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Thursday, July 15, 2010

My Boda-Boda Driver

My consuming fear of motorcycles has been well-chronicled, but in Kampala, you can't avoid taking bodas. They are everywhere, traffic is horrible and constant, and to get anywhere quickly, you simply have no choice but to flag down a boda, haggle over the price, hop on the back of the bike, and pray.

As soon as I began riding bodas, I met a driver named Jon, who parks himself outside of my apartment complex, waiting for customers. Demure in stature and wearing an ever-present smile, I hopped on the back of his boda while going to a bar one night. Preparing to watch a USA world Cup soccer match, I was wearing my red white and blue jersey.

"USA!" Jon exclaimed! "I love USA!"

Before beginning our journey, I grabbed hold of Jon's arms and made a deal. "OK, Jon, you like this jersey? If you give me rides, charge me fair prices, and keep me safe for the next month, I give you this jersey."

I could virtually see Jon's mouth watering. He let out a high-pitched "Eeeeh!" and we sped off.

Last night, I called Jon to my apartment complex, needing a ride to meet a friend at a restaurant. I approached him, one hand behind my back, and we embraced. After chatting for a minute about how we were doing, I stepping back and brought my hand around, showing him the shirt he craved. I tossed it to him, and he grabbed it out of the air with glee. Hopping off his boda, Jon gave me a huge bear hug, not an easy feat given that I am at least 8 inches taller and 50 pounds bigger than he is.

"Thank you, Mr. Ross," Jon said. "I will wear it every day!" He drove me safely and slowly to the restaurant, and refused to take any payment.

This morning, I left my apartment to walk to work for the last time. Jon was perched on the side of the road, straddling his boda, chest puffed out and proudly wearing my red, white and blue jersey.

Last Day

My last full day in Uganda.

It's difficult to reflect on the last month, as I have encountered a full spectrum of emotions, and much more, during my time here.

One thing is for sure, I will miss this place. There is an aura of humanity here, a genuineness of place and people that I have not found elsewhere. Smiles and hugs are like currency, passed from person to person easily and without second thought at every turn. Ugandan friends excitedly grab my hand and walk me from place to place, eager to show me something new. Little children saunter up to me in the clinic, wary at first, until I stick out my hand. Their curious eyes widen, followed by a toothy grin, as they slap me high five.

I will miss the laughter in my office, the constant cultural comparisons that brought curious looks and never-ending giggles. I will also miss seeing the doctors and nurses working; they have a sense of purpose and devotion to their patients that is subtle, but breathtaking. I will miss the walks through downtown Kampala, a place that at first looked like utter chaos but, as I have gotten to know this town, exhibits a free-flowing, sometimes-manic, order. I will miss riding buses across Uganda, packed three into a seat built for two (small) people, as chickens wander on the ground, clucking and pecking at my feet, while Ugandan hip-hop music blares from the bus's speaker system. I will miss the boda-boda rides, the matoke and beans, the African sun, and so much more.

Of course, this is Africa. Poverty abounds, to the point that after a month, I often ignore it. Walking home from work yesterday, a coworker pointed to a collection of makeshift shacks, right off the main road, with disbelief. I recall noticing them on my first walk to IDI on my first day here, and then never looking again. In Africa, suffering blends slowly into the background.

I will never forget the faces at the clinic. Given how much I love this place, it is not difficult to forget that the people we are here to help are sick. Really, frighteningly, sick. Before Uganda, HIV/AIDS was an abstraction for me, a list of statistics chronicling the plight of a people far away. For me, far away meant Africa, or the other side of Washington, D.C. But these faces, they will stay with me. They are old and young, mothers and fathers, daughters and sons. Their faces tell stories of suffering, but they are resilient. Their faces are strong.

And, of course, the bombings of Sunday night will forever remain etched in my memory. I have seen a city at its lowest point, trembling and afraid. But I am also watching it slowly return to normal. Despite the repulsive efforts of those that want to do us harm, life always returns to equilibrium. The decency and humanity of so many will always outweigh the unconscionable behavior of a few. It simply must be so.

Perhaps my lasting memory of Africa will be saying goodbye to one of my colleagues, Benson, who I have written about before. Embracing, we discussed the bombings, my trip back to the United States, and my plans to return. I then thanked him for everything he had done for me, helping me to get adjusted, and explaining how the clinic worked.

Benson, HIV positive for ten years, smiled beneath his bushy mustache.

"You are most welcome," he said. "See you next year."

Wednesday, July 14, 2010

The TB Clinic

The tuberculosis (TB) clinic at IDI has come along way since its founding in 2008. Back then, only one nurse, Ariko Immaculate, was charged with caring for, and managing the files of, every TB patient that came to IDI. The clinic was housed in one small, cramped room indoors, a severe health risk considering TB is transmitted through the air.

When the clinic finally moved to an open-air space, Immaculate and her colleagues encountered a new problem: the rain. Housed underneath flimsy tents, rain would pour in to the clinic, soaking the doctors, nurses and patients, along with their files and medicine.

Almost two years after its founding, the TB clinic now has six full-time staff, sees up to 50 patients per day, accepts 30 new patients per month, and is looking to expand. The staff does integral work, treating patients co-infected with HIV/AIDS and TB, many of whom are in dire need of care. The HIV virus breaks down the immune system, approximately doubling one’s risk of acquiring TB. When a patient becomes dually infected, administering medication becomes increasingly difficult. Side effects intensify, more pills must be taken, and there are only certain kinds of ARVs that can be prescribed with TB drugs.

Faced with vexing challenges and forced to make difficult choices, the only way the TB team can survive is by working together. Medical officers Catherine Katabira and Peter Mbidde work closely with three nurses and one full-time staffer to make sure the clinic runs smoothly, and patients get the care they need.

Additionally, peer counselors at the IDI clinics interview new incoming patients, asking them if they are showing symptoms of TB, such as weight loss, constant coughing, or a high fever. If so, they are immediately taken to the TB clinic to be examined by a nurse. Then, the patient sees one of the two medical officers, before seeing a nurse to get their prescription and receive counseling if needed.

It’s an efficient, streamlined effort that requires maximum cooperation from the entire team, particularly at a time when money is tight. While a grant from a European organization has lessened the financial burden on the TB clinic, there is still tremendous need. There is no outdoor toilet for patients to use, forcing them to go back into the clinic and, in the process, risk the transmittal of TB to other patients. An x-ray reading box and other general supplies are also needed. Perhaps most importantly, there is no separate space to provide urgent care for TB patients who need immediate medical attention.

Despite the needs, the TB clinic staff dedicates themselves to providing excellent care to every patient they see, every day.

“This team has been great at improvising and trying to implement new things,” said coordinator Sabine Hermans. “We are constantly working to raise the level of care, and do it with minimum cost.”

One example of the team devising ways to do more with less is the food delivery program. Funded almost exclusively by donations, one of the nurses, Jennifer, delivers packages of food to the homes of patients who are too sick to venture out. It’s a cost-effective way to ensure that immobile patients have enough to eat.

The TB clinic also plays an important role in the research portion of IDI. As the team works hard to devise new and improved strategies to treat dually-infected patients, observations and trends are entered into a database and examined. A recent study showed that after only one year at the TB clinic, about 14% of patients were not finishing their treatment, down from 30%, a remarkable improvement. Two more studies are planned in the near future at the TB clinic.

Treating TB presents difficult challenges for the clinic staff, but because the disease is curable, unlike, HIV/AIDS the rewards are tangible. Dr. Katabira said that watching a patient diagnosed with TB correctly take their medication and recover is extremely gratifying.

“When you see someone get better, some one make it, that encourages us as a team,” Dr. Katabira said.

Cultural Observations

Getting over the trauma of Sunday night has been difficult for everyone in Kampala, but each successive morning makes it slightly easier. As my time in Uganda winds down, I have spent more time with my Ugandan coworkers and other friends, and our jokes have begun to return.

Today, over a good-bye lunch of delivery pizza from Domino's Pizza (coincidence? I think not...), my office discussed some of our favorite cultural differences about one another. The lunch ended with all of us holding our sides in laughter. With all that we have gone through, I can't tell you how good it feels to laugh.

Ugandans, for example, think eating cheese pizza is weird. Putting toppings on is fine, but just cheese disturbs them.

They also think it's quite odd that for breakfast every morning, I put my banana inside my chapati (kind of like a potato-pancake). It's like a crepe with banana on it (I'm only missing nutella), but this baffles my Ugandan friends.

Ugandans also think that iced tea is near-blasphemous. I understand the rationale behind this one; with few refrigerators outside of Kampala, it's difficult to produce ice in a country that lies on the equator. But even here in the capital, where you can find ice, they think it's abnormal. I tried to explain my iced-coffee obsession; they looked at me like I had three heads.

They also can't comprehend that they are sitting in a room with a Jewish person. When I told them I am Jewish, Angelina, Caleb and Diana almost fell out of their chairs. They touched my skin to see if their hands would pass through. This isn't anti-semitism; I'm just probably the first of the Tribe that they have met. We constantly laugh about this one.

I poke fun at the Ugandan accents (for example, if Diana says "You wear a hat, you have a heart, you get hurt and you live in a hut," it sounds like "You wear a hut, you have a hut, you get hut and you live in a hut"), their powdered coffee, and too many other small things to count. We all have a good time.

These inside jokes are remarkable not for their incredible humor or their window into different cultures. But the fact that we were able to kid each other and laugh together meant that life was returning to normal.

Finally...

Tuesday, July 13, 2010

Recovery

This morning, the sun rose in the east, my boda-boda driver drove too fast causing me to panic, and the coffee at IDI is watery and bland.

In other words, it was a normal Kampala morning.

Of course, the searing memory of Sunday night still looms. The death count rose to 74. At the hospital where I work, people still linger, waiting for any late news on friends and relatives. Doctors and nurses still look bleary-eyed, overworked and overwhelmed.

A city begins to recover, and I am both impressed and disturbed by the resolved of my Ugandan friends and colleagues. They are devastated, of course, but have plowed forward in a way that is surprising. Yesterday, my coworkers made small talk while I stared into space, shellshocked. Today, another colleague came and told me that they were going to play football after work, and he wanted to teach a mzungu how to play "the beautiful game."

People grieve differently, but I think living in Uganda has, if not conditioned people to tragedy death, at least exposed them to it in a way that I have not. Having barely slept the last two nights, I am still grappling with what happened. Ugandans, reslient and proud, seem intent on moving on as quickly as possible.

For me, the most difficult part of this entire ordeal has been reconciling that something so horrible could happen in a place so wonderful, and to a people so kind. After having lived here for a month, the stunning contradiction between the warmth and beauty of Uganda, and the cowardice and destruction of the bombings, is too much to bear.

Tragedies happen all over the world, and life goes on. For me, this has been an acute reminder that we live in a dangerous world, no matter if you are in Washington, D.C., Kampala, or anywhere else. The last 48 hours have been truly awful.

I'm looking forward to beginning the process of moving on, just like my Ugandan friends.

Monday, July 12, 2010

I'll Never Forget Today

Tonight, I'm sitting in my living room, drinking wine with my roommate Peace, and watching bad American sitcoms on DVD. It sounds like any other Monday night. Except that it wasn't.

Today was quite possibly the worst day of my life. After a sleepless night contemplating all that happened in Kampala last night, I arrived at Mulago National Hospital to see hundreds of people gathering outside. They were waiting to hear of news about loved ones. Some were crying, others were staring into the distance with hollow eyes, and still others chatted absentmindedly.

Going inside to offer my assistance to the Red Cross, I saw victims of the attacks on rolling hospital beds. Some were bloody and bandaged. Others were missing limbs. It truly looked like the aftermath of war.

It was impossible to work. I kept thinking about how close I was to meeting Peace at the Rugby Club. Had I not gotten a text message from a friend, I would have been at the bar where the second, more powerful bomb exploded. I also thought about her, what she saw, and what she felt. She tells me she's ok, but it's hard to know.

Rumors have flown around Kampala about what did happen, what could have happened, and what is going to happen. I heard that a bomber was on his way to the bar that I was at. I heard that two bombs were defused today in Kampala, sparing more lives. I heard that more attacks are on the way. I don't know what to believe.

It's unclear what my future plans are. On Monday, July 19, the day that I am supposed to leave, a meeting of African Union leaders will begin in Kampala. It may be prudent to leave before then.

Thank you everyone for your kind words and support. Today was a horrible experience for me, but my day pales in comparison to the hundreds that lost a friend or family member last night. I know lots of those people, and their ordeal is just beginning.

I need to get some sleep. Will post more tomorrow.

Sunday, July 11, 2010

The Bombings

I'm not sure what I am supposed to feel.

Last night, three bombs went off at popular bars in Kampala. The attacks killed at least 65 people, including one American.

My roommate Peace, a lovely Ugandan woman who is in graduate school at the University of Washington, was at the Rugby club, a big outdoor space where hundreds gathered to watch the World Cup final. At halftime, I was about to leave the crowded bar where I was to go meet her, when I received a text message.

"Two bombs have gone off, get out of bars."

The rest of the night is a blur. As information trickled in and rumors swirled, I was left feeling a weird combination of lucky and helpless. No one knew what was going on, and we all relied on whispers.

I could have been in that bar. I could have died.

Having worked on national security issues at the U.S. Department of Justice, I feel as if I have gone from watching a scary movie to actually being thrown in it. It is a surreal sensation, and even know, I'm unable to keep from shaking. Thankfully, everyone I know here has survived, and for that I am grateful. But it is a stunningly unsettling notion to think that so much death and destruction happened so close to me.

Immediately, flashbacks to 9/11 came racing back. Many of my emotions are the same, some are different. Perhaps I will write more about this when I have had time to process this ordeal.

The morning did not bring respite; in many ways, it has been worse. The national morgue is at the hospital where I work. Everywhere, people are gathered around wailing victims, consoling them, hugging them. I am too confused to know what I feel.

Uganda is a beautiful country, with kind, warm, generous people. Last night, evil tore through my adopted home, lowering a dark, bloody cloud on what was a joyous, boisterous evening in a fantastic place. In the world we live in, terror can strike anywhere, anytime.

I am shaken. To those that lost their lives or know someone that did, all of our prayers are with you.

Friday, July 9, 2010

Hoopin'

I received the outlet pass and immediately turned up court. Taking a long dribble, I surveyed the scene in front of me and saw one teammate and one defender streaking towards the basket. Getting closer to the goal, I considered the options: continue onwards for a lay-up, pass the ball off to my teammate, or pull up for the short jump shot. I chose the third, and about 8 feet from the basket, stopped on a dime and rose into the air. With a flick of the wrist, the ball left my hands as it has done thousands and thousands of times in my life, and swished softly through the net. The crowd cheered, and I rushed to get back on defense.

Sounds like a pretty typical basketball scene, right? Could have been a pick-up game in DC, or scrimmaging with my teammates at Vassar. But this game came at the YMCA in Kampala, and my teammates and opponents were my new Ugandan friends.

One sunny day, on the recommendation of a friend, I wandered over to the court in a bustling section of the city. A fast-paced pick up game was already going on. Taking a place in the bleachers, I watched for about 15 minutes, before asking another bystander how to get on the court.

"Say you got next game," he sneered to me, and walked off.

Sounded simple enough. "I got next!" I yelled, and no one seemed to pay much attention.

When the game ended, a few people coalesced around me, and I chose four others to play. I learned that the players were all part of Team Power, one of the better teams in Kampala. Last year, they won the city championship, and so far were undefeated this season. We walked to center court to meet the winners of the last game, when one guy put his finger in my chest.

"Mzungus don't play here."

"We'll see about that," I said, and brushed past him.

The game began. Despite being 5,000 miles away from home, playing hoops felt like... home. Pick-up basketball is universal. The rules are the same. The terminology is the same. The competitive fire is the same. I almost wanted to pull a Gene Hackmann and go measure the height of the basket. And yes, it would have been ten feet tall, just like in Indiana.

My team won the first game, and then the second. People crowing around the court were having fun with the idea that a pale, short mzungu could hoop (take this with a grain of salt - while I've played a lot of basketball in my life, I am in terrible shape after drinking too many Nile Specials (Ugandan beer), and spent most of the game trying to keep up with my talented, athletic counterparts.)

Finally, after an hour, I was exhausted and retired to the sidelines, breathing heavily.

One of the players on my team, a lightning-quick guard named Richard, ambled over to me. "You'll be here tomorrow, right?"

Yup, I said, and we slapped hands.

Felt like home.

Courtship in Uganda

Today at lunch, a colleague and I had a discussion about dating, marraige, and relationships in our two cultures (timely since it seems like so many of my friends back home are getting engaged).

I asked my coworker about how she met her husband, and what it was like getting engaged in Uganda. She explained to me that in her tribe, longstanding ritual demands that the groom's family offer cows to the bride's parents in exchange for the young woman.

Apparently, my coworkers parents asked for 60 cows. Eventually, they settled on ten.

The system of determining how many cows are to be given away as a dowery depends on the qualifications of the bride-to-be. My coworker's family demanded a high price (evidently 10 is still quite a lot) because she had a master's degree and was educated in the UK. A young woman with lesser qualifications would be worth far fewer cows.

In the end, my colleague's family did not take the cows from the groom's parents; rather, it was a ceremony based on tradition that still resonates in modern, urban Uganda. I felt uneasy coming to terms with the idea that a woman, a human being, could be worth a certain number of livestock, and that the number was on a highly fluid sliding scale based on her resume.

My coworker found this idea quite normal, and said her husband's family would have been happy to give up the cows.

Makes buying a drink for a girl in a bar seem far less daunting...

Wednesday, July 7, 2010

A Success Story

To all of the faithful readers out there, you must be sick of hearing my voice and reading my words. I don't blame you. That's why I wanted to share a story written by my good friend Elizabeth, who works at the front desk at the Infectious Disease Institute.

Elizabeth is a beautiful young woman with a bubbly personality. She helps me send faxes, retrieve office supplies, and knows pretty much everything about the office. Elizabeth sent me this story, and gave me permission to post it on my blog. I have not edited it at all. Hope you enjoy.

MY SUCCESS STORY IN IDI

My name is Kembabazi Elizabeth Mercy and I am 22years old, HIV positive. Here I am to share with you my success story.

In 2008 I joined IDI infectious diseases institute as one of the young adult living with HIV. after a long period of suffering with a lot of worries and stress with a lot of pain deep down in my heart,IDI was able to make me have a better hope for success towards a bright lovely future. When I had just joined IDI, I never believed that one day, things would be much better as they are today. I believed that to me life was all about pain, a lot of rejection and misery, not knowing that life had always wanted to give me a second chance to be happy and smile once again.

Before I got to be at IDI, life was too painful and unbearable, that it had to lead me to the unwanted suicidal commission. All the time, there was nothing else I could think of apart from committing sucide. Time came and IDI offered to be giving me free treatment (ART) from its clinic. Although I started getting free treatment from IDI, that didn’t stop me from wanting to commit sucide. insted the feeling just kept growing deep down inside of me, not until it became a fundamental problem to me. I could talk to some one, but in the actual sense, I would be only thinking about the worst thing I could ever do to finish off my self.

But after along period of time, IDI gave me the best hope of how to admire living my own life once again by offering me the best opportunity to work with it. IDI indeed has been my father, my mother and above it all, it has been my family, place of hope and success. I never believed that I could also have the best smile on earth, but IDI has truly done the best to see me both happy and smiling too. Long live IDI.

Am now looking forward to my success in IDI and all around the other nations around the world. I really enjoy working with IDI because, the more I work with it, the more experience I get and I keep learning new better things in my life, for example, customer care, official work, how to love my self and others, etc. And above it all IDI helps me focus towards abright, lovely future with a positive attitude towards life. If it wasn’t IDI, I don’t think I would be living today. To me IDI will always be my life saving hero. Thank you IDI and long leave too. Indeed you are the best.

Yours joyful,

Kembabazi Elizabeth Mercy.

Tuesday, July 6, 2010

Accountability

I want to tell you about two of my colleagues, Benson and Charles. Benson, a stocky individual with a bushy, disheveled mustache, is the Director of the Friends Council and head of the Resource Center. Charles, tall and elegant with defined cheekbones and a huge smile, is the deputy director of the Greater Involvement for People Living with AIDS (GIPA) program and the head of the music, drama, and dance initiative at IDI.

Their jobs are to expand the options for patients at the clinic. By making educational, entrepreneurial, and spiritual resources available, Benson and Charles encourage patients to understand that a positive diagnosis doesn't mean life is not worth living.

I met them both on my first day in Kampala, and over the last few weeks, both have been instrumental in making me feel welcome, and have helped me immensely at work. Benson and Charles have explained how the clinic functions, introducing me to doctors, nurses, and patients. They have taken me to performances and let me sit in on meetings. Needless to say, I have a far greater understanding of this clinic, and the people that make it run, because of Benson and Charles.

Today, after working side-by-side for three weeks, I found out both are HIV Positive. While interviewing them on the successes of the GIPA program, Benson told me he learned of his positive status in 2001. Charles found out all the way back in 1993.

After the interview, I reflected on the lives and fates of these two men. Both are strong, handsome, and eloquent. Both are highly respected at the clinic, and command attention when they speak. And both have been infected with a deadly disease for years.

Before I got to Uganda, I considered HIV/AIDS to be a death sentence. No doubt, this is true for some, as a positive diagnosis can lead to desperation, depression, and ultimately, the end. But Benson and Charles are proof that it doesn't have to be. They have transformed their lives, taking a horrible negative and turning it into a positive, becoming role models in their community. They have become accountable not only for their own well-being, but for the well-being of thousands of others living with HIV.

Both men use their stories to inspire others. When they talk to patients, Benson and Charles can relate to their plight. Patients, in turn, know that they have found a friend and confidante who understands what they are going through. Rather than shy away from the stigma of HIV/AIDS, Benson and Charles embrace it and use it to educate others.

In the last few months alone, almost 2,000 people have used the Resource Center, a collection of computers, games, and health resources that exists primarily due to the hard work and dedication of Benson and Charles. The skills and lessons learned at the Resource Center tangibly helps patients in physical, emotional and intellectual ways.

I was impressed with these Benson and Charles before I chatted with them today. I found them to be smart, dedicated, impressive leaders.

Staring down a debilitating disease only makes them exponentially more impressive.

Sunday, July 4, 2010

The Games We Love

Happy Monday morning to everyone, and I hope you all had a great 4th of July! While I was sad to not be in DC, I went to a great bbq, complete with African dancers and a surprisingly good fireworks display.

I wanted to post quickly about two experiences that I had this weekend concerning sports, and the effect they have in any culture.

On Saturday, some friends and I attended the Uganda-Kenya rugby match in Kampala. On a warm, sunny day, about 5,000 people crowded around the pitch and cheered on their team. Obviously, most spectators were pulling for the home team, but Kenya traveled with quite an entourage, and there was a strong Kenyan contingent.

I was struck by the festival-like atmosphere of the occasion. Ugandans and Kenyans a like danced, sang, and cheered for their teams, but always with one arm draped around the rival's shoulder. Would Yankees and Red Sox fans cheer hard for their team, while embracing a rival fan? Not likely. And I've been to enough Duke-Maryland college basketball games to know that few friends rooting for opposing sides are made.

In the end, Kenya won the match, but not before a furious comeback from Uganda late in the game. The Kenyan players and fans - about 250 people in total - then circled the field, stopping every few meters to sing their national song, do a little dance, and get down on the ground and show the soles of their feet to the Ugandan fans. I took it as a sign of disrespect. The Ugandans around me laughed and said it was funny.

Most surprising of all, that night, I saw members of both teams in the bar I went to, drinking congenially and enjoying each other's company. Members of two rival nations, after just having played a violent and brutal rugby match, went to the same bar. On purpose. It was both surprising and inspiring to see the players, so intense on the field, act so civilly towards one another off it. Sometimes, in America, we let our rooting interests take on too much importance. Not so for the Ugandan and Kenyan rugby teams. Their perspective was pitch-perfect.

The night before, I had a wholly different experience. I went to a bar to watch the Ghana-Uruguay World Cup match. Filled with Ugandans, the atmosphere was tense throughout the game. When Ghana scored their goal right before the half, the bar exploded in a jubilation unlike I had ever seen. Ugandans and mzungus hugged and kissed. Vuvuzelas made the walls shake. It was glorious.

Of course, everyone knows what happened. Ghana's star played missed a game-winning free kick, and then Uruguay went on to win in a penalty kick shootout. I could almost feel the bar, the country, and the continent, deflate. All of Africa united around Ghana's team. For a continent short on accomplishments, a win would have been monumental. Instead, they lost in the worst, most heart-breaking, way possible.

As one friend said to me, "If the world was a good place, if there was justice, Ghana would have won." Maybe so. It was hard not to feel terrible for my Ugandan friends sitting glumly next to me after the match. Football is just a game, but it's much more than that here. Even if a single match couldn't cure any of Africa's problems, a win would have meant that for just a few hours, a continent could rejoice.

In much of Africa, such opportunities are few and far between.

Sports bring people together. In the case of the rugby match, opposing players and fans bonded over a great game on a beautiful day, a bond that lasted well into the night. An entire continent bonded over Ghana's success. And while the end result was disappointing, I was heartened to see Ugandans - and all Africans - cheering on their African counterparts. Ghana and Uganda don't have much in common; they only share their "African-ness". But Ugandans adopted Ghana's team as if it was their own. If this type of unity and togetherness can extend to arenas off the football pitch, this continent stands a much better chance of moving forward.

Friday, July 2, 2010

Fourth of July

Just a very quick post wishing everyone back home a happy 4th of July weekend.

It's been well-documented that America's Independence Day is my favorite day of the year. I love the fireworks, I love Ben Safran flipping burgers across the patio, I love the warm keg beer, but mostly I love hosting all my friends, in my backyard by the pool, having a great day.

I'm sad to say that tradition takes a hiatus this year. While there is a big, American 4th of July party here, I'm certain it won't be the same.

Perhaps the only person who is happy that I'm in Uganda for the 4th is my mother. Mom, you're off the hook... no big parties at the house this year. Oh, and that crazy German neighbor that hates me. If you've been to one of the parties, you know who I'm talking about.

To everyone back in the states, have a safe and happy 4th. Sorry I won't be there to celebrate with you!

Thursday, July 1, 2010

Song and Dance

The HIV/AIDS virus is much more than just a physically debilitating disease.

I do not mean to understate the tole it takes on the human body. You can see the damage as you walk through the IDI clinic; patients are weak and vulnerable, their bodies brittle and their immune systems frail.

But HIV/AIDS also weakens the mind and the heart. A positive diagnosis can lead to depression. It can end one's motivation to work, to learn, to provide for a family, and most of all, to just keep going. When all you can think about is getting sick, you get sicker.

Or, it can have the opposite effect. It can motivate you to overcome your diagnosis, rise above it, and teach others to do the same.

That's the approach taken by the IDI singing and theater group, whose performance I watched today. These ten individuals (there are 25 total, comprising two groups), use song, dance, and drama to motivate themselves and others to live healthy lives and take care of themselves and their loved ones.

The troupe started with a song about disclosure, encouraging the 50 or so audience members to be honest with their lovers and loved ones about their positive diagnosis. Then, another song about the benefits of modern medicine, pushing them to continue visiting the clinic and refilling their prescriptions. Afterwards, one by one, the members of the group introduced themselves, and a few told the story of when they found out they were HIV positive and how IDI has helped them stay healthy. Finally, one last song about practicing safe sex and abstaining from alcohol and other dangerous substances.

The audience clapped and cheered, and the members of the troupe smiled and bowed proudly. The sense of pride and accomplishment on their faces was palpable; they rehearse twice a week, and it shows. Songs were pitch perfect, dance steps were highly choreographed and in unison. Their performance was significant not only for the lessons imparted to the audience, but because of the feeling of purpose and self-worth it gave the members of the troupe.

Every singer has been diagnosed with HIV/AIDS, a disease with no known cure. They could have easily chosen to curl up and wait for the disease to break down their bodies.

Instead, they sing.

Conquering My Fears

Everyone has their fears.

Some people hate spiders, others don't do well with heights, still others get nervous on airplanes. Mine biggest fear is motorcycles.

Let me explain: as a 15-year old budding basketball player, my idol was a point guard named Jason Williams. In 2001, he led my beloved Duke Blue Devils to the national championship (a game I attended). He was strong and elegant, and could do anything on the basketball court. I loved him.

After one year in the NBA, Jason Williams got on a motorcycle one day and crashed, sustaining serious injuries. He never played professional basketball again. Hearing that, I swore to never get on a two-wheeled, motorized device, for the rest of my life.

Fast-forward eight years. EVERYONE in Kampala takes boda-bodas. They are quick and cheap, and with traffic jams galore, bodas are by far the most efficient means of transportation. Everyone does it, except for me.

Until now.

This morning, I forgot my cell phone at my apartment. With lots of work to do, and friends coming into town, I needed to run home and get it quickly. I walked home - about 15 minutes - and retrived it, but was running out of time. Outside of my apartment complex, a boda driver waited patiently.

We locked eyes, and he motioned me over. "Mulago Hospital?" I asked him. He nodded.

I got on the back, clenching his shirt a bit too tightly. "Pole pole," I said. Slowly, slowly.

We lurched forward, over a bump. I thought I was going to be bucked off and tightened my grip on my poor driver. He snorted, and looked back at me over his shoulder.

Once on the main rode, we cruised towards the hospital. It was... fun! Not nearly as scary as I expected. I loosened my grip, and began to smile. I was riding a boda-boda, in Kampala! Surely, I became a bit more Ugandan on that ride.

Upon arriving at the hospital, I jumped off the motorcycle like an old pro and gave the driver a big high-five. He asked for 500 shillings, I paid him 1,000. It was glorious.

Don't worry mother, I won't make riding boda-bodas a habit. But I conquered my fear, and it feels wonderful. Does this mean I have to change the name of my blog?

Wednesday, June 30, 2010

Growing Up...

Sharon is a beautiful, vibrant 23-year old woman. With light brown skin, dark almond eyes, and a lovely smile, you would not think twice if you saw her modeling the latest fashions in a magazine or strutting down a runway in New York or Milan.

Mercy is a bouncy, lively 24-year old woman. With dark curls and a sheepish grin, she giggles constantly, and loves reading and hanging out with her many friends.

Gideon is a shy, sweet 22-year old young man. With sunken eyes, a wispy goatee, and a small, athletic frame, you have to lean in to hear his quiet voice. He told me he’s certain that Brazil is going to win the World Cup.


Above: Sharon and Mercy at the IDI clinic

All three are kind, smart young people around my age. We deal with many of the same pressures and issues: fights with friends, impressing the opposite sex, finding work, and most of all, figuring out what kind of person we want to be as adulthood steadily approaches.

There’s only one major difference: Sharon, Mercy and Gideon are trying to do all that while living with the HIV virus.

Once a week, the Infectious Disease Institute holds a clinic specifically for young adults, ages 16-24. These patients receive medication, and listen to workshops focusing on, among other things, health and well-being, computer skills, and business acumen. Peer counselors are on hand to discuss HIV-related issues with the patients. A staff member told me that up to 100 young people come each week for the clinic.

Speaking with them, I was struck by how similar we are. Sharon spoke glowingly about her loving parents that support her every decision. Gideon and I watched a World Cup game on television and discussed how best to convince a pretty girl to go on a date with you. Mercy told me that she often feels bad about having to choose to hang out with one group of friends over another.

And yet, I simply cannot comprehend the dilemmas and obstacles my three new friends face. For Sharon, coming to the clinic is extremely difficult while holding a job, as she can’t tell her boss about her positive status or she will be fired. Attending school, while regularly visiting the clinic and taking invasive drugs, is extraordinarily hard. Finding a boyfriend or girlfriend is even tougher. These young people yearn for a partner, and know that they must disclose the fact that they are HIV positive, but dread having someone they like leave them. A youth counselor named Rachel told me that many couples do try and stay together even if one person is HIV positive, but there are no guarantees.

Gideon’s story is perhaps the most tragic. He moved to Kampala three months ago to find work, living with friends of his former guardians back home in a small village on the Ugandan-Congo border. After being verbally and physically abused by his new landlords, he moved out. One month ago, Gideon discovered he is HIV positive. Now, living alone in a tiny apartment without running water or electricity, he has no money and not a single friend in Kampala. What money he does make comes from selling meat on a skewer. He has no one to confide in, no one to trust.

After telling me his story, Gideon asked for my advice. I was speechless.

Growing up is hard. My peers and I continue to get older and work through the pains and obstacles brought on by maturity. It’s often difficult to know if you’re making the right decision, who you can rely on, and what’s best for your future.

Sharon, Mercy and Gideon deal with the same issues. But they also do daily battle with the HIV virus and the pain that it brings physically, mentally, and emotionally.

I can’t even imagine.

The Obama Dry Cleaners

So far in Kampala, I have enjoyed a cold beer at the Obama bar, stopped in the Obama church, haggled over the price of an Obama belt buckle and, if I ever need shirts pressed, will make sure to take them to the Obama dry cleaners.

After working on President Obama's campaign, and then in his Administration for a year and a half, I was curious to see what Ugandans would think of America's first African-American president, whose father comes from Kenya, just to the north. I got the answer I was expecting: utter infatuation. In the rural districts, men and women wear "Yes We Can" t-shirts. When I tell people I come from Washington, D.C., it's a guarantee that they say, "Where Obama lives!" You see Obama bumper stickers on cars (not sure where they got them, we certainly didn't have any in our campaign office).

Eyes light up when I tell Ugandans I used to work for Barack Obama. Some have even asked me if I can convince the president to come visit Uganda. Sure, I say, I'll just give him a call...

The change in attitudes towards America, simply based on his election as president, is palpable and tangible. I have had numerous people say to me that they thought America was destructive and evil under a certain former president, but that if the American people could elect Barack Obama, we must be alright.

But there is another, more subtle, reaction to our 44th president going on, particularly in NGO circles. Think what you want about George W. Bush, but he made a committed and sustained push to combat AIDS around the world, and specifically in Africa. PEPFAR (the President's Emergency Plan for AIDS Relief), launched by W. in 2003, funnelled billions of dollars to African governments and organizations devoted to AIDS research, prevention, and care. The results have been mostly positive, as AIDS rates are dropping around the continent (although they are beginning to rise again in Uganda).

By contrast, in his time in office, Barack Obama has had to deal with the worst economic climate in 80 years, two wars, and more recently, a horrific oil spill. As I try to explain, it's not that our President isn't as devoted to helping Africa; it's just that he's been busy and purse strings are tight. But how do you tell Africans that their plight is simply not a priority for the American people?

Some here in Uganda are frustrated with Obama. They understand the historical significance of his election, but wish he would devote more time, energy, and resources to his father's home continent. As one colleague told me, in Africa, Obama is beloved as a person and as an idea, but the jury is still out on his policies.

I plan to discuss this topic further with my Ugandan friends and co-workers over beers at the Obama bar.

Tuesday, June 29, 2010

The Friends Council

Having grown up in Washington, D.C., and having just worked in the world of American politics for the last two years, I confess to being a bit jaded regarding the possibility of true cooperation and political representation.

While many work in the business of politics to enact reforms that they believe will help the American people, others are motivated by avarice, prestige, and power. These days, constructive dialogue and compromise are rarities in Washington, D.C.

Contrast the situation that I left with the one I found myself in today, sitting in a meeting of the Friends Council at the Infectious Disease Institute in Kampala. The Council is made up of 11 members, five from IDI and six from other clinics around Kampala. They are elected by their peers to serve 18-month terms on the board.

The Council, seven women and four men, advocates for HIV/AIDS patients in Kampala and around Uganda. They come together every quarter to discuss the issues that matter most to those that are infected with the virus. Today, topics ranged from increasing the number of chairs and boardgames in the clinics, to disseminating female condoms and how to institute cards that track medicine dosage for illiterate patients.

I was struck by the earnest dialogue that took place. The council members were there not to preen or ramble; they were there to work. Members were respectful, opinions were heard and discussed, and conclusions were reached. All were interested in only one thing: working to better the lives of HIV/AIDS patients in their communities.

At one point, a disagreement arose about how to replace lost ID cards and prevent the theft of expensive drugs from clinics. Voices were raised. But instead of deteriorating, one woman calmly suggested a compromise. Council members nodded their heads in approval, satisfied at the common ground.

Sitting in the meeting, it was easy to forget that members of the Council are patients themselves. All of them are infected with the HIV virus. Think about that for a moment. While waging an all-out war against a ravaging disease tearing at them physically, mentally, and emotionally, these 11 men and women were volunteering their time and energy to work for the betterment of others, to support those around them and advocate on their behalf. They all had lives to live, and families to support. Some travelled long distances to attend. All participated heartily, making their voices heard and working towards solutions. They stepped up to become leaders in their communities, not for money or fame, but to ameliorate the lives of their friends and families in ways big and small.

Near the end of the meeting, one member of the IDI staff thanked the group for their energy, and implored them to keep fighting. "Push for policies and government funding that help you, and help your community," he said. "That's the only way we will survive."

I wish more people working in Washington, D.C., could have been in that meeting.

Monday, June 28, 2010

USA-Ghana

Most of you know by now that the USA was unceremoniously knocked out of the World Cup on Saturday night by Ghana, the only African team remaining in the first Cup ever played on African soil. Due to a lack of electricity at the lodge where I stayed in Murchison Falls National Park this weekend, I was unable to watch the game, but seemingly everyone in Uganda wants to discuss it with me after learning I am American.

The world knows that as a nation, we have not adopted football, but Ugandans also see the USA as the preeminent superpower on Earth, and take tremendous glee in the fact that an African nation beat us. "But this isn't that surprising," I try to convince them. No matter. In their eyes, a little African nation beat the all-powerful Americans. Case closed, time to celebrate.

There is some truth to this worldview. With unparalleled resources and a huge pool to choose from, the U.S. should theoretically succeed in football (and just about everything else, for that matter). In comparison, Ghana is tiny, relatively poor, and shouldn't stand a chance. But that's the beauty of the World Cup. In no other forum could a small West African nation stand up to, and beat, the United States. I can understand the jubilation taking place all across Africa right now. I don't like it, but I get it.

Over the past few weeks, I have become quite the USA football fan. I wear my jersey proudly, brag about Donovan, Dempsey and the boys to anyone who will listen, and watch every game. They were a scrappy, physical, resilient bunch, and easy to root for. Even though I'm happy that an African nation has advanced, I wish it wasn't at the expense of the Americans.

On Sunday, I was talking about the game with a security guard at the national park. He asked me if I was sad about the result, and I told him yes. He smiled and said, "I am very happy that Ghana beat the United States." He paused for a second, and then continued. "But you are a superpower, so in the end, you win."

I guess we do...

Safari at Murchison Falls!

Note: if you want to see pictures from the safari weekend, check out my facebook profile or visit: http://www.facebook.com/album.php?aid=2067524&id=8400574

It is an uncomfortable feeling when you find yourself in a position where you're well-being is completely out of your hands. For those that are afraid of flying, I would imagine this is why. Something bad could happen to you (even if it probably won't), and there's nothing you can do to prevent it.

That's how I felt staring into the eyes of a four ton rhinoceros yesterday. Only about 25 feet away, we crossed paths in an open field near Murchison Falls National Park in northwest Uganda. I was immediately struck by his massive girth. When you see an animal in a zoo, or even from a car on safari, it's difficult to gauge just how big it is. But put yourself on a level playing field, and the size disparity smacks you in the face. She was huge!! Even worse for my well-being, she was grazing with her new-born baby named Obama (more on this later). A wild animal will do just about anything to protect her young. When you're talking about an 8,000 pound rhino, I shudder thinking about what "anything" might be.

Of course, just like flying on an airplane, the chances of encountering any real danger were slim. Rhinos are peaceful grazers, and the two that I saw contently munched on grass, occasionally glancing up to look at their observers, before returning to lunch. They rarely act aggressively, and that's for the best, as their massive horns, almost prehistoric in appearance, could do serious damage. After about thirty minutes of watching them in silence, we moved on. It was a fitting end to an incredible weekend on safari in Murchison Falls.

The journey started on Friday, as five friends and I loaded into a van and made the five hour trek from Kampala to Murchison Falls. On the way, we picked up another friend in a town (more like an intersection) called Kafu. While waiting for her, I engaged some of the local merchants selling meat on a stick. We discussed the World Cup, they asked what America was like and if I could bring them a mzungu girlfriend, and I ended up selling two of my safari-mates for 500 cows. Unfortunately, the transaction was voided.

Upon arriving at our lodge, we drove to the actual falls themselves, a truly amazing sight. At this point in the Nile, the wide river converges into a gorge about 20 feet wide, causing the water to rush through with incredible force. I'm not sure how water force is measured, but Murchison Falls is the most powerful waterfall in the world. We hiked around the falls, took in the sights, and then retired back to the lodge for the evening. Wake-up calls for the safari were scheduled for 4:30 am the next morning, so we needed our rest.

---

We arrived at the beginning of our safari just as the sun was rising above the Nile, making for a beautiful African landscape. Only one problem: it was 7 am, I had already been awake for two-and-a-half hours, and there was no Starbucks for about 5,000 miles in any direction! Oh well, I persevered. We set off into the park, our driver David at the helm, and seven eager mzungus riding along in back. Almost immediately, we spotted a gigantic mass about 100 yards off the road -- an elephant! Whatever haze I was in due to a lack of caffeine was shaken off immediately. I can't describe the feeling of seeing one of the mythologized African mammals in the wild. After seeing them for years in zoos, the real thing is magical. Here they are, on the savanna! As I muttered to my friends over and over again, "this is so cool!"

We continued on through the park. The terrain was hilly, with wide swaths of grassy fields interrupted occasionally by collections of trees. We came across wildebeests, warthogs, antelopes, water buffaloes, a leopard (but very far away), lots of different species of birds, and my favorite, giraffes. Seeing a herd of giraffes slowly amble across the landscape is a truly incredible sight.

Perhaps the funniest moment of the day came near the end of the morning safari. David, our hilarious Ugandan guide, is an ornithologist, or bird-watcher. Books about East African birds were strewn about his van. Whenever he would see a new species, he would stop the car and excitedly tell us all about it: what it ate, where it lived, who it was rooting for in the World Cup, etc. "Boringgg," I thought, but kept my mouth shut because David was so excited, and I needed him to get back to Kampala.

As we were riding along, David screeched the car to a halt, and pointed out a small, red-chested bird on our right. It was about the size of a pigeon, and not much more interesting, at least to me. As he was talking about its qualities and preferences, I noted something out of the corner of my eye, and it kept getting bigger. An elephant appeared from behind the brush and was crossing the road about ten meters in front of us!

"David," I screamed, "pull the car up! There's an elephant right there!"

David looked at me, perplexed. "First, you all take a picture of the bird. Then, we go."

"David, if you don't pull this frickin' car up right now, I'm getting out! It's walking away!!"

My safari-mates laughed hysterically. Our guide looked at me with a combination of pity and annoyance, and then moved the van forward. Luckily, we were able to see the elephant up-close, and I snapped some great photos.

In the afternoon, we took a cruise up the Nile to the base of Murchison Falls. On the way, we saw hundreds of hippos, elephants drinking on the banks, and a few crocodiles. The day was beautiful, the river teeming with wildlife, and the beer on the boat was cold. Nothing could have been better.

My night ended sitting by candlelight at our lodge (there was no electricity), listening to the USA-Ghana soccer game on the radio in Lugandan while David alternated between translating, laughing at me, and falling asleep. When he told me that the U.S. scored the equalizing goal in the second half, I'm quite certain I roused the park's entire elephant population sleeping far away as I ran around the grounds of the lodge, wearing my American jersey, screaming U-S-A! Alas, the game ended badly, but I'll always remember the circumstances listening to the game. Much more fun than just watching in a bar.

Early on Sunday morning, our group awoke early and, with two guides, went chimpanzee trekking through the jungle. I was very excited to see our closest genetic cousins in their natural habitat. We were rewarded early on in our trek, as our guide spotted two chimps eating at the top of tall tree. We strained our necks and, using binoculars, could see the primates lazily lounging, eating fruit, and then tossing the rinds to the ground below. I was hoping to have a "the chimps are just like us!" moment, but alas, they were too far away to enjoy any such revelations.

We trekked on, but unfortunately, came across no more chimpanzees. Still, walking through the dense jungle, listening to the sounds of wildlife hidden in the thicket and watching us from the trees, was amazing. So often, we seek experiences that bill themselves as "wild," when in fact they are just slivers or imitations of nature. Even on my safari a day earlier, I felt shielded. We were, after all, sitting in a car, able to drive away at any minute should an animal act unpredictably. It's rare that we truly immerse ourselves in untamed surroundings. Walking through the jungle, my friends and I did just that. In an expansive jungle that seems to go forever, you feel very small.

Finally, just before heading home to Kampala, we had our run-in with the rhino. I became very excited to learn that the baby rhino, the first rhinoceros born in Uganda in almost 30 years, was named Obama. Hunted to extinction in the country in the 1980's, rhinos are just starting to make a comeback with the help of the Ugandan government and devoted conservationalists. Obama the Rhino's mother was born in a zoo in the U.S. and his father born in Kenya, making his name an obvious choice. See? Obama makes history in more ways than one.

I will be posting pictures and more thoughts from the safari weekend later this week. Hope everyone is well!

Thursday, June 24, 2010

Lions and Tigers and Bears... or not

Just a quick note for all you faithful followers out there (talking to you, Grandma!!). This weekend, I'll be heading up to Murchison Falls National Park with a few friends to go on safari.

Along with lions, elephants, giraffes and the normal national geographic set, the park has one of the largest wild chimpanzee populations in the world, and we are going to trek into the jungle to see them. It should be pretty amazing.

Don't worry guys, I won't adopt one like that crazy woman in Connecticut:
http://www.huffingtonpost.com/2009/11/11/charla-nash-chimp-attack_n_354001.html

I'll post on Monday with updates on any and all adventures.

Have a great weekend, and go USA!!

Plastic Water Bottles



The young boy, held tenderly by his mother, stared at me with unabashed curiosity, and then back into his mother’s eyes. He said something to her in Luganda, and the group of women and their children turned to me and laughed heartily.

“What did he say?” I asked Angelina, my colleague in the communications department at IDI. Angelina giggled.

“She said that you have a small nose. And that you are hairy.”

That little boy’s observation about my mzungu appearance was my welcome to Kiboga District. I spent time there this week touring the local health facilities supported by IDI in the district with two colleagues, Angelina and Medard, and a documentary film crew as they filmed newly constructed buildings and interviewed the staff at each location. As a mzungu who recently arrived in Uganda, it was my first trip outside of Kampala. While the local children might have had fun observing me, I most certainly learned far more from them.

At our first stop, we met Veronicah, a young medical worker, who explained some of the challenges she faces trying to help people living with HIV in rural areas. The ratio of patients to medical staff is extraordinarily high, and the supply of drugs too low. However, she beamed when discussing the new building recently built by IDI, which allows Veronicah and her colleagues to treat far more patients in an orderly and secure environment.

We continued on to Kiboga Referral Hospital, and then to a number of satellite locations. At each, there was a stark contrast between an old building and a newer structure that significantly upgraded the capabilities of the clinic. All built recently by IDI, these new structures have made getting care more efficient and more accessible for an untold number of Ugandans living with infectious diseases.

At one our of last stops, we parked our van next to the clinic and, seeing me, at least a dozen children came running to greet us. At first, they were wary, eyeing me like a guppy might look at a shark – no sudden movements, unsure of what to make of me. Finally, they loosened up, and in no time, we were fast friends. They would come near me and offer high-fives, or just want to get a closer look. Occasionally, I would run at the kids, causing them to scatter quickly, all the while laughing with glee. Gather around me, then scatter. Gather, then scatter. And so it went for some time. Just kids playing, experimenting, enjoying something new. And I knew that just about all of them were very sick, born with the HIV/AIDS virus.

Finally, we loaded up the van to depart, and the kids faces turned sullen. Sad we were leaving, I asked Angelina what, if anything, we could give them. She had an idea. Scattered on the floor of the van were empty water bottles from the day. She picked one up and held it out of the window. The children clamored, excitedly. She gave the bottle to one kid, and then another to another. A look of pure jubilation came across their faces when they received an empty water bottle. Finally, I held the last bottle, and a few children remained. One girl, in a pretty but worn pink dress and holding a small baby, peered at me. She was not aggressive like the others. I motioned for her to come to the van, and handed her the bottle. Her face shone of unabashed elation. She curtsied, and scampered off.

Think about that for a moment. It took an empty water bottle to make that little girl’s day. I promised myself not to use this blog to preach or scold, and so I will refrain. But the next time I bemoan the fact that I don’t have an iPad, or a hotel room I’m in doesn’t have a comfortable bed, I’ll remember that girl.

Reading about the HIV/AIDS epidemic from far-away places like my living room in Washington, D.C., it’s easy to analyze the situation in a big picture context. How many millions are infected? Are rates going up or down? And how many billions of dollars will it take to improve the situation on a huge, complicated continent? But meeting Ugandan children personalizes the disease in a way I could have never imagined before I arrived in here. It makes the work done by everyone at IDI that much more tangible and worthwhile.

As the day ended and we sat in endless traffic on our way back to Kampala, I reflected on the work done by the doctors, nurses and staff that I met in the Kiboga District. While IDI does a tremendous job of providing resources and support, it’s never enough. How could it be? Challenged by limited space and medical supplies, and an ever-expanding list of patients, the doctors and nurses face extraordinarily odds and work diligently, saving countless lives, always doing it with a smile on their faces. They were some of the most welcoming and generous people I have met, anywhere. At each location, a doctor or nurse explained the challenges they face with honesty, but remained hopeful that they can help the numerous patients who desperately need their services.

Patients like a little girl in a pretty pick dress.

Nsenene!

"It's such a small world!"

This is a phrase we say quite often, when we run into a old acquaintance in a bar, or we have common friends on facebook, or we meet someone whose parents know our parents.

Well, I am now convinced that it is, in fact, a really small world. On my first day in Kampala, I ran into Miriam Schwartz. If that name sounds familiar to some of my high school friends, it should! Miriam was three years older than me at Georgetown Day School, home of the Mighty Hoppers (our fearsome mascot). Turns out, she had been working at IDI, the clinic where I am, for the past year. I can't tell you how reassuring it was to see a familiar face on that first day on a strange, new continent.

Unfortunately, Miriam had to leave Uganda a few days ago to return to the U.S. and finish medical school. To celebrate her last night, Miriam, my colleague Angelina, and I went out to eat traditional Ugandan pork, a delicacy here. As we were sitting at our table, a street vendor ambled up to us holding a big bucket.

"Yes! You have to try these!" Miriam squealed when she saw him.

"What are they?" I asked, hesitantly.

"Nsenene," she said, as Miriam and Angelina could barely contain their laughter.

I peered into the bucket. Inside were hundreds, if not thousands, of dead grasshoppers. I shuddered. No way was I putting one of those in my mouth. While I don't think of myself as overly cautious, let's just say I was in no hurry to eat a hopper.

Miriam took my hand and plunged it into the bucket, ordering me to grab a few nsenene. I relented, and picked up a little one. It felt airy and frail in my hand. I peered at my future meal, and unnervingly, the eyes of the dead hopper peered back at me!

Cringing, I looked at my two friends and gulped. I put the dead insect in my mouth. It was... not bad! It crunched like a potato chip, and was a bit salty. Miriam laughed and then popped a grasshopper in her mouth. I swallowed the nsenene, and the vendor asked if I wanted to buy a whole bag. Nope, one was enough for me, thanks.

Think it's a small world when you run into a friend from college at a bar in the west village? Last weekend, there were two Mighty hoppers eating hoppers in Kampala!!

Wednesday, June 23, 2010

USA!!!

A quick note about the World Cup and the USA's thrilling victory to win their group and advance to the elimination round.

It's a given that we Americans don't really appreciate "the beautiful game." True, we ALL play until we are about 12 years old (I still miss those orange slices), and then every four years, become patriotic and root on our boys in the World Cup. But unlike the rest of the world, most of us think of true football as a fun, once-every-four-years respite from our normal sporting schedule. Think about it. If you saw a professional soccer game on television, and the Brewers were playing the Pirates in June, which one would you watch?

Of course, for most of the rest of the world, football is life. And that's what I have witnessed in Africa over the past week. Every night, people of all sizes and colors gather at the local bars to watch the World Cup. It's the best conversation starter there is; no matter who I'm talking to, if I ask who their team is, we instantly become friends. Ugandans in particular are passionate about the game. One Ugandan friend told me that if his home nation makes the World Cup, which it has never done, he can die happy. Nothing else matters. And Red Sox fans call themselves intense.

Tonight, about 25 Americans gathered at a bar in Kampala to watch USA take on Algeria. We were on the edge of our seats for 91 minutes, and when Landon Donovan poked home the game-winner, the place exploded. We hugged and kissed, drank and danced. In other words, we acted like non-Americans.



Heavily breathing, with a beer poured on my head, I escaped the bar and stepped outside to catch my breath. A Ugandan was standing outside. He looked at me, in my U.S. soccer jersey, and laughed. "Now don't you Americans see why it's the best game in the world?" he asked.

Yup, I think I got it.

My Friend Kenneth



Everyone, meet my good friend Kenneth.

Kenneth just turned two. We met in Kiboga, a rural district about two hours from Kampala.

He loves basketball (or at least I'm pretending he does, as evidenced by his "Slam Dunk" tee shirt). Kenneth also loves playing peek-a-boo, hide and seek, putting his fingers in his mouth, and exchanging lots of high-fives and hugs.

He approached me as a I sat on the steps of an IDI clinic in his village, and for the next 20 minutes, we giggled and played games. When I had to leave, he gave me a big hug and smiled. Kenneth is a bright, curious, social fellow, not to mention he's adorable. In other words, he's a normal, growing two-year old.

Except that he's not.

Kenneth was born with the HIV virus. His parents died from the virus. The doctors in Kiboga don't give him long to live.

Rafting the Nile

I’m upside-down, being tossed around like a t-shirt in a washing machine, caught in a whipping current, and I think I’m going to die. Ok, so perhaps that’s a bit of an overstatement, but it’s a discomforting sensation to be thrown from a raft and plunged into the churning waters of a class V rapid on the Nile, and have no ability to control your fate. You are at the mercy of the swirling water. The only thing you can do is hold your breath, close your eyes, and hope that you pop up further on down the river.

Of course, you do surface sooner or later, you life jacket ensures it. But whitewater rafting the Nile is quite an experience. Last weekend, I gathered the courage to drive two hours from Kampala, my adopted home for the summer, to Jinja, a small town at the base of the Nile River. This stretch of water is known as perhaps the toughest rafting in the world. There are four class V rapids, the highest one can do without being a professional (or certifiably insane). Friends here that had done the trip told me that it was incredibly fun, incredibly memorable, and incredibly scary. “You’ve rafted plenty of rivers,” I told myself. “This can’t be that bad.” In retrospect, those sentiments are laughable.

I loaded into my raft with two other Americans, medical students volunteering in Kampala, a Chinese couple and a Japanese couple, the four of whom spoke a combined three words of English. Our guide, a charming Ugandan named Peter who looked like he was no more than fifteen years old, found this hilarious. He could hardly get through giving us instructions without breaking down in laughter at the quizzical looks on the faces of my raft-mates. When Peter said paddle, they didn’t. When Peter said stay in the boat, they jumped out. “Great,” I thought. “Half the boat can’t understand the guide. This should be interesting.”

After a morning of torrential rain, the skies cleared and we were on our way. The first few rapids went quite well. They were big, but we cruised through and the boat stayed upright. I was gaining foolish confidence. Finally, about an hour into the trip, we approached a class V torrent nicknamed Silverback, the longest rapid on the river. As we approached, the first look of seriousness came over our guide’s face. If you fall off, Peter explained, hold on to the raft and I will pull you back in. He wasn’t joking.

The water quickened and we entered Silverback, immediately were smashed by a punishing wave. The boat went perpendicular to the river, with my side cresting above the frothy water. Before I knew it, I was spring boarded from the raft and into the depths. The first few seconds were terrifying. It’s like every piece of your body is being pushed in a direction opposite the one next to it. I went limp, like a ragdoll. With no idea which way was up, which way was down, and which way the current was taking me, I began to talk to myself. “Keep holding your breath,” I told myself. But I couldn’t. I swallowed one gulp of Nile water, and then another. Finally, after what seemed like an eternity – but was probably closer to 20 seconds – I saw daylight. Coughing, I took a quick breath of air only to be submerged again and thrown underneath. Finally, after about 200 meters of crazy whitewater, I looked up to see the raft near me, and was pulled out of the drink by my savior Peter who, by the way, found my ordeal quite funny.

I should note that the parts of the trip that were spent above water were breathtakingly beautiful. Uganda is a gem, called “the Pearl of Africa” by Winston Churchill when he first laid eyes on its striking terrain. We passed through dense jungle and rolling hills. Villagers would come to the banks and should “Hello Mzungu!” at us (Mzungu is the Ugandan all-encompassing, not terribly derogatory term for white people). In calm stretches, naked children would jump in and swim after the raft until they tired. It was also humbling to be rafting at the origin of the Nile, perhaps the most important river in world history. I imagined what it would be life to continue on all the way to Egypt, as early settlers tried (and often failed). The length of the river, both in terms of miles and centuries of history, is awe-inspiring.

But back to the rafting. The last rapid of the day was aptly named “The Bad Place.” It was optional, as Peter gave us the choice to get out of the raft and watch while those crazy enough to enter risked their lives and limbs. The three Americans whole-heartedly accepted the challenge. The Asian couples had no idea what was going on, and smiled. Peter laughed.

The Bad Place is truly that, a narrow stretch where the mighty Nile dumps its waters into a canyon far too small to handle the volume it receives. This makes for a fast, powerful blast of river. Having pulled the raft to the banks, we watched another boat go through – they made it! A rarity, to be sure, but they stayed upright. Ok, let’s do this. We got in the boat and pushed off, Peter yelling instructions while trying not to grin, aware of the fate that was to come. Immediately, we were sucked into a hole in the river and then, like a wide receiver being crushed by a linebacker as he catches a pass, we were enveloped by a wave. The raft crumpled, and we were tossed. Sitting in the front of the raft, it felt as though I had been punched viciously in the solar plexus. The wind was knocked out of me as I was thrown a few meters from the boat. Just like before, after much struggling, I mercifully emerged further on down the river, in one piece.

I survived the Nile. Barely. It was exhausting, as I could barely walk up the hill to the van that was to take us to salvation: barbeque and beer. My ears were still ringing for hours afterwards, and my head pounded. There’s no question, however, that it was by far one of the most exhilarating experiences of my life.

An Introduction to Uganda

When I think of my first few days in Kampala, my initial sentiments towards the city can be summed up in a greeting used by most of the Ugandans that I have encountered. Upon meeting someone from Kampala, they normally ask where I come from. “United States,” I tell them. “You’re welcome,” they respond with a smile.

Greeted this way for the first time, I looked around uneasily, trying to figure out what the local had done to help me and what I had done to give the impression that I was offering thanks. But Ugandans mean it literally. They want me to know that I am welcome in their country, their home, and from the moment I set foot in Uganda, I have felt that way. Ugandans are warm and cordial. Despite widespread poverty across the country, the scourge of infectious diseases like HIV/AIDS, malaria and tuberculosis, they are a people that smile. A lot. They smile when discussing the weather (which has been good so far), and they smile when discussing football (obsession is a severe understatement when discussing how Africans feel about the World Cup). People offer directions on the street, children wave hello and there is a general feeling of congeniality in the air that home often lacks. Could this be because they see a mzungu (white person) and think that I have money to spare? Of course. But there is no denying that the Ugandan people are a friendly lot.

They are also proud. Ugandan men and women take incredible pride in their appearance. The men wear dress shirts, dark pants and shined shoes to work. Women either wear professional outfits, or beautiful traditional robes. The garments hint at a burgeoning middle class in Kampala. There is truly a banking and telecommunications revolution taking place. There is a bank on every corner, and everyone, and I mean everyone, has a cell phone. But smart dressers are not confined to the metropolis. On a trip to the Kiboga district, I was greeted by men in button-down shirts and slacks, and even business suits, as they rode their bicycles and boda-bodas (motorized scooters) down dusty roads. They live in communities mired in poverty, yet choose to wear hot, formal clothes, even during intense African heat. Like I said, a proud people.

If the people are friendly, safe and polite, the city itself offers a stark contrast. Keep in mind that I have only been here for a week, and these are just initial impressions. But Kampala is not a beautiful city, in the traditional sense of the term. There are few monuments and museums, parks and open spaces. The Ugandan capital is chaotic and stressful, and can be overwhelming at times. Conveniences designed to maintain public safety – and ones that we Americans don’t think twice about – such as cross-walks and stop lights, tow trucks and traffic cops, are few and far between. Cars and boda-bodas whiz by at top speed, making crossing the street an adventure. Combine that with the fact that they drive on the wrong (read: British) side of the road, and I have already had a few near-death experiences.

Most of all, Kampala is a city in transition. Thirty years after Idi Amin left power, the capital has made a remarkable comeback. There are lively markets, upscale hotels, international restaurants and a thumping nightlife. Foreign investment is booming, evidenced by the growing number of multi-national corporations that are setting up shop in town. Old, decrepit buildings are torn down and modern offices and apartments spring up. Elementary schools and medical clinics dot the main roads, providing educational resources and healthcare to a growing number of Ugandans (although far too many still lack decent schools and medical care).

But poverty remains rampant. Just a few blocks from the hospital where I work, in an upscale neighborhood, is a massive slum. Driving by it, a colleague quietly murmured a warning to me: “Don’t go there.” The political system, while relatively stable, is seen as self-serving and corrupt. Ten years ago, I imagine Kampala would have had few of the luxuries that I am enjoying (I have eaten great Indian food, drank good local beer, and even went bowling). Ten years from now, it will be interesting to see if Kampala continues its rush towards progress, or whether the city, like many of its African peers, regresses.

Still, my first week here has left me hopeful, and the reason lies with the kindness of its people. Last weekend, I went whitewater rafting in the town of Jinja, situated at the birthplace of the Nile River, about two hours from Kampala (more on this to come). The next morning, as I tried to find a matatu (public taxi) back into the capital, I came across a group of five or six children playing by the street while their mother looked on. With nothing to do, I knelt down and extended my hand. Happily, the kids took turns running up to me, giving me a high five, and then sprinting away. I was strange and exotic and exciting to them. We then found a makeshift soccer ball, and began to play. After a few minutes, the children were climbing all over me as we all could hardly contain our giggles. Then, their mother got up and walked towards me. I expected her to be cold; here I was, a strange, white person playing with her children. She would have been forgiven for thinking I was a threat. The mother walked up to me slowly, placed her hand on my shoulder, and looked at me for a few seconds. Then, she smiled.

“You’re welcome,” she said.