Saturday, July 30, 2011
“Have you ever seen this type of infection before?” was the question asked by the doctor working in the pediatric ward of the hospital.
Believing he was talking to the medical student who was also working in the pediatric ward, I ignored him and went about my business. The doctor then asked again, “Have you ever seen this type of infection before?” I looked up to realize that, to my surprise, he was talking to me. I walked over to the child whom he was examining to see the infection. The doctor spoke to the seven-year-old girl in Luo, the local language spoken in Gulu Town, to tell her to open her mouth so that I could look. Inside, her mouth and tongue were covered with raised, white growths.
The doctor who had asked me about the patient was the same doctor that had been coming twice a day, once in the morning and once before lunch, to check on the patients in the Acute Pediatric Ward. The doctor that normally oversees the pediatric ward had been on strike all week, leaving patients to be quickly diagnosed by inexperienced medical students or by doctors practicing outside of their specialities. Ironically, the strike’s goal is to bring awareness to the community regarding the lack of resources in public hospitals and health clinics across Uganda.
After working at my internship for a week, I understand the pediatric doctor’s frustration. In the specific ward in which I am interning, there is only one nurse and one doctor. This can cause the work load to become overwhelming, especially on days where the number of patients exceeds the number of beds. Besides the lack of personnel , the lack of diagnosing equipment, such as chemical test and cultures, makes diagnosis difficult. To compound the problem, once diagnosed, the chances of the hospital having the medicine for treatment are slim. Speaking from an ethical standpoint and on-the-ground experience, instead of benefiting the patients and healthcare workers, the strike hinders the hospital’s efforts to aid the people.
Turning to the doctor, I replied, “It looks like oral thrush caused by a candida species.” I had diagnosed the patient.
Friday, July 29, 2011
- Abducted at a young age, they had limited education, and could not read or write.
- They returned with children from the Bush, whom new husbands refused to support.
- In order for their children to receive an education, the mothers had to support them.
- The mothers had to support them with limited educations and no vocational skill training.
Tuesday, July 26, 2011
Walking and driving around Gulu town, it is generally the people and vehicles that command attention. But I like to keep an eye out for the signboards and slogans that grow more vibrant and diverse each time I visit—one indicator that Gulu is really picking back up after the war. There is a strong oral component to traditional African cultures, but with the advent of modern forms of education and mass communication, written texts have assumed greater importance. Even with the mobile phone revolution, texting trumps calling as it nearly always works and costs far less. Incidentally, it seems that the best way to get your store painted is to advertise national products. The phone companies dominate the store-painting scene. You could opt for Warid’s pink and white color scheme (“We care”) or the striking red of Airtel. Blue buildings are either Uganda Telecom (“It’s all about U”) or pharmacies advertising cold and flu medicine. There is the longstanding yellow of the oversubscribed MTN or the orange of, yes, Orange, the company that boldly declares that “Choice changes with Orange.” The market pitch of Nile Special (a beer some of us are partial to) declares “You’ve earned it.” That looks rather out of place in the context of Gulu, where livelihood is more the watchword than leisure. Senator Beer is described as the “true taste of our land”—tea and coffee are surely stronger candidates for this accolade. Opposite our hotel is the slogan for cooking oil that reads: “Buy Fortune, Build Uganda.” I will refrain from commenting here where Uganda’s fortune currently lies, beyond its people and agricultural potential that is.
A couple of us attended the morning service at the rapidly growing Watoto (a Pentecostal/”born-again”) Church last Sunday. No-one appeared to be texting during the service you may be interested to know. Rather, all eyes were on the large, computer-mediated images that communicated the number of “celebration points” or branches of the church, its mission statement, and then the words of the various songs that were sung with great gusto by the mainly young, upwardly mobile and English-speaking congregation. There was a point in the sermon when congregants were exhorted to open their Bibles at the texts for the day. The lively preacher jokingly remarked that he hoped that they had not brought the King James Version of the Bible as “they would only be able to understand one word out of three.” Since he was wearing jeans and advocating a more modern, upbeat Christianity I suppose that I was not surprised at his choice. But I immediately thought of the many churches I had frequented around Africa, whether mission-related or independent, where the KJV reigned supreme. Only that text was held to have the requisite sacred power because of the historic beauty of the language. As an educator, I preach that words do matter, and while I enjoy a clever slogan, I sincerely hope that Africa’s oral richness does not get swamped by the powerful forces of late capitalism.
Sunday, July 24, 2011
I have been doing health related research in Uganda since 2006, but every day I go out into the field I learn something new. In Gulu District, I have been traveling to rural villages to talk to community members about their access, obstacles, and solutions to healthcare. I have also been traveling to various medical facilities to talk to patients about their healthcare experiences and to observe patient/provider interactions.
Recently I was observing such an interaction. The patient was an older woman who was complaining of stomach pain, chest pain and general weakness. She, like nearly every other patient that day, was prescribed amoxicillin and acetaminophen after a consultation with a nurse that lasted less than 4 minutes. She wasn’t prescribed these drugs because they were the best ones to take for her ailment - her ailment wasn’t even tested or diagnosed – she was prescribed these drugs because these were the only drugs available due to rampant drug, supply, and staff shortages.
Perhaps hypertension was the cause of her chest pain – but there are no anti-hypertensives available. Perhaps it is indigestion – but antacids are not there. Perhaps the pain is due to tuberculosis – but the lab tech is too busy to run TB tests that day. Maybe it was malaria – but even if antimalarials are available, women are often told they are too old to be taking medication and they should save these drugs for children.
As the woman was leaving I stopped her to ask if she was satisfied with the services she received that day. She said she guessed so, but she didn’t think the medicine was going to work because it was the same thing she was prescribed last time and saw no improvement. I then asked her if there was anything else she would have liked to ask or tell the doctor. She then launched into detail: “I’ve had a persistent cough that has lasted for over a year. Sometimes I cough up blood. I think I have TB, but I can’t go to the hospital because it is too far, too expensive, and I have young children and my husband won’t care for them if I’m not there. Oh…and I have AIDS.”
I asked her why she did not mention this to the nurse and she said, “She didn’t ask.” Then she gathered her things and left for her long walk home. My translator explained that women in Northern Uganda are often raised to be quiet and submissive, which greatly discourages them from asserting themselves – even at the doctor’s office. I asked my translator, “Since when is AIDS an afterthought?! How is that something she forgot to mention?!” He gave me sympathetic smile, but said nothing more. When HIV/AIDS seems as common as the cold but still carries a heavy social stigma, anti-retrovirals are not in regular supply, and no one cares to ask anyway, I suppose it’s just not worth a mention.
Friday, July 22, 2011
On the 11th of July the GSSAP students were fortunate enough to meet with the Honorable Betty Amongi-Ongom. One of the most prominent topics focused on the governments Peace, Recovery and Development Plan (PRDP). This plan rises out of the recognition that the conflict has left the North politically and economically underdeveloped; and thus directs efforts toward institution reconstruction, education, peace building, and of course economic recovery. These overarching areas are themselves composed of myriad aspects. As part of the implementation at the local level, the government is working to support cultural and religious leaders to ensure that they have the capacity to mediate conflicts that may arise in their community, such as land disputes (which is currently one of the major issues affecting communities). With this information in mind, I inquired about the possibilities of women becoming cultural leaders and having a voice in the outcome of the dispute resolution, especially in what has historically been a rigid patriarchal system. This question itself requires a little extra information about the evolving negotiation of gender roles in Northern Uganda.
During the conflict with the LRA, portions of the population spent roughly ten years in camps as internally displaced persons (IDPs). During this time, gender roles were reversed as women became the breadwinners of the households. This renegotiation occurred because food distribution targeted women rather than men, as men could potentially have several wives (thus needing more food). This essentially equated to women gaining power that they had not been afforded in the past. Now, after the conflict is over and people have returned home, the women are understandably unwilling to relinquish it and revert back to more traditional systems; hence, my question about the prevalence of women becoming cultural and/or religious leaders.
The response we received was slightly surprising (at least to me). The answer was none, that only men are allowed into these positions. I immediately found myself questioning how effective this approach would be at social renegotiation if recently empowered women were not allowed increased capacity. However, it was then revealed to us that part of many donor contributions included an aspect of sensitizing cultural leaders to both the needs of women and the social benefits of including their opinions, especially concerning economic issues.
As we left parliament, I reflected on not only how informative the presentation had been but also on how naïve my expectations were; I was projecting my goals from my culture onto that of another. My perception had been that somehow a cultural system that had been in place for centuries had suddenly taken a sharp turn in another direction in a matter of a few years. Betty Amongi-Ongom’s discussion with us painted a realistic illustration of what the early appearance of change can look like, and she allowed me to gain a more reasonable understanding of the current situation, as it pertains to gender roles in Northern Uganda.
Thursday, July 21, 2011
In northern Uganda, the idea of forgiveness has been put on a pedestal as the ultimate path to reconciliation. Since I started learning about this region in 2008, I’ve been told by various religious, political and community leaders that the community, seeing their children abducted to serve as fighters, porters and sex-slaves, wanted amnesty instead of punitive measures for crimes committed while in the bush. It was this popular sentiment that led to the Amnesty Act of 2000, which granted those who came forward and surrendered, a pardon for their role in the LRA insurgency. Because of its selective application, however, the Amnesty Act has been met with much controversy. Top level LRA commanders have received “amnesty certificates” alongside the very children they abducted.
What makes this problematic is that abducted children are placed in the same category of individuals as those that led the rebel movement. Victims thus are treated as perpetrators.
In a strange twist of events these young people (many now in their mid-twenties and older) literally sign a certificate that says they “denounce all rebellion against the government” … a rebellion that they did not start, but were forcibly recruited into. While some actors feel that amnesty is part of the Acholi culture and was initiated by the victims, others have contested this by saying that Amnesty is the government's forgiveness not the community’s and that is was first initiated by religious and political leaders. I have no official stance on this, but the concern that I want to express is at what stage does the government ask for forgiveness from abductees and survivors for failing to protect them?
I’m still working my way through this idea of forgiveness and how applicable it is to the northern Ugandan community in terms of what the community really wants and as a blanket method to resolve an issue that has many different players. The type of forgiveness that I believe the community wants to extend is one that will bring as many abductees back home as possible. However, dozens and dozens of communities have been destroyed by violence perpetrated by the LRA. Thousands of lives have been devastated in horrific physical and psychological ways, making peaceful co-existence that much more difficult or some would say impossible.
This is not to say that there are no punitive judicial methods being sought. There are numerous being pursued, not without their own criticisms though, by the International Criminal Court, the International Crimes Division and at the local level with traditional and transitional justice processes such as Mato Oput, Iluc or Ailuc, and Cayo Cuk.
It may be true that a significant portion of the Acholi community along with other groups such as the Langi and Teso do not regard abducted children as criminals, but it would be reductionist to assume that the whole does not. I have encountered many civil society organizers and workers who’ve suggested very strongly that the community is not ready to receive former soldiers. So if forgiveness and amnesty is not truly coming from the grassroots then the real benefits of its power cannot be harnessed by the public.
I’m a believer that forgiveness can create trust, restore broken human relationships and promote healing.But it is this very tough reality that needs to be confronted before real reconciliation and forgiveness can take place on the community level.
*Wa Winye is “let us agree” in Luo
This is one of the main streets in Gulu town that we walked down on our way to the Anglican Church.
Sunday, July 17, 2011
Saturday, July 16, 2011
This is a picture of the GSSAP group in front of the Gulu Universtiy Institute of Peace and Strategic Studies, where we have been attending class. A panel of people that have been affected by the war here in Northern Uganda spoke to the group and are also in the picture. They told personal stories about their experiences and discussed the kinds of justice and reconciliation processes they would like to see occur in the future.
The group visited this beautiful Anglican cathedral on Namirembe, one of the tallest hills in Kampala. We met George Piwang-Jalobo there and he explained that much of Uganda's history is tied into events that involve the church, Christian missionaries and Islamic traders. The views of the city are amazing from the top of this hill.
This picture shows matoke, a green banana used for cooking, being sold on the side of the road headed towards Kampala. It is a staple of the traditional Bugandan food and can be prepared many ways.
Friday, July 15, 2011
Thursday, July 14, 2011
When we arrived in Kampala, the environment changed dramatically. Kampala had a haze of muggy air from the hustling and bustling streets of the busy city. Fumes ran through the streets everywhere you walked and the traffic was unbelievable. We traveled around in a “Matatu”, a 14-passenger taxi. Every time you get inside a Matatu in Kampala it is a potentially perilous experience. Sometimes it seemed that two-lane roads turned in to four-lane roads as vehicles tried to skirt around other vehicles, possibly leaving two cars heading straight towards each other until just the last second. On top of all the Matatus and cars, there are “Bodas” (moped taxis) that speed around in between traffic with literally no room to spare. This hardly describes the experience of driving on the city streets of Kampala but lets just say it is often stressful.
The highlights of our two days in Kampala were going to Miracle Center Church and visiting the Ugandan Parliament. Sunday church, or rather performance and preaching was an incredibly unique experience. The singing and dancing in the church really brought about a spiritual atmosphere that flourished throughout the entire congregation. This was in some ways contrasted by the fiery message that faith leads to financial prosperity. Our group was recognized on stage and Dr. Hackett had the opportunity to tell the community about our Gulu Study and Service Abroad Program to which they were very receptive and responsive. The next two days we visited parliament and were able to meet with Betty Amongi, a Member of Parliament and Honorable Jacob Oulanya, the Deputy Speaker (Discussions with these two individuals will be detailed in another post).
The next day we headed to Gulu, in northern Uganda, where we will spend the rest of our time in Uganda. For the next week we are listening to lecturers from the local communities about the history of the Ugandan conflict and how they are trying to now restore peace and have reconciliation between the people.
Today we heard from Ketty Anyeko, a Team Leader for the Justice and Reconciliation Project here in Gulu. She spoke mainly about Internal Displaced Persons Camps (IDP), child soldiers, and Formally Abducted Women. The IDP camps were where the Ugandan government brought people to stay in order to try and protect them from the Lords Resistance Army (LRA). She also talked about the consequences of these inhumane treatments and how the challenges have developed and are still developing. Just a few of the consequences that she mentioned were broken cultural and social structures of the Acholi people, orphaned children, many psychological problems, sexual abuse and exploitation, poor or no access to education and health services, early marriages, forced prostitution, and spread of HIV; these are just the start of the challenges. What made this speaker so inspirational and moving was the fact that she lived so close to everything that was happening and she has been very involved in the peace process, trying to help people reconcile with each other and themselves. She was not giving us simply a history lesson, but instead provided a very sincere dialogue, so that we could more humbly understand this complex conflict, and the lost and damaged land and culture that the Acholi people are trying to restore.
Though our journey has already brought us into contact with many amazing sights and no dearth of new experiences, perhaps the most unique aspect thus far has been the opportunity for our group to meet some remarkable people. A particular highlight transpired when we toured the Ugandan Parliament in Kampala. "Tour," however, does not adequately describe or encapsulate the experience. Through Dr. Hackett's previous connection and friendship with an incredible man, Mr. George Piwang-Jalobo, we were fortunate enough to meet several important parliamentary members, and to listen as they brilliantly spoke on issues specifically relevant to the complex conflict and current social and cultural dynamics in Northern Uganda, even engaging them with our own questions and dialogues.
Because of this incredible opportunity, and with profound acknowledgment to George, who continuously extends unprecedented kindness to GSSAP, we were ultimately allowed to meet the Deputy Speaker of Parliament, Honorable Jacob Oulanya, who is himself from Gulu. To merely shake hands with this man would have been a unique and fortuitous opportunity, much less to gather around a table and hear him speak for nearly an hour. He shared with us his personal involvement with Betty Bigombe, a renowned former government minister, with peace negotiations to end the insurgency of the LRA.
Deputy Speaker Oulanya conversed openly, illuminating some of the complex challenges that Northern Uganda now faces. In the wake of two decades of protracted war, displacement, atrocity, and suffering, Acholi communities have changed in manifold ways. Mr. Oulanya commented on the way that language, especially among youth and the younger generation has changed; how it has been “militarized.” He lamented the ways in which NGOs and countless aid organizations have wrought debilitating changes in local homes and communities, cultivating a culture of dependency while remaining largely ignorant of the broader historical and political complexities of the conflict and of Acholi culture. He contended that the conflict has eroded many traditional moral values, resulting in a situation of moral disengagement where formally held values no longer hold. And finally, he shared with us his own thoughts concering the tension that exists between traditional justice and transitional justice.
I will conclude with two quotes by Mr. Oulanya. Though they may have merely been passing comments, I found these words particularly striking and profound:
“Post-conflict transitional justice has to coin an appropriate justice mechanism that allows for both justice and reconciliation, traditional and transitional. We must take both sides and construct a larger structure of justice”
“We are trying to transform the effects of the war. Or as my favorite verse says, to bend swords into plowshares.”
Sunday, July 10, 2011
Wednesday, July 6, 2011
More than fifteen years ago I stood in their shoes as I departed for the country of Eritrea with Operation Crossroads Africa, to participate in a very similar international service learning program. It is not an overstatement to say it changed my life. Living and working in the village of Nefasit, alongside Eritrean high school and university students; learning firsthand about the history of political conflict and its impacts on individuals, communities, and the nation; feeling the intensity and energy of post-conflict reconstruction, led me to pursue graduate studies in anthropology and ultimately doctoral fieldwork in Eritrea. My life and my career were indelibly shaped by that one summer experience. Among the most important and longest-standing relationships in my life are those formed with Eritreans I met that summer and in subsequent years. While the path has been challenging every step of the way, it has enabled me to use the opportunities, skills and resources at my disposal to work effectively with Eritrean people, and through that, enrich my life with meaning and direction. It has taught me commitment, responsibility, and the power of human connection across differences of language, culture, politics, religion, and economic disparities.
I want to say to my GSSAP 2011 students: this summer experience may or may not change the course of your life. But it will forever shape the way you think about the world and your place in it. You will grow in ways you can't yet imagine - and some of it will be painful as well as joyful. You will return home more critical in your thinking, more empathetic, more inspired, and perhaps a bit disillusioned as well. You will form friendships that may last the rest of your life, both with one another and with the Ugandans you meet. And hopefully you will leave something equally important behind, something you co-create with Ugandan friends and mentors - the sense that human solidarity can always transcend the arbitrariness of our birth and nationality. From that realization great things can follow.
My final word of advice before we depart. (You'll get a lot more of my advice along the way whether you want it or not - isn't that my job?). Be yourselves. Be who you are. Be students. Submit yourselves to the experience and soak up everything. Listen before talking. Observe before judging. Shed your skin and grow it anew.
Thank you for giving me the opportunity to share this experience with you!
See you in Uganda!