The Last UW Hoorah!

Last Tuesday I presented my capstone project for the department of Global Health and it went really well! Everyone on the panel had a lot of interesting questions and comments about the ultrasound device and the data I collected from the midwife and patient interviews.

With this final presentation I have successfully fulfilled all of my departmental requirements and will officially graduate from the University of Washington next week!

Lunch with a Jedi Master

Arrived in Amsterdam yesterday morning and immediately hopped on a train to Bruges, Belgium. It made for a long day but the city's laid-back atmosphere has made it an easy transition from life in Mbarara.

My last week in Uganda was spent collecting our deployed systems, checking in with the midwives I had been working with for the past month and having a good time with my housemates. We had been debating whether one of the dogs that reside at the house was pregnant - and since I had retrieved our ultrasound systems, we decided the give Naomi a quick scan. Turns out that yes, she is pregnant.

My last night in the house we ate by candlelight and talked about our different projects over spaghetti and fresh pineapple.

I finally took the opportunity to have roadside roasted maize - which is similar to corn on the cob but not nearly as sweet.

One of my favorite things to come across is this medium size tree that has these wonderfully delicate blossoms.

The day before I flew from Entebbe my housemates and I spent the day in Kampala together watching Harry Potter at the Oasis Cineplex and shopping at the big mall. The next day I went solo around the city, via boda boda and met up with my new bff Mary for lunch. She is the wife of the Ecurei administrator who I spoke about my first week in Africa. She had been in both Star Wars 1 & 2 playing the Jedi Master Luminara Unduli. Not only is Mary hilarious, talented and very sweet - she is also training to become a professional runner for the upcoming Olympics.

I'm here in Bruges until Saturday when I travel back up to Amsterdam to meet up with a fellow UW grad for a night on the town. Finally, come August 2nd I fly back to the States, graduate from the University of Washington with a Masters in Engineering and 2 graduate certificates in Usability and Global Health. And then... start searching for the most amazing job e.v.e.r!

Cheers!

On the Road Again

I spent yesterday in the field making house visits with Annah – the CHW extraordinaire!  We made it to 4 homes in just under 5 hours and it was a great way to experience the field outside of the clinic setting. It also gave me the opportunity to have a longer conversation with Annah about her role as a CHW and what she hopes for her future. Each woman we visited agreed to be interviewed but none seemed very comfortable having a muzungu in their homes unannounced. I wish there had been a way to ask for their permission earlier. Alas…

The consent form and interview questions had recently been translated into the local language of Runyankole by a university in Kampala. This made the process go much more smoothly than the last time Annah and I worked together. Although looking back at all of my interviews I wish there was a simple way to pull a Cyrano de Bergerac so that my presence in the room would not be required. I fear me being there detracts from the process and affects the ladies’ responses.

After the interviews Annah and I stopped by Fang Fang for a late lunch. I had never been even though the small enclosure sits right across from the Ruhiira Health Clinic – where I spend most of my time. Unfortunately we arrived too late as they were out of food, so we went down the road a bit to another place which served fish and matoke.

I skipped the fish and ate matoke and g-nut (a soupy, grounded nut dish) instead. 

The Ugandan diet relies heavily on carbohydrates like matoke, posho, rice, chapatti and Irish potatoes. Vegetables and meats can be found in the larger villages and cities but are more expensive. For those living in remote areas (who tend to be poorer), I would suspect that they have high protein and iron deficiencies because they cannot afford such nutritious luxuries.

As I was waiting for my ride back to Mbarara I hung out in the Ruhiira MVP radio studio with Moses, the local DJ. They are currently trying to expand the reach of the station’s signal in order to serve the entire Isingiro district.  

Tomorrow is my last day in the field and I must pick up the two ultrasound systems we deployed last week. Then on Friday I am off to Lake Bunyonyi ('place of many little birds') and return late Sunday evening to pack and leave for Kampala the following morning. Tuesday I leave Uganda and head to Amsterdam!

20 Cows, 5 Goats, 8 Acres & 10M Shillings

I’m not sure how the conversation began but my Ugandan housemate Sam and I started to discuss marriage dowries. In other countries it is usually the woman’s parents that offer the dowry to the man’s family. However, here in Uganda the male suitor offers the woman and her family livestock, land, oil, paraffin and money in exchange for her hand in marriage. I asked Sam how one decides what a woman is worth and if there is a negotiation process. He said that based on my higher education, if I were a Ugandan I would be offered 15 cows, 8 acres and 5 million shilliings. “Ahh” – I said. I’m worth far more than that. So I negotiated upwards of 20 cows, 5 goats, 8 acres and 10 million shillings.  He finally agreed – although I fear I may return from the field one of these days only to find our front yard filled with cattle. There is a very fine line here in Uganda between being serious and joking about something.

Sam continued to tell me that parents want to have girls in order to grow the family wealth and boys to grow the clan. I then asked what happens if the man’s family does not own cattle. In all seriousness Sam replies, “Then he gets a shitty girl.”

Yesterday was the big day! Jeff Sachs flew into Mbarara along with an entourage of reporters, photographers, donors and cabinet ministers. They were here to celebrate the five year mark of the MVP project here in Ruhiira. Lots of ribbons were cut, tress planted, speeches given and promises made. Sufficed to say, it was an extremely long day but well worth the trip. At about 5p everyone gathered in a field for the speeches and we were invited to sit under the tents with the VIPs. There were dancers and singers, lots of politicos and some of the midwives and community health workers I’ve been working with were present. Hundreds of locals had also come to join in the celebration – although I later learned they were promised a meal if they attended. Some things are just done for show I guess.

My housemate Diana spent weeks preparing for Sachs’ arrival. She is currently working on 4 separate projects but the one that seemed to attract the most attention was a group of local women who were recently trained in jewelry making. The pieces are all fantastic and they are hoping to be funded by a big contributor to the MVP project.

Most of the Sachs' visit consisted of getting in and out of cars at the different sites. At the top of the list was the grand opening of the water tap-stands. By piping in water from the lower valleys up to the top of Ruhiira this project will save women and children hours of hiking the mountains everyday with their jerry cans.

Earlier that day several of the researchers and MVP staff drove to Kabuyanda for an amazing meal of cooked pork. I had never been and probably couldn't find the house again if I tried. We had called ahead and ordered several kilos of pig and when we arrived, it was close to being done. 

The final product was amazing! I also got to try tonto, a fermented banana juice that...I probably won't try again. Here are my housemates Molly, Stephane and Diana. No silverware or napkins allowed.

Later my housemate Gaelle and I chilled under the VIP tent sipping room-temp sodas.

The day before Sachs' arrrival my UW crew departed for Kampala but we were able to snag Dr. Ema (the MVP health coordinator) for a quick conversation about our ultrasound deployment and a photo op. Dr. Ema is the nicest, most genuine person I've met here in Mbarara. I'm glad he accepted his recent promotion to the health coordinator post.

Later that day, after Wayne and Alexis left for Kampala a couple housemates and I had lunch at the High Way, a local restaurant owned by Moses' mother. The most popular dish consists of matoke, posho, goat, peppers, chapatti and rice. It is delicious! And for 5,000 shillings ($2.50) you can't go wrong.

Luckily the walk back to the office helps burn off all of these carbs.

Here's our lovely interns' house. The water tank was a recent addition. I guess the previous one was much smaller and with 8 people trying to shower at the end of the day - the warm water did not last long.

The other day I had asked Henry if there were any bats in the area. He said that they were migratory and usually came between August and September. Well - this year they came early. I watched from our backyard as hundreds flew around in circles until they finally landed in a couple of trees next door from our place. I was so excited!

 I tried to get a closer shot but they kept to the higher branches.

Saturday night we headed out to Heat, a very popular club here in Mbarara. It's an open space filled with tables and chairs, 3 bars, pool tables and darts and lots of people. The dance floor ends up being wherever you are - you just get up from where you are seated and start dancing. The music was a mix between American and Ugandan hip-hop. Here's Molly and Sam.

Since local liquor is so cheap, when you order a beverage - you get the bottle.

Even though I've been warned against it, I've now ridden a boda boda three times. The first was with Henry on the way home from dinner. I sat wedged between him and the driver. Not feeling super comfortable with hanging onto the driver I grabbed Henry's thighs and dug in with my nails every time we hit a bump or took a corner. The second time was after Heat. Gaelle and I left earlier than the rest of our group and got a ride from this gentleman. It wasn't until now - looking at this picture that I realize the driver is also looking at the camera. Hmmm...

The third (and I promise the last) time was after Molly and I did our Sunday shopping at the market. We brought home bags and bags of fruit, vegetables, dry goods and water. We each hopped on a boda boda and for 1,000s (.40cts) got to skip the long uphill walk home.

One of my favorite memories of this trip thus far was walking into our kitchen to find Henry making pancakes for breakfast. P.a.n.c.a.k.e.s. I immediately offered to help to ensure I too would get to eat some. Henry mixed while I fried and flipped.

With a little jam and nutella - we were all thoroughly stuffed and happy.

There are several different places to buy food here. But for fresh fruit and vegetables the open air market is the best. Although you have to negotiate with the vendors in order to avoid the muzungu prices.

Henry took us on a longer-than-anticipated trek to a different market that sold pork. Walking through the different stalls it became obvious that few muzungus traveled here.

I haven't had the fish here yet, but it makes for very popular Ugandan dishes.

As I enter my last week here in Uganda I hope to be in the field at least two more times for one-on-one interviews. Unfortunately I had to begin a third round of cipro so being in the villages all day has not been the best for my stomach. Thursday I will pick up the two ultrasound systems we deployed in Ruhiira and Kabuyanda and copy over the data before leaving for Amsterdam next Monday.

I am tentatively traveling to Lake Bunyonyi for my last weekend here in Mbarara. Per Henry, it is one of the most beautiful places in Uganda.

The Latest and Greatest

We just returned from a long day in the field and although we were pleased with the data collected, Alexis and I were plagued by a very determined cockroach in the back of our driver's SUV. First it ran over Alexis' foot, then mine, crawled into A's bag, climbed back out and somehow managed to get up on the seat between us. I then flicked it to the front of the car but it quickly made its way back to us. Between the screaming, laughing, riding around for an hour with our feet tucked under us and off the car floor we decided that we should name the cockroach Bob so he would seem less threatening. We were hoping that Bob came alone and that none of his friends had joined the car ride. Bob made one final attempt to climb up a seatbelt and was met by the bottom of my flipflop. We hope he rests in peace.

Now that we have safely arrived at the UNDP office, we are writing up field notes and emptying Alexis' bag to ensure it is cockroach free. Here's a picture of my two Ugandan housemates Moses and Sam.

Sam brought home dinner the other night. I wasn't there for the preperation, but very much enjoyed the soup afterwards.



On our way to the villages.

Some down time in one of the clinics.



Interviewing Deztiranta, my fave midwife.



A visitor in the maternity ward of Kanywamaizi.

Tomorrow is my last day with Alexis and Wayne. They are returning to Kampala for a couple of days and then flying back to the States. I return to the field next week to interview patients and make house calls with local Community Health Workers. My time here has been incredible and the next two weeks will be packed with more inteviews, adventures and deet. Lots and lots of deet.

Field Research = A Lot of Time in the Car

Alexis, Wayne and I (the UW 3) are in the field for the next few days conducting usability tests and design ethnography activities at the MVP sites and it is going really well! However, it is most definitely dry season because the amount of dust has doubled on the roads which makes driving out into the field and back a gritty ride. In some steep areas our car slides a bit as if we were on ice - due to loss of traction. Luckily our driver is amazing, minus the bird we almost hit today and the goat we buzzed by yesterday. Oh, and the chicken and pig we might have lightly grazed. Thankfully the children run to the side of the roads.

Although parts of the road to the villages are being smoothed out for Sachs arrival on Friday, this is what most of them look like.

Passing boda bodas on the way to Kabuyanda.

As we're flying by Ruhiira.

This little girl was very interested in what I was doing while sitting outside of the maternity clinic.

On the way back to Mbarara we passed the machine responsible for our smoother rides.

But we were forced to stop due to a traffic jam.

Here's a truck filled with matoke. We pass several of these a day.

Best part of today was our drive back to the city. I'm not sure whether the cassette tape belonged to our driver or our translator but it consisted of 60 minutes of remixed 70 and 80s music - like When a Man Loves a Woman, Lean on Me. Alexis and I belted out the best ones - making Wayne's trip back absolutely enjoyable!

Tomorrow we head to Ntungu and Ruhiira for more focus groups and interviews. The day will be long but we've been able to collect a lot of data for future papers and grant proposals. Sadly Alexis and Wayne return to Kampala on Thursday.

I'm hoping to skip town Saturday and visit Queen Elizabeth Park with a couple of my housemates. More zebras, hippos, monkeys and hopefully some lions. Woohoo!

No Lights, Gas or Internet - Oh my!

Oh - it feels like a long time since I've been able to sit down and write about my adventures. Our house has had spurts of electricity since Monday but only during the day when we are all in the field - which makes it difficult to charge our phones, cameras and laptops for the next day. At night my housemates and I have been hanging out together in the living room reading, playing cards or talking by the light of candles, headlamps and glow sticks. It was kinda cool the first night but now it's just annoying.

We then ran out of gas for our countertop stove which put a damper on eating anything. And since the electricity had been out for some time nothing that had been placed in the fridge was safe to eat. Luckily many of the larger bars and restaurants have generators so we've been going out to eat a lot.

Lastly, the UN office's internet has been down all week so trying to send correspondences was moot. But today the three of us UW students and our HCDE professor are camping out in the lobby of her hotel using their wifi and enjoying their bright lights and hot water. I'm sure the front desk was somewhat suspicious when our prof asked for three extra towels for her single room so we could each take a shower.

On a much happier note I made it to my tenth day in Uganda before getting sick! I was out for two days and felt very sorry for myself but with the help of cipro and some a.m.a.z.i.n.g. homemade chicken noodle soup my housemate Diana made for me I returned to the field yesterday.

The UN/MVP office has been buzzing with activity getting ready for Jeffrey Sachs to arrive late next week. He's the Director of the Earth Institute at Columbia University and his trip here has caused a mad dash to get some of the major MVP projects completed. For instance, this is a picture of piping that has been sitting behind the Ruhiira clinic for (supposedly) 2 years waiting for trenches to be dug so workers can install these pipes and start the process of getting water pumped from the lower valleys of Isingiro up to the higher villages like Ruhiira.

When we drove out to the field yesterday they had also begun working on leveling out the roads with a pile driver. Thank you for your timing J. Sachs! At least until the next heavy rainfall my two hours in and my two hours out of the field will be much more comfortable.

This past Monday was my first time in the field solo without the extremely knowledgable and kind David. The day was a success. I met with the community health worker, Annah, who acted as my translator while interviewing female patients. Once done with the patients I interviewed Annah about her work and range of responsibilities. She is assigned to a minimum of 150 households that she visits on a regular basis by foot - to check on villagers. She prioritizes certain homes based on whether women are pregnant, if there are children under 5 or when someone is showing signs of malaria. It seems like an intense and most likey very underpaid position. However, it is one of the most critical jobs since she helps bridge the gap between the very rural areas and the clinics.

My ride home from the field that day was scheduled to pick me up at 4p but by 5p I became a bit worried. My calls to the driver weren't going thru and so I called one of my housemates and asked how much time should pass before I should really be concerned. His response was that no one had been left at a site yet this summer. It was very reassuring... At 5:30p I finally got word that the UN driver was on his way and that I should wait outside the clinic gate.

Shortly after I took this picture about 20 school children passed by from the other side and decided to stand about 6 feet from me and just stare. So I set my bags down and took out the bubbles I had brought from the States. Everyone quickly surrounded me to have a try at it - the best was when the boys would try and show off and blew really hard and nothing happened and then the girls gently blew and several bubbles were blown upwards. One by one everyone got a chance to blow bubbles and when my ride arrived and the bubbles were put away they all said thank you and waved. It was pretty cute. Next time when I hand the bubbles over to the kids I will remember to have my camera ready! 

And to bring everything up to the present, here are a couple of  pictures I've taken around town. This is one of the four UN vehicles used for field research. I've quickly learned which drivers go really really fast and which ones just go fast. It can be a bit scary going around blind corners, especially once the dust gets kicked up by other vans and trucks. Vision = Zero. Plus goats, cows and chickens tend to roam free and wander across the roads. Luckily they have all managed to dodge the vehicles I have been in...thus far.

The main UNDP office is where the vehicles are based from. So every morning I check-in with the vehicle supervisor to be assigned to an individual driver.

This is a picture of the most common, and as it turns out the most dangerous mode of transportation in Uganda: the boda boda. They zipzag through traffic at alarming speeds and since helmets are not mandatory no one wears them. Interestingly, Peace Corps volunteers must sign a contract stating that they will not ride on boda bodas during their two year commitment. Since I saw one boda boda driver skid on its side this morning with the rider falling off the back I can understand why.

Here's the kitchen I share with my seven housemates. To the left is our front door which has a hole towards the center. Through this you reach in from the outside to lock up the house and then padlock it when you leave for the day. At night when we're all accounted for, we lock the hole shut from the inside so no one can reach through and let themselves in.   

The toilet and shower are in seperate rooms. I am excited to report that we've replaced the shower curtain and although I miss the upside-down penguins from the old, I appreciate the lack of mold from the new.

I haven't had much time to explore all of the shops along High Street in Mbarara but this is the grocery store I buy my bottled water, peanut butter and other dry goods from.

Tomorrrow we (the UW crew) are going to check out the open-air market and do some exploring around town. Then our prof heads back to Kampala (the capital) and we get ready to begin our usability testing on the portable ultrasound systems with the midwives on Monday. It's going to be a full week.