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*This is an African proverb, made famous by Chinua Achebe’s novel “Things Fall Apart.” It describes how if one is ready and prepared, he can join the activities. The definition shows that anyone can make positive changes and become successful. I made this the title of the blog because I felt like a little person in a big crazy intimidating world, but I did feel welcome, as long as I was prepared to become a member of the community I served. 

Monday July 30– I wake up to an unbelievable spread of greenery: a misty expanse sandwiched by the powerful, but kind, Rwenzori Mountains. Joseph, my well-articulated co-fellow, recently called our views here a “Chinese brush painting.” Our view is of the quiet and quaint town of Fort Portal.  A cool yet inviting breeze greets me good morning as I step out of my room. I was so caught up in my mama Africa’s magnificence that I didn’t even realize that I was terribly under slept, grossly over traveled, and wondrously excited! It’s 7:00 am at the Sunrise Hotel in Fort Portal, Western Uganda, and I feel ready.

I frantically struggle to close my awkwardly heavy door, and head downstairs to meet the very prompt Joseph for breakfast. Today we head out to Kasese, the beautiful cove of the Rwenzori Mountains and we are pumped…sleepy, yes, but crazy pumped. A week into our fellowship, and our first week of orientation in the capital city Kampala, is done. Joe and I have been reflecting all through our journey, and at this point, we just simply feel ready. Spending the last 3 weeks with my Bostonian co – fellow, I have even developed a love for the once – foreign to me-art of sarcasm. In fact, we now collectively experience moments of silent giggles when Joe’s sarcasm is responded to by awkward moments of silence, when shared with my typically sarcasm-ignorant Ugandans!

Today has been our premier field day. As policy support officers in the STRIDES team, we accompanied the Regional Coordinator, BCC (Behavior Change Communication) Officer, and the VHT (Village Health Team) Officer. In way of explanation, Behavioral Change Communication is a methodology used by STRIDES to change people’s behaviors positively reproductive health, child survival, nutrition and family planning. It focuses on health seeking behaviors such as child immunization and child feeding behaviors. The Village Health Team concept is a very efficient and maintainable method of reaching the communities. Village volunteers encourage healthy behaviors by going homestead to homestead to encourage healthy behavior change such as inspiring mothers to go for antenatal care visits (we encourage at least 4 visits per pregnancy), or educating villagers on family planning methods. The fertility rate in some of these villages is alarming- it is presently 6.7 per mother in Uganda.

The basic aim of the meeting was to bring together an integrated district health team, consisting of representatives from the different stakeholders. For example, heads of district hospitals and the district health officer come together in order to plan the upcoming year work plan.

A couple of things stood out to me at the meeting:

1)     Firstly, and most importantly (in my opinion), was the acknowledgment of a need to be self reliant by the district members. As we progressed through the meeting, a common statement heard was, “We know that STRIDES can not do everything, so we must find the solution to problem A as a district.”

I believe this is very important as it goes hand in hand with one of the STRIDES main goals –Sustainability. As  a project, donor or community organization, it is one thing to provide services to a community, but, how do we ensure that once we pull out [which is inevitable one day], these services will continue and strive?  Here I now think of the rising rates of HIV infection in Uganda…. could there be a connection with the ending tenure of more than a couple HIV/AIDs funded programs? It is food for thought.

2) Secondly, the genuine gratitude that the district had for the STRIDES team stood out. Everyone appreciates STRIDES for their work. As I sat through maybe the fourth thank you to STRIDE, two things came to mind: First, during our week-long Kampala MSH orientation we spent quite some time with the STRIDES communication specialist. He is a very impressive, innovative, well-spoken, progressive (in my opinion) man. He was heading a program titled Visibility, which aimed to make communities and partners comfortable, informed and knowledgeable of the work that STRIDES is doing through branding, resource center formation, online information access, a newly produced bi-annually newsletter and inviting partners to attend in field visits. And you know what- it was working! Everyone there – at all levels – was well cognizant with what STRIDES was doing. The second thing that came to mind was that I remembered a meeting that we had with a rep from the US government who was informing us that they struggled with the fact that most USAID donor recipients in the community had no idea that the funds were coming from the US taxpayers… and sadly, from my experience with the community, he was right. I had a sudden urge to call him up and give him the STRIDES communication specialists’ number!

 

Two other other thoughts to leave you with..

This week’s brush with panic:

EBOLA.

As it stands, 14 people have been confirmed dead in Uganda from Ebola.

Oh man…. Where do I even start with this one? On our second day in Fort Portal, we heard that Ebola had been identified about 40 km away in one of our district hospitals. The president came on TV and provided us with a list of “do not’s”:  no hugging, no shaking hands, no attending large public gatherings, etc. etc., and then he very calmly concludes, “but don’t worry!” Is he serious? I turn to look at my very calm co – fellow Joseph who very kindly smiles at me. WAIT! Why is he smiling? O.K., maybedoes he not know that EBOLA kills! And it kills terribly! Blood oozing out of eyes and so on…. O.K. wait, he’s American maybe he doesn’t know what it is… Why am I the only one having a semi – break down?

Wednesday morning, I had a quick meeting with the Regional Coordinator before I head out to the field meeting (which by the way is only 20 km from the Ebola Index case hospital), and he concluded by stating to remember that I was very close to where Ebola has been identified so make sure that… (at this point my brain went blank so I’m unable to even remember what his words were after that!)

As a disclaimer, I am generally not a panicked person, and in all fairness a huge amount of public health notices and regulations have been put in place by the government and our organization to make sure we are all well protected, but I think what stood out for me through this was the cool, calm and composed nature exhibited by my co-fellow. I wonder if the GHC team knew I would be a panicked mess and would need a non–panicked mess co–fellow to experience these brushes with panic with! Hmm…

And finally, this week’s brush with awesomeness:

As I walked into the room where all the district health team members were getting settled, there was a lady sitting at the center of the table with such presence. It was a room full of very important men, but here sat a beautiful lady with well-groomed short hair. She was quiet, yet commanding. As if as a response to my gazing curiosity, she commences the meeting by requesting one of the meeting attendees to say a prayer, as is typical in the Ugandan culture. So, this week’s brush of awesomeness is Sister Stella Baruga and I’ll tell you why:

Sister Stella Baruga is a registered nurse and midwife by training with immense achievements including Certified training in BEmONC, CEmONC, IMNCI and HN to mention a few. She boasts a Public health diploma and Diploma in Health Management, a degree in Community based development and is seeking to pursue a MSc in PH. She has lived and worked in numerous areas including Tanzania and Kasese and has a clear passion for maternal and child health.

Now I know I’m getting carried away with all the letters after her name and achievements; however, this is just the foundation of the awesomeness that I was touched with. Let me continue.

The reason Sister Stella sits at this table is because she is the acting assistant district health officer of Kasese district. In her district, she is power.  She so gracefully sat with me after the meeting and explained the source of her passion. She speaks of having an interest in community health because of her frustration with the fact that people don’t look at prevention. She stresses the need for people to look at an integration of health and development. She rhetorically asked, “How great it is to have all these family planning services being provided by STRIDES, but how do we access them when our roads are so poor and depleted?” She talks of how Kasese is such a hard to reach mountainous area, and the problems associated with high level of illiteracy, only 21% facility staffing levels, and increasing fertility.

Sister Stella Baruga oozes such professionalism, class, patience and expertise. Her passion and knowledge of what she does comes through, as she nods in respectful acknowledgement as her fellow meeting attendee argues against her point. She is beyond awesome!