Settling In - Week 2 in Ruhija

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Week two in Ruhija brought with it many new many new experiences not to mention the comfort of a routine and and sense of settling in. Keeping with the practice of rising early each morning, I put the water on the stove to boil in preparation for daily tea and coffee for the group. While this may seem like a straightforward task, it takes considerably longer when the first requirement is to heat charcoal on a clay oven. I believe I have the entire process of coffee making down to approximately thirty-three minutes which is a considerable improvement from the first time which took over an hour. I will say it is well worth the wait however as Ugandan coffee easily rivals any of the world famous Kenyan or Tanzanian varieties. Breakfast usually consists of either chappatis or mandazes, two distinct types of bread, the first being similar to a pancake and the second a deep fried dense bun, both of which I would highly recommend trying if you get the chance. Following breakfast, we embark on the thirty minute walk to the community health centre often times stopping to talk with friendly locals along the way. The scenery is incredible and we are all often times in need of the reality check that the view isn't simply a postcard.



For myself, mornings at the health centre are usually spent helping out in the pharmacy with administering prescriptions to those patients who come seeking treatment for minor ailments of which diarrheal diseases and peptic ulcers are common. The underlying cause of both are likely a result of poor sanitation and water quality due to the prevalence of parasites. Unfortunately, the limited availability of prescription medications results in most patients receiving treatment for pain or other symptoms and not necessarily solving the root cause of the disease. In addition to the scarcity of drugs, communication remains one of the biggest challenges for our group as only two individuals speak the local dialect (Rukiga) with any fluency. However the odd time, I have managed to string together a handful of the dozen or so words that I can speak in order to get my point across.



In addition to working at the pharmacy, I have spent time in the medical laboratory where I witnessed how both HIV and malaria tests are conducted. While both diseases appear to be under control In Ruhija at least, other conditions such as food security and malnutrition are two areas in need of desperate assessment and research. Although food intake levels are adequate among the majority of individuals in this region, child malnutrition remains high due to micronutrient deficiencies likely caused by a combination of factors including lack of dietary diversity, low protein intake, and a high reliance on inexpensive starch based foods such as matoke (boiled green bananas) - the staple food in southwest Uganda, posho (maize flour boiled with water in a consistency similar to mashed potatoes), polished rice, and Irish potatoes. These foods are supplemented with either beans or groundnut (peanut) sauce as the major protein source. We have had the opportunity to live this first hand as I believe we have ate the same five foods for the entirety of our stay in Ruhija s - all part of the local experience! Unfortunately, the reality for many families is that crops are often sold for profit rather than consumed in order to pay for costly expenses such as child education and medical care. Clearly, this is a topic of research that is of interest to me however it is also one that has been continuously addressed without considerable success due to the large number of associated barriers and thus our research team has been advised to consider other health challenges. Presently, we are examining topics surrounding antenatal care or the prevalence of Humanpapilloma virus and cervical cancer. More information to come from Montana and Richele's posts.



On a personal note, despite the challenges we have faced as a group with regards to our work at the health centre and with our research project, I have truly enjoyed my time spent in Ruhija up to this point. I have embraced the slower pace and am very happy to take a break from the all too consuming workload that we often get wrapped up in while at the same time taking a moment to enjoy the beauty of the natural environment that I am currently surrounded by.

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