Unsuspected Site Visit

Receiving an email saying there is someone coming to your site always gives an initial knot in your stomach that being informed of an audit always does. Sure, even if you have been doing a great job and things are going well, you never know what the auditor, or in this case the visitor, may learn.

That knot came to me upon opening an email from not just Peace Corps, but also USAID indicating they wanted to send a photographer to document my Peace Corps life. Each year the US Mission to Uganda creates a “Report to the Ugandan People” outlining all the work the mission is doing in county. This report aggregates stories, projects, photos, and reports from the US State Department, USAID, Centers for Disease Control and Prevention (CDC), Peace Corps in Uganda, National Institutes of Health, PEPFAR, and the Department of Defense (DOD)… and the photographer was sent to capture my story in the hopes of adding it to the 2017 report.

Fortunately, the communications officer and photographer downplayed the assignment indicating they just were going to be in the area and were looking to get a glimpse of my life as a Peace Corps volunteer. Although I haven’t been all too busy at work and felt like I may not be the ideal candidate, I accepted their request to stop by for some photos and an interview.

Dorcus, the USAID communications specialist, and Karin, the contracted photographer, swung by the office on a busy morning as the team was preparing to host a prospective donor for a capacity assessment. With the chaos in the office, Karin recommended we head outside to sit down and discuss my work. Her questioning started with familiarizing herself with my technical work, but the conversation quickly switched as I talked about goal two and three of Peace Corps to explain how two thirds of my work pertains to cultural exchange.

As we discussed and the conversation deepened around goals two and three, my interactions and holiday celebrations with my homestay family blossomed as the essential element to my Peace Corps story. After sharing a few laughs of my Easter stage fright we took a walk around the office to get some “action shots.” The whole ordeal took only an hour before they were off to their next assignment for the day.

Peace Corps Volunteer Derek Smith-3

While sitting at my desk that afternoon I was thinking to myself that there is no way my story makes the report because the office photos don’t match the fun cultural exchange stories that came out in the interview. Just as I was pondering that thought my phone rang. It was Karin and she asked if I could organize a visit to my family’s house the following day since one of their assignments canceled and she wanted to capture those interactions I spoke of.

Although my host sister Maureen currently lives in Kampala, she still worked as my main point of contact to ensure that my mom would be home the next day for us to swing by for some photos. That initial knot of a site visit deepened as I thought about whether or not this visit would live up to my eccentric story telling…

Mum on the sigiri
First we cooked

Mum and I Cooking

Tasting the salt
Then I tasted
Family Lunch
And we ate

Neighbor and I

Meet the parents

Derek Brothers

The visit ended with some small drinks and hugs all around. Karin was welcomed into the family and Dorcus continued to giggle from the stories. Not only did the photos live up to the stories, but now my family and I have more stories (and photos to go along with’em). Perhaps even one day these stories will also be shared with the Ugandan people.

All photos were taken by Karin Bridger, a freelance photographer and videographer based out of Kampala, on assignment with USAID

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An Easter Sunday Baptism

The Tuesday before Easter I received a call from my host sister, Maureen, asking if I had any plans for Easter. My initial response was to ask, “when’s Easter?” Once hearing it was the upcoming Sunday, I knew there was nothing planned so I committed to celebrating Easter in Iganga on the spot. The phone call was brief and I was thrown off about how soon it was so I forgot to ask some key questions such as when should I show up? How do you celebrate? What should I bring?

On Easter Sunday I was out the door as a storm cleared mid morning. I received a few messages from Maureen early in the morning letting me know that I was going to miss church and the baptism because I didn’t travel before the storm. I had to give my head a shake because I didn’t know that we were also celebrating the baptism of my oldest host brother’s first born. I made a mental note to never forget to ask the appropriate questions when committing to attend a celebration. Although I missed the ceremony at church I made it just in time for lunch to be served at home.

As I was walking up to the house I went from hearing to feeling the bass thumping and saw three party tents taking over the front yard. At Christmas there were about 15 of us at home celebrating, which is what I was expecting, but once I saw the tents I realized this was a bigger ordeal. Upon my arrival there were already over 100 guests eating their lunch.

 

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The size of the event was larger than any I’ve been to before, but the structure remained the same. As everyone was finishing their meals to the pulse of the loud music, it suddenly cut to tapping and blowing on a microphone. In Uganda, its not a celebration without speeches. As per tradition, the father of the father of the baptized child (my host father) was introduced to welcome everyone to the event. After the welcoming remarks came a musical interlude before my host father was reintroduced back to the stage to call upon his close friends and brothers to join him and introduce themselves to the mother of the child’s family. Usually these introductions are short, but you can always count on at least one person to fully utilize their time with the microphone.  This whole ceremony was conducted in a mix of Lusoga and Luganda so in order for me to understand what was going on I needed to pay very close attention. Rather than take this opportunity to work on my language I was working on my peek-a-boo skills with the little kids around me instead.

Once all of my homestay father’s brothers and friends returned to their seats I heard, “something something children” in Lusoga. Unsure what that meant I continued to play with the little kids without looking up. One of my host brothers came over and gave me a tap on the shoulder and I saw all of my siblings walking to the front. Oh no! It was our turn to go up and introduce ourselves. That “something something children” was him calling up all his children. Since the mother’s side of the family was from Kampala and were openly speaking to each other in English, I ignored the initial panic of needing to speak since I knew I could grace them eloquently in English. As we went down the line of the 12+ kids up on stage everyone was greeting and welcoming the other family in Lusoga. Just as my host sister was passing me the microphone my host brother Derrick smirks at me and whispers, “in Lusoga, in Lusoga, in Lusoga!” That very moment was the first time I have ever felt stage fright and a loss for words. It was as if my brain was a car engine revving in neutral. Processing processing processing yet going nowhere. Eventually I found the words in the local language to greet them and tell them my names are “Derek Smith … Masanja,” which gave everyone a good chuckle to lighten the mood after the nervous silence that preceded.

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My host brother, Joseph, with his girlfriend and baby boy accepting gifts.

This sequence of introductions with heart thumping musical interludes continued next with my host mother with her friends and sisters before the microphone was passed along to the other side of the family. During the musical interludes children were rewarded with sweats and face paint for dancing, which tactfully broke in the dance floor for the adults to join as they finished their drinks.

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Music and dancing continued throughout the afternoon and roasted goats’ meat was prepared for an afternoon snack. With goats’ meat in my belly I said goodbye to my family and vouched to come by more frequently before getting into a mutatu headed home with ears ringing and mouth grinning. All the while, laughing at myself for forgetting how to speak.

Initial Programmatic Implementation

Now that the contracts are signed, the scope of work solidified, and action plans verified, implementation of our integrated health project has begun. Although this is a health project and I’m new to the health sector, I’m currently tasked to support my partner organization, Action for Relief and Development (ARD), implement. Through this USAID funded health program, implementing partners are tasked to support the Ministry of Health by strengthening community-based networks to increase access and continuous utilization of government health services.  The targeted health issues include HIV/AIDS, tuberculosis (TB), malaria, maternal, newborn, and child health (MNCH), reproductive health, family planning, and water, sanitation, and hygiene (WaSH).

Family Life School Approach

Although this task seems broad, our approach to achieving the objective is precise. Using Family Life Schools (FLS) we look to identify, mobilize, and refer patients in rural areas with these health challenges to linked health centers. A family life school consists of a group of women that have been joined together and targeted based on their proximity to one another and based on their pregnancy status or age of youngest child. As the base of the family and the most at risk to health challenges, pregnant women are the key target population. By forming groups of expecting or new mothers in rural villages we are able to work with them as a group to address their pressing needs and health challenges. Additionally, by working as a group, these women are able to learn together and from one another as we host a wide variety of health education sessions addressing the targeted health issues of the project.

Group Formation

Last week in the field we worked to create and solidify three family life schools in three different villages. Identifying pregnant women and mothers with newborns in remote villages seemed to me like a daunting task since we had no knowledge of our surroundings, but it proved to be easy with the help of Village Health Teams (VHTs). A VHT is a member of a rural community who works voluntarily with a health center to provide health education and medical assistance to their community members. Although they are not medical professionals, their core competency is their knowledge and the trust of their community members. By utilizing the core competencies of the VHTs, we were able to create three family life schools consisting of more than 40 women each in just two days. In addition to the VHT identifying our key target population and mobilizing them for group formation, they will also be the family life school instructor responsible for educating and referring their community members to program linked health facilities. In essence, we train the VHTs and they train their communities.

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Dr. Nelson, Health Team Lead, sharing a laugh with a FLS

At each family life school entry meeting, our team met with the newly formed group to give the women an overview of what they can expect from us over the course of the year. Our goal was to share with them the knowledge they will soon gain to motivate strong attendance to trainings and group adherence. Not only will these women receive various health topic trainings, but they will also receive tools, resources, and trainings in ARDs core competency, economic empowerment. These groups will be more than educational cohorts, they will also be Village Savings and Loans Associations (VSLAs) with supplemental income as we teach them about savings and investment, income generating activities (IGAs), fuel efficient cook stoves, and kitchen gardens.

Through this targeted group approach, mothers will gain the knowledge and skills required to raise healthy families along with supplemental income and savings to manage health emergencies as they arise.

Health Center Capacity Assessment

Forming the family life schools through a targeted approach is our method for identifying, mobilizing, and referring women to health facilities to fulfill our objective to increase access and utilization of government health services, but we also need to ensure continued utilization.  This part requires us to confirm health facilities linked to various family life schools have the resources required to perform their tasks. While visiting newly formed family life schools in the field, we also spent considerable time reviewing the records of the linked health facilities and listening to the challenges they have. By doing a capacity assessment at each of the linked health facilities we are now able to advocate with them to receive the resources and training required to properly fulfill their tasks. We look monitor these health centers to see if obtaining resources and training will create positive health care service experiences for their community members to subsequently ensure continuous utilization.

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Rosette, Nutrition Officer, leading the Health Center capacity assessment.
Next Steps

With 3 of our targeted 96 family life schools securely established we have plenty of work ahead of us. As new groups in different geographic locations are formed we will also focus on supporting VHTs to provide weekly trainings and referring community members to linked health facilities when required.

Friday, January 5th, 2018

The day began as every other day in Tofo, Mozambique. The sun began to rise just before 5am and the first beam of light came through the window, past the curtain blowing in the sea breeze, and hit my face at 5:35am. After rolling over a few times to dodge the expanding beam of light the persistent sun convinced me to start the day. It was 5:45am and the sun was already bright and disorienting, light penetrated throughout the entire house. I opened the door as gently as I could and tried to step over Charlie, the dog who sleeps at my door, without waking him on my way to the bathroom to shower and start the day.

Still wiping the sleep off my face to look in the mirror after the shower, I could hear Dolly, the little terrier, prancing down the steps from the loft to greet me. Upon opening these groggy eyes, I could see the line developing for the bathroom with Elliot, my friend from University, and Richie, Elliot’s friend and the owner of the home, waiting patiently with coffees already in hand.

While eating a bowl of granola with soy milk, an indication of this life of luxury they were providing, we calmly went through the talking points of our morning discussion including number of dives, conditions of the ocean, any surf, who is making dinner, what’s for dinner, a beer in the market after work? Once the boxes were checked Elliot and I walked two minutes out to the main road and at 6:40am we were picked up by one of his coworkers and piled into the back of the pickup and were off to the dive shop.

As the employees of Tofo Scuba went through their morning routine of opening the shop and preparing the gear and boats for the dive clients, I made my way through the bustle and out to the beachfront restaurant to stay out of the way. In the restaurant with a toasted egg sandwich in hand I watched the waves come in, all the while calculating how long I would be able to hold the sandwich down before sea sickness would take over out on the water.

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At 8am, Elliot’s dive instructor safety briefing was complete and we began walking down the beach ready to push the preloaded 9-meter inflatable sided boat, for our two sequential dives, out into the water. With a tractor behind us pushing the boat through the sand stronger than the waves crashing ahead of us, the five divers and two instructors managed to launch the boat and we all heaved ourselves aboard just as the skipper fired the dual engines to bring us to our first reef of the day.

Since the diving conditions are a bit challenging in Tofo, we were instructed to take a negative entry to start the dive. The easiest way to describe a negative entry is by imagining how a boat full of Navy SEALs would enter the water. Our instructor, while using a GPS, counted down the meters to our drop spot. With 20 meters remaining we were instructed to put our masks on and hold our regulator in hand. With 10 meters remaining we were instructed to put our regulators in our mouth and prepare for the count down.  Elliot gave us the three, two, one, go! And we all rolled back off the boat at the same time and immediately began our decent to the ocean floor 30 meters below. Once oriented in the water we found the dive line Elliot was swimming to the bottom and we followed it down to ensure we did not lose the group in the current. Once reaching the ocean floor we checked in with our buddies and the instructor to give the OK sign before following the current along the reef beginning the dive.

Continue reading “Friday, January 5th, 2018”

The more the merrier

Christmas with the Masanjas

Family Christmas with my family in Iganga felt the same as family Christmas back at home. Sure there were some differences, but the structure and feel of the whole festivity contained the same core components that makes celebrating this holiday so special to me.

Just like at home…

… It was a huge ordeal with extended family traveling out of their way to celebrate together.

… There was a large special meal prepared.

… There was an open door with friends and anyone else without a celebration welcome to join.

… The little children were running around screaming and drinking bubbly, sugary beverages.

… The youths were up to no good, but stiffened their backs and were extremely respectful when facing the adults.

… An uncle showed up with a home brewed alcohol beverage.

… Some went to church while others stayed back.

Unlike at home…

… We cooked on open fires outside.

… We sat and talked under the shade of the trees.

… The main meal was a late lunch instead of dinner.

… The evening turned into a massive party throughout town.

As one can tell, the only differences seemed to be situational upgrades. Cooking and relaxing outside on a nice sunny day rather than tucked away from the ice and snow outside created a whole new dynamic. Rather than the little kids’ screams and shrieks filling the house, they faded out in the open air. Rather than cooking in a crowded kitchen with well meaning hands getting in the way, only those who knew what they were doing got close enough to the open fires. Rather than enjoying a warm beverage under a blanket after the meal, cold beers were consumed under the cool shade of the trees as the sun went down. Rather than everyone teetering out as sleep consumed them, beers kept flowing till the heavy bass from the music in town motivated them to stumble to the party.

The only addition I’d like to add that doesn’t run parallel to this story is the underlying feel of Christmas in Uganda. In Uganda people talk about where they live and where they are from. Where someone works is usually where they live, but where their family has lived for generations is where they are from. Christmas is all about reconnecting with where you are from with people fleeing the cities and taking the trip “out to the village.” A Christmas is best spent out in your village, with your family, enjoying each others company alongside a hefty meal. For me, this raw celebration of those around me, in the sought out simplest of settings, and without the distractions of my daily toil really made celebrating Christmas a treat this year.

To give you a visual sense of how Christmas day played out, a few photos and captions may tell the story better.

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Upon arrival I was greeted with morning tea and spot in the shade.
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My host mother hustling between open fires preparing the meal. On the left is matooke steaming in banana leaves. Matooke is from the banana family but doesn’t have any sweetness and is usually prepared mashed like potatoes.
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My host mother and sister, Maureen, checking the status of the matooke.
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Maureen and host brother, Pius, preparing to serve the fried rice. Mother is multitasking as only moms can really do. You’ll also see a chicken and a beef stew just above and to the right of the rice. Matooke can be seen still wrapped in the banana leaves.
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Maureen sipping the malwa (local brew) as my host father grins with joy and uncle wonders why I’m taking a photo.
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Post meal relaxing with the family.

Hiking Sabinyo

Mount Sabinyo has three peaks and the third marks the intersection between Uganda, Rwanda, and the Democratic Republic of the Congo (DRC). Getting there required an approximate 10-hour bus ride from Kampala to the town of Kisoro in the far southwest of Uganda. The early rising group decided to take an 8am bus all the way to Kisoro to (hopefully) ensure arrival before dark. The other group elected for a 9am bus to Kabale, which is the city before Kisoro and roughly still two hours away. Once in Kabale their plan was to catch a mutatu from Kabale to Kisoro for the last leg of the journey.

I quite predictably joined the early departure in order to take just one mode of transit all the way to Kisoro. The hope of arriving earlier meant getting situated and properly eating before the 6am hike the next day. A lesson learned over and over here is you can only plan so much. Our 8am bus ended up leaving at 9:15am, the same time as those taking the 9am bus. Our bus then proceeded to stop significantly more throughout the journey. Then once hitting Kabale, the bus driver decided there were not enough passengers to drive all the way to Kisoro, so he made us get out and set up a car to take us the last leg. The sedan from Kabale to Kisoro lasted about two hours as we rode four in the front and four in the back. This was the first time I’ve ever seen someone drive with a passenger also in the driver seat. I’m still unsure if she was helping to receive a discount on the fare or if she just sat there perhaps getting in the way of the clutch and stick.

I wouldn’t call it predictably, but not at all unsurprisingly the “early morning” crew managed to reach the destination over two hours after the other group. Fortunately, our group was in high spirits as we arrived late in the evening because other than the high spirits, our bodies were in no way in proper shape for a 10-hour hike departing early the following morning. To ensure safe passage on these long haul rides, tactically dehydrating and fasting is a technique commonly used. Although this strategy can enhance minor discomfort throughout the journey, it prevents all sorts of extreme discomfort that can otherwise not be attended to.

The Mountain

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Mount Sabinyo means “tooth” in the local language. Other than that, I cannot really tell you much about the significance of the mountain for a few reasons. The first is because I was usually sucking wind and using all my energy to try and seem cool any time we caught up to our guide as he frolicked up and down the paths significantly ahead. The second is because the guides were there for our physical safety. There were two men who went out ahead of our party with guns to scope the trail and one with a gun who followed behind. The guns were not meant to shoot anything in particular but to scare off large animals that may have wanted to share the trail.

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Of the three peaks, the first one took the longest, roughly 4 hours to reach. We started off on quite a flat trail that led through a bamboo forest, a stream, and a swamp on the way to the base of the mountain before gradually hitting steeper and steeper inclines.  The pace set at the beginning felt more like a jog than a walk, which really did not instil any confidence in me in regards to my chances for success. Upon reaching the first peak we took a well needed extended rest before proceeding to the second and third peaks. Each of these next peeks only took about an hour each as we climbed up and down ladders and steps to the tops.

If it were up to me, I would have liked to have been airlifted to the first peak to skip the grueling hike and to just enjoy the adventure of the ladders in the clouds. The way up the ladders was physically challenging, but focusing on breathing and keeping a steady pace occupied the mind with the finish line feeling closer and closer each step. The way down proved to be a bit trickier. A few of the people on the hike were scared of heights, which required me to coach one of them down the ladders. Although heights are not particularly scary for me, coaching someone down makeshift ladders in the clouds proved difficult.

For example, I’m was telling my friend Ashya, “okay now put your left foot on the rung that your right foot is currently on.” I look down to provide some insight on how far to go. “Okay now let’s keep going steady one at a time. We have at least 5 or 6 more before we need to switch ladders. There is a space big enough to hold one foot before switching ladders. I’ll let you know how I maneuver it when I get there, because I can’t really see where the next ladder starts.” As I’m trying to guide her down I’m also wincing as I speak because I know my words aren’t exactly helping or downplaying the frightening component.

Once we made it back to the first peak we were all either riding the adrenaline high from the ladders or shaking from fear, but little did we know, the hardest part was yet to come. The journey back began with high spirits as we chatted down the path, but bend after bend we started realizing just how far we had to go. At least 3 times someone stated “Ah the final stretch is here,” and each time they were incorrect. Eventually, once somber silence took over the excited euphoria, we made it back feet dragging.

While simultaneously doing some reflection on the bus journey home while also deeply exhaling and grunting as I massaged out the aching legs I realized how my physical health has really been low on the priority list since arriving. Focusing on work, reading, meditation, friendships, and building community have all been of the utmost importance but for some reason exercise has not made the cut. Now that the grueling yet rewarding hike is over, I’m realizing its time to start focusing on my physical health since all those other focuses seem to be stable or developing nicely. Perhaps that will start after New Years though… I need to gorge this Christmas with my homestay family and enjoy myself on vacation in Mozambique.

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Pleasure doin’ business with ya

Being awoken at 5:04am by a text from my counterpart, Dr. Nelson, is not how I intended the morning to begin. We agreed as we were leaving the office at dusk the previous evening that he would pick me up at 5:30am for our day trip to the far east districts of Tororo and Manafwa. I had set my alarm that night thinking we agreed on 5:30am, so there is no way we leave any earlier than 6:00am, but I’ll be prepared for 5:45am only because I get anxious if I’m not early. So I set my alarm to get up at 5:15am in order to be early and prepared at 5:45am for our scheduled 5:30am departure.

The text at 5:04am said “Are you awake? It is 5am.” To which I replied before getting out of bed, “Good morning. I’m awake and nearly dressed.” After throwing some water on my face to get the blood flowing and beginning the teeth brushing portion of the morning routine I glanced back down at my phone to see that he immediately responded, “In the next 25 minutes we should be at your place.” I had to give my head a shake while brushing my teeth to figure out if this was just another anxiety dream or if I was actually running late for something here in Uganda. I went back over our conversation as we were leaving work the night before in my head, ran the numbers to see where I had made an error, and continually I kept coming to the same conclusion. I should be sitting around aimlessly for at least 15 minutes this morning and not rushing out the door.

Lesson learned. Dr. Nelson is always on time and therefor I need to start getting back in that habit when I’m working with him.

Our early morning, on time departure was to ensure that we had enough time to meet with the District Health Officer in both Tororo and Manafwa, which are near the Kenyan border. Meeting with district level government is part of the process to receive access to the district before program implementation. These meetings are less than a pitch, but more of an informational discussion with the key players. If all goes well, hands shake and an MoU is signed by my organization and the district stakeholder commencing programmatic implementation.

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Dr. Nelson admiring his project booklet before the meeting in Manafwa.

Continue reading “Pleasure doin’ business with ya”