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.