Living well

20th December
This weekend we have been getting ready for Christmas and the arrival of Hamish and Morven, our son and his partner. We can’t wait to see them on Tuesday. So this blog is devoted to life chez Hogg Kampala style. There have been rumours that we are a) living in a mud hut and b) booked into the Serena International Hotel for the year and demands for proof of the true scenario are increasing. Also, we have a fair few visitors booked in over the next few months. While we have offered the true volunteer experience, including bucket showers, to them all, we expected most to come for a cup of tea and make endearing remarks about our quaint lifestyle, before scuttling back to the Serena for power showers, air conditioning and all the mod cons which they (but we no longer) take for granted. However, they are all made of stronger stuff than we thought and it may be reassuring for you who are booked in, to see your accommodation. It doesn’t feature on Trip Advisor yet. 
We have a bright and sunny living room, spacious bedroom, now with wardrobe and chest of drawers, a second bedroom for guests, and a kitchen and shower room.

 

 

 
We are lucky to have nice accommodation and particularly to share the compound with a fellow- VSO volunteer, Bernard from Kenya, and the landlord who lives in a recently completed “big hoose” with his three children aged five, three and nearly two years, plus two maids, Florence and Maria. They are all lovely, and have made our experience truly African.
The maids speak very good English, and are very bright young women, they just have not had any education beyond primary level, and even that was very basic.
One maid is more senior, and is very committed to the children since their mother died two weeks after the youngest one was born. They do our housework and washing by hand and are great at coming in to put on our security lights when we are out in the evening etc. Florence works some afternoons as a tailor in the nearby market, and she us always stylishly dressed in her own handiwork.
 
During our in –country training we were told not to give our underwear to the maids to wash, so here is Bobby washing his smalls of a Saturday morning. 


 
The house is really nice and newly decorated and refurbished and we had to furnish it from scratch which was a hassle at the time but means everything is fresh and clean, and lovely to come home to at night.

We have a nice compound with grass and low hedge and in the evening it is very relaxing sitting on the verandah in the late sun, watching the birds and enjoying a Nile Special. Most compounds are very closed and private, but although we have high walls and barbed wire it is fairly open to the track leading to the village which is very busy with people and cars.  We still worry slightly about security, as most of out fellow VSO ers have a guard, but so far we have had no problems at all. We do have quite  regular power cuts, which in the evenings means our security lights go off as well. Bobby is very good at playing his fiddle during these slightly uneasy times, somehow I can’t imagine people breaking in to the tune of “Wha Wadna Fecht for Charlie” and that’s all that matters. It certainly stops me hearing imaginary footsteps on the gravel outside. His special power-cut party piece is a Shetland tune by the late Tom Anderson, “Da Slockit Light”, slockit meaning extinguished so very apt. We had a spell of water cuts, during which we stock-piled jerry cans, but we have not had any for some time. 
Our access road (track) leaves something  to  be desired - a surface - but its no obstacle to the 4WD. 

The view down from our black gate.

The view up past our black gate with a village at the top of the road.

 
All the VSO volunteers we know in Kampala have good accommodation, some with hot water and fitted kitchens. Up country it is different and in other countries I know that houses are much more basic and in poor repair. We have two gas rings which are very efficient and because Ugandan meat is very tender I can cook goulash etc in a very short time without it being tough. VSO does not supply a fridge or electric kettle, and few households have them, although most volunteers buy them and then sell them on. Given the heat, it would be very difficult to manage without a fridge, although most Ugandans eat mainly beans and shop daily in the market. The local supermarkets only have “Blue Band” margarine which does not have to be kept refrigerated and no cheese or milk. When we entertain it is all on a simple scale, with no oven and limited utensils, and no “good china”. I’m sure I will love getting back to my fan oven and microwave and using my granny’s silver teapot for visitors, maybe they will make up for the sunshine I will certainly miss, especially next Christmas.
We have also been very surprised at how few insects we have, there are very few mosquitoes and no cockroaches. We have occasional little lizards running up the walls but they count more as pets.
We hope everyone has a good and peaceful Christmas.

An international week.

Saturday 5th December.
This week was very busy for us; Tuesday was World Aids Day and it is also  International Volunteering Week so for us who are volunteering in a HIV/AIDS Initiative it’s been pretty hectic. On Tuesday Reach Out had an amazing day for staff, clients and a whole lot of others who came.

After  registering, we were given The Tee Shirt. 

We then marched off to mass to the swinging rhythms of the Reach Out youth brass band. The day continued with a parade through all the areas Reach Out serves and lunch for a very large number of people. Things seemed very unorganised and left to the last minute, but it all worked out very well. Africans just seem to have the knack of doing things without fuss and they certainly like to party.
 
There were activities on all week to celebrate volunteering in and outwith Kampala. The theme was climate change and conservation. We could have gone to Soroto for parades and tree planting but we really don’t have time to do much as we are both very busy at work. 

However, we went to a barbecue in the very nice gardens at VSO headquarters and met up with VSO people, some of whom had travelled from up-country and we had not met before. As always, it was interesting comparing experiences which are very mixed. Some people have difficult living conditions, with houses no electricity. One couple rely on a hotel generator which is only on when there are guests staying at the hotel. They do not have a house as such but a collection of rooms round a courtyard and so have to go outside to go between the rooms. Others are two hours drive form reasonable shops where they can buy fresh food, apart from vegetables, such as milk and meat. Some have difficult placements - with no funding; colleagues who have not been paid for  months; working in very isolated conditions with no real plan or support. So once again we think we are incredibly lucky to have great and busy placements, a great work ethos in the organisation and nice house. The lack of hot water, the power cuts and occasional water cuts all seem somewhat trivial now and part of the fun (well, experience!). 

The highlight of the barbecue was an African dance performance by some of our fellow VSOers who have been attending dance classes. We went to the first class which was organised during (but not part of) our recent VSO in-country training. A few of the  Kampala based volunteers continued with a two more sessions to prepare a polished performance. They did a great job  providing a fantastic display and encouraging everyone to join in.
 

Last night we were at a cocktail party at a big international hotel where volunteer awards of the year were presented. Cocktail parties and VSO seemed a bit incongruous, but it was a great night – the Ugandans made sure of that. Prior to the cocktail part there was a meeting about climate change and its devastating impact on Africa. Some areas are experiencing drought and flooding for the first time, with loss of crops and subsequent food shortages.

A volunteer, Michael, from Reach Out received one of the awards and there were quite a group of us there.  Michael was obviously really thrilled at being recognised and we have nice photos, with Ben a VSO volunteer from Kenya who also lives next door to us, Lydia the HR manager and Faith, another volunteer.

Visit to Jinja on the Nile

30th November 2009 

We had our first trip out of Kampala to somewhere other than Entebbe.We went to Jinja for the weekend to see the source of the Nile 

and the Bujagali falls. 

Jinja itself is interesting - it’s on Lake Victoria, 80 km east of Kampala.  It was mainly home to Asians who set up businesses but, under the Amin regime, they were expelled and their businesses generally were given to incompetent Ugandans. There are lots of grand buildings, some colonial and some Asian style, but most are in decay and look unsafe although there were obviously African families living in them - sometimes many families in one building. So parts resemble  a ghost town while some parts are well maintained. We stayed in a very nice place, Gately on Nile, with our own lodge 

overlooking the lake in very lush and colourful gardens and there was also a  good restaurant.
The driving was relatively straightforward as Uganda goes. We decided to go a longer scenic route which the Bradt guide (our bible while we are here) said took much the same time as the direct road.  However there were long stretches of speed bumps at frequent intervals (corrugated road) and the road was very quiet. We thought we had taken much longer than the direct route until we met up with others who had come the direct route and had been stuck in traffic jams almost all the way.  
The Nile is the only major river which flows from south to north. It takes four months to flow to the
Med and is 4,000 miles long ( I realise that there are geography teachers reading this who know
it all already -  or may wish to contest this - but we didn’t until Saturday). We met up with some
other VSOers for a boat trip on the Nile 
and then went back for a sundowner sitting on our own verandah overlooking Lake Victoria. It was wonderful and a nice birthday treat for Bobby. 
On the way back on Sunday we stopped at Mabira Forest Reserve and had an interesting walk with a guide seeing and hearing lots of birds. During the Amin years it was given to people who destroyed a lot of the trees which drastically affected the ecology of the area. It is now back in safe hands and boasts over 300 species of birds  and over 300 species of trees and bushes.
The main road back from Jinja was fairly clear until entering the outskirts of Kampala. We were back home about 3 pm. However that night on the stretch in Mabira Forest an MP was killed when his car ran into a tractor towing a sugar cane trailer. Typically these trailers are poorly lit and, since the accident, there has been a proposal in parliament to ban heavy vehicles travelling in the dark.  We also learned that there was a minbus accident at night on the Jinja Road at Nakawa - at the end of the Port Bell road which we live on. Three people were killed and several injured.  Night travel is best avoided. 
Wednesday 2nd December.
Hamish and Morven are setting out today for their African adventure, and coming to us on 22nd
December. We are spending a few days over Christmas on safari at Murchison Falls and Murchison National Park which should be different to our usual Edinburgh festive rituals.

They are meeting up with our niece Becky tomorrow in Nairobi, as she is working there. The three of them are going off travelling together, starting with an overnight train journey to Mombasa. A few years ago Hamish and Becky happened to be in Africa at the same time, and bumped into each other in a shop doorway in Dar es Salaam during a downpour so this time round they are more co-ordinated. The family will be well represented in Africa for the next few weeks. Hamish and Morven are coming to Kampala by bus from West Kenya. It makes sense for them to get off up the road from where we are staying as they will pass along that way and the bus station in central Kampala is chaotic and crime ridden especially just before Christmas. However, I feel we should be meeting them at an international airport with a brass band playing in the background, rather than off a bus opposite where we do our food shopping.

Eight weeks in

Rhona - 25/11/09
Last week we had our second in-country training course now that we have had a chance to get started in our placements. It is great meeting up again, especially with those who are up-country and came back to Kampala for the week. As expected, there is a mixture of feelings about placements, and we feel really fortunate to have such a well-structured and well-resourced organisation and to have been able to slot into our roles so quickly, especially as we are just here for one year. Some people have gone to organisations who have simply no money at all to do anything, in some cases even to pay their staff who have been waiting for their salaries for a few months. Some organisations are only interested in getting money from the volunteer and assume that the volunteer will arrive with money, laptop for the organisation etc.  One couple are staying in a very remote area, Bwindi Inpenetrable Forest, and are living in a house with no water or electricity. They also share the house with two others. They are near a “trading station” where subsistence farmers sell some surplus, perhaps three tomatoes or a few bananas. Their nearest food shop is two hours away by very rough track. They have no fridge so cannot keep food. However, the location is magical and they are working in Bwindi Community Hospital which another VSO volunteer, Paul, has transformed over the past three years. The website is worth a look.
Another woman is doing a short-term assignment in a remote area for eight weeks. She is a social work manager and is writing a proposal for a district during a secondment supported by the Welsh Assembly who seem to send people all over the developing world to carry out short-term very focused work.
Many of us are in Kampala, with the rest scattered to the east, west and south. The war in the north seems to be stopped and many people who have been displaced are now returning. VSO is planning to work in the area and are particularly looking at community-based health, so any public health nurses or district nurses would be welcomed.
Although it is recognised that young organisations with few staff require volunteers to do some hands-on work, the main aim of placements is capacity-building within organisations. A few people are working only at a strategic level.
On Wednesday evening we had a dancing session, with a dancer who performs at the cultural arts centre and a band of drummers. It was great fun and very energetic.

 
 

 We had some good evenings eating and drinking and then said fond farewells to some people who we won’t see again as we are all finishing at different times.
On Sunday I was at a meeting of discordant couples (one HIV+ve, the other –ve) who had taken part in an eight-week intervention from March – June. They look at protecting the negative partner, disclosure to family and friends, supporting the positive partner etc.  We were doing follow-up questionnaires six months after the intervention finished. They are all continuing to meet in small more local groups. The counsellors who ran the intervention completed the questionnaires with about thirty couples. It ran all day, with a stop for lunch. 

 
Kampala has been “a chilly 23º” and there was an article on the fashion page of New Vision about winter outfits to cope with the cold conditions, including boots and body warmers.
I now have a  young Ugandan woman working with me, she has just finished an MSc in public health in America, has come back to Uganda and is looking for some experience before applying for jobs. It is great having someone to do the more hands-on work on the studies that are on-going and I can look at more strategic issues, such as research governance and building research capacity and strengthening links with academic institutions.
We are going to Jinja at the weekend to celebrate Bobby’s birthday by visiting the source of the Nile and staying at a nice lodge. It is our first venture driving further afield than Entebbe, and we are ready for a bit of exploring before our guests start coming. Hamish and Morven leave for their African adventure next week and we can’t wait to meet them off the bus from Kenya on 22nd December.

Planning and Partying the Reach Out Way

Rhona -
Saturday 14th  November
I had a busy time the week before last at work. There was a three day strategic planning workshop to discuss the external evaluation of Reach Out and plan for the next five years. The organisation has grown exponentially and has far outgrown the plan which was supposed to last until 2011, so it was time to take stock. As well as the three linked sites, there is now a separate one 100 km from Kampala. It is interesting that Reach Out is described as a low resource model, but providing a holistic service to very poor people where there is no welfare state is very expensive and poses questions about how far the organisation should go to provide food, school fees, microfinance schemes etc. On the other hand, if families have no food, what is the point of giving drugs? Also some of the activities which caught our imagination and more importantly  the eye of potential donors, such as the piggery run by grannies looking  after orphans and the tailoring workshops are not necessarily cost-effective but could be worthwhile loss leaders to attract funding for other activities.
The three days gave me a chance to talk to the academics from Makerere University Institute of Public Health who carried out the evaluation and discuss possible collaborative studies. There is a collaboration among the Institute of Public Health and the Faculty of Social Science at Makerere and Reach Out and some other organisations set up with the aim of increasing research capacity but it seems to have lapsed a bit. We now also have meetings of a research capacity group and they would like to start a journal club, which I’m happy to do, though I am unsure that anyone will have time to read the papers. Although English is the official language and everyone speaks it at work, it does seem very much like a second language when used both in speech and written, and people seem to struggle a bit with reading it, even those who are obviously very bright. 
 
A week ago on Friday we had Reach Out annual day our, to the beach at Lake Victoria. Every department had to do a skit on Positive Living (with HIV/AIDS) and Africans need little encouragement to act, sing and dance. It is the rainy season just now, though the rain is sporadic and mainly consists of downpours followed by more sunshine. However, at one point we were all huddled under a gazebo and it was rather reminiscent of happy holidays on Bute in the 1950’s ( I was very very young then!). We decided to drive down to Entebbe ourselves as we correctly thought that we might be happy to leave before the end. In fact we got quite sunburnt in the queue for lunch, being two of three muzungus out of three hundred we forgot that we have “special needs” when it comes to sunshine. Interestingly, there was only one man other than obby wearing shorts, and many women were all dressed up in their formal dresses, and certainly would not have managed a game of rounders to finish off. Ugandans love to party and they don’t need alcohol to get going.

Anyway, we left when Bobby’s legs had had enough sunshine and the dour Scots in us had had enough partying. Just outside Entebbe were stopped by two very pleasant policewomen, who showed us that we had been speeding, just past a sign. Given the absolutely appalling driving in Uganda, and the road accidents that are so commonplace, it seemed ironic that Bobby was stopped, and we’re not sure he was doing 69 km instead of 60. The situation was difficult and we had our first experience of the Ugandan  police as described to us before we arrived. 
 
In anticipation of the visitors we are expecting we have started sorting out the second bedroom and today went to buy bedlinen and towels from a nice Ugandan shop and went to a lovely craft market behind the National Theatre and bought some batik wallhangings to make the house more homely. We also discovered that our one chest of drawers is riddled with woodworm and unfortunately Kampala markets don’t have the same guarantees as John Lewis. 
This week we are having our second week of VSO in  country training where we have a chance to discuss our placements now that we have been here for a few weeks. We are looking forward to meeting up with the other thirteen we arrived with and the six others who came later. The Kampala based people meet up occasionally but we have not seen those who are up-country, including a young couple who have gone to Bwindi Impenetrable Forest (the name says it all) which is very remote and are living in a house with no water, sanitation or electricity, and are an hour from access to the most basic foodstuffs. Our lack of hot water may seem trivial by comparison in a few days.

The harsh realities of Ugandan lives

Bobby -
Friday 13th November
This week has given us cause to reflect on some of the differences between life in Britain and life in Uganda. On Monday at morning reflections it was announced that the son of the vice president of Uganda had been killed in a car accident. On Tuesday morning it was announced that a member of the Reach Out staff had been involved in a Boda Boda (motorcycle) accident while making her way from one Reach Out site to another and had smashed her arm. Rhona has seen a boda boda driver being knocked off and the executive director also collided with a boda boda and had to take the driver to hospital with a broken arm. It is a very common and often the only means of transport but they drive recklessly and there are many accidents. There is a nursery school in the same compound as Reach Out and many three year  olds arrive by boda, with up to four children on each one. On Wednesday morning it was announced that the son of a member of staff had died in the operating theatre after a car accident. Ironically the person with the broken arm didn't get to theatre as planned because the surgeon was operating on the car accident victim. Road accidents are very common and a major cause of death in Uganda.

On Tuesday, as we settled in for the evening, we received a request to take the landlord's 21 month son to hospital as he had fallen and cut his head badly enough to need stitches. This required a half hour journey through Kampala. I've not driven much at night yet but couldn't turn down the request. Day driving in Kampala is an experience that I may get used to but night driving brings another set of challenges. No street lights, the many potholes are more difficult to avoid, in the busy centres pedestrians are difficult to see, dazzling lights or no lights on approaching or parked vehicles. However the thing that scared me most was the antics of very young children (possibly age 2 upwards) on a large busy junction. As we waited to turn right the children approached the drivers begging for money. This was around 9pm and they were wandering up and down the middle of the road. I was cautious enough  when moving off but when you see the children round a large articulated lorry the situation seems intolerable. We don't know how these children live, if they have adults in their lives or if they receive any care.

Life is often harsh here. Although there is supposed to be free education, and in some rural areas schooling is free but very inadequate (100 children in a class and teachers who spend much of heir time doing other jobs), in  Kampala the schools are fee paying. We have work colleagues in their 20s who have had to shoulder family responsibilities from their early teens. We know of one man in his twenties whose parents died when he was fifteen leaving his 17 year old sister, and his four younger siblings, the youngest two years, and himself, to fend for themselves. That these colleagues have responsible jobs, pursue their education at weekends and care and support their younger siblings is evidence of their strength of faith and resourcefulness.

Seven weeks in

Rhona -
During the water and power cuts a couple of weeks ago, while we heated the water from the jerry can on the two burner gas stove, it did occur to me that I could be sitting in Edinburgh with all mod cons, reading the Saturday Scotsman, drinking real coffee, and looking forward to a night out at the Lyceum with friends, perhaps followed by a trip to the Sheraton, the main attraction for me at the moment being the idea of the beautifully appointed and sparkling clean ladies room! I have stopped complaining about having no hot water as having no water at all is unpleasant, especially when you don't know when it is coming back on. We now have a large stock of jerry cans, in different colours, and the landlord’s father lives nearby but his water supply comes straight off a hill and he rarely has cuts, so we have a back-up plan.
However, the magic of Africa and the Ugandans does make up for the "challenges" and we are really enjoying what is a big adventure. Work is really busy for both of us, and contrary to the advice we have had to take
things slowly and spend the first few months observing etc, the organisation have a clear idea of what they want from us and realise that we are here for a year and we need to get going. Bobby has come at a
very opportune time, as they are installing a new computer system  and has become everyone's new best friend. He is busy working with an IT consultant, and has had to go straight from retirement to high-pressure working.

Although there have been research studies going on in Reach Out, they have not had it co-ordinated, and so have created a research section (me) and a research capacity group (me and a few others, who don't
really know much about research). The organisation are very go-ahead, and people are very bright and committed. However, time management is an issue, meetings start very late, and I have noticed that nobody wears a watch, there are no clocks and no-one had a diary. Also there are few phones, which rarely ring, and there never seems to be any mail. Everything is very ad-hoc and important meetings seem to happen without any warning or preparation. But they are so nice and courteous, and ask about all your family and care about people as individuals. They have very soft, gentle voices and even in an open-plan office it is very quiet, with the odd person singing (mainly hymns) as they work at their computer. Sometimes after lunch it all get a bit soporific. People don't really have leisure activities, apart from following football, if you ask them what they are doing at the weekend they don't seem to get it, though most go to church on Sunday. Many are studying in their spare time. Nor do they go on holiday as we do, they just rest. But a lot of what surprises us is really how people lived in Scotland two generations ago, people toiled and rested, and lived in very
basic accommodation.
Last week I went to a meeting for discordant couples (where one is HIV +ve and the other –ve). I just went along to meet them, as they are taking part in a  research study, they were very welcoming and the staff were as usual really kind and warm. We got  a matutu (a minibus taxi) part of the way and then walking a nice route the rest. We were delayed by heavy rain and hailstones, of course we thought it was all normal, but in fact our verandah roof has holes in it, and some houses were damaged.
We have Hamish and Morven arriving on 23rd December, the best Christmas present I can imagine (unless they arrived with David and Kelli in tow). Allison and Alison are planning on coming at the end of January and Donald and David in mid-February. There are a few other provisional bookings and tentative enquiries. So this weekend we are sorting out the second bedroom and going shopping for bedding in the market, which sounds good, but my haggling is so bad it would probably be as cheap to get an order from John Lewis. There are 3,000 US to a £., but we reckon that Ugandan salaries are about a third of ours in the UK, so for example, wine which is considered expensive here is 18,000 US for a very ordinary bottle, which is £6 to us, but probably to a Ugandan is equivalent to £18 to us.
We are enjoying having our vehicle, it makes life more convenient and gives us freedom at weekends. We bought it from Danny and Annie, VSO volunteers who have just returned to Dunoon after two years in Mbarara, upcountry, and who we met briefly after we arrived and before they left. I found their very good blog really helpful when we were getting ready to come, and hence we decided that we should do the same.

We have discovered a short walk up the hill to back of the house. This picture is the view from the top over to Lake Victoria.

Water, water everywhere.............

Bobby -

Thursday 29th October
It's been another interesting week for us. The rainy season has intensified andi ts been cloudier
and cooler. Last Friday night and Saturday we had the heaviest rain we have experienced so far
(have I said  this already?). On Saturday afternoon sheets of rain were falling and suddenly turned to hail stones 3-5 mm in diameter. They were big enough to punch holes in the corrugated plastic roofing over our porch. The Port Bell Road had severe flooding and several trees were brought down adding to the hazards.
Ironically this week has been one a water cuts so we have stocked up with jerry cans and feel a
bit more prepared. As I write the water is off and may not be back for a couple of days as there
are major works on Kampala's water supply and we were warned it would be off for 3 days.
Power cuts are also frequent (3 or 4 a week) although they are short around 2 hours or less.
There is no postal strike as I hear there is in the UK, so there!
 
The great excitement is that we bought a car.
We are the proud owners of Danny and
Annie's old Suzuki Escudo 4x4. Its good fun to drive, makes the shopping easier and opens up many new opportunities for us. We received a lot of good advice through  D&A's blog (see link) before we came out and now we are delighted to have their car.




  




Friday 30th
Well that was a pleasant surprise. We were woken at 2am to the gushing and spluttering of
water as the supply was restored.

 
Next Friday Reach Out has its staff day out -don't know where we are going yet. Each department has a 15 minute slot to portray Positive Living through drama dance and/or song. Not my forte but the Monitoring and Evaluation department (my department) had their first rehearsal this afternoon and I was amazed at how many of the staff could act and ad lib.

Back to the golf

Bobby -
Rhona and I are settling into our work at Reach Out and feel really fortunate with our placements in such an interesting organisation. One of Reach Out’s sponsors is the Kenny Family Foundation based in Canada. Peter Kenny and his son Paul have been over checking out a number of projects they have on the go and they have been particularly interested in what we are doing. Peter asked me for a game of golf last Sunday at the only course in town, the Kampala Golf Club. This was the first game since I broke my arm in June but I found I was no worse than before and had an enjoyable game – the first time I’ve had a caddy to carry my clubs – I could get use to this. The course is very good although the greens are a bit slow with the coarse grass. The round cost £20; hire of clubs £10; caddy about £3 but being big spenders we gave £5 – very reasonable but nearly a week’s pay here for us.
At work I have been learning more about the database developments underway. The main server has MS SQL Server supporting four linked databases providing Reach Out's Health Management Information System. An external IT consultant was supposed to deliver the system in the first few months of the year but it's a familiar tale. A lot of data has been loaded going back over Reach Out's 8 years but the acceptance testing has been lacking. I'm finding it interesting and hope I can help resolve some of the problems. I have not, yet, got used to the delayed meeting starts. I had a few meetings this week - all started late - the worst one started 90 minutes late.
Another frustration is the speed of our mobile internet link supplied by MTN. Our month's subscription in just about up so we thought we'd switch to Warid and buy another modem. We trecked into town after work today to discover that Warid had underestimated demand and are not expecting to have new stock for few weeks - whatever that means!
Things do just take a bit longer here but it's fine and warm so can't complain.
We have a bit of a routine at lunch time when we walk along the Port Bell Road towards Nakawa where there is a local supermarket, Capital Shopper, and a good coffee shop. Good African Coffee.

This photo was taken on the way back on Wednesday and shows through  the fumes from a passing matatu the Mbuya Church and Reach Out in the trees on the hill just above Rhona's head. You may think there is a good broad track for walking at the side of the road but you have to be alert because the matatus and boda bodas (motocycles) often want to share it with you.

This photo was taken at the morning yoga and prayers with the main office block at the back. Rhona and I work in an office on the first floor which looks out over Kampala.

This shows people in front of the  main office block collecting rations from the food programme which has been cut drastically in the last year. It has become less fashionable to give food aid although what good is medical care if people don't have food to eat.

Another good week

Rhona -

We have had another very good week at work and feel very fortunate to have been given the chance to work with such a great organisation and really inspirational people.
I have spent some time with the nursing team at meetings, and also reading up about the basics of HIV/AIDS care so that I can talk the language and understand the different regimes. TB is very common among people with HIV/ AIDS and much more serious than in others. Although many people live very positively with HIV/ AIDS, there are always a number of clients at the clinic who are clearly very weak, and also some who are too ill to come and are visited by the nurses at home. There are some mattresses on the floor of the clinic where people can sleep and they always seem occupied. Clients often have to wait a  long time to be seen and then wait for their drugs from pharmacy. However, many seem happy and they get lunch provided, and they are treated very warmly and compassionately. Clients are encouraged to join in our yoga and reflection and the area used for this had been moved closer to the client waiting area to encourage them to take part. I was at a meeting of clinicians looking at draft Standing Operational Procedures and once they are finalised I will help to correct grammar etc.

 I met with the research officer who is leaving and she has handed over projects and other work. I also have to look after students, who seem to write proposals to carry out studies at Reach Out but don’t tell Reach Out until a few days before they are planning to start. In the UK researchers need honorary contracts, and to undergo  disclosure checks etc, but here things are more relaxed. However, there is an ethics procedures which can be quite complicated so I haven’t escaped from that.  So it looks busy. I spoke to the Executive Director Dr Stella and it looks as if I will be doing two evaluations. One is the Prevention of Mother to Child Transmission Programme, which is very well organised and uses mother – to – mother support using mothers who are HIV + who have gone through the Programme to support other women. Their adherence rates are high and transmission rates low compared to other programmes. Although the guidelines seem straightforward, the stigma associated with disclosing being HIV +ve are enormous so women are worried about people finding out they are on the programme, and also while in the developed world, HIV +ve mothers would not breast feed, in Africa the risks associated with bottlefeeding outweigh the risks of transmitting the virus, and few women could afford formula anyway. There is PMTCT team comprising members of the counselling team, members of the team who support clients to adhere to their complicated drug regimes, and the mother-to–mother health workers who are part of a bigger team who support all clients by home visiting. The whole set-up is amazing and very low-cost apart from the drugs.
On Tuesday evening we went to a VSO cluster meeting for all the volunteers in Kampala, 18 out of 29 came along for a good evening in an Indian restaurant. We saw some of the people we arrived with, and also two who we knew from a course in Birmingham. Most folk seemed very happy and settled. A good bit of  the business was discussing the emergency procedures for alerting volunteers in times of trouble and their movement to safe houses.
Reach Out had a visit this week from Canadian donors, the Kenny Family Foundation, which was set up by Peter Kenny, who came with his son Paul. They support many good causes, and have been impressed (as we have been) by the executive director of Reach Out, Stella. We were supposed to go to have dinner with them at Stella’s but unfortunately Stella and her family were unwell so we had lunch in to an Irish pub with Peter and Paul instead. In terms of attracting funding, success certainly breeds success, and Reach Out does seem well resourced and has funding from a variety of sources. Bobby is playing golf with Peter on Sunday, the first time since he broke his elbow, so he may have more of a handicap than usual. It is slightly strange to come to do VSO in Africa and spend time with very rich people, but they are good company and they were keen to get our perspectives on Reach Out, although it is early days for us.
We were at a management meeting yesterday which was interesting. Like all meetings it started and ended with a prayer, and people treated one another with great respect, even when the debate got a little heated. Ugandans have a great sense of humour, and don’t take themselves too seriously (so like Glaswegians) so there are always plenty of light moments. The laboratories had been evaluated by an external evaluator and there was discussion about addressing some of the recommendations, such as maintaining the fridge temperature when having frequent power cuts and periods when the power is very low. The labs in each of the three sites are tiny, squashed into a corner of the clinic area, and they do all their own HIV| and TB testing, liver function tests etc. In the afternoon representatives from a large travel firm came to hand over a cheque for money they had raised by an art exhibition and we had a great band and dancing and a drama by clients. Ugandans seem to be intrinsically musical and all sing and dance at the slightest excuse, they are also heavily into drama. Some of the money is going to be spent improving the tailoring workshop which provides training and employment for clients, some of whom go on to set up their own businesses using the microfinance loan scheme. One of the women who is employed in the workshop spoke very well about how the scheme had helped her, people are generally very articulate though their written skills are not so good. Reach Out also run adult literacy classes to help clients read and write and to improve their English (every facet of clients’ lives is taken care of it seems).
We have had several power cuts in the evening for up to three hours. Bobby plays his fiddle and I read by torchlight and can cook dinner on our two gas rings. So far we have had no water cuts, nor do we have any problems with cockroaches, have few mosquitoes and we have had electricity in the mornings, so I get my kettle of hot water for a shower. So really it’s quite civilised really, our ideas of mod cons have changed very quickly.

WHO published a report this week which showed that diarrhoeal illnesses can be cut by 40% by encouraging hand-washing.  One morning this week, after the yoga and prayers one of the Reach Out staff did a very funny short session encouraging staff to use the tippy taps at Reach Out. It all seemed timely, as I have found it difficult to live with the lack of water at work. There is one sink with cold water in the clinic which can only be used by clinic staff, and a tippy tap, outside  the toilets, consisting of a container with a hole which operates by standing on a wooden plank attached to the container by a string which tips up the 

container and provides a stream of water. Given, that in the spirit of Reach Out, staff and the clients from the slums of Kamala share the same squat toilets, and that there are lots of unpleasant diseases and worms, I go through alcohol hand gel at a fair rate and am relieved to find that it is available here.  We also go to a nearby nice coffee shop at lunchtime for both the coffee and to use the facilities. Only 7.5% of households in Kampala are linked to a sewage system and the Government are going to borrow money to increase this percentage to 15%. 

Settling into work at Reach Out

Rhona – Friday 9th October
We have a holiday today as it is Independence Day, probably four days is enough for us for our first week. 
Our routine this week has been we get up at six and leave the house at 7.15 to get the matatu (mini-bus taxi) to Reach Out Mbuya and are getting surprisingly used to it.
Reach Out is an amazing organisation and Ugandans are great people. There is a genuine warmth and concern for fellow human beings and they have a great sense of humour. We start the day with yoga and then have reflection, with each department taking a turn to organise it. Everyone in Africa seems to be actively religious, they are very respectful of other peoples’ beliefs but don’t understand that some people are not passionately involved with some religious organisation. We sing a hymn and the Reach Out anthem and there are lots of fantastic harmonies added in. There is a bible reading and someone says a few words. The effect seems to last all day, it’s great and although it would not be acceptable in the UK, I think we can learn from the philosophy. Everyone we have met in Reach Out is really passionate about it, and it is run very efficiently on a small budget and with limited resources. Although only 6% of the workforce have a degree, we have been very impressed by the standards, for example the pharmacy is run by a great man Timothy who has a technician’s diploma but is very knowledgeable and committed to developing the department. Few departments are computerised, everything is written down in big ledgers, so Bobby has lots of scope.
The nurses are a great bunch, and again although most have the equivalent of an enrolled nurse’s qualification, they are very professional and patient-centred, and they could certainly show us what compassionate care is. They do most of the diagnosing and prescribing and call on the few doctors for advice about complex cases. The clients, all of whom are HIV +ve, get treated for other conditions such as malaria and TB, and also for hypertension and diabetes etc. There is a department which  gives support to people with complying with their drug regimes and also a special team who look after pregnant women and their babies up to the age of 18 months to help prevent the transmission of HIV from mother to child. There are WHO guidelines they follow and the have a very low transmission rate. They use community health workers (mother to mother support) and this seems to very effective. All patients with HIV have a community health worker who helps to support patients and alerts the nurses if there are problems.
The executive director Dr Stella is a very charismatic and strong leader and she is keen for Reach Out, and especially the pivotal role of the nursing staff, to be more widely broadcast, and to get some nursing research going. I still have a lot of discussion to have with everyone, but Stella has suggested that I might help nurses to write an abstract for a conference and to work with the nursing team to identify some areas for research. There are academics at Makarere University Institute of Public Health who have just completed an external evaluation of Reach Out, so they may be interested in further research.
So it’s all very exciting work-wise. On the domestic front, we are progressing, we seem to have progressed from camping to feeling that we are living in a bothy, and I will certainly appreciate my home comforts (and built-in wardrobes and fitted kitchen) when I return to Scotland. Also, having familiar people around, but we came for new experiences and we are lucky that we are expecting to see a good few kent faces in the months to come. Our landlord, his three lovely children and two really nice maids are  providing us with a very authentic Ugandan experience. Chiseveni took us for a very long walk one evening up the hill behind us through villages and also past some smart houses, one of which belongs to the President’s daughter. He is a really nice man, and the maids Florence and Maria are great with the children, who are
just a delightful combination of politeness, liveliness and fun.

Visit to Entebbe

Bobby -
Tuesday 6th October - We have started work. This is our second full day at Reach Out. Like yesterday, the morning started with torrential rain and a thunder storm. After picking our way carefully down the track to the main (Port Bell) road, we stop a matatu (taxi minibus). We are quoted 1000 shillings each but on declining to board we are quoted 500 shillings which seems to be the local rate (not the muzungu rate). We feel very pleased with ourselves.
At Reach Out the morning starts in the training room with a short service, a presentation by Dr Stella on her trip to Canada, and then Rhona and I are blessed in song by the group.Yesterday when we arrived, Lydia, the HR manager, a set up a very comprehensive induction programme for us which will run over the next two weeks.The programme will introduce us to each of the departments and we will visit 2 of the other 3 sites.
I also met Daniel who supports IT. Reach Out has around 56 networked PCs on the Mbuya site with a mail server and a file server. There's around another 20 Pcs on the other 3 sites. I discovered the air-conditioned server room which should be a cool refuge in the hot weather!








Last Saturday we bought some more items for the house – a cane sofa and 2 chairs, a small desk for the  second bedroom – still no beds, and chest of drawers which allowed us to unpack our suitcases.








On Sunday we visited the botannical gardens at Entebbe. From the Old Taxi Park in Kampala it took about an hour to get there. It’s a very beautiful setting on the shore of Lake Victoria. 

A guide took us round pointing out many fasicinating plants and animals. 

A crocodile tree with roots like crocodiles.









 

The great orb spider whose net is strong enough to capture small birds.

The bird life was amazing including the dozens of African Kites soaring over us. 

There were acrobatic Colobus monkeys and Vervet monkeys that couldn’t be bothered to move off the track as we passed.

Apparently the 1932 Johnny Weismuller Tarzan was filmed in the gardens.











We finished with lunch at the golf club before returning to Kampala.