a summer solstice is irrelevant here

Thanks so much for the thoughtful conversation regarding Gulu. I'm slowly realizing the universality of such ideas and the pervasiveness of the debate among my friends around the world. In spite of having garnered all this wisdom, I'm (surprise!) still conflicted. Nevertheless, I'm fully convinced that it is an important conversation to have, and I'm so grateful that I have some stellar company as I continue thinking about it.

If I did go to Gulu, I'd likely be involved in an IDP project regarding drug packaging and medicine disbursal. Having taken part in a couple of urban outreaches so far, I've noticed that when drugs are given to patients there seems to be a consistent lack of clear prescription directions. What usually happens is that the medicine is placed in a small ziploc bag and a ratio is scribbled on the front, indicating the frequency and duration of time for taking the medication (for example, 1:2:2 means to take one at a time, twice daily, for two days/weeks/months). It's easy to see how such "directions" could be confused or forgotten by the time a patient leaves the site. I'd like to come up with a way to provide clearer directions for the medications, including simple details like, "take with food," or "do not mix with ___." Ostensibly, it seems like a fairly simple task, but my solution needs to be sustainable. Printing out labels for the time I'm here won't be sufficient, nor will be buying a printer that will run out of expensive ink and paper within a very short time. The solution may just require the providers to spend more time with clients, to ensure that they understand how to take their medicine, but I'm skeptical of how realistic this is in an IDP camp or village. Resources are scarce, though given some time I'm hoping to come up with an idea that works for the long haul (as always, musings and ideas are more than welcome).

Last week I went to a regional conference on reproductive health in emergency/crisis situations. It was incredibly interesting to hear so many diverging opinions about how to achieve the same goals; I appreciated the chance to meet and speak to people from the International Rescue Committee, Medecins Sans Frontieres, and countless local NGOs. Because the conference was near June 21st, I remember making an off-hand comment at lunch about how it was the day with the most hours of sunlight back home. It incited some laughter about "those crazy Americans and their counting of sunlight-hours." Clearly, I should have targeted that riveting story at a different audience, preferably one that does not live on the Equator.

I'm back at RHU for the remainder of the week, putting the finishing touches on surveys to be conducted at the health outreaches. I'll be speaking with the clients, providers, and community mobilisers for each outreach, in the hope of getting a rough idea of how RHU is progressing toward the Millennium Development Goal of reducing child mortality through these outreaches.

While all this work has kept me sufficiently busy and intellectually satisfied, I think my greatest achievement thus far has been my recent experience at Ovino, the outdoor bazaar in Kampala: I successfully bartered and bought two pashminas for 3,500 shillings, which is roughly USD $2.50 . In the process, I discovered that I am pretty much the world's worst barterer, as demonstrated by the following conversation:

merchant: "My Indian mazungu, please come here."
me: "Sebo, how much for the football jersey?"
merchant: "10,000."
me: "I'll give you 2,000."
(merchant laughs hysterically, gets his friends to join, mocking of Paula in Luganda ensues)
me: "Fine. 9,250."
(mocking continues, but this time, in reference to the triumphant ripping off of the mazungu)

NB: I learned that a fairer price for a football jersey is somewhere around 5-6,000 Ugandan shillings.

This is a remarkably accurate representation of what happened. I think I'll get better with time. Hope all is well.

the specter of development tourism

At some point in March, I remember reading a post on Chris Blattman's blog and feeling strongly dissuaded from coming to Uganda for several weeks of spring. Upon reading his piece, I gathered that Blattman was explaining the potential (yet, decidedly unintentional) harm one could inflict on a population by engaging in what one of my friends refers to as, "conflict tourism". I suppose that the concept can best be oversimplified by looking at the imbalance between one's broader usefulness and one's personal enrichment, while traveling to areas of the world that are most well-known for their helplessness. While it may seem admirable for someone to want to experience hands-on field work and become exposed to these vulnerable populations in the hopes of learning from them, I guess I couldn't help but wonder, "Who are you really doing this for?" and "Are you going to cause more harm than good throughout the course of your experience?"

I dreaded becoming another college student who traveled to the Equator because it sounded sexy, or foolishly thought she could save Africa in a summer. Like Blattman says,

"...these towns increasingly feel like circuses, and I think you have to ask yourself whether you want to really help out or become part of the sideshow."

After much thought in April and May, I decided that I wouldn't let myself be a part of the problem. I took the mild admonition to heart, and came here with the following mindset: I am someone with skills that are meant to be used by those who know how best to use them here. A concept or skill which I might consider transferable may prove to be utterly worthless in this contrasting environment where I am the most conspicuous component. As such, I guess I could best describe my purpose in Uganda as that of a "tool" (ha).

The whole debate returned to the forefront of my thoughts when a friend asked me if I'd like to travel to the district of Gulu next week with RHU. Gulu is the birthplace of Joseph Kony, the leader of the Lord's Resistance Army, which is the group currently responsible for terrorizing parts of northern Uganda (for the historically curious). Kony is arguably credited for much of the violence and internal displacement in the region, though it truly depends on whom you're talking to here. As a result of this regional instability, there's great need for health services, immunization outreaches, and family planning education. Were I to go to Gulu, I would be a part of these efforts. I expect that I'd work with the nurses to help immunize children, diagnose and treat patients to the best of my ability (which is again, limited as an undergrad). I expect that I could get much more done for my organization were I to remain in Kampala. Yet, it's remarkably difficult to ignore the potentially incredible nature of the experience: I don't know if I'll ever have the chance to see regions of former IDP camps, or help out as part of the UN Food Programme for displaced persons. But doesn't that make me just another circusgoer?

My potential trip would last no more than three days, so I'm really just blowing my impending repercussions out of proportion (i.e., whatever I choose to do is really not that critical, nor will it have any profound impact on anyone else). I'd return to Kampala to continue my job in evaluating current processes and outputs, which is where I think I'm being put to greatest and best use. I guess I'm just unsure about what degree of detraction from these responsibilities will leave me with a clear conscience--if any.

In the end I'm glad I'm experiencing this internal turmoil (though at a reader's expense), because at least now I'm constantly aware of using my time as wisely as possible while I'm here. Also, the silver lining of conflict tourism may lie in its ability to provide perspective for those who will hopefully be in positions to effect change in the future. How else am I supposed to alter the state of things if I never see/hear/breathe/feel what is going on?

At this point, I'm hoping for a pretty amazing epiphany in the near future (I hear there's a full moon tonight, so maybe that will help with the clarity). In the mean time, I'd love to hear any sage advice that comes my way.

jinja (not the weed) and outreaches

I think one of my favorite things so far is my morning walk to buy a newspaper: inevitably, a small group of schoolchildren congregates behind me, and collectively whispers about whether or not I'm a mazungu (which translates from the language of Luganda to, "white person"). Sometimes they erupt into a pretty heated discussion, and I tend to settle the debate as soon as I leave the vendor's stand. One boy seemed a little disappointed by the fact that I was just a visitor, and subsequently asked if I was sure that I wasn't just a really pale Ugandan.

Last weekend, I opted for whitewater rafting instead of bungee jumping when we were in Jinja. Our guide was a forty-year old Zimbabwean man, who shared stories about his hippopotamus-wrestling days as he led us for 30 km down the Nile. In his non-rafting spare time, he was singlehandedly doing everything possible to cause further collapse to Mugabe's economy in the hope that it would drive him out of office. In fact, I'm pretty sure that he spent the past four months in the "money laundering" business. Jinja was beautiful, and the picture below is a view from our point of portage . I'm hoping to go back during a lazy weekend and reconsider bungee jumping.

I'm excited that my project is becoming more lucid as I get a better grasp of the situation here. I've spent the past few days working on outreach visits, which are supplied by UNICEF and orchestrated by RHU. We drive to the slums of Kampala and post up an office, consisting of two benches, a cooler with vaccines, and a duffel bag of generic drugs. For four hours each day, I sat with a nurse as we diagnosed and treated patients as they came to our post. I learned that in order to get babies to take their oral polio drops, I have to make the strangest facial contortion before they'll open their mouths to laugh. I also learned how to give a subcutaneous measles shot, and recognize malaria from a mile away. While I'm almost certain that I'm entirely unqualified to do most of these things, I discovered that it really doesn't matter. Dire need trumps almost all else.

I've spent the remainder of my time researching different types of health indicators in order to write evaluations on the quality of these outreaches. Assessing quality of care is pretty difficult when you have to make immunization cards out of post-it notes, but I'm working on figuring that out. I think I lucked out with my job in that I'm being exposed to both sides of a constantly growing, yet flawed, system. I get the feeling that there is a serious disconnect between the administrators of projects and the actual implementors, and I'm not sure on which side I'd fit best at this point. It definitely makes for some interesting conversation with the doctors here.

My Luganda is getting better with time. I can now ask, "What is your name?" and "Have you been tested for HIV?"

Thanks for the emails, and for checking to make sure I'm still alive. My internet connection is sporadic at best, so I apologize for my delayed responses (though they're actually fairly characteristic of me when I'm in the US, too...). Let me know about life and everything else when y'all get a chance.

politics, prostitution, and a pen

I was smiling for the greater part of yesterday because almost everywhere I looked, Ugandan newspaper headlines celebrated Obama's nomination. As a result of the news, I was stopped multiple times on the street by people who were curious about my opinion of the man and US politics. One woman asked me why the American people are more sexist than they are racist; another man wondered whether it was safe for people to be projecting their hopes and dreams on an inexperienced politician. Most people were excited by the potential for profound policy shifts from a man who can find Kenya (and probably Uganda) on a world map. I'd like to think that the fact that people are paying such close attention to American politics--before the general campaign is even in full swing--can't be a bad thing.

Yesterday, I also went on a site visit to a part of Kampala's red-light district, and sat in on a focus group discussion among a group of commercial sex workers, their "aunties" (the brothel owners and bosses), my coworkers, and a program funding consultant from Toronto. The experience put me on sensory-overload and even as I write about it now, I expect to have trouble extricating my thoughts. The sex workers, who prefer to be referred to as "moonlight stars", had all completed an extensive peer educator training session. They were responsible for going back to their respective communities and educating their colleagues about disease transmission, safe practices, sound family planning methods, and their individual rights. In the middle of the discussion I was left wondering, what rights could they really claim as their own? Prostitution is illegal in Uganda, and law enforcement officials are far from sensitive to their lifestyle. Regardless of what international declarations will claim, are their rights really secure? Sadly they likely are not, but I still think it's important for the women to understand the concept of unalienable human rights. I would think that such mental empowerment is essential to developing the internal motivation to ultimately demand a better life.

I learned that becoming a peer educator was seen as somewhat of an honor among the workers, and that they really enjoyed the training sessions. I was surprised at how open the discussion was: no one (except perhaps the woman from Toronto) seemed afraid of causing offense or asking too much. I had a hard time reconciling my feelings about the "aunties," and our decision to work with them. It turns out that these women act as gatekeepers, and if any of our efforts are to permeate the target population, we have to work through them. The "aunties" spoke very articulately, and I found it slightly bothersome that I couldn't help but like them. They also seemed to be very interested in me, my age, and what I was doing with my life; I'm inclined to think it was because the majority of their workers were around my age, give-or-take a few years. After the session, they said a prayer for me, and invited me to come back soon. I'll try to take them up on it.

I'm in the process of reading some papers on maternal mortality, and community-based reproductive health services. Apparently, surveyed households were chosen by the following method: "the direction to follow was selected by tossing a pen in the air and following the direction where it pointed. The starting household was the one nearest to the starting point." I'm fairly certain this is how I'm going to perform all my future studies. I might just use it to make all life choices from now on.

Finally, I just noticed that the time of my last posting was at a ridiculously early hour (and decidedly uncharacteristic of my normal diurnal habits). I think it's worth noting that whenever I travel, regardless of how long I'm away, I keep the clock on my laptop set to the time at home. It's fairly irrational, I realize, but for some reason I get this twinge of disloyalty if I try to change it. For clarity's sake, Kampala is seven hours ahead of Eastern Standard Time.

finally here

So I suppose that this is starting out purely as an experiment. I'm still not quite sure how I feel about the whole blogging atmosphere. I think that in spite of the bit of hopeless self-indulgence it can bring, it offers a chance to keep in touch with home, family, and friends, who I miss dearly. I hope you're all doing well and staying safe wherever you are. As far as the blogging goes, we'll see how things pan out.

After 67 hours of transit and layovers, I arrived in Kampala last Saturday. The city is far more developed than they had described it to us back in New Haven. Everything is so wonderfully green, and the city is situated among 7 hills (from where it derives its name). Adjustment hasn't been awful, and I've discovered that going without Internet for extended periods of time is pretty liberating. The city is more of a melting pot than I expected, with large pockets of minority groups spread pretty evenly throughout our area. I suppose part of our regional diversity can be explained by the welcoming back of portions of the Ugandan population (South and Southeast Asians in particular), who had been formerly expelled from the country by Amin.

I started working at Reproductive Health Uganda (RHU) on Monday, and have been assigned to work on two projects (one more so than the other). I'm peripherally working on a project involving the empowerment and education of commercial sex workers in Kampala. It turns out that nearly 47% of the workers in the city are HIV positive; because of the nature of their work, it makes it difficult not only to combat social stigma in order to effect change on their behalf, but also to garner resources to even begin to address their plight. However, RHU has an amazing project devoted specifically to this portion of the population. My project is focused more on the Children's Millennium Health Initiative. RHU is working on establishing care centers in rural Uganda to address the absurdly high maternal and infant mortality rates. They also work on educating men on family planning, and making sure that the issue is addressed in a gender-sensitive, rights-empowering way. I just started this today, but I'm excited to see where the project goes.

Living with 12 (or so) other Yalies is great. We're from very different walks of New Haven, and have our own reasons for spending our summers in sub-Saharan Africa. Already, I'm developing stronger appreciations for traveling in groups, as well as exploring on my own. I'm also trying not to get run over by motorcycle transporters, or boda-bodas, on a daily basis.

I'm contemplating bungee jumping near the source of the Nile in Jinja, Uganda this weekend. Talk me out of/in to it?

While things are amazing here, I miss home and friends quite a bit. Hope all is well!