I spent the past two weeks living in Namayumba, a village
about 2 hours from Kampala. I had spent time in a rural community earlier this
semester when we did our rural homestay, but this time I was by myself which
was a very different experience. The Namayumba sub-district is a small town
with many surrounding villages. Most of the people in the area are farmers and
spend the whole day in the gardens, especially now that it’s the rainy season.
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| Namayumba Health Center |
I stayed in a guest house at the Health Center (it’s about
the equivalent of a small public hospital/ large clinic) with one of the nurse’s
family. While living on the health center property I learned a lot about health
care here in Uganda which further secured my passion for medicine and becoming
a doctor. Every morning after taking tea, I’d walk down to the Health Center
and find the place packed with patients. Some there for ARV’s (for HIV
treatment), many with diabetes or hypertension, some extremely ill with a high
fever (most commonly malaria), others with terrible wounds or skin infections,
and so many others in desperate need of care. The first day I was there I was
asked to assist with the triage center. I was responsible for taking each
patients height, weight, BP and directing them to the appropriate wing of the
facility. I realized very quickly that there was a serious concern: no one
spoke English… Because most of the people in the community had not completed
schooling, they never fully learned to speak English and spoke only the local
language, Luganda. The few who could speak, did not understand my accent so
they would just stare at me as I talked. I quickly learned to gesture to people
and used the little Luganda I knew as much as I could.
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| Me and Nurse Celine (my host) |
The nutritionist, Sister Martha set me up with a few people
she thought could help me with finding participants for my study and I began
looking for children that first afternoon. The biggest challenge I ran into was
finding a translator who could walk around the villages with me and communicate
well enough to conduct my study which included consent forms, parent surveys
and the cognitive assessment. After a few stressful days of being literally
lost in translation, I finally found the perfect guide Issac, who could speak
English very well and knew the area very well. I realized right away that the
results of my assessments in the village were very different than those in
Kampala, indicating a huge cultural difference between the urban and rural
environment.
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| The beautiful view of a village road (when it's actually a road) |
I spent most of my days trekking through the villages
carrying a height board and a weighing scale for measuring children. We walked
from home to home looking for 5 year olds, both adequately nourished and
stunted so that I could compare the two groups. Some days we managed to get 7-8
participants, and others we would spend over 9 hours in the villages and find
only 2 children. We were able to work with Village Health Team members (VHT's) who helped us to locate many children within each village. Although it was difficult lugging all our supplies up and down
each mountainside, especially in the pouring down rain, the air was so clear
and the surroundings so breathtaking that it was worth it. After 9 straight
days of looking for participants we managed to find all the children we needed,
and all the hard work paid off.
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| Issac giving a digit span test to a participant alongside a VHT |
Rural poverty is very difficult to explain because in this
area everyone would be considered “poor”. Everyday people eat posho and
porridge, often their only foods because others are so expensive. Even foods
like beans, potatoes, greens, rice, milk or silverfish are too expensive for
people to buy on an inconsistent farmer salary. With the amount of starch in
the normal diet it’s not surprising that the rates of diabetes follow the rates
of malnourishment. It was hard to distinguish a difference between what mothers
fed their children to explain why chronically malnourished children were
stunted and other children who ate the same foods were not. Within a given
family, the older sibling may be stunted while the younger one is normal height
when they are fed the same foods. This phenomena was really strange to me and
opened my eyes to the unfortunate truth that many of these children don’t receive
enough food, but some are just more resilient than others.
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| One of the village homes made of mud. |
The people there were so kind and welcoming, even though we
could not fully communicate. Some of the people had never seen a white person
before so I experienced many different reactions to my presence. Some children
cried when they saw me, some were fascinated by me and couldn’t stop staring,
some were really excited to meet me, and others ran away as fast as they could.
Here’s a short list of some great things that happened:
- One child who saw me ran inside his hut and pulled out a
torn up poster of a white model. He pointed to it and then pointed to me and
kept comparing the two.
-I could see the Milky Way and every star in the sky at
night. I have never seen a sky so clear.
-I was proposed to by 3 men, one was my taxi driver which
made for a very awkward bus ride.
-Rain+dirt= mud… I slipped and fell in the mud way too many
times. I gave the village people quite the giggle.
-I met a woman with the same Buganda name as me, Namoli. She
was 95, kept calling me twin, and the only English word she knew was soda.
-During one day that we were in the field, we walked 25 km. I
really wish my fitbit worked here…
-Most white people that come through the village are doctors,
called Musawo. I kept getting called Muzungu Musawo or “white doctor”. I had a
few people take off articles of their clothing to show me a weird rash or other
ailments they were concerned with.
-One of the kids I tested screamed every time he saw me so I
had to walk away while Issac worked with him. Apparently he associated doctors
with immunizations, so muzungu=needles
-The last morning I was there, they needed me to fill in for
a nurse so I ended up working the hypertension and diabetes station, giving
insulin tests and monitoring blood pressure.
-This past weekend we went white water rafting on the Nile River to take a much needed break from our research. We finished our rafting adventure with some Nile beer on the Nile!
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| Enjoying our Niles after a long day of rafting! |
My experience in the village was very isolating and
challenging (especially with no electricity or contact from the outside world)
but extremely rewarding. I learned so much about the community I lived in and
about myself as consequence. Although it was only 2 weeks, this experience has
impacted my life in so many ways and definitely changed the way I perceive the
world.
I have less than 3 weeks left here in Uganda, during which
time I will be finishing my research and reuniting with my 4 other classmates.
I’m excited to be back in the US, but I still cannot believe I will be leaving
here so soon. There will be more to come before I return!!!
