Uganda, the Pearl of Africa, was farther away than anything I had ever known. Once I arrived, I quickly learned that Uganda is a beautiful land where wildlife teems, finding their homes among the green rolling hills, forests, and farmland nestled between the red dirt roads. People live simply, both in the city and the villages and have a joy that is infectious, a joy that does not come from belongings or accomplishments, but a joy that stems from resilience, gratitude, and a love for other people. At the time that I stepped off of the plane, I had no idea how much this country would change my life both personally and professionally. The trip was packed full of a variety of experiences, from visiting tourist attractions to spending time at a local university to learn about current research on alcohol and its effects on the Ugandan people.
Before coming on this trip I was unaware of the huge role that alcohol plays in this culture. After the initial shock from the chaotic traffic wore off, I began to notice how many billboards advertised alcohol. In our pre-trip meetings I had learned about these ads, but I was not aware that they were so pervasive. The billboards that advertise alcohol like Budweiser, Johnny Walker Black Label, Captain Morgan, and local Ugandan brands were far larger than any of the other ads and were also in areas with high traffic. Ads like these were unlike any I had seen in the United States. In the US the alcohol ads are mild showing people drinking beer while grilling dinner in the summer. The ads around Uganda showed people having fun, dancing, and even included famous people promoting the alcohol and spanned from the city to the rural villages. There was even a 5k run that was sponsored by a local beer company. It seemed like a dirty marketing scheme unlike any that I had ever experienced.
The closest thing that I could compare these advertisements to are the beauty ads in the US that constantly tell people that they need to look or dress a certain way to be “enough”. I have experienced the harm that these ads cause both personally and by watching other women and girls, in an effort to feel worthy, look to beauty products, clothing, and surgery for fulfillment. After years of this kind of programming, people’s beliefs about themselves have changed, leading to a shift in cultural norms. I see this same thing happening in Uganda, except instead of beauty, alcohol is the focus. Alcohol use has become a cultural pastime for Ugandans, is part of who they are, and no one seems to know why or question it.
I learned during our symposium at Makerere University that alcohol in Uganda comes in various forms, both commercial and locally brewed. Locally made alcohol can come from sugar cane (waragi) or millet (marwa), while empty plastic sachets, unique to Uganda, once filled with alcohol litter the streets. Alcohol use is prevalent in both the cities and the villages.
During my time in the village of Nasuti, I saw a group of men sitting in a circle around a bucket drinking marwa through straws three to four feet long near their huts. There were 10 men and 1 woman surrounding the marwa. I learned that the women often prepare this drink for the men. When I realized what they were doing I waved to them and asked if I could come talk to them. They were elated to have a visitor and were eager to share their cultural practice with me. They told me that they drink marwa every Saturday to “chase the boredom” and offered me some “Ugandan beer” that smelled very similar to US beer. While this group of men drank their millet, other men sat off to the side drinking commercial liquor. Had I not learned about the different cultural practices related to alcohol, I would not have noticed what these men were doing.
Young people make up the majority of the population in Uganda, and alcohol use is high among youth and young adults living in the city of Kampala. I learned from Dr. Swahn’s research that male youths living in the slum areas tend to drink more than females, but when the female youths endorse drinking, they are more likely to drink heavily. Alcohol use also leads to numerous health problems, including HIV, violence, and depression. When people drink, they are more likely to engage in risky sexual behaviors, these behaviors put people at a higher risk for contracting HIV. Alcohol use is also a risk factor for sexual violence, non-sexual violence, and unintentional injuries. Boda bodas, a kind of motorcycle, are common modes of transportation around Uganda. Many times, the boda boda drivers are under the influence of alcohol; this increases the likelihood of injury beyond that experienced in the already chaotic traffic.
Consistent use of alcohol often creates a dependency, leading to substance use disorder. In Uganda, there are not many resources for people with substance use disorder to go to get healthy. During our trip we visited Butabika Psychiatric Hospital, the only government funded hospital of its kind in Uganda. This hospital served people with all kinds of psychiatric disorders, including substance use disorder. At this hospital, there are separate wards for men and women, for severe cases, less severe cases, and for people with additional physical ailments. While the majority of the wards are separated by gender, the substance abuse ward is predominantly men. During our visit there were no female patients at the substance abuse ward. During our visit I learned that a large portion of Butabika’s resources goes toward services for the substance abuse ward. The way that these resources are allocated shows just how big the problem of alcohol use is in this country. Despite the efforts of the hospital to provide healing for their patients, there is a stigma surrounding Butabika and its patients that prevent people from seeking the help that they need. There is a huge need in Uganda for services to treat and rehabilitate substance use disorder.
While there are few organizations that work to treat and prevent substance use disorder, we met with a man working to make a dent in this mountain. Bill Bekunda, a man recovering from substance use disorder, told us his story of how he became an alcoholic. Bill started drinking alcohol because his friends were doing it. At a young age alcohol use slowly started to take over his life. His once high ranking in school quickly fell and he became trapped. Bill eventually decided to check himself into Butabika Hospital and it was there that Bill started his healing process. After Bill finished his time at Butabika, he realized that he could use his story to help prevent other people from experiencing the same pain that he went through. He decided to start an organization that helps to rehabilitate people with substance use disorder and aims to prevent substance use disorder among youth by visiting schools to share his story. Bill is one of the only organizations in Kampala that focuses on preventing substance use.
Alcohol use also impacts more than just people consuming it, it also impacts the people who make it. The village of Kakira is home to a sugar cane factory. Some of this sugar cane is used to make homemade alcohol called waragi. This alcohol making is the primary source of income for the families in this village. The women in Kakira are the backbone of the community; while the women brew the waragi from start to finish to provide for their families, the men, if they are around, are often drunk and unproductive. The process to produce waragi is dangerous and harmful to the health of not only the people brewing it, but also the people who are in the vicinity that smell its fumes. Many of the women in Kakira had problems seeing, and the majority of the kids looked sick because of the brewing process. Despite all of this sadness, the women and children were so joyful to see and to welcome us. The joy that radiated from the women and children in Kakira, despite such heart wrenching circumstances and experiencing so much loss, gave me more than I could have ever given them in material goods. These women and children were resilient beyond measure and were filled with joy as they loved us like we were part of their own family. The women and children in Kakira inspired me to rejoice in all circumstances; they showed me that spiritual poverty is far worse than physical poverty. My heart was forever changed by the sweet people who call Kakira home.
This study abroad experience, the women and children in Kakira, and the other organizations we visited not only impacted me personally, but also influenced my future goals and professional aspirations. Before I left for this trip, I was certain that I would want to take a job in Atlanta. While earning money was not my primary focus, I had a selfish motivation for achieving goals; I wanted to achieve things for my own personal gain. After experiencing the culture, the people, and how the organizations in Uganda work to improve the health and lives of Ugandans, I feel called to join in the fight, but now, not for my own gain. I was blown away by how Dr. Swahn’s research was applied directly to Uganda and the youth she surveyed, and I was shocked at how welcoming the people of each organization that we visited were; they all wanted us to come back to visit and join in their cause. Professionally, I have had a heart to do research, but also feel a pull to get my boots on the ground and get my hands dirty. Doing research in Uganda, or in another country, would give me the opportunity to get my hands dirty and to interact with the people I want to help. This work could also have a greater impact that could eventually lead to system and policy change. I don’t know what the future holds, but I have committed to being open to new opportunities and to practice choosing to be grateful and joyful like the sweet people of Kakira.
