working in her garden all morning, like she does almost every day, weeding, pruning, and caring for her small crop. Catherine Namatende from Muira village is a sustenance farmer; she grows food for her family to eat and a little more to sell to cover life’s typical expenses such as health care and school fees. Staying healthy is important to Catherine; if she is too sick to work or if she has to take a child to the health center, her crop can falter and her family can go hungry. There’s a lot at stake.

Catherine also acts as a Village Health Team member (VHT), one of five people in her community dedicated to spreading positive and accurate health messages to prevent illness. UVP works directly with VHTs like Catherine to ensure they maintain updated knowledge and provide support for the work they carry out in the villages. These are the first contact persons in the village and they contribute greatly in disseminating information about health related programs in the villages.

For the past four months, Catherine and her colleagues have been moving around the village talking with neighbors about the need for good hygiene and sanitation, and have helped community members to install hand washing facilities (also known as tippy taps), dig rubbish pits, put up plate stands, and, above all, improving or constructing latrines. In fact, Catherine reported to UVP staff recently that since June, 30 tippy taps have been constructed. More importantly, she notes that she has strengthened her relationships with her community members.

Despite the fact that VHT work is voluntary, Catherine is proud of the respect that comes with her title, and enjoys her new nickname, “Musawo”, or person with health knowledge. She is constantly consulted on health-related problems and she has been in the position to guide community members and also refer them to the health center for further assistance. Catherine is proud to work with UVP; through the training provided, she has acquired more skills and knowledge related to the health problems in her home and she shares her experience with her neighbors.  

Want to help us continue to support Catherine and other VHTs in Muira? Make a contribution and specify the WASH program. And follow us on Instagram, Twitter, and Facebook to see your UVP family in action in the villages. Catherine's story has been used with her permission.

Condom Demonstrations Attract Attention

by AnQuavis Simpson, Cally Braun, Wagaba Brenda, Arinaitwe Emmanuel, Emily Leibo, Christie Tzelios, and Bamwoze Christine

Irenzi interns demonstrating the proper use of a
female condom.

This was a big day for the interns in Irenzi. A few days before the family planning day, Irenzi interns started mobilizing by placing posters throughout the village and verbally inviting people to attend the event at the local trading center.

The day began with mobilization by biking through the village. While mobilizing, Emmanuel met a group of around 10 men in the trading center. These men had eager questions about family planning, so Emmanuel tried to answer some and promised to answer others when they come for the sensitization.

Around 40 women attended the event and the intern team presented their skit which included information about family planning methods and sexually transmitted diseases in addition to discussions with Loy and the Nurse David who answered questions and taught the women about obstetric fistula and cervical cancer.

Although the women were engaging in the sensitization, the men had not shown up, so the interns decided to collect them from the nearby shops and places that they normally gather to spend their leisure time playing games. As these interns were mobilizing, they realized that the men were still resistant and because they thought family planning sessions were only for women. 

If the men wouldn’t come to the sensitization, how could the interns bring the information directly to them in their game-playing environment? The interns quickly brainstormed and decided to request to have the sensitization between two tables of Ludo. Most of men accepted and a few refused but they decided to follow majority vote.

Similar to the sensitization provided for the women, the interns talked about sexually transmitted infections, contraceptive options, and demonstrated condom use. The men were more interested in seeing how a female condom is correctly used, so the interns started with that. Slowly, the demonstrations attracted more men from the trading center. They also educated why men should be involved in family planning and later men appreciated the interns’ efforts.

Interns conducting a soccer match to engage adolescents in a discussion about reproductive health. 

After all the educational sessions, participants were invited to see Nurse David for contraceptive services and cervical cancer screening. As women went for the above services, some interns were giving out free condoms. It was a successful day that the Irenzi team is proud to remember.

To learn more about how we implement reproductive health programming in our communities, visit our website.

Tapping into the Lives of Kamira

By: Jasmine Zhang, Josev Aquino, Maria Gorret

Kamira Intern Team poses with a tippy tap (from left to right):
Josev, Doreen, Kai, Catherine, Maria, and Jasmine

Imagine this: you've just come from the toilet or latrine, your hands are soiled, and there is no running water nor a simple bowl of water for you to rinse off your hands. For those of us that live in countries where running water is ubiquitous, this situation would never cross our minds; however, the case is different for the local primary school where, not only is running water unavailable, but where the local borehole is a significant forty-minute walk away (heavy 20 liter jerry cans not included). And for those who do live close to the borehole, a majority of them have limited knowledge regarding water access and sanitation, such as the simple fact that washing your hands after coming into contact with feces prevents major, life-threatening diseases such as cholera or dysentery. 

Enter the tippy tap. It is small, cost-effective hand washing device constructed from wooden poles, a five liter jerry can previously used to hold milk or cooking oil, a few nails, wire, and string. The jerry can is suspended by wire to the top pole and can be tipped by a piece of wire or string attached to the lid. The string/wire is attached to a piece of wood on the ground, which tips when one stands on it. Thus, when tipped, the can dispenses a small amount of water enough to wash hands. Typically, a piece of soap or a container of ash is tied next to the jerry can. In Kamira, villagers can purchase a tippy tap for 1000 shillings (approximately USD $0.28). 

When we were touring the schools during our second week, we noticed that none of the three schools in the Kamira village had tippy taps. After we conducted our first WASH sensitization at the Kamira Seventh Day Adventist school, where we taught the children the importance of hand washing, treating water, and keeping it clean, we recognized how futile it is to stress the importance of hand washing when they did not even have a tippy tap. So, a week after, we built two for free and consequently, brought a facet of reality to our lesson.  

Our education session, in collaboration with the school, not only served as a motivating catalyst for us to encourage other schools to purchase tippy taps but also provided the schoolchildren with valuable and sustainable knowledge to take home. Up to date, we have built a total of eight tippy taps at the local schools inKamira. Although this seems like a meager amount, we know we've made a difference, albeit small: the kids always sing the "naaba mungalo" (hand washing) song--even when we're not at the schools--and regularly use the tippy taps. Sure, this may seem like only a drop in the bucket (pun intended), but Uganda Village Project has almost three years left to educate Kamira Village, and we've only been here for two months. We've planted the seeds. We're confident that they'll grow.

Profound, Little Conversations

by Yesigomwe Kennedy 

Interns Jessi and Kennedy act out a skit at a family planning
outreach in Muira. Here they are demonstrating just one way
having many children can strain a family.

Sometimes, the most profound moments of a baseline survey are not the ones scripted and choreographed by the data collection tool, but the ones that happen in the little conversations. One day, as I set off with Langa to conduct baseline surveys, we met Hassan, a young man of 28 years from Muira village with seven children between 1 - 8 years. He said, “I don’t want my wife to use family planning because I still want more children.”

Like Hassan, many people mistake family planning to mean that a family simply stops having children. On the contrary, with family planning you can have the number of children you want and gives you the ability to provide for your family based on your specific available resources, ensuring that your child grows healthy, with all the necessities like food, good education, love, and medical care, just to mention a few. Child spacing also considers the health of the mother by spacing births far enough apart to allow a woman to heal properly.

Based on his comment, I recognized an opportunity for one-on-one education. I took Hassan to the side and had a little talk with him about family planning, briefly discussing its advantages and how child spacing supported the health of the mother and the family as a whole. By the end of our talk, he was very interested in learning more about family planning and intended to attend our sensitization the following week.

On another baseline survey day, Langa and I found a group of ladies belonging to a savings group

Team Muira from left to right: Kennedy, Alex, VHT, Jessi,
Langa, Keiko, and Emily

and sparked a discussion about family size with them. It was so amazing to see these ladies energetically discussing the advantages of family planning and sharing scenarios about smaller families compared to bigger families. They were grateful to us for starting this conversation and looked forward to attending the upcoming education sessions.

These little discussions with our neighbors in the village provide a platform for us to create deeper relationships and allow us to better convey how we care about their health. UVP’s approach is more about building relationships and health knowledge which creates a more profound impact and we are happy to be a part of it.

To learn more about team Muira and other interns in UVP's 2017 cohort, check out their bios or learn more about their work by liking us on Facebook.

Stories Reveal the Truth About Health in Bulondo

by Sabrina Warwar and Nancy Fitzgerald

Bulondo team members walking in the village
to collect baseline surveys. From front to back:
Sabrina, Jeanne, Osborne, and VHT Alex

 Team Bulondo is comprised of two Ugandans, one Australian, one Swiss and two Americans living and breathing together in the same house. Like the other UVP teams we have been conducting baseline surveys over the past couple of weeks, and these surveys have become the forefront of learning about the Ugandan way of life. Being able to have a hybrid of culture and personalities has been crucial to our success here in Bulondo, and this has been reflected in our incredible community response during surveys. Surveys have become the windows into people’s lives, allowing us an opportunity to bond, laugh and understand the intricacies of Bulondo’s everyday issues.

Greeting everyone we see has become a way of life, and continually expanding our word bank of Lusoga has proven to be the international interns’ most valuable tool.  As told to us by a Ugandan himself, learning Lusoga and attempting to adapt to the way of life here is a small but powerful way of showing respect.

Sitting down with families, mothers, wives, husbands, and fathers to discuss some of the most pressing issues has opened up more conversations both within and outside of households. The surveys raise questions about HIV, malaria, family planning, obstetric fistula and WASH (water, sanitation, and hygiene). We have also taken the time to ask about other issues people are facing which prevents them from being able to live the best life possible. The realities faced by so many in the Bulondo community has made us incredibly aware of the cycle that allows so many issues to persist. Misconceptions about family planning causes fear and families end up having more children than they can provide for. This financial burden makes it difficult to afford food, and much less an education to broaden the available opportunities. Poverty and lack of education has lead inadequate nutrition making people more susceptible to disease. The lack of job opportunity and job security means people constantly fear becoming sick as they will need to stop working in order to afford healthcare or to stay home. Lack of job opportunities exist even among the educated here in Bulondo, teachers are delayed payment and paid very little  giving little incentive for future generations to pursue an education over quick money making jobs. These are some of the issues that we have identified through our baseline surveys and discussions with community members from all over Bulondo.

It takes time to create a rapport with the community. Nancy
and Sabrina with two Bulondo VHTs listen to stories from
community members while collecting baseline surveys
house-to-house.

 Many people in Bulondo are unaware of the safe water chain: keeping water safe from the source to the mouth. Some don’t know that water from the borehole is not safe to drink without treatment. When we interviewed one particular woman, we asked how she prevented her water from becoming contaminated. She said she had no idea! After the survey, she eagerly asked what she can do to keep her water safe. We had the opportunity to explain that boiling water kills the bacteria that can make her and her family sick. She was grateful to have this information, and we were excited to be working a with a woman who was looking forward to improving her health. Through her initiative and our knowledge, she was empowered to keep her family safe. It was amazing to provide practical knowledge to make an impact on this woman’s life by addressing common misconceptions about different issues.

Here in Bulondo we believe in the power of listening and having a notebook and pen to document and learn from the stories of each person we meet. It is in these stories that answers can be found for a healthier future. That future may not come today or tomorrow, but the first step toward equal opportunity and good health begins with each person’s story, just as we have written ours here in Bulondo. 

To learn more about team Bulondo and other interns in UVP's 2017 cohort, check out their bios or learn more about their work by liking us on Facebook.

The Benefits of Discomfort

By AnQuavis Simpson

Irenzi Team from left to right: Christine, Cally, Emily,
Emmanuel, Simpson, and Christie (not pictured: Brenda).

As my plane landed at Entebbe International Airport, I felt a sudden rush of conflicting emotions: excitement for the upcoming journey yet already missing the familiar faces and places that I left behind. I felt confident to pursue this summer’s public health work but also felt fearful for the the potential obstacles and cultural barriers that I may encounter. Balancing these emotions, I remained calm and recalled my mother’s wise words, “At times comfort can be a hindrance rather than a blessing.” Applying my mother’s knowledge, I realized that in the absence of comfort there is more space for growth. One week into my internship with Uganda Village Project, there had already been moments where comfort was scarce. Driving to Irenzi in a crowded matatu, squished between two people I barely knew, and arriving to a new home which lacked running water, phone service, and reliable electricity—my feelings were far from comfortable. However, bonding with my teammates about previous traveling experiences, our educational backgrounds, and enjoying the scenery around us, I felt prepared to embrace the journey that lay ahead.

View of the compound of the interns' house
in the village.

 Day one in the village consisted of meeting the lead Village Health Team (VHT) member, Paul, and a walking tour of Irenzi. VHTs are government-appointed individuals assigned to specific villages in attempt to improve the health and well-being of their village. The VHTs are equipped with a comprehensive understanding of the village’s culture, events, and chair persons, so luckily for UVP interns, we work very closely with the VHTs. On the village tour, interns were introduced to members of the Lead Counsel and the teachers of two primary schools. As we sauntered through the village, we attracted the attention of a large crowd of children. At first, they gazed curiously and the braver children shouted “Jambo!” or waved cautiously from afar. We greeted them warmly and offered our hands for high-fives and fist-bumps and soon all of the kids were eager to interact. I became increasingly inspired as the villagers’ enthusiastic and generous welcomes reaffirmed my decision to spend the summer with UVP.  It also solidified my desire to work with the people of Irenzi and to improve their health and sanitation. My interests in human connection and relationships, as well as my desire to work on a diverse team to achieve a common greater good will carry me through the coming weeks.

The interns's house in Irenzi village does not have running water
or electricity in order to give interns a better understanding
of the context of the village.

To learn more about team Irenzi and other interns in UVP's 2017 cohort, check out their bios or learn more about their work by liking us on Facebook.

Neither Rain or Hail Stops Surveys in Muira Village

From left to right: Keiko, Jessi, Langa, Emily,
and Alex (not pictured: Kennedy)

On Monday of this week, team Muira woke up extremely excited to begin our second week in the village. We woke up to an amazing breakfast of eggs and bread with Nutella - the Nutella being our prized possession. From there, our team leaders, Emily and Kennedy, headed out on a boda for their weekly meeting in Iganga. Meanwhile, the rest of our team went over the baseline survey in preparation to begin surveying households in the village. The survey asks each household about their general knowledge and attitudes about each of UVP’s program areas: HIV, malaria, reproductive health, and WASH. The responses help us assess the greatest health needs in the community and helps UVP evaluate the effectiveness of the health programs. Around midday, we met up with our VHT, Moses, and headed off. 

It was a beautiful day in the village; the sun was shining, there were very few clouds in the sky, and there was a nice breeze. Jessi asked the first household the survey questions and Keiko the second. As we approached the third household for Langa’s first time giving the survey, a front of cold wind and dark clouds rolled in. After introductions, we quickly moved inside due to the impending storm. Just as Langa and Alex began giving the survey, the rain began hitting the metal roof so hard that no one could hear anything that was being said. As we sat in the pitch-dark room with the doors and windows shut, small balls of ice began flying in through the cracks in the door. We all began laughing as we realized that it was hailing outside. We sat in the home waiting for the storm to pass until finally Alex and Langa were able to finish the rest of the survey and we could continue with the remaining houses for the day.

Now, as we approach the end of our first week conducting baseline surveys, we have all gained new insight about how to best give the survey as well as insight about the lives of people in the village. As all our team members have different backgrounds and experiences, we are each able to contribute something unique to the team, allowing us to gather a wealth of information to the best of our abilities. Now that we have familiarized ourselves with giving baseline surveys as well as adjusted to the slow pace of “Village Time”, our team looks forward to continue conducting baseline surveys as well as begin our sensitizations in the coming weeks.

The intern team in Muira will be collecting baseline surveys to measure the beginning health knowledge and practice of the community. To learn more about Keiko, Kennedy, Emily, Langa, Alex, and Jessi, check out their bios.

The Muira team walking through the
village to collect baseline surveys.

First Impressions by Jasmine Zhang

From left to right: Jasmine, Maria, Doreen, Josev,
Kai, and Catherine

At Nekoli Guest House, where all the interns stayed for orientation, I repeatedly reminded myself that we were lucky to have a shower curtain—no matter how many huge holes it had. I told myself the toilet was nice—no matter that it didn't flush sometimes. Phone service was even a blessing, because, in four days, these simple things would be unavailable.

My first glance at the Kamira house and compound was promising: colorfully-tiled walls, a spacious yard, and a welcoming party of children. But when we entered, it honestly felt dark and hollow. I had never seen so many insects in one place, except for the bug museum I went to on my 3rd grade field trip. And the latrine? If I fell in, I wouldn't even have phone reception to call for help. I think most of us seriously considered (or are still considering) purchasing chamber pots.

However, a week later, after decorating and making the house our own, interacting with the curious children, and seeing, actually, how fortunate we are compared to some homes, I've readjusted my expectations and have come to terms with most things. Over the weekend in the bustling city of Jinja, the atmosphere was dissimilar, foreign, too fast. With electricity, I found myself whisked up in technology and my phone more than with real human beings. I genuinely missed the kids staring at us and giggling on our porch. I had urges to greet the Jinja store owners with "mosiibye motya" instead of "how is your day". After six mosquito bites on one arm, I even missed my scratchy mosquito net. Thus, I came back Sunday and, truthfully, didn't feel any regret or disappointment. Only content, and that it would be the start of a new week soon; we had people to meet, conversations to make, work to do. 

Jasmine Zhang is a sophomore at New York University studying global public health. After completing her undergraduate degree, she plans to pursue medicine. She recently spent her freshman year in Florence, Italy. For more information on the Kamira team members and other UVP interns, check out their bios.

Team Kamira with UVP intern coordinators Keneth
and Tom in the village.

Personalities of 2017 Healthy Villages

by Kelly Child, Managing Director

As we select new Healthy Villages each year, we kick off activities with a series of meetings: first, with the executive committee of the village, and then with the community at large. At the meetings we officially introduce our program to the village and set expectations. 

Each village we work in is unique, and these initial meetings give us a little smattering of the underlying personalities we will learn over the next three years. Below are my initial impressions of the villages.

21 March 2017, Irenzi village, Nambale sub-county

Our group grows to approximately 50 people seated under a mango tree outside the coffin shop in a small trading center within Irenzi. As the Local Chairman (LC) introduces us, he reassures the crowd that I would be willing to eat dodo (spinach-like greens) with the community. Each of the UVP staff members introduces themselves. Although I get through my introduction in Lusoga, Keneth translates for the crowd. My American accent does not serve my fledgling Lusoga well. While Patrick is discussing sanitation and hygiene, a baby defecates 10 feet away from the group. The Health Assistant shakes his head. As I stand to speak, I mention that the rain is coming (Amadi gali kwida! I will speak mangu mangu.) and that I will speak quickly. We round out the meeting with some words from the sub-county Health Assistant, one of UVP's many partners in Iganga District. He works with Village Health Teams (VHTs) and part of his role is sanitation enforcement. He has great influence in the villages. 

23 March 2017, Bulondo village, Nambale sub-county 

With nearly 500 households, Bulondo village is large and widely spread. Because of this, we decide to conduct two separate meetings, which immediately illuminates the fact that interns living in this village will have nearly double the work as they try to implement activities this summer. Due to a slight miscommunication, the VHTs mobilized the community for 4 pm, even though we've arrived for the meeting at 2 pm. So, in typical village fashion, we wait. When the meeting finally begins, we find the community members are a vibrant and lively bunch. Several participants, both male and female, have questions -- mostly surrounding reproductive health. "Do you provide long-term family planning for men?" one male participant asks, and others request outreaches specifically for adolescents. Later, Titus provides a thorough description of the internship program, and the LC comments, "Please know that we do not have guns, but I can assure your (interns') security." His understanding of American security may have been influenced by Hollywood action movies, but we know that his comment about keeping interns safe is heartfelt and accurate.

31 March 2017, Kamira village, Nambale sub-county 

As afternoon prayers finish, community members pour out of the mosque to find us sitting under the tree in the adjacent field. We invite them to join us, but they must first go home to have lunch and so promise to return. After a few minutes, members from Kamira's executive committee arrive. When one member is told that his fellow community members are having lunch and will be joining shortly, he remarks that "they might have gone home, but there is no food there." Because of a drought in December and January, many families are struggling to feed themselves, which makes the need to stay healthy even more acute. The meeting begins with only a few participants, but increases slightly as we move through the agenda. As we cover the most pressing health concerns in their village, someone mentions the lack of electricity in Kamira. Patrick, our WASH Program Manager, keenly responds, "Electricity without a latrine is not development. Build your latrine and electricity will find you." 

12 April 2017, Muira village, Nambale sub-county 

Muira stands out from the other villages because the health issues brought by the community seem more serious. There is a high incidence of malaria, and water access is very poor. There is a burial the day of our first meeting, so only half of the executive committee attends, but we are told that the others are also invested in the upcoming UVP program. On the day of the community meeting, as we wait for things to get started, there are some younger men seated away from the group. Patrick explains to me that in Ugandan culture, it is not appropriate to mingle with your in-laws and that if you wanted to greet them, you should do so a good distance away in a squatting position to show your respect. The Chairperson opens the meeting by asking if community members welcomed health programs, and if so, to clap. There is boisterous clapping five minutes into the meeting and the remainder of the gathering was a continuation of this elation. 

Giving young families a head start

In the past year, UVP added reproductive health outreaches specifically for adolescents. Teenagers don’t always want to attend the same reproductive health sessions that their parents are going to, and yet they have unique questions and needs that we are poised to address. We’re not just reaching young people through these outreaches, though. They are participants in all of our programming. In February, UVP held an HIV and Malaria community outreach session in Mwendafuko village. The focus was on voluntary testing and counseling and encouraging people to know their HIV status, and we took some time to talk to one of the teenage participants.

Kagoda Safe is a 17-year-old father of one child who shared his motivation for attending the outreach. He and his son had both been sick for three weeks, so he came to find out his HIV status and test for malaria. His wife was unable to attend because she had obligations outside of the village and wouldn’t arrive home until late, but he plans to go with her to the local health center to be tested.  

Kagoda talked to us about the challenges he experiences as a young father. One of them is being unable to provide the basic needs for his family, including medical care and better nutrition for his baby and wife. Kagoda and his son both tested positive for malaria and were provided with the treatment, and we talked with him about ways to prevent malaria such as sleeping under a net and how to keep his family healthy. Kagoda was thankful that UVP provides these health and education services in his community. We’re glad that people like Kagoda are getting involved with our programs. We want to reach out to everyone in a community, and it’s even better when a young family can make changes now that will affect their health for generations to come.

Innovation in the village

by Titus Obbo, UVP Program Manager

"Necessity is the mother of invention."
-Plato

Tippy taps are locally-constructed hand washing stations that makes it easier for people living in the village to wash their hands in a place without running water. Re-purposed plastic jugs are hung next to a latrine or living space, and a piece of wood is used as a foot pedal to tilt the bucket and drip water onto your hands. It's a great invention -- but it also runs out of water quickly when used in a public space.

Anna has been an intern two times with UVP, but she's also an entrepreneur and innovator. While working with rural communities in Iganga to promote hand washing best practices, Anna decided to think about how to improve hand washing facilities in order to support public places that have no running water. She innovated a modern tippy tap that can serve hundreds of people per day, perfect for a busy primary school or other public location.

The new design has a larger-capacity tank that refills the smaller tippy tap with water. One of the biggest issues with tippy taps is the need to regularly refill the jug, so this reduces the number of times it needs to be refilled and keeps it full longer.

Tippy taps help to prevent recontamination after washing hands since a pupil doesn't need to touch it. The students step on the paddle connected to the bucket to enable it tip over and allow water to flow. My dream is to scale up this project to all primary and secondary schools in all the healthy villages where UVP has worked in before and the future healthy villages. Coupled by my interest in sharing knowledge with others, part of my plan is to identify local fabricators and train them to begin producing and supply the local markets around Iganga and the neighboring districts.

Right now we're continuing to focus on household tippy taps, but we're pleased that interns like Anna help us innovate and dream of big plans for the future.

Building on success of HIV program

By Kelly Child, UVP Managing Director

For the first time in months, I see faces I haven't seen. Elizabeth, the nurse in charge, and her barely-walking

daughter; Busoga Christopher, a vibrant Village Health Team (VHT) member who offers me lunch upon my arrival; the ever-smiling, HIV positive actor from the drama group gives me a boisterous hug when she sees me. Though I haven't been here for months, I'm welcomed like I'm family.

As the Managing Director, I don't go to the field often; my role at UVP is mostly based in the office. But the warm reception received in the village makes it seem like I'm here all the time.

Following the thorough review of programs we conducted last year, the first quarter of 2017 has been one of implementation and evaluation; a time to see if our ideas for improvement are working or if they need to be reconsidered. Today in Mwedanfuko, it feels like success. We've been engaging our VHTs differently over the past three months, and you can feel their dedication in the smooth-running event, along with the pride in their smiles. Their success is tangible with the multitude of people that arrive before noon (a rarity, as most people are working in their field, especially at the beginning of rainy season).  Due to the increase in early attendance, we were able to serve 61 more people than during the last outreach.

Titus, our passionate HIV and Malaria Program Coordinator, escorts me through the various points of data entry at the event. We've revised the data collection forms to more accurately capture our efforts and, despite a few misunderstandings, have been implemented successfully. Today's event provided HIV testing to 190 people, malaria testing and treatment to 100 people, and, thanks to our new partnership with Musana Community Health Center, we were able to provide reproductive services including contraceptive distribution and cervical cancer screening to the community of Mwendanfuko.

At UVP, we gauge success by witnessing a community assigning more importance to their health with the passing months. By those standards, today was a success!

From outcast to advocate: Janet's story

Janet has a list of names, and it’s changing lives.

Janet is one of UVP’s Fistula Ambassadors. We recently saw her during our Fistula Ambassadors debrief. We hold these twice a year to have the Ambassadors share experiences and personally check in with them about their work. This time, Janet brought a list of five names of women she has identified who are suffering from fistula and on the waiting list for the next repair camp. We asked her how she feels about disseminating information about fistula, and Janet said she’s more than happy to help other women understand the causes of fistula and how it can be avoided. In fact, she’s so passionate about this work that she visits patients at every camp to provide encouragement and dances and sings to make their stay at the hospital more enjoyable.

It's been a long journey for Janet to get to this point. In 1975, Janet had an obstructed labor and needed to be seen by a doctor. The health center was far from her village, and given the bad roads and their transport via bicycle, it took a long time for Janet to reach the hospital. By the time she got there, her only option was a c-section, but the surgery was unsuccessful and Janet lost the baby and left the hospital with an obstetric fistula. She lived with the condition for 35 years. She tried traditional healers with hopes of getting better, but nothing worked and she was isolated from her community. In 2010, UVP’s Fistula Coordinator visited Janet and assured her she could be repaired and rejoin her community. After 35 years of living with fistula, she didn’t take him seriously and ignored the advice, but the idea stayed with her, and after talking with a friend she agreed to try the surgery since it was fully paid for. The surgery was successful and Janet was thrilled to bring back the good news to her family.

Four years after being healed from fistula and nearly 40 years after first living with the condition, Janet was trained as a Fistula Ambassador. Her list of names keeps growing. To date, Janet has identified more than ten women with fistula and encouraged them as they traveled for surgery. Thanks to her efforts, other women won’t have to wait as long to restart their lives. 

2016: Review and Evaluate

By Kelly Child, Managing Director

During 2016, we held a lot of meetings at the UVP office in Iganga: staff meetings, partnership meetings, planning meetings, and, most importantly, SWOT analysis meetings. We used the 2016 - 2018 Strategic Plan, devised in 2015, as a launching pad to analyze and dissect every aspect of Uganda Village Project (UVP). 

Strengths, weaknesses, opportunities, and threats (SWOT) is a simple concept where you take a topic -- or program in our case -- and evaluate each category. During these meetings, we would agree on our greatest weaknesses and best opportunities within each program. From there, we made small adjustments in immediate programming and started developing concepts for additional shifts. 

One of the most notable decisions is something that most people will never witness: a small shift in our human resource. We better aligned similar programs under one person, rather than spread between two or even three staff members. Below are some thoughts from each staff member on the current and future direction of each program.

Keneth oversees all of our Village Health Teams (VHTs) and the internship program. The two main aspects he is looking forward to is the increased accountability of our VHTs and continuing to professionalize our internship program. We’re aiming to formalize reporting procedures for our VHTs and continue development of the Global Health Leadership Curriculum to accompany our interns’ experience in the village.

Patrick will be managing all of WASH (Water Access, Sanitation, and Hygiene) in order to more closely align resources and approach this very important program in a more holistic manner. In additional to a more cohesive approach to WASH, Patrick will be spearheading partnerships. Currently, UVP utilizes partnerships from government and private organizations whenever possible. The fresh approach in 2017 will focus more on collecting partners for our Graduation Fairs and couple that with a farewell sanitation push, also executed by a partner. Patrick muses, “We really want to leave the village with a bang.”

Titus will be taking a closer look at how our HIV and malaria programs interact, specifically with data collection. “Consolidating our health package allow for more efficient data collection and education delivery,” he says. By coordinating our supply requisitions for both programs, we can assist the government health centers to operate more efficiently.

Loy took over reproductive health in early 2016 by adding family planning to her fistula program responsibilities. In addition to adding specific family planning outreaches targeted to men, we are exploring options for expanding our fistula program to serve double the number of women with repair surgeries.

From these SWOT meetings, we are better aware of where we stand and, most importantly, where we want to go. With your help, we can continue to strive to serve our beneficiaries better every year. We greatly appreciate your support thus far and are excited to share with you our future successes in 2017!