wolfordm-blog - Tumblr blog

[wolfordm-blog]

Fam & Friends

[wolfordm-blog]

Culture Shock & Awe

I have finally returned home from Uganda!? After 9 months 26 books, countless movies, a few TV shows, countless friends, and a vast collection of indelible memories.

The differences in lifestyle are more subtle and yet more powerful than I ever imagined. It’s not the big differences I miss between home and Uganda and vice versa, but the small ones. An ice cold glass of skim milk at home, or how in Ddegeya people take the time to stop and say hi as they pass by. Over the past two days I have spent a lot of time thinking about my time in Uganda and the work I did there. Did I make a difference? What work did I actually do? Was that work beneficial and sustainable for the clinic/community?

 While I may not know the answers to these questions for a long time, if ever, I can talk about what I did learn:

1. Relationships matter, it doesn’t matter how amazing your idea/ dream is without good working relationships between the people involved your idea will never come to fruition. Collaboration with members of the community to make sure that you are addressing their needs and concerns, not your perceptions of what their needs and concerns are.

2.  Sustainability is really hard to achieve (but that doesn’t mean we shouldn’t try), with almost every project we worked on in some way or another it was dependent on skills, knowledge, personnel, or materials that are not wide spread in our community. But that doesn’t mean you shouldn’t try to find materials to source locally, or work with community members on repairing a borehole so that in the future they don’t need you to fix it again. Sustainability is really hard and it really falls on a spectrum. So the question becomes, how sustainable is your idea?

3. Charity is not always the best solution. I have seen so many cases where charity builds a dependence in a previously self-sustaining community. Have you ever donated clothes to Salvation Army or another organization? Most of these clothes end up in Africa, robbing skilled tailors of good jobs because they cannot compete with vendors who peddle donated clothes for next to nothing. With less tailor’s, what happens if donations stop suddenly? There will be a huge shortage of clothes and no capability to make them. That being said the private sector isn’t always the right answer either since I have heard also heard of several companies exploiting vulnerable worker populations. USAID also has a huge host of problems, but I truly believe that there are better ways of doing this such as *cue Professor Hal’s voice* “A social entrepreneur”

I most certainly learned a whole heck of a lot more about Uganda, and the rest of the world. I would like to take this time to thank all the amazing, strong men and women I met. All the incredibly hardworking staff at Engeye Health Clinic, the Artisan’s women we worked with during our time in Uganda, the Peace Corps. Volunteers that are stationed in rural parts of the country for 27 months. And lastly to Brianna (Namukwaya) who put up with me for 9 months, even on the hardest days, during the happiest moments, everything in between, and lastly with all of my terrible attempts at humor. Thanks. Mweebale nnyo nnyo.

I’ll end by saying, I may not have been able to provide any noticeable transformation on the community of Ddegeya, and I may not have changed the world. But it was still worth it, because I think that at the end of the day the people of Ddegeya will look back and say “We have done it ourselves” and that’s fine by me.

[wolfordm-blog]

Go to the people  Live with them Learn from them Love them. Start with what they know Build with what they have,  But with the best leaders When the work is done,  The task accomplished, The people will say  'We have done this ourselves.'

Lao Tzo

[wolfordm-blog]

Few things have given me such immeasurable joy during my short stay here as watching these kids pump their first jerry can of water at the newly repaired borehole.  Before it was repaired, kids had to walk and extra half-mlle of red road to reach the next closest borehole, and then carry all of their water back, uphill.  Jerry cans come in several sizes, but by the time you are an adolescent, you are carrying a full 20L jerry can to and from the borehole. To give you some perspective, 20L is roughly 44 lbs of water that kids carry at least a half-mile, sometimes more than once a day.  There are many challenges when it comes to providing water access in rural developing parts of the world, one of the biggest of these are sustainable repair and maintenance of existing boreholes and getting funds to actually make said repairs/maintenance.  In Uganda each borehole is suppose to have a committee that oversees it and collects nominal amounts of money from users periodically.  This money is then suppose to be used to pay for repairs.  The problem with this system is two-fold.  First, there is no oversight to stop the collectors from taking the money and using it for their own personal benefit. Secondly, most Ugandans, and many people around the developing world, don’t see the need to save money now for some potential problem that will occur at an unknown point in the future.  Luckily, Engeye has a dedicated borehole repair fund which we used to make these repairs.  I know this is not the most sustainable solution to this particular problem, but we had the money now and simply put, if we didn’t pay for it, nobody would and the borehole would continue to be unused.  For sustainable repairs/maintenance, there is a local borehole mechanic.  However, the mechanic was overcharging us by a lot when we met with him to get a quote.  He quoted us a higher price for parts, as well as a charge for labor.  Now, I’m not very keen on taking jobs away from locals here because that is a more sustainable approach, but I also think an honest business partner is essential to sustainability.   Because of this situation, I decided to work with a small team of local men, spearheaded by Eddie.  Eddie has a natural aptitude for such things and enjoys making the repairs.  I worked with them to source the parts locally, and then to get the parts adjusted to the correct length locally. (Every borehole has a different depth depending on where the water table is)   I didn’t do a single step of this entire ordeal, from start to finish, by myself.  Eddie was with me the vast majority of the time, and actually a few times he took the initiative and went to get some parts welded himself!  During installation, I worked side by side with Eddie and another local man so that they saw every step of the way to do it.  Although, to be honest, I don’t think they really needed my help on this, they already understood how everything fits together.  All I really brought to them was a tape measure and attempted  to install a mindset of “measure twice, cut once.”  With more dedication to taking measurements, my hope for future repairs is that Eddie and others will be able to take up the mantle and successfully source/make repairs on their own!

[wolfordm-blog]

Coffee Coffee Buzz Buzz Buzz

Wow! January has been my busiest month here by far.  We had visiting Medical teams and Brianna’s family here at various points from January 2 through the 29th.  In that time, we had a massive party for all the children in the surrounding communities with over 1,000 kids (I tried uploading pictures but the internet is slow today)   We had our busiest period of patients at the clinic since July.  I would like to thank the medical team plus Kathy, Joe and Brianna’s mother for volunteering their time at the clinic and integrating seamlessly in with the clinic staff.  Especially the AMC team for seeing 110 patients on their first day AND going through a whole day with the EMR system down.  Like the title says, there was lots of nice coffee consumed this month and plenty of french presses made at lunch as well as breakfast.  Thanks to everyone for sharing a cup of Ugandan or Green Mountain Coffee with me.  I’m hoping to have a more low key February.  

[wolfordm-blog]

Bugs Life!

 Here in Uganda, several types of insects are consumed seasonally as part of the local diet. For this blog post I would like to give a shout out to my fellow Fellow Fellows, who is currently in Ghana on a Minerva Fellowship helping people micro-farm insects for food! Here it has recently turned to grasshopper season!! Which means that each night bright lights and smoke permeate the skyline. These traps attract grasshoppers with the light and smoke, and when the insects jump in they slide down the corrugated metal into barrels. The grasshoppers or ansenene are prepared by removing the legs/wings and then pan frying with some spices! They are best eaten warmed and have tons of natural flavor (don’t knock it till you try it). Another insect harvested is the white ant. These insects come into season around November when they shed their wings. The ants then burrow into the ground in shallow holes. I personally harvested some white ants (with some help) by walking around my house and turning over rocks in the shade. After an hour of gathering we had enough to cook. Similarly to the hoppers we simply pan-fried with some salt and voila, a ready-made snack. The white ants are a bit crunchier than hoppers but also have lots of natural flavor. Insects represent a cheap and much more environmentally friendly option to meat. Being on a much lower trophic level (think lower on the food chain) than traditional meat sources. This means that they need much less food and water to produce the same amount. For example (these number are purely fictional and just to highlight the contrast) it may take 10lbs of feed to produce 1lb of beef, but only 1.1lbs of feed to produce 1lb of insects. Rearing insects represents a much more efficient way to gain the same macro-nutrients and protein. If you ever get the opportunity I highly recommend trying some grasshoppers, and who knows maybe you will find a new favorite afternoon snack!

[wolfordm-blog]

From our brief time at the Lukome Center run by Child Voice

[wolfordm-blog]

Small Sacrifices

I want to start by sharing a story with you, but first a little context. This week Bri and I had the opportunity to travel to Gulu, in northern Uganda, for a few days. While there we spent the week volunteering with another NGO, Child Voice, which takes in child mothers and Sudanese refugee women, and over 18 months provides them with counseling and vocational training so these women can make a positive impact in their communities and support their children. While at Child Voice we heard a moving story from their Ugandan director, Richard, about his recent trip to the USA. Richard talked about how while presenting at a school in the States that one middle school aged girl told him how she saved her lunch money every day from school and donated it to Child Voice instead of eating. The point of his story was that people from the USA are not extremely wealthy with tons of disposable income, but that they too make sacrifices about their own lifestyle when they choose to support others. This story rang true to me on so many levels for its compassion and sympathy, coming from a Ugandan. However the fact of the matter is that a little hardship on our part can go an extremely long way towards improving the lives of people in Uganda. For example, $25 a month is enough to fund student scholarships and ongoing educational programs for the deserving village children. This covers all of their expenses from school fees and books to uniforms. Just donating one dollar a day, $365 a year (ok so $366 this year), is more than manageable for the majority of Americans and even some broke college kids. I think the proverb “many hands make light work” is apt here, because a small sacrifice from all of us could uplift struggling and impoverished communities around the world!! So go do some research on different initiatives out there, find one you like, and lend a helping hand.

[wolfordm-blog]

New Horizons

I want to start by sharing a passage with you that I read recently from the book Half The Sky:

“Young people… often worry about the safety of volunteering abroad.                 There are of course, legitimate concerns about disease and violence,                   but mostly there is the exaggerated fear of the unknown-the mirror                       image of the nervousness that Africans or Indians feel when they travel               to America for their studies. In reality, Americans and Europeans are                   usually treated hospitably in the developing world, and are much less                   likely to be robbed in an African village than in Paris or Rome. The most   dangerous part of living in a poor country is often the driving, since no                 one wears seat belts, and red lights-if they exist-tend to be regarded as               mere suggestions.”

This passage really struck me because it seemed to check all of the boxes regarding my initial impressions and the reality I have lived in for the last two and a half months. Yes, there are dangers in Uganda but if you can get over the fact that you may be sharing a taxi meant for fourteen with upwards of twenty strangers than you are more than cut out for a visit to Uganda. You will still have to barter for the price of a boda ride and the driver will try and overcharge you, but this has more to do with the perception that white people have money than disrespect. When walking around towns that are not as used to westerners as the hospitable people of Ddegeya, we get the usual “Hi Muzungu” from local children but that is it. Nothing more dangerous than kids playfully hollering and waiting for you to say “I’m fine, how are you?” When we attended church with one of our friends from a neighboring village all the parishioners came to greet us and insisted we sit on one of the two rows of pews (everyone else was sitting on mats), Afterwards we were invited home for lunch. Although Bri and I have talked at length about how uncomfortable this special treatment can make us feel at times, this story is by no means an exception.

The truth is you really don’t need a whole lot to live a comfortable happy life. The best resource you have to help other people achieve a comfortable happy life is yourself, it doesn’t matter how much money you have or give you are still the best resource (just ask Neil Golub who has done exactly that for years). Investing your time and skills into meeting people, making connections with them and then helping them is, in my opinion, the best way to make change. Best of all you, don’t need to go to Africa or any other continent to meet new people, speak a different language, or learn about a different culture. New horizons are everywhere; Go help out at a youth shelter in Schenectady, visit a pueblo built by the Navajo, take a class in a subject you know nothing about, or start training for a marathon (ok a 5k is more realistic). In the wise words of Theodore Roosevelt “Far better it is to dare mighty things” So stop reading this blog post, get out there and watch the sunset from some new horizon, I promise you it will be different and beautiful.

[wolfordm-blog]

Juggling Projects

While I have already written extensively on our work in the clinic and Scholar’s Center, Bri and I also have several projects we have been working on when work is slow elsewhere. This work provides us more flexibility as to when we do it, and also what we do for each. For example we have been interviewing TBAs (Traditional Birth Attendants) and VHTs (Village Health Trainers) with the end goal of creating promotional material Engeye can use while fundraising for the building of their new maternity ward (The link for more information or to donate can be found here http://www.engeye.org/minerva-fellow-project/ ) But during the interviews we were able to ask any questions we thought of that may highlight why a maternity center would be a benefit to the community.

              A second project we are working on is a thru a partnership with another NGO Womentum. Womentum has provided $150 (~500,000 UGX) grants for two local women to start businesses based on ideas they initially submitted to Womentum. Both women have big dreams of large successful businesses. But our task has been to help the women scale their ideas down to something that can be started with only the money provided.

              Another project we have started is helping one of the Clinical Officers (COs), Henry, to get one step closer to his dream of opening his own “Engeye Style” clinic one day in his hometown. I have been helping Henry learn to computer program and will soon be attempting to write my own EMR based on Henry’s vision for what his clinic’s EMR will need (Okay so this idea is really ambitious and I’m not even sure I can do it, but I can try!)  Lastly we have continued to try and improve the library, taking an inventory of all the books so that come November we will be able to let scholars check out books for a period of time.

              While it can at times feel like we are struggling to make progress because we are juggling so many projects plus our work, the projects give us a lot more flexibility to schedule and come up with our creative ideas for how it should be done. Although challenging I find the projects to be much more engaging than some of our other activities. (i.e. Tallying for the government health ministry). We also had the opportunity to go on outreach for the first time, last week. Once a month Engeye packs a van full of drugs and one CO heads to the village of Kalabubbu to see patients. Bri and I tagged along to help speed up the process. This involved taking vitals for patients, so that Bridget didn’t have to when she saw each one, and helping John fill prescription orders.

[wolfordm-blog]

Wilbur and Jackie hard at work in the Scholar’s Center 

[wolfordm-blog]

Ddegeya Days

          I thought it would be a good idea to outline a typical day at the clinic for readers back home. We typically have breakfast at ~8AM and then transition to a lesson in the Luganda language soon after. Once we are done with our lesson we head into the clinc to do tallying of diseases/ diagnoses, from yesterday, that our tracked by Engeye or the Ministry of Health. Once done tallying we transition to my favorite part of the day, helping the other staff in the clinic. Jobs include laboratory testing (for things like HIV or counting malaria parasites), helping the clinicians take vitals of patients (blood pressure, temperature, etc), or working in the pharmacy filling prescriptions and writing instructions on how many of each med to take, and how often. 

           Through our first month here we have worked almost exclusively in the pharmacy. The reason for this is two-fold; first only one staff member normally works in there and she can always use an extra hand, and secondly it is in our opinion the easiest job to master. Engeye is lucky enough to use a  custom built Electronic Medical Records program (EMR). This means that instantaneously after a clinician adds a prescription to a patients file that we can see it and start filling it. We usually continue clinic work until ~2PM at which time all of the staff breaks for a hearty lunch (for most Ugandans lunch is the biggest meal of the day). 

          After Lunch Bri and I have time to work on our own projects or other work for Engeye. Lately that has meant cleaning out an old bunkhouse to be repurposed as a library/ artisan center. The library is almost complete, with hundreds of books successfully sorted an shelved along with school supplies and crafts for the Scholars (students sponsored by Engeye to attend school). Im happy to say that the library is almost complete, we are only waiting on tables and chairs! The other half will be a space for local artisans to come in and work on crafts that Engeye will buy from them, and then sell to visitors of the clinic (proceeds go to funding the scholars program).  

[wolfordm-blog]

Pictured from left to right: Meg Sonnekalb (Public Health Intern who was here for the summer), me, Brianna Carruccio

[wolfordm-blog]

Departure

As I sit in Dunkin Donuts, thinking about how fast today crept up on me I am reminded of how this all began.The Minerva Fellowship application has no formal structure the committee simply asks you to submit whatever best shows why you would be a good candidate. So a few months ago I submitted a fully packed backpack with everything I could possibly think of that I would need for nine months on a Minerva Fellowship, today that same backpack will be accompanying me to Ddegeya, Uganda. Although considerably heavier than the one I submitted for my application. The idea behind my application (which came with a very brief explanation) was that I was ready to go on the fellowship. The Boy Scout motto is “Be prepared” and as an Eagle Scout I argued that with everything I packed, I was “Fully Prepared” for whatever my fellowship might entail. Today I know that wasn't quite true, and have already learned so much since accepting my fellowship. Shout out to Joe and Charlotte (Last years fellows in Uganda), my parents, as well as anyone else who helped me prepare for this! Next stop Uganda!