A Sub-Saharan African Miracle?

Is it too much to hope for? Can the poorest region of the globe escape the worst?

What’s happening right now in Sub-Saharan Africa is nothing short of astounding. We have porous borders, poor healthcare systems and people packed together in chaotic cities and informal settlements. By conventional wisdom, it’s a recipe for infectious disease disaster and you’d expect coronavirus would slam the region.

But no

Sub-Saharan Africa is the least affected region of the planet. By a long way. About a billion people live here. On Saturday 11th of April only 509 cases were reported across the entire region in 24 hours.

Not 509 deaths, but 509 confirmed cases. Only 5 deaths were reported.

Including Russia, there’s about a billion people in Europe as well. On the same day East Africa reported 5 deaths, Europe reported 3143 new deaths. Sub-Saharan Africa is doing very, very well. Or so it seems. There’s a couple of obvious rebuttals to this apparent success story, which I’ll deal with with before I move on.

Isn’t it still early in the outbreak?
Yes, but this doesn’t explain the low numbers. At the same stage of the outbreak in Europe, countries did not have huge case numbers, but most countries saw case growth rapidly increase. Over the last 10 days in Sub-Saharan Africa, not only have countries been spared exponential growth, we have not seen significant growth at all! The number of daily cases for most countries is a flat line. Below I’ve graphed cases per day for the four Sub-saharan African countries with the highest total number of coronavirus cases, plus Kenya from East Africa  to really prove the point. I haven’t even included countries the raft of countries where nothing much is happening, like Uganda which had only two positive cases in the last 7 days!

10 days of coronavirus.png

Looking back a month at South Africa, the country with the most cases and the most advanced outbreak, they appeared just on the cusp of exponential growth before….. flatlining. Incredible. Wonderful!

South Africa case.png

Are countries not testing enough?
Yes many African countries have far less testing capacity than more developed countries, but while their testing capacity is INCREASING, the number of positive cases remains stagnant. Here in Uganda, we have gone from testing around 200 a day two weeks ago to testing 600 in a day. South Africa, the Sub-saharan African country with the most cases has increased testing capacity from 1000 to 5000 a day in the last two weeks. If the virus was spreading fast you would expect increased testing to increase case numbers which isn’t happening. Poor testing capacity isn’t the reason for the low number of cases.

So why is Sub-Saharan Africa doing so well?

We really don’t know. Wow that’s an unsatisfying answer, I’m sorry.

Over a month ago on the 6th of March I predicted that coronavirus “would not devastate Uganda” My three reasons were Uganda’s young population, a rural population, and a history of avoiding flu outbreaks. Of these three reasons the young population and rural population are currently irrelevant, because coronavirus hasn’t spread enough for us to know whether our young population will lead to low mortality (no-one has died yet in Uganda!) or whether coronavirus will spread less to rural areas.  My historical observation was the unexplained phenomenon that neither SARS nor H1N1 swine flu touched Uganda, which bodes well. None of these observations however even begin to explain the tiny number of cases reported across the region.

So what could it be? Why so few cases?

Is it the weather?
There is evidence that hot weather reduces spread , but this alone doesn’t explain the lack of cases. In other hot countries like Malaysia and Brazil, coronavirus is spreading far more quickly than any African country, although still not as rapidly as in Europe. Also there are regions such as Johannesburg in South Africa where the temperature isn’t exceeding the mid 20s, yet those areas aren’t seeing large numbers of cases. We can’t praise hot weather alone!

Genetics?
Significant genetic protection from the virus seems unlikely given the high infection and mortality rates among African Americans. That population hasn’t been in America long enough (a few hundred years) for their genetic code to be significantly different from (mostly) the population of West Africans where they originally came from.

Immunity?
Could it be that exposure to many pathogens, or malaria, or some other specific disease leads to increased coronavirus immunity? This has been suggested, but there is zero evidence to back it up. I hesitate to even suggest theories with zero evidence, especially this one which has been doing the fake news circuit but we know so little that I’m clutching at straws.

Harsh lockdowns?
Restrictions on movement and gatherings are not the secret to Sub-Saharan Africa’s success. Restrictions here just can’t bring about the same degree of social distancing possible in richer countries. Families are packed together in small houses. People can’t afford to stockpile food so have to interact with sellers every day. Corruption and laxity at borders is rife.

In Uganda 13 people with coronavirus passed through the airport without being stopped, and went back to their communities. Some of them went to the market and  used public transport before they were advised to self-quarantine. As far as we know so far, those 13 only infected three people, all family members! If this kind of breach happened in a European country, it would have lead to hundreds or even thousands of infections.

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Social distancing becomes a farce, as Kenyans fight to receive food in Kibera settlement.


I’m sorry I’ve come with observations and not answers, but I don’t have any.

So not only do we not know why coronavirus isn’t bad, I haven’t heard any great theories. Hopefully soon someone will come up with better ideas, although there are obviously more pressing matters in other parts of the world at the moment.

Before finishing, I want to make clear that the virus is taking a heavy toll in a different way. The effects of Lockdowns in Sub-Saharan Africa have already killed thousands of people, and continue to kill many more every day. These lockdowns have caused crippling economic and healthcare system breakdown, with wage workers struggling for food and sick patients unable to reach hospital. In Uganda lockdowns are almost certainly going to kill far more people than the virus will, and tragically perhaps more people than the virus would have killed even if there had never been a lockdown. I plan to write about this in more detail soon.

Make no mistake, Some countries in Sub-Saharan Africa will probably have outbreaks that will kill a lot of people. We may well be far from seeing the worst of Coronavirus here. But that aside, right now the coronavirus situation is more positive than any epidemiologist, doctor or even layperson could have imagined.

May the Sub-Saharan miracle continue.

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Four Reasons to Hope

Yes things seem dire, but there are actually a lot of reasons to hope that we’re going to get through this. Humanity has come a long way over the millennia, and we’ve never been in a better position to fight a global pandemic. Here are four reasons to hope.

China’s miraculous efforts
China houses 1 in every 6 people on this planet. Just 6 weeks ago China had 4000 new cases in one day. Now, for 3 days they have reported no cases of internal transmission and they only have to worry about the rest of the world bringing it in. China  proved this thing is not only controllable, but it can be decimated quickly and completely. This is nothing short of a miracle, and should give us great hope.  The west should swallow their pride and look to China for advice and the way forward.

China new coronavirus cases.png

Summer is coming!
90% of the world’s population lives in the northern hemisphere. Europe, the biggest problem zone has moved into spring. For the next 3 months it’s getting hotter and hotter there which is ideal. There’s no question that hotter weather makes it harder for the virus to spread. Summer alone isn’t going to solve the problem, but it could be just what we need to turn the tide.

Promising Medication research
Initial medication trials have been more promising than for previous viral outbreaks. These medications won’t cure the virus, but could greatly reduce transmission and mortality rates. We have to be cautious, as randomized controlled trials haven’t been completed, but it’s possible that within a few weeks effective treatments could be disseminated around the world.

The vaccine will happen
A Vaccine isn’t going to help us int the near future, but even if we fail to control the virus this year, by early next year the vaccine should save us. Over 20 vaccines are in development, and early human testing has already started. Once we vaccinate the world, it’s likely we won’t have to worry so much any more.

Keep loving amidst both hope and fear (an encouragement)
Hope is important, but it’s even more important in this stressful time that we continue to love each other every day, through both kind words and kind actions. Remember that every time we wash our hands, we love our fellow human.

“And now these three remain: faith, hope and love. But the greatest of these is love.”

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Uganda closes schools – before Case no.1!

Ugandan President Museveni has just announced sweeping restrictions on social contact. This might seem normal to many of you around the world except…

Uganda hasn’t had one confirmed case yet!

For 1 month (and almost certainly longer)

– All schools closed!
– No religious gatherings
– No weddings/funerals/political gatherings/concerts
– No regular market days (This cuts off large scale trading between the village and town)
– No foreigners from 32 coronavirus rampant countries (Sad for people on holiday overseas)
– Only “essential” public transport (whatever that means, maybe more bribe opportunities…)

These are (I think) is THE MOST EXTREME MEASURES any country has taken before having a case

Do I agree? Probably not. Closing schools before the first confirmed case seems  premature if you believe in your Covid testing system. If you think you are missing cases than I would understand. Perhaps Uganda could wait for the first few cases at least before pulling the plug on the entire education system. Also we haven’t seen previous influenza pandemics or coronavirus go rampant in tropical countries, so we don’t know what course coronavirus will follow in Uganda – it’s not quite Europe in winter.

On the other hand many countries that haven’t acted so early have suffered terribly, so I understand the sentiment. It’s impossible to be even close to sure what the best decision is yet, as we are still so early in the pandemic process.

More than anything, this is going to be a test of the power of the government in the everyday lives of Ugandans. Previous orders have failed both due to poor implementation and public resistance, like forcing people to register sim cards and enforcing a plastic bag ban. Will market days in remote places really stop? Will public transport slow down or will the police just cash in on extra bribe opportunities? Fear however is a powerful motivator, and will help enforcement

There’s also going to be huge grey areas. At the moment we are in the middle of launching 20 remote health centers through our social enterprise OneDay health. Are we allowed to keep doing that?

Also if you are Ugandan and keen for Uganda-specific advice and updates, St. Philip Health center just started sharing twice daily Coronavirus news and advice to help keep yourself safe. Sign up and stay informed!

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Fake news goes viral – in the time of Coronavirus

First switch on your brain, then read carefully, then decide what’s right, what’s wrong, and what needs checking.

If there was ever a time for fake news to go viral, it’s now. You can publish anything with “coronavirus” in the title and people will clickity clickit. Even better if it instills fear. Who cares if a few of the facts are you know, not quite correct…

This matters because masses of us (me included) mindlessly scroll our facebook feeds, clicking on every coronavirus blog post, graphic and article. What we read affects how we feel, how we react and what we do. Every error-ridden article that instills fear can push our mental health down a notch. Or fuel a run on toilet paper. Or encourage us to stockpile masks…

I present 3 cases of fake news I’ve observed over the last few weeks, both from viral blog posts and the mainstream media.

Fake news no.1
“In Italy, doctors are having to decide who is worth saving”

When the clickbait article is entitled I need you to read this…”, your bullsh!% radar should already be going ding ding ding. She propagated the  myth that Italian doctors are forced to decide who should survive and who dies. Currently Italian doctors  are stretched to the limit, but The Lombardy health chiefhas stated they aren’t turning critically ill away. “Gallera denied that ICU capacity was so limited that doctors had changed the criteria for ICU admissions.”

The Italian health system (and others) might well reach that point, but they haven’t yet.

Fake news no.2
“Coronavirus deaths and cases spike”

The BBC had the nerve to lead with this, after the number of new cases in China had been reducing for over a week! China had changed their case definition, which made the reported number of cases artificially increase, while the real number continued to drop. China had been doing an amazing job, and if I had to pick the headline, I might have gone for the opposite. “Coronavirus cases plummet” or “China defies the odds to control the virus”.

China coronavirus cases.png
In this light, it’s a bit rich that the the BBC thinks that they are above major errors. “Over the past month, 12 February to 11 March, there have been over 575m page views globally to stories about coronavirus. People want trusted information and – unlike Megyn Kelly – know where to turn”. The BBC has proved more than once they are far from immune from using fake news to go viral. Another shocker was “There is no specific cure or vaccine. A number of people, however, have recovered after treatment.” By “a number of people” I take it you mean 98% percent of people? Nice one BBC… To their credit though, they did  remove this statement eventually.

Fake news no.3
“One of many tidbits of misinformation the president has broadcast during the coronavirus outbreak is his belief that warm weather will halt the spread of COVID-19. “The heat, generally speaking, kills this kind of virus,”

This New York magazine article popped up at the top of my feed when I googled “Weather and coronavirus”. Trump spouts so many lies about coronavirus and everything else, why did they bash on a rare statement that is largely true? Heat, generally speaking does kill this virus. What’s more bizarre is that the second half of this ‘publication’ contradicts the title and first paragraph, quoting a scientific article which states that hot weather will in fact, slow the spread of the virus. Absolute trash journalism!

A not yet peer reviewed Chinese study  showed that Coronavirus appeared to spread best in chilly temperatures of around 9 degrees celsius, and in a much better AlJazeera article one virologist stated that coronavirus is “not very heat-resistant, which means that the virus quickly breaks down when temperatures rise”.

This is just the tip of the fake news iceberg, and there’s plenty more coming soon so…

First switch on your brain, then read carefully, then decide what’s right, what’s wrong, and what needs checking.

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Why Coronavirus won’t devastate Uganda

This may seem like a bold statement with the probable pandemic peeking over the horizon but even based only on reason 1  (spoiler alert), I’m happy to make it. Uganda has multiple factors in its favour when it comes to Coronavirus.

Here are 3 reasons coronavirus is unlikely to be as bad in Uganda as in other countries, 3 reasons why Uganda might struggle with the virus, and 3 actions Uganda should take to mitigate the risk.

The BIGGEST REASON why coronavirus will not devastate Uganda

Ugandans are SUPER young

 It’s hard to fathom how young Uganda  is. Half  the population is under 15. Only 2% of Ugandans are over 65 years old and 9 out of 10 are under 50.

To compare this with other affected countries, China and Italy have over 10% of their population over 65.

Coronavirus mainly kills older people. The contrast between the mortality rates of the old and the young is staggering. If you are over 70, coronavirus is very dangerous – you have more than a 1 in 10 chance of dying from the disease, if you are under 50, it’s only 1 in 500.

Death rate coronavirus

So even if the virus becomes widespread here, few people would get severe disease, and far, far fewer people would die compared with current countries ravaged by the virus. Based on Uganda’s demographics, 0.5%, less than 1 in every 200 infected people would die from the virus.

Reason 2: Previous pandemics have spared Sub-Saharan Africa

Africa was the least affected continent (besides Antarctica) in the two most recent viral pandemics, SARS and H1N1 swine flu. We don’t know why exactly, but one factor is that diseases spread by droplets don’t do well in hot, dry conditions. Perhaps the relative lack of international travel here also means less virus is imported. Although coronavirus a different disease, it has a similar mode of transmission to SARS and H1N1 so worldwide spread may to some extent follow past trends.

H1N1 pandemic map

Ref: Swine flu and the current (H1N1) pandemic in humans: A review. Pwaiya et al.

SARS map

Black indicates countries with confirmed death, red countries with confirmed cases.        Created by Maximillian Dorrbecker, using WHO data.

Don’t get me wrong, coronavirus will reach Uganda and will most likely cause a major public health problem, but if this virus follows past trends we may get off lightly compared to countries from other parts of the world

 

 


No. 3 Most people still live in the village

 Uganda is 70% rural. Many people are still in remote villages, and only have sporadic contact with people from town. Yes people move around and there is connections  through market days and visitors from town, but most people in Uganda aren’t packed into busy cities where the virus can easily spread. This means that the virus may spread more slowly, and may be easier control. This factor is weaker than the previous two, and is based on logic and intuition rather than evidence.


Reasons why Uganda might not manage the virus well

1. Lack of government ability to implement plans

It’s ironic that although Uganda has suffered under 35 years of a one-man dictatorship, the Ugandan government struggles to implement their most basic plans. This impotence is caused by understaffed government departments, disorganized bureaucracy and (obviously) corruption. Last year the government threatened to cut phone lines off if people didn’t register their sim-cards. People didn’t take the order seriously for a long time. The deadline for registration was extended 3 times, before the government finally started cutting of some lines.

In China, when the government ordered people to stay at home because of the virus, people stayed at home. If Museveni tells Ugandans to stay at home, it might take weeks for it to actually happen. If roads are blocked to prevent virus spread, “important” people will bribe their way through. If medical supplies are needed in remote regions, corruption and poor supply chain systems will cause huge delays. Government orders and the law aren’t taken seriously, which doesn’t bode well when managing an epidemic


2. The health system (obviously), especially the lack of oxygen

It goes without saying that the Ugandan health system is poorly equipped to cope with current health problems, let alone a new viral epidemic.

One major problem could be the lack of beds with oxygen. Coronavirus kills through respiratory infection. To grossly oversimplify, the virus damages the lungs until they can’t supply enough oxygen to the body. Supplying extra oxygen to the lungs is a crucial part of supportive care in severe coronavirus cases, buying time while the body fights off the disease. Towns of 200,000 people like Lira currently have under 20 hospital beds which can supply Oxygen, nowhere near enough.

3. Co-infection with malaria

Unfortunately if coronavirus does hit Uganda hard it may well be between May and August, the heart of malaria season. We don’t’ know how malaria interacts with coronavirus, but we do know that when pneumonia and malaria combine it can be a deadly combination. Coronavirus both causes a pneumonia like syndrome, and leaves the lungs vulnerable to secondary bacterial pneumonia infections. With over 50% of the population contracting malaria up North here in a bad year, there will be a ton of Covid Co-infection and it could turn ugly.

 

Actions Uganda should take

 1. Don’t waste Money and human resources testing for the virus

There will be the temptation to try and roll out expensive Coronavirus testing facilities across the country. Testing may have some value in the early “containment” phase to track where the virus initially spreads, but after the virus starts to move around the country it will be an exercise in futility to test everyone with a runny nose. Uganda doesn’t have the money, expertise, or infrastructure to track the virus real-time around the country in the same way as countries like England or China.

This global pandemic isn’t like an Ebola outbreak, where experts from around the world and tens of millions of dollars descend on the affected country to track and manage the virus. As the whole planet is affected at the same time, Uganda will have to manage this largely alone, and they should focus their efforts on fundamental public health measures and treating sick patients rather than virus testing. Unfortunately I doubt this will happen, and a lot of money and human resource is likely to be wasted on futile efforts to test for the virus and track the spread.


2.
Supply More Oxygen to hospitals

Oxygen is a key resource to support patients who are critically ill with the virus and Uganda doesn’t have enough for their current illness burden, let alone for coronavirus patients as well. If the virus does take hold, Uganda is going to need more beds with oxygen. There may only be a few weeks to prepare now, so we should start buying now. Every empty cylinder in Uganda should be filled, and other oxygen production devices like concentrators should also be purchased. Uganda needs to stock up in a big way, and start transporting the extra oxygen to rural hospitals as well. Ugandan hospitals need more oxygen anyway so even if the virus doesn’t hit in a big way, it’s not like the money will have been wasted.


3.
Break connections between “town” and the “village”

70% of Ugandans live rurally, in clusters of households on subsistence farms. Many of these people could be protected by minimizing the movement of people between towns and villages. Simple measures could be taken. Only allowing food and commodity supply vehicles to travel on main roads, while cutting off public transport would be one simple way to slow virus spread. Uganda has a huge advantage in that most people are largely self-sufficient and produce their own food, so cutting off the town from the village for a month or two wouldn’t be dangerous.

All things considered, coronavirus may not devastate Uganda to the same degree it will other countries. Feel free to share you own views and questions!

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Ignore the fake News – Let your kids be vegetarian!

Sloppy reporter Esther Taunton should be reprimanded by Stuff for quoting the quack dietician “Sylvia North”, and said dietician Sylvia North at least re-educated for spouting this distasteful misinformation (let the food puns begin). It boggles ones mind that in 2020, these false ideas about vegetarian diets not only exist, but are cooked up by a supposed dietician, then fed to the public by a mainstream reporter.

https://www.stuff.co.nz/business/farming/118905679/preteens-too-young-to-make-vegetarian-decision-dietitian-warns

I’ll say it straight up. Vegetarian diets can be 100% fine for children. In New Zealand. In India where almost half the population is vegetarian. In Uganda. Anywhere.

Dietician Sylvia North, who is registered with the New Zealand council of dieticians somehow decided that some year 7 or 8 kids who made the wonderful decision to go vege for their own health, and to save the planet was “hugely concerning”. She then backs up her vegetarian hating with a combination of extremely poor logic, and straight up lies. Let’s start with the lies.

“”Plant-based protein sources such as beans, lentils, rice, quinoa have lower protein bioavailability and are incomplete sources of all the essential amino acids needed to support life.”

WRONG – Rice and beans eaten together have all the amino acids that you need. If she is trying to say that individually these foods don’t have all the required amino acids that’s technically true, but then her argument is meaningless because no-one eats only one type of food.

“Children could also miss out on necessary iron, zinc, essential fatty acids and B vitamins if meat and dairy was removed from their diet.”

Again, just wrong for half of these. The article states that kids are become vegetarian not vegan. Don’t burn strawmen! I’ll set veganism aside for simplicity, and am happy to say (backed up by real professionals) that any vegetarian kid eating a halfway balanced diet aren’t at any more risk of iron or zinc defficiency a meat eater, probably aren’t at risk of clinically meaningful fatty acid deficiency, but yes unfortunately are at risk of B12 deficiency. She got one out of four right for vegetarians at least.

In New Zealand, we don’t have a swathe of vegetarian kids with nutrient deficiencies. That’s not our problem. Our problem is that 1 in 3 of our children are overweight or obese, fuelled by diets with way, way too much animal fat in them. For Sylvia to focus on the unlikely problems of nutrient deficiency on a vegetarian diet, while ignoring the enormous protective effects of a vege diet in reducing the risk of death from the real killers Heart disease and Cancer, is completely ridiculous.

Now for the inane lack of logic

“North said children were less likely to eat dishes like lentil casserole and quinoa salad, which adult vegetarians would do to ensure their diet was well-balanced.”

Children will eat what they are used to and what their parents eat. Kids brought up on lentils in India eat lentils. In Uganda, you won’t find one kid who refuses to eat beans. In addition, kids in this article decided to become vegetarian. Kids who make the fantastic decision to go vege, are unlikely to then refuse staple vege food. Scaring parents that feeding their 10 year old kids actual healthy food might make them have a less balanced diet is straight up irresponsible.

kids blog reading

Many Ugandan kids are perfectly healthy with next to no meat.

Children making the bold decision to go vegetarian is not “deeply concerning”, but a fantastic step both for the planet and their health. Don’t believe everything you read in the news!

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Well done USAID! Allowances goooooone.

This seemingly small announcement in a minor Ugandan newspaper, might herald one of the most significant changes in the future of foreign aid in Uganda,

“The US government will also never support facilitation, participation, or sitting fees for any event,” – US Ambassador Deborah Malac. WOW WOW WOW. This is fantastic for so many reasons, but here are three.

1) There will be less meetings in general as not having a huge cash bonus assoiciated will remove the incentive to hold so many of them. I’ve mentioned this before in a ranty blog about NGO trainings/meetings.

2) More relevant people will be at meetings. There’s no reason why random government officials need to be a major distraction at every health, education and agriculture meeting.

3) Maybe this will spark a local mindset change. Perhaps meetings will become more about the thing they are supposed to be about, not the allowance you get and whether the important politician attended.

Call me optimistic, but this could be huge. I hope that this other foreign aid agencies (DFID, GIZ etc.) and large NGOs follow this lead and ditch the allowances!

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OneDay nurses discuss how to deliver quality care deep in the village – A meaningful meeting!

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Still powerless! a local perspective.

By Akwero Fiona!

Umeme Gulu. So frustrating!!!

3/7 days power presence, thanks for trying but I expected more from you guys than this

Because of the fani power issues, know that

1. People have failed to perform along their duty line as a result of 2/5 days power presence on weekdays (of coz weekend is a must power off).
2. Some bodys daughter or son out there failed either a paper or so because of this annoying power absence
3. Some body out there could die/ has ldied because of your half day half night or even 1 or 2 hours on n off power. So disheartening.
4. Business people are stranded in all corners, don’t know whether you people are able to provide food for all their families members since they can’t work because of power.
5. For leisure we can’t follow to the dot the amazing series on telenovela (South American soap) peacefully. Before you sit for 20 mins on the couch, boom power is off. Goodness.
6. Alot of insecurities at night because of nooooooo poweeeeeer. Lord have mercy.

Now what I have failed to understand is if this main power line having fault n technical team working on it as always said can’t be corrected at once or so for some good time. because this line gets problem like ten hundreds thousand times a year (if it exists) both in dry n wet season?. Or is it the so called technical team not technical enough? Or is it some intentional arrangement to fastrate people? Or what’s going on……………………………?

Some customer care issues with this team(umeme guys)

1. These guys are never moved with customers complains. Apply for connection and then wait for the wrath of time they take to come n connect you and then finally when they come they behave like they just dropped down from heaven( real angels from heaven are more humble) n they think they are only guys who went to school. You need to do some kind of community dialogue otherwise people have lost hope in umeme a great deal.

2. When removing power for some reason they are so timely but returning it back takes forever years

3. Speed at which they come to disconnect you is for World Cup (if this was the same speed they use to sort out the things people complain of, this Gulu area would be a better place but waa ) but go to their office n pay their reconnection fee. Goodness it’s another night mare to be reconnected back let alone the arrogancy.

We pray that you improve at least in some what way with your service delivery otherwise it’s won’t be pleasing at all. For some reason one time surprise your best power users by rewarding them just out of no where.

Anyway in the end, “who cares for the fish when the sea dries up”

 

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Fiona with the American ambassador to Uganda

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Making Gulu Powerless. A conspiracy?

Every modern society needs constant electricity. It’s a necessity, not a luxury. Electricity drives development. If you run a photocopying business, without power you can’t feed your kids. If you are a student at a boarding school you can’t study in the evening. If you are a midwife at a health center you can’t delivery a baby at night. Labour waits on no woman.

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Our Health Center Oberabic now delivers 30 babies a month helped by a generous solar donation

Gulu is the biggest town in Northern Uganda. It is a hub serving a wider population of over a million people. Gulu has been powerless for 5 out of the last 10 days. This is an unmitigated disaster for business, education, health and anyone who wants to use a computer, a phone or a light. I write this from the lap of luxury, in a solar powered super-hut which keeps my computer running despite almost 72 hours without mainline electricity.

Today was hot and I wanted my daily cold soda (#confessions). No chance! Power cuts cause first world problems here, as well as serious ones. Brian the soda seller thought that sinister forces were behind the power cut…

“They are ruining our children’s future. Last week our students were sitting senior exams, and the government turned power off. This week the primary final exams are on, and they want our students to fail. How can they study minus light?”

Brian believes there is a conspiracy against the North. He thinks the government has cut power to the North to prevent kids studying at night, so they will perform poorly in their exams. They are trying to further weaken a traditional area of political opposition, which has already been developmentally delayed by war and economic stagnation. I’m not sure if this conspiracy is true, but when Brian is running a shop selling warm sodas in 30 degree heat, who am I to argue?

Power in Uganda is a ridiculous monopoly, run by one company called “Umeme”. Since 2004 they have build infrastructure, repair the lines, manage distribution, everything. But from the beginning Umeme has been plagued with problems. With constant power cuts around the country, rife electricity theft and extremely poor service, it’s hard to call their time in ‘power’ anything other than a failure. The situation is exacerbated as the government saving scheme NSSF owns 23% of the company This means that the government is in bed with the company, so is unlikely to pull the plug or they will also suffer. In 2011 the Ugandan electricity authority did consider throwing them out, but corruption, poor decision making, an unfavourable contract or a combination of all these factors led the electricity authority to renew the contract, facilitating another 10 years of Umeme failure. 

Conspiracy or not, the problem is especially bad in Gulu and the people aren’t happy. A year ago hundreds of businessmen and local politicians protested in the streets and brought the central city to a standstill.

Umeme must go polycarp.jpg

Buisiness and Politicians protest. credit Polycap Kalokwera

Just a couple of hours ago, some local residents decided to burn an Umeme truck, probably out of frustration at the ongoing power cut. Burning a truck which may have been on its way to repair a pole may not be the wisest decision, but you can understand the anger. If Umeme don’t sort this power cut soon, I’m sure the unrest will worsen.

For the moment, there is no obvious solution. We remain underpowered, and overfrustrated. Until Solar batteries become cheaper, some genius cracks cold fusion or Bill Gates’ funding produces a magical new energy generation method, Gulu’s development is at the mercy of an incompetent business, and the way forward isn’t clear! “Umeme peke!” (Power is not there).

If you can think of a better way to power Gulu, let us know and become both a saviour and a millionaire!

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Stop giving money to World Vision!

Please stop giving money to World Vision. They are misleading you and they are misleading the people who they are trying to help. At the ripe old age of 32 not much blows my mind anymore, but this revelation did.

World Vision do not sponsor children. Yep, you heard that correctly. World Vision do not sponsor children. Although this might seem ridiculous, allow me to man-splain.

Misleading the donor – No sponsorship
The bedrock of World Vision is child sponsorship. The concept is simple and it makes sense. A donor pays a monthly amount of money, which pays directly for the child’s education and other important necessities like uniforms and healthcare.

So when you ‘sponsor’ a child through World Vision, do their school fees get paid? Do they get uniforms? Do they get health care?

The answer is a clear NO. The kid writes you letters, you send them cards, but none of the money you donate benefits that child directly. This might seems absurd, but it’s true. World Vision don’t publicise this clearly, but when you dig a little, they admit it outright. World vision do not sponsor children

We believe true community development is not about providing money or even services. It lies in helping people discover their God-given potential as human beings, and working together to realize that potential.” 

So instead of sponsoring a child, they instead run community projects involving water, education and development.

So why is that so bad?

First it is misleading. Child sponsorship sells and World Vision know it. They are raising money through selling the attractive vision of the donor transforming the life of the individual child they are connected to, but they are not delivering what they sell. They are downright dishonest.

Nickandkids.JPG

Some of these children benefit from real sponsorship. Their schooling is paid for

Second, the community development work that World Vision do under the veil of child sponsorship, is unlikely to be effective. Here in Northern Uganda, rich World Vision workers drive expensive trucks, deliver trainings at fancy hotels and write reports espousing the great work they have done. There is little accountability, and no meaningful way to measure the outcome of their work. It is possible that many World Vision programs worldwide do close to zero good. The idea of focusing holistically on a community in order to bring sustainable transformation sounds and feels amazing, but it just doesn’t work.

And this comment just made me angry

“The goal of sponsorship in a community is to help break the cycle of poverty so children and families can step into the future with well-founded hope. When these goals are met, World Vision can move on to serve children with great need in other communities.”

 

The idea that an NGO can walk in, meet some development goals, fix the communities problems, celebrate and then move on to the next disadvantaged community is ridiculous. The deep seated socioeconomic issues In Northern Ugandan communities can’t be fixed by any NGO, even those far more effective than world vision. Of course we can make a difference and help people’s lives become better, but you can’t ‘fix’ a community in a few years. If you visit communities here that World Vision has been working with for years, you won’t find any objective difference between them and the next village over

Individual child sponsorship on the other hand works.

One study of children properly sponsored by the NGO Compassion, showed that “sponsored children realize 1.38 more years of schooling than their unsponsored siblings and 1.79 more years of schooling than their unsponsored peers”. Sponsored children were also more likely to get jobs. Other studies have shown similar positive results.

When 16 economists were surveyed, child sponsorship ranked 4th on their list of most effective interventions. I am not claiming that child sponsorship is necessarily the best way to spend money, but real sponsorship is effective, and transforms children’s lives.

Misleading the children – Exploit the most vulnerable
World Vision are piloting an ‘exciting, innovative new system’. Instead of the sponsor choosing the child, the child chooses the sponsor! They select the “most disadvantaged kids” in the community, put them in front of a photo board of smiling rich white people, and they select their sponsor. It seems like a great idea. Disrupting the system, turning the tide, shifting the power balance from the rich to the poor and all that.

Except that the process is a farcical and twisted public relations exercise. After the child chooses their ‘sponsor’, they do not benefit directly. It is not fair to pair a rich white Westener, with a poor Ugandan, when the poor Ugandan doesn’t get anything meaningful from the relationship, except a few letters. The poorest children are therefore exploited to raise money for a program which doesn’t directly benefit them. This makes me sick inside.

So World vision doesn’t sponsor children. Both the donor and the children are misled, and the money instead goes to unproven, money sink ‘community development’ programs

 So what could World Vision do to change my mind?

  1. Get rid of the word sponsorship. Change your marketing. Start promoting your community programs, because that’s what you are doing, not sponsoring children.
  2. Allow external organisations to do meaningful research on your community programs and prove to me that they are doing more than zero good.
  3. Perhaps just go back to actually sponsoring kids. Nothing wrong with that!

And that’s why you should not give money to World Vision right now. There are so, so many other great ways to give and make a huge impact  so why give your money to a dishonest, ineffective organisation?

I would love any questions or feedback about this, and if you agree with me I’d encourage you to share this and get the message out there.

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