Wednesday morning at the health center, and suddenly two shiny silver UN vehicles pull into the compound. I look on with some interest as people climb out, carrying cameras, video cameras, and notepads, people who clearly aren't from around here. Before I know it, the pediatric ward is abuzz with activity, people snapping pictures and taking video footage of some of the most pathetic malnutrition cases, and vying for Jennifer's attention, asking her questions and carefully recording her answers.
As it turns out, today was the launch of a major child malnutrition campaign in Bundibugyo, spearheaded by the World Food Program, and WFP staff and newspapers reporters were looking for information for their pieces on the project. The scene on the ward was unlike any I've seen, the mothers chattering back and forth, probably amused and confused by the commotion. Pitiful little Kabasa, a five year old with horrible malnutrition resulting in massive edema and his skin deteriorating, probably had 200 pictures taken of him, but he, and his father, seemed to like the attention. I was glad that the reporters also wanted to speak with the families of these kids, not only to the hospital staff. Perhaps people who never have a voice will be heard, or will at least feel that someone wants to hear. That, however, is probably overly optimistic.
When Jennifer mentioned one of the programs that I work on she indicated my involvement, and soon reporters turned to me with their questions. Mostly, I was afraid of saying the wrong thing, saying something that would somehow hinder efforts to address malnutrition in the district, or would cast the work being done in a poor light. But there I was, taking questions from reporters from the two biggest national newspapers in Uganda, and almost laughing that they felt that talking to me might be worthwhile. Finally, they asked me for my name and my title, so that they could site their sources. I froze - what is my tittle? I don't have one! But I can't tell them that. Some jocular titles that I've considered for myself here flashed through my mind - assistant bean counter, head of vermin control, nondescript duties officer - but in the end I stammered out something about being a nutrition worker with World Harvest.
It was interesting to hear these reporters talking to Jennifer and trying to get the one phrase that summed up the problem, the core of the issue, while she kept repeating that it is much more complex that any one thing. There's no one thing causing malnutrition here, rather it is a host of problems like child spacing, increased cash cropping, low education levels (especially among girls), and families splitting, leaving the kids with only one parent to provide. The outside agencies want the key point, the issue to address, the sound byte, the target, the money raiser, which isn't a bad thing to want, but the reality is not nearly so straight forward.
Today was the big event, a major gathering in Bundibugyo town, including members of parliament, the district governor, district health officials, and the WFP country director for Uganda. Of course, the program started about an hour and a half late, but here that's actually pretty good. A march through town, led by a marching band (this is crazy stuff for Bundibugyo) kicked off the event. Singing, dancing, and dramas about nutrition provided the entertainment, and in addition to the one or two hundred invited guests, there were hundreds of people who crowded into the open boma grounds to see the spectacle and listen to the speeches. There were some good messages, and while a lot of the program seemed to be just for show, and I'm still hazy on what the program being launched actually is, it was great to see the awareness of the need, and to hear of the commitment of the WFP to the district. This sort of activity and awareness could do good things for this place.
But one of the coolest aspect of the event was that the impetus behind it came largely from research done by World Harvest missionaries. The BBB program that I work on was started by Stephanie Jilcott, a PhD in nutrition who has published research done on malnutrition in Bundibugyo, and this program was furthered by the work of Scott Ickes, whose doctorate was based on his work with BBB. They have both recently presented and published research on malnutrition here, and this major WFP campaign seems to stem directly from that. One WFP worker who I met, an American, asked me, "So do you know Scott Ickes? I've talked with him about this program and we've look at his research a lot." It was thrilling to see the hard, and sometimes tedious, work of other World Harvest people paying off in such big ways - big enough that the UN and WFP are deciding to make Bundibugyo a major focus for their work in Uganda.
Friday, February 26, 2010
Sunday, February 21, 2010
What is going on here?
Several interesting, frustrating, surprising cultural experiences in the the last couple of days.
A good friend stops by my house in the morning, and I invite him in for tea. In seconds, he has grabbed a loaf of bread, cut himself two massive slices, polished off my peanut butter, and used a massive amount of jam in making himself a sandwich. Never did I indicate that I would feed him, nor did he ask - it was simply the obvious thing. It doesn't occur to someone here that I might want to save those things for later, or for another use, or to actually use some of them myself. It seems that in this culture, it wouldn't make sense for someone to have a use for something that would trump supplying a friend while he was over. Therefore, why would someone even need to ask? Also, the idea of saving for later isn't very strong in this culture, for a number of valid reasons, so it doesn't occur to someone that I might be trying to stretch this peanut butter over a couple months rather then weeks. This sort of thing is difficult as an American, and challenges me not to view everything through a narrow cultural lens and to be humble, open to other ways of thinking and understanding.
In meeting with the local chairman to report a recent break-in and theft in one of the houses, he began talking about the string of incidents at my house over the last few months, the have involved children coming in in-between the bars on my windows. The identity of one of the children has become clear, and unfortunately he is a good friend of mine. However, is discussing this, the official would never actually use his name. He said things like, "Your friend," or "That neighbor." At one point he even looked at me uncomfortably and said, "Sorry, I don't want to name him." Social harmony is of utmost importance here, and accusing someone of something, even if they are clearly guilty, is offensive and apparently unacceptable. This sentiment is so strong that, even in a conversation with me, away from those involved, an official can imply the identity of a boy who has stolen from me, but can't actually use his name.
I came across an acquaintance who was cutting lumber from tree he had felled, and he began telling me about the construction project he was using the lumber for. He had paid someone for lumber, but they refused to give it to him, keeping his money and the lumber. My response was to say that they had stolen his money. He replied that he had tried to get the lumber from them, but they had refused again, so he said, "So I avoided a quarrel, and decided to harvest my own lumber." Never mind that they took his money and didn't provide that which he paid them for - he avoided a quarrel. That was the important part. This was shocking to me. Most of you probably know me well enough that I definitely like to avoid conflict, but this passivity in the face of blatant dishonesty and theft still seems incredibly foreign to me. But I suppose that we all see things through the filter of our own culture - for him, the theft was not the most important thing, rather, maintaining social harmony, not making enemies, and not engaging in conflict was the highest priority.
These sort of encounters, along with many others that stuck out a little less in my mind, all of them occurring in 24 hours, are the sort of things that can make my head spin. Make me feel like I just don't understand people here, and give life a continuous background of stress. But they also challenge me, stretch me, force me to think about things in new ways, shed light on many of my presuppositions, and reveal my idols of control and respect. Cross-cultural living is wonderful and terrible, fun and frustrating, exciting and maddening.
A good friend stops by my house in the morning, and I invite him in for tea. In seconds, he has grabbed a loaf of bread, cut himself two massive slices, polished off my peanut butter, and used a massive amount of jam in making himself a sandwich. Never did I indicate that I would feed him, nor did he ask - it was simply the obvious thing. It doesn't occur to someone here that I might want to save those things for later, or for another use, or to actually use some of them myself. It seems that in this culture, it wouldn't make sense for someone to have a use for something that would trump supplying a friend while he was over. Therefore, why would someone even need to ask? Also, the idea of saving for later isn't very strong in this culture, for a number of valid reasons, so it doesn't occur to someone that I might be trying to stretch this peanut butter over a couple months rather then weeks. This sort of thing is difficult as an American, and challenges me not to view everything through a narrow cultural lens and to be humble, open to other ways of thinking and understanding.
In meeting with the local chairman to report a recent break-in and theft in one of the houses, he began talking about the string of incidents at my house over the last few months, the have involved children coming in in-between the bars on my windows. The identity of one of the children has become clear, and unfortunately he is a good friend of mine. However, is discussing this, the official would never actually use his name. He said things like, "Your friend," or "That neighbor." At one point he even looked at me uncomfortably and said, "Sorry, I don't want to name him." Social harmony is of utmost importance here, and accusing someone of something, even if they are clearly guilty, is offensive and apparently unacceptable. This sentiment is so strong that, even in a conversation with me, away from those involved, an official can imply the identity of a boy who has stolen from me, but can't actually use his name.
I came across an acquaintance who was cutting lumber from tree he had felled, and he began telling me about the construction project he was using the lumber for. He had paid someone for lumber, but they refused to give it to him, keeping his money and the lumber. My response was to say that they had stolen his money. He replied that he had tried to get the lumber from them, but they had refused again, so he said, "So I avoided a quarrel, and decided to harvest my own lumber." Never mind that they took his money and didn't provide that which he paid them for - he avoided a quarrel. That was the important part. This was shocking to me. Most of you probably know me well enough that I definitely like to avoid conflict, but this passivity in the face of blatant dishonesty and theft still seems incredibly foreign to me. But I suppose that we all see things through the filter of our own culture - for him, the theft was not the most important thing, rather, maintaining social harmony, not making enemies, and not engaging in conflict was the highest priority.
These sort of encounters, along with many others that stuck out a little less in my mind, all of them occurring in 24 hours, are the sort of things that can make my head spin. Make me feel like I just don't understand people here, and give life a continuous background of stress. But they also challenge me, stretch me, force me to think about things in new ways, shed light on many of my presuppositions, and reveal my idols of control and respect. Cross-cultural living is wonderful and terrible, fun and frustrating, exciting and maddening.
Monday, February 8, 2010
Lessons in cooking, and life
One benefit of being almost alone in the district this week (it's just the Clarks and me) is that I've spent a lot of time with Ugandan friends. Yesterday, my good friend Vincent had me over to his house for dinner, and to teach me about local cooking. So when I arrived at his house at 6:15, I stepped into the kitchen and started helping out.Now, kitchen is a relative term. This kitchen, and almost all kitchens in this district, is a small, free-standing structure made of mud packed onto a frame of wood and reeds, with a thatched roof and packed dirt floor. One the ground is a wood fire with three stones around it, which support pots and pans over the fire. There is no chimney. Where does the smoke go, you ask? Into my eyes. And lungs. Ok, most of it escapes through holes in the roof and through the door, but my eyes were burning the whole time, and I woke up this morning smelling strongly of wood smoke. The kitchen counter is outside - a piece of wire mesh suspended between four small poles, where food is placed to keep it clean and dry. There is one knife in this kitchen, and no cutting board; everything is cut while in the hand, pulling the blade back toward your thumb.
I arrived while the sombe was in progress, one of my favorite Ugandan dishes, made from cassava leaves. Vincent walked me through the process of making it, and I was glad to learn, and hope to give it a shot on my own sometime soon. Soon after I got there, Vincent's sister-in-law walked over and just started laughing at us. The sight of two young men cooking is so unusual that she couldn't contain herself. In American culture, it is common for women to be the primary cooks, but here, it seems almost unheard of, and certainly comical, for grown men, and especially married men, to cook. This led me to give me to give Vincent a lesson in American culture: in America, a lot of young men learn to cook, primarily to impress women.
One aspect of food preparation here that didn't immediately occur to me is that dishes are prepared serially. That is, first we cooked the sombe, then we cooked some vegetables, then we cooked the rice, then we cooked the g-nuts. All of this after Vincent and already steamed bananas and cooked cabbage, and prior to that, the firewood had to be collected and split, and the fire started. But the time invested is even more than that makes it seem, as the sombe has to be ground by hand, the rice has to be hulled with a mortar and pestle and have the hulls removed (which took over an hour), an I spent about 30 minutes pounding g-nuts, also with a mortar and pestle. Combine all of these activities, even with several nieces and nephews helping out, and we didn't eat until after 9. It was a great dinner, spent with good friends. I sat next to Aliganyila, to whom a previous post was dedicated, and had a great time laughing with Vincent.
The evening made me think about how different my experience of something as basic as food preparation has been. Yesterday, I almost cut my fingers off several times, while Vincent barely even has to look at what he's cutting in his hand. I buried my eyes in my arm when they filled with smoke, while Vincent hardly flinched. I felt like everything took a long time, and, well, Vincent did too, but he is used to cooking one dish at a time, and people here don't rush like we Americans do.
The smoke, the dirt, the arms tired from grinding, the heat, blowing on the fire, the darkness, the laughter, the silence, time passing - a meal. An experience of life. Simple, unremarkable, everyday life. The mundane. The activities that fill up days and years, the necessary things, the very fabric of experience for so many people here, and all over the world. I was glad to be there for it.
Thursday, February 4, 2010
Hitting the ground running
My first full day back was as busy as I would have expected, and then some. After sleeping only three hours the night before, I slept soundly until I was awakened around 7 by a thunderclap that rattled my bed, and I once again had no idea where I was for a few seconds. I set off down the road for the health center, greeting people on the road, and grateful for the cloud cover (I've already been told "You have changed your color, you are now very white").
Wednesdays are always busy at the health center, so I was trying to get back into the swing of things with Jennifer on the pediatric ward as well as working with Baguma on a nutrition program for ARV patients. It was good to be back there, but hard to see so many sick children again. The main event happened in the afternoon, as I went with Baguma for the opening day of a new site for our BBB nutrition program. He had trained community volunteers and taken care of the logistics in my absence, and I came back just in time for the big day. When we arrived around 1:30, there were about 20 mothers there with their children, and I expected that more would come throughout the afternoon. I spoke to the mothers about the program, lavishly thanked the volunteers, and then we began weighing kids and measuring their height in order to evaluate their nutrition status. We began to draw a crowd of onlookers, which didn't surprise me, given that this was a new event at this site, and that there was a white person there (this place is way out in the village). I wasn't prepared for what happened next. More and more children came, and I began to notice that most the kids we were measuring were big, chunky, healthy kids. Then I looked at the stack of papers for kids waiting to be weighed, it was growing rapidly. For every child we weighed, two more showed up. I realized that every mother passing on the road was stopping to have her child screened, and I was told that some women had run to their villages, shouting for everyone to come have their kids weighed - it was possibly the most effective community mobilization I have ever seen. Everyone, healthy, sick, and in-between, was coming to be weighed, probably in the hope of getting a free handout. But after measuring about 100 kids, with at least that many still waiting, we decided that Baguma would do triage, and send away all of those who were clearly not malnourished. Then we started to see the malnourished kids, and we finished weighing and measuring, but hadn't even started evaluating them, after three hours. After sorting through all of these papers, we decided on 17 kids who were in bad enough shape to qualify, and one who was barely clinging to life who I referred to the health center. As I started entering names and date into record books, the fun part began. Baguma demonstrated how to prepare the food we distribute, and watching him teach and engage with the mothers is a pleasure, even if I can't understand much of what he is saying. Then came the best part of my day - watching these malnourished kids stuff their faces with the nutritious food from the demonstration. It is simply beautiful. Whenever we do a demonstration at one of these programs, this brings joy to my heart and a beaming smile to my face - it gets me every time.
It was getting dark by the time we left, and we didn't get home until 7, officially the latest I have ever seen one of these program run. But it was great: eager mothers, competent and excited volunteers, health center staff present and helping, good food, smiles, crying, laughter. I felt sadness at working with pitiful malnourished children, and knowing that they may not improve, but also hope for recovery and excitement at the start of something new.
Wednesdays are always busy at the health center, so I was trying to get back into the swing of things with Jennifer on the pediatric ward as well as working with Baguma on a nutrition program for ARV patients. It was good to be back there, but hard to see so many sick children again. The main event happened in the afternoon, as I went with Baguma for the opening day of a new site for our BBB nutrition program. He had trained community volunteers and taken care of the logistics in my absence, and I came back just in time for the big day. When we arrived around 1:30, there were about 20 mothers there with their children, and I expected that more would come throughout the afternoon. I spoke to the mothers about the program, lavishly thanked the volunteers, and then we began weighing kids and measuring their height in order to evaluate their nutrition status. We began to draw a crowd of onlookers, which didn't surprise me, given that this was a new event at this site, and that there was a white person there (this place is way out in the village). I wasn't prepared for what happened next. More and more children came, and I began to notice that most the kids we were measuring were big, chunky, healthy kids. Then I looked at the stack of papers for kids waiting to be weighed, it was growing rapidly. For every child we weighed, two more showed up. I realized that every mother passing on the road was stopping to have her child screened, and I was told that some women had run to their villages, shouting for everyone to come have their kids weighed - it was possibly the most effective community mobilization I have ever seen. Everyone, healthy, sick, and in-between, was coming to be weighed, probably in the hope of getting a free handout. But after measuring about 100 kids, with at least that many still waiting, we decided that Baguma would do triage, and send away all of those who were clearly not malnourished. Then we started to see the malnourished kids, and we finished weighing and measuring, but hadn't even started evaluating them, after three hours. After sorting through all of these papers, we decided on 17 kids who were in bad enough shape to qualify, and one who was barely clinging to life who I referred to the health center. As I started entering names and date into record books, the fun part began. Baguma demonstrated how to prepare the food we distribute, and watching him teach and engage with the mothers is a pleasure, even if I can't understand much of what he is saying. Then came the best part of my day - watching these malnourished kids stuff their faces with the nutritious food from the demonstration. It is simply beautiful. Whenever we do a demonstration at one of these programs, this brings joy to my heart and a beaming smile to my face - it gets me every time.
It was getting dark by the time we left, and we didn't get home until 7, officially the latest I have ever seen one of these program run. But it was great: eager mothers, competent and excited volunteers, health center staff present and helping, good food, smiles, crying, laughter. I felt sadness at working with pitiful malnourished children, and knowing that they may not improve, but also hope for recovery and excitement at the start of something new.
Wednesday, February 3, 2010
Return to Uganda
The north-east winter gave me a frigid send-off, and now, after several airline meals, some bottles of British Airways wine, cramped legs, laps around the cabin, too many movies, and not enough sleep, I'm back in Uganda, where I was welcomed by a wall of hot, heavy air as I stepped off the plane. I can't seem to find moderate temperatures. It's a transition to a different world, but the sights, sounds, and smells have a familiar feel this time around.
Kampala:
The thick dust that stings my eyes. Roads that are more pothole than pavement. Waking up with absolutely no idea where I was. Jetlag. Dogs barking all night; birds singing all morning. The loud, chaotic, lawless rush hour traffic. The hair-raising rides on a boda-boda, weaving in and out of traffic, but only once truly fearing for my life. The equatorial sun. Haggling over prices.The little boy who cautiously approached me and then took my hand and walked with me for a minute - he trying to tell me something, and I trying to tell him I don't speak any Luganda. The ubiquitous garbage heaps. Eating Indian food. The ash floating slowing down through the air like black feathers, and landing on my table, as well as any other exposed place in downtown, as a result of the burning of a major trash dump in the city. Meeting up for a lovely reunion with Heidi. Being completely overwhelmed by the prospect of shopping for the next few months, and responding by shopping barely at all.
The Road:
The first leg is four hours of pavement - using the term loosely - between Kampala and Fort Portal. No lanes: survival is the rule, and the bigger vehicle is always in control. Coach buses come hurtling down hills, swinging onto the other side of the road at breakneck speeds around bends, pushing other cars off of the road, always giving the impression of being about to roll over and smash through anything caught in their way. Children run along the sides, sometimes a mere foot or two from the cars going by. Cows saunter across, seeming unfazed by the vehicles screeching to a halt to avoid them. And the birds - massive, beautiful, tropical birds - swoop overhead, majestic creatures like the Great Blue Turaco and the Black and White Casqued Hornbill.
The second leg is the Bundibugyo road - to which I have dedicated a fair amount of writing in the past year - 3 hours of dirt, rock, craters, and dust. Dust in my hair, dust in my teeth, dust coloring my skin red. Running along the side of the Rwenzori mountains, there is often nothing separating the edge of the road from a drop of several hundred feet. It's beautiful, but the dry-season haze filled the air and shrunk the stunning vistas to small, fuzzy hints of grandeur. On the western side of the mountains, the slopes were ablaze. Fields are often burned periodically, but in the dry conditions and hot breeze, many of these fires seemed to have spread up the mountainside, through forest and brush. I heard it said that many young men sometimes burn land "stubbornly" - probably best translated "just because." Black and gray dominated. The further we came off of the mountains, the more green we saw, the more people we encountered, and the more cries of "Mujungu!" we heard, a sound that I had almost thought that I missed, but quickly remembered that I didn't.
I arrived in the early evening and had great reunions with the Myhres, Ashley, the Clarks, and my neighbors. Kids jumped all over me, telling me they were starting to think that I had lied to them, and wasn't coming back; their beautiful smiles and exited laughter were heartwarming. A clean house was a pleasure to come back to (Scott Will, you are the man), and I took a lovely cool shower to quite literally wash off the road before sharing a wonderful dinner at the Myhres. We sat around, catching up and telling stories long after dinner was over. In addition to all of these great things, there were no snakes, rats, or giant lizards in my choo. But I do hear there have been bats in my house. It's good to be back.
Kampala:
The thick dust that stings my eyes. Roads that are more pothole than pavement. Waking up with absolutely no idea where I was. Jetlag. Dogs barking all night; birds singing all morning. The loud, chaotic, lawless rush hour traffic. The hair-raising rides on a boda-boda, weaving in and out of traffic, but only once truly fearing for my life. The equatorial sun. Haggling over prices.The little boy who cautiously approached me and then took my hand and walked with me for a minute - he trying to tell me something, and I trying to tell him I don't speak any Luganda. The ubiquitous garbage heaps. Eating Indian food. The ash floating slowing down through the air like black feathers, and landing on my table, as well as any other exposed place in downtown, as a result of the burning of a major trash dump in the city. Meeting up for a lovely reunion with Heidi. Being completely overwhelmed by the prospect of shopping for the next few months, and responding by shopping barely at all.
The Road:
The first leg is four hours of pavement - using the term loosely - between Kampala and Fort Portal. No lanes: survival is the rule, and the bigger vehicle is always in control. Coach buses come hurtling down hills, swinging onto the other side of the road at breakneck speeds around bends, pushing other cars off of the road, always giving the impression of being about to roll over and smash through anything caught in their way. Children run along the sides, sometimes a mere foot or two from the cars going by. Cows saunter across, seeming unfazed by the vehicles screeching to a halt to avoid them. And the birds - massive, beautiful, tropical birds - swoop overhead, majestic creatures like the Great Blue Turaco and the Black and White Casqued Hornbill.
The second leg is the Bundibugyo road - to which I have dedicated a fair amount of writing in the past year - 3 hours of dirt, rock, craters, and dust. Dust in my hair, dust in my teeth, dust coloring my skin red. Running along the side of the Rwenzori mountains, there is often nothing separating the edge of the road from a drop of several hundred feet. It's beautiful, but the dry-season haze filled the air and shrunk the stunning vistas to small, fuzzy hints of grandeur. On the western side of the mountains, the slopes were ablaze. Fields are often burned periodically, but in the dry conditions and hot breeze, many of these fires seemed to have spread up the mountainside, through forest and brush. I heard it said that many young men sometimes burn land "stubbornly" - probably best translated "just because." Black and gray dominated. The further we came off of the mountains, the more green we saw, the more people we encountered, and the more cries of "Mujungu!" we heard, a sound that I had almost thought that I missed, but quickly remembered that I didn't.
I arrived in the early evening and had great reunions with the Myhres, Ashley, the Clarks, and my neighbors. Kids jumped all over me, telling me they were starting to think that I had lied to them, and wasn't coming back; their beautiful smiles and exited laughter were heartwarming. A clean house was a pleasure to come back to (Scott Will, you are the man), and I took a lovely cool shower to quite literally wash off the road before sharing a wonderful dinner at the Myhres. We sat around, catching up and telling stories long after dinner was over. In addition to all of these great things, there were no snakes, rats, or giant lizards in my choo. But I do hear there have been bats in my house. It's good to be back.
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