Making babies and being born in the right place 8/12/09

I came to Uganda hoping to do achieve two things; Number one-learn more about the people and difficulties here and secondly, learn FROM them. I hope to take what I learn and find at least some ways to help improve the lives of those here with the extremely generous support in all typs of ways from my friends and family. Just as importantly, I hope to bring back what I learn from this country and those who make it so incredible for those who, for numerous reasons, might not be able to experience it themselves. Today I think I achieved a little bit of both.

I started my day sitting on the floor writing my pregnancy presentation on large sheets of poster paper with the help of Sam, a KACCAD worker. Basically, it was my job to present to a roomful of women (one man!!) and their babies the importance of antenatal care and then postnatal care. Clearly my specialty what with my background in child development and personal experience with childbirth…right. So that’s why my day started with the books, Where There is No Doctor and a very visually descriptive book for women ranging from how to find a comfortable position for sleep to what you can expect to look like during every month of pregnancy, at my side as reference guides. Luckily Brooke, a volunteer nurse who has been working at the hospital was able to help as well. She explained the most common problems they see are women who are malnourished bringing in their malnourished children as well. Sometimes it’s because they can’t afford food and other times it’s because of a lack of knowledge on what foods are needed.

The objective of the morning was to scan both books while discussing with Sam the culturally appropriate explanations and then put on a good presentation to a lot of skeptical women. I have to say I think I did a pretty decent job. I tried to keep it simple but informative and I thought it went well! At the end, the lone father in the room stood up and said in English, “thank you for teaching us” to which of course I responded, “thank you for listening!” For the most part, the babies behaved very well and the women were very attentive. My only obvious error was just a cultural difference where, when speaking about the proper weight of a growing child from birth to 5 years, I mentioned that a baby born under 3.1 kg is considered underweight. This, in fact is true in the United States but in Uganda, as the nurse politely corrected me,” 2.5 kg and under is considered underweight. I was very grateful that she politely put it in question form and then allowed me to explain that I was incorrect rather than trying to correct me in front of the group.

After the presentation I came back to my home to wash clothes only to find that we have no water. Normally, there are taps outside that you can use for cooking and filling up water. Today that lucky modern privilege is no longer. I was told it could be a day or possibly a week before we get working pumps so that was frustrating. Luckily it went off right when I was finishing my clothes so I will have clean underwear for another week! Now we will have to walk down to the community water pipe and fill up our jerrycans when they are low to have enough water for washing and cooking. It really isn’t too bad but it was a little frustrating when today the gas also went out so we no longer can use the stove to heat coffee or boil eggs in the morning. Oh AND the electricity comes on later every night now. I know I am lucky to have it at all and I definitely realize how I have taken it for granted. Now when I spend every night eating by flashlight, I am trying to be appreciative while literally sitting and waiting until around 10 when I will have electricity to read or take a shower (VERY difficult with no light and water in a small shower room the size of a port-a-potty.) It can be really uncomfortable but in a way, I am proud of myself for being able to deal with all that is coming at me and just kind of figuring a way to deal with it. It really helps and puts my discomforts in perspective when I constantly see people in more dire situations than I will probably ever encounter. It makes me grateful for the fact that I still have water, clean clothes to change into and food that I am able to complain about having to eat in the dark! It also helps to have Chris and Brooke around to sarcastically complain with and laugh 2 seconds later!

An update on the orphanage: the kids are taking their exams this week and so I helped with P.5’s exam today. I will try to put this in stark contrast with my memory of an exam I took in 5th grade in a public school in the U.S; Taking a little liberty with detail, I imagine I woke up, ate a breakfast of cracklin oat bran (Yes I KNOW none of you probably relate. Kirk and Catherine were what I will delicately call sliiightly overprotective and that they even invaded the kitchen where sugar cereals seemed to be as bad as cigarettes. Don’t you guys read the labels? Lucky Charms gives children bad attitudes and makes them want to smoke cigaretters) Aaaanyways, I probably headed to school with my XL GAP t-shirt which was totally cool back then, my umbro shorts and comfortable samba sneakers. I bet I brought my backpack filled with colored pencils, markers, pencils and pens (black and blue so when I wrote notes in class, I could change it up) and I ALWAYS had my trapper keeper with the clear outside pocket so I could put pictures of all my friends and draw around them when I didn’t want to listen to the teacher. When I got to school. I would sit in my assigned desk and have a few minutes to prepare for my exam while my college educated teacher would hand out clear print-out copies that were the same for everyone. I was nerdy so I would have been a little nervous and probably look around the well-lit room to all my friends making faces like, “oooh great. I would waaay rather be playing POGS and talking about my new slammer.” After finishing, I would have continued with the school day eating a hot lunch prepared by the lunch ladies and hoping my mild had the sticker on the bottom for the free cookie.

Here is the day for a P.5 student at the Raising Up Hope Orphanage; Most of the students wake up under their mosquito nets next to one or two other kids in the orphanage. Without breakfast they start the day by getting dressed and doing chores like sweeping or mopping the floors or maybe going out into the neighborhood to try to climb the trees with fruit in them to eat with their friends. Many of the kids in P.5 are older so they would take care of the two 3-month-old babies or other little ones.

(Photo: One of the kids drawing a picture with some donated crayons and paper)























Preparing for the exam is easy. They cannot study from the book as there is only one copy for the teacher so they would have to look at their notes. Coming to class which is an unlit room next to the main building, they might have had one pen and one pencil or perhaps shared with another student. At the “school,” there is no door to close to your classroom and there are children ages 3 months to 15 years running around outside playing. In the class, there is no electricity and the ages range from 10-20 years old. There are two tables and four benches. The tables are similar to a picnic table so the children sit across from each other and if anything is written on the board, the kids in the back either stand up or strain their necks around all the other kids to see. Before I arrived, one of the founders of the orphanage handed out the exams. Since he was the only one available at the time, he left the children in the room on their own in order watch the other children. The exam was handwritten and photocopied. Sam, one of the guys who started the orphanage had explained to me on Monday how he did not have the money to make photocopies for the exam. As they did not have sufficient funds to print the pages, Sam had written them out by hand and photocopied them because it is cheaper than printing. The handwritten words were very difficult to read and some of the pages were cut off on the bottom or the sides so while it is timed, you are constantly having to stop and ask the teacher, or in this case class monitor (me) what a word is or what word(s) are missing. At times I wasn’t sure so I had to leave the class to ask Sam the meaning or ask what word was missing on the page. Oh and don’t forget-this exam was not given in their native language! With minimum education, some of the students do not have a good level of English. If a child’s level of English is not good, he/she might not even understand the instructions even if fully capable of comprehending the concept.

One example of this today was a question asked after a short story where they had to answer the simple question; What is the relationship between the two characters? One child asked me what the word relationship was and thinking she couldn’t read it since it was written slightly illegibly, I told her. Without any look of understanding on her face, I realized she didn’t have a clue what a relationship was. Asking the class, none of them did. They simply didn’t know what the word meant in English.

Another problem resulted in the lack of paper and ability to print. I started noticing once I had the original copy that some of the students were working on pages I did not have! I realized that because all pages are two-sided, some of them had sides from another class' exam. Therefore, while they should have been filling out transition words on page one and moving on to short stories with short answers for page two, some kids were drawing parts of the body or asking me when I wanted them to demonstrate the commands on their paper like “clap” and “jump.”

I guess the main thing I took away from this experience was how much harder these kids have to work for an education than I did. Not only do they lack supplies but they are faced with numerous other challenges ranging from noise and illegible wording to lack of food and space. Even completing simple repetitive exercises for things like math take 3x longer. They don’t have their own books so they must first write down the entire problem. In P.5 it can be a tedious task with all the story problems. Even if a child is quick with math but slow when writing, they will have less opportunity to grasp a concept than the others. They don’t have a quiet place to study or review and they don’t have a strict parent making sure (like I did) my homework was done before I went and played nor one who is concerned if their grades slip or their behavior changes.

(photo: Kids copying their math problems from the crude blackboard where I wrote all their problems out. The orphanage finally got a single copy for most of the school books so a teacher can actually follow what they would be studying in school.)























It may sound surprising since today if you look at it in one way, it was one of my roughest days yet. However to be honest, it was one of my best! I felt hopeful when I saw all the great parents at the clinic waiting patiently for their child to get immunized and that hope carried over to my time at the orphanage where I talked with Carlos, the 11 year old who, for whatever reason loves Spain and wants to learn Spanish. I had taught him the numbers 1-11 (so he could say his age) and within two days he had it down! He seemed really proud of himself and I also noticed he had decorated his special notebook for our “Spanish class” with glitter. I felt hopeful when I cut string for bracelets and saw how when even the smallest kids wanted string to make one, the older kids immediately commanded everyone to get in a line and let all the little kids all go first. And maybe hopeful is not the right word but I felt good about my bargaining skills when after telling a boda-boda driver I would walk if he was going to charge me more than I normally pay to get home, he conceded and I got the regular “mzungu rate” of 1000 USH to ride home.



Life is good :)


(Photo: Studying so hard she's not even distracted by the camera!)

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. :)