Sunday, January 30, 2011

Women in Ugandan Society

We’ve all heard about how women in many parts of the world are still marginalized and considered second-class citizens; we even continue to struggle with gender equality in the United States. However, before moving to a developing country, I never really understood what it meant to be a woman in such a culture. This post will be a bit graphic, but no apologies – this is reality.

Here in Uganda, the men are definitely the decision-makers, the ones with the power. While urban areas are becoming more gender-equal than before, most people still consider women and men to hold very distinctive gender roles, with the household work left to the women but the household decisions and prestige being given to the men. Women are seen as weak, yet they are the ones doing most of the manual labor for the home, such as fetching water (jerry cans are heavy!) and firewood. The women care for the children, but if the couple ever separates, the children generally belong to the father (who never actually cares for them – he either hires someone or already has another wife). Here, there is no such thing as rape within marriage, legally or culturally. Men pay a bride price (often paid in cows or other in-kind payments), which means the man has a huge amount of leverage over his wife. While becoming less common, “marriage by abduction” does happen, in which a man kidnaps a girl who has refused to marry him and rapes her. The girl’s ‘purity’ is then ruined, and out of shame, she accepts to stay as his wife – she usually feels she has no choice, as many families and communities would disown her at this point, and few other men would want her. If a woman wants to use a condom with her partner or go for HIV testing, she is accused of sleeping around (even though it is commonplace for men to have extramarital affairs, thus putting women at risk for HIV infection from their own husbands. 42% of all new HIV infections in Uganda are intramarital).

As a female Peace Corps Volunteer, my struggle is mainly from issues of harassment. Many Ugandan women (unfortunately) have become used to sexual harassment or even assault, so consider it a normal part of life. For myself and my fellow female PCVs, however, harassment is probably one of the biggest issues we face. It can be everything from cat calls (“Hello baby!”, “I love you!”, “My size!”) and blatant inquiries for sex to sexual assault. I have never been assaulted, but several of my friends have. The emotional effects have serious consequences for us as volunteers – some are afraid to leave their houses for fear of unwanted attention or worse. I find that I avoid most Ugandan men, which is something I wish I didn’t resort to because of the potential for positive, professional relationships. Unfortunately, I’ve heard too many stories of female PCVs thinking that they have great friendships and working relationships with co-workers, only to later be propositioned for sex. I have faced very few issues in my small village – everyone knows me and respects/looks out for me. The main challenges occur when I go to bigger cities.

This post wasn’t meant to make anyone at home worry about me, but only to point out one of the biggest challenges we’re facing as PCVs and the reality of life for Ugandan women. Since this blog is supposed to be a window into my experience, I decided to share this with you. A lot of these issues were brought up in a recent 20/20 episode about the murder of a volunteer in Benin and the sexual assault and rape of other volunteers, which I watched with my training class. It prompted a several-hour discussion within our group, after which we spoke with the Country Director about our concerns and priorities (and he has responded to everything positively. I really think Peace Corps-Uganda is already doing an excellent job in being proactive about these issues). The reaction to the 20/20 episode, and our action about it, made me so proud of my fellow volunteers.

As a Peace Corps Volunteer, I’m trying to improve the lives of the girls and women around me. I’m going to start teaching life skills (such as setting life goals, communication skills, decision-making, healthy behaviors, etc.) to girls in my community soon. As a health volunteer, I’m promoting family planning options, such as condoms or birth control, to try to curb the high fertility rate of about 7 children per woman, but I believe that the only way to truly reduce family size is to empower women and give them other options in life besides having lots of children. Make sure they get a good education and are able to make their own life decisions, allowing them to pursue a career or envision a different path for themselves, and then they will probably choose to have fewer children. This opinion was solidified after reading Half the Sky by Nicholas Kristof and Sheryl WuDunn – highly recommended book. Peace Corps Volunteers in Uganda have started an annual program called Camp GLOW – Girls Leading Our World – which is a week of empowering activities for young girls which I hope to be really involved with at the end of 2011; I can even nominate girls from my village to attend. Of course, to empower women, you must involve men and change their ideas about gender roles, so ‘women empowerment’ should involve both men and women. While I won’t single-handedly change the gender roles and treatment of women in Uganda, I hope I can help improve the lives of a few women and girls around me.

Life is a Raging River

Probably the most exciting thing to happen recently was when most of our training group headed to Jinja for white water rafting on the Nile! The night before was the booze cruise at the source of the Nile (where Lake Victoria flows into the Nile), where we had beautiful sunset views of the area. We stayed in a campsite/hostel run by the rafting company, and were all overwhelmed by the number of attractive muzungus there – we hadn’t seen that many Westerners (besides each other) for months. I remembered why I love backpacker places so much – in an hour or two, I met people from Scotland, Canada, England, South Africa, New Zealand, Australia, and Denmark. Makes me excited to backpack again after Peace Corps and before I get strapped down with vet school loans.

Drinking a Nile on the Nile

Our training class on the Nile booze cruise

The rafting itself was soooo much fun (although a few people were feeling the effects of the booze cruise the night before – the guy who organized our trip almost literally missed the boat because he overslept). Not only were the rapids crazy (it’s really like a water rollercoaster), but because we knew almost everyone else on the river, we really had a blast. I was in a raft with some of my favorite people and we were cracking jokes the whole time. Our mantra was “Stay in the f***ing boat”, and we only flipped once and nobody drowned, so the mantra seemed to work for us. Between rapids, we would jump out of the raft in the calm stretches of water and just drift down the Nile, thinking about how we were on our way to Egypt. At one point, we were on a Class V rapid and were told there were two routes – one to the left, which was some ‘normal’ Class V rapids, and one to the right, which went over a waterfall. We ended up on the right, but got stuck on a rock at the top, allowing us to tremble in fear as we looked over the edge of the 8-10 foot drop. We were the last raft over, so everyone else was waiting at the bottom, watching us – and it was actually fun! We didn’t jackknife and flip over like I thought we would, and now I can say I went over a waterfall while rafting on the Nile. That night, we all watched the video as a group back at the campsite and laughed hysterically at the ridiculous flips, the facial expressions, and the crazy antics of our whole group.

Going over the waterfall!

The one time we did not "stay in the f***ing boat"

However, while being a tourist around Jinja, I was acutely aware of the impoverished people we were passing and felt very uncomfortable, despite the fact that I’m not strictly a tourist and I’m a Peace Corps Volunteer trying to help Ugandans. I don’t remember feeling this bad about my tourist excursions in Africa in 2008, and I’m actually glad I have more than just a twinge of guilt now. But what am I to do? I want to do the touristy things when I have the money saved up, and I am pretty much completely against hand-outs to local people. Still, it feels awful to be driving by in a big truck on the way to rafting, or waving to people in a dugout canoe while I’m on a booze cruise having a great time, trying to be friendly but also feeling like I’m sticking my tongue out at them by waving.

Between Christmas, New Years, and the workshops in Kampala, I’ve been away from my site entirely too much lately, so now I have no plans to travel for at least a month. We had almost two weeks of workshops on language, project design and management, and teaching life skills in Kampala before rafting (staying in a nice hotel with hot showers, TVs, delicious buffet meals, and a swimming pool along with my 44 friends from training was amazing), so I’m working to implement new skills at site. I’m trying to move away from my previous duties as “pill counter” in the clinic (with some resistance from my organization, but full backing from Peace Corps) and am now working on lesson plans in Runyankore-Rukiga for health education at our clinic and the primary schools, hopefully starting life skills classes for adolescent girls, still working to start a dairy cooperative, plans for demonstrating compost piles and SODIS – solar water disinfection using only regular water bottles, continuing my hand washing/tippy-tap ‘campaign’, and preparing for the arrival of a donated microscope from the U.S.! Thank you to Mom and her neighbors for finding one – now we’ll be able to do malaria testing at our health center. My head is still swirling with ideas for projects to work on but putting ideas into action isn’t always easy here (and it probably shouldn’t be if I’m doing it right and getting full community involvement with the activities).

Thank you to everyone who sent a Christmas package, and Kibo thanks everyone who sent dog treats (there were several! We are now fully stocked with Pupperoni, Milk Bones, and Beggin’ Strips). Kibo is now 4 ½ months old and is definitely in an awkward teenage stage. My counterpart’s two dogs now come by on a daily basis, or she sometimes goes to visit them at their house up the hill – really adorable. It's like watching 6-year-olds go over to each other's houses to play - "I'll be back for supper, Mom!" They’re always really happy to see each other, and I’m glad my dog has friends. :)

Random thoughts:
I recently splurged on the expensive, imported American peanut butter and have eaten almost the entire jar by the spoonful in 5 days – I’m essentially vegetarian while at site so I need my protein somehow!

I continue to have random people, usually kids but sometimes adults, show up at my door and just stare in my doorway, and don’t seem to get the problem when I ask, “Nooyenda ki?” (“what do you want?”) and they just shrug and continue to stare.

There are a ton of bats living in my ceiling, and I have no idea what to do about it.

It’s been really hot here lately and we haven’t had rain in weeks – I can’t wait for the wet season to roll around. It’s supposed to be raining at this time of year but global warming has altered the timing of the wet and dry seasons, causing lots of problems for farmers (and everyone is a farmer here).

Thursday, January 13, 2011

Pictures of My House!

My living room. A sofa set and picture wall are in my near future!

My bedroom

My bedroom

My indoor bucket-bathing room

My kitchen. I cook on a gas stove and have a sink! No running water, but a sink!

Pit latrine with my beautiful tippy tap for washing my hands

Where the important business happens.

Wednesday, January 12, 2011

Health Care in Uganda – Problems determined, solutions unknown

Here's my latest blog post for SCOUT BANANA, the awesome organization I was involved with at MSU:

The health care system in Uganda is overrun with problems. As a community health volunteer for Peace Corps, I have been working with a Health Center II (a basic-services clinic) and have been assessing the state of health care here in Uganda.

While government health care is intended to be free, there are so many hidden costs that patients are often still unable to afford health care. The government provides free drugs and care, but when those drugs run out (which is all-too-often), the patients are responsible for going to a private drug shop and buying their medicines. Women who want to deliver at a government health center are often required to bring their own “mother kit”, a set of supplies which can include such things as cotton, gloves, needles, etc. At our small Health Center II, we have no capability of running tests such as urinalysis, blood smears for malaria, or even taking blood pressure, and often have to refer patients to either a larger government health center or a private clinic for the care they need. Many people cannot afford even 4,000 Ugandan shillings roundtrip (less than $2) to the Health Center III, a few kilometers away, for testing or maternal care, let alone a trip to a private clinic where all costs are out-of-pocket. Some of our patients walk several miles to get to our clinic.

Malaria is one of the leading causes of morbidity and mortality, and is severely over-diagnosed. Practically everyone with a fever is given anti-malarial drugs, and subsequently health centers often run out of the drugs before the next shipment arrives from the government. The cost of these drugs in a private drug shop can be 15,000/- (about $7), which is too expensive for the average rural Ugandan. The nurses at the health centers have little choice when they have no way to test for malaria before dispensing drugs – if the patient does have malaria and is not treated, he or she could die. Better to be safe than sorry, but being safe in this situation causes its own host of problems.

There is also a big problem with motivation among health workers. Salaries are very low, and some workers feel no obligation to give good ‘customer service’, which is a huge concern in privatized health care systems such as the U.S. Health workers often show up whenever they feel like it, and leave the clinic hours before the official closing time, leaving some patients to wait for hours to be seen. A small aspect of this stems from the culture where family comes first – if the nurse has to harvest millet or help a family member out, they don’t see a big problem in staying home.

So what, as a Peace Corps Volunteer (PCV), can I do? It’s a difficult question to answer – if there were an easy fix, Uganda would have great health care. PCVs don’t come with any funding or external assistance, we come to act as change agents and co-facilitators to mobilize local resources and work with what is already available. While it’s difficult to make system-wide changes or improve facilities and equipment without funding, I am working to encourage healthy behaviors, build capacity among health workers, and provide people with the knowledge they need to keep themselves and their families happy. Another PCV I know is working at the district health office, so he can encourage health officials to improve efficiency and make positive changes in the health care system. These are small steps, not a big NGO project with millions of dollars backing it, but these small steps are (hopefully) sustainable, using local resources and requiring the community to get involved to make changes in their own lives.

Hati ndi Mukiga! Well, almost...

Life in Uganda isn’t easy. One of the reasons that Americans can focus so hard on being productive and getting lots of professional work done is that their daily routines are easy. They don’t spend several hours hand-washing their clothes, cooking over firewood or charcoal, or waiting for what could be hours for a car to come by in order to get to the market. I’ve never appreciated washing machines as much as after spending a couple of hours scrubbing away in the hot sun and only getting a few outfits washed. Please viciously shake me if I ever complain about doing laundry in the U.S. ever again – you throw it in a machine, add some soap, hit a button, and come back in an hour. Amazing. My neighbors are all busy harvesting millet, groundnuts (peanuts), maize, etc. There is always something that needs to be done in their fields – thus the life of the subsistence farmer, and here everyone is a subsistence farmer, even the nurse next door and the businessman up the road. I was helping to harvest millet and spread it in the sun to dry, and this simple act threw the groundskeeper into hysterics, especially when I said, “Hati ndi Mukiga” – now I am a Mukiga (person of one of the local tribes, the Bakiga – half of the name of the language I’m learning, Runyankore-Rukiga). That happens a lot – when I was learning how to harvest the millet the other day, people stopped and stared/laughed at the muzungu. Imagine! A white person doing manual labor and working in the fields!

I just met with the local dairy farmers to do a needs assessment, and they have decided to start a cooperative to increase their bargaining power (the middleman who buys their milk just dropped his buying price from 500/- Ugandan shillings (about 23 cents) to only 250/- per liter). I’m going to be helping them form the cooperative, come up with marketing strategies, and I’ll also be teaching them different management systems and husbandry techniques. I want to host a lecture series at their meetings and teach them about such things as hay/silage making for the dry season, zero-grazing systems, cow health and nutrition, breeding, etc. I also found out there is no veterinarian close by, so I might even get to implement the Community Animal Health Worker training program I designed during training (and that I also researched for my Specialization in International Development senior capstone project at Michigan State). I’m so excited!!! I’m finally doing something that I envisioned for myself when I joined Peace Corps.

It’s mango season! The other day, I went for a beautiful walk up to the top of a hill with my neighbors to someone’s house (I still don’t know whose house it was), where we ate our fill of mangoes (and it was a lot of mangoes), took in the views of the distant mountains, then brought home a huge sack of mangoes, which we used to make fresh mango juice! Sooo delicious and no added sugar needed. Too bad we have no refrigerator – the juice is only good for a couple of days.

Making homemade mango juice with the neighbors

Kibo is doing great and getting huge – 4 months old now, probably weighs 25+ pounds, and a little calmer but sometimes still a little terror (especially to the neighbor’s chickens – she loves to chase them). She’s wary of strangers, but in general likes women way more than men. If she doesn’t know a man, she barks viciously before running the other direction. Her latest stunt happened when I was getting water at the stream (the rainwater tank is low so we’re saving that water for drinking only, and water for bathing and washing is coming from the stream). I was standing knee-deep in the water, filling my jerry can. There’s a big rock in the stream, and Kibo was standing on top of it. I was thinking how she looked pretty regal up there, and what a good-looking dog she is in general, when she decided to jump to the opposite bank…except she was about two feet short and came down in a magnificent belly flop right next to me, soaking both of us. Terrorized, she quickly swam/ran out of the stream and back towards the house. I haven’t laughed so hard in days – definitely some much-needed comic relief. She’s a great, affectionate dog (she loves to cuddle and she still follows me everywhere when I’m near the house), and I’m definitely planning to bring her back to the U.S. after service.

The next couple of weeks include Peace Corps workshops in Kampala on language and project design/management – very excited to see people I haven’t seen in a few months. Then, our entire training group is going white water rafting on the Nile!

P.S. Our first patient the other morning, a 1-year-old baby, was named Obama.

Photos from Christmas and New Years

With some of my Peace Corps besties :)

Our beautiful Christmas tree. The Yankee Swap gifts have such classy wrapping.

We're on a boat! PCVs heading to our private island at Lake Bunyonyi for New Years

Lake Bunyonyi

Lake Bunyonyi from our private island :)

Wednesday, January 5, 2011

Yankee Swaps and Private Islands and Skinny Dipping, oh my…

It’s beginning to feel a lot like…. summer. It always feels like summer here to me, so it’s hard to believe that it’s truly Christmas time without freezing temperatures, streetlamps decorated with wreaths and lights (there are no streetlamps), sweaters and scarves, fireplaces, decorating the tree with family, people bustling around for shopping, etc.

For Christmas, I headed back to Kasese to spend the holiday with some of my best friends in Peace Corps. Along the way, the road passes through Queen Elizabeth National Park, and I saw at least 60 elephants, including one huge bull that crossed the road right in front of the taxi! Merry Christmas from Mother Africa.

We went swimming on Christmas Eve – felt a little out of place, but the pool had gorgeous vistas of the mountains and the plains below, and we listened to some good American tunes, courtesy of a former PCV who had her wedding there and left the CDs behind. For dinner, we went back up to Hotel Margherita, where we waited forever for our food but it was worth it – FILET MIGNON! Best meat I’ve had in Uganda, hands down, and only 9,000 (about $4). Good meat is a rare thing to come by here – usually it’s tough, fatty, and full of bones.

On Christmas Day, we had French toast and scrambled eggs, then went to lunch at a friend’s supervisor’s house. A Ugandan holiday isn’t complete without really cheesy 80’s-style music videos playing, so we were treated to an hour or two of some random African music group singing in fur coats with various scenes set in Russia, the Caribbean, etc., followed by a video of the supervisor’s wedding. The food was good, typical Ugandan fare – matooke, chicken, goat, pasta, potatoes, pineapple, etc. I got a wonderful text from my host family wishing me a Merry Christmas, so called them to reciprocate – so good to talk to them. In the afternoon, we had a Yankee Swap gift exchange with such coveted items as JIF peanut butter, pirated DVDs, or Annie’s macaroni and cheese. For dinner, we went to a nice hotel in town for a delicious buffet, then returned to Skype with family and friends. I also got my first guitar lesson from one of my friends and am planning to buy a guitar soon – I really want to learn to play while I’m here.

For New Years, a bunch of PCVs rented out a private island at Lake Bunyonyi, a gorgeous spot in the mountains near the Rwandan border. The island is a basic camp with bandas and tents (yours truly was camping), pit latrines with seats, really delicious buffets, and beautiful views across the lake – all for about $10 a day. We spent our days swimming in the cool water (hello schisto!), getting sunburned after about 20 minutes in the equatorial sun, reading, napping, playing Euchre with other Midwesterners in the group, and just chilling. So nice. I’m not sure why just chilling felt so nice because I already have so much downtime at my site, but I definitely felt like a tourist – a very nice change of pace.

On New Years Eve, we all split the cost of a generator and speakers so we could have a dance party. During dinner, our music was switched off so we could watch some traditional Bakiga (Ba-chee-gah) dancers and even joined in for some of the songs. After that, we danced the night away, and had our own countdown to midnight. This might be the first time I haven’t watched the ball drop on TV (except the one time I was actually in NYC for New Years). A little after midnight, a group of us decided to ring in 2011 by skinny dipping! Thank God there was no moon so it was pitch black – you literally couldn’t see anybody else if you tried. It takes living in Africa to realize that white people glow in the dark. Also good to know that there are no (known) crocodiles in Lake Bunyonyi.

Possibly the most exciting thing that’s happened lately is returning to my village after the holidays to discover that a local pastor has set up a chapatti/rolex stand about 300 meters from my house!! Seriously, I don’t think anyone except for PCVs in Uganda would understand the excitement. I can now get a delicious egg-and-chapatti roll (rolex) for 800 shillings (about 35 cents). Amazing.

Other recent activities: learned how to make a compost pile from a fellow PCV which I hope to do as a demonstration in my village, and watched the installation of a biogas digester at my counterpart’s house (takes cow dung and captures the methane to use for cooking and lights). One of the most shocking things that happened lately was when I was teaching HIV fact vs. fiction with another PCV at a youth conference. One of the fiction statements was, “White people brought HIV to Africa to kill Africans.” The kids burst out in an enthusiastic “Yes!” even clapping and laughing. It was the biggest reaction we got from them during the whole session. While a Ugandan facilitator explained that it was a joke, my friend and I were really upset by it. I sort of get why they would make a joke like that, but regardless, when two white PCVs have dedicated their lives to helping Ugandans and the kids decide to laugh and say white people brought HIV here, it hurts.

We’re all a little nervous about the upcoming elections in mid-February. Presidential elections in Africa are rarely peaceful, and Peace Corps has had to pull out of a number of countries before, whether for just a few weeks or even sometimes permanently, due to political violence. Some of my Ugandan friends say it will be peaceful with no problems, while others are convinced there will be riots. Museveni has been in office since 1986, and he remains very popular in my area, which is his home district. However, other areas of Uganda have grown tired of him and are ready for change. While we’re all hopeful that things work out for the best, it’s something on our minds, and we’re mentally preparing ourselves for the possibility that the elections might not go so smoothly here. Time will tell either way, and for now we just have to keep on keeping on.

I’ll post pictures from these adventures another time – the internet is just too slow and spotty at my site.