I am an applied medical anthropologist beginning my PhD in Public Health this fall. For the second summer in a row, I will travel with my research partner, Ginger Mckay, to Kampala, Uganda. Last summer, we evaluated an HIV education program for children developed by the Savannah Sunrise Foundation, which is a non-profit organization. We we will be residing in Kampala from the end of May until the end of July to conduct additional fieldwork. This summer, our colleague Nicole Smith will be joining us as we wrap up our project.

Thursday, June 23, 2011

12/6 to 22/6

Sunday
The three of us spent the afternoon preparing for the big birthday event by prepping the food and wrapping presents. We had a successful birthday party for Joan even though we couldn’t make “tacos.” There are no taco shells or tortillas available for us to make the real thing, but we did find some pita chips to use as “nachos.” I enjoyed meeting Joan’s kids and her housegirl Daphene. Joan was the only one out of the four of them that enjoyed the nachos we made. I ate them even though they were made of beef. Ginger is a really good cook. See the pictures to appreciate the way the Joan and her family enjoyed the party. They loved the cake and the presents.

Ginger thought to buy two books by Roald Dahl for Joan’s children, Lighton and Louis. She also gave Joan one of her necklaces with a silver sand dollar pendant that has a small pearl on it. Nicole did a great job wrapping and creating a bow and a flower to tie on the presents. I wrapped up a matchbook to make it look nice, and put the earrings we bought at Mary’s church inside. Even though it was her birthday party, Joan brought us three mangoes and an avocado. We ended up cutting the avocado since we didn’t have enough to make guacamole. I think they all really liked their presents, especially Joan, who shed a couple of tears and told us it was the best birthday party she’d ever had.

I think they all liked the cake the most and were happy to bring the leftover cake home with them. Before they left, the kids played in the bathroom and turned the faucet on all the way, and it got stuck for a minute. When they left, they asked if they could come back the next weekend, and we said yes. Joan looked lovely wearing her new jewelry, and the necklace really suited her.

Monday 13/6
Ginger and I went on an observation today, and Nicole stayed behind. We saw Mary mentor at one of the large schools where they’ve recently began mentorship. It seems like a huge undertaking since there are thousands of primary students. We went to four streams (classrooms) of primary one students, and it took us two hours. If there are several streams for each grade level and 7 grade levels, you can imagine how trying it is to mentor all of them. I admire Mary for her perseverance.

We ate lunch at 1000 Cups after, and visited with Joan. She was wearing her new necklace, and she gave us some cake to take back with us. It was the chocolate cake they sell in the store. We also saw this guy named Frank, who we met last summer. He invited us to dinner with his girlfriend and said he would call us to finalize our plans later in the week. It’s fun to run into people you know.

Afterwards I suggested that we stop by at the SAS Clinic since we hadn’t been there yet. We saw Andrew and Paul who we remembered from last summer, both of whom work in accounting. Paul gave us a tour of all the new facilities and showed us the expansion of the clinic into the surrounding offices in the building where it’s located. SAS has really grown since we were here last summer. Now they have a birthing center, more equipment in their laboratory, a dental clinic, a surgery wing, and a cardiology specialist. They have one of only a few C.T. scanners in the entire country. Paul told us that they began to market to local businesses and centers to develop a better customer base for the clinic on Bombo Road and the one in Bugulobi. They want to expand their clientel before they open a new hospital, so that they will have outpatient services to clients they are familiar with already from the clinic. They seem so organized and collected, which is not the same vibe you get at the foundation. I wish the two were more similar in management strategy.

We decided to walk home. Later on, we met our friend Pharouk at a local hang out nearby. We also got an email from the UNCST today saying that we could resubmit our research proposal from last summer. Apparently it’s been misplaced. For now, we have temporary approval to begin our data collection, but I’m not really sure what that means exactly.

Tuesday 14/6
Today the three of us discussed the issue with data entry, and how we are going to get everything finished in time. We want to present our results at the mentor meeting on the first of July. We also plan to travel upcountry before the meeting so we need to be finished before we go. Our friend Moses has been helping us, but we are still going to be pressed to finish before we travel to Hoima and Gulu. We’ve had several errors with data entry, and with all four people working on the files it’s becoming challenging to make sure we’re all on the same page. So far we have graded and enter 745 tests and it barely looks like we’ve even started. If you recall our sample size of 620 from last summer, then you have a pretty good idea that we have a lot of work to do!

Wednesday 15/6
Today we went to the foundation and met with Reverend. We discussed our plans to travel with him and we decided to meet again next week on Tuesday to finalize our plans. We are picking up more pretests in Hoima, and I suspect there will also be tests in Gulu since we haven’t seen any schools from that district yet in our stack. More work!

We ate at a Mexican place for lunch, and with exception of their tortilla chips, the food rivaled some of the best Mexican food I’ve had in both Mexico and the US. Afterwards we walked downtown to buy air time and to find a place where Ginger could take more passport photos since we have to resubmit our application. We sat inside of a small store, which is really just a room, for nearly 45 minutes waiting for her photos to develop. There was no air in there and it was very hot. We read the tabloids while we waited and I had forgotten how disturbing they are.

On the way home I told Ginger to go on without us and Nicole and I went by the SAS Clinic. Nicole got to meet the several of the staff, including Dr. Grace, Paul, Andrew and Rachel who happened to be there. Nicole switched her antimalarials from Doxycycline to Mefloquine, which is what Ginger takes. I am staying with the doxycycline even though it gives me crazy dreams. Afterwards, I tried to board a matatu and even though I was waved to by the conductor, the other matatu drivers stopped us and would not let us on. I couldn’t tell if it was because of where they were trying to stop, where we were standing, or because the other conductors did not want them to stop at the stage. Sometimes it’s funny, and they will fight about letting a taxi pull over especially if they are not at the stage proper. But, I really don’t know what was wrong. In short, not a day goes by where I’m not embarrassed somehow or questioning if I did something wrong.

Thursday 16/6
The data is never ending. I worked all morning while Ginger and Nicole went to the UNCST without me, which was necessary. I spent a large part of the day today thinking it was Friday, and I even opened the garage in anticipation of Grace and Annette’s arrival. Moses came a little later than usual and began to work. I went to meet Mary at a school to document the way that she proctored the pretests, which I think will give us insight into how the other mentors administered the tests we are grading now. The power was out all day, too, so I was happy to get out of the house. I was also anxious to get to the school on time. As a result, I got there really early so I just walked around. I pacified my hunger by reminding myself that lunch would be ready when I got home (of course, I was wrong about that since today is actually Thursday).

Mary did an absolutely fantastic job giving the test to the primary seven students. There were 320 of them outside on the courtyard, and we stood on a raised platform while she yelled out the questions. I took video and photographs of the experience and I was just in awe of how it all went down. The gratification I felt was immeasurable. In that moment, I could see the product of all our hard work, and the analogy of the dandelion seeds Ginger had described last summer came to my mind. Somehow, the seeds managed to turn into flowers against the odds. I never have felt so elated about a successful research strategy; our planning, methods and practice have created a genuine product that works and is replicable, although it needs to be refined. Even though our quantitative instrument has some flaws, the experience has been awesome. I loved hearing Mary ask the 20 questions and see the students fill out their papers. There are 2 videos in “week four pictures” so check them out!

I collected the tests and walked to get a boda to Kamwokya since there were rainclouds forming. It has rained so much this year, even though it’s the dry season in Kampala. I had this terrible vision of losing all the data and the answers running together on the wet papers. I held the tests really close to me, inside my bag from the AAA’s in New Orleans trying to protect them from the rain. I thought of how upset I would be if I were robbed today of all days, and determined that I was not going to part with the tests.

When I came home I realized it was Thursday. It was after 2 pm. The power was still off, and everyone was still diligently working on the data entry. I began to grade the new set of tests from the observation today, and then we decided to go to Mulago hospital to charge the computers and work more there. I wanted to go by the craft shop, too, and to get some coffee since I was tired.

I realized today that whoever ends up handling the pre and posts tests at SAS after we’ve left is going to need to have a developed a guide to reduce the potential for human error. We are working out the kinks of some of our own mistakes, and Ginger has been documenting the careless errors we’re making. The potential for human error is problematic and the ability to produce inaccurate data without knowing it is something we really need to think about more. We’re all still learning.

Friday 17/6
We ate bagels for breakfast. It’s the first time I feel like I’ve had bread because they’re so dense. I don’t know if they’re really overtly dense, or if I’m so accustomed to airy bread here. Either way, we only needed half of one each. We graded and entered tests all day long.

I talked to Grace about our tests, and she was curious about our sampling strategy. She told me that the IBES program would not work in some schools because children who are very impoverished do not share information freely with each other or their parents because they have a different relationship and outlook than others. They are busy doing chores, and are not “free” to discuss such matters. She told me that students can’t talk about HIV because of their poverty which creates a lack of confidence to freely converse on difficult issues, and because it creates a serious lack of free time to socialize with peers. I was annoyed because it seemed like she was telling me that the program was futile. I prefer to think that what she described may be true for some students, but not for all. And anyway, the ones who don’t feel confident are the ones the mentorship is geared toward.

I stayed home tonight while Ginger and Nicole went to meet Frank and his girlfriend Ruby for dinner. I just really needed some alone time. I watched Seinfeld and took my first real “break.” It was great.

Saturday 18/6
We are on a data entry marathon, and the end is in sight. One funny thing about this process: the Excel programs on both Ginger and Nicole’s computers are having a difficult time processing the large file that is our main database. As a result, we had to start making individual files for each school. Someday we will laugh about the computer software we tried to use, and ponder how computer programs like Excel have become much more powerful since 2011. We’ve been discussing finding a free statistical software package like R or encouraging the foundation to purchase Access for future analysis. Any thoughts on this issue would be very helpful.

Sunday 19/6
We were supposed to be leaving for church at 9 am, and the rain prevented us from leaving on time. We decided to wait for the storm to pass since the city sleeps when it’s raining and it makes traveling more dangerous because the roads are so slick. We left for church around 11 and reached Kireka by noon. We went to Echiba’s church this week, which is just down the road from Mary’s house.

As we walked up to the third floor of a building that has several other offices and shops, we passed a painting of a stairway to heaven. The analogy was not lost on me. Fortunately, the service only lasted around an hour after we arrived, since we were so late. I did, however, enjoy listening to the visiting Nigerian pastor, who was telling jokes in his sermon. At one point, he said “There’s no rush! We’re not in Russia!” His accent was really very different from Ugandans and I especially liked the way he said, “Amen.” He told everyone to put all of their worries in little bags that they should press deep down inside them and to let God handle their stress.

Afterwards, Echiba took us to the Hospitality Lounge, where church members encouraged us to join the congregation and had us introduce ourselves. We also were given a tour of the facilities. Echiba did not have his family with him at church because of the weather, and he did not invite us back to his house for lunch to meet them, which surprised me a little. I wonder if he was upset that we were late. In any case, we called Mary and told her we wanted to stop by. When she heard my voice she said, “Ah! You come!!”

We ended up beating Mary to her house as she was still at church, and we also woke up baby Shem who was sleeping. I didn’t mind because I love playing with him. After we hung out for a few hours we ate lunch. Mary served us “baby portions” as she calls them, although it was still really a lot of food. We left around 5, and Julius took us on a quest around the neighborhood; he was determined to help us get three Rolex’s from a vendor even though it was early to be selling them. A rolex is akin to a breakfast burrito, only it has cabbage, onion and tomato inside the egg and it is wrapped in chapatti instead of a tortilla. They are so delicious and we were excited for Nicole to try one since she’d never had one before. See pictures!


Monday 20/6
Moses came over to work with us today, and we all knew we would finish entering the tests by the end of the day. 2,482 tests later, we finished! In other news, Moses has been trying to get into a German language school in Germany and he was accepted today. He used the money from selling the computer I left for him last year to buy a passport, so now all he needs is a student Visa and a plane ticket. It seems likely he will achieve his dream to study at a German University and be closer to Sonja. I am so happy for them both. He had to leave right after he found out to go to school, where he takes night courses to study German here in the city. After he left, we decided to skype with Sonja and she seems elated about the news. It’s great. Ginger and I were talking about how we have been rooting for their cross-continental love affair, and it seems like they will end up living happily ever after. It’s like a movie.

Tuesday 21/6
We made it to the foundation by 9:30 to meet Echiba and discuss our plans for focus groups at three target schools from last summer. Echiba is going to help us make plans with the school administrators since some of the schools have been zoned out of mentorship this year and are no longer receiving the IBES program. We took a break after meeting with Echiba and had some chai next door while we waited for our next meeting. It was supposed to start at 10 but it was postponed (it wasn’t clear if it was because Reverend had an engagement or if Beatrice did). The actual meeting ended up beginning at 12:30. We made plans to go to Hoima and Gulu this weekend with Reverend. We leave on Friday and we will be back on Tuesday afternoon. I’m excited to see how mentorship is going in Hoima, and to reunite with the mentors we met last summer at Meeting Point. I am also thrilled to be traveling north into parts of the country I have not yet seen. I now have to catch up on writing/blogging/emailing and skyping before we go without internet for five days!

Wednesday 22/6
Today Ginger and I went to the post office and to the Aristoc bookstore. I wanted to purchase a book about birds to take with us on our trip, but they are so expensive I decided not to buy one. I should have gotten one before we came. Hindsight. Nicole went on her first outing to meet with local NGOs today. She is running out of time, so I hope she can network and make some connections before we leave. Time is so different here.

The rain in incessant and so is our lack of electricity. Ginger and I worked on analyzing the data all afternoon and prepared the descriptive statistics to be presentable for next Friday after we return. Things are starting to happen rapidly now, and I remember feeling like we were scrambling last year when we had only six weeks left. The pressure is even greater now at four weeks. I know it will somehow all work out because it always does. I am sad to be leaving so soon. I really want to come back next summer, even if only for a short time, but I don’t think that will be possible.

Sunday, June 12, 2011

6/6 - 11/6

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Sunday, June 5, 2011

5/31- 6/4

Tuesday
Today I woke up at 8 am, again! I think I am adjusting well, and I don’t even need an alarm clock. Other than going to the grocery store, and eating lunch, we stayed at the house virtually all day. We had three visitors, Cathy from the SAS foundation came by to talk to us briefly about our summer plans. Our friend Pharouk stopped by for some tea, and he drove Nicole to find an ATM that would work. Even though she tried a few times, turning her card and trying various strategies, Pharouk got it to work the first time. Kitufu! Later, Moses came over. It’s his 2 year anniversary with his girlfriend, Sonja, and we had arranged for them to have a skype date. It was a slow day, and I am anxious to begin work tomorrow.

Wednesday
We made it to Mary’s house by 10, proving that we are now experts at “keeping time.” Mary is one of the few Ugandans who really means 10 am when she says it, so she was happy when we arrived promptly. She calls us her white children. When she first saw us she tried to pick me up, then she really did pick Ginger up. Mary had lots of exciting news to share with us. We met her new boyfriend, Henry, who she plans to marry within the year. She invited us to the wedding and I think I am going to try to come, maybe just for a week next summer. It would be so much fun, and Mary is like a mother to me. She also has a new housemaid, Rosemarie, who is from her village in the west. Other exciting pieces of news for Mary: she bought a car within the last eight months, and her eldest daughter gave birth to her first grandson. His name is Shem and he is 3 months old. Things are going very well for Mary and her family right now. When she described buying her RAV-4 she told us she just said, “To hell with the matatus, and to hell with the bodas! It’s too risky!” haha.

While Nicole and I accompanied Mary to our first school observation of this season, Ginger made her way to the foundation. We are already dividing up which will make things so much easier to accomplish. Ginger met us later on, and it was nice to do an observation with all of us in attendance. The children are wonderful. I love them. I warned Nicole that they slap you and run away, and they will swarm you when they see a camera and so she wasn’t surprised when it happened. I’m glad I did because the school we went to has over 2 thousand students, and the classes are huge. We were outside when they went to lunch and it was organized chaos in the courtyard. Nicole brought a Polaroid so we can leave a picture with each class and they LOVE it! It’s such a fantastic idea, and much appreciated. We watched Seinfeld when we got home, which always makes us happy. Thanks, Mike, for letting me bring a few DVDs!!

Thursday
Eggs and toast for breakfast! We made it to the foundation at 10, where we accompanied Echiba to another new school. SAS has begun to target schools with large populations in the city. We had a successful meeting with Echiba afterwards, and made plans for our summer research, including focus groups, traveling to the North, and conducting more observations and interviews. We also discussed the one thousand or more pretests we have to grade. Echiba told us there are more from Hoima, and we also think we should administer them in these new large schools so we have TONS to do. One exciting piece of news: Echiba told us that in lieu of a charity walk, they are going to do a music festival to communicate HIV this year. The festival will be themed and based upon traditional dance/music most likely. Echiba said that music and dance is a way to show the “emotional scenes and occurrences” that HIV/AIDS fosters within the community. I think it’s the best idea ever. We ate at the pizza place we loved last year, and went home. We’ve been losing power a lot lately

Friday
We graded tests for 3 hours and barely made a dent. For lunch today, we ate bush crickets and ants. I still don’t like htem much, but Ginger seems to enjoy them a lot, the bush crickets anyway. She dips them I ketchup. I just really dislike the antennas. I can’t separate from my mind that I’m eating a bug when they crunch. We had coffee at Roses, and basically ate 2 lunches. I forgot how much people make you eat here.

Saturday
Nicole isn’t feeling well, so we went to the soccer match with Moses without her. I think it’s best she didn’t come because we walked a lot and it was pretty hot out. She would have felt worse for sure. After Moses’ team won, we decided to go watch Uganda play Guinea Bissau and stopped by the house for Gigner to get her Uganda Jersey. Nicole felt well enough to join us, so we all went to Steak Out and watched Uganda win 2-0. It was fun, and an early night.

Sunday
We went to church with Mary, and it was very similar to last year. There were a few differences, however. This time, it lasted 4 hours. Also, there were traditional Buganda dancers and a collection for one of the 5 pastors weddings. We put 5K in an envelope around hour three. Then, at the end, one of the pastors passed earrings around. Whoever got a pair was asked to donate 5K for the wedding. Even though Mary go a pair, she handed them to me to buy them, so we ended up giving 10K UGX for the wedding. Interestingly, before the asked for money the second time, they passed out an itemized list of wedding expenses.

After church we hung out with the family, and played with baby Shem. He has lighter skin than his relatives and they kept joking that he looked like he was white and more related to us. I loved holding him, and he was so sweet and well behaved. He ate a lot, and they were giving him a bottle. Playing with Shem sort of makes me want a baby, which is something I never really felt before. I don’t know what’s happening to me!! When we ate lunch, the three of us shared 2 plates, which were not as full as everyone elses. We got seconds, which made Mary happy. Nicole ate her first sugar cane, and we had a great time. We were at Mary’s from 9:30 to 5. We got home at 6. It was a long day. I am also getting sick, which I really dislike. I didn’t bring any sinus medication, so I am going to look for some at the store today (Monday). More pictures coming soon!!