Blog Post #5: Community project and Canada Day weekend!

Published: July 5th 2016
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I’m a little behind in blogging my adventure. But if you bear with me, I’ll catch you up.

Last Saturday, three of the muzungus returned to Mbarara to start their hospital placements. Five of us elected to stay here in Rugazu and see through a little bit more of the community projects. Dayna and I are the remaining muzungus in Rugazi Group B and Jill, Joline and Carrie remained here to work with Group A. The past two weeks our group has been making a lot of headway on our community project. Our goal/objective (or “measurable result” as they call it here) is to increase the number of people using family planning in our village.

Two weeks ago Britany, Dayna and I were stationed in OPD. The week was fairly standard, except for Thursday and Friday. Thursday we showed up in OPD, only to find out that one room would act as a diabetes and hypertension clinic for the day. The clinical officer, Mary saw all of the patients. Joline took blood pressures and taught me how to do a finger prick and take blood glucose. Britany packed up the meds in the patients’ prescription right in the same room while Joline and I would start to assess the next patient. This week, the clinic ran again and I did all of these jobs on my own while Mary talked to the patients. It felt good to actually be doing so much but my morning in the clinic was cut short when we were told that the Dean of Medicine was coming to check in on us and we needed to assemble at home immediately.

Friday of that week, I helped out in the ART clinic dispensary. I packaged cotri-moxazole medications that everyone on ART takes to prevent opportunistic infections. My job for several hours was to count out 30 pills and put them into a plastic bag. 5, 10, 15, 20, 25, 30, zip, toss…. 5, 10, 15, 20… Another student was packaging them in groups of 60. The bags of 60 are distributed to the clients who had few enough side effects and high enough medication adherence to be given medication for two months at a time. I sat on a stool and stacked boxes to make myself a small workstation. Here I worked quietly until I hear someone say “Muzungu!” out the dispensary window. That is my cue to peek around my boxes, smile and wave to the person looking in at me. For some reason, they usually laugh after that.

That weekend we went to the orphanage again. There was a really big group of us this time, and we had a total blast playing with the kids. Of course I forgot my camera battery though. The next day we went on a long group walk. We saw several different crater lakes (Stevo even decided one should be named after me). We were able to find one that didn’t have such a steep bank, so we could walk right up to it. As we arrived at the water, a group of people pulled up on a boda boda. They walked into the water and two men and a woman baptized a lady while we watched. It was at sunset and actually quite beautiful.

This week I spent Monday and Tuesday mornings running around for our community project. We had invited VHTs to a training session about Family Planning for Wednesday and there was a lot to do to prepare. This involved talking to nearby health centers and drug shops to find out what Family Planning methods they offered. We also visited the primary school, our village VHT and the village chairperson, or LC1.

Through our community survey on Family Planning, and our ongoing communication with community stakeholders, I have been into many homes in the Kasarara I village now. Some homes are made out of mud, while others are made from brick. The reception to visitors is amazing; as soon as we walk up, people either invite us inside or bring chairs outside for us. I highly doubt the reception would be the same if I walked up to 100 Canadian homes and said I was doing a survey about Family Planning. We’re told that although a warm welcome is fairly customary, we may be getting extra special treatment because we have muzungus.

The houses I’ve been in have small rooms separated by walls and curtains and there is furniture in a common area. Often the walls are decorated with old calendars, religious posters (hello again, Pope Francis), the occasional newspaper clipping and candidate posters from the most recent presidential election. One home even had several newspaper clippings that all featured Barack Obama. My favourite poster was one written in the local language that featured nutrition and feeding advice for babies from birth through age two.

Wednesday and Friday morning I spent in the ART (HIV) clinic. This time I sat at the front and measured the MUAC for everyone who checked in. MUAC stands for mid-upper arm circumference. This measurement and changes in this measurement help to indicate nutritional status. Every time I had enquidde about MUAC measurements for HIV+ patients, I have been told that they are taken at each visit. I had never seen anyone measure it at the check in desk or in the appointment rooms; instead, I have seen people record the previous visit’s MUAC measurement value on the line for the current visit. I finally decided to just go start taking them myself, so I rummaged around for a measuring tape and took MUAC at the check in both Wednesday and Friday. Friday when I arrived to work, someone was already taking MUAC. I though this was because I set a good example on Wednesday… but its actually because they were preparing to be audited.

Wednesday we held our VHT (village health team member) education session. Twenty-one VHTs came, which was an excellent turnout. We only advertised to certain VHTs because our budget for sodas was not very large. They asked us plenty of questions and we were able to come up with answers for everything. They asked us to host another education session on the same topic so that they could better digest the information we had given them. I think we will probably create and print a handout on Family Planning methods available at Rugazi HC IV to distribute to the VHTS and possibly host another education day.

We held education sessions about Family Planning for the entire community on both Saturday and Sunday this week. I was surprised with the great attendance on Saturday, since we moved the date from Friday to Saturday at the very last minute. Over 30 people attended. We enticed people to attend by offering blood pressure testing and free testing for some common diseases in the area (HIV, syphilis, malaria and a few others). The people who attended made good use of the testing and asked many really good questions.

The Sunday session was held at the Primary school, with the intention that people from other villages would also be able to attend. We had asked VHTs to advertise to their communities about this event. Unfortunately, only seven people attended this second presentation. We are still not completely unsure why there was such low attendance. Likely because there was a Bishop visiting the Anglican church all day or because the VHTs did not do a very good job mobilizing their community members. VHTs often expect money for working and we didn’t pay them to attend our education session or to call/visit homes advertising about our event. We waited until well after 4:00 to start the session and shortly after that it started pouring so we moved inside. We still have a few things planned to help improve Family Planning in Rugazi, so we will be working hard on those for the two days I am left here.

By far the best part of the week was the celebration we had for Canada Day on Friday. We played games outside in the afternoon. (Rugazi Team A vs. Rugazi Team B). Everyone, including the patients who came out from the inpatient wards to watch us, had a blast. The games we played included: bocce ball, pin the maple leaf on the flag, jackpot with water balloons, flippy cup, and hide the bottle (a game we learned at the orphanage). The competition was close but Team B ended up taking home the win after a riveting last round of flippy cup.

After the games, we gave everyone two hours to get cleaned up while the muzungos set up for the main event; a mock wedding between Dayna and Julius. Dayna and Julius have been through extensive ridicule for the past few weeks ever since they played a couple in the play we presented to the secondary school. We finally decided that we would take the joke all the way and that they should have a mock wedding on Canada Day. (I’m pretty sure Julius regrets pinky swearing me we would have an awesome party on Canada Day). It’s amazing how much we pulled off with so little planning. We decorated the table with a pop bottle vase of flowers, some candles (thanks, Mugga!), loose flowers and banana leaves. There were party favours (lollipops) with each place setting card. Dayna had a flower crown and her and Joline both had bouquets while the men had matching boutonnieres (all flowers scavenged by the side of the road at lunch time). The ceremony was in the back yard at sunset. Marius (Dayna's father in our play), walked Dayna down the aisle. There was a little said about Dayna and Julius and of course, Stevo (the Reverend) had to read 1 Corinthians 13. Dayna and Julius vowed to be together through times of many patients in OPD, and times of few as long as they both shall live at Rugazi HC IV. They sealed the deal with a nice, friendly hug and were announced mock man and wife.

Dayna’s maid of honour, Joline and Julius’ best man, Eli, made speeches after dinner at the reception. I was the MC. We also had welcome to the family (country) speeches by Carrie and Maria. It sounds strange, but the speeches were so nicely prepared that there were almost some tears. We also played a wedding game, had the first dance and a cake cutting. DJ Ambs spun beats throughout the ceremony, reception and dance. Carrie played the role of wedding videographer and makeup artist for the bridal party. Once it got late, we cleaned up the mess and sound equipment and headed down the road to a club. We headed out earlier than I expected, so I never got around to serving the midnight lunch - bananas. We had so much fun throughout the day and Dayna and Julius felt really special. It was one of the best days of my life and by far the best Canada Day I’ve ever had.

Tomorrow marks the half way point of my time here. I’m heading back to Mbarara on Wednesday next week. We have a short weekend safari planned, then I will be starting my clinical placement. We might even plan another wedding for July (Joline caught the bouquet). Stay tuned!


Tot: 1.623s; Tpl: 0.047s; cc: 9; qc: 51; dbt: 0.0273s; 1; m:saturn w:www (; sld: 1; ; mem: 1.4mb