Culture with a Corporal C

Tuesday, July 22, 2008

I think that many of the differences that I see between Johannesburg and Kampala are related to the type of interactions I have with the environment. In Joburg, I was with family all the time. It was a welcome break from being in Uganda and basically being on your own all day. Now that I’m back, however, I am clashing with the culture on a more basic level.

Today 2 students from Makerere and I went to 3 different schools around the Kiteezi landfill to ask permission to recruit students from them. It was so nice to hear the students learning in sing-song, really it was something out of a movie. I hate that I don’t have a camera… hopefully I will fix that tomorrow. The children greeted us to their school in unison. And then we went to the field, among little children playing, with the deputy of the school to discuss the project.

The meeting went very well. We discussed all aspects of the study and what help we needed from the school. At the end, he asked us to do ourselves and other researchers a favor. He said that other people come into the schools, take samples and then nothing. Nobody contacted them to inform them what the results were, nobody took the research any further. He said (something like) “don’t just take our children’s’ blood and write a book about it in America, help us make a difference.” Wise words. They reminded me of a professor at Mount Sinai who at first blew up at me when he found out that we were going into schools to analyze blood for lead levels. He thought that we weren’t going to provide treatment or education, just go in there with some skewers, stick some kids and run. Some people have a lot of distrust for researchers because they have been used by them in the past. Just an aside, this happened in America not so long ago… check out the Tuskegee Study on Wikipedia.

We assured him that we have no intention of leaving them high and dry, and he agreed to look over the forms and call us in a day or two. As he was walking us out, however, the visit turned very sour, for me anyway.

As the little Muganda children with bags on their back were walking, holding hands, back to their homes, I saw six boys are lying face down on the ground, their teacher above them. One of them was already crying, protecting his bottom by lying on his side. It took me a few seconds, but I realized that the teacher had a cane in his hand. I prayed that he didn’t hit the children in front of me, I don’t know what I would have done. I almost stopped him to begin with. The Makerere students were chuckling embarrassedly because, as they told me, they were in that position before. Students in Uganda can get up to 3 hits of a cane for any reason. Henry told me that at his school they hit him for getting below average marks; he’s been studying as hard as possible ever since. Teachers are allowed to give 3 lashes per student per day, the headmistress/master can give 5, and parents have no limit.

I wanted to say that it was barbaric and cruel; only savages hit their children. I wanted to judge them with my American values. Instead, I, an American medical student who learned that any evidence of abuse is required to be reported to the authorities, witnessed abuse and walked away. Abuse, you should just be aware is not reportable in Uganda…that’s what I was told by the medical students (I’m not sure if that is a legal or practical opinion). I haven’t had any lashes ever. Besides, that abuse is legally sanctioned. I don’t know if I did the right thing and I feel like I did not. I hope the teacher is now telling his wife how hard his day was because he had to cane six children.

I’m not sure what hospital (in America) I was in, but once I saw a woman slap her child very hard; not the kind of slap that people give to stop their children from doing something wrong. This slap was out of anger. I made sure that we caught eyes, and in my full ID tag regalia, I gave her a very stern look. She blanched immediately and apologized to her child. I could have taken it further, but didn’t out of embarrassment for me and the woman. I think this will be one of my biggest challenges as a doctor; learning when to be nice and understand where the people are coming from, and when to report them to the authorities.

I don’t know if I did the right thing.

I can’t end there. It’s too dramatic.

For the past two evenings I have been greeted at the Luboga’s by two amazing species of bird. One had a head that looked like it had been hit on both sides by a frying pan. Seriously, the head was almost 8 inches tall. The other was an extremely skinny light blue bird that stood about 3 feet tall.

That didn’t work. I’m going to make some comfort food…Black eyed peas. There isn’t any kosher French fries or barbequed/fried chicken here.