Week of January 22

I apologize for the month-long break in posts. School work and activities have picked up, so I found myself putting off writing longer and longer until the thought of writing an update for the whole month became too overwhelming. So as a compromise, I'm going to post my practicum journal entries for the past month. I hope they will suffice; in the future I'll try to be better about it!

Here are some pictures of my trip to Sipi Falls a few weeks ago: http://enc.facebook.com/album.php?aid=2005116&l=80038&id=149000028

January 22, 2007

At this point, I think my journal reflections are not going to be as long, since things are starting to become routine. Yet at the same time, I know that I will continue to be challenged in ways I do not foresee and surprised by living in Africa.

This week held two large highlights for me. The first was participating in a rally sponsored by Mama Janet Museveni, the president’s wife, to promote faithfulness in marriage as a way to combat the spread of HIV/AIDS. Prior to the march on Tuesday, 300 couples participated in a conference outlining qualities of faithful marriages and how to make sure they happen.

(Here’s a side note: In Uganda, polygamy is actually a fairly common practice. Simply put, it is not a big deal and is even expected in some areas. Faithfulness to one’s wife is not a highly esteemed quality, either. A man could be married to a wife in Mbale and have a girlfriend in Kampala. Some Ugandans will ask even Charles if he has a Kampala girlfriend. It isn’t uncommon for the wife to know about the girlfriend; it is just a fact of life, apparently.)

About fifteen of the CURE staff took a bus to the Mayor’s Municipal building to march in the rally. After following the parade throughout Mbale, the crowd returned to the mayor’s place and listened to several speeches by government personnel and other local leaders, including someone from TASO (The AIDS Support Organization). The Minister of Health spoke as well, outlining tactics to reduce the spread of AIDS. Finally, Mama Janet spoke, giving the last speech of the day. Her love for Uganda is apparent, and her passion for reducing the spread of AIDS has had a profound impact on her country’s health. She was adamant about faithfulness in marriage and even suggested praying together as a way to promote togetherness.

AIDS, sex, and condoms are simply not taboo subjects of conversation here. Everyone is informed by posters, billboards, and the government of these issues and the measures needed to reduce the spread of this disease.

The second highlight of the week was a trip to Kampala on Thursday. Sylvia, the HR director, was invited to participate in a government workshop debating the implementation of the SHI (Social Health Insurance) Bill. The government presented their proposals, and the FUE (Federation of Uganda Employees) gave their reasons for being hesitant of the implementation of such a bill so soon.

It was very interesting to hear the different sides of the argument and realize how little I know about the workings of health insurance, especially in Third World countries. The Ugandan government has researched the SHI of Tanzania, Kenya, and other countries in similar situations to decide the best route to affordable health insurance for all citizens. The plan, however, is to take 4% of each employee’s gross salary for the SHI and require the employer to pay another 4%. In the end, this could cost employers a lot, since they have to pay the required 4% in addition to possibly paying the employee more to make up for the employee’s 4% cost. The FUE argued that Uganda cannot afford this blow in the private business sector at this point; there is no reason to further cripple an already struggling market.

The government officials and those heading up the SHI bill listened to the concerns of the FUE and agreed to hold another forum to discuss the differences and try to come to a “win-win situation,” as they said. It seemed quite democratic.

At the hospital this week, I made sure to visit more of the departments to better understand all its workings. I sat with Dr. Rita, who does initial diagnoses with the patients, and she explained hydrocephalus and spina bifida as well as the procedures to correct these problems. I think I’m finally starting to understand these well. It’s actually quite interesting.

As I continue to decide my place here and what I need to be doing with my practicum, I am realizing how different social work in Uganda is from that of the U.S. As Sylvia mentioned this week, social services in Uganda are in their infant stages. I am continuing to discuss these differences with the social workers here and trying to decide how applicable the Code of Ethics is here. I certainly don’t want to discount it, but a lot of it just doesn’t fit here. Fighting to adhere to the Code of Ethics would be a futile battle. But I will continue to dialogue with Charles about it as well as with the social workers, and hopefully we will come to some conclusion.