The relationship between garlic and HIV 8/11/09

Memorable. That word best describes my day today. I woke up and had my routine cup of coffee where I boil water and then put in what I can only describe as “flakes” of coffee that I believe are supposed to be filtered into my cup. After pouring the water in and letting it sit for about 2 minutes, it is drinkable. The flakes sink to the bottom and form a murky brown pool that clumps together in the bottom of my cup enabling me to drink what I pretend is coffee. After this delicious drink I helped Sam, an employee at Kaccad write out 30 signs on white poster paper in Luganda, the native language in this part of Uganda. The signs indicate we are having another free testing for HIV this Thursday and the time and location for the event.

Today was also the last day for Melissa, a volunteer who had been here for a month. We decided to "go into town" and get an amazing breakfast rather than our standard 2 hard boiled eggs and toast. We walked on the dirt path towards the main road where there is a stand selling an incredible concoction called a Rolex. A rolex is a chapatti with an omelet rolled up inside or the chapatti is cooked between a layer of eggs, depending on the stand. It usually includes diced cabbage, tomato and onion as well and costs 700 USH (less than a dollar.) The taste is amazing! It was my first one and I will definitely be back for more!

Following breakfast, I went out to deliver the signs we made around Bulenga, the village I live in and also Kuwuuzi, where the testing will be. This is where my day became memorable. I am pretty used to the regular call of “Mzungu” (pronounced ma-zoon-goo and meaning foreigner or more specifically, white person) and the children following me down the street yelling “SEE YOU MZUNGU.” I think they believe it means hello. There are also the kids who manage to warble out “MIJOONGOOO.” This from the babies who probably can’t even formulate 10 words in Luganda yet. This really happens…every day. Today was no different and because it gets old really quickly and kind of annoying to have kids saying “Hello white person” everywhere you go, I usually only acknowledge the little ones or the kids who ask “how are you?” instead of screaming after me. The difference today was the intensity of the Mzungu greeting. Walking around with Nicholas, another employee at Kaccad, I heard a group of 10 kids (you always here the “Mzungu” cry before you spot ‘em.) Suddenly, I have 10 kids following us chanting “A Ma-zoon-goo, A Ma-zoon-goo” over and over. It probably took us 5 minutes to get the sign up and walk away before they stopped. It was…outrageous. I actually had Nicholas tell them in Luganda that my name was not Mzungu but Caitie to which the adults nearby laughed and the kids accepted by responding cheerfully with “See you Mzungu!” Fine. I accept it. Mzungu will likely be my name for another month and a half.

This was not my only memorable event of the day. I also had a man aggressively pointing at me and speaking in rapid Luganda which is very rare (the word rapid does not seem to exist in Luganda, it is a very slow and smooth language). Nicholas translated and told me he was saying to him how no white person like me (thus the finger pointing and the word Mzungu sprinkled through the conversation) dies of HIV and no one in the US suffers from AIDS. Of course, I told him it wasn’t true but his gaze was certainly not one of confidence.

Photos: Some of the "Mzungu" repeat offenders greeting me with the official "See you Mzungu!"

Third, we were stopped by a group of 4 guys probably in their 20’s who proceeded to have a long conversation with Nicholas. Upon leaving he remarked, “young men, they have so many questions.” Apparently they wanted to know if the rumor was true about getting tested. You are probably as curious as I was; Uh, what rumor? Oooooh that one. The one where if you have garlic before the test, you will always show up negative. That surprised me a little. I have seen a lot in a week and had so many new experiences but finding grown men with serious questions equating garlic to HIV testing was a little scary. I have been struggling to decide my opinion recently on international aid and its benefits and how it can be abused. I guess in a way, this helped me a little bit with my belief that aid IS important and the number one way aid can assist impoverished countries is by providing money for education. This idea continues to be reinforced by what I have seen and experienced.

The rest of my day involved reading more of a really great and informative book on the kidnapped Aboke girls during the late 90’s. Joseph Kony, head of the LRA and Museveni, the current and at that time president of Uganda were fighting for control of both Uganda and areas in Sudan. Joseph Kony's army, commonly referred to as the "children's army" kidnapped, indoctrined and used thousands of children to fight the Ugandan military. In order to "toughen" his soldiers as young as 5 or 6 years old, many were forced to kill members of their own family or friends in order to save their own lives. Anyone who tried to escape was killed by other child soldiers to “strengthen their emotional state”. Atrocities like this occurred frequently and with brutality all throughout the north of Uganda and Sudan.

The rest of my night will involve me researching and completing my presentation on antenatal and postnatal care for the pregnant women and young mothers at the Bbiri clinic tomorrow. If only the power would go back on so I could read without flickering candles…

"What a Woman!" 2nd week at KACCAD-8/10/09

Today is the start of my second week at Kaccad. I have started to get into a routine where almost every morning, I go on 3 house visits to a client of Kaccad’s afflicted with HIV. We bring them Malaria nets donated by The Real Uganda and try to establish if they are able to eat a balanced diet, maintain good hygiene, and find out how they are doing in general. Like I mentioned before, it’s really interesting and quite different the way being ill is treated here versus in the U.S. I keep thinking about how when I am ill, I usually just want to lie down and feel bad for myself. That does NOT happen to include entertaining guests as I am well aware my bees nest hairdo coupled with the sweatpants and XL tshirt is not my most flattering look. Plus, most of the time I am tired and selfishly don’t want to feel obligated to be a good host! Another difference comes with the acknowledgement of serious and life threatening or terminal illness. Most of the time in western culture, when you have a serious illness it is kept private. Details are not asked and usually not freely given. Even if your guests are aware, it’s not something you defer to when having a conversation and certainly isn't the first subject! "Hey I just stopped by to see how that painful STD treatment is coming along?" or, "yeah, I was bored so I came over to hear if those skin lesions they think are a result of you having AIDS are progressing." Here, the exact opposite is the case. It is a sign of compassion and respect to go to a friend or family member’s house and inquire after them. You do not have to clean up, get dressed, or act like you are ok. You welcome the visitor and tell them what is ailing you. After being asked, it also does not seem uncommon to volunteer an honest truth and sometimes some very personal information!

Another striking difference between visiting people in a country like the U.S and a developing country is the type of ailments encountered. I have visited people who are suffering from illnesses they will never recover from and are currently suffering yet still in their home. Most will stay there until they pass away without the opportunity to receive costly check-ups or hospital stays. Not only that, this is rural Uganda. Their poverty reaches all aspects of their life. Combined with trying to stay physically strong, they have to battle the massive stress resulting from searching for opportunities to earn money and eat well to paying school fees for their children.

Having said that, a situation that at first glance appears overwhelmingly hopeless can lead to an environment that molds incredibly strong personalities. I just so happened to meet one and I hope everyone, at some point in their life, has the opportunity to do the same. The person I am referring to (I will call her Mary) is phsycially misleading; I first saw her walking out of her home with a very noticeable limp where it appeared she was not able to comfortably bend her left knee. Mary was wearing a very well-used collared shirt and a skirt that has likely been worn and washed hundreds of times as evidenced by several tears and holes placed throughout. She came straight for us even though another woman I later learned was her daughter-in-law, had already unrolled and sat down on a straw mat next to us. I was confused. Meetings are usually private and with only the client. For Mary, that norm did not seem to register with her "take-charge" personality. I originally thought the younger woman was perhaps her caretaker and Mary was the client. I was completely mistaken. Contrary to what I have heard and seen on other visits, Mary, related only by her son's marriage, was fully invested in the health and spirit of her daughter-in-law. Her son, having died of AIDS, left his wife and 4 children in a difficult situation; with little income to cover food, shelter and school fees, her daughter-in-law was headed down a very difficult path to come out from. I have already heard how when the husband dies first, his family ostracizes or stops caring for his ailing wife and children and she is left to fend for herself. Mary did just the opposite.

She is one of those strong, incredible women where you just have to step back and the only thing that comes to mind is…"wow." She started talking right away to Nicholas, the head of the HIV sector of KACCAD. She expressed condolences for the loss of his father who recently passed and then included me in the conversation by telling me (via Nicholas in Luganda) how I was most welcome and she was so thankful I came. We started asking various questions trying to establish the level of hygiene practiced and to ensure a reduced risk of malaria. Usually this means asking about the area surrounding the house; having it cleared of long grass and standing water as well as covered latrines to help prevent flies and malaria-carrying mosquitos.

The conversation ran a bit different with Mary there. By the end, I felt like perhaps we should be checking where we live to be certain we had done everything properly! Mary explained to us that not only were their latrines covered but they also burned banana leaves and placed them in the pit deterring flies and creating a pleasant scent. Further conversation revealed that she seemed to be one step ahead of every suggestion we provided. This was the first time I had seen a mother-in-law so active and fiercely determined to provide the best care she could. It was obvious Mary prided herself on being able to help her daughter-in-law and most importantly, her grandchildren.

I think the most powerful moment for me was when she began to speak to us about her clothes. Surely, we must notice the holes in her skirt and how old her clothing was. She got up on her knees and turned to the side to make sure we could clearly see her stained and torn skirt and blouse. It was clear that not only had these clothes seen better days but possibly better DECADES. From her previous behavior, I imagine this must have been difficult for her to wear such an outfit. She had such a desire for her family to fare better. She explained she wore clothes like these so all the money could go towards her grandchildren’s school fees. However, even with sacrifices like that, they still do not have enough.

I have been told that often when children are sent to school with unpaid fees, the teachers will harass them and point them out stating how they have not paid. Their classmates might also pick on them and it is an incredibly shameful experience. Mary was a woman who clearly found this consequence unacceptable and therefore decided to do everything in her power to keep her son's family moving forward.

The cost of school fees is the main worry for almost every family I have visited. I am struggling with how I can help or what can be done to allow these kids to go to school. Most of the parents believe that it is the only way for their children to live a better life than they have and yet they are not sure how to enable this to happen. To the people in the rural areas, education is the only sure way to enable options for their children in the future.

So why did this visit stand out to me? I think it had to do with the feisty attitude of a grandmother who realizing the situation she was in, decided to do whatever she could to improve it. She never begged us for money but she wasn’t shy about stating her issues and what the concerns of her family were. She spoke directly to me which Nicholas would translate and she took care of her daughter-in-law and grandchildren like they were her own. It was incredible to see her mental toughness show when she spoke and it left a lasting impression!

Another visit I had today stood out but for a different reason. It was the first home we visited today and in it was an HIV-positive woman living with her twin brother and 2 grandchildren, 1 ½ year old twin boys. Unfortunately her brother has been in the hospital due to STD complications for over 4 months. Before entering her home I saw feces on the ground near the door from the two small diaperless boys too young to knwo better. Inside was the frame of a couch which I almost managed to break sitting in the unsupported middle. A bag was hanging up and it looked like a brush and perhaps clothes spilling out. On the floor were spots I imagine was a urine stains and both children were playing with scraps of paper in the dirt next to it.

This woman has no source of income and the boys are orphans; she is their primary caretaker. Her hope is to be able to start a chapatti stand on her property. In order to do that, she needs to get enough money to purchase the ingredients to make chapatti, a type of bread really popular in Uganda. The closest description I can give is of flash-frying a Mexican tortilla (It is delicious!) Since her home is on a well-trafficked road (by traffic I am referring to people walking, occasional bicycle and of course the goats, chickens and dogs that want a little exercise.) she would hopefully have a steady stream of customers.

(Pictured: 2 twin boys playing in the rarely used charcoal hut next to their home.)

I have really changed my mind on some of my beliefs when it comes to giving aid since coming here and I can now appreciate the rising voices of people claiming foreign aid is debilitating Africa. However, in this instance, I believe it is possible that money could help someone generate her own income sustainably. It is also difficult to see a woman who has already raised children now having to raise another generation when she should be able to enjoy the efforts of her hard work as a wife and mother. Finally, I believe this woman truly needs help. Caring for two young boys while battling HIV is an incredible challenge. She has little to call her own; Her house is bare as she had someone rob her while she was caring for her brother. Unfortunately, they took almost everything of what little she had. I even noticed that for a type of hat, she was wearing the shirt of one of the twins.

This is one of thousands of dire situations but I want this to be a situation where I can assist someone in improving their outcome. Since she lives so close with her two boys and after seeking the opinion of a few others I believe it is a realistic possibility, I am going to use some of the money donated by my incredible friends and family to get the supplies she needs to sell chapatti. Hopefully with this income she can afford to get to the clinic to receive the medication she needs as well as support her grandchildren while her brother remains unable to work. Luckily for us at Kaccad, if she is able to make these daily, she will have several hungry KACCAD employees and volunteers as regular customers! I will make sure to provide updates on what I hope will be a successful opportunity for this family and I will also be sure to sample the product! :)

Getting to work!

After arriving at my new placement in the village of Bulenga, I met with Derrick, the director of KACCAD-the grassroots organization that specifically works in the community to spread accurate and important information regarding HIV and prevention/treatment methods. I will be working a lot with them and doing a variety of things from participating in testing days to going on home visits where we follow-up with people in the community who we know are HIV-positive. Right now the situation is a bit crazy. Several volunteers are here through a different organization but most are leaving this week. I am sharing a room with 3 other girls and there are 2 more in the room next to us that also holds our "shower" for all 6! We are all short-term volunteers and besides us, there is an English guy from Engineers Without Borders and a girl in the Peace Corp. who has been living in Uganda now for roughly 18 months. However, within 5 days, there will only Brooke, a nurse from New Jersey, Chris the engineer, Jennette from the Peace Corps and myself. All of us are doing different things and I believe I will be mostly on my own or working with the guys of KACCAD, native Ugandans.

I had my first round of home visits Tuesday, two days after I arrived. To help explain the purpose of visiting someone's home rather than at a clinic or hostpital, it is important to understand the difference in culture from most Western countries: in Uganda when you are sick with anything from a cough to a serious disease it is expected to go to the house and show concern. Where we are used to calling someone so as not to make them feel burdened with someone they have to entertain at their home, here visiting is expected! So not only do we go and monitor the progress of HIV and how to advise them to better care for themselves, we are also there as a sign of respect and concern. Apparently, it is also seen as an honor to have a mzungu (white person) all the way from America visit so hopefully even if that is all I can do, they will know people are concerned and care from everywhere!

A little bit about my visits: We went to 3 houses and I came out a little discouraged and confused-I went with Nicholas, one of the guys who works for KACCAD and on the way, he handed me a notebook and asked me if I would hold it. Sure, no problem! We arrived at the first house and by house, I am not referring to a multi-floored building with a shingled room and doorbell where through the peephole you can see a well-lit living room for guests. The house was a two room home with the rooms separated by a sheet hanging up in between. In the first room the only furniture was a small table and 2 cushion-less wood chairs. Both Nicholas and I were offered the chairs while the woman who appeared much older than she must be, unrolled a straw mat and sat on the floor. Her baby, under a year old sat on the floor while her other boy, 6 years old, sat on the table. After sitting, Nicholas asked me to start taking notes. Here is where I got a little confused. Notes on....what?! I had no idea what to do or what I was supposed to be recording. I felt a little nervous and frustrated as I wanted to do a good job but felt like I had no idea how to do that! What/who/for what purpose are the notes? I took the best notes I could. With Nicholas translating, I wrote down how she is HIV positive with 2 children both tested negative. Her only source of income is manual labor. I couldn't help but think how that's the last thing she should be doing. The positive note-she is taking Septrin, the (free) drug that you can pick up at any HIV center which must be taken daily from the day you are first diagnosed until you die. The negative? She is not eating a balanced diet because she like most people here cannot afford it. Her main concern is her children and when she dies, how to continue their education. All children are required to pay school fees and while it seems very small, for many parents it is not feasible.

This woman speaks no english so the entire time Nicholas was speaking to her in Luganda and translating into english for me. The other frustrating part was when I was asked if I wanted to start asking her some questions. I felt a little taken aback; What is an appropriate question? What can I ask her that will not seem completely ignorant or worse, condescending? I had been "trained" the day before when I was given 2 print-outs talking about nutrition and sanitation. These were very basic points like making sure you cover your toilet as toilet here means crude hole in the ground. I did learn that here, the 4 basic food groups are considered carbohydrates, lipids and fats, protein, and water. Yep, water. To be honest I just felt like saying, "what is the point of me asking a question when it is just having to be translated in Luganda and surely you are aware of everything I am?" I didn't understand why I was needed and how I was useful for these visits. Of course for me I am getting an education and learning a lot but what about these people? How would it be helping them?

I think it is going to take me some time but I know I will be able to adjust and appreciate the differences as well as contribute!

(Below: Our in-house engineer Chris made this greatly detailed layout of our home at KACCAD for his family and friends and I loved the clever captions so decided to show it to all of you as well. The top left picture is the "office" where we tend to hang out at night together waiting for the lights to come on. Top right is outside on the steps with the head of KACCAD, Derek, his wife Doreen and me! Bottom left is Chris' room including his pet (possibly slightly poisonous) spider that has made a web by his window the final picture was taken when Chris climbed the water tower. It shows our kitchen made up of a collection of dishes and an outside charcoal stove for cooking along with Chris' washing he (successfully?!?!) completed and left to dry. Hopefully you can read the descriptions!

The Do's and Don'ts of International Immunizations

(photo: In the doctor's office in Dublin prior to receiving 3 shots.)

The following is my experience getting immunized abroad. Basically, through my own errors as well as success, I learned some valuable lessons. Hopefully if you ever decide to travel to a malaria hotbed, you will be PREPARED! Here is my list of do's and don'ts.

Do: Get immunized. Duh. I didn't want to be too obvious but you neeever know.

Don't: Go through the Michigan vaccination clinics list and pick one that says "international" with that being your only qualifier.

Dont: Got continue with your appointment when the nurse whose job it is to give vaccinations specifically for African travel gives you a blank look when you state your chosen destinations name

True story; (attendant) "wow so yellow fever shot, where are you going?"

(me) Uganda

(attendant)...(pause)...oh, ok. hmm.

(slightly concerned me) yeah, it's a country in Africa.

(attendant, now much more enthusiastic) "Ooooh wow great! How cool, I'm so jealous!"

So that was sign #1. Sign #2 was probably when I had to explain and add up my own pills for malaria to the DOCTOR. Apparently, I really threw her off guard when I said I needed them now (May) even though I was leaving in August due to the fact I lived in Madrid. She proceeded to start the count from the day I left for Madrid to the day I return from Uganda. Sign #3? She still prescribed the wrong amount. (mom, remind me to get one more pill when I come home!) BUT...don't think I'm completely ridiculous-I had 2 days to get it done if I wanted to do it in the U.S! Moooving on...

Don't: Attempt to do any type of immunizing in Spain. At all. While in the U.S you pay more for a 2 second shot than a life coach and I admire Spain's no nonsense approach to last minute requests, the whole humanitarian/"uh this is kinda important" aspect hasn't settled in. I tried to schedule appointments for shots that are considered HIGHLY recommended (you know like meningitis, hepatitis, polio, nothing serious...) and the response? "Sorry, we are booked for 2 months." I guess I understand when their office hours are literally a whopping 5 hours a day, 4 days a week. I am the first one to tell people Spain does not follow the siesta rule like everyone thinks but apparently immunization clinics DO.

Do: Go to Dublin! One email and 24 hours later, I had an appointment, a personalized email confirming all costs and recommendations, and a "See you soon!" as a closer. Still a little dubious, I can now confirm that this was the best decision. The doctor had lived in Africa for 2 years and has been to Uganda several times. Not only did I get these shots for waaay cheaper than if I had gone in the U.S, I also got health safety brochures he actually wrote and publishes. The ultimate affirmation this clinic rocks? Free suckers. No need to ask.

Don't: Wait until the last minute. Duh.

Do: WAIT to write about it in your blog until after you have your situation worked out. I advise you to wait until you have secured your chances of survival from all water/food/animal borne diseases during your chosen experience. For me that meant waiting 2 weeks until 2 of my immunizations became 100% effective. :)

When thinking it would be an experience  I would never forget, was right!  Arriving in Uganda was like nothing I have seen/done before. Getting off the plane and onto the tarmac was a crazy feeling-I no longer had the choice of choosing when to think about what to bring or how to prepare- I had arrived. It felt slightly overwhelming and I started to think of all the things I could have/should have done to be more organized or pack more responsibly but  within 2 minutes, I gave that up. I'm here. It's now. Here I go!

So the first thing you have to do is get your visa which you can do at the airport. You pay $50 U.S dollars and is is usually good for 60 days- in theory. However, the issuer is at liberty to allot more or less time if he/she chooses. Luckily, the man I had gave me 90 days so I won't have to worry at all while I am here. After getting my passport stamped and getting my THREE bags feeling a little self conscious of the amount I had (to which, when Leslie saw my luggage responded; "well, you don't pack light!") I was warmly received by Leslie who was holding abig sign with my name on it. Taking me to her car, it was an awesome surprise to see she had brought a giant water bottle for me for the roughly 1 1/2 hour drive to Mukono where the volunteer headquarters is. Leslie is the program director (the big boss) of The Real Uganda, the program I am working with while here. Originally from Canada, she volunteered for 3 months in Ghana several years ago. Deciding it wasn't enough time to be fully immersed in the culture and experience, she chose to come back committing herself to a year and this time choosing Uganda. Falling in love with the country and it's people, she just celebrated her 5th year here and built up her organizations to partner with over 20 small grassroots organizations sending them funds and volunteers to encourage expansion and constant improvement.With Leslie telling me a little bit about herself and her work, she also gave me great information and advice ranging from "you should cry your first week here" to "people believe that the problem with Africa is simply there  is not enough money. There is money it's just not handled in the same way. Relationships come first. There is not training in business practices." I tried taking it all in but at the same time my eyes were probably having mini epileptic fits moving in every direction following the-I guess I will use the word, "traffic."

We were taking the main road and by main road I should be a little more specific and say, ONLY road that goes through a majority of soutern Uganda and actually ends in Nairobi, Kenya. There were so many sights to absorb;  cows and goats grazing on the side of the road while Ugandan taxis (which we would call vans) are stuffed with enough people

to have a football game with both sides accounted for; perhaps even a few extras thrown in to keep up concessions. These taxis and boda-bodas, motorbike taxis that would give an overprotective parent nightmares for the rest of his/her life, are the main source of transportation. On boda-bodas, you jump on the backseat and (holding on?!) 

just go. I will let you know what it's like when I get to try it! The way they are used is incredible. I saw a woman holding a baby and a large package clearly comfortable and without concern go by as well as a man cradling two large plastic bags with each hand and one between him and the driver. It's also common to view more than one person using the boda-boda. It was definitely a little crazy but also cool to watch how this thing called "transportation" rises to a whole new level here. However, that was by no means the most surprising thing I discovered on my first day. I noticed something that seemed a little strange about the people all around me; ALL of them look incredible! Bright colored clothing spotless with beautiful skin and hair. They may be walking into their home which is little more than a hut with no electricity or running water and yet their shirts and pants look pressed and their shoes are shined. I on the other hand was fully aware that my appearance was less than immaculate. Within 5 minutes of walking down the road, I am accumulating dust and already feel grimy.

I was aware before coming of the standard of dress here: it is not really appropriate for women to wear shorts or short skirts. Shorts are really only worn by children and dressing conservatively is standard. It does not matter what you do or who you are, you are expected to look nice and it is easy to spot a backpacker a mile away. Ugandans pride themselves on their appearance as they absolutely should. Trying to take the image of a well-dressed, beautiful person and meshing it with the reality of poverty is difficult for me. It is quite humbling to understand that while someone might have so little, they will make the best use of what they have. For example, a man might have only 1 or 2 shirts that he can wear to work and so every night, he will take them home and his wife will wash and dry it (by hand of course!) and then in the morning, use her coal burning iron to press it. It will honestly look brand new and no one would know he had worn the same shirt the previous day. Incredible. As for me, I'm attempting to master the art of bucket showering and looking decent before I go into the one outfit mindset. One day at a time...

As far as the living accommodations go, I am staying in the volunteer house until Sunday when I go to my placement about an hour and a half away and closer to Kampala. The place I am staying now is basically headquarters for The Real Uganda and also a place to hang out if you want a place to meet with other volunteers. I am staying with one other girl from New Zealand who leaves tomorrow for her placement and am getting acclimated to the new and interesting differences about my life in Uganda. Bucket showers and pits for latrines are standard here but nothing I didn't expect. I attached a picture of the sink used in the room where you can shower as well. It's functional and low maintenance that's for sure! I am a little nervous about getting used to the bathroom but I have confidence if kids and elderly can do it, so can I!

I also attached some pictures of the coolest part of the house; the walls. In the main room where we eat and can relax anyone who volunteers can write on the walls when they leave. There are some really interesting as well as some awesome artwork on the wall and I attached a few of my favorites. People have come as far as Taiwan to volunteer with this program and it is really cool to see what people have said to leave a mark!