Enjoying the local brews

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First night in town, had to get the brew that commons most recommended.
Arguably the most popular brand and brew in the country.
Arguably the most popular brand and brew in the country.
When you're anywhere, you must try the local brew.
Thursday night chillin’ at Big Mike’s. We even met Big Mike himself.
There was a promotion going on, buy 4 get 5.
There was a promotion going on, buy 4 get 5.
There was a promotion going on, buy 4 get 5.  How can you say no to that?  I'd be losing money if I didn't partake.
How can you say no to 5 for 4? I’d be losing money if I didn’t partake.
Almost like a mix between a Yuengling and a Heineken.
Almost like a mix between a Yuengling and a Heineken.
A very simple, lite and refreshing brew.
A very simple, lite and refreshing brew.

SOMERO

IMG_2861Today we visited SOMERO, a grassroots non-governmental organization located in Bwaise, a slum in Kampala. SOMERO, which means “school” in Lugandan, aims to empower slum children and young women to lead a self-determined life. They offer education in vocational skills and health promotion among slum girls and young women in order to improve their living conditions and rehabilitation. They also promote education and the protection of human rights in their communities.

IMG_2899We arrived at SOMERO around 10:30am and met Geofrey Nsubuga, the National Coordinator who took us on a tour of the facility. SOMERO has several computer labs as well as a library. Many of the girls who come to the facility are young mothers so childcare is provided. There can be up to 100 students per term and there are two terms per year. 30% of those who come in have addiction issues. SOMERO works closely with Hope & Beyond a private rehabilitation center located elsewhere in Kampala. Later in the afternoon we had the opportunity to engage in some community outreach with HaB bringing awareness to the community of Bwaise about HIV testing and treatment (we’ll get to that later).

IMG_2863 After our tour we teamed up with some of the girls and started cooking our lunch. I worked on preparing the leafy greens known as nakati. We pulled off all the leaves and then rolled them up in banana leaves. Another group worked on peeling and cutting up cassava, yams/sweet potatoes, potatoes and matoke (a kind of banana). The matoke was tightly wrapped up in banana leaves, followed by the potatoes, yams, and cassava. The nakati bundle was then placed on top and then all three bundles were packed into a large pot and placed on the fire. It took about an hour for everything to cook.

IMG_2882In the meantime, several of us were pulled aside and had the opportunity to dress up in East African traditional wear and walk in a fashion show. It took two women to help get me into my dress. My dress was SO beautiful and everyone was so nice! After the show I got caught up in a game I fondly refer to as, “Tickle the Mzungu!” Somehow I ended up being chased around and tickled by about 20 kids. At one point, before the excitement of our new game, several of the kids closely examined my arms. They pulled at my arm hairs and ran their fingers along my veins. They kept holding their arms up to mine for comparison. It struck me as odd that they seemed so interested in the color of my skin but during a group discussion the following day, IMG_2877Maryam shared her experience with one of the young girls. The girl came up to Maryam and said she wished she was Maryam’s color because it was so beautiful. According to Maryam, in many cultures lighter skin is considered more beautiful. It is a shame that beauty can be is based off a single physical feature. Maryam made it her mission to make sure this young girl knows how beautiful and powerful she truly IMG_2869is, something really important for girls from the slums to remember. And that is what SOMERO strives to teach young women, that they are more than where they came from and that they are capable of achieving anything they set their minds too.

Lunch was delicious by the way.  They “made” us eat with our hands, “like Ugandans” but it was what came after lunch that excited me.

After lunch we walked about 20 minutes through Bwaise slum to Kawempe-Kazo where every fortnight an outreach program between with Hope & Beyond and SOMERO is held engaging the community in FREE HIV testing, counseling, and treatment. A temporary tent and benches are set up near the community football pitch where people line up and IMG_2892wait their turn for testing and counseling. Our part was to walk through the surrounding area and “convince” people who were not already up at the pitch to go up, get tested, and grab some condoms. We split up and were paired with girls from SOMERO. I felt more like a distraction walking around with my partner. Whenever she stopped to talk to someone I noticed that they spent more time watching me and nodding along than actually paying attention.

 
IMG_2894Once we got back to the pitch, I got a chance to speak with John Senyondo, an employee of Hope & Beyond.  I was able to ask him questions regarding substance abuse treatment offered by HaB.  HaB utilizes individual, group and drug therapies during alcohol rehabilitation and patients are placed on a strict diet in order to “reboot the body.” Many of the patients are there non-voluntarily and some are even brought in by police.  Alcohol treatment takes about 3 months while other drug abuse treatments last 6 months.  First, drugs are used to draw the alcohol out of the blood to help with detox.  Therapy then focuses on rethinking one’s behaviors and encourages patients to focus on oneself. Counselors work with patients to identify a strength or skill providing patients with another way of connecting with people without the aid of alcohol.  They also teach patients to substitute the time they would have spent drinking to instead do something constructive for themselves and/or for their communities.  Our conversation was cut short because our group had to leave but John and I exchanged e-mails and Facebook information so I can e-mail him if I have anymore questions (which I did).

As we were getting ready to leave, we discovered a stow IMG_2898away sharing a seat with Catherine. Needless to say, I think Dr. White will be checking everyone’s suitcases before we check in for our flight back to the States. Someone might just try and take a little boy or girl back as a souvenir

We started from the bottom now we’re…

IMG_2698 …here in paradise!

IMG_2671Today was the day we had all been waiting for, BIKE RIDE!  GoFreeUganda is a bicycle tour company whose mission is to create employment opportunities to people from all walks of life by offering the best and most adventurous bicycle tours in Uganda.  GoFree trains people from less fortunate backgrounds into professional and reliable tour guides, bike mechanics, and other professional jobs affording them the opportunity to find a way out of poverty.

When pitching this bike ride back in April, Dr. Swahn warned us that it was about 12km over rough terrain and wasn’t something to be taken lightly.  She wasn’t joking.  The roads were rocky and had deep trenches running throughout caused by water erosion from rain.  IMG_2675Before we could start biking we had to get there, there being across Lake Victoria.  We climbed into what is best described as a large canoe from a market port called Ggaba after walking through the fish market and motored across Lake Victoria.  They loaded us into one boat and piled our bikes into another.  Once everything and everyone had been unloaded the fun began.

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I stayed in the “fast” group the whole way (actually I lead the group for much of the ride) and at times it felt like we were celebrities.  As we passed by houses or small communities along the road all the kids would come out and chant “mzungu” which means “foreigner.”  They would wave and laugh as we passed by.  I would wave and say hi, a couple of times I spilled into the trenches and once ran into a bush because I took my hand off to wave, which of course made the kids laugh even more.

IMG_2692Charles stayed busy all day riding up and down the road checking on everyone on a boda boda.  I kept yelling at him because EVERY TIME he passed by I was either walking by bike up a hill or taking a water break.  I SWEAR I was actually biking.  We all got caught in a rain shower, more so than others.  Us at the front caught just the front of the shower and powered through.  The rain was actually really refreshing and cooled everyone off.  For those further back several groups actually were invited into people’s homes to escape the rain.  They played with the kids teaching them “Namaste” and some ballet poses.  I’m actually really jealous that I didn’t get to experience that.  The worst part, besides the three big hills, was the last 1 km.  Being that it had just rained, the last 1 km was down a very steep hill, with a lot of tree cover and was super muddy.  I started going down on my bike but quickly found that my brakes did very little to prevent me from sliding in the mud.  So we all hopped off and very slowly made out way down with our bikes.  Once things flatten out a little, and also after seeing that Jibril was still riding his bike, I jumped back on and pedaled the rest of the way.

IMG_2702TO BE CLEAR, I was the first to arrive at our final destination, making me the champ.  However, Jibril was in front of me, which I was fine with, until he chose poorly and tried to ride through a big puddle and popped his chain.  I slowed down and asked if he was okay or if he needed help, to which he said he was fine and that he knew how to fix it.  So I kept going.  Rachel, Lora, Lauren, Dr. White, Aaleyah, Jibril and I were the first ones to make it to the resort.  The next group didn’t arrive until almost 30 minutes later.  We had biked about 10 miles in an hour and a half, according to Dr. White’s GPS.

 

IMG_2720Our final destination was Lake Side Resort and it was gorgeous!  I’m no poet, so I’m just going to show you how beautiful this place and view was.

 

 

 

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It’s a toss-up whether we were lucky or unlucky not to have to ride our bikes back down to the beach after lunch.  Going down would have been considerable easier than coming up but to save time we all piled into a van, road to the beach and got back on our big canoes.

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We were on our own for dinner and because we were so tired, Rachel and I stayed at the hotel and ordered food at the bar.  I think it was about 9:30pm when we started yawning and decided it was an acceptable bedtime.  Rachel said that she had convinced Charles to go for a run in the morning and they were heading out at 8am.  I laughed and said I’ll be dreaming about it from my bed.

Twekembe – “REAL SMILES!”

First and foremost, I SAW MY FIRST UNITED JERSEY TODAY! Glory, Glory Man United!

Charles asked if I would be willing to write an article about his organization Twekembe Slum Project, so part of today’s entry will double as that.

Today 15 Georgia State University students and 3 faculty members descended into the slum of Kampala. Led by Chandia Kato Charles, or better known simply as Charles, is the director of the Twekembe Slum Project (TSP) we visited two schools within two slums.

Our TSP t-shirts, compliments of Charles
Our TSP t-shirts, compliments of Charles

A little background first about the TSP.  Twekembe, as explained by Charles, means “let’s get together and work together.” TSP is a non-profit, community based organization started in 2009 by Charles who set out to engage the community. The organizations vision is to uplift people from poverty and promote sustainable urban development by improving the standards of sanitation and overall welfare of the residents of Kampala slums. This is done through education, work-related demonstrations and enterprising opportunities. It’s mission, to stimulate a sense of insight into all aspects of life, effect change, and influence policies aimed at giving second opportunities to vulnerable groups, such as orphans, youths, widows, elderly, and disabled. TSP also looks for ways to uplift the status of single mothers and ways to help the HIV/AIDS affected population cope with everyday life. TSP aims to engage youths in slums into charitable works aimed at improving their sanitation, economic, social, human and educational status. TSP’s goal is to improve the well-being of mankind and the environment.

IMG_2508A little more about Charles and his volunteers. He grew up in a Naguru slum north of central Kampala. He attended school and received a scholarship for college through rugby. He used to be on Uganda’s National Rugby team. We were joined today by Charles’s half-brother Martin and Michael a young man who credits Charles with help raising him. Both do a lot of volunteer work with Charles and other community organizations.

IMG_2566Our first stop was to Masajja Slum. Masajja is Lugandan for “many men.” TSP is working to build public wells throughout the slums. A community run was organized to help pay for the project and one completed well was funded by Uganda Stove through TSP. Rasta Man met up with us at the start of our walk or rather hike down through the slum. He is a local “celebrity” of sorts who makes films and movies about life in the slum. Another man Mr. Brown or Teacher Brown met up with us and showed us the school he runs and operates at no charge and on a volunteer basis. He teaches the kids English and other basic subjects before they are sent to the larger school.

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The kids sang us a song and we taught them to Casper Slide. Apparently it was the first time they were performed for by visitors. Then the mayhem began. SELFIES!!! Whenever I pulled out my phone to take a picture the children swarmed to the point of violence to get into the photo. They LOVED seeing themselves on our phones. They all kept coming up to us and saying, “picture?” or “selfie?”

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IMG_2567On our way out of the slum I asked Dr. Swahn if there was any place in Kampala where we could develop some of our photos and give them to the school. She loved the idea and I believe that outing is being planned. I also asked how much it would cost to have a few more benches made for the classroom. She said that a bench would be pretty inexpensive. I’m hoping that at the end of the trip if anyone has any Ugandan Shillings left over we can pull our resources and donate to the school.

 
Masajja is different from other slums because most of the houses are built out of hand molded mud bricks. Teacher Brown and Rasta Man took us through the build site. Once made, the bricks are transported to market in trucks and sold for 200 USH each.

IMG_2573Next we visited slum name where the “main” school is located. Parents Care Infant Academy has 366 students from kindergarten to Primary 7 (14yrs). There is one teacher per grade with anywhere from ~20-60 students per class. The school is called Parents Care because many of the students are orphans whose parents have died from HIV or other causes or whose father or mother might have died during the civil war in Northern Uganda.

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Before our trip, we collected donations in the form of clothes, tooth brushes, tooth paste, and stuffed animals or “dollies.” We gave one suitcase to Mr. Brown’s school and one to Parents Care.
We had lunch at Coffee at Last very close to Parents Care. Rollex’s are a staple food in Uganda. They are made of rolled chapatti filled with a fried egg, vegetables and cheese. Most of the time they are easily found being sold on the street from carts but Dr. Swahn advised we stay away from those and instead try a Rollex here. It was very filling and a “small” was massive. I also got my first Ugandan Coca-Cola because Michael ordered one and it just sounded good.

Property of Anna Varella and GSU
Property of Anna Varella and GSU

After lunch we went to the Makenya Craft Market. Like most open air markets, it was very overwhelming and I bought EVERYTHING; purses, jewelry, a Uganda futbol jersey, parachute-ish pants, a woven bowl, and other gifts (I don’t want to give anything away ;). In total I spent about 124,000 USH which is approximately $37.50. Before we got off the bus, Dr. White told us not to haggle too much because this market and selling these goods are these peoples livelihoods and to us, $37.50 might not be all that much but to them it might be food and shelter for a week. As we piled back on the bus a surprising number of us said that they even bought things they didn’t really want. Jibril said it’s hard to refuse an old black lady. He came out with a very nice leather framed painting that he said he didn’t really even like but at the time felt he had to buy. I personally found myself buying more things are certain vendors just in order for them to break some of my larger bills. But all in all I like all of my purchases and have made a gift list of family and friends.

Once back at the hotel we were given 45 minutes to nap, relax, shower and change before heading out for dinner and a performance at the Ndere Cultural Centre. Mr. Rwangyezi Stephen is the founder and acted as the MC for the performance. They performed many traditional dances from all over Uganda. It was truly remarkable. Ndere is also a school, so all the performers are also students. They danced for 3 hours and then asked us to join them on the dance floor and when we left, one of the performers was still dancing.IMG_2662 IMG_2628 IMG_2644 IMG_2652

“Wanna be my wifey”

Today was our first “educational” day here in Uganda.  We were supposed to visit Makerere University, however, at the last minute (and by that I mean the day before) the newly re-elected “President” Museveni declared the day a National Holiday and closed all the schools in order to celebrate his inauguration. I put “President in quotations because he is on his 6th 5-year term, having removed the initial 2 term rule and continues to lie about his age in order to stay below the cutoff age.  According to Wikipedia he is 71 years old, however, Dr. Swahn says that might even be too young.

Besides a last minute change in schedule, my day started out pretty normal.  That was until breakfast when Dr. Swahn quietly informed us that Aaleyah and Jibril had discovered bed bugs in their room last night.  They only found four and after inspecting all of our own rooms, NO infestation was found.

So we stayed at the hotel and heard from our two guest lectures, Dr. Naxarius “Naz” Mbona Tumwesigye and recent School of Public Health graduate, Sissy.

Dr. Naz’s lecture was titled “Patterns of Alcohol Consumption in Uganda and Legislation” here are some highlights:

  • Naz and Dr. Swahn are starting an alcohol unit at Makerere University in the Fall. Dr. Swahn received a Fulbright Scholarship to remain in Uganda off and on for the next several years.
  • In 2004, WHO listed Uganda as #1 in the world for consuming 19.4 litres/annum per capita. In 2011, Uganda dropped down to 28th in the world because they removed the estimated amount of unrecorded alcohol consumed.  But Uganda was 2nd in Africa.
  • 57% of male drinker’s report drinking heavily and most people drink in bars and with friends because is it frowned upon to be found drinking alone.
  • A study conducted by Dr. Naz in Kampala found that when someone has MORE children they have a HIGHER odds of drinking. His explanation is that it is burden based and parents drink to feel relief.
  • The major problems with current legislation is that it is OLD & OUTDATED
  • Uganda ranks in the top 10 in road traffic injuries and alcohol consumption has the highest significant association with boda boda (motorcycle taxi’s) accidents.
  • The more alcohol one consumes increase one’s risk of HIV. But while Uganda has had success in the past raising awareness for HIV, alcohol has never once been the subject of an intervention campaign.
  • It is common practice, more so in rural areas, to spend all income on alcohol. Children are sent to live with relatives even though their parents are still alive.
  • At one time, a local bank refused to lend money to men because they would spend it all on alcohol. So the bank would lend only to women and it seemed to work however, an increase in domestic violence was seen and today a man and women can sign together.
  • Law enforcement does not see alcohol as a priority so any current laws related to alcohol sale and consumption are not enforced. There is also a lack of incentive and in some instances a conflict of interest since Police wives are involved in production.
  • “Sachets” similar to CapriSun packets in the States, are filled with alcohol and sold extremely cheap. Some can be up to 50 proof and sell for 1/5 of a US$.

Sissy spoke to us about current alcohol restrictions.

Restrictions for Minors

  • Underage drinkers (<18) are supposed to be reported to counselors or the police. However, this is RARELY done.
  • Outlets (i.e. bars and stores) are supposed to deny sale to minors and while a few places uphold this law, many just want more money.
  • Informal alcohol sale is dependent on the individual

Restrictions for Adults

  • Bars/Clubs are supposed to have set opening and closing hours as well as sale hours. It is common in Kampala for a bar to stay open as long as there are people drinking.
  • Higher prices on alcohol
  • Bars are not supposed to build within a certain distance to a school or church

General

  • Parents will take children to a bar, so the kids grow up thinking consuming alcohol is normal.
  • There is no clinical diagnosis for FASD because there a no experts or people trained in dealing with FASD children.
  • Recently, the police set up a Family Support Unit. It deals with BIG issues (i.e. violence) but as previously mentioned, alcohol is not considered important.

Next we heard from Dr. Swahn herself.  She presented the World Health Organization’s “Harmful Use of Alcohol” presentation.

  • Unrecorded alcohol consumption is VERY hard to determine, which poses a MAJOR issue and hardship in Uganda.
  • The New Alcohol Policy
    • Led by the Ministry of Health, which already is a problem because they can only collect data, study it, and disseminate the results. They have no REAL power to enforce new laws.
    • Swahn has been working with the Ministry of Trade trying to get them on board and involved because “they have teeth!” They regulate and control sales.
  • Alcohol Marketing Research
    • Swahn talked to us about her current research in Uganda. She and her team walked through the slums and picked up empty sachets off the ground, took pictures of alcohol adverts and gps’ed the coordinates around 5 UYDEL (I’ll talk more about this in a second) of adverts.
    • She said that this is sometimes referred to as “garbage epidemiology”
    • She has discovered that when attacking the Ugandan alcohol problem, it is important to think broader in a social context rather than at the individual level.
    • The current “policy” is that alcohol industry should be the only ones in charge of monitoring alcohol marketing.

Uganda Youth Development Link (UYDEL) is Rogers Kasirye’s organization.  While it is really known for its vocational training, Rogers was the first person to bring Uganda’s alcohol problem to light and recruited Dr. Swahn into Uganda.  Dr. Swahn met Rogers about 6 or 8 years ago at a conference where he was giving a presentation on Uganda’s alcohol problem.  At that time UYDEL was serving about 500 kids/month.  Today, they serve 1,600 youths/day!  There are currently no funding opportunities available for alcohol research in Uganda, again, because it is NOT CONSIDERD A PROBLEM!

IMG_2469After lecture, a few of us walked up the street to Café Kawa.  I ordered a Grilled Chicken Salad and passion juice.  The passion juice was amazing.  It was freshly squeezed and there was no sugar added.  The only issue was we were given 1 hour for lunch and an hour after we ordered, we still didn’t have any food.  We were warned about “African time” before we left the States and boy they weren’t kidding.  It’s hard to complain though because everything is made fresh when you order.  Some of the others ordered burgers and curry and everything came out piping hot and freshly made from scratch.

After lunch was set aside for Group Work.  Being in a group of one.  I took this time to make final corrections to my returned IRB proposal and after Dr. White’s review submitted the darn thing.  All I had to do was revise to interview questions so they were more focused on the organizations policies regarding substance abuse treatment rather than the individual’s opinion.  Oh, and check YES instead of NO in one section…don’t get me started.  ALSO, our great and powerful professors invested in 3 interner hotspots.  Another unforeseen outcome of the “President’s” inauguration was that he had the whole internet of Uganda SHUT DOWN!  You don’t know what you’ve got till it’s gone, and that’s all I’m saying about that.

Big Mike's is so popular, they support the Uganda Police.
Big Mike’s is so popular, they support the Uganda Police.

For dinner, we decided to go to a bar called Big Mike’s in Kololo, very near to where we ate last night at The Lawn’s.  On Thursday’s, they host a live band.  Tonight’s band was Janzi Band and according to Charles, “one of the greatest bands in Uganda.”  Service was slow, remember “African time” and there were more alcohol menus than food menus, as pointed out by Samantha.  Maryam and I went halvies on a bucket of Nile Gold because they were having a promotion, buy 4 get 5.  Because we were there for about 4 hours, we got two buckets and each paid for one (28,000 USH which is roughly $8.50/bucket.)  I ordered a Margherita pizza which was actually pretty good, although it didn’t beat the one I got in Salamanca, Spain in 2011.  Finally, the moment I know you’ve all been waiting for, I will give the very short explanation for my title.  It’s the chorus of a Nigerian song the Janzi Band played tonight.  I thought it was such a funny line that I decided to write it down and make it the title of today’s post.

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We are all the King’s wife

We were free till 1pm.  Breakfast is served from 7am to 11am.  I arrived downstairs for breakfast around 9:15am.  Breakfast consisted of sausage, a pancake-ish thing, fresh juice, pineapple and watermelon.

Lora, Portia and I decided after breakfast to walk up and explore the surrounding area.  We walking up to the Barclay’s ATM where Portia took out money and then continued down towards Kapalagala, an entertainment district within walking distance of our hotel.  Last night as we were driving in the Manchester United vs. West Ham game was in its second half and there were people crowded into all the bars.  The game was a disappointment to we United fans but there’s still hope we’ll make it into the top 4!  GLORY, GLORY!

During our walk we got our first experience with local traffic.  There was more foot traffic than expected, however no sidewalks along the main roads forcing pedestrians to walk along the edges of the streets where a 2-foot drainage ditch runs.  Boda boda’s which are motorcycle taxi’s speed by you as you walk, close enough to reach out and close line if you are strong enough.  Not to mention there hardly seem to be ANY traffic laws and cars weave across the road passing slow moving vehicles at whim.  (Sidenote: they drive on the left side of the road.)  We ate lunch at the hotel which consisted of lamb, chicken, rice, and a bean mix.  The adventure started after lunch.

IMG_2400Our first stop was Khadafi Mosque.

On our way, we were stopped by the Zambian President’s motorcade.  Charles told us that he was in town for the Ugandan President’s swearing in that will take place tomorrow May 12th (I’ll talk about that more tomorrow).

Back to the Khadafi Mosque.  It is the national headquarters of Islam in Uganda.  It was a project started by Idi Amin in 1972 but wasn’t completed until the early part of the 21st century.  Our tour guides, Asharof, explained that the mosque is built on a VERY (x5) important spot.  It is where Uganda was born, the first spot settle by the British or Muzungu’s.  Kampala is actually an English word and the city was named by the British.  It comes from “camp” and “impala.”  It is spelled with a “K” because that is how the Ugandans pronounce their “C’s.”  Asharof is a “Usi,” which means he was born in Uganda.  We are “Usa’s” because we were born in the USA.  Simple right?

IMG_2416Before we can enter the mosque we had to cover our hair and if we were wearing pants we had to wrap a scarf around our waists.  As we entered we removed our shoes.  The inside is huge and opens into one giant room.  The walls and ceilings are ornately decorated.  Asharof explains that each part represents a piece of Uganda’s culture.  The Arab Islamic etchings on the columns and ceilings are “symbols of paradise,” IMG_2413the stain glass is European, and the wood itself is a representation for Africa.  Asharof has a very sing-song-y way about him, even when he wasn’t chanting.  He explained that the words are Arabic but the song and accent are Mam-Africa.  Mam-Africa or Mama Africa because we all came from here and he welcomed us home.  This sentiment brought tears to several eyes and touched people more than I think they could have imagined.

Asharof warned us that there would be a test at the end.  The test turned out to be the 380 stair climb to the top of the mosque’s tower.  From up here you can see all 7 hills that make up Kampala.  From the top, it’s clear that all roads in the city lead to the mosque.

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Our second destination of the day was Mengo Palace.  It is the official palace of the Buganda King or “Kabaka” and was built in 1936.  Although the King doesn’t live here anymore, official ceremonies are still held here.  Mengo comes from Mango’s.  The design of the palace is English after the architect visited King George.  No one but the King may enter out of respect.

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The grounds are vast and the men and women who serve the king reside there.  Out front there is a canon that was given to Idi Amin by Gadafi, who was a close friend of his (imagine that.)  The canon is painted the colors of the Buganda kingdom’s flag.  Next to this are the remains of three cars that belonged to Mutessa II, the father of the current King.  Mutessa II was over thrown and fled to England by Obote, one of the first “President’s” of Uganda.  There is a Bentley, Cadillac, and Rolls-Royce.

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IMG_2452The tour took a depressing turn as we walked down thetunnel towards the ruins of one of Idi Amin’s torture chambers.  A lone cow, with impressive horns I might add, seeks some shade from the hot African sun.  It was first constructed as an armory for the former Dictator but when Amin started getting suspicious he began arresting anyone suspected of being disloyal.  It is estimated that he killed 19,000 people in here.  Electricity was used not only to keep people in but also a way to torture and kill them.  His soldiers would take the bodies of the dead to various nearby lakes where they would be eaten by crocodiles.  Obote eventually overthrew Amin and he continued to kill 6,000 people in this place, totally the death toll to 25,000 individuals whose lives were lost here.

IMG_2459We had dinner at The Lawn’s in Kololo district.  A reservation for Madame Swanny and her 22 guests.  This is probably going to be the only “fancy” meal of the trip so I had crocodile cubes in a white wine sauce and sampled my first Ugandan beer Nile Special, when in Uganda right?

 

Before we ate, Timothy Kintu, or Trekking Timmy, gave us a “cultural introduction.”

  • The people of Kampala, on top of speaking English, speak Bantu which came from the Western & Central parts of Africa.
  • There are over 56 languages spoken in Uganda
  • More than 10 natural parks
  • Over 65,000 species of birds
  • There are Mountain Gorillas in the Northern part of Uganda that very closely resemble humans
  • The city of Jinja, “the adventures city” claims to house the source of the Nile.
  • Winston Churchill called Uganda “the Pearl of Africa” a saying that you will see very often in adverts or advertisements and brochures around Kampala.
  • Dancing is a huge part of Ugandan culture
  • Over 90% of the food consumed is organic and mostly streamed
  • Some major cash crops are coffee and tea, though I have heard/read that a cup of coffee in Uganda is hit or miss, but mostly miss.
  • A traditional food here in Kampala is a Rollex, which is made up of a fried egg and vegetables rolled up in a chapati (go ahead and add that to my must try list)

And there ended day 1.  I quickly passed out upon returning to the hotel.

 

2 Planes, 4 Countries, and 19 Exhausted Individuals

We met at the airport at 2:30pm.  I arrive via MARTA and (of course) I’m in the wrong terminal.  I jump of an International terminal bus and tap my foot against the floor for the duration of the 20-minute ride.  My luck continues as I get ushered into the slowest baggage check line.  The lady keeps asking US questions about weight limits and number of free bags.  After about 30-45 minutes we move onto security, everyone’s favorite part of international travel.  As our luck continues, we again are ushered into the slowest moving line through security and my carry-on bag is pulled out for further inspection.  Dr. Swahn has asked that we meet up at the gate by 4:30pm.  Our flight is scheduled to start boarding at 4:45pm and depart at 5:40pm.  4:30pm comes around and I’m still standing at security waiting for them to further inspect my carry on.  Like most people whose bag is pulled aside, I’m racking my brain trying to figure out what in there could have possibly caused alarm.  The TSA agent finally gets to my bag and asks, “Are there any sharp objects in here that could stick or cut me?”  The correct answer of course is NO but silly me I’m thinking, “Well the magazines could give you a paper cut…”  She wipes a piece of paper on the Yoder’s Red Hot and Candy Raspberry bags, tests the strip for what I assume was explosive residue and zips up my bag.  GOOD TO GO.

The plane ride proceeded like any other.  I had taken some NyQuil while waiting to check my bag so by the time we boarded the plane I was feeling pretty darn good.  I don’t exactly remember taking off from Atlanta because I passed out pretty quickly after taking my seat.  I woke up for dinner which was a vegetarian pesto pasta and then dozed off again for a couple hours.  I woke before reaching Amsterdam and watched Deadpool followed by Ride Along 2.  Have you ever watched a funny movie with head phones in when it’s completely inappropriate to LOL (laugh out loud)?  There were moments during Ride Along 2 where I was crying in my seat from laughing so hard, of course I was trying my best to hold in my laughter so as not to 1.) wake up those around and 2.) look like a complete idiot.

IMG_2387We arrived in Amsterdam for our roughly 2 hours long layover.  It was around 6ish am (I think) and I was HUNGRY!  I grabbed a panini and orange juice and we sat on the floor by the windows at our gate.  Again I slept the first part of the trip from Amsterdam to Rwanda, where we stopped to drop off passengers, clean the plane and probably refuel.  When I awoke I watched Ronaldo, the documentary on my beloved Cristiano and then started watching a documentary on Michael Owen a Ballon d’Or winner and one of the youngest players to ever start for the England International team.  We stopped in Rwanda for about an hour.  We didn’t get off the plane or really even leave our seats.  The flight from Rwanda to Entebbe, Uganda was only about 45 minutes enough time to rise to cruising altitude just in time to start our decent.

IMG_2394We were a little early arriving to Entebbe, around maybe 11:30pm.  We went through customs, paid our $100 visa fee and collected our baggage.  Our driver Joffrey (who is AMAZING btw and I will describe him more later one) was waiting for us in the parking lot.  Because we had 25+ suitcases we ended up having to hire a taxi because not all of us could fit into the bus after stacking the suitcases in the back.  Dr. Swahn, Rachel (Dr. Swahn’s doctoral student) and I got to ride in the taxi. IMG_2393

 

 

I sat next to a Ugandan woman on the flight from Amsterdam to Uganda.  She was very nice and answered all of the logistical questions.  One of my questions was “How long the drive was from Entebbe to Kampala?”  She said that it could take anywhere from 45minutes to 3 hours depending on the traffic.  I had read in my guide books leading up to the trip that Kampala traffic can get REALLY congested, think D.C., LA and Atlanta COMBINED! (more on that later).

However, arriving close to midnight on a Monday had its advantage there, the ride was about 45 minutes and no traffic.  We got to our hotel, the Landmark View Hotel, around 12:30am.  We unloaded our suitcases and headed to our rooms.  I quickly passed out while other’s the next morning said they had a harder time because Kampala is 7 hours ahead on Atlanta so at 12:30am here it’s 5:30pm there, not quite bedtime for most.

Sidenote: I sleep under a BOSS ASS mosquito net.

IMG_2395

 

“You WILL Survive”

Brazil Blog Title Page
2015 blog title page

Last years trip to Salvador, Brazil felt more like an educational vacation with my two best friends

Flashback with Naomi and Anu
Flashback with Naomi and Anu

and I will never forget the amazing people I met.

My Mãe and her "real" son, Andre
My Mãe and her “real” son, Andre
Simone, our AMAZING tour guide
Simone, our AMAZING tour guide
Freddy (Fre-jjy) because g's are pronounced as j's in portugese
Freddy (Fre-jee) because g’s are pronounced as j’s in Portuguese
It's like the beginning of an epic joke. What happens when 7 Brazilians and 9 American's get together...
It’s like the beginning of an epic joke. What happens when 7 Brazilians and 9 American’s get together…

 

Today (currently) Dr. White has Skype-ed me into the MANDATORY Study Abroad pre-departure meeting for students travelling to both Uganda and Brazil.

Our May 4th Study Abroad departure meeting
May 4th Study Abroad pre-departure meeting

You see I am logged into the Uganda trip’s Brightspace and I have the Powerpoint lecture open (please ignore the Game of Throne’s tab.)

Now if you (meaning Dr. White) happen to read this post in the future…I was/am paying attention, really I was/am.

1.) Inside out is a GREAT movie

2.) Small vs. Large napkins

YOU WILL SURVIVE3.) Dr. White has quite the sense of humor.  As she was reading through the Powerpoint she casually read “You will survive…” paused, thought about it and chuckled.  She turned to the rest of class and said, “TRUST ME, I and NOT losing ANYONE on ANY TRIP. So you WILL survive!”  Thanks Dr. White, good to know.

4.) Etic and Emic.  On a side note, I actually did read the pre-meeting articles and while I truly enjoyed the paper on Photovoice the paper explaining the difference between Etic and Emic points of view gave me a headache.  I had to break the article down into 3 parts and spread out my reading over 3 days.

5.) “First, do no good.” A good starting point for any US study abroad student.  While you may think you can help, we are first and foremost there to LEARN.

(The meeting continued after this but I think I made my point.)

A new year, a new trip, a new title.
A new year, a new trip, a new title.

It is a tradition in my family whenever I have a trip coming up my Papa gets me guide books.  I was so prepared after reading through all 3 that when I went to my pre-departure physical I surprised the doctor with a list of immunizations I already had and what I still needed; her response, “I love Public Health students.”

“Two of the Four of the Seven”

I have been fortunate in my life to have been afforded the opportunity to travel.

My first trip across the pond (so to speak) was at the young age of 4 to Italy.  Although I don’t remember everything about that trip there are several things that have stuck with me; 1.) My introduction to cinnamon toast.  2.) Throwing a temper tantrum at the Colosseum because I wanted to go to the petting zoo across the street.  3.) Not being able to wrap my head around the fact that the “statues” at Pompeii were once living, breathing human beings.  And 4.) Italians are CRAZY drivers with whom you NEVER make eye contact.

Since then I have been to Mexico (twice), the Bahamas, Venezuela, Costa Rica (and sort of Panama), the Dominican Republic (almost Haiti), Spain, Brazil (last year), and finally Uganda (now).

In this blog I will have documented my trips to Salvador, Brazil and Kampala, Uganda; two countries, in two different continents, from the four continents I have visited out of the seven total.

Study Abroad Trip to Kampala, Uganda

Program Description:

The program is aimed to provide an educational, applied, and cultural opportunity for up to 15 students interested in public health research and practice in the epidemiology of alcohol use and alcohol-related harm (including violence, injuries, and HIV) in Uganda. Students will be introduced to information about public health issues from a global perspective. Through mentoring and hands on experiential activities, students will gain invaluable knowledge and skills that will augment their academic preparations at GSU.

The program develops coursework around the global epidemiology of alcohol use, particularly in vulnerable populations. The course will place special emphasis on the structural drivers of alcohol use and alcohol-related harm including injuries, violence and HIV primarily among youth and young adults. Instructions will be provided by GSU professors and professors at Makerere University in Kampala, as well as by local Non-governmental Organizational partners who work in the alcohol prevention field or health promotion more broadly. Our key collaborator, the Makerere University is a flagship university in Eastern Africa. The university is considered highly prestigious and is very research active with substantial research funding from the U.S.

Course Description:

The course will present issues in contemporary alcohol epidemiology research and examine alcohol use and alcohol-related harm among vulnerable populations. The course will allow program participants to explore and understand these issues in a global context, particularly, as related to the Ugandan population in Sub-Saharan Africa.  In addition, it will examine the intersection of three major epidemics (i.e., alcohol use, gender-based violence, and HIV), particularly among women, and appropriate prevention strategies and policy initiatives.

I will be using this trip as my practicum opportunity and will be conducting my own research outside of the group.  

Practicum Title: A comparative analysis of traditional healers and Western-trained practitioners in the treatment of substance abuse in Kampala, Uganda

Proposed Dates:  from 05/08/2016 through 05/31/2016

Location: Kampala, Uganda

Practicum Description: (Describe the nature and scope of the proposed project)

My practicum experience will be to utilize my MPH knowledge to conduct a small comparative research project in Kampala, Uganda aimed at understanding the impact of traditional healers and Western-trained practitioners in the treatment of substance use in Kampala.

The ratio of individuals to traditional healers in Uganda is 290:1 compared to 10,000:1 ratio for Western-trained practitioners in urban areas and 50,000:1 in rural areas.  Roughly 80% of the population rely on traditional healers for a variety of reasons; they are more readily available, affordable and are accepted and trusted by the communities in which they live.

During the Spring Semester, I will conduct a literature review and annotated bibliography.  Based on information gathered, I will create questions to ask hospital or rehabilitation personnel and traditional healers.  Most questions asked will be the same, however, I reserve the right to tweak questions or add new ones as interviews progress.  I would like to begin an e-mail correspondence with Mutaawe Rogers, Dr. Swahn’s close contact in Uganda.  I would like to ask for his help identifying and contacting tradition healers in the Kampala.  I have found it difficult to identify Traditional Healers via the internet and would like to set up interviews prior to departure.  If necessary, I may have to voyage out in the first few day of the trip and organize times to visit and interview healer.

While in country, I will conduct an environmental scan (documented with pictures) of alcohol propaganda.  I will look to see how alcohol is marketed and towards what populations propaganda is geared.  I will also do a scan for informational bulletins describing signs and symptoms of alcohol abuse and available treatment options.  I will visit two hospitals, Mulago Hospital (public) and International Hospital Kampala (private).   Interviews will be conducted with both hospital personnel and patients (if allowed).  Interviews with personnel will target policies regarding admittance and treatment of individuals who present with alcohol abuse related problems.  Interviews with patients will focus on why they chose a public/private hospital.   I want to visit a public and private hospital to account for all possible uses of western medicine to handle alcohol abuse and hear reasons why people visit either/or.  I will also visit two substance abuse rehabilitation centers.  Hospitals offer medicinal help in emergency situations but rehabilitation centers work with individuals who have identified that they have a problem and are seeking treatment.  Hope and Beyond uses western medicine while Serenity Centre applies a holistic approach in treatment.  I will conduct interviews with both personnel and patients (if allowed).  Interviews with personnel will focus on policies while interviews with patients will be focused on personal beliefs, why they chose the specific facility and whether they have found it successful.

The data being collected will be qualitative.  During interviews I will take notes and I will also record all interviews, if granted permission by interviewee.  I will then transcribe all records and identify common themes in responses.

From this practicum experience I will have the opportunity to practice interviewing, conducting qualitative data analysis, and developing relationships with health care providers and community members.  Gaining research experience in Africa is important to me because I would like to work in Africa conducting more research and tracking disease after I graduate.

Final Reflection Paper

I enjoyed hearing from the Graduate Students our last day at UFBA. I am an Epidemiology concentration and my area of interest is in infectious disease, specifically tropical diseases. I really enjoyed hearing about their research into dengue fever and new ideas to monitor and improve reporting. They discussed several barriers Brazil faces involving the reporting cases; such as, no cure and treatment is generic, rest and hydrate. Why would you go to a doctor when the treatment is common knowledge? In Brazil, seeing a doctor could take hours or days to wait in lines and in the US you would have to pay a co-pay with insurance or for the whole visit with no insurance. How do you successfully track a disease when the barriers to care outweigh the benefits?

Our last week in Brazil, we got to experience the thrill of a disease outbreak. Zika virus is similar to dengue fever with similar treatment options. One graduate student was absent during their presentation due to the virus and several girls in our programs had suspected cases. Unfortunately, since zika and dengue have similar treatment options, they also share similar barriers to care resulting in poor monitoring and reporting of the disease. So the next question is, how do we improve surveillance of a disease when going to a doctor is more of a hassle than a solution?

What helped me the most in understanding the difference between collective and public health was the idea that public health prevents disease while collective health promotes health and like Professor Mota said, “to be happy is to be more than healthy.” Collective health encompasses a magnitude of research and policy areas. The first possible step would be listing zika and dengue in the notifiable diseases list, requiring doctors to report cases; however, sick patients would have to go to the doctor in order for their cases to be reported. An earlier step could be developing a community-based education aimed at educating people about mosquito breading and the dangers of standing water. A far off and expensive research option would be improving treatment option by developing a cure or anti-viral drugs to help patients after infection. Taking a collective health approach to improving surveillance of infectious diseases such as dengue and zika, would involve multiple areas of practice; political, ideological, social or economic.

The United States and Brazil differ greatly in certain areas but share many similar problems. I was surprised to learn that Brazil shares similarly high rates of elective caesarian sections during childbirth, organ transplants and electronic imaging usage as the US. I expected more natural births to occur in Brazil; however, Brazil has succumbed to the same over utilization of C-sections. It is not necessarily the mothers who elect for C-sections but the doctors who prefer scheduling births during business hours. The unnecessary and over use of electronic imaging software is a big cost concern in the US and Japan but again it surprised me to learn that it is also a problem here. I think one cause of the increase in unnecessary health care expenditures here in Brazil could be that SUS provides health care coverage to everyone in Brazil and doctors are going unchecked. Doctors get rich by performing procedures and charging SUS or private insurance companies (we have similar problems in the States). In a country of roughly 200 million people, providing universal coverage requires increased monitoring of procedures and payments in order to avoid excess spending.

While Brazil and the US share many of the same cost and care concerns, a major difference in access to care between our two countries is health insurance. Brazil has national health care visiting a doctor is free, however, queues can be incredibly long. The US has private bases insurance, which can be expensive, and still a high percentage of the population is without any form of health insurance making a doctor’s visit very expensive. The collective health options mentioned above are great prevention strategies but a big problem is still visiting a doctor once infected, there is not a whole lot a doctor can do and in Brazil it could take hours to see a doctor and in the US it could cost a lot of money; and for what, the doctor to tell you to go home, rest and drink lots of fluids…that hardly seems worth all the hassle in either country.

I think the US could adapt several aspects of the Brazilian national health care system into our health system. The US is struggling to find a happy medium between public health care coverage and private insurance, while Brazil successfully utilizes both. Private insurance in Brazil is voluntary and picks up where SUS leaves off, but SUS still provides health care coverage to every person in Brazil, citizens and visitors. I personally think a hybrid national health care system is the best option for us here in the US as well. Since private insurance currently covers most Americans, developing a national health care system would provide coverage to everyone but private insurance would still be available to those who want, need and can afford it further coverage. Of course that opens up the argument that health care provided to those with private insurance is better than those under the national health care system. There lies the next step for public health practitioners in the US, making sure access and quality of care is the same between those using public health care services and those who have private insurance, everyone has coverage and those who want or require more can have it as well. I would call that a win-win.

This was my first study abroad program and it wasn’t exactly what I imagined. I knew we would be taking classes at the Federal University but what I wasn’t expecting was to learn so much about Brazils national health care system and from my understanding of their health care system get a better understanding of national history and culture. My favorite part of the trip though was taking what I was learning in classes at UFBA and turning around and asking my host family what they thought about SUS and other government programs. Living with a host family definitely added to the overall experience. It allowed us to take knowledge learned in the classroom and directly apply and question it at home. I think I gained a good understanding of Brazil national health care because in class I learned the policy and good intentions of SUS and at home I was able to get a practical and personal understanding of the pros and cons of the system. Hearing the negative opinions from my host family was surprising because everything we learned in class about SUS sounded good and promising. Sometimes good intentions and policy can be lost during implementation and utilization of a program. This realization shows me the importance of program evaluation. Just like any program or policy implemented SUS the successfulness and positive/negative feedback for a national health care system needs to be evaluated. Only through evaluations can improvements be made resulting in a better and more successful program. The voice of the people is important when it comes to national health care. Everyone has different needs and wants; it is important that the government listens and makes corrections as necessary.

Public health aims to prevent disease while collective health wants to prevent disease and promote health together. Collective health is social movement that encompasses various practices including, political and policy, theory and ideology, social and economic context. The US can learn a lot from the Brazilian national health care system.