“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 6^th 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 28^th in the world because they removed the estimated amount of unrecorded alcohol consumed.  But Uganda was 2^nd 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• The major problems with current legislation is that it is OLD & OUTDATED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!

After 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.

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.