Week of March 26-April 1

A famous American journalist and author, David Lamb, said in his book The Africans that the only time an African is in a hurry is when he is behind a wheel. The Ugandan is no exception. Little wonder then that in spite of having the lowest vehicle per capita ratio in the world, our continent also lays claim to a fatal accident rate that is ten times higher than that of London and New York. Sensible car driving has simply refused to blend with our culture….

Once on the road, what matters most is confidence. Learn to sneer at other drives and in a traffic jam, ask the fellow disputing the lane with you if he just bought his license, unlike you who passed the driving test. When you approach a junction, never leave any empty space in front of you. Whether you can clear the junction or not, enter it anyway. A thick jam will build up on your side. Regard it and nod with satisfaction. Then look behind you in the rearview mirror and behold the nice, long snakelike jam growing longer by the second. Savour this all, take a deep breath and smile. Roll up your windows to close out the impatient hooting as the fellows you have blocked build up blood pressure like yours.

Like the British, we keep left while driving. But that is only while driving on a straight stretch. At junctions, left and right stop making sense – just take the shortest straight line to your objective. Jam on the breaks when you are almost head-on with the fellow from the opposite direction who insists on keeping left. What are brakes for, anyway?

- From How to be a Ugandan by Joachim Buwembo

I thought I would offer you Ugandan insight into the insanity that is called driving in Uganda!

This week was slow; we attended two days of child counseling classes with TASO counselors and then were taught the basics of counseling. On Friday, however, an American study abroad group visited TASO from Kenya, and one girl went to high school with a friend of mine from ENC, Amanda Fish. Another guy in the group attends Boston College, so he promised to show me around when I start attending in the spring. How funny!

On our walk to TASO, Aubrey and I pass a mosque. We’ve heard rumors about camel sacrifices there but had never actually seen the camels. Well, this week we lucked out and got to see two of them! After taking pictures from the road, someone inside the mosque grounds invited us in to take pictures, and the camel graciously slobbered Aubrey’s face.

Since Charles is back home in the States for a few weeks, Aubrey and I have become better at using boda bodas (bicycle taxis with an extra padded seat on the back) and picky-pickies (motorcycle taxis) to travel. We’ve definitely decided to stay away from the boda bodas in town, however, because they don’t have as much control in traffic (yikes!). Don’t worry, all you parents; we’re fine and we don’t travel after dark. We’re taking a mini spring break this week after TASO since we don’t have many practicum hours left and are traveling in two weeks to learn about counseling for LRA returnees in Lira.

Aubrey and I are currently house-sitting for the Howards, mostly so we can have a break from the nonstop flow of guests in the CURE guesthouse. Right now, two Welshman, Rob and Aowyn, are living there. Both of them are great and are working with a community development organization. Across the street for the next two months is Justin, a British medical student from the University of Edinborough. I’ve finally found someone to accompany me on Mt. Elgon!

Two American guys who’ve been living across the street since mid-January, Nick and Patrick, are leaving soon to head to Kenya, Tanzania, and Egypt (and who knows where else!). I wish I could just travel like that! They organized a boda boda race on Sunday, complete with cash prizes and a new bike for the winner. Patrick insisted on slaughtering a cow for a barbecue afterwards. Ha! The head was just sitting in a room next to their apartment yesterday. Gross. Apparently a Muslim has to cut the cow’s throat facing Mecca to make it acceptable for Muslims to consume.

Well, there’s last week for you! I’m sitting here trying to finish all of the papers for my practicum portfolio. I have two more papers, two revisions, and three reports. I will be ecstatic when I’m done; I had no idea it was going to be this much work!

Pictures!

new pictures!
http://enc.facebook.com/album.php?aid=2005622&l=9ee66&id=149000028


And I got into Boston College for grad school!!!

Uganda Makes Me Laugh Part 3

1. Eating with your hands is common. Even at a wedding reception, we were given beans, matooke, posho, meat, etc., and expected to eat it and not make a mess.

2. Cheese here tastes awful. That’s all.

3. Oranges are green.

4. We have two chickens in a plastic bag in the back of the hospital ambulance we’re currently riding. This is probably one of my favorite pictures because the chicken looks so ridiculous.

Oh look! I'm in our ambulance. And there is a chicken sitting on some cassava next to Christine's backpack.

5. Eight people fit quite comfortably on a four-person bench in the taxi-vans (matatus).

6. In our hotel room a few weeks ago, the first rule of hotel conduct on the door was, “Esteemed guests: Please do not throw your used condoms out the window or on the floor. Use the wastebasket provided.”

7. Potholes are everywhere. You just drive through them. Seatbelts? What? (these are some serious potholes. They're not even potholes...they're like ditches. But they're not meant to be ditches.)

8. The innards of animals are delicacies – the gizzard, liver, kidneys, the neck ….

9. The showers in hotel rooms are simply a shower head in the bathroom. It makes for quite a wet bathroom floor and toilet.

10. They like to eat whole fish. The eye is the favorite part. Mmm.

11. Cars have right of way, not pedestrians.

12. It is common to say, “Well done,” not necessarily as a response to anything. I don’t fully understand it yet. The proper answer is “Okay.” I still get flustered because it throws me off.

13. “You are lost” = “Where have you been?” We spent a few weeks trying to tell them we weren't lost and then realized what they were saying.

14. “Where are you from?” = “Where did you just come from?”

15. They pick their noses in public. No big deal.

16. Seeing squirrels is a big deal. I don't get it. There are lions and hippos and giraffes here. And squirrels are a big deal.

17. They say, “Yes, please” in response to everything. We haven’t really figured out why. It’s polite.

18. Cows roam the streets all the time. Goats climb trees. (These ones are just hanging out on the side of the road, which is quite common.)

19. We are celebrities everywhere we go. Why? We're white. (Kids are chasing our van here.)

Awful Roads and Cow Hoofs: Week of March 19

This is me not standing out in the crowd.

Melissa (Charles' wife) and Breanne

Melissa, Aubrey, Elyse (their daughter), and me before they left for the States this week

Sunday, March 18

I just learned that my friend Grace here is from a polygamous family. It’s funny when you learn all these crazy (to me) things about a different culture and then separate those you know from it. Her grandfather had 30 wives.

Monday, March 19

We went out into the field for home visits again today. We only connected with one client, however. Several were out, and one had died the previous day, which was sobering. The one client we talked to asked Aubrey and I for our clothes. There it was, the biblical commandment to give your shirt to the person who asks. The problem was, I wouldn’t be wearing much if I gave her my shirt. If I was a guy, I don’t think it would matter, but somehow I didn’t think it was a good idea!

We passed a beautiful two-story house surrounded by a large wall and intricate gate on our way back from the village. One of the Ugandans said, “In Uganda, if you have such a house, you must have deprived many people of resources.” They seem much more aware of injustice and inequality than we are sometimes.

Tuesday, March 20
ELISA HIV tests

After a talk about STIs and STDs (I have the worst time trying to pay attention to Ugandan preachers and speakers. I zone out because I can’t understand them half the time), we went out into the villages for HIV testing. Aubrey and I each went to different sites with a counselor on a TASO boda boda (bike with an extra seat on the back or motorbike). Visiting the home of a current client, the counselor explained HIV and its transmission and then offered to test those who were willing. Altogether, he tested 21 family members (and this was not a polygamous family!). After the results were in, the counselor talked to each person away from the group.

HIV testing in the community

I held a one-month-old for a bit while his mother was in counseling, and they asked if I would feed him since he was hungry. I said I hadn’t had children yet and therefore was quite unable to feed him, and they were shocked. I guess it’s just normal to always have a breastfeeding infant around, so if you’re holding a hungry kid that’s not yours, no big deal. Haha.
I think I want a motorcycle.

Thurdsay, March 22

The executive director of TASO Uganda came to our site today with a group from SIDA (Swedish International Development Cooperation Agency – http://www.sida.se/), most of them Swedish and one from Kenya, one from Zimbabwe, and another from Senegal. SIDA funds the TEACH (TASO Experiential Attachment To Combat HIV/AIDS) program.

We visited seven different sites with successful interventions. Most of the projects were similar to the ones I’ve described previously. Two of the clients today, however, were orphans. Kelly Flamos (http://blog.case.edu/kellio/), who worked with TASO last summer through Case Western Reserve University, helped build a house for a family of five orphaned children. The oldest is seventeen; both parents died of AIDS a few years ago. Only the youngest, who is probably about five, is HIV positive. TASO provides him with ARVs and other medical attention when he needs it. They also gave the children a bike so the oldest could more easily bring the youngest to the TASO center for ARV refills and any other services. Before they got the bike, the boy would wake up very early, skip school for the day, and carry his brother to the center. It takes about 20 minutes or more to drive to their house from the center.
The boy in the paragraph above

TASO is really doing wonderful things for the people of Uganda.

Friday, March 23

What a day! We drove out to Sironko district (almost to Sipi Falls) to visit clients in the mountainous region. As we got in the car, I asked Aubrey, “Is this the guy who drives way too fast?” She said, “No, I think the other guy is worse.” Boy, were we wrong! After leaving the main road, we began to bump our way up the switchbacks. They were probably the worst roads I have ever seen, and I promise you I have experienced some awful ones! Our driver seemed to think that racecar driving was the way to tackle these barriers, so we flew/jostled/tumbled up the mountain. I yelled, “What is wrong with you?” one time. I don’t think he heard me, but everyone else laughed. Needless to say, that was our last day in the field at TASO, so it looks like that driver won’t be responsible for my life anymore!

The mountains were breathtaking. I wish my camera could capture them, and I wish my words could describe them. I don’t even want to try!

We probably stopped at six different homes today; we were out in the field for seven hours. At most of the homes, we simply dropped off ARVs, but we did HBHCT (Home-Based HIV Counseling and Testing) at two of them. At the first house, we met a widower who is HIV positive and lives with his two boys. We tested the boys; all I could do was hold my breath. You can’t help but hurt when you have to test a six-year-old for HIV. But they were both negative!

The second household we tested had about 14 family members; two of them were HIV positive. The counselor said that one of the HIV positive clients was shaking and could not believe the news. I think we are too quick to separate ourselves from things like this. Especially when we only have to read about them. I try to place myself in their shoes, in their fears and challenges, and imagine what they must feel. I know I fail miserably, but it helps me remember that this is real life, that people all over Uganda are facing this awful reality every day.

On the way back, we stopped to drop matooke off at a counselor’s house and even took a 45 minute detour to a market to buy molokonyi. Cow hoofs. Disgusting. This culture is worlds away from my own!

My time here is coming to a close. I have about four weeks left, and I don’t know what to do with myself! I have 348 hours, so I only need to work for about two more weeks, and then Aubrey and I are hoping to head out to Kenya for our long-awaited spring break.

I want to make sure I get everything I can out of being here, though. I’m trying hard to focus on Uganda and the present instead of getting excited about graduating and being on a Summer Ministry team for ENC.

Uganda Makes Me Laugh - Part 2

1. They MUST iron their clothing. When Aubrey and I stopped by our friend Sam’s house to pick him up for church, he came out, saying, “Oh, I’m sorry, the power was out last night so I couldn’t iron. You will have to continue without me.”

2. “You are smart today” = “You look nice.”

3. Just because the receptionist said there are rooms in the hotel doesn’t mean they really have available ones.

4. They have wedding introductions AND wedding ceremonies, both of which involve lavish ceremonies, receptions, and dresses. Sometimes the wedding introduction is the day before the wedding. My goodness.

5. They pronounce words very differently. Leopard=lay-o-pard, Giraffe= gea-raf, divorce=die-vorce, Deuteronomy=due-tronomy, wafers= wah-fers

6. They’re blunt when describing people. “That old one over there,” “the fat one here,” etc.
One of the ladies in administration looked at me one day and said, “Oh, you are doing well in Africa! You have gotten fat!” (note to self: start running)

7. There was a patient named Cinderella.

8. Short call= going #1 and Long call=going #2

9. shift=move, pick=pick up (“I’m going to pick you at four.”)

10. If you’re new, expect to introduce yourself to the entire crowd and make a speech.

11. Men can have as many wives as they want.

12. “Happy New Year’s” wishes last at least a month after New Year’s.

13. To fund weddings, they hold weekly wedding meetings to get money from friends and relatives. The concept of the bride’s parents paying for the wedding is quite foreign.

14. Speaking softly is a sign of respect. However, it’s really annoying because I can never hear what they’re saying.

TASO & AIDS: Week of March 12-18

one of the beautiful little girls who is HIV positive

My favorite quote of the week: “Laundry is not one of my greater talents, but I do love ironing.” – Brian, 24-year-old employee at CURE. (I told you they like to iron!)

Monday, March 12 – Tuesday, March 13

We began our first full week at TASO (http://www.tasouganda.org/; my site is www.tasouganda.org/mbl.php). I was surprised to learn that many TASO employees are HIV+ themselves and even more surprised to realize that people with AIDS have a lot of hope for the future. Living positively with AIDS is one of their goals.

They start the patients off with septrin, a drug that basically wards off sickness since their bodies’ immune systems are weakened by the HIV virus. HIV attacks the body’s CD4s, which are part of the immune system (they call them “little soldiers” when talking to the children). When the person’s CD4s go below 200, they are put on ARVs (antiretroviral drugs) that cause the HIV virus to become dormant, allowing the body’s CD4s to rise again. Otherwise, the person would get sicker as opportunistic diseases continue to manifest themselves in the body.

Here’s Wickipedia’s explanation: “CD4 is also a primary receptor used by HIV-1 to gain entry into host T cells. The HIV-1 virus attaches to CD4 with a particular protein in its viral envelope known as gp120. The binding to CD4 creates a shift in the conformation of the viral gp120 protein allowing HIV-1 to bind to two other cell surface receptors on the host cell (the chemokine receptors CCR5 and CXCR4). Following another change in shape of a different viral protein (gp41), HIV inserts a fusion peptide into the host T cell that allows the outer membrane of the virus to fuse with the T-cell membrane. HIV infection leads to a progressive reduction in the number of T cells possessing CD4 receptors and, therefore, the CD4 count is used as an indicator to help physicians decide when to begin treatment in HIV-infected patients.” (http://en.wikipedia.org/wiki/CD4)

TASO works with clients to counsel them throughout the entire process, from pre-testing to death. They provide clients with food, ARVs, septrin, support, and income-generating projects. They work to sensitize the communities, dispelling myths about the disease.
On Tuesday, they held a general health clinic, so Aubrey and I took down the information of about 150 patients. Some of the names of their hometowns are crazy: Budaka, Namakwekwe, Bukedea, Sironko … you get the idea. Now try only hearing the names and figuring out how to spell it!

Wednesday, March 14

We played with the kids in the Children’s Play Center today. Most of these kids are aged 3-12, and most of them look fairly healthy. Trained counselors work with them, going through their ARV regimen and making sure they are taken care of. They read a comic book of sorts to the children that explains HIV, CD4s, and ARVs. It breaks my heart to see these happy children, knowing they are HIV positive through no fault of their own.

The first client we saw was a thirteen-year-old girl who attends boarding school in town and travels to TASO alone. She’s been on ARVs for about four years and has consistently attended TASO workshops and counseling by herself. I don’t understand.

these boys were goofballs. they don't look like they're HIV+, do they?

The funny thing is, I thought at first I would be uncomfortable working with so many people who have a fatal and somewhat contagious disease. But knowing that I can’t get it easily (you can only contract it through sex, sharing infected needles, receiving an infected blood transfusion, etc.) means that I don’t mind being around them at all. In fact, I feel very lucky to see their struggles and victories with this disease. It’s very encouraging in light of the disheartening situation.

Sarah, age 12, wrote this poem.

AIDS! AIDS!

Who created you?
You are finishing us all
You kill the young and the old
You are finishing our lives
What is your mission?
You are a threat to the population
Why do you rob a man of his good life?
Last week you killed our father
The other month you killed our mother
Now you are killing our brother
Leaving us orphans
We wish we knew where you live.
Where are you, AIDS?
The old and the young have died
The poor and the rich have vanished
The handsome, the beautiful, the ugly have disappeared
Because of AIDS, the killer.

Thursday, March 15

We did intake again today with a TASO employee and client named Doka. He’s 47 and was diagnosed with HIV a few years ago. At that point, he had two wives (remember, polygamy is not a big deal here), and one was HIV+, the other HIV-. The uninfected one left him. He went from 77 kilograms (170 pounds) down to 49 (108 pounds), and his CD4 count dwindled to 43 (a healthy person has about 800-900 per cubic milliliter of blood, I think). However, he began taking ARVs, and his CD4 count went back up. I honestly had no idea he even had HIV; he looks very healthy and happy. Again, it was so encouraging to see that life does not have to stop when someone is diagnosed with HIV.

We traveled to Mbale Progressive School (a secondary school) for a school outreach in which we showed two videos to a group of about 300 in a small room. They didn’t seem to pay attention very much. I guess it was a typical high school crowd, but it was frustrating.
I did see an ostrich across the street in someone’s yard, though! I’m going to go visit it before I leave.

Friday, March 16

These goats and the cage were given to clients to generate income

Friday we went into the field for follow-up again. We drove out of Mbale into the villages to check on a few income-generating projects involving goats, chickens, and cages for them. Driving through miles of lush green rice fields to reach the towns was amazing. I love driving through Uganda. I never get bored.

a home visit with the group. Seated L-R is Dennis from Malawi, Prisca from Zambia, a TASO employee, a member of the client family, and Aubrey. Dennis and Prisca are part of our TEACH group.

We also went to another outreach in another school, though this one was intended for the entire community. A singing and drama group from TASO presented songs and skits to explain AIDS, and several HIV-positive clients shared their stories.

Barbara, our supervisor at TASO, relayed two stories of confusion about transmission of HIV. One drug user was using needles without fear, and when asked why he wasn’t scared of contracting HIV, he replied, “Oh, I’m safe! I have on three condoms!”

Up north in Karamoja, there is a group called the Karamojong. I haven’t visited them, but they seem quite interesting. They hardly wear anything except for their AK-47s, and they believe that all the cows in the world belong to them (don’t ask me why). So they often raid villages and take their cows.

Anyway, apparently the Karamojong were given condoms as well so they could practice safer sex. So what did they do? They put on the condoms and wore them all day, took them off to pee, and then put them back on. They would take them off to have sex, and then put them back on (remember that these guys are in the nude most of the time anyway). Oh my.

Saturday, March 17

A friend here at the hospital visited today (Brian, the one who gave me that wonderful quote about ironing). He believes that there is not one person in Ugandan unaffected by AIDS in one way or another. “I personally have lost count,” he said. He has lost two brothers and a sister to AIDS as well as countless aunts, uncles, and cousins. This is a man from a well-educated, seemingly well-off family, and they are still suffering from this disease. I didn’t realize how much it has affected this country.

Uganda makes me laugh

Aubrey and I made a list of things about Uganda that don't quite fit with our own culture. It was really long, so I'll post it in segments.


1. Guys hold hands in public. It’s normal. However, guys and girls cannot hold hands. In fact, the bride and groom do not even kiss at their wedding. They just hug. “We would never kiss in church!”

2. Some of the appliances are European and therefore have European plugs, which are two thin, round prongs instead of the three large, rectangular prongs on the African appliances. To plug in these European appliances, I have to switch off the outlet and stick something into the extra hole so I can plug in the appliance. It cracks me up every time.

3. "That's okay" means "yes."

4. They all carry handkerchiefs.

5. We eat bugs in our food all the time and we just don’t care anymore. This is our closed butter dish. (Don't worry, we don't eat them in excess. haha.) They like to eat food in our fridge, too. Jerks.

6. “You are lost” means “You haven’t been around in awhile.”

7. They complain about it being hot all the time but put on sweaters, scarves, hats, and winter coats when it gets below 70 degrees Fahrenheit. (It is hot in this picture!!!)

8. “You are welcome” means “I’m glad you’ve come. Welcome.”

9. Ugandans speak really, really proper English.

10. To communicate, I have to slow down and enunciate every word, emphasizing the t’s and d’s.

11. To say yes, they often just raise their eyebrows.

12. Anything and everything can fit on the back of a bicycle: mattresses, bedframes, chairs, several chickens, several people…. this goes for cars, too.

13. The same rule applies to their heads. I’ve seen a man carrying at least 10 foam mattresses on his head.

14. Out in the village, the local bar is a pot of local brew surrounded by men with 6-foot-long straws.

15. Circumcision is a really big deal here. They have public ceremonies for them. When we went out to Sipi and walked around the villages, a friend of our guide actually had a whole roll of pictures of circumcision ceremonies and tried to sell them to us. I am glad to say that all three of us girls were able to pretend that this was normal. A few days ago, one of the two national newspapers featured a cover photo of circumcision. Wonderful.

16. Meat (think entire skinned animals) just hangs out in the market and wherever else a butcher decides to open up shop. When you buy a piece, they just whack off a chunk with a big knife. Check out this very nice goat below. At least he still has his tail. I think the other one is a cow.

(this guy is really whacking that meat ... you should have seen him. can you see the splatters on the wall? mmm....)