And Here We Go...

Published: June 26th 2016
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Hi everyone,

For those of you who may not know me, my name is Ian Niu and I’m part of the University of Saskatchewan - Queen Elizabeth Scholar group that is in Uganda for the summer of 2016. It is my greatest honor to introduce James Bayne (Nutrition), Montana Zacharias (Nursing), Richele Berzolla (Nursing), and myself (Veterinary Medicine) as the 4 QE Scholars who have been placed in the Ruhija community placement group. For the next month, we’ll be living in the rural and remote sub-county of Ruhija on the outskirts of Bwindi Impenetrable National Park along with 5 other Mbarara University of Science and Technology (MUST) students. After the month-long rural community placement, we’ll be returning to MUST for hospital placements for another 5 weeks. We welcome you as you join us along our journey through this blog…

I have the distinct pleasure of starting this blog, so I’ve taken the opportunity to describe each day of our first week in Ruhija. Hopefully, this gives you a unique glimpse into the life in rural Uganda.

*EDIT* I've attached photos for not only the first week, but the entire 4 weeks we've been here. Hopefully that'll give you a better glimpse into life in Ruhija.

May 28, 2016 (Saturday)
First day in Ruhija

Today is officially the day we leave Mbarara University of Science and Technology (MUST) and head over to Ruhija for our community placement. For the past week, we’ve been sitting through long (8AM – 5PM) and tedious days of lectures on leadership development. Throughout the leadership development, we’ve talked about challenge models, action plans, the fishbone technique, the “five whys”, priority matrixes, and stakeholder analysis. Hopefully, all this information will pay off and will be beneficial once we get to Ruhija.

Officially on our schedule, we were supposed to leave Mbarara at 7:30AM, but in Ugandan time, that meant at least an hour or two later. As much as we knew we were at the mercy of Ugandan time, we still arrived relatively on time (8AM) and pack our bags onto the van. By 8:30AM, everyone, including the MUST students, had arrived, but surprisingly, we didn’t take off. Instead, people simply stood around chatting.

The entire QE Scholars group consists of 12 students from the University of Saskatchewan from a variety of different fields. However, the group of 12 was split into two groups with different destinations. One going to Rugazi, and ours going to Ruhija. Saying goodbye to the other QE Scholars was surprisingly more difficult than I had expected. Even though we had only been together for ~10 days, the bonds we had established were stronger than we realized. Being away from any sense of familiarity and exposed to a blast of different culture really brought the group together as a family. Finally, at around 10AM, after some tears had been shed and hugs were shared, we managed to get our MUST students together and took off in our van.

On our way over to Ruhija, we stopped in Kabale, the nearest “city”. There we grabbed lunch before continuing towards Ruhija. Unlike many of the other community placement locations, Ruhija is relatively far from Mbarara. In total, it took us about 4-5 hours worth of driving, almost half of which was in mountain roads. Despite the long drive, we did have the luxury of seeing L’Hoests monkeys and beautiful scenery along the way over to Ruhija. Ruhija happens to be situated near a National Park which is one of only two national parks where you can see mountain gorillas. As the name suggests, these gorillas live in mountainous regions, which makes Ruhija a relatively difficult to access and very remote town. To put things into perspective, it takes us 30+ minutes to walk to the health centre which we volunteer at everyday… and that’s only one-way!

Upon arriving at our home for the next month, we’re greeted by Dez, the accountant and finance officer for Institute of Tropical Forest Conservation (ITFC). As it turns out, we’re staying at a guest house that belongs to ITFC. Dez, along with several other ITFC staff, welcome us to Ruhija and answer a variety of questions we have regarding our living conditions. At the time, my biggest concern was whether or not we’d have internet access to keep in touch with the outside world. And though we were assured that there was internet access at the ITFC office, I didn’t realize that getting internet would be much more difficult than I expected.

That evening, as we all settle into our new home, I’m surprised to feel just how chilly Ruhija is in the evenings. If someone had told me that I’d feel cold in Uganda before I left Canada, I would have scoffed and ignored their words. But the reality is that Ruhija is quite high up in the mountains (~2400m elevation), causing it to get quite cold in the mornings and evenings. Fortunately, all the group members brought long sleeve shirts, sweaters, or hoodies, otherwise we’d be very unhappy and cold campers =). Before heading to bed, all 9 of us (Silas, Gordon, Lynn, Julian, Clement, Montana, Richele, James and I) sat down to discuss our “welfare”, meaning whether or not we’d hire a cook. In the end, we decided that we’ll hire a cook.

May 29, 2016 (Sunday)
Second Day in Ruhija

Today, we hired a cook called Emmanuel for 200,000 UGX for 20 days (4 weeks, excluding weekends). In Canadian dollars, this translates to about $80 for the month. As our official placement doesn’t start until Monday and today is only Sunday, we spent the morning touring the neighborhood. First, we walked up to the ITFC office, which is a short, but steep hill climb away. The ITFC office is where we’ll have access to a generator for charging electronics. This is also the location where internet is available, as opposed to our residence, where we only have electricity for lights from solar power. As I’ll write in a later blog, the internet access wasn’t as accessible as I had originally thought.

At our residence, we also share the kitchen and resources with some mountain gorilla trackers. These trackers meet at our site at 7AM each morning to eat breakfast and prepare for a morning of tracking gorillas for research. Surprisingly, they actually follow muzungu (foreigner) time, meaning they arrive at our campsite at 7AM and leave the campsite at 7:30AM, on the dot. This morning, they invited me to join them for breakfast, which consisted of posho (a white starchy paste) with beans and cabbage.

From 11AM to 1:30PM, we basically did nothing, which raised the question in my mind, “What will I do with all this free time?”

At 1:30PM, lunch prepared by Emmanuel is served. Afterwards, we head out to visit the Ruhija Health Centre III, the III standing for the level of health services provided (I being the lowest level of health services provided and IV being the highest). The walk over to the Health Centre takes about 30 minutes one way, with constant uphill and downhill portions. My cardiovascular is going to be amazing by the time I finish this community placement. =) Along the way, there are gorgeous views of the mountains and the neighboring Bwindi Impenetrable National Park. The pictures simply don’t do justice to the local scenery. It’s truly an exquisite opportunity to experience this unique beauty. Simultaneously, however, there’s a sense of overwhelming inability to make an impact. The reality of life in rural towns has so many limitations. From what I’ve seen so far, the distances villagers have to travel to get any health care is significantly longer than what I expected. Plus, with all the farm land and primitive harvesting and cooking techniques, the majority of one’s day is going to be spent on basic daily survival. And with our limited resources, there’s very little we can do to make a large, significant impact which I had envisioned our team doing.

When we finally arrived at the Ruhija Health Centre III, we met a midwife and a lab technician that work here. They told us that their “in-charge” was not around, so we’ll have to meet him tomorrow. In the meantime, the midwife and lab tech gave us a tour of the health centre. We saw the maternity ward and outpatient department, which is pretty much the extent of this health centre. It’ll be interesting to see the working dynamics here. At this point, we started to head back to our residence.

As we’re walking back, I notice that the people here in Ruhija don’t seem to display that “pure happiness” which past QE Scholars have talked about in rural villages. Those scholars mentioned that in people in rural villages don’t have the complexities and frustrations from city life, leading to a general sense of greater happiness in individuals. However, since this isn’t really seen in Ruhija, I’m not sure whether my initial judgement is off, or whether there are some characteristics of life in Ruhija that make the people less content or less happy.

Finally, we arrive home, eat dinner consisting of rice, posho, spaghetti noodles, and ground nut (aka gnut), and then played “Contact” (a word game) before sleeping.

May 30, 2016 (Monday)
Third day in Ruhija

Today’s our first day of work at Ruhija Health Centre. Initially, we meet a man named Moses, who’s the local health officer. According to the MUST students, this means that he’s received a diploma in clinical medicine, but has no basis or background for his medicine, meaning his education didn’t include courses such as anatomy or physiology. Once we all introduced ourselves, we were basically thrown right into the thick of things. The first patient was invited into the examination room, and Moses basically was expecting us to take charge of everything. Obviously, as students, we were all inexperienced and incapable of performing our clinical duties to due diligence, but in the current situation, we had to make the most of the situation. All this time, Moses just stood beside, helping to translate. As I’d later notice, he would leave the health centre and return an hour or so later. I’ve been told that this can happen, where the local staff disappear once we students arrive at the health center, thinking that we’ve come to “relieve them”. Hopefully, this doesn’t become a habit.

Later, Silas, James, and I moved out of the examination room and started helping out in the drug dispensary portion of the health centre. Silas is a student in Pharmacy, so he has a bit of expertise in this area. As for James and I, we do our best to help him dispense the drugs as we’re fish out of water in the examination room. At the very least, we can help fill out prescriptions with Silas in the drug dispensary department. Up until 10:30AM, most of the staff of the health centre hadn’t even arrived. So we were actually working without any staff present for most of the morning.

At 12PM, we finish our “shift” at the health centre and head home for lunch. After eating lunch, we start to work on our community assessment project, specifically our mission and vision for Ruhija. Then, some of the MUST students headed up to the ITFC office to charge their electronics. It almost feels as though the MUST students are more dependent on their electronics, internet, tv series, and movies than we muzungu are. =)

Another interesting thing I’ve noticed here is the fact that “we all speak English, but we don’t all speak the same language”. What I mean is that even though what’s coming out of everyone’s mouth is English, for some reason or another, we still don’t understand each other. It could be due to accent or it could be due to different local vernacular, but this is a particular challenge when I try to say something, and the person on the other end says “yes” or “ok”, but doesn’t actually comprehend. For example, James gave Emmanuel stickers to take home to give to his children. At the time we gave Emmanuel the stickers, we thought he understood that the stickers were for him to keep. But the next morning, Emmanuel brought the stickers back to us, probably assuming that the stickers were a loan. It took more explaining that the stickers were for him to keep that the message finally came across. This isn’t necessarily a big issue, but it makes everyday communication difficult and more frustrating than necessary. Plus, it’s probably equally frustrating for the local Ugandans on the other end because they must feel the same way.

In the late afternoon, we learned a new card game called “playing cards” with Silas. It’s a simple game of getting rid of your cards first, with special abilities associated with some cards. It’s actually really similar to uno. After dinner, everyone turns in for the night after a long, tough day.

May 31, 2016 (Tuesday)
Fourth Day in Ruhija

Today when I woke up, I ate breakfast and started to feel a bit of stomach discomfort. I wonder if it’s a result of the food, water or other factors starting to get to me. We left for the Health Centre around 9AM, but were planning on visiting the sub-county office along the way to get in contact with a representative of the sub-county. Instead, we found a guy called Gideon in a yellow Arsenal jersey who basically said that all the reps or officers were out or at meetings. He offered to bring us around to get some data for our community assessment and perhaps meet a VHT (village health team) volunteer. At this point, because we were supposed to go to the health centre, we held a quick team meeting to decide what we should do. We quickly decided that Gideon’s offer to guide us around town was too good an opportunity to collect data. To be responsible to the health centre, we sent two of us, myself and Clement, to tell the health centre staff that we wouldn’t be able to make it today for unexpected reasons. When Clement and I arrived at the health centre, we found the Moses sitting behind the health centre, resting in the shade, not doing anything. The rest of the staff weren’t there either, aside from the lab technician. I’m starting to worry that the staff may actually feel that they can slack off now and not show up if we’re here.

So Clement and I head back to catch up with the rest of the group. As we’re walking back, we see them standing in the street talking with a guy. Apparently, this guy had done a research project on nutrition in Ruhija and was willing to share his project binder with us, which was a BIG help! Afterwards, we came home, solidified our information, worked a bit on our mission and vision for Ruhija, and had lunch. Gideon told us earlier that every Tuesday is a market day, so we went to the local market and bought some groceries and fruits. Then, we went up to ITFC to charge electronics and try to figure out the internet situation. I tried talking with Dez and Clemencia (an assistant who is in charge of our residential situation) about using the internet, but I quickly discovered a reluctance to share the wifi password. As it turned out, they have limited bandwidth and the internet is an expensive cost for ITFC here in Ruhija since it’s so rural and remote. Negotiating with them was really difficult because I could see/tell that they were reluctant and intentionally withholding info, but they weren’t willing to be straightforward and honest. Instead, they pushed off their responsibility to another higher up officer and said they would get back to me on the usage of the internet. This seems to be the case for anyone who’s in a position of authority whenever it comes to making an unfavorable official decision. Just push it off to someone with higher authority and request that I wait until later for a response. I’m not sure whether persistence would help in this case, but my gut feeling tells me that this is their go-to response to say “no” without saying “no”.

This experience has provided two very interesting and positive silver linings though. For one, this experience has challenged and developed my skills in reading or interpreting people’s expressions, body language, and other hidden context from a different cultural perspective. Secondly, and more importantly, this will be a great opportunity to return to life without a dependence on electronics and internet. I’ve always told myself that if I had to, I could easily live my life without electronics or internet. This should be a nice social experiment to see how well I can adjust and how I’ll spend my time that was previously used on electronics. Now, to figure out what to do with all this spare time…

While we were at the ITFC office, we also learned another interesting piece of information. Some of the gorilla trackers told us that for us to go gorilla tracking; all we need is permission from the warden at the park entrance, which is about 1km away from where we’re staying. I’ll be visiting him tomorrow to ask for his permission. Fingers crossed for free gorilla tracking!!

We also made a couple a new friends called Julius and his roommate Jack from the UK. They live right by the ITFC office and invited us to go to their place sometime to play scrabble or go to the local pork joint to eat some fresh pork. We may have to take him up on his offer someday.

June 1, 2016 (Wednesday)
Fifth Day in Ruhija

We had posho and beans with tea and mandaze (a fried bun) for breakfast today. Hopefully, I’ll remember to take photos of the food more often so you can see what it looks like. We worked at the health centre today, came back home to eat lunch, and didn’t do much else afterwards. James and I went to visit the warden, but we walked the wrong path, so we’ll have to go back again tomorrow.

I noticed that there are thunderstorms nearby Ruhija all the time, even during the night. However, where we live never seems to be on the receiving end. We must be right outside the edge of the storms. The storms are particularly pretty at night, when the cloudy sky lights up as thunder strikes.

From 7PM-8PM, we as a group did some brainstorming towards what type of health challenge we want to attempt in Ruhija. We’ve got a couple ideas (increasing IPT2 treatment for pregnant women or increasing HPV vaccinations for young girls), but we still need more information before we can conclusively decide our topic.

June 2, 2016 (Thursday)
Sixth Day in Ruhija

Today we went to the Health Centre to meet with the health assistant officer. He’s supposed to be a very important link for establishing contact with a variety of different individuals which are relevant to our community health project, as well as an important source of data for past health records within the community. However, as with many of the other authority figures in the past, he seemed more willing to push things off to someone else or defer our attention to something else. In this case, he told us that there was a big group of men from the local “stretcher health team” which we could talk to and ask questions. This health team consists of volunteers of men who carry sick or injured individuals on stretchers to the health centre for medical attention. These men, I could tell, were very involved in their community and devoted and concerned towards improving the health of their community and community members. Sadly, of the many issues they brought up, including lack of accessibility to the health centre, lack of appropriate medication, a small inadequate lab facility, no water or electricity, and a long list of common health problems, most of these issues are outside of our scope or ability of help. Even more sadly, the local and national governments probably are unaware or don’t care enough to do anything to improve the conditions at Ruhija. It’s moments like these are the most discouraging for anyone who wishes to make an impact in poorly developed areas of Uganda.

On a brighter note, we did meet a researcher called Dan who’s associated with the United States Agency of International Development (USAID) and UNICEF. From a meeting with him at the sub-county office, we learned that he’s been working on a nutrition project called Uganda Nutritional Action Plan (UNAP) for the past 5 years. The aim of the project is to establish guidelines and standards for sources of nutritional requirements for people in rural Uganda, particularly in the district of Kabale, which encompasses Ruhija. Not only is this encouraging knowing that there’s concern for the people here in Ruhija, but it’s also nice to see large scale international groups that are invested in these areas.

In the afternoon, James and I went to visit the warden again, but he wasn’t around at the time. Instead, we met the second in charge, who said to come back the next morning at 7AM. Afterwards, we bought some beers for the group to celebrate Montana’s birthday party. Then, we did some work on our community project before eating dinner. We then played mafia until 9PM, at which point people began preparing for bed.

June 3, 2016 (Friday)
Seventh Day in Ruhija

Today, James and I woke-up at 6:45AM to visit the warden. Sadly, the warden didn’t wake up until 8AM. When we finally met him and introduced ourselves and requested for his permission to go gorilla tracking, he said he had a meeting with some “chief” later today and would give us an answer on Sunday (typical Ugandan authority fashion, not being direct and not giving a straight answer). So we’ll have to go back on Sunday to see what he says.

After coming back to camp, we ate breakfast (posho and beans with chapatti), then went to ITFC to charge electronics.

Today is Martyr Day, an official holiday in Uganda. Therefore, Ruhija is relatively quiet and inactive, with church service being the main event on Martyr Day. However, with other objectives in mind, we used the day towards drawing a complete, final sketch of the transect walk (a picture of the local area) and discussing our health challenge options, which seems to be leaning towards HPV vaccinations. We ate lunch (posho, matoke, and beans with dodo), played “Sets” (another Ugandan card game), and then I walked with Silas to return the HPV records book we had borrowed from the health centre. After returning to our home and playing a few rounds of Kaiser (a card game similar to bridge), we then proceeded to eat cabbage and rice for dinner. Finally, we played “Crazy 8s” (another card game) before sleeping. It was an early night for most because a cold or flu is going through the group.

June 4, 2016 (Saturday)
Eighth Day in Ruhija

Today is the last day I’ll be blogging for the time we’re in Ruhija. Today, being a Saturday, I slept in until 8:30AM rather than the usual 7:30AM. At around 9:30AM, we went on a guided tour with Gideon (yellow Arsenal shirt). We visited several spots, including the local traditional healer (who uses herbs as her primary means of medicine), a swamp created by mountain elephants, and a nearby waterfall. Not only was the journey filled with amazing scenery and an exclusive cave with the waterfall, but we also saw massive earthworms, giant grasshoppers, and plenty of other wildlife. As the swamp and waterfall were situated in the valley close to the bottom of the mountain, the hike up and down were quite tough, which was evidenced by the long naps everyone took after coming back from the tour. Personally, I stayed up and chilled until 3:00PM when it was time for me to meet Eliab (a gorilla tracker) to go visit his youth soccer team. Lunch was rice and posho with gnut and cabbage sauce.

So back to Eliab and his youth soccer team…. This was actually the first time that I felt like I made an actual direct contribution to members of Ruhija. To give you some background information, Eliab is a gorilla tracker who I’ve met and said hi to in the past few mornings. He coaches a local youth soccer team consisting of children aged 13 and under. For the children, the soccer team poses a unique opportunity to earn a sponsorship to secondary school and a free education. The schools scout these children at occasional Coca-Cola hosted tournaments and if they notice any children that are promising, they’ll actually sponsor the child(ren) with school materials and supplies towards completing a secondary school education consisting of subjects like history, geography, math, English, and science. This education can open the door for university (though this can be quite tough for their parents to afford), but at the very least, offers more career options after secondary school graduation. Otherwise, the life that awaits them is poverty-stricken daily struggles of farm life in an environment which requires constant surveillance of crops to prevent crop-raiding from local wildlife.

Eliab has personally visited as many, if not all, local families to talk with the parents of children aged 13 and below. All he asks for is 3 hours of the children’s time on Saturdays to train them in soccer. Obviously, some parents have refused to give permission for their children to leave their home duties to play soccer, but for the more open-minded and hopeful parents, their children come every Saturday at 3:30PM to play soccer. In my opinion, Eliab is an inspiration role-model for these children as he came from a similar background to these kids. Eliab also grew up in poverty. And through playing soccer, he managed to earn a sponsorship at a secondary school, which enabled him to earn his current job of gorilla tracking. And starting this Monday, he’s actually switching jobs to act as a teacher at a local secondary school, teaching geography and history.

So from 3:30PM to 5:00PM, Eliab and I played and practiced soccer with the kids. Not only does he train the kids to develop strong passing and teamwork skills, he also makes them run drills to train their strength and endurance. After the drills, he sat them down so that I could give them a “motivational speech”. In my speech, I told the children to train hard and persistently, for the potential of earning a life-changing sponsorship. I also reminded them to listen closely to their coach, Eliab, as he is a great source of wisdom and skills. And finally, for the hard work they had put in for the day, I left them with some stickers on their foreheads and Taiwanese milk candies as some motivation. The smiles on their faces as they enjoyed the sugary treats was such a rewarding moment that I’ll never forget. It’ll be an even more remarkable and extraordinary experience if one of these children end up in international headlines leading Uganda’s national soccer team. The work Eliab has and is doing gives me great hope and it’s these kinds of people that I wish could drive the world. I left him some of my clothing so he could dispense it to the children as he sees fit. Hopefully it’ll serve as more motivation for the kids down the line to continue practicing hard.

After enjoying more discussions with Eliab regarding his team, we finally returned home, where he thanked me and bid me a good night. I shared my experiences with the rest of the group, had dinner (spaghetti and potatoes with gnut sauce), and played mafia before finally going to sleep.

Additional photos below
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