Farewell from Uganda

As the end of February quickly crept up on me I found myself struggling to wrap up all that needed to be done before I returned home to Canada with my research and work in hand, to begin the process of pulling together my Master's thesis. A couple of weeks before leaving Uganda I traveled up to the familiar area of Kumi district and spent the week conducting surveys at health centers, interviewing patients and staff and finally checking in with the community of Ongino sub-county to see how the project led by the Rotary club of Kampala West and District 5330 in California had been progressing.

All these activities in addition to packing and saying my goodbyes came up much more quickly than I had anticipated and left me scrambling to make the most of my remaining time in Uganda. Just a few nights before leaving I was fortunate enough to be invited for dinner with two visiting Rotarians from California Mrs. Margaret Bukenya (a Rotarian with the Rotary Club of Kampala West, with whom I have worked on a development project in Kumi district over the last year) and her husband, the Vice-President of Uganda, Hon. Gilbert Bukenya.

It was an incredible experience and one I will not soon forget. It was a rare and unique opportunity to talk about the challenges that Uganda faces and take in another perspective from the highest ranks of leadership in Uganda and Africa.

Ugandan Proverbs

One of my favorite things about speeches and lectures here in Uganda is that you can be almost certain that you will hear at least one or two proverbs relating to (and often not necessarily relating to...) the topic of discussion.

Here are a few of my favorites for now:

"When two elephants fight it is the grass that suffers"

"The man who has not traveled widely thinks his mother is the best cook"

"The hunter in pursuit of an elephant does not stop to throw stones at birds"

"A roaring lion catches no prey"

"He who hunts two rats, catches none"


Some of the proverb require a particular knowledge about unique animal species or cultural practices which I often need multiple explanations to understand. One of my ultimate favorite proverbs is about the African pied wagtail bird. This bird apparently has noticeably skinny legs with a distinct bend at the knees (see picture). So the proverb goes....

"When the African pied wagtail bird arrived to enter a dance competition, all the other competitors laughed at him. To this he replied, 'I'm not here to show off my legs, I'm here to dance.'"

Maternity Experiences Worlds Apart

On January 27 the world was stunned to hear that a woman in the United States gave birth to 8 healthy babies. Three days later in Northern Uganda at Lacor hospital near Gulu, a Uganda woman gave birth to 6 babies, all of whom died.

Hearing this news in Uganda, I felt compelled to highlight this example of the extreme gap that exists in health services and antenatal care. The American woman checked into the hospital 23 weeks into her pregnancy, was attended to by 46 medical staff and delivered in 4 separate rooms. In Gulu there was one stillbirth and the other children were all born very prematurely. The mother to be suffered unimaginable psychological and emotional devastation as the next 2 babies died hours after birth, one the next day, another one the day after that and the last baby died of respiratory failure 2 days after that.

Maternal health in Uganda remains the most challenging health issue in the country as statistics indicate that only approximately 40% of women give birth in a health clinic, most opting to deliver in the bush for a variety of reasons including poorly trained and abusive/overworked medical staff, substandard medical facilities and long distances to these centers.


Woman delivers six babies, losses all - Monitor News

Ugandan women shunning hospitals to give birth traditionally - Earth Times News

On the border: Volunteering at Nyakabande Refugee Camp

Last November and December renewed fighting in eastern Democratic Republic of Congo (DRC) forced hundreds of thousands of civilians to flee their homes. By mid January 2009 it is estimated that over 250,000 people are on the move, either in the DRC or have crossed over into neighboring Uganda. By early December heavy fighting between recently arrested rebel general Laurent Nkunda's CNDP and government forces.

As fighting increased, thousands of Congolese fled their homes into Uganda each day. In one week in late November, it was estimated that 30,000 refugees crossed the border into Uganda. It takes a lot of resources to receive and accommodate such a huge wave of refugees entering the country at one time and humanitarian agencies struggled to cope with the massive influx.

So, with some free time in between the end of my classes and the beginning of final exams, I met with the Ugandan Red Cross Society and arranged to travel to the border area between Uganda and DRC to serve as a volunteer, assist with refugee camp maintenance and profile the stories of refugees arriving at the United Nations High Commissioner for Refugees (UNHCR) camp.

I was sent to Nyakabande camp on the border with DRC. It is just up the road from Bunagana, one of two main transit routes between Uganda and the DRC. In fact, it was rumored that since Bunagana was a rebel stronghold, general Nkunda and his main forces were very near to our location. When Nkunda was arrested, he was apprehended in Bunagana. We traveled to the border area frequently (which was at that time controlled by Nkunda's rebels) along with Doctors without Borders to assess the situation and see how well local health centers were dealing with all the new patients.

Working at the camp was a very powerful experience. Nyakabande camp is a transit camp. It is located very close to the border and the refugees we received mostly all came in small groups on foot having just crossed the border. Many refugees did not want to come to the transit camp because they would then be transferred to a more permanent camp about 300km away, with better resources to deal with the large numbers. Nyakabande refugee camp's mission was to receive immediate refugees, attend to immediate medical and food needs and organize their transport to Nakivale (the more permanent camp).

It was interesting to see how the various organizations all contributed to the functioning of the camp. UNHCR was in charge of general camp organization and coordinating refugee transportation. The Red Cross registered incoming refugees and assisted with camp maintenance, Doctors without Borders ran a clinic at the camp, UNICEF installed the water system and Save the Children attended to child rights issues.

As refugees entered the camp, my job was to ask them questions about the situation in DRC, the ongoing fighting and details about how they arrived at the camp. The general idea was to get a better sense of the people the camp was serving and then be able to adapt to these needs for future refugees.

We did our best to make those we received feel safe and comfortable. Occasionally we played football with the children, giving the parents a rest from their journey. I attempted to learn some of their local Congolese dialect, with little success but with many laughs from the children and adults. Although I was only there for a short while, the opportunity to interact with the same adults and children for several days at a time meant that I was able to get a better understanding of their circumstances and their perspective on the conflict and their hopes for the DRC's future.

I was struck by the resilience of the people I met at the camp. Having fled their homes, been separated from their families and lost most, if not all, of their possessions, they were generally in good spirits and eager to talk at length with me about their experiences and life back home. Considering that conflicts of this nature have been going on for well over a decade now in eastern DRC and this was by no means the first time these people had fled, I began to wonder if it was strangely possible that these incidents were becoming a part of life.

Overall, most people I spoke to had traveled about an average of 10km and had carried very little, forced to flee at the sight of approaching rebels or heavy firefights. Mainly mothers with young children or individual men arrived at the camp. Most had been split from their families in the midst of confusion and were trying to find their relatives. The young men I spoke to all had stories of government and rebel forces trying to force them to join their groups or had escaped forced enlistment in these groups.

While there is certainly a lack of coherent action to end the violence and conflict in DRC that is largely targeting innocent civilians, by speaking with the refugees I began to understand some of the complexities. During the day, for example, the conflict zones in DRC are largely peaceful. However, it is during the night that rebels are active, villages are looted and abuses occur. Considering the environment of eastern DRC, remote villages in dense mountain jungle terrain, intervention is very difficult. That is not to say that more cannot be done.

Furthermore, wanting to demonstrate their control of territory, Nkunda's rebels ordered the destruction of internally displaced persons' camps in DRC, then housing tens of thousands, and ordered civilians to return to their homes. Near the end of my time at the camp, I was beginning to receive reports from refugees of discoveries of mass graves near where these camps once were. In addition, an increasing problem was that rebel agents had infiltrated many refugee camps and were actively or coercively recruiting young men to return to DRC and fight.

By far most of the refugees that crossed into Uganda remained right on the border, not at the camps, hoping to be able to return back to their homes in the DRC when the fighting temporarily subsided. I was also told by refugees that rebels were spreading rumors that if the civilians went to the UNHCR camps, their possessions would be taken from them and that, in fact, they would be killed by us...This presented some unusual challenges to convincing those on the border to come to the camp, receive food, shelter and medical assistance.

Cutting a Few Corners...

Last Sunday MTN (one of the largest telecommunications companies in Uganda) held their annual marathon and 10km road race through the streets of Kampala. It's a huge event and they estimate that over 10,000 people ran in one of the two races. At this point I could produce a health list of reasons why I did not enter the race but I'll leave it at the basic fact that running from anything not immediately life-threatening straddling the equator in Sub-Saharan Africa for at least 10 consecutive kilometers would in all likelihood kill me.

My pathetic excuse aside, the 10k race features some Olympic caliber runners from across East Africa. According to first reports, Moses Kipsiro, one of the top Ugandan runners crossed the line an astonishing 48 seconds ahead of Haile Gebrselassie's world record of 27:02 that has stood for the last 6 years. Or did he....

It turns out that although the course was measured and officially approved by an internationally recognized team several days before the race, the course had to be rerouted at the behest of the police two days before the start due to security concerns. They remeasured the course and it turns out that it was 800m too short.

Surprising indeed, but it's actually not the first time something like this has happened. Word on the street (though I'm not sure it has ever been confirmed officially) is that a the Israeli swim team recently came to train in the only Olympic swimming pool in Uganda at Speke Munyonyo resort on the outskirts of Kampala. When they began training they were amazed that they were all crushing their personal bests. As skepticism grew they pulled out the tape measure and discovered that the "Olympic" pool was two meters short, merely 48 meters long...