So the last few days in Kampala went very well. Alejandra, Ben, and I continued our quest of meeting with individuals and ministries to find out more about the current projects in Uganda that are integrating human rights and health care together. On Wednesday morning, we met with the director of the Minnesota International Health Volunteers (MIHV) office in Kampala. The meeting was excellent and the director, Paige, gave us a lot of insight into the MIHV family planning and child spacing projects targeting the districts just north and west of Kampala. Most of our discussions in the capital came back to the question of accountability, of how to hold partners, NGO's, health workers etc. accountable for the work they claim to be doing as well as to making true, effective change. Paige described for us the whole monitoring and evaluation process that her organization uses for its current family planning project. I will not bore anyone with the details of the monitoring process here, but i will let you know that it was the first example of a thorough strategy to keep track of all the time, energy, and resources spent on a "sustainable" health care iniative that I have come across so far. After our discussion of accountability, she gave us a list of contacts that might assist us in working further on the Orphans and Vulnerable Children policy.
After our meeting that morning, Alejandra and I went to the ministry of health to look for statistics and data about the district we are working in, Bududa. We were disappointed to find out that the ministry had very little to offer us. We were tossed around like a ping pong ball from one side of the building to the other as employees of the ministry kept directing us to some other department, and in the end, we were told that most of what we wanted was not even present in the building but in print some where else, or in storage in another building, or could be found on-line (in truth very little of the data that we want regarding the common illnesses and health facilities'provision of services in Bududa has been digitalized). We did not walk away completely empty handed, we were able to get a few posters for our clinic regarding malaria management and few other diseases.
The following day, I met with the Uganda Human Rights Commission and had a great discussion with the head of the vulnerable persons unit, who is also in charge of developing a new unit regarding health care rights, in particular the right to health care. One of the many important points that he made to me, in terms of health care rights in uganda, is that the most common violation is maintenance, there are services provided but none are really maintained. Today I spoke with the director of health for another district in eastern uganda, and echoed this statement by saying that the health sector itself is partly to blame for its failure to provide services. As he put it, "we have spread ourself too thin." In the government's attempt to offer everyone free health care at a fairly micro level, it has left the country with a lot buildings but no resources, human or material, to fill them adequately. I could go on forever about my conversation at the commission, but I will just state here that I am going to continue to have meetings with the commission's regional office in Soroti to work on a program for FIMRC to help it monitor the right to health care in the region as well as help it in other areas.
I am being forced to leave my computer, but will write more in the coming days about the past few days that I have spent in Tororo where I met the Japadola king, numerous district officials, and experienced a whole other side of rural ugandan life.
Tuesday, July 3, 2007
Today Alejandra, Ben, and I met with two ministers in the Ministry of Gender, Labor, and Social Development. We first met with the Assistant Commissioner for Youth and Children Affairs to discuss the ministry's strategies for carrying out the National Orphans and Vulnerable Children Policy (OVCP). One possible initiative that we may be able to partner with them involves making health care more accessible to youth by making it more appealing to them, or as the commissioner put "more youth friendly." He explained to us that there is a 33% teenage pregnancy rate in Uganda and that one of the main health projects within the OVCP targets these young girls so that they feel more comfortable receiving both advice and treatment. FIMRC's Bumwalukani clinic resides in the Bududa district, which is the most densely populated district in Uganda outside of Kampala. For this reason, FIMRC will have great opportunity to assist the ministry with this initiative. We also met with the ministry's director of community development. We were put in contact with him through a good friend of Ben and mine, Jacob Oboth, who some of you might remember from the University of Minnesota Law School's LLM program. The director was excited to meet us and to formalize a relationship with our organization and his ministry which will provide for us access to many resources for learning about cultural prjoects and rural developement in Uganda. One future way we may be able to also partner with the ministry involves our men's and women's groups which have recently focused on domestic violence and gender equality.
This is a picture of me with a group of villagers who live at the very last house in Shamwiyi Village in Bumwalukani. Alejandra and I are trying to survey at least twenty homes in each of the six villages of Bumwalukani (pop. 5406). While several other FIMRC volunteers were doing health education in the village's primary school, we walked an extra hour and a half up into the foothills of Mt. Elgon to reach this home. Once we got there, we crossed the boundary and found this beautiful garden of eden in the distance (if you look closely in the photo you can see a very tall waterfall).
Monday, July 2, 2007
This is the Head of Security for the Busongi Village with some of his family. While we were at his home doing our survey, his children, along with a fair number of his neighbors' kids, formed a wall of curious eyes staring at us. When we left, they followed us almost all the way to the next home.
After all the rainy days, around 5 men finally came one Thursday afternoon to start the men's health education group. A few of these guys we picked up during our health surveys in the community. The small number has grown to almost 20 members, with about 10 regulars.
This really shows two of the challenges for members of the Bumwalukani community trying to access medical care: their remote location and lack of smooth roads/ pathways.