"But, money is the most important thing"

I beg to differ.
...quoted from my boda driver this afternoon in response to me telling him that having a big house was not the most important thing. sigh.

My homesickness here doesn’t come in fits as I remember it from childhood. It accompanies me as a slow undercurrent, a subtle sort of white noise I’m disengaged from most of the time. Speaking with Dr. Judith yesterday, a pretty & petite 24-yr-old from southwest Uganda, I encountered a loss for words when posed, “what sorts of differences do you observe between your country and ours?” I struggled with this one. How about, are there any similarities? I think it’s easy to avoid stumbling into a pit of yearning for home when there are so few stimuli to pique my memory of the place. Sometimes there’ll be an onslaught of reminiscence; the dinner party in Rwanda…the salad, the wine, familiar music, that particular incidence was really overwhelming, but we mustn’t dwell, must we?
Bbbuuuuttttt……


I miss my home.
I miss ice cream, my family. I miss good beer, I miss my queen bed with the tableside denim lamp, I miss electricity. I miss good roads, comfortable drives, having a sweetheart, dancing. I miss my favorite kind of ethereal trippy flow music, walking through the property, privacy and my long hair. There. Done.
I had a hot shower this weekend. My first in a month or so, I couldn’t believe how consumed I was by it. I never wanted to leave. Granted it was a rusted metal spigot in the confines of a dark cement room, granted there were cockroaches on the floor and hoards of lake flies… but it was a hot shower, and I felt clean, and warm and sexy and it was great.

This past weekend, the other FSD mzungus and myself fled eastwards towards Sipi Falls for our mid-term retreat. Mid-term…yup, week 6 of 12… that shit trips me out. The place was beautiful, a common theme in this part of the world I’ve found. Rich soulful plateaus freckled with ancient caves that were inhabited by the local tribes worlds ago. The falls itself comes teeming over the edge of one of these cliffs, all white watered and roaring, plundering into a damp valley. Eucalyptus groves, banana plantations, burbling creeks and tributaries flanked by delicate purple-white flowers and kawa plants. Everything: GREEN. Everything: GREEN. We each paid 50,000 Ush to repel down the side of the beast; edging fearful and exhilarated 25 feet to the left of her, at the same time being spat away and seduced towards her violent coursing artery. That was fun, that was really fun.


I'm the little red spot to the left, and that big gushing thing is the waterfall.

Monday night I facilitated my HIV education seminar for the secondary school teachers. I had assumed that we would start at about 7:30, after all, I’d told them to show up at 6:30, its called African Time. When I got to the hotel at 5:30 I’d set out to practice, set up, calm my nerves and my newly arrived bout of nausea…what do you know? All the teachers were there, sitting, waiting patiently. That blew my mind. I was really impressed, impressed by the honoring of their commitment to come, their timeliness, their motivation…it was really inspiring, it made me feel like perhaps I’d gotten this one right, perhaps I’d tapped into something that they really wanted, that they felt could help them make a difference. I’d asked the hotel to provide refreshments on my bill… you know, coffee, tea, sodas… so when I saw all the teachers kickin’ back with cold beers I knew the communication barrier had once again gotten the upper hand. I paid nearly three times more than I’d budgeted for, but the heated post-seminar roundtable discussion on teaching techniques was a lot more fiery thanks to the happy glowing buzz the teachers were feeling. Everything happens for a reason?


I spent that night throwing up (beers were not involved in this I assure you) and wasn’t able to go to work on Tuesday thanks to a number of GI issues. All I wanted was sleep, the temperature in my solar oven house to drop below 90 and my host-mom to please stop offering me fried macaroni… and then down the path to my house comes trotting a whole band of cohorts. My clinic was worried about ‘the sickness’ and so they all decided to abandon their health profession posts for the afternoon and come visit me; needless to say it was the first sick-in-bed day I’ve ever spent surrounded by a doctor, two nurses, a lab tech and a cook…just in case.

Feeling tip-top now though, will go to Kampala (nation’s capital) on Friday and partake in gluttonous carousing theatrics… determined to catch Ugandan premier of “Superbad”…we’re a little behind the times. Its better than Jinja though, our local theatre here is playing Anaconda (circa 1996- feat. J-Lo {before she was J-Lo} and Ice Cube), mmmm mmmm quality film.

saving little pieces of world

Sub-Saharan Africa continues to harbor 64% of the world’s HIV infections and that number is growing 12 times faster than anywhere else on the globe. Uganda’s rural youth are becoming an increasingly high-risk demographic with over 80% of new infections attributed to unsafe sex. At this moment 7% of Uganda’s adult population is living with HIV/AIDS and that percent is on the rise…

This information probably isn’t very surprising, probably didn’t even make you blink. These are the sort of statistics that ooze out of journalists in high rises and news broadcasters backdropped by flat screen images of desolate villages teeming with gaunt children. This is the kind of news we file in our brains with the new Iraqi casualty count and North Korean refugee figures…we’ve heard it all before.
And yet our subconscious apathy… or helplessness or disinterest or confusion towards the matter doesn’t change the should-be-shocking reality that our globe’s poorest nations are being ate bone dry by this pandemic. In India, the Caribbean and Africa the tributaries of this infection are slowly but surely working and winding themselves into every community… flooding entire families, entire villages, and soon entire islands, countries and continents. No, this isn’t the bubonic plague; it isn’t a thief that comes in the night and ravages a populace. But considering HIV/AIDS has been on the forefront of confounded medicine for nearly thirty years and the western nations have been watching their numbers drop for ages now, there is obviously an identifiable disconnect between developing countries and developed countries with regards to this issue (among countless others). I don’t want to ramble on about that, but this is clearly different than not being able to fight corruption or develop industry…and it isn’t necessarily a shortage of money (the U.S., France, UK, Scotland, Canada…etc. all donate billions of dollars to the ‘fight against AIDS’ in SSA) as much as it is a misstep in distribution of funds *surprise surprise*. Musevini, or M7 as he’s known here, basically blew his whole foreign aid wad on one campaign: the ABCD’s- Abstinence. Be Faithful. Condoms. Or Die!! Clever marketing I think. Blech. Anyways, the bottom line is that despite how tired of an issue HIV/AIDS may seem over yonder, its so evident here you can touch it, it looms over homes and children like rain clouds.
A virus is a small infectious organism that needs a living host cell in order to reproduce. The virus often attaches to a specific type of cell, releasing its own RNA or DNA coding information in to the cells decoding machinery. The virus hijacks the host cell’s equipment so that components of the virus are manufactured and reproduced with in the host cell’s machinery and subsequently released into the host where the cycle restarts.
Normally, when a virus enters the body, your immune system (white blood cells) is able to attack and destroy any infected cells. Immunity from viruses can only be achieved by receiving a vaccine. Babies receive vaccines for polio, measles, rubella and other awful difficult to combat viruses. However once contracted, there is no cure for a virus, bits of it will always be lurking somewhere in your system like a drug addict waiting to score.
HIV is a virus (hence the V). It’s a smart virus. A very very smart virus. It has evolved or adapted or come to be by happenstance in such a way that the specific host cell it feeds off of and destroys is the very cell your body needs to combat it…see the problem? The CD4 lymphocytes, or helper T-Lymphocytes are the Godfather’s of your immune system. When something infiltrates your body (a bacterial, fungal or viral infection), it’s their job to call their friends, cousins and other mobster white blood cell cohorts and coordinate the subsequent destruction of said infiltrators. When HIV enters the picture it handicaps that mode of communication, activation and coordination. Everyone starts to panic, doesn’t know where to go, who to kill…Montague vs. Montague, Capulet vs. Capulet…the immune system begins to commit suicide.
Meanwhile the host is chillin. Maybe a fever here, a headache there…nothing a joint and a Simpsons re-run couldn’t quell. If the host isn’t looking for them, it can take years for your CD4 counts to drop low enough to recognize abnormal symptoms…you can see the issue with sexual transmission; if you don’t know your HIV+ you probably don’t think your HIV+ so your pledge that your “clean” to your partner isn’t necessarily a lie as much as a fatal error.
Ultimately, despite the best efforts of ART (antiretroviral therapy- which aims to abolish viral RNA reproduction), your body is no longer able to defend itself. AIDS is categorized by the development of rare infections and cancers: thrush (yeast infection in mouth, vagina or esophagus), pneumonia, tuberculosis or Kaposi’s sarcoma (red/purple raised patches on the skin); though there are many more. 95-100% of HIV infected people will develop AIDS at some point, though it may take more than 10 years.
Last week my supervisor wanted to demonstrate how our HIV test kits in the clinic work. He carelessly grabbed a blood sample from the dozens of test tubes perched on the counter and dropped a blot on a tiny receptor strip. Ten minutes later we went to check it out and it had read positive. The random lab sample, the older women in the hall who’d complained of dizziness was living unknowingly with HIV. We couldn’t inform her I was told, as its illegal to test for HIV without consent. So I sat and stared at the test for a few minutes until the doctor came and threw it in the rubbish bin. I bid the woman a safe journey and refilled my water bottle. Those are things I don’t know what to do with.


So. I’m here for 3 months (1 of which is gone with the wind). I’m not going to eliminate AIDS from rural Ugandan communities. But I’d like to think I could take a stab at educating, informing and testing my district, my community; with the hopes and idealistic longing that my efforts will propagate themselves elsewhere in the country. With the money I raised at home, the money that was donated so generously to this project by my dear friends, family and even distant acquaintances; I’ll be implementing a pilot project for Soft Power Health.
The project is called S.H.A.R.E.
Sharing HIV Awareness through Resources and Education (I think it’s a title rule of acronyms that you don’t use the acronym in the full name, but alas). It’s a three part project, whose wheels and wings are already rolling and flapping with the wind at our back…wind being generated by a people who know the situation, know what they need and are willing to work to get it.
I’ve been coordinating with 4 rural secondary schools in the Butugaya and Budondo sub-counties of Jinja District. My goal is to make HIV education, resources, testing and post-test counseling readily available to those who need it most at no cost. Those who need it most in Uganda are the youth (15-24) living in rural areas… so highschools in the bush it was! Here’s a basic breakdown.

Part 1: A teacher’s information and education seminar conducted by Soft Power Health (i.e. me) aiming to educate and train teachers from each of the four selected secondary schools about the HIV virus, transmission, treatment and prevention; as well as equip them with the skills and framework to initiate an HIV based curriculum in their schools. The program will serve as a great opportunity to build the resource capacity of the schools, clear up any HIV/AIDS misconceptions and equip the teachers with the knowledge to be an on-campus HIV education resource for their students.
The free teacher training and education session will be at
6:30 pm on Monday, October 22, 2007
At the Cool Breeze Hotel in Jinja

Part 2: Soft Power Health and the AIDS Information Centre will facilitate an on-campus HIV prevention program at each school. The program features an education and information seminar, followed by free on-site voluntary testing and post-test counseling for teachers, students and the local communities. Soft Power Health will be partnering with the AIDS Information Centre in order to offer the highest quality services. We hope the program will help the students and their communities gain a better understanding of HIV and the risks associated with its contraction and transmission, as well as provide a free testing service to the community in the hopes of stopping the spread of HIV. This program will occur at each school on a day that works for AIC, SPH and the school; we prefer to conduct the program between November 12th and November 30th.

Part 3: The creation of a savings account that will generate funds in order to pay for 2 Soft Power Health staff members to become HIV post-test counselor certified. I had originally intended to pay for and have the trainings completed by the time I leave, but I’ve learned it’s a much more involved and expensive process that Id thought and so ill just be setting the wheels in motion. Once SPH has their own post-test counselors, we wont need to rely on AIC to provide their own staff to carry out the testing and counseling… it’s a way to make SHARE a SPH dominated project so that they can be more self reliant.

So that’s it. The calling I’ve been waiting for. I visited Lubani SS and Trinity College this morning and met with the entire staff of both. I was showered with cups of tea and mandaze (African doughnuts). Everyone I’ve worked with thus far has been so responsive and I’ve been more efficient here than ever at home, despite the stigmas attached to getting things done in the ‘third world’. I was fortunate enough to wander into the AIDS Information Centre in Jinja (the JFK of Ugandan AIDS work) in my first week of work just to ask a few questions. I ended up in the manager’s office, describing my project and having him offer to provide all of the testing equipment for the program. Nearly $6,000 worth of HIV kits, needles, test tubes, gloves, tourniquets etc. So I’m just trekkin along. I’m really enjoying it thus far. I anticipate huge pitfalls, but as the program director of FSD handed over 1.2 million shillings for SHARE this afternoon I was flying pretty damn high. Ill be creating posters, pamphlets and other various text-y things in the next week and then we’ll just hold our breath and jump I guess. Its pretty exciting to find yet another thing that makes my tick though. I always was one to tick.

Gone ta Rwanda

The drive there was majestic. Simply. Purely. Truly. Cruising blissfully through Mother Nature…her valleys and ridges, her peaks, hills, gorges and effortless endless curves. The drive from Jinja to Kigali, Rwanda takes about 10 hours; and as it’s Africa many of that ten hours is spent circumnavigating surprise potholes, goats and toddlers or muscling your vehicle, fists clenched, lungs pursed over the boulders, stumps and other odd solid masses that have been mistaken for smooth concrete by the public works ministry. Upon arrival we were told by the ‘Cavern du Auberge’ that unfortunately a group of 6 mzungu girls traveling from Kampala that very day had been mistaken for our group of 6 mzungu girls traveling from Kampala and thus our reservation had been surrendered mistakenly to the wrong group. Which is all fine and well when you can freely glide across the metropolis that is Kigali asking each friendly Rwandan where might there be alternative lodging… however when their first choice language is Kirwandan, the second Swahili and the third French… I find it a tit bit more difficult. In any case we bunked up across the street at the Dream Inn for a few dollars more, had running water, two double beds, flushing toilets (!!!) and a television that broadcasted CNN world, French golf and low budget Rwandan hip hop videos.
This experience was intermingled with the kick in the mouth reality that there were no ATMs in the entire city and that the following day was Sunday meaning no banks would be open. Four of seven of us were unable to withdraw money the whole trip, keeping reckless spending to a minimum and alcohol consumption violently stunted. Despite my pauper status I was able to score three beautiful Rwandan fabrics and am now on the market for a Ugandan tailor to craft me some style.
An honest ‘sad truth’ about the whole trip was that the food was maybe my favorite part. You must understand however that food takes on a different kind of meaning in your life when you are confined to cabbage, potatoes, matoke, rice and beans for every meal…such is my eating reality in Uganda. We met up with this really fun cute couple from U of O who had just graduated and decided they’d play house for the first time in Rwanda (whatever you’re into I guess)… anyway they were Kigali experts and the first night took us to an UH-mazing Indian restaurant complete with Mango Lassi and every muted color curry you can imagine…heaven. The following evening they hosted my favorite kind of yuppie wine, salad, pasta, bruchetta party; I remenesced about yuppie parties past. I was a little homesick, a little tipsy and sufficiently stuffed as we departed; it made me happy to know that half way across the globe I can still find a few conscious Americans who want to step out of any present catastrophes and bask in wonderful indulgence.
Monday we drove 3 hours east towards the DRC to Volcano National Park, only to be met with a firm “no, I’m sorry, it’s not possible” upon request to a private guided volcano hike…only 1 hike leaves a day, and that is at 7am. Somehow we whined and lied and puppy-eyed our way into the system and before I knew it we were trekking upwards at a pace that me and my “I’ve been sitting on my ass in Africa for a month” thighs were not prepared for. The ascent to the top of the volcano whose name I can’t remember was 3800 meters, and took about 3 hours. About 100 feet from the top, it started raining…sorry, I meant pouring…sorry, I meant hailing. My mantra of “wait till you see the view from the top” was immediately dashed upon summiting. I realized that my only view was of the thick envelop of cotton ball mist and the thick bowling ball raindrops wailing in front of my hooded view. We all kind of half-smiled at each other, choked down some donated glucose biscuits and prepared for the descent. This experience I may add, was perhaps one of the most challenging I’ve encountered and demanded from me supplies of patience, focus, strength and humility that I had never tapped into. Going down took longer that hiking up as each step had to be calculated perfectly keeping in mind hill grade, mud viscosity, leg shaking vibration gradients and how-close-to-tears measurements…all in all a very scientific experience. All I could think about was how I wished I’d brought a helmet and how I had no medical insurance in this country, it was great. We did see two gorillas though (normally a $500 event, seriously); they were hanging placidly in the big huge jungle trees making noises I’ll never be able to replicate despite my tireless efforts.




On our first day there we visited the Rwandan genocide memorial as well as Niyamata, a memorial church. It’s hard to speak about what that was like. How it affected me. How it changed or broadened or shed light on or confused my perspective of Rwandans. The whole event was nothing but devastating, nothing but utterly horrifying. The brutal itching scars of colonialism coming back to haunt a culture years and years after their occupation. It makes me sick. It makes me wonder how a Rwandan could ever look at a mzungu with anything other hatred. I don’t quite feel up to describing the experience right now, but I will and I ought to. But I really encourage people to do some research into the history of the genocide in Rwanda.

We saw zebras on the drive home. They were grazing by the side of the road. So free, so wild…we were able to slide the windows back in our taxi-bus and I could feel the cool equatorial air whip at my face and my chest. My ipod was playing Neil Young I think. It felt good, one of those “I love Africa moments”…

love from a clinic in Kyabirwa

Soft Power Health came to be in the first rainy season of 2006. An American physician, Dr. Jessie Stone laid the bricks of the clinic herself and worked her tiny frame all day for months till the mosquitoes became too ferocious each dusk. Her vision was a world without malaria. A world without one of the most preventable diseases imaginable; a world without the disease that kills more children under 5 in Uganda than anything else…think death counts in the millions. She began chipping away at this by conducting basic community training with the rural villages; talking about malaria, its transmittance and offering absurdly subsidized insecticidal mosquito nets (about a buck n’ a half each). The program was a success and she now finds her cell phone in the states being blown up with the LC’s (local councilmen) of villages wondering when she’s making the rounds in their neck of the bush.
They do good things here; the facilitation of an extensive rural outreach program in which they discuss, educate and train villages about everything from HIV awareness to prenatal care to proper mosquito net hanging. Soft Power Health also manages a full time primary care clinic operating out of Kyabirwa Village (my home sweet home); we treat mostly malaria cases, the occasional malnourished baby, here an infected open sore, there a hypochondriac suffering from “back pain”. The flat fee is 5,000 Ush… about $2.50, this includes your consult with the physician, any lab work rendered necessary and whatever drugs we can prescribe you from our aforementioned closet pharmacy.
As this is the first real job I’ve had, short of ringing in cocktails for The Man, I was slated for obvious hesitations about what life in a 40 hour work week really entailed… but lucky for me and all future employers, I’ve been pleasantly surprised to find it isn’t the black hole of energy and pleasure I’d imagined. In fact, on the contrary I enjoy it…ya might even say its turned me into a morning person *gasp*.
I wake up according to my own free will (which is just weird because my own free will says 8am is cool, opposed to like noon) and then hop out of bed. I pull back the colon trap mosquito net that sets me into claustrophobia induced fits a few times each night, maybe pee in the pit latrine (but only if I know I’m not going anywhere with a flushing toilet before 2pm) and then sit myself down to a breakfast that’s been waiting on a tray for me for a few hours…just how I like my eggs really. I then do some questionable guess work as to how my newly short hair looks and eye myself awkwardly in my pocket-sized “mirror” made out of the tin foil-esque material they use when fashioning the looking glasses for porta-potties, hiking bathrooms and prisons. After my fashion biddings have been tended to I jump on my new mountain bike and cruise through a few kilometers of dense jungle village dirt paths to none other than the Soft Power Health Clinic.
And then begins the real work, the real nitty-gritty… but first and foremost, we take tea. As is the way of their colonial predecessor, Ugandans also agree that any time is a good time for tea time…an thus I’m offered piping hot milk tea (boiled milk with sugar) or water tea (boiling water with loose floating tea leaves and sugar) dozens of times over the course of my sub-tropic equatorial afternoons. Oh, and for clarification, when I say with sugar, it isn’t our delicate few teaspoons…its 3-4 heaping tablespoons of it…literally...ya like cavities?

Tomorrow at dawn Ill head south west, slicing through the countryside to the border with Rwanda…which if I’ll goes as planned, I’ll be able to cross. Ill be taking a 10-hour taxi ride with a few of the other interns into the capital city of Kigali. We plan on doing the tourist thing for a day or so, visiting war memorials, genocide museums ect, but I’m also stoked to go to their volcanic national park and ascend to the top of one of the inactive volcanoes…yeah, crater lakes! We’ll return home on Tuesday, which is Ugandan Independence day. This marks the 45th anniversary of Uganda’s independence from Britain. Their 45th anniversary as a ‘democracy’; although they have yet to see their country bask in the glory of the ‘people’s choice’ as their current ‘president’ Musevini has modified the constitution over a dozen times in order to maintain his rule for the past 21 years. Ah well, such are the scars left by colonialism.

Happy Independence Day Uganda…may we live to see the day when the millions of displaced northerners return to their villages, when you no longer coexist as the most resourceful nation on the planet as well as the poorest and most exploited and when HIV and AIDS no longer claims the lives of 10% of your people. Maybe next year…eh?