…… applications for the first grade

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On Monday and Tuesday of this past week, the compound was full of screaming excited 5 and 6 year old boys and girls. The energy level was outrageous…. Kibaale Community School was accepting applications for the first grade… or for those in Uganda, Nursery 1. In Canada and in the USA the new school year starts in September but in Uganda the beginning of the next grade or the start of school is the last week in January.

At 8 am on both days, there was a line up at the gate to enter. All the mothers came dressed in their finest goma (an Ugandan dress)….. there was a bright array of colourful dresses covering the grassy lawn just outside the sponsorship office. Each mother had to speak with one of the office staff since many mothers do not read or write but know the importance of a good school…. Kibaale has a very fine reputation since many of the students are able to pass the various exams which allow a student to continue their education as far as university.

The reason why I am writing this blog is because after two days of craziness….the sponsorship office staff were able to complete over 500 applications. Yes, over 500 mothers wanted their little James, Janet, Joyce or Johnny to get one of the possible 45 seats available in Nursery 1 at Kibaale Community School….

The sponsorship staff will spend the month of January going over every application carefully; then going out into the community and seeing which ones of these 500 plus students are the most needy…. because the hope is that each one of these new students will find a sponsor who will help them with their education….

In this rural part of Uganda …. education of one child is very expensive for the average family…. and no family has just one child. Many families in this area have more than 4 children. Beside their own children, it is not unusual for a family to take in one or two or three children who have been left, abandoned for a variety of reasons: death of mother, father departed and left the mother with all the kids to care for, lack of family ability to support all the children and family members with AIDS, poor crops, and abuse to name a few…..

Education gives the child… the family…… and the community hope and the opportunity for everyone to move forward and grow. There are presently four members of the clinic staff who were born and raised in Kibaale area, completed their education in various cities across Uganda with financial support from sponsors and now have chosen to return to Kibaale and give back to their community….. I think it is amazing!!!!!!

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….. December 1, 2012

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December 1 is World AIDS Day…..

A few weeks ago, in late November, Rakai District sent all clinics a notice that they were a little short of funds for the events plan for World AIDS Day. After much discussion with various people, we decided to help support the event….. as I was handing over the shillings to one of the coordinator, I was graciously invited to come and see what was happening…. I had not thought about going until that moment.

The theme for this year is “Re-awakening leadership against AIDS”. Rakai District was going to have there celebration at Kasensero (Ca-sense-ee-row). Now, I have never been to this village but was told it was a very small fishing village on Lake Victoria near the Tanzanian boarder and the trip from Kibaale to Kasensero would take anything from 2 to 4 hours… This would all depend on the road and security. I understood that most of the trip would be on a single lane dirt road… what I mean is that only one vehicle can travel on the road at a time. The first vehicle has to move over and hang off the side of the road to let a second vehicle pass. What I did not understand was security….. everyone believed that the President of Uganda was coming to this event. I could understand why anyone was going to travel to the far end of Uganda to this place in the middle of nowhere. Nevertheless, I was interested in finding out what was happening with AIDS in Uganda. The clinic has the ability to test for AIDS and we counsel every patient who has been tested…. but we do not have or prescribe antiviral medications this is done at a government clinic.

The clinic was closed and seven of us left Dec 1 at 8:30 for Kasensero. We got as far as Ssanje (sand-gee) which is on the main road leading to Tanzania. We stopped for a few minutes which turned out to be many as one large white vehicle with black lettering stating UN passed us by. After the UN convoy passed by, I moved in behind the last truck and headed off down the road…. but by the time we reached the turn off… they were long gone. I was surprised at the speed they were traveling down this rugged, narrow dirt road.

Less than 30 minutes later, a dark blue police jeep pulled up behind me with sirens on… I pulled over to let at least 20 large, black, shiny impressive cars passed by….. Once again I moved into behind the last one and tried to follow them down the road but I was uncomfortable traveling at those speeds….. I may have gone a 3 or 5 miles when another dark blue police jeep pulled up beside me this time and told me to move over…. and another long convoy of big, black shiny cars passed me by. By now, the clinic staff were positive the President was coming to this AIDS Day events but I had my doubts.

Finally, at 11 o’clock we arrived and found parking in an off the road field; went through security where I was told I could not bring in my camera…..and was directed to seats under one of the six or seven large tents set up for various dignitaries. The next 2 1/2 hours was one set of amateur entertainment after another…. I made me think we were waiting for some… It was truly local talent from numerous school music and dance groups to a high school marching band to two young boys doing acrobatics…… Finally, the activities changed and became more like the start of the program… it was because the President of Uganda had arrived…. He walked into the small circle of tents and passed by the many booths promoting various items, programs or agencies for the fight against or supporting those with AIDS.

Once the national anthem of Uganda and AIDS had been played the speeches started…. I asked the staff what was being said but no one was willing to translate…. after numerous speeches, a little girl come up to the mike and just by her actions I guess that she was telling the President about her life with AIDS…. The clinic staff finally translated her story… she was an orphan, both parents and grandparents had died of AIDS…….. she asked the President for the necessary medications to kept her healthy, a new house and a new school since both were falling down….. It was just then that I understood the everyone’s speech as really a request for money.

There were two English speeches…. the first one was by an UN representative, Janet Jackson, presented the following information…. today, Uganda’s is one of two countries in Africa where the rate of AIDS has increased. In the beginning, Uganda was the example to all countries and governments how to educate about the ABCs for the prevention of AIDS, (A = abstinence; B = Be faithful during marriage; C = use condom); how to ensure that those affected receive the necessary antiviral medications; and how to support those living with the infection. But over the past few years things have changed….now 50% of those tested are positive and only 50% of those infected will receive antiviral medications. Unprotected sex and mother to baby transmission accounts for 99% of all cases…..

The second speech was from a gentleman who represented the international partners…. he expressed the deep concerns the foreign partners had as to why things had deteriorated over the past few years to cause a significant increase in Uganda’s rate of the infection.

By 3:30, I was hungry and the speeches were continuing… I had obtained the information I want… so we walked down the narrow vehicle filled street to see Lake Victoria and find some lunch which was fresh fish…. I would not call this village picturesque in any way…there was no motels, no hotels, no gas stations, no restaurants overlooking the lake with patios where you could enjoy a cup of coffee or tea… the village was made of old broken down wooden huts which look like they would fall down with the next wind storm…. it was foul smelling and dirty. I could not understand why a large event like this would take place in this village…. I later learned that the first case of AIDS in Uganda was from this village of Kasensero.

My plans were to leave at 4:30 so I could be home before dark… I do not like traveling on these road after sunset which is around 7 pm, but at 4:30, I quickly learned the President had just left…. Now, I had to wait for all the police vehicles and all the other support vehicles to depart before I could even think about moving my land cruiser.

I was expecting the trip home to be faster and easier but I was truly wrong…. first of all, many of those who had attend the event were impatient and wanted to get home immediately and therefore demanded that I pull over and let them pass… So it was stop and start most of the trip into Ssanje. We had to stopped to check and see if everyone was O.K. for two accident where the vehicle had rolled over but each time we were told everyone was alright.

I was less than a half mile from the turn off to Kibaale in Ssanje when I saw a very large military helicopter surrounded by the same vehicles who had just passed me minutes ago….. just then one of the staff informed me that the President had two appointments that afternoon. They did not say where the second one was…. I thought it must be in Ssanje… and I was wrong.

I was half way to Kibaale when I came face to face with a dark blue police jeep coming straight at me… I quickly pulled over and learned that the President had gone to the small village of Mannya to open the school and new health clinic. Now…. the various police and military vehicles were not coming from behind me but were coming towards me…. and once again I had to pull over and wait for them all to pass….. I saw the President a second time.

Once I got to Mannya….. the narrow dirt road was filled with crowds of people and I was not able to pass for sometime….. the trip back to Kibaale was extremely challenging…. I did not want to hit anyone and everyone was in very good spirits celebrating the fact the President of Uganda and come to their village….

Yesterday, I spoke to all members of the clinic staff about the events of December 1, World AIDS Day and I expected the discussion to be about the fact the President had come to this remote village but the staff talked for sometime about what we as a clinic can do to educate the community about the AIDS epidemic and the ABCs (abstinence, be faithful and the correct use of condoms); the importance of testing and receiving counselling of the results and making sure the person who is infected receives the antiviral medications….

….. an invitation to a celebration

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Last Friday, I was invited to be a guest at the Kibaale Vocational students graduation celebration. It was to start at 1 pm sharp…..

Friday was also a National holiday…. Eid al-Adha also called the Feast of the Sacrifice. It is a world wide Muslim holy day, a celebration to honour the willingness of the prophet Abraham to sacrifice his son as an act of submission to God. God intervened and a ram was provided as the sacrifice (Genesis chapter 22).

On Thursday afternoon, I had been asked to teach a leadership class for the Senior 5 and 6 girls at the Timothy Centre from 3:30 to 5:00. The purchase of medications for the clinic takes time and I did not think there would be enough time after class was over to run into town and shop….. So, I decided to leave first thing Friday morning and head down to Kibaale around 11:30

But this is Africa and things never go as you predict, hope or expect. Normally, I shop at one pharmacy; I check the prices, order the amounts, check the expiry dates and discuss price and manufactures of medications where there is more than one brand. From putting in the order to collecting the supplies packaged ready for travel can easily take up to 3 hours. On Friday it was raining, the downpour made me slow to start but I headed out…. The pharmacy did not have the everything I needed… one specific medication used in the treatment of Malaria called “Coartem”. I walked through the rain to a second pharmacy were I learned that they had increased the price almost 50%. Since I refused that price, I continued to wonder down the road stopping to purchase the other necessary items. I popped into another pharmacy and asked them their price for Coartem which resulted in discussion. The manager was willing to sell me as much as he had for a price I was willing to pay. Of course, this all took time…. What made everything take so much long was that even though many of the shops were closed those which were open were filled with smartly dressed Muslims…. young boys, and girls, men and women all out on the town to celebrate their special day……………………. and as a result I was going to be late. So, I called Kibaale to let them know I was on my way but was going to be late. coming….

The roads were wet and slippery especially the last 21 kilometers of dirt road into Kibaale but I finally made it…. it was 3:30. Before, I could stop the Land cruiser, one of the students was standing at my door ready to escort me into the celebration. I was given no time to change or fresh up…..

The students dinning hall which is a cement building with large open spaces for windows and doors was beautifully decorated. My escort directed me to a table at the front of the room. The MC announced my arrival and thanked me for coming.

The next 3 hours went quickly….. I arrived in time for the “food” which was typical Ugandan fair….. matoke, rice, beef, chicken with a lovely sauce accompanied by a soda. After the meal, there were many presentations including one which surprised me. The male students formed a line and in a slow rhythmic motion moved in time to the music around the floor ending up in front of specific teacher. As each student presented their gift, the male teacher would join the dance which brought cheers from the rest of the class…….

There were times in the celebration when the students were given the opportunity to get up and dance….. girls separately from the young men. As part of the activities, a piece of music was put on and those seated at the head table were expected to get up and dance…. YES, that included me. As I started to dance, there was a very loud cheer of appreciation for my willingness to be a participate in their celebration.

The last event of the ceremony was the presentation of awards to students who were outstanding in a certain area. when the Principal of the Vocation School announced the name…… if it was a male student who had won the award, he would slowly dance to the front of the hall to accept his gift whereas when a female student won an award, she would walk quickly to the front and race back to her seat.

There is so much pressure for students to complete the courses required to attend university…. and I think this is important. But there are those students who do not have the ability or desire to attend university. Kibaale Vocational school gives those students a trade… a future. There has been a sacrifice for each of these students to complete a two year vocational program….. Friday was their day to celebration…. Well done.

…… what is my name?

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A few weeks ago, the head of the primary classes in Kibaale Community Centre came and requested that each of her students be given medication for “worms”….a de-worming treatment. After speaking with our medical officer and the comprehensive nurse we all agreed that this was a great opportunity to talk to the students and teachers about hand washing as well.

The recommended medication was Albendazole… the treatment for worms is two Albendazole chew-able tablets to be taken at one time; no water or juice is necessary… they do not taste great but are very tolerable…… So, off I went to speak to each of the seven (7) classes about the importance of hand washing and then to give them the Albendazole tablets. The students would take the medication in my presence and the treatment for this term would be complete. The teachers informed me that in the past the students were de-wormed each semester. So, plans have been put in place for teaching on hand washing and a de-worming treatment to be done the second two or third week of each semester.

I brought back from Canada some teaching posters including one on a child washing her or his hands and one on the basic steps ….. 1. turn on the water; 2. wet hands; 3. soap up hands so bubbles are formed; 4. remove/ rinse off soap; 5. turn off water; 6. and dry hands.

It all seemed to be very simple and straight forward…. I had the head teacher or the class room teacher to translate, I had the posters, and the medication…..

In the first room as I stood up at the front looking out over the class, I saw a few familiar faces……..The teacher asked the class “Who is this person, what is her name?”…….immediately a young boy stood up and before the teacher could say anything declared in a very loud voice “Mzungu”…. and the class broke into laughter…….. finally after a few seconds which may have been a few minutes another student stood up and informed the class that I was Aunty Margo and I worked in the clinic.

This was the same in each and every class room…. the majority of the students thought my name was Mzungu and they did not know that my name was Aunty Margo….

The urban dictionary and Wikipedia have similar information….. Mzungu or muzungu (muh-zun-goooo) is a white man or white women usually a foreigner. In Uganda the plural is bazungu but in Kenya, Rwanda or Burundi the plural is wazunga The word stems from a Swahili phase which means a person who wanders aimlessly or without purpose. It is believed to original from the early explorers, traders and missionaries. The word mzungu is not a derogatory or negative term.

But I could not help but laugh as I thought back to each of the classes and how so many of the students thought my name was Mzungu… I have been told a number of times from various staff members in Kibaale as well as from the Timothy Centre that I should not be called ‘mzungu’ because I do not wonder without purpose but that I always have a place to go and a reason for going.

PS……… the Ugandans have great difficulty saying Margo. It is the “r” in the middle of the word which they cannot incorporate…. it sounds very strange to me and many times I do not recognize the fact they are speaking to me or calling out my name.

So…. what is my name?…. it does not matter if I am called me Mzungu…. because God knows my name, how many hairs are on my head and exactly who I am and he loves me.

……50 years old and getting better

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I am talking about the amazing country of Uganda….. Yes, on Oct 9, 2012, Uganda will be 50 years old….. 50 years of Independence. This small 236,000 square km landlocked country of 33 million people lies astride the equator has been described as the Pearl of Africa…bordered to the north by Sudan, the east by Kenya, the west by Democratic Republic of the Congo, to the southwest by Rwanda and the due south by Tanzania. Famous Lake Victoria lies in the southern part of the country is shared with Kenya and Tanzania…..

Uganda is the place where the East African savannah meets the West African jungle….a destination to see lions prowling the open plains, track chimpanzees through thick lush rain-forest, travel along tropical waterways like the Kazinga channel to see water buffalo and hippos or visit the majestic Rwenzori Mountains where half the world’s population of gorillas inhabit. This wide bio-diverse country is the home to more than 1,000 species of bird…. I truly understand why Lonely Planet declared Uganda as the Best Travel Destination for 2012…. Well done, Uganda.

For the past few weeks, the staff of the clinic have been discussion the growth and development of their country. It seems each person has an opinion of how good or how bad or what should be done or what could be done…. as much as this may be a time of reflection…. they each are excited to know that their African country is moving forward and slowly improving.

I am in Masaka, one of the top ten cities in Uganda…. and I am thrilled to be in Uganda during this special event…. There is only a few days left before the BIG DAY and there is an atmosphere of excitement in the air.. Everyone is in a joyful mood…. the shop keepers, the store clerks, the market vendors, the security guards, even the shoppers or customers….. everyone made it a point of giving me a blessing of thanks for 50 years of Independence….It is a time of celebration and plans are being made to enjoy the day with family and friends and of course good food. Some folks spoke about traveling long distances to spend the day with their loved ones….

I just hope that since Uganda is still a very young country the day will not be spoiled by riots and demonstrations causing the police to step in and become aggressive…… but that the people of Uganda will be able to see the amazing progress which has been accomplished in the past few years…. I have listened to many stories and learned what the country was like only a few years ago and can see such impressive improvements….. I have seen changes even over the past few months….. Uganda is a growing country and like all countries it will have changes which not everyone will agree with. BUT this is what comes with independence.

There is so much which could be said about Uganda…many know some bits of its history as well as some of its past leaders…. the country is still one of the poorest countries in the world where 40% of the population lives on less than $1.25 US per day and that 75 to 80% of the population live off the land in rural areas. BUT there is much more to Uganda…..there is its culture and cuisine along with the numerous “must see” points of interest for tourism….Uganda’s first 50 years may have been challenging but its resilient, hard working, entrepreneurial and friendly people are what is making the difference.

Kwa ajili ya Mungu na Nchi yangu…. is the motto for the country translated from Swahili means “For God and My Country”. If the people of Uganda continue to follow their country’s motto… their amazing country of Uganda will go far and do well…..

Congratulations for making it to 50 years!!!!!

…. the primary one class came to my home in Kibaale

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Today, all the primary one students…. all 61 of those little ones 6 years of age came to my home as part of their lesson on refrigeration. I have the only functioning fridge in all of Kibaale…. that is what the staff of the clinic told me. They thought that it was funny that there were a few fridges in Kibaale but the only functioning fridge was in my home.

The young girls were all wearing their school uniform of a blue gingham dress with dark blue collar and waistband…. the boys had on dark blue shorts and a blue gingham shirt. As my home is small we brought in a three groups of 20 students each. The student entered my home in a very orderly fashion and stood in a semi-circle to listen carefully to the teaching explaining the function on my fridge in Lugandan.The girls were all listening carefully while most of the boys were looking in every other direction but toward the fridge.

With the first group, I was outside counting off students and the teacher was inside giving guidance and directions to the students….. they made a perfect semi-circle around my stove and not around the fridge….. I did not have the heart to correct the teacher …. so let them know that I have two things in my house which would be new to them…. a cooker/stove and a fridge (pointing to the stove first and then the fridge) so we had to explain what a cooker or stove was…. I even light one of the burners to show them how it worked. Of course, some of students wanted to know if it would burn them like the fire at their house. A few of them had to put their hand right next to the flame and before I had a change to explain….the two students jumped back and made an exclamation of pain. Everyone erupted in laughter.

The teacher tried to explain the function of the fridge…. “it is to keep food good for more than one or two days”… so to prove this a kilo of meat, a litre of fresh milk and a small fresh catch fish were put in my fridge. On Friday morning, A few of the students and a teacher will come back to collect their various items…. and see if the meat is still fresh, the milk is O.K. to drink and the fish can still be cooked and eaten. Yesterday, Tuesday, I wrote my first draft and last night my fridge ran out of fuel and I spent most of this Wednesday morning getting the propane tank changed and the fire lite at the back of the fridge. Up until today, I have always left this responsibility to other but with all the problems finding staff to change the tank and light the fridge…. I have now learned and can instruct anyone how to do it.

The students looked very closely into what I had in my fridge…. they saw that I had eggs…. in fact I had two boiled eggs which I took out and let the students touch; to show them how cold the fridge not the freezer can get. It was like the old fashion game “passing the hot potato” … the egg got passed quickly between the various students and of course it was dropped numerous times with each group. They said it was “hot” … but then they do not really know the difference between hot and cold… other than they both can cause some discomfort or pain.

One little girl asked if I got shocks from the wiring to my fridge…. the teacher had to explain that my fridge work with fuel and not with electricity. Another little boy asked where I kept my milk…. of course, I do not drink fresh milk but use powder milk. The teacher translated as I talked about the use of powdered milk and I even had to show them the box. Another little girl asked if I eat makote and did I kept it in the fridge……..there was a discussion and translation on what I ate and this was demonstrated by what was in my fridge…….. eggs, tomatoes, carrots, green peppers and onions with bread in the freezer.

As each group left, they each thanked me….. but I was not sure what for… was it that they got to see a fridge, to see how a stove or cooker worked, or that they were allowed to enter the “white lady’s” home and see what it looked like or that they got to ask me a few questions.

After the students had departed, the teachers asked a few questions…… one thought that a fridge kept food indefinitely and that the coolness or cold killed all the bacteria, another wanted to know why I needed a fridge, and still another thought that it could work and keep food cold but did not understand how the fuel made the fridge work.

It was an exciting and quick hour…. I am not sure who learned the most… Me, the students or the teachers.

… the clinic has an autoclave or does it?

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For those individuals who do not know what an autoclave is….. it is a device used to sterilize medical and laboratory instruments by subjecting them to very high pressures with saturated steam above 212 degree Fahrenheit or 100 degrees Celsius. It is like a pressure cooker but the one for the clinic is the size of a large old fashion microwave oven (2 feet by 2 feet by one foot)and it weights about 35 pounds.

In cleaning out the various store rooms for the clinic, I found this new, unused autoclave still surrounded by the manufacture’s bubble wrap. I could not believe my eyes…. I was wondering how to improve the sterilize process for the various pieces of equipment the staff use to clean wounds, change dressings or when we would need to suture a patient and then remove the stitches. I found a perfect spot for the autoclave but many of the staff had never seen an autoclave or one this small and so it was an opportunity for learning…

I read the manual to discover that not any tap water would do but a certain kind of de-mineralized water must be used. and not any wate…. so my search was on and I finally after a number of trips to Masaka I found a place where I could buy a 5 litre jug. Now, I could test the autoclave and see if it would work. The manual was passed around and various individuals who are responsible for the maintenance agreed that we could trial it….. but all that took time and the clinic was without its use. In the meantime, I ordered the special autoclave tape which indicates the process worked and had drapes or large wraps made from hospital standard material I had ordered from Kampala. I was not able to do a trial run before I left for Canada in August but immediately after my return, I was given permission to do a trial run… It was on a Market Monday when the autoclave was set up with water and a set of instruments to be sterilized. Within a few minutes, the device was off and I had over loaded the generator…… now. how do I or can I use the autoclave?…….. After a numerous of discussion, it was decided that we would attempt a second trial at lunchtime… between 1 and 2 pm. The generator would be turned off to the rest of the compound and the only power would be for the clinic. We had success… the process took just over 60 minutes and the autoclave functioned perfectly.

WOW!!!!!!!!!!!!!! We were in business….. Joyce, one of the nurse’s spent the next week cleaning all the various forceps, scissors and cutting gauze making up 10 packages ready for sterilization.

The plans for this past week were to sterilize each afternoon until all 10 packages were through the process…. Tuesday, everything went well, Wednesday I noticed that the device turned off and had not completed the process…. in fact it had overloaded the generator or so that is what it looked like to me. The maintenance men arrived to discover that the wall socket had been blown. Thursday, the socket was replaced and on Friday we tried one more time… without success. It could be a number of things including the wiring to the clinic…..the wiring may not be able to handle the power surge. It is going to take some time before anyone knows for sure the cause…..

Some one in the past years gave a very expensive gift to the clinic. Something which is needed and can be used….. in the meantime…. there are more questions then answers.

BUT I AM STILL GOING TO TRY AND FIND AN ANSWER……. in the meantime, back to the old method of cleaning equipment.

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