Ugandapanda

Walter is unique. Of all of our nurses, he’s the only one who makes sick patients laugh before they even sit down. It’s impossible to feel bad when you are around him. We had great hopes for the New health center he ran on the border of South Sudan, when disaster struck. The banks of the Unyama river burst, and within an hour the water was up to his thighs. He saved our drugs. He lost 2 sacks of rice and beans. His wife and baby were safe.

He was shaken, as any of us would be. He moved to another new health center based in the a youth remand home. It’s a place where justice isn’t usually done. Youth between 12 and 18 await trial. Some for one month. Some for a year or more. Many are found innocent after already serving months in a poorly kept, poorly fed institution. Our misson and Walter’s mission is to promote good health for these vulnerable youth. And who better than Walter to do it?

The remand home health team is amazing. Nurses Emma and Shirley work with Walter to oversee health education and screening. Every new youth gets screened for malnutrition, malaria, hepatitis B and HIV. Over 30 youth were positive for malaria that was immediately treated and cured. One had HIV diagnosed for the first time, and was started on life saving antiviral drugs. Dangerous outbreaks of bloody diarrhoea, conjunctivitis and skin infections have been stopped with a combination of good treatment, education and public health measures. After 7 kids got bloody diarrhoea, Walther and Emma found that kids were hiding extra food in their rooms, then sharing it later without washing their hands. A hygiene nightmare! This was stopped, the kids were treated and there were no more cases.

Unfortunately though, it wasn’t working with the community. Its understandable that many people didn’t want to enter through prison gates. People would rather go to drug shops, which were easy to access but expensive and low quality. Others weren’t aware of the service in the sprawling peri-urban area. Some gave up after they couldn’t find the health center. The few Community who did come loved Walter, the fair price and quality treatment, but despite Walter’s amazing work with the youth, it became hard to justify a full time nurse for only 40 youth with only a few community patients.

We felt terrible, but hope wasn’t lost. The team decided to step out in faith and make one last push with the community. They went to market days with free HIV screening and health education. Trusted community leaders reached 200 houses with the services we offered. There was a three month deadline. If we couldn’t double the patient turn-up, the place would have to close. I thought the hill was too steep, and it probably wouldn’t happen. We awaited the response. We didn’t have to wait long.

Their community push worked better than expected. In the last 3 months, the number of community patients has more than doubled. In March, April and May there have been 170, 180, and 190 community patients respectively, in addition to 40 to 100 monthly consultations with the remand hoe kids. The money coming in from the community sustains our nurse, and pays for the drugs needed for the community. In the meantime, the number of youth in the remand home doubled to 80 and they are now 2 to a bed, so it was crucial for them that we remained. Hope for the future has become a reality, and we’re even hoping a team will come later this year to expand the facility with a couple more rooms. After being here 5 yeas, I’ve found that its easy to on dwell failure, but its important to remember success like this.

Emma, Walther and I, looking forward to the future of the remand home clinic!

Its important to say that I didn’t do any work towards this amazing turnaround. I’m just writing what’s happening! Walther, Emma and Shirley had the faith, hope and love required to make this work and it was amazing to see it happen from the sidelines.

As I arrive home on my iron donkey, I notice a resplendent fluorescent orange mango. My eyes flick down the tree to ten expectant children sitting underneath. It’s reading time!

“‘I can jump,’ said the frog. ‘I can’t jump,’ said the snail’” exclaimed Gloria proudly. Tessa, Phoebe and I read the books with the ten kids. Eight read well enough to swap their book for a new one and receive a sticker from the magical sticker book. Stickers are hot property here, and due to their relative rarity are extremely valuable. One kid often knows the sticker she wants before she even reads the book! Every five books a kid earns the ultimate reward: a sweet! Generous Tessa has just spent big on some ginormous ‘Big Daddy’ sweets which have blown some kids’ minds.

About two years ago we started our book exchange with the kids from our English class. Mum and Jodie (thank you!) brought the lions share, and with contributions from other visitors we now have hundreds of books to swap. We have books at every level, from two words in a page to young adult fiction.  Latim has read more books than anyone else. He’s clocked over 60 books and counting. To see his reading and vocabulary level soar in just two short years has been a joy. Sometimes, Tessa and I alone struggle to find the motivation to read with the kids who come to read every day. Visitors like Lydia and Phoebe have reinvigorated the book exchange, and right now it is soaring to unprecedented heights.

Reading books isn’t a common practice here. I know of only two adults who read in their spare time. Many kids reach high school having never read a fiction book, and almost no-one has books at home. How do you learn English without reading, you might ask? How does your imagination and worldview expand? We hope that as well as improving their English, the unusual practice of reading books will open these kids to new worlds, both in their imagination and in their own lives.

No it’s not heroin.

It’s probably not coffee, or maize, or soya beans like you might expect.

It’s probably charcoal. I don’t have solid evidence, but it’s hard to imagine it being anything else.

A year ago, my parents and I made the mistake of travelling North to Gulu from Kampala at night. To distract ourselves from the many near death experiences, we decided to count the overloaded charcoal trucks passing from the North towards Kampala the capital. We counted 20 trucks in the first hour, then gave up counting to concentrate again on the near death experiences.

The scale of the industry is enormous. 15 million Ugandans use charcoal every day to cook their food. As forests have been either decimated or protected in Western, Eastern and Central Uganda for faming, timber, and charcoal, the country is chopping the North down instead.

The sad thing is, Acholi people are not making most of this money. After a local person here puts in the huge effort of chopping down the tree, cutting it up and burning the charcoal, they sell it for 15,000 shillings. In Kampala its sold for 80,000, which means that locals only get 20% of the total money. The lion’s share goes to the truckers (who are usually not local) and sellers in Kampala.

Even more concerning are large commercial operations, which are regulated mostly through bribery. Poor Acholi rural citizens are cut out of the picture. Consortiums from Kampala come with power tools, cheap labour and their own trucks. Just yesterday I passed this group of 8 trucks (some are out of shot), all loaded with charcoal. A local man told me this group operated near his home. They gave his family 1 million shillings to cut down their trees (about 300US dollars). The end-sale price of the charcoal in the picture alone is 100 times that, at around 110 million shillings (30,000 US dollars). The local communities are getting the raw end of this deal, with rich officials and business people making the big money.

Queue predictable NGO rant… I only know of one NGO who is working in this area. There could be 100 NGOs here flailing away fruitlessly on agriculture improvement achieving next to nothing, while NGOs are not working on the biggest industry in the region. Where are the NGOs promoting more efficient, cleaner kilns? Where are the NGOs empowering local villagers to control the supply chain? Where are the environmental NGOs protecting the forest? One positive development is that USAID project GAPP has started investigating the issue in the north, and I only hope meaningful action will follow.

Part of the problem is that we know little about this enormous industry. It has only really boomed in the last 10 years, and I don’t believe that either the local or international community has woken up to either the opportunities, or pitfalls of the industry. We don’t know how much deforestation is happening. We don’t know who’s doing most of the chopping and burning. We don’t know

Will we look back in 30 years and wonder where the forests have gone? Will we wonder where the money went that should have developed our Northern region? There’s plenty to be done. Lets start doing it.

I felt you coming

I thought you were a mere fart

You were so much more

(Heiku describing a shared experience. By an Anonymous Visitor)

(Name, location, age, job title and gender may have been changed to protect identity)

“Your contract finishes in a month. I’m really sorry, but we’re not going to renew it. We’ll pay for your transport and your belongings to be relocated back home from the health center…”

He cried, right in front of me, head in hands on a blue plastic chair in our office. We sat in silence for what seemed like forever. I tried to say something to console him, but it was meaningless.

Opwonya, a health center cleaner worked for us for 4 years, and held the only steady source of income for his family of 5 children. 60 US dollars a month may seem like a pittance, but in Northern Uganda that’s enough to feed your family, and send all of your kids to the primary school at least. Steady jobs for unqualified people aren’t just rare here, they are a precious lifeline.

I can defend myself until the cows come home. Opwonya’s work ethic was poor. He didn’t up to work for days on end without telling anyone. We talked to him, sent warning letters. Less patients were coming to the health center as malaria levels plummeted, which meant not enough work for our staff, and less money coming in to the health center. The health center was functioning well, but was nearly out of money to pay staff. We we had to reduce staffing, just to keep the place above water. The local management agreed that he should go. My job is to provide sustainable, quality healthcare to rural citizens, and this was a hard but necessary decision.

But justification doesn’t make me feel better. The chances of him getting another job are close to zero. His kids may now sit at home and not go to school. His life will be full of new stress and problems.

Its not the first time I’ve made decision like this, and it won’t be the last. When you work with limited resources, trying to make a dent in seemingly bottomless poverty, situations like this will continue to arise. Juggling sentiment with practicality is an ongoing struggle, and with limited resources practicality usually wins. Is it fair that Opwonya lost his job just because he wasn’t a good worker? Perhaps. Is it fair that his life will now be an uphill struggle? No. If he had lost this job in New Zealand, the safety net would have kicked in, and at least provided enough for his family to live on. His kids could still go to school.

I may or may not have done the right thing. Regardless, it hurts. I consider my easy life, and overwhelming privilege. I ask for forgiveness.

Call me old fashioned, but due to the sheer quantity of swearing required, from henceforth ‘shit’ shall be written as $#%

Straight after the famous $#%@hole comment, the internet flooded with response, my facebook wall included. Many nice, thoughtful responses were from Americans who apologised for their President. Of course the mega-rich, corrupt African leaders came out immediately, up in arms that Trump had said such a thing. How could he?

A significant number of Africans however, agreed with Trump’s assessment. At least on some level. And its not just on facebook. Some of my friends here in Northern Uganda found his comment refreshing. One friend laughed when they heard it, and expressed that Trump was ‘very accurate, politicians don’t usually talk like that’.

Patrick and Jairus are not just well educated, but are top young leaders in Liberia and Uganda. I got to know Patrick at a conference in Demnark, and I’ve never met anyone so passionate about changing women’s lives by improving access to family planning. Their responses are well thought through and fantastic.

By agreeing with Trump they don’t think the Physical country, is $#%@hole, or that the regular people are $#%@hole. That’s obviously not true. Jairus and Patrick love the land, and the people of Liberia and Uganda. They are devoting their lives to improving it. They just realise that their ‘nation states’ and their institutions, are indeed $#%@hole. Many Westerners, especially in the mainstream news talk about countries like Uganda as if  they have governments and institutions that are trying do the right thing, but just have a lot of work to do. They are wrong. This is what I mean from a Ugandan perspective.

– The policeforce is so corrupt and evil they are probably worse than useless, it would probably be better if they weren’t there.
– In rural areas, when you complete primary school you still can’t speak English, the language you have apparently been taught in for the last 5 years.
– Your government health centers don’t have drugs half the time because of corrupt leaders and zero accountability.
– Even if you struggle through the system and get educated, jobs are hard to get. I had 80 people with university degrees apply for my assistant’s job 3 years ago which at the time was paid 200USD a month. That’s right, 200 a month.

I agree with Jairus and Patrick. That’s $#%@ hole. Its good to recognize the plain truth. If we get out of our privileged ivory towers and recognize just how messed up these nation states and their institutions are, we’d understand why Trump’s comments resonate with a surprising number of people here. And this will continue while Western Governments continue to prop up these nation states and institutions, and fund the militaries of countries like Uganda, all the while turning a blind eye to the violence, corruption and inequality inherent in the institutions they support .

There is huge irony that the US government, the institution which Trump himself heads is one of the most guilty parties in funding these evil governments and perpetuating the problem. He’s a little bit guilty himself for the whole $#%@hole situation.