Archive for December, 2008

Mali pre-trip

December 30, 2008

I am mostly caught up with this blog, though I have a few pieces in the works for when I return. The next time I write will be in mid-January after returning from Mali where I am headed in a few days.

I am meeting Jess, the Fogarty scholar in Mali, for a trip of a lifetime. A group of 9 of us are meeting in Bamako and heading by pinasse (unique canoe) up the Niger River to Timbuktu and disembarking there to go to Essakane, home of the Festival au Desert West African music festival in the Sahara. For more information visit: http://www.festival-au-desert.org/.

During the trip we will meet people in Dogon country and Touareg nomads, to name two legendary groups of the region. We will visit a spectacular mud mosque and see the “Venice of Mali” – the town of Mopti. We will get to experience the music of Mali and the surrounding nations in an intimate, unforgettable venue. There will be no shortage of stories from this trip as a Fogarty student who went last year assured me. Until those stories are told… have a safe and blessed New Years.

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Thanksgiving Thrice

December 30, 2008

I had more formal opportunities to give thanks in Uganda than at any time previously thus far in my life. On Thanksgiving Eve, the USAID Mission Director for Uganda very graciously had a group of us over for a quite proper American Thanksgiving meal with thanks to our friend Mitra for help organizing.

Pumpkin pie, turkey, mashed potatoes, cheese galore, we ate a fantastic dinner that left me in a tryptophan coma by the end of the evening (tryptophan comas are apparently urban legends now according to evidence-based medicine, I’ve heard). My friend Jesper (Swedish – you know, those healthy, in-shape Europeans with the highest life expectancies) experienced American gluttony in its completely culturally-sanctioned form for the first time.

One of the guys at dinner, Andrew, started the following organization up near Gulu (see previous post on Gulu): http://freedomincreation.org/. Some of us finished the evening watching a video about his organization which deals with art therapy for child victims of the Lord’s Resistance Army conflict.

Thanksgiving #1 group photo:

Thanksgiving Eve post-prandial picture

Thanksgiving Eve post-prandial picture

I slept well on a full stomach nervous about Thanksgiving #2. On Thanksgiving Day, Sarah, Julie, and I headed to La Fontaine for another Thanksgiving feast at the place where we watched the election in November. Again, amazing fare – turkey, green bean casserole, pumpkin pie, stuffing, even cranberry sauce – filled our stomachs. I was starting to feel really, really full now by Thursday night.

But wait! Third time’s a charm. Saturday night, my coworker Dennis had his annual Thanksgiving event at his house. The stuffing and cornbread were particularly amazing. Julie, Sarah, and I had a great time mingling there, including with a woman who heads an organization supporting pediatric oncology patient families. (More on that in a later post.)

I never thought giving thanks so much could hurt one’s stomach. Now I know. But as far away from “home” as I was, home is where the stomach is just as much as it is where the heart is. I now know that Thanksgiving is quite reproducible even in far away lands. Feeling drowsy on a couch in a glucose-induced stupor with friends nearby is all it takes to make you smile and remember home (and be thankful that you don’t have to eat like that again for another year).

Rotaract at Ssese Islands

December 30, 2008

One of the first weekends of November, our friend Chris (a Rotary Ambassador scholar – see: Chris Deal’s blog link) invited some of us to come along on a Rotaract service trip. Rotaract, as described to me, is for younger Rotary members. Most of the Ugandan Rotoract members we met were in their upper 20s/young 30s. We took a lively bus ride with about 60 Ugandan members and 5 expats from Kampala down to a port near Entebbe to hop onto a ferry bound for the Ssese Islands.

The Ssese Islands are a group of 80-some odd islands in Lake Victoria. They are thought to have separated from the mainland 12,000 years ago. The largest island, Buggala, is also the most developed. The islands have a rich cultural and religious history and belonged to the Buganda kingdom.

We arrived on Buggala and walked to our lodging. We spent the first night getting to know each other and then dancing. Although I tried to go to bed around midnight or so, the music played all the way until breakfast at deafening volumes! Our leader came by with drums at 6AM to wake us all up for a morning run before a day of service work.

A group of us ran a hilly course before breakfast, all of us having had no/little sleep due to the music. The run served as a great way to see some more of the island and the vistas grew increasingly beautiful and wide as we ascended the island.

After breakfast, we hopped on rudimentary, large fishing boats for our journey to Serinya island, an island lacking electricity and plumbing. We met some community leaders and started the manual labor. We carried large stones in our hands, wheelbarrows, or in human chains to lay the floor for a school clinic being sponsored with Rotary Club funding from various Kampala chapters.

We then collected barrels/buckets of sand and cement after moving the stones. I tried balancing the barrels on my head (successfully) given that mode of carriage’s popularity in many African regions. Did we felt the heat as we transported these building materials! I can say we definitely had a fun time, though. I felt a tiny bit of what some manual laborers here may feel after a day of such work in the hot sun which is far removed from my usual daily activities.

We also saw the in-progress construction of a biolatrine being sponsored by the Rotary Club consortium. The premise being that human sewage collects in a tank and the methane gas will be used a source for cooking. Which brings me to lunch…

We had a fantastic lunch made by local women in HUGE iron/steel vats. I wish I had a picture of these vats! The fish and meat were excellent and the whole lot of us fed the hunger work created in us. The local people were extremely hospitable, and we even took some time to play soccer in a round with some local kids before leaving.

Before dark that night and after we boated back to Buggala, a local Ssese Island Peace Corps volunteer took us a tour of the Speke Fort in the jungle of the island. Not in either major guide book of Uganda, this fort came with colonialism on the island when John Speke came here in the mid/late-1800s. We reached the stone buildings after a short, nice jungle hike rife with monkeys. The site had been mostly swallowed up by the jungle, clearly rarely visited, as trees growing inside of the outposts and vines and moss covering the stones suggested. Our Peace Corps friend hadn’t visited it since three years ago when she started Peace Corps here.

Thoroughly exhausted, somewhat dehydrated and sun-exhausted, it made sense after dinner to dance again and stay up late. (Insert a tinge of sarcasm.) A few of us took a short night hike to see the stars in their magnificence sans the plaque of city lighting. I tried to go to bed early again, but the music kept me up all night again, but this time we awoke to find out only one person had stayed up that late! And he assumed the role of DJ, unfortunately for me.

Only 5 of us 60-some people went for the morning run after the drum call at 6AM, an event akin to a fraternity hazing event I decided. I ran in the jungle along the coast instead of the ascending run from the day before with the others and took in the sights and sounds on a quiet, cloudy Sunday morning on the island.

Arriving back in Kampala after a nice ferry ride bacy to Entebbe, I slept WELL that night! The service trip afforded a lot of great experiences and Rotary and Rotaract clubs do excellent and needed structural improvement work here. Sacrificing sleep every once in a while can be accompanied with rich, unforgettable experiences.

Rain continued

December 29, 2008

I wrote some ruminations on rain previously at: https://healingnumenor.wordpress.com/2008/11/02/i-bless-the-rains-down-in-africa/

Here’s a “gutter” “in action” during a rain storm:

Gutter

December had unusually heavy rains. I captured a few shots while at work one day:

Fort Portal and the foothills of Rwenzori Mountains National Park

December 28, 2008

In my quest to catch up on my blog, I am writing about a trip I took out west the weekend of October 25 to Fort Portal and the Rwenzori Mountains national park.

We left on a Friday afternoon traveling about 1hour to go 3km or so to the bus station in Kampala. Our trip to Fort Portal went by quickly. We arrived just at dusk, the indigo sky allowing us only faint glimpses of the environment around us, the mountains at the horizon. We hopped into a taxi and quickly found out that it had no functional headlamps, hence the driver put his hazard flashers on to alert people in the dark that we were in fact on the road. We made it to a lovely guest inn run by an expat British/Dutch couple. After one of the best dinners for my particular palate in Uganda, we rested up before getting ready for the big hike the next day.

We met the tour guides in the town of Fort Portal and were driven out to the foothills of the Rwenzori Mountains. The Rwenzori Mountains are Africa’s highest mountain range (mountain sizes surpassed only by Kilimanjaro and Mt. Kenya) and straddle the border of Congo and Uganda. They are thought to be the “Mountains of the Moon” noted as the source of the Nile by Ptolemy in year 150 A.C.E., but the first Europeans known to have seen them did so in 1889 (see “Uganda” Bradt guidebook).

We began a steep, but not out-of-control ascent and stopped at a newly formed ecotourism station started by some local people on the mountain. After a pleasant visit with the owner and some excellent herbal tea, we continued on our way. The ascent, although difficult, was nonetheless awesome as views widened during our climb.

We reached the border of the foothill with the national park boundary and took a breather for lunch. The line sharply demarcated two worlds. The foothills had been largely deforested and used for crops. Although there were trees and grasses, none were ancient per se. Only past the boundary of the park though, we gazed at thick, lush, enveloping green cloud forest.

I steadily, slightly surreptitiously, entered the park but not without reprimand from our guides. I wanted to venture further, however, the results if a ranger would see me would not have been so great for the tour company. We didn’t see the snow-capped mountains of the Rwenzori’s unfortunately. Had we ventured not too much further into the park past the boundary, an amazing vista supposedly awaited at the ridge.

After lunch we started a ridiculous descent. People were sliding downwards everywhere. Had the trail been more muddy, it would not have been doable without injury. I mean, we were laughing as we would hear (but often not see through the dense foliage) people falling or sliding. All part of the adventure I am sure.

We came back feeling successful, dehydrated, and well-hiked to the guest inn and had intense political conversations with the British owner during another fantastic dinner. Quite engaging and thought-provoking. He provided me with some lenses through which to view some of the sociopolitical and cultural interpretations he had as a foreigner having been here for decades. My friend Brendan chatted it up with some interesting geological facts about Uganda and the Rift Valley before we called it a night.

My curiosity piqued, I definitely hope to return to the Rwenzori Mountains. The geography is fascinating and unusual and the mountains are known to have a slightly bluish hue. Here are some pictures from the trip:

“Obama don’t leave us” and the Kampala Marathon

December 16, 2008

You may be wondering how these two topics in the title are related. You will know by the end of this post. I will start with the Kampala 1/2 marathon which I ran with my friends Jesper and Chris. We trained for a few weeks (literally 2-1/2 for Jesper and me) and then ran on Sunday, November 23 with thousands of other people divided among a 10K, 1/2 marathon, and full marathon (http://mtnkampalamarathon.com/).

Talk about hilly! Although one can only train on the hills, 13.1 miles of a hilly course at 1000m certainly challenges a flatlander’s body. There were few expats running it overall, we thought. I mean, c’mon, I was the 3rd American to finish the 1/2 marathon – that is not because I am fast! Many runners wore tattered shoes and untypical running clothes.  At the end there was a huge after party with sponsored tents all around. Ugandans won the top awards in all categories, especially exciting for them because of the famed success of the Kenyan runners. I had fun running the race and enjoyed the challenge and seeing different parts of Kampala, some new to me.

Now the link to Obama. As Ugandans cheered people the runners, I constantly had “Obama, yea!” yelled at me while I was running. Actually, it was astounding. I would smile back or high five the people, more just to be engaging. There was something celebrity-esque to it. Americans abroad in most places are undoubtedly experiencing celebrity status as the world celebrates Obama’s election — there were only 5 countries officially supporting McCain. Yet, there are many dimensions to this election.

I stopped counting after literally 2 dozen times people cheered me on with something related to president-elect Obama. There was a key moment, though. At one point, I passed 2 Ugandans running and they said to me, Obama don’t leave us.

Obama don’t leave us, indeed. This line summarizes something in the air here. Since I arrived in August, Obama has been on the lips of everyone. No, I mean that literally. On the bus to Kigali, Rwanda someone was reading The Audacity of Hope in front of me. On the street DAILY pre-election, Obama’s name would appear in conversation. Many cars here have bumper stickers like “Obama/Biden ’08”. People wore Obama t-shirts. My co-workers would talk about it with me almost daily. One of my neighbors had a “Ugandans for Obama” bumper sticker. Boda boda drivers still say OBAMA! as a greeting to me on the street. Catholic, Muslim, Pentecostal – Obama! everywhere. While some people were using the word “elitist” to make Obama look unaccessible or different to Americans in the US, some of the most nonelite people in the world cheered him on from here.

I would speak with drivers, people on the street, and others who would have an analysis of the US election beyond some Americans I knew, including myself at times. One of the drivers at the project for example – I don’t think he has secondary level education – stayed up all night for all the debates and offered analysis of all the candidates that often left me amazed because of its comprehensiveness and thoughtfulness, all coming from a non-American.  Did I know that much about Ugandan politics?

At dinner one night, my Dutch roommates and I went out with some Ugandan adult friends. We talked American politics and Obama most of the time – definitely not by my choice. Even when I tried to veer the conversation away from Obama, it always came back to Obama and Bush and passionately so. (My European friends often had to deal with Obama conversations that started when someone saw me as an American. They graciously allowed them to continue, even when I knew it wasn’t as important to them as we later discussed.) More than Obama, the broader vision of America the Ugandans I have spoken with has opened my eyes to some new foreign interpretations and ideals of what America stands for to them.

Celebrity status indeed. But as with many things there is a Janus-face to such popularity.

The reasons Obama is so liked here are plentiful. He has a lineage relationship with Luo tribespeople who are present in Kenya and Uganda, for example. He is part African and a leader and example by extension to many in the African diaspora of countries around the world, a diaspora with a horrific history and endless struggle globally. He offered a new type of international relations method, not original, but unseen for many years by the world. He has the potential to challenge African leaders in a way a non-African may not be able to do, and there is hope (where there is not pessimism) that many African leaders are feeling precarious at the very least. Obama, many here believe, will not pat “democratic” or otherwise undemocratic dictators on the back like predecessors have. But what else?

The local papers wrote ad nauseum about what an Obama presidency may or may not mean for Ugandans. I will summarize the obsession in three points from what I can surmise, though there are more: (1) his obvious roots in East Africa; (2) the potential challenge he’ll be to East African dictator democracies; (3) and unfortunately because of how they experience politics, some people think America is going to throw all sorts of “goodies” to this region now. Open the Treasury floodgates.

Let me unpack (3) a bit. I have spoke with Ugandans and expats alike about this one. Because of his relationship with the region, some people think/thought Obama will/would provide Deliverance…in the form of aid and direct structural improvements. Some people wrote about it in the papers, while others warned against such a belief.

The economic crisis in the USA does not seem (as far as I can tell) to translate here in Uganda, so its obvious priority to Americans is not really appreciated. While Uganda is rising economically (and with increasing wealth disparities at the same time), many people here are always in some way in an economic crisis like every other country in this region, crisis meaning inadequate employment and weak political/social/economic/legal/health rights and nonexistent safety nets. So in one way they understand the economic crisis more than most Americans ever will. But at the same time an economic crisis is not conceivable or accessible here when American media exports show and inculcate a far more glamorous depiction of America. I am occasionally telling people that all of the US is not California or NYC wealth.

In a country where politics is intertwined with corruption and corruption translates into “goodies” for friends of a corrupt politician, I offer one lens of many at play that makes the expectation for “goodies” understandable. Some regional authors discussed this in op-ed pieces. Kenyans were happy for many reasons, but in some regions some people were especially happy because of the expectation for goodies. Obama’s constituents, to some here, are the world’s left behind. Talk about a populist spin on corruption! Simply put.

Hopefully, Obama will show the world that the corruption-handouts/goodies relationship is not the status quo; he is not Robinhood. Relatedly, Illinois Governor Blagoyevich’s resignation would be another beacon of democracy, one to inspire hope that the world is what we make it and that corruption is not always hopeless or tolerated.

Obama don’t leave us. Whether or not they should say it, that line is palpable in the air: among Americans losing jobs and watching benefits drop in the media I read from here, among those in neglected conflict areas of the world, among the disenfranchised in Uganda. Such immense pressure on our country and one person makes me nervous, despite my personal sense of immense hopefulness and change this election can bring. My precariousness aside, my time here at this point in time has humbled me given my affiliation as an American. And while trite, I continue to realize all those great things most of us realize we take for granted at some point as Americans. Yet, I know we can be ever more the beacon. It continues abroad, but it will need to be restarted at home. Ahem, health care reform for example. But I digress!

So in summary to a potentially much longer post, it’ll be interesting to watch the new dawn of international relations…. and expectations.

Picture from Chris Deal at our expat all night election viewing party: http://2.bp.blogspot.com/_z5E_4idIFXI/SRxYUFjDQ8I/AAAAAAAACZE/qkWH6LTOYAA/s1600-h/11-10-08+251.jpg. (The concession/acceptance speeches occurred slightly before 8AM local time.)

“The Big Get Down” and other tales of rafting the Nile (aka THE SOURCE)

December 15, 2008
I am terribly behind on my posts, so I am trying to catch up. This post refers to a trip taken to Jinja, Uganda (the “Source of the Nile”) in mid-October.

The night before a group of us (mostly Yale residents and medical students) went to Jinja, we visited a popular Irish pub here, Bubbles. The crowd was quite interesting, diverse, and as the night went on, we joked from the terrace part of the bar where we settled that the inside was becoming “the room of bad decisions” as we guessed who in the indoors crowd would make bad decisions. The funnier part of the dialogue occurred when one of our friends decided she and others going to the bar to get another drink would carve through as “the wave of innocence” in the “room of bad decisions.”

The next morning we departed for Jinja by matatu. We arrived and walked through the town a bit. The main street’s architecture felt reminiscent of parts of New Orleans and Latin America.

One side of Main Street, Jinja

One side of Main Street, Jinja

We enjoyed a leisurely stroll before getting to The Source Cafe, the namesake of esoteric jokes my friend Rachelle and me would commence shortly thereafter. The Source was the source — of wonderful coffee, the elixir of energy and the life force (or source).

Michiel getting some coffee beans at The Source Cafe

Michiel getting some coffee beans at The Source Cafe

 

The Source of coffee and friends

The Source of coffee and friends

We headed to a resort-type place for the afternoon and after checking in we took a boat ride to the Source of the Nile.

Kingfisher Resort Jinja

Kingfisher Resort Jinja

 

Roof of vines at Kingfisher

Roof of vines at Kingfisher

Well, the Source is quite arbitrary so we saw many hypothetical sources.

The touristy Source that's not the Source

The touristy Source that's not the Source

 The ride was nice though, and we enjoyed watching the fishermen. 

Idle boat on Lake Victoria

Idle boat on Lake Victoria

In fact at night, Lake Victoria at the mouth of the Nile was awash with lights from men fishing at night. I didn’t capture it well on digital, but it reminded me of pictures I have seen of lakes and rivers in China lit up at night by hundreds of laterns.

Hundreds of fishermen on Lake Victoria at night

Hundreds of fishermen on Lake Victoria at night

In the morning we checked out and a group of us set off for rafting on the Nile.

Team Tutu pre-rafting

Team Tutu pre-rafting

And wow. In all of the amateur rafting I’ve done around the world, this experience was by far the most exhilarating and perhaps unpredictable. We had one particular flip on a rapid where my helmet somehow got caught in the rope after the flip thus preventing my ascent to the top of the river. I simultaneously freaked out and then remained calm as I started to gulp water. I finally unfastened my helmet after a struggle and surfaced after going through a bit more of the rapid, coughing up the Source water engulfing me. I saw the others downstream now reunited with the raft and a safety kayaker collected me. The fall there was called “The Big Get Down” but I am certain it should be renamed to “The Great Fall Out.”

Rafting the Nile 1

Rafting the Nile 1

 

Rafting the Nile 2

Rafting the Nile 2

Yikes

Yikes

Yes please

Yes please

Needless to say, I approached each subsequent rapid with a little bit of anxiety! We had ample time to float and wade in the immensity of the Nile along the way, and sun we did absorb. We even saw some river otters, which we were told is a rather rare sighting for rafters. There are class VI rapids on this stretch of the Nile, but we didn’t run beyond class V. I was fine with that.

We finished with Nile Special beers and soda from the rafting company at the end of a full day of rafting. The motto of Nile Special as depicted on the bottle is: “True Reward from the Source”. But why have beer brewed from the Nile River water when you can just swallow it yourself during a day of rafting? Nonetheless, the reward mellowed out a day of fun, sun, and exhilaration.

Tuberculosis medication shortage

December 10, 2008

As I continue to learn more details, I am realizing that I should have written this post a while ago and have to no reason to delay it further. For the past few weeks, there has been a shortage of anti-tuberculosis medications in Uganda. As I learn more stories, I am getting a better sense of the impact of this shortage. Of note, the shortage is not making headlines, for which reasons I have no clue, though \”corruption,\” the common response to most problems, is being uttered on the lips of health professionals.

Right now, patients who come to the National Tuberculosis & Leprosy Programme (hospital ward across from my office) with tuberculosis have to pay 80,000 Ugandan shillings (~$41 USD) to a private pharmacy to receive a month\’s worth of treatment including isoniazid, rifampin, and pyrazinamide – 3 of the 4 necessary medications in a tuberculosis treatment cocktail. That is, if even the private pharmacies have it. The NTLP only has ethambutol, the fourth medication, in stock. In order to receive it, the pharmacist needs to see the purchase of a month\’s supply of the other three drugs before he gives out ethambutol to a patient to complete the tetrad.

Previously, the patients would receive all drugs at no charge through the international funding of the NTLP. Now, the poorest people (the ones who experience active Tb more often) cannot afford or obtain the medication given that it is likely much more than their monthly salary.

There are the obvious risks of death, especially in HIV+ co-infected persons, increased transmission to others, and people who in some way will get incomplete treatment regimens. This in turn, may lead to increasing drug-resistant strains of Tb, the last thing needed to be exacerbated here.

Forebodingly, Nicholas Kristoff in a recent NY Times article (07 December 2008) talks about the global concern needed and the action we must take with the continued growth of multi-drug (MDR) and extrememly-drug resistant forms (XDR) of Tb: http://www.nytimes.com/2008/12/07/opinion/07kristof.html. He relays this grossly underreported health issue that continues to accelerate, an issue global powers need to address with the fervor HIV/AIDS has received.

One of the doctors working in the NTLP told me patients have cried when they realize they cannot receive their medications. This doctor also told me that even 80,000 USh would be costly for him, to put price in context. At $41 per month for 8 months of treatment, it is easily seen how families making less than $300 USD/year equivalent would have a hard time paying for such medication for one person.

If that were not enough, a similar shortage is occurring with anti-malarial drugs right now. This is especially problematic because we remain in the rainy season when malaria infection is higher. Here is the latest I have found on this topic: http://www.monitor.co.ug/artman/publish/regional-special/Govt_hospitals_running_short_of_malaria_drugs_75510.shtml. I need to speak with a few more doctors on the current situation since I do not interact with malaria studies or clinics much. And recently, there was a shortage of anti-retrovial medication for HIV, though I have heard by word-of-mouth that this one has been improving.

You will note in the conclusion of the malaria news article that Global Fund money has not been forthcoming. I do not know the exact reason why but I have heard it has to do with the mismanagement of funds previously. Perhaps this article lends credence to this possibility: http://www.monitor.co.ug/artman/publish/news/We_are_using_Global_Fund_money_better-_PS_65626.shtml. Are funds being used better since three years ago? I am not sure, but for some reason, the needed dispersements have not been provided.

Research project participants in our collaboration continue to receive anti-Tb medications. Those that receive referrals to the NTLP through a research project are part of contigency plans to the best of my knowledge, including the study on which I spend the bulk of my time where patients were previously simply referred to the NTLP.

I am going to try and spend time in the NTLP on Friday and next week to gather individual stories and learn how doctors convey shortages to patients. It will make for a sobering prelude to Christmas, but for many here, it will be an even more difficult and possibly life-threatening Christmas for them.

It is particularly frustrating because Uganda, at least in this region is modern, growing, promising. (Some Ugandans would agree or disagree with this.) Maybe this could be \”expected\” (though unjustly so) in a less developed country, but because Uganda appears at face value to be one of the more modern African regions, I believe events such as  these should be all the less tolerable. I will amend this post as I receive updates and change the data/time of the post to make it appear \”new.\” Stay tuned…

Portrait of a team

December 4, 2008

Every morning at 8:15AM I meet the health home visitor team to crosscheck data collected from the previous day and to listen to how things are going in the field, among other tasks as needed. We meet at the “Brown House,” a place just outside Mulago hospital where research participants with tuberculosis come for care in various MU-CWRU research collaboration studies:

L-R (Micheal Angel, Hassard, Esther, Kezron, Joan, Sheila, Joan

Part of the CF team: (L-R: Micheal Angel, Hassard, Esther, Kezron, Sheila, Joan)

Kezron and Sheila work on another study; the “CF” (the study on which I work) and “Alcohol” study teams meet every morning in the same room. Joseline, Joyce, and Godfrey, other CF HHVs, were not in the room when I took the picture. Micheal Angel is our data manager, and he crosschecks my crosscheck.

After I finish there, I head up a hill to the MU-CWRU office. This is where I spend a bit of time currently. (It is the Medical Officers’ office.) The doctors below are principal investigators or co-PIs on studies here. If I am not in here then, I am either shadowing physicians or in the field, though I will not be doing the latter now until I have ethics board approvals of the study I described in the pilot study blog post previously.

 MO’s office:

L-R (Dr. Grace Muzanye and Dr. Phineas Gitta)

Medical Officers (L-R: Dr. Grace Muzanye and Dr. Phineas Gitta)

Beyond Juba and transitional justice

December 3, 2008

On October 30, I attended two events of the Peace Film Festival put on by the Transitional Justice Project at the Faculty of Law at Makerere University and other collaborators. The program flyer can be found at this link: http://www.beyondjuba.org/other_documents/filmfestival.pdf.

You may be thinking, “what is transitional justice?” So was I. Here is a working definition from International Center for Transitional Justice (http://www.ictj.org/en/tj/):

“Transitional justice is a response to systematic or widespread violations of human rights. It seeks recognition for the victims and to promote possibilities for peace, reconciliation and democracy. Transitional justice is not a special form of justice but justice adapted to societies transforming themselves after a period of pervasive human rights abuse. In some cases, these transformations happen suddenly; in others, they may take place over many decades.”

Here is a bit about the project (http://www.beyondjuba.org/project_info.php):

“The project builds on the participating organisations’ work on peace and conflict related issues in Uganda, and in particular reflects the outcome of a three day stakeholders dialogue under the same title which was hosted in Kampala by the three collaborating partners in December 2006.

Uganda’s post colonial history has been characterised by division and conflict.  One of the most violent and protracted of the conflicts is the 21 year war in northern Uganda waged by the Lord’s Resistance Army/Movement (LRA/M).  The current peace talks between the Government of Uganda (GoU) and the LRA/M, which are mediated by the Government of Southern Sudan (GoSS), are welcomed as a solution to attain sustainable peace in Uganda.  However, there are reservations about how the peace consultations are proceeding, and some stakeholders feel that the discussions around accountability and reconciliation may not result in process that is sufficiently comprehensive in ensuring sustainable peace in northern Uganda or in the country as a whole. For reconciliation to be effective, the northern Uganda conflict must be placed within a wider national context.

In the past there have been attempts to establish transitional justice mechanisms for Uganda. They have not related to broader political dynamics like decentralisation or gender, however. Another challenge is that current reconciliation initiatives like the Peace Recovery and Development Plan (PRDP) view reconciliation in a localised fashion and therefore only allocate a small part of their budget to it. If the Juba Peace Talks offer hope for sustained peace and create opportunities for meaningful national reconciliation in Uganda, then considerable efforts to create a climate conducive to change should be made.

One such effort is the Beyond Juba Project, a three year project funded by SIDA and NORAD. The project constitutes of three pillars: (1) In-depth consultation and training with key stakeholders including different branches of government, (2) research on critical legal, and psychosocial issues for inclusion in the national reconciliation process and (3) a multi-layered public information campaign that reaches all sectors of society.

I caught the end of a panel, but I was able to view the movie “Uganda Rising” which finished the day’s events on 30 October 2008. Despite all the stories I have heard here about the LRA, nothing to date has given me more historical context, narrative from victims, and political explanations than this video. Although I knew of horrific LRA crimes and briefly encountered a post-internally-displaced persons camp in Gulu (see Gulu post), the magnitude and brutality (and yet hope somehow) relayed through the interviews of survivors made me realize how much work remains in terms of educational, political, legal, health and infrastructure improvements, and mental health care needs for northern Ugandans. Everyone talks about the long road and improvments that have been made since the LRA left the region. The amount of work to be done remains large. I STRONGLY encourage you to view the video if you can get it. Visit: http://www.ugandarising.com/home.html. I will definitely buy a copy to bring home or get while at home and have a showing. I am thankful that my friend Sheena here, whose roommates, recent graduates of Yale College, helped organize this, alerted us to the festival. Groups such as Invisible Children, World Vision, Rotary International, Save the Children, and others (including one I will describe in my Thanksgiving Day post) need our continued support to do the important work up north.