USD-Uganda Team 2007

2007-04-14T18:58:00.000-07:00

After the meeting and gifts, we had a ceremonial team meeting. Then the Archbishop gave us a day off, which we put to good use at Queen Elizabeth National Park on the Uganda-Congo border.

2007-04-14T18:56:00.000-07:00

After our presentation to the Archbishop, he and and committee gave each of us a gift in thanks. The men all got beautiful print shirts, and the women lovely print dresses. Plus we all received a gourd and a hearty handshake from the Archbishop himself.

2007-04-14T18:55:00.000-07:00

We meet with the Archbishop.

2007-04-14T18:43:00.000-07:00

Our big day. Dr. Hunter presented our recommendations to Archbishop Paul and his hospital committee.

2007-04-14T18:32:00.000-07:00

Our research nearly over, it was time to settle down and prepare our report. We borrowed Fr. Charlie's laptop, took over a meeting room at Monfort House, and got to work.

2007-04-14T18:25:00.000-07:00

Uganda has achieved its progress against HIV/AIDS in part with help from international partners. This sign was on the door of a state-of-the-art lab at Mbarara University. In fact, the Mbarara skyline is dominated by a modern blue-roofed building housing all the HIV/AIDS programs in the region.

2007-04-14T18:17:00.000-07:00

The next day, Wednesday, we visited Mbarara Hospital, the government-funded hospital in Mbarara. As I've written before, it was a difficult experience due mostly to overcrowding and scarce supplies. Here are 4 infants on a transfusion table receiving blood. One of the effects of malaria is hemolysis (disintegration of red blood cells), which leaves its victims anemic. Thus transfusions are very important. As part of its campaign against HIV/AIDS, Uganda has made great progress in ensuring the safety of its blood supply, by accepting donations from volunteers only, extensive testing, and safe storage.

2007-04-14T18:12:00.000-07:00

The hospital at Ibanda has a nursing school in addition to its other services. Dr. Hunter gave these 3rd year students a pep talk about the nobility of nursing. She was so inspiring, she made me want to sign up!

2007-04-14T18:05:00.000-07:00

Although the majority of hospitalized children we met were there for malaria, we would sometimes meet kids who were injured just being kids. This little guy punctured his abdomen during a fall from a tree, and developed peritonitis. When we met him, he was recovering nicely from surgery, and his mom was very relieved.

2007-04-14T18:01:00.000-07:00

Whether adult or child, a hospitalized person in Uganda ALWAYS has a family member at the bedside. In fact, family members provide for most of a patient's needs, such as bathing, laundry and meals. Mothers are of course at the bedside in pediatric wards. These two moms at the Uganda Martyrs' Hospital in Ibanda, are with their children, who were being treated for malaria. At Holy Innocents Hospital, we hope to make better provision for family members at the bedside.

2007-04-14T17:58:00.000-07:00

Fr. Bonaventure and Matt C., with four new friends and the sister in charge at Ibanda Babies Home.

2007-04-14T17:54:00.000-07:00

These are just two of the dozens of toddlers at the Ibanda Babies Home, an orphanage for children under 4. Some are AIDS orphans, others have a single parent somewhere who will return for them when they reach 4. All the toddlers wore the same blue cotton pajamas, making it impossible to tell the girls from the boys. It was an emotional experience for me to be surrounded by these kids as we got off the bus.

2007-04-14T17:45:00.000-07:00

Crested cranes are the national symbol of Uganda, appearing on currency and visa stamps. We were fortunate to spy two beautiful cranes in a cow pasture, and they were polite enough to stay put while we backed up the bus, opened all the windows and snapped away. John Baptist pointed out that the crane on the national seal is balanced on one leg, indicating it was at peace. Dr. Hunter was inspired to suggest that the Holy Innocents Hospital be painted in the colors of the crested crane.

2007-04-14T17:40:00.000-07:00

Another clinic, and I'm sorry to say I don't remember which one. But it is typical of the clinics we visited: brick construction, metal roof. Windows had wrought-iron grilles, meaning they could be left open in the consistently mild weather. But we saw screens in very few places, which seemed odd in a place where malaria is such a problem.

2007-04-14T17:36:00.000-07:00

On the road in rural Uganda. I wish I had kept track of how many kilometers we covered.

2007-04-12T13:06:00.000-07:00

Fr. Charlie told us that a recent visitor to Monfort House from Ireland taught the ladies in the kitchen how to make pizza. So this is pizza, Ugandan style, with mushrooms, sausage and cheese. To be honest, it was a little more like lasagne that pizza, but delicious nonetheless.

I'll post more photos tomorrow

2007-04-12T13:03:00.000-07:00

Ugandan cattle. I think you get the drift on those horns, borne by male and female alike.

2007-04-12T12:59:00.000-07:00

Bosco is the Archbishop's driver. He was lent to us, along with the diocese bus, to be our transportation all week. And we covered a LOT of miles. Or kilometer, I guess. Sister Germina is the diocesan archivist. She was trained as a journalist in Rome, and recorded our every action on her videocam. Except when we pleaded with her not to. Both Bosco and Germina were very pleasant company on our travels, and special kudos to Bosco for bringing us over all safely over those kilometers.

2007-04-12T12:52:00.000-07:00

After Kakoma we went on to Kyabirukwa Health Center III, which is near the mother house of Sr. Margaret's order, the Sisters of Good Counsel. Several families waited under the trees outside the clinic, and with Fr. Bonaventure's help in translation, I interviewed them to learn more about their lives. Most, like the woman on the left in orange, were there for care for their children with malaria. With Bonaventure's gentle encouragement, they gradually opened up to tell us that they walk many miles to reach the clinic, that the smallest families in their villages have 6 children, the largest 14, and that their most urgent health care need is clean water. That's Fr. Bonaventure in the middle.

2007-04-12T12:46:00.000-07:00

The rolling green landscape of the Mbarara district of Uganda. We learned that the north of Uganda is a very different place. Where the south and west are green, peaceful and relatively prosperous, the north and east are poorer and arid, and have felt the impact of conflict spilling over from Sudan and eastern Congo.

2007-04-12T12:45:00.000-07:00

Dr. Hunter and Sr. Margaret interview the lab technician at Kakoma Health Center III.

2007-04-12T12:41:00.000-07:00

The inpatient ward at Kakoma. Patients there receive the most basic of inpatient services, such as blood transfusions and IV antibiotics. Doctor visits are irregular and expensive. The clinic also offers exams, pediatric care, prenatal care and some medications.

2007-04-12T12:35:00.000-07:00

The clinic staff at Kakoma Health Center III. This is a church-owned clinic open to anyone. The staff consists of 2 nurses, one midwife and a lab tech. The father on the left is their chaplain and I think that's Sr. Margaret on the right. She is the diocesan supervisor of all the nurses, and a nurse herself.

2007-04-12T12:29:00.000-07:00

We learned that most neighborhoods in Uganda's major cities and towns are served by the National Water and Sewerage Corp., a private entity owned by the Ugandan government. This Mbarara neighborhood had a communal water pipe delivering fairly clean water (although the NWSC recommends that residents boil it before drinking). Despite this supply, many people collect water from the natural sources nearby. This woman and child were at the river that ran at the bottom of the hill in the previous shot. The ubiquitous water-collecting jugs are visible behind them.

2007-04-12T12:26:00.000-07:00

A Mbarara neighborhood. Only the main roads are paved. And while it was technically the rainy season while we were there, we had only a sprinkle once or twice. Overall the environment was very dusty.

2007-04-12T12:24:00.000-07:00

A not-very-good shot of one of those raucous ibises. Noisy AND ugly.

2007-04-11T21:02:00.000-07:00

Dr. Hunter and friend at Palm Sunday Mass. Those are Sr. Margaret and Matt Simone in the foreground.

2007-04-11T20:59:00.000-07:00

The children's Palm Sunday procession begins at the Convent of the Poor Clares.

2007-04-11T20:57:00.000-07:00

Some of the children who met us on Palm Sunday. Their costumes were part of the day's church program

2007-04-11T20:55:00.000-07:00

A Kampala street scene, headed for Mbarara.

2007-04-11T20:45:00.000-07:00

We cross the Equator! Front: Joanne, Matt S., Sister Margaret, a young helper, Sister Germina. Back: Dave, Kelly (hidden), Robin, Matt C., Fr. Bonaventure.

Monday, April 9, 2007

2007-04-09T16:42:00.000-07:00

Hello from San Diego!

By now you probably know that your loved ones are home safe. It was a long. long journey from Mbarara; 5 hours into Kampala, another 45 minutes to Entebbe Airport after dinner with Professor Paul at Thomas More House, 8+ hours to Amsterdam, an hour layover, 11 hours to LAX, then 90 minutes by road to San Diego. Needless to say, we are awfully glad to be home.

And we were nearly unanimous about our desire for our first meal at home -- Mexican food!

I hope to post pictures by tomorrow. Please check back, and feel free to leave comment at the spot located at the end of each post.

Best wishes from San Diego,

Joanne of the USD-Uganda team

Saturday, 07 April 2007 Part 2

2007-04-07T05:58:00.000-07:00

And hello one last time from Uganda!

We leave for home tomorrow so here are few anecdotes and word pictures from our travels around Mbarara.

The Uganda Wake-up Call

It’s barely dawn, but we have to get up soon. Did I remember to set my alarm? Will Dr. Hunter come down the hall and knock on my door? Suddenly, a blood-curdling screech from the treetops, then another and another. A short pause. What the heck was that? Then, from the other side of the building, another chorus of ear-splitting screeches. And so on, and so on, and so on.

Welcome to morning in Uganda. No need to set your alarm here at Monfort House. The local population of ibises will wake you in plenty of time as they battle their way back and forth across the roof at daybreak. I love wildlife, but a few well-placed BBs would make this place a lot more peaceful.

ET Phone Home

Cell phones have transformed Uganda. I’m not kidding, the nation has better coverage than the U.S. But rather than contracts and billing like we do, Ugandans buy airtime by means of little scratch-off cards sold almost everywhere in various amounts. ($1 US = 1750 Uganda shillings). So, as the Ugandans say, be sure your phone is “topped off,” meaning if you talk too long and run down your balance, you will hear two beeps, then it’s a sudden bye-bye.

Ecclesiastical Warfare

Everyone told us Archbishop Paul Bakyenga was a warm, informal guy, and he is. We’ve met him twice now, and he treats us like old friends. Pictures of him and his assistant, Bishop Lambert, in their official red-and-white vestments (similar to what cardinals wear) are everywhere around here, including on the wall of the room where he greets his guests. When we complimented Lambert on his photo, Paul boomed out his laugh and said, “Yes, Lambert looks good there in his combat uniform!”

Have Some, You Must Be Starving!

I’ve said before that this is my first time as an “official guest” of anything. Part of being an official guest in Uganda is accepting hospitality under all circumstances. That includes eating, because we find an elaborate spread wherever we go. Yesterday we ate 6 times.

Hook ‘Em Horns

The University of Texas Longhorns have NOTHING on Uganda. The native breed of cows around here has the longest, thickest, heaviest horns any of us has ever seen. 18 inches average sounds about right, probably 10 inches around at the base, males and females alike. Note: these dimensions are approximated from a distance. To be honest, I didn’t want to get close enough to be more exact.

A cow is a valuable piece of property here, for its milk, meat and hide. Although they are domesticated, don’t get too close to one.

Words can’t do these cows justice. You’ll just have to wait for the photos.

And While We’re on the Topic of Livestock

Goats may outnumber people here. They are everywhere, often tied to a nearby tree to graze the greenery along the roadsides. Some roads have berms running alongside, and the goats’ heads just pop up as we rumble by in our bus. They are of every color and pattern, and for the most part look well-fed, thanks to the abundant greenery they help keep trimmed.

Fasten That Seatbelt!

Fr. Bonaventure tells us that the number of motor scooters has exploded in the last few years. You can imagine how they zip in and out of traffic. I’ve seen two helmets since I’ve been here, one of which was actually a football helmet. For everyone else, it’s more of a devil-may-care approach, including for the ladies who ride side-saddle on the back for these death-defying rides.

And while we’re talking about traffic, bring your rosary beads and use them. Last night was Friday, and the traffic was intense. Many people were headed back to their home villages for Easter, others were just trying to get out of town for the weekend. Whatever the reason, driving in Uganda is not for the timid, nor for those with no experience with driving on the left.

How to Say Hello to a Ugandan Child (best done in a high-pitched voice while shaking hands or hugging)

Hell-o-o-o-o. How are y-o-o-o-u?

I yam fine. How are y-o-o-o-u?

I yam fine.

If You Want Something Done, Look for a Big Man

Sister Margaret has been our constant companion throughout the trip. (I suspect she was dispatched by Sister Romina to keep an eye on us.) She is soft-spoken and very kind, but not a woman to be trifled with. Also an astute observer in all situations.

As I’ve mentioned, Dave met with the director of the National Water and Sewerage Corporation to discuss how a new pediatric hospital might be supplied. Did I mention that Dave is 6-foot-3, and that the average Ugandan man is in the 5-foot-6 to 5-foot-9 area? So say that Dave stands out in that company is something of an understatement, and may be a significant asset to the pediatric hospital project, in Sister Margaret’s view.

“I think he is a size agreeable to get things done at the waterworks,” she says.

What Makes You Think It's Water Pollution?

We were fortunate to take a boat ride on the Kazinga Channel yesterday to view some wildlife. A passing stork let out a long stream of urine into the water. As he gazed dreamily into the distance, Fr. Bonaventure observed, "Well, that will give the fish something to think about."

Good-bye from Uganda! Please don’t forget to check back in few days for photos.

Saturday, April 7,2007 Part 1

2007-04-07T05:56:00.000-07:00

Hello from beautiful Uganda!

I promised an account of our excursion to Queen Elizabeth National Park, which is located in the far west of Uganda, on the border with Congo. It is a massive park, hundreds of square kilometres, which incorporates both Lake George, Lake Edward, and the Kazinga Channel that connects them. The park is famous for its wildlife, and we saw a lot, including baboons, many elephants, lions (from a safe distance), mongoose, hyena, crocodiles, hippos, several species of antelope, water buffalo, velvet monkeys and dozens of species of birds. It was an adventure of a lifetime, although all too short. I’ll post lots of pictures of what we saw when I get home, although you can probably see better shots on the Nature Channel. That’s what it was like – the Nature Channel, but in real life.

Now it’s Saturday and threatening to rain. Lots of thunder and lightning, but few drops as yet. We visited two privately owned, for-profit hospitals this morning to see (1) what facilities that wealthier patients are willing to pay for and (2) what the best medical care Uganda has to offer looks like. The facilities were better than those we have seen so far at the not-for-profit sites we have visited. Yet that intangible “certain something” was not there, that feeling that the staff was not as fully committed to the well-being of patients as those at the Church-run facilities, or even the Mbarara public hospital I’ve already written about. Still, seeing the spectrum of Ugandan health are has given us a great perspective on the task facing Mbarara. I hope they will be able to incorporate the best of both kinds of facilities.

And now our official work is over. It’s raining now on our corrugated tin roof but we are safe and dry at Monfort House. We’re catching up on rest, emailing home, reading, doing crossword puzzles, napping, tweaking our final report and preparing this blog. And a few of us are drinking some of the good Ugandan beer, but specific identities have to be protected.

I’ve already said that it has frustrated me no end that I’ve not been able to post photos due to our slow internet connection. So I will sign off now and start a new posting that I hope will paint some verbal pictures of some of our moments here in Mbarara, Uganda.

I’ll be back.

Joanne of the USD-Uganda team

Friday, April 4, 2007

2007-04-06T11:56:00.000-07:00

Hello from beautiful Uganda!

Sorry for the gap in entries but we’ve everything from power outages to a elephants blocking our travels. More on that tomorrow.

To catch up, on Wednesday we had wonderful news and a discouraging experience. First, we met with the deans of the Schools of Medicine and Nursing at Mbarara University of Science and Technology. Both were fully supportive of the children’s hospital idea and pledged to work with the diocese as the project progresses. We also learned a lot more how about how doctors, and especially nurses, are trained. We were happy to find out that advanced training is available for nurses, including in pediatrics. Hopefully at some point the programs will be ramped up to ensure a steady supply of nurses who can practice at an advanced level.

The discouraging part of the day came when we visited Mbarara University Hospital, which is Mbarara’s public hospital. The conditions were very grim, even by Ugandan standards. Wards were so crowded with patients and their families that they appeared impossible to keep clean. The staff had little space to move around. The windows had no screens, and none of the beds were mosquito-netted. In other words, patients – especially the children – were being cared for in conditions very similar to the ones that brought them in in the first place.

Please understand that the staff at the hospital is fully aware of its shortcomings. They work very hard, but the odds against them are vast. They turn no one away. Their funding is eternally inadequate. Their equipment is broken and can’t be fixed because it is obsolete. For example, both the hospital’s x-ray machines have been broken for more than a year, and bureaucracy is holding up a decision about getting new ones.

One bright spot at the hospital is the lab, which spends most of its time working on HIV testing. As you may know, Uganda has made remarkable progress in reducing its HIV infection rates. It shows that progress can be made with the right investments.

We came back from the hospital and set right to work on our report to Archbishop Paul’s hospital planning committee. Dr. Hunter jotted down a few notes, then we all sat around a table with a laptop computer and jointly wrote a first draft. Our recommendation: a strong “thumbs up” for the hospital, along with a concurrent program to train lay community health workers.

Fr. Bonaventure dropped in for a preview of what we would tell the bishop the next day, and he left very enthusiastic. On Thursday morning Dr. Hunter met informally with Archbishop Paul for his preview, then the whole committee met with all of us for the formal presentation, and when I say formal, I mean formal.

I’ve never been an official visitor before, so I’m not used to being treated like a VIP. But here, it’s formal introductions at every meeting (Dr. Hunter’s doing a great job on this), a blessing, opening remarks, etc., etc., etc. A confession: it gets a little tiring, but our welcomes are so warm and everyone we meet is so happy to see us that we really can’t complain. Plus, there’s refreshments at every stop.

I haven’t seen one ice cube since we got here. Refrigerated soda and water is common, but room temperature soda and water is even more common and we’ve gotten used to it.

Anyway, back to the meeting with Archbishop Paul. It was very successful. Fr. Bonaventure gave a nice summary of what we had done up to then, then Dr. Hunter took the floor and made a good presentation. The committee’s questions were cogent and the suggestions they made were good ones. We concluded with action plans for both sides of the globe and now the project is in the hands of the Ugandans (and their American supporters at San Rafael Parish). We from USD will be standing by, of course, to assist whenever we can.

Then it was a lovely lunch with the Sisters of Good Counsel, Sister Margaret's order. I met Sister Margaret’s Mother Superior, Sister Romina, and told her what a great job Margaret had been doing keeping us out of trouble. Margaret saw me talking to Romina and I loved teasing her about what I had said. I finally broke down and told her, but I don’t think she believed me.

After the meeting the Archbishop gave us the rest of the day off, so we hustled off to Queen Elizabeth National Park for some wildlife viewing and a good dinner.

More on that tomorrow. By the way, at the bottom of each blog entry is a place for you to add a comment if you would like. We would LOVE to hear from you.

Love from Uganda,

Joanne of the USD-Uganda team

April 4, 2007

2007-04-04T08:45:00.000-07:00

Wednesday, 04 April 2007

Hello once again from Uganda!

It is really bothering me that I am unable to attach pictures to this blog as we go along. Unfortunately, our internet access is not broadband, and our connection “times out” before the photo files can upload. I will have to be content with trying to create word pictures, then post lots of pictures when I get home and my bandwidth widens.

Right now it is 5:25 pm. We meet with the Archbishop’s Hospital Committee tomorrow at 10 a.m. and Dr. Hunter is holed up writing a preliminary report. Everyone on the team is out on the lawn with Fr. John Mary, drinking beers and sodas and relaxing. We met as a team earlier this afternoon and were astonished at how much information we have collected. We are in basic agreement with the recommendations we will present to the Archbishop’s committee.

A few words about yesterday . . . we visited the Ibanda Babies Home, an orphanage for children 0-4 years. There were 41 kids in residence, boys and girls, about evenly split between infants and toddlers. All the toddlers wore the same haircut (short), and the same clothing (dark blue playsuits). And they were all about the same size, so I’m glad I’m not the one responsible for telling them apart.

To say that they were adorable would be, well, understating it a bit. They were chattering and running around our legs, hugging us, playing with the few toys Dr. Hunter brought. As far as we could see, they were the only toys around.

Most of these children were abandoned by their parents. Often, when a mother dies in childbirth, the father will take the infant to an orphanage, then return for it when it reaches 4-6 years old. Some kids were AIDS orphans. Some are just left somewhere to die, presumably because their families can’t take care of them. It’s daunting to think of their futures. They’re getting the best care possible, but Uganda has few resources to help these children overcome their beginnings.

Our next stop was Ibanda Hospital, a 180-bed general hospital, known as a district hospital here, run by the Sisters of Good Counsel (I love that name). Dr. Emmanuel Byaruhanga, an OB-GYN, is the medical director there. Sister Grace Kyomuquisha is the administrator. After a nice lunch the sisters waited 3 hours to serve us, we toured the hospital, and it was our first glimpse of inpatient care. This is where photos would come in handy . . .

Can you picture a hospital ward from an old WWII movie, one huge room with beds aligned along the walls? That’s Ibanda. On the beds are men, women or children (in separate wards), and almost all have family members present who meet all their daily needs for food, bathing and all of what nurses call ADLs (activities of daily living).

Ill children have mothers and even their siblings at their bedsides 24/7. Mothers may have their babies with them. Men are sometimes alone, sometimes with their own mothers or other family member. There is no way nurses or other personnel could attend to patients’ every needs, not when the nurse-to-patient ratio is 20-to-1 or more.

Family at the bedside is a fact of life here in Uganda, and something which will definitely need to be factored in to the Holy Innocents project. Families also acquire and cook their family member’s food while they are hospitalised, so Holy Innocents must also provide for this practice.

Care at Ibanda is loving, but basic. Midwives deliver most babies, but Dr. Emmanuel does the high-risk deliveries (breeches, prolapsed cords, etc.) and gynaecological surgeries. (They spell it differently here.) Beyond that, we met a little guy who had punctured his abdomen falling from a tree, and was recovering from peritonitis. But, like most other facilities we have seen, many people and almost all the children were there for malaria and its complications, especially anaemia and dehydration.

Dr. Emmanuel is onsite most of the time, along with several young doctors who are just beginning their careers. But when specialists are needed – almost all of whom are private practitioners – the costs become astronomical. And most patients are charged little or nothing for their care, because they can’t afford any more. And when I say they can’t afford more, I mean it.

Our day ended with a visit to the Water and Sewer Corporation of Uganda, which supplies most of Uganda’s cities with their, um, water and sewer. As always, we had a ceremonial introduction, Dr. Hunter said a few words, we signed the guest book, and the meeting got underway. David Webb is our infrastructure guy, so he and the general manager got down to business, talking backflow, connection diameters, and other water and sewer stuff while the rest of us ate cookies, drank soda and longed to return to Monfort House. We ended with an invitation for Dave to return Wednesday for a tour of the waterworks, and more guy-talk about how the Holy Innocents will get drinking water and dispose of its waste.

More tomorrow, I hope, about our visits to the Mbarara University of Science and Technology Schools of medicine and nursing, and how Sister Margaret has identified Dave’s height (6 foot 3) as a significant advantage when trying to get things done in Uganda.

One last note: last night I identified Matt Simone as a pediatric intensive care nurse. Wrong Matt – that’s Matt Cerchie. Matt Simone is actually an ER nurse.

We sent all our love to everyone at home,

Joanne

April 3, 2007

2007-04-04T08:43:00.000-07:00

Tuesday, 03 April 2007

Hello again from Mbarara, Uganda!

Sorry for the delay in this blog. We had no power last night, from about 7 p.m. Monday until after 8 a.m. Tuesday. Fortunately Monfort House, the church property where we are staying, has a gadget that banks solar power for the outages that are almost-daily occurrences here. So we had basic power and the cooks cook with bottled gas, so we could do what we needed to do, but that did not include using the computer. What we call “rolling blackouts” in America are routine in Uganda, as electricity generating capacity has never caught up with demand. So time for some catch-up on our activities.

Our work began in earnest Monday morning with a visit to the Kakoma Health Center III, founded in 1986 by the Sisters of Good Counsel. Health facilities are classified by the Ugandan health ministry from levels I through VII, basic to most advanced. The work at Kakoma centers largely on prenatal care and midwifery, but most of all care for children with malaria. Several children were receiving IV fluids for dehydration in a small, stuffy room. Their mothers were at their bedsides, many with their other children nearby. Matt Simone, one of our pediatric nurses, described the children as very, very sick. Here they are treated in a very basic clinic by a loving and dedicated staff that has limited help to give. I think most of us knew what to expect in coming to Uganda, but the impact of witnessing it in person was very powerful.

We went on to Kyabirukwa Health Center III which, while still basic, seemed better equipped than the Kakoma site. Kyabirukwa was also larger but, by our standards, very poorly equipped or stocked. While the others toured the facility, Fr. Bonaventure and I stayed outside to interview families who were waiting to be seen (no appointments necessary at Kyabirukwa), or for medicine or the like. Fr. Bonaventure was a sensitive and attentive interpreter.

Almost all the families were there for malaria treatment for a child <5. The smallest families in the vicinity have 6 children, the largest up to 14. And of the seven families we talked with, only three owned a mosquito net. When I asked if their children slept under the nets, most said no. One mother asked, “All of my children won’t fit under the net. Which ones should I cover, and which ones leave out?” There is no right answer for that question.

Despite their poverty and disadvantage, these families – like many Ugandans – want the best for their children and understand the advantages of things like clean water and health care. They are not ignorant or superstitious; they are just very poor and must overcome barriers like money and distance to access medical attention. Their choices are stark and difficult.

Today is Tuesday. We ventured into downtown Mbarara to change some US dollars into Ugandan shillings. The exchange rate is roughly 18-20 shillings to $1. Fr. Bonaventure did our money-changing at the bank where he is a regular customer, and got us a slightly better rate. Then it was on for a very brief stop at the St. Fransiska Makonje Health Unit II, a tidy facility full of mothers and children being treated for all manner of conditions, mostly malaria. Sadly, we were running late, and had to decline the sisters’ hospitality. More on Tuesday tomorrow, the electricity gods willing.

Before ending, just a word about Ugandan hospitality. Everyone we meet greets us in the warmest way, with “You are welcome here. Every facility, no matter how humble, has a sitting room to receive guests, and all offer us sodas, water and often sweets. There are handshakes and hugs all around. Sr. Margaret, who met us at the airport, has seen many of her sisters from within the Sisters of Good Counsel, and from other orders as well. It’s like old home week for her.

We have also had lovely lunches, generally catered by a local lady who brings in the food in big pots, sets it all out, covers it with a lacy tablecloth to ward off insects. We have eaten lots of chicken (not cut into the pieces most Americans would recognize), cabbage, potatoes, sweet potatoes, sometimes green beans, cooked plantains and today the Ugandan delicacy, cooked millet. Dessert is always fruit, and if you ever get to try a Ugandan pineapple, you won’t forget it! They are great!

More tomorrow, I hope.

Joanne

April 3, 2007 6:44 PM

Sunday, April 1, 2007

2007-04-04T08:40:00.000-07:00

Sunday, April 1, 2007

Hello from Mbarara, Uganda!

First things first . . . the name of our home for this week is pronounced Bah-RAH-rah. That’s one of the first things we learned. We are finally here and there is much to report.

Our flights here were uneventful, except for the 3-hour delay in Amsterdam when a catering truck poked a hole in our plane and the pilot deemed it unsafe to fly. We moved to another plane. All told, we spent 20+ hours in the air, and 7 hours on layover. But the welcome we received in Entebbe, Uganda made it all worth it. Father Bonaventure Turyomumazima, Sisters Margaret Katyoko and Gemina Keneema, and John Baptist Mujuni were there to meet us, and a warmer welcome I have never had anywhere. We exchanged hugs, kisses and handshakes in the humid Ugandan night, and met our first mosquitoes. Every moment was recorded by Sister Gemina on her videocam (she is the archivist for the Diocese of Mbarara), and dozens of photos shot.

From there it was 40 minutes to Kampala, where Fr. Bonaventure arranged for us to stay at the Thomas More Leadership Academy and guest house, where our host was Professor Peter Kasenene. Although it was 1 a.m. Uganda time, the professor and his staff had laid out a welcoming buffet of cold drinks, including an assortment of cold beer. Bedtime waited while we spent an hour with Peter – a former university professor and Ugandan government minister – learning as much as possible about Uganda. It was a very valuable hour.

Our host sent us off for our 5-hour drive in the diocesan minibus west to Mbarara. Our driver was Bosco, who skillfully shared the road with double semis, bicycles, scooters and goats. By the way, they drive on the left here.

About half-way we had an unexpected treat – we crossed the Equator, most of us for the first time. And what you learned in school is true – water goes down the drain in the opposite direction than in the northern hemisphere. We even had a demonstration, and it was amazing. And in case you are wondering, the water drains straight down when you are actually on the Equator. Another opportunity for lots of pictures, which I hope to post on the blog soon.

We also visited a possible site for the Holy Innocents hospital, about 30 km east of Mbarara. David Webb, the engineering/construction guru on this trip, asked Fr. Bonaventure and John Baptist some penetrating questions about the site and for me, at least, the project actually started to feel real.

We arrived in Mbarara at about 4 p.m., and went straight to the Monfort, which is the priests’ residence and visitors’ house. As a southern Californian, I was immediately reminded of a hacienda – a building where all rooms face a central courtyard. It is part of the diocesan complex on this side of town, which also includes the cathedral, the archbishop’s headquarters and all the diocesan administrative offices. And the banana plantation.

Speaking of the archbishop, we had dinner with him, his auxiliary Bishop Lambert, and the hospital committee last night. Archbishop Paul Bakyenga was very warm and welcoming. He also has a booming voice and a great sense of humor. (He refers to a bishop’s red-and-white formal vestments as a “combat uniform.”) It was something of a formal occasion. Dr. Hunter had to make a speech she didn’t know about beforehand, and try to come up with something nice about each of us. Then Bishop Paul gave us a formal welcome and a blessing, and let us go back to Monfort for more of the sleep we were craving.

Today is Palm Sunday, and we went to Mass at the convent of the Poor Clares, an order of contemplatives who live within the convent walls, and spend their days praying, making hosts and vestments, and cheese. Our minibus was met by hordes of costumed children preparing for their performance, to lead us all into the church waving our palm fronds. Another round of photographs, of course. The kids got a huge kick out of seeing their pictures immediately on the screens of our digital cameras, and John Baptist promised he would distribute them if we sent them back via internet.

Now we are resting back at Montfort and preparing to go into town for a look around with John Baptist, so a few general words to close.

Uganda is a beautiful, green country and it is working hard to modernize. The people we have met treat us like visiting celebrities and sincerely want to work with us to make the Holy Innocents’ project a reality. We begin the hard work of our project tomorrow, but in the meantime have been made to feel so welcome. It may be harder to leave than we expect.

More soon.

Joanne

April 1, 2007 2:58 PM

Thursday, March 27, 2007

2007-03-27T22:29:00.000-07:00

Tuesday, March 27, 2007

Welcome to the USD-Uganda blog. We hope this blog will tell the story of our 12-day trip to Uganda, which begins March 29. Our purpose is to perform a community assessment study in preparation for building the Holy Innocents Children’s Malaria Hospital in Mbarara, Uganda. The project is the brainchild of Tom Harold, of the San Rafael Parish in Rancho Bernardo. After learning of the terrible toll malaria takes on Uganda’s youngest citizens, he and his friend Lane Freestone created a nonprofit corporation and have enlisted volunteers to help with all aspects of the project -- legal, accounting, fundraising, web hosting, and so on. Their goal is “better health for all children in Uganda,” and the Holy Innocents project is only one of the goals they pursue.

And now about Mbarara. It is a town and a district in the southwest of Uganda. It is home to about 1.1 million people. It is Uganda’s principal milk-producing area, complete with cooling plants, and also grows bananas, coffee, maize, beans, vegetables and Irish potatoes.

The town of Mbarara is home to the Mbarara University of Science and Technology. Founded in 1989, it is Uganda’s second public university, and grants degrees in computer science, tropical forest conservation, community development, medicine, and science. We’re hoping to learn more about the university after we arrive.

We’re still here in the US. We leave from USD Thursday, 3-29, at 3 a.m. on a shuttle for LAX. Then it’s 20 hours in the air and 6 hours of layovers until we reach Entebbe, Uganda.

Our team is made up of Dr. Anita Hunter, associate professor at the Hahn School of Nursing and Health Sciences of the University of San Diego, four registered nurses and two nursing students. Here’s more about us:

Dr. Anita Hunter has been actively involved in international nursing and has led medical missions since 1995 to Cuernavaca (Mexico), Bani (Dominican Republic), Ghana (West Africa) and Belfast (Northern Ireland). She has served as a medical consultant to the Minister of Health in Takoradi, Ghana and to the Nuestros Pequenos Hermanos Orphanage system in Mexico. She has taken over 500 students, faculty, and health professionals on these medical missions and has been personally involved in providing care to over 75,000 people around the world.

Dr. Hunter has nine years’ experience working in Ghana with malaria and other illnesses endemic to that region. She continues to serve the underserved around the world in her role at USD, integrating her expertise in the curriculum and facilitating the mission of USD to internationalize its students and faculty.

She teaches in the master’s and doctoral programs, directs the RN-BS Program, Master’s Entry Program into Nursing, and the MS in Clinical Nursing program. She received her degree as a pediatric nurse practitioner at Northeastern University in Boston, her MS from the University of Massachusetts/Amherst, and her PhD in Educational Leadership from the University of Connecticut in 1994.

The RNs on our team will focus on assessing the Mbarara community’s professional, educational, social and technical resources. They are:

Matt Cerchie, a pediatric intensive care nurse who is working on a master’s degree in nursing USD. Matt has prior international health experience working in Mexico and Guatemala, but this is his first trip to sub-Saharan Africa.

Matthew Simone is a nurse in the emergency room who is also completing his advanced training as a family nurse practitioner. This is his first trip toAfrica.

Robin Simms is an RN working at Scripps Mercy Hospital in the Emergency Department. She is currently working on her master’s degree as a clinical nurse leader. Robin has a strong passion for international work, and has previously been to Tanzania. This will be first visit to Uganda.

Kelly Woods has been an emergency room nurse for five years. She has been a volunteer in Central America for three years and has assisted in opening and maintain clinics and schools. Like Matt and Matt, this is her first trip to Africa.

Our two nursing students were added for their individual non-nursing expertise. Both will finish their RN training in May, 2007.

Dave Webb is finishing his first years of the Master’s Entry Program in Nursing (MEPN) program at USD. In his prior career, he spent several years managing large design and building projects, and will be assessing the feasibility of constructing the Holy Innocents clinic and hospital.

And I’m Joanne Gribble, also a MEPN and the writer of this blog. My background is in communication and nonprofit marketing. My job will be to work on the community assessment and development aspects of the trip. Like most of my teammates, it’s my first trip to Africa.

Let’s hope we can line up some internet access in Mbarara, so we can keep you up to date on what’s going on.

Wish us luck!