Student Blogs 2008

Alex Flynn - May 31, 2008
 
As I am sitting on the couch of my flat trying to write this blog, I am filled with mixed emotions. I have enjoyed working at Nsambya Home Care Department and appreciate the kindness bestowed upon me by Dr. Bbaale and the rest of the staff at Nsambya.  I could write about Uganda's culture and what it is to work in a clinic in a third world country, but I don't think that would do my Kampala experience justice.  Despite everything that has happened only one memory sticks out in my mind that I will never be able to erase.   In my opinion, this memory captures the essence of Uganda's health care system and the role of students who wish to leave an impact on the world.
My first Friday in Kampala has by far been the hardest day of my trip.  I was given the opportunity of going to Mulago Hospital's Cancer Institute. When we first arrived at Mulago, Wendy and I noticed patients lying on mattresses outside the entrance.  We later learned that upon arrival at Mulago, many patients couldn't be seen.  As a result, they sleep on mattresses outside hoping to be seen the next day. As we entered the ward we noticed an emaciated little boy around eleven wearing no shirt and no shoes sitting on a plastic red chair. The little boy's eyes were rolling back and he was panting making slight moaning sounds. We entered into the ward where we shadowed Dr. Oling Michael.  The particular ward that we were in was for patients suffering from Backus Lymphoma. There were approximately ten beds in the children's ward. One of the beds had cleared up and the little boy in the red chair was transferred to that bed.  Dr. Michael examined the little boy and noticed that his body temperature had dropped dramatically. Before treating the boy his body had to warm up. The little boy's aunt used warm wet, washcloths in an attempt to heat the little boy's body. I noticed that the mother began to break out in tears at the site of her son lying in the bed so ill. I did not know what to do so I gave her a hug and offered her a tissue.  Dr. Michael instructed the aunt to carry the little boy to the nurse's station to receive some sort of injection. She then carried the boy back to his bed.
We were with Dr. Michael in a type of break room when he was rushed out upon hearing shrills of desperation. We quickly followed and as soon as I stepped out of the room I looked at the bed and noticed a still body. It was as if time had stopped. The mother and aunt were screaming and throwing themselves on the floor. The aunt later ran out of the ward and down the street screaming and crying with her arms wide open. Dr. Michael pronounced the child dead and the nurse walked over to begin the process of wrapping up the body.
Words cannot do justice as to what I saw or what I felt at that moment.  I had never seen a corpse. I watched as they wrapped the body and saw the faces of the children and mothers in the ward watching the child being carried away, knowing that they possibly await the same fate.  During this time I couldn't help but think that had this boy been in America he probably would have survived.
The doctor walked by Wendy and I and said, "this is Africa, this is what we deal with everyday."  He later told us that he had lost a total of three patients that day.  
So as a premed student at Vanderbilt I asked myself how this experience has impacted me. I still do not understand as to why God has blessed me with education and a comfortable life in the United States. The only reason that I can fathom is that God has put a desire in my heart to take my education beyond the borders of America.   After consulting Dr. Michael and the staff at Nsambya one way that we as premed students can contribute to global health care is by becoming doctors and offering our services.  So to wrap up my experience in Africa I have come to the conclusion that the Kampala Project opens up our eyes and hearts to the problems in the world.  Our mission began in Africa, but it continues in the classrooms at Vanderbilt.  Currently, we can't do much to physically heal the people, but we will be able to pay our thanks in the years to come when we can offer our services to those less fortunate.

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Wendy Xiong - May 23, 2008
In the Land That I Live, That They Live
 
            Where we live in Kampala, Kololo, is one of the nicest parts in the country. We have almost continuous electricity, running water, a water heater, and tall, barbed-wire walls and guards to shield us from the perils of the rest of the world. In the flats, we have our own little havens with mosquito nets, solid flooring, fans, stocked kitchens, and hot showers. Here, I do not feel as if I am in Africa, the so-called land of rampant extreme poverty. I just feel like I am at school, living with 16 awesome people. Nonetheless, when I go to my sites during the week, I am reminded that I am where I am.
           On Wednesday, I went on home visits with a clinician from Reach Out and a community leader of the clan we were visiting. We took boda-bodas up the mountain and then walked the rest of the way up. There could not have been running water or electricity up this mountain. As we climbed up the steep, brown, dirt-covered incline, I saw kids with tattered clothing and many villagers of all ages striking piles of rocks with sticks to break them into smaller rocks. Stella, the clinician, informed me that they did this for a living. We continued upward, passing by women and children with yellow plastic jugs for collecting water to bring back to use in their homes. And then there were the homes.
           I am not usually shocked by circumstances of poor housing, having seen the bad living conditions present in much of China. However, somehow, this village topped even that. The walls of the houses (or should I say huts?) ranged in composition from crumbling brick and cement to large wooden sticks filled in with the mud from the ground. Each place could not have been any bigger than 6 feet by 6 feet. Generally, there was one mattress and then room for a few belongings and a chair or two. If you were lucky, you had a solid floor with a mat to cover it. If not, you coped with the mud floor. The narrow walkways between residences were mounds of rocks and mud. It had rained recently, leaving sporadic puddles of murky water and slush on the ground. We visited a woman who was living by herself. She had left her family more than a year ago to come here and receive free treatment for her TB and HIV problems. Her hut had a curtained entrance. The ground jutted upward at the entrance. On it was a busy trail of ants. Inside, the withered woman sat on her bed, a mattress on the dirt floor. In a flowery traditional dress, she greeted each of us congenially, holding our hands in both of hers. I sat on the bench, facing her, with my feet on potato sacks used to cover the uneven ground.
           As I was sitting there, looking at her, looking at the wooden planks for walls, looking at the corrugated metal ceiling, looking at the soiled soap on the ground, I felt an aching inside. Even now, it makes me slightly nauseous. Even in Uganda, I have lovely flats and clean bedding to return to every night. Waiting for me at home, I have a loving family with a big, sturdy house to return to. What did this woman have? Sickness, scraps of metal and plywood, fewer worldly possessions than would fit in my luggage bags for this trip. What could be done? What was my responsibility? Even if I gave this woman money to fix up her home and eat a little more, what have I really done? What happens when she runs out of money? What about all the other shanties in the village? In the country? In the world? This leads to the major question of our entire trip: How do we make a sustainable impact? It's not enough to just donate time and money. You have to find the proper way to help out—the best way to really work towards bridging the gap between how I live and how they live.

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Erika Burnett - May 15, 2008

After a day of work, group outing, etc. we (myself and my flat mates) come in, debrief for a moment and proceed to man our separate stations of the flat, equipped with an ipod, journal and pen, books and magazines. It never fails, we function like clock work. One of the three components comprising the Kampala Project’s mission statement is cultural immersion. However witnessing this scene daily in my flat for the past two weeks, makes me wonder how feasible total cultural immersion is. For example, every time we get into a taxi or special that has the radio on we are flooded with music from American Pop Culture. Upon first experiencing this, my initial reaction was frustration. No matter how hard we try or far we go there is no way to escape “American culture.” Over time this realization has become both comforting and simultaneously appalling for me. But it does bring about the question of how exclusive is “culture”? Do Ugandans consider 50 Cent, Alicia Keys, Akon and Kirk Franklin a part of their culture? Sean Kingston’s “Beautiful Girl” is seemingly more population here than it is in the states. Additionally, considering the practices of my flat mates, is there only a certain extent in which cultural exchange can take place before it becomes invasive and/or overwhelming. I would argue that the “American” music we allow to flood our minds with ipod is our way of “dealing” with the reality around us. Or is it our methods of not “dealing” with death, AIDS, poverty, lack of control or tangible measures of making a difference? Daily I try to embrace and appreciate every aspect of Ugandan culture; but at the end of the day, I unapologetically want my ipod, Essence magazine and cell phone… somehow it seems to rectify our daily experiences even if falsely so.

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Elise Michael - May 12, 2008
 
I have been working at the ISS clinic at Mulago Hospital, an adult HIV/AIDS clinic, under Dr. Fred for a week now. My original fears of being in the way have been removed but I can't help feeling that I am not being helpful. I am learning more than I ever imagined I would learn, and retaining a lot more than I usually do in 4 days of a Vanderbilt class, and all people want to do is teach me. It's this amazing feeling going in to work every day and learning new and interesting things, however… what can I give back?
 
This is something the group and I have been struggling with since before we left. What are we actually going to be giving back? During a meeting the other night we were trying to think of something to give the kids with out extra money from fundraising, not necessarily something they needed but something they wanted. At home we have this sharp line that divides need and wants, and out needs are rarely, if ever, no met. The people who work at the Meeting Point said there was not a whole long they can think of that they (the kids) would simply want. How incredible, because I know I want too much, and have what I need. But again, here I am learning, learning about myself.
 
So I struggle with ways to think of how to give back, thank everyone for all I've be taught. People here have told me when I become a doctor I have come work in Uganda. Unfortunately I am not premed but I do want to do something sustainable. My friend Lizzy and I talked the other day, she is getting ready to end a semester in Spain and when I expressed these concerns to her she helped me out a bit by explaining that even if all I did was inform my friends and family at home about what I am doing and learn, and seeing here in Uganda, I should be proud. So I am happy to share all this would you, but I am still waiting for my epiphany, my "a-ha" moment where I feel as though I am giving something back.
 
Until then I will continue to get excited about the prospect of learning everyday, and will continue to try to answer the hard questions I get asked every day. Hopefully I will be able to come back and help, actually help. Because, really, it's the least that can be done after all that I have been taught and will continue to learn.

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Kelly Burbank - May 12, 2008
Home Visits: Perspective on Poverty and Illness
 
At Meeting Point, the non-profit where I work, one of the services they provide is home visits to clients with HIV/AIDS. Meeting Point sends counselors to over 3300 clients and the counselors visit each client every other day. I have had the opportunity to spend two days shadowing counselors on visits into the slum areas of Kampala and to villages outside the city. Many of the clients we visited were female. Their husbands typically refuse to get tested and many have walked out on their families. Some of the husbands have already passed away. It is almost certain that these husbands are HIV+. Not to mention, most clients have several children.
 
Prior to my home visits, I didn't know what to expect. I was nervous about going and what I would see. Home after home, however, I began to get frustrated by what I saw. When the husbands refused to get tested or let their children be tested, they were being selfish. Without testing positively, an individual can not receive treatment. This treatment can help to extend their life as well as help them to be less prone to catching other diseases. By not being tested, these husbands were more likely to pass away and leave their wives to fend for themselves and provide for their children. Furthermore, by not having the children tested, these husbands are withholding their children from receiving medication to help lesson the symptoms of the disease. If the husbands left their wives upon discovering that the wives were HIV+ they created additional stress to the wives who now must find ways to support her family. This stress wears on the wife's body and generally intensifies and accelerates the disease. Perhaps these husbands did not want to face the reality of real with the negative stigma of being HIV+. However their short term selfishness impaired their long-term health and family stability.
 
Additionally, I grew frustrated by how poverty impacted health. Many of the clients were near what seemed to be the end of their battle with HIV. They had contracted additional diseases such as meningitis and TB. While most has access to medications, they lacked food to take with the medication. The clients had become too ill to work and not able to provide for their families. Meeting Point, in the past, had a grant that helped to provide food to these families, but it was not renewed. Without food, the medications, including ARV's caused painful side effects that caused many patients to choose to discontinue to take their medication. In order to live longer, these patients needed to take these medications. Had they had the access to food, perhaps they would not have contracted additional diseases and would live longer.
 
It was a vicious cycle that I saw repeated at every home I visited. Death was inevitable and the rail thin, sickly bodies were the result of poverty and illness. Looking at the many children these clients have, it appeared that they too would follow a similar path and suffer the same fate. When these clients pass away, they will eventually become a statistic. But behind that statistic there are real people, a few of which I have met. These real people show not have to suffer more as a result of their circumstances.

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Emily Zern - May 7, 2008

Today, I sat in front of thirty five HIV-positive women and as they each told me their name, number of children, and how long they have lived with AIDS, I realize the true impact of the epidemic in this country. The majority widows, these women had an average of four to five children each and have been living HIV positive for a minimum of eight years, yet still displayed immense strength. The women of NOCOA (National Coalition of women with AIDS in Uganda) and their spirit and determination to better their situations and improve the status of AIDS patients truly demonstrated the power and rich culture and connections I have noticed in this country in the last five days.

Since Monday, I have been working at the PMTCT (Prevention of Mother to Child Transmission) lab at Naguru Health Center and I have had much time to reflect on my own and Uganda’s attitudes toward AIDS. After testing over 100 pregnant women for HIV, reading lines on testing strips became a little monotonous, and I found myself saying to the lab technician, Esther “4260 is positive.” 4260 is positive. Who are we to reduce these strong, unique women to a four-digit number? And who am I, as a sophomore in college, to run the test that condemns these women, and possibly their unborn children, to a lifetime of challenges, stigma, and hardships?

The issues of numbers and their association with AIDS reminds me of our t-shirt slogan, a quote from a young, HIV-positive boy—“we are not a statistic.” After seeing the people who suffer from poverty and disease, I have come to ultimately realize the people of Uganda are far from a statistic. The motto of NACOA, “Nothing is about us, without us” exemplifies the desire and rightful obligation that these women, men, children, and families of Uganda have to be known by the rest of the world. More than the beauty of this country and the culture, I have noticed the people and their happiness. Knowing that a child, who has nothing but a pair of shorts to wear and a stick to play with, will smile and wave excitedly at a small smile from one of us and the knowledge of the togetherness of the people in Kampala forces me to want to learn more. I now feel guilty for ever thinking of the AIDS epidemic and the people it afflicts as statistics. After watching adults and children sing and dance for us, and seeing their excitement for us to visit and try to help their country, I hope to do all I can to make sure that the people are known for who they are, and not a number on a vial.

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Learning the African Way
Lauren Page Black - May 5, 2008

Sunday, the Kika Troupe, the best dance troupe in Uganda, gave us African dance lessons… this was a comical experience, to say the least. At one point Yusef, the director, poked fun at the rapid stiff, long strides of Americans in a hurry. It was a sickeningly accurate impression of me a week ago. Our lives here are so different: at the end of a long day we can sit under the warm African sun on tree trunks and reflect.

That Sunday I looked in Yusef’s eyes, and in the eyes of the other members of the Kika troupe and something struck me. I saw the same thing in the eyes of Sister Robin and Dr. Kawangee at the Naguru Clinic: I think it’s joy. I think they are dancing or treating impoverished pregnant women because they love it. Perhaps in America we all started down the paths we’re on with genuine passion and interest… but somewhere along the way work became stressful, intense, and exhausting.

Today when I watched Dr. Kawangee drain a patient’s infected fallopian tubes and remove three baseball sized tumors I actually wished that I had my biology books with me. I realized I still have that passion and the Ugandan people are helping me- and all of us- find it again.

I wonder if it is competition, or the need for outside approval that disconnects us from our original desires? I feel I am far from sorting out this mystery.

Kampala Project | Office of Active Citizenship & Service
Vanderbilt University | Box 6308, Station B | Nashville, TN 37235
615-343-7878 | www.vanderbilt.edu/oacs