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.

We have arrived

Bobby -

17th September, 2009. We are off to Uganda. Now the day has come we seem to be in a no man’s land between the familiar and the new and unknown. We have shut down our lives – cancelled the Radio Times – to pass through this day in order to grow gradually again through new experiences. From the trivial – what to switch off as we leave the house – to the more substantial – what will our accomodation be like? – what will the work ahead demand? - we are full of anxieties and excitement. Our first flight is at 4 pm from Edinburgh and true to form we are ready half an hour before the taxi is due. We fill the taxi with 4 23kilo bags (our missionary allowance) 3 cabin bags, a violin and a mandolin. We are expecting to entertain ourselves of the long dark nights.

The transfer through Heathrow is uneventful but it provides the opportunity to read the last quarterly report of Reach Out Mbuya, our new employer. It’s full of statistics, some disturbing, some puzzling. Out of around 1000 clients 27% tested positive for HIV. The tailoring workshop made a gross profit of 12,424,500 Ug Shs.

It’s 2am somewhere over Africa – or maybe its 4 am. I’m thinking that maybe I don’t realise what we’re in for. In my whole life, I don’t think I’ve been away from Edinburgh more than 4 weeks at a time. This is more than a holiday.

0715 hours – landed at Entebbe. The rain is pouring down because it’s the wet season. We are met and welcomed to Uganda by Benon Webare, the Country Director for VSO Uganda and minibused to Lwezi Training and Conference Centre, about 10 km from Kampala, where we will spend the next week on in-country training . There were 8 of us on the flight from Heathrow although we didn’t know it at the time. Five more volunteers (from Kenya, the Phillipines and India) are due to join us later today.

Tuesday 22^nd September – Four days have passed. The in -country training has included so far an introduction to Ugandan culture, the history to the government structure (decentralisation) starting with the resistance councils of the early eighties, child protection, a walking tour of Kampala (photos), a visit to Ndere Cultural dance theatre and a visit to the VSO office with introductions to the staff. Today we had the first of three language sessions in Luganda, the language of the Baganda who traditionally inhabit Buganda the area of Uganda around Kampala. On Friday the training finishes and we move to our accomodation for the next year.We have found out that we will be staying in a house with only a bed and mattress so far and so we expect to be doing a lot of shopping over the weekend .We have seen a good variety of shops in Kampala so we don’t expect to have too many problems getting the house furnished. The rainy season continues. There has been around one heavy downpour each day but between “showers” the weather is very pleasant.The food is good and there is beer just outside the centre. The Ugandan people are lovely, the VSO staff and volunteers are a great crowd so things are looking very good just now.

Friday 25^th September – a mixed day. Today we met Lydia, the HR manager of Reach Out Mbuya (ROM). She explained how ROM is organised how our placements fit in. It was reconfirmed that the skills and experience that Rhona and I bring to Reach Out are expected to help it develop over the next year. We have quite positive feelings about this although we have a lot to learn about ROM over the coming weeks.

The downside today was that our accommodation was not ready so we are back in the conference centre tonight. This morning we were told the painters were in and we couldn’t move today but we asked to visit our house this afternoon. We found a very empty house with the painters busy and quite a lot of dust and rubble around. We realised that even with reasonable effort tomorrow it is unlikely that it will be inhabitable tomorrow evening. After discussion with VSO, they have agreed to put us up in a hotel tomorrow and their staff will help us to shop for the essential items. These include two tables for the kitchen, gas cylinder, fridge, chairs, curtains, plates, cup, cutlery, pot and pans, kitchen utensils, bed linen, towels. Then we will require to stock with some basic food supplies.

The house appears to be a physically secure compound with two other houses but we were surprised that there was no guard as this is fairly common in Kampala. This requires further investigation.

We have a bit of work tomorrow and we will review our progress tomorrow evening.

Accommodation problems have not been uncommon today. Of the 16 volunteers in our group 10 are still in the conference centre tonight where only a few expected to be here.

Monday 28^th September. Some progress today after a frustrating weekend. We didn’t get to the house on Saturday or Sunday but did manage to purchase two small tables, 4 dining chairs, a gas cylnder and some bed linen. We also had our first experiences on the matatu s or taxis. These are the minibuses that provide the cheapest form of transport (apart from foot) about Uganda. Although not too safe outside Kampala they are licensed in Kampala to carry a max of 14 passengers. They have a driver and a conductor whose job is to collect the fares and fill the taxi before it leaves the taxi park. The fares range from about 15p to 30p for journeys in Kampala. (photo Old Taxi Park Kampala)

We ate out well on Saturday evening at the Palm Café (photo) but were not so impressed with the Ethiopian Village last night although some like it. Tonight we ate well at the Indian Summer with Annie and Dannie who are just finishing their 2 year stay in Uganda. Annie’s blog has provided us with lots of useful advice about doing VSO in Uganda.

After a bit hanging around we got back to our house in Luzira on the Port Bell Road. It was a big improvement on our first impressions but we are still concerned that there is no guard and is a bit out of town and beyond walking distance to work. However we expect to move in tomorrow.

Rhona -

Friday 2^nd October We finally moved into our house yesterday. We have had a frustrating time with most of our energy going on trying to get curtains made and hung so that we can move in without being observed by everyone walking up the street. It is strange setting up home from scratch and makes us realise how much we take for granted. Even basic things seem complicated, we have to boil not just drinking water but also water for washing up, though we may become less fussy as we go on. Although the house is nice we have no hot water, so we are having to work out how best to use the cold shower with a kettle fulll of boiling water. The landlord is a widower with three young children, his wife having died two weeks after the birth of his son now aged 15 months. His niece and also another woman who lives in his house (I’m not sure f she is a relative or employee) are around most of the time and have been very helpful with advice about basic housewifery. They have arranged for a woman to come and clean and wash for us. Washing is by hand using cold water and OMO (I think my mother used it in the 1950’s) and a long bar of special soap, so I am off to get one large wash tub and three smaller ones as directed. They must think it strange that I need instruction in basic housewifery skills. Most people are very smatly dressed and schoolchildren have pristine white shirts so we hope we can trust OMO. You can’t ask maids to wash your smalls, which you also can’t hang up outside. We have discussed getting a night guard (with gun) with VSO and our landlord, as everyone has warned us about the dangers of being the only muzungus (white people) around. The landlord is talking abut getting guard dogs who apparentky can tell the difference between residents and burglars, but I would be reluctant.

We went to see the staff at ROM on Wednesday and we were very impressed by the whole organisation. We are looking forward to getting started on Monday, and if the placements work out well, we will be really pleased, as we have had mixed reports from people who have been here for some time.

After being bogged down by the more mundane side of coming to a new country we are hoping that we will get out and about at the weekend and maybe visit the botanic gardens at Entebbe. Uganda is a beautuful country with perfect weather and I am sure we will have a great time exploring the countryside during the next year.