Back in the Saddle

It's interesting to go somewhere, leave it and then return. Prospectives change. I came back to Uganda knowing what to expect... funny story, about 10 minutes before entering the house, the electricity went out. 10 minutes later, the water stopped running. Thanks to my trip to South Africa, I have fresh pita which was dinner and will be lunch today. Seriously though, I find that coming back to Uganda is like coming back to what is normal for me, it was nice to be back in my own room surrounded by all my familiar clutter. I slept like a baby.

Everyone in the neighborhood also recognized me. I got a bunch of "culicayo," "welcome home" from the bodaboda guys in Mpererwe, from some of the shopkeeps on the road to the Luboga's house, and especially from the Lubogas. They said that they have to start fighting for their rights to me. Then when I showed Dr. Rev. Luboga that he made the front page of The Jewish State, he exclaimed "YOU TOOK ME INTERNATIONAL!" He loved it!

Faith, Dr. Luboga's neice, really took on the advocate's role last night. She made sure that there were fruit cut up and rady for me, she kept on sneaking me bananas, and made sure that nobody asked me to do anything besides relax. After stuffing my face with tons of fruit and pita, I excused myself and took off to hit the sack. I slept for 11 hours, 10-9. I guess a fast day (Sunday) will do that to you.

Now that I'm back in the Makerere School of Medicine Library, I feel like I'm back at the helm. There is much to do. Our first school visit is on Thursday, and Lauren lined up 2 more after that. All of the red tape has been shredded, and now there will be blood (reference to a movie by the same name, but probably a bit inappropriate here). I am very excited to start the testing. In retrospect, it's amazing how much we had to go through to get to this point. I feel like now that we can finally work with teh schools there will be much less work to do (not really though).

Talking about work... It's time I get back to it.

Note about pictures... there will be none until I get my camera fixed or buy a new one. Please send your donations to Danny Asher care of Nancy Asher...... (Not a real appeal for money, but if you want, be my guest)

Guilty!

I'm sorry. It's been so busy here in South Africa that I have not updated in almost a week. I had one very disappointed reader contct me and I had to act.

THis week has been absolutely nuts! I've been hanging out with the kids (Paul and Chev Bacher's kids), babysitting, cooking...it's wonderful to have more than a little stove. There was a bris on Thursday, lion park on Sunday, cool African market on Thursday too. It's been so nice being busy with other things here, but I can't wait to get back. Lauren has been working so hard!

Worst part: My camera broke yesterday. It's a summer of so many firsts so it fits that I shouldn't be able to capture it with my camera. I think I'm going to buy one in Uganda.

Amazing news: I have the front page of The Jewish State, a NJ newspaper, on July 18th. I share it with a great friend, Avi Hoffman, so this one is a keeper. Somebosy save me a copy! www.thejewishstate.net. Most of the article is very accurate, I know it's hard to interview and remember things perfectly, but Jason Cohen did an amazing job. They even put a link to the blog! Hopefully people will read and send money... we still need some for the project. AHEM!

I know I said it before, but it rocks to be with family, especially when my sister (in law) gave birth to Channa Asher, picture below.
Anyway, after a wonderful 10 days with my family and I have so many stories to tell and pictures to post, but Shabbos is in about an hour (its the winter here) and Zahara, 2 years old, is standing on the stove... i gotta go.

Have a wonderful weekend!

Lazy in SA

Sunday, July 14, 2008

Family is paramount. Even the kind of family that is not specifically related to you, but you still go through the trouble of explaining how you are related through marriage. I do that because my family in South Africa rocks. I am really living it up here; big bed, tons of food, and the best showers in the universe. Seriously, I feel like I am in a steaming hot downpour. They have one of those shower heads that is probably illegal in the US because it’s a foot or more in diameter and just deluges water in perfectly-sized drops.

I’ve been doing a lot here in SA besides improving my hygiene. Today we went to a game reserve and I pet lion cubs…yes, I’m a tourist. We also hang out on the trampoline, yes, TRAMPOLINE in their yard. I can almost do a back flip…will post the latest attempt. Shabbat was wonderful and full of all types of great conversation (and sushi). And, throughout it all, I have been comparing South Africa to Uganda.

South Africa is a mix of third and first world aspects that have not yet come to terms with each other. We drove down a 6 lane highway and saw huge shantytowns on the hillsides. It’s hard to explain, but there are sections of town that look like Manhattan and others that look like Kampala. Here you can really feel the tension between the “haves” and the “have nots.” There is also a lot of (violent) crime here, probably because of a lot of that tension. In Uganda, I don’t feel that tension. There is a large history of pain and separation here; I went to the Africa Museum on Friday and had a disjointed history lesson. Seriously, skip it.

Left uncompleted…

Snaps (like pictures in Luganda)

This is a sex free school zone
Rev. Dr. Luboga at the focus group

Mount Sinai's lesser known branch in Entebbe

Chameleon on St. Stephen's Hospital's road
Sunrise in Mpererwe

Sunrise in the Luboga's yard

Lake Victoria at dusk

Tastes like babies?

Just a quick update from South Africa:

1. I just ate meat for the first time in 3.5 weeks... twice.

2 MY SISTER IN LAW HAD A BABY GIRL! Mom and baby are healthy. Baby was 6lbs5ounces (ish).

It's great to be with family!

Lake Victoria Luxury

Wednesday, July 09, 2008

Today I went back to the Ministry of Health, but I had a problem. I didn’t remember the name or location of the person/people whom I spoke to last time I was there. So, naturally, I smiled a lot, pretended to accidentally open the wrong door, and walked around the entire building faking epiphanies when I reached the end of a hallway and did not recognize anyone in the offices in that hall. Eventually, I found Christine who was so helpful to me. She was, of course, all business until the very last second of our meeting. “Are you a believer in Jesus?” (completely out of the blue, no religious discussion before this at all!)

I answered quite candidly, “No, I’m Jewish.”

“You’re JEWISH? One of the chosen people?!”

Immediately she started crying to me and told me about how much her church prays for the Jews and for peace in Israel. She hugged and blessed me with the priestly blessing of the old testament among other blessings for about 5 minutes, still crying. I was a bit shocked. After all that impersonal service and telling me that looking at our proposal would take at least another week, a complete breakdown of any boundaries. She then asked me to bless her. So, I blessed her with the same blessings of the old testament, but in Hebrew. She really liked that. I know because she thanked me… and because at 5:30PM I got a call from the Asst. Director of Health who approved of our study. My friend Mike decided that he is going to play the religion card here too, but he’s an atheist, I doubt he’ll have as much luck. I know I’ve said this before, but people are really religious and religiously motivated here in Uganda.

This is going to be a treat. I went to a hotel tonight. You see, going to Entebbe, staying in a hotel, and then getting a free shuttle to the airport in the morning is just about the same as praying that your private hire taxi shows up on time in Kampala. I am paying $55 for the night in a hotel where I can hear Lake Victoria’s waves crashing on the shore, and I have hot water in my shower. LUXURY! I just took my first hot shower of the summer. It’s nice to be spoiled like this. Though, I did miss eating dinner and relaxing with the Lubogas.

Before my shower, I went for a walk to the beach. There were bugs everywhere. I took some pictures and will attempt posting them (writing this one in advance). There were also no muzungus around at all. Just me. So, naturally, I hung out with the security guards and talked about the differences between American and Ugandan culture. (for some reason, every single dog in town is barking and howling now). They get paid 150,000 shillings a month…about $95. We talked about religion, that always seems to come up here, and kidded about starting a business importing obutunda, passion fruit. Passion fruit at 1000USh for 15, in the US they are about $4 each; that’s a 100 fold difference in price and you can get passion fruit much cheaper in bulk. They made me promise that if I started a company importing obutunda and omuyembe (mangoes, also really cheap here), they could work for me for American wages.

On my way back to the motel from the beach, I had a bit of a scare. It’s about a 4 block walk, but instead of paying about 33 cents for a ride on a bodaboda, I decide to walk; the streets were empty and dark. I thought it was an economical decision. Of course, I see someone across the street sitting on the curb who gets up just as I pass by. My prejudice precedes me. I figure, like a good New Yorker, that I’m about to be mugged while carrying my passport, all my money, and my ticket for tomorrow’s flight. So, I turn around and ask him where I can get a bodaboda even though I saw them about a block away. He pointed, but then asked me where I was going. I said Sophie’s Motel. He offered to walk with me. I think I wet my pants. I immediately introduced myself and asked for his name, Emmanuel. I then drove the conversation towards religion, figured that I could get lucky twice, and also spoke about my research “helping the poor children of Kampala.” I put that in quotes because it’s what I said, not because it was a lie. Naturally, he was a real sweetheart who had just finished his shift at the big hotel nearby and had to walk home. I felt stupid and smart at the same time and will probably react the same way if it should happen again.

Tomorrow, I’m off to South Africa; don’t worry, the blog will continue and I will still be working on research for Uganda. You see, Dr. Angela Mathee, in Johannesburg,did similar research and has been helping us all along. I want to get a good night’s sleep for the meeting, so I’m off to bed. It’s 10:20PM..

Rights and not so rights

Tuesday, July 8, 2008

So yesterday was a day full of accomplishment. We got up very early, a huge accomplishment if you know me, and wrote a flurry of emails to different people around the world for some more information about study materials. Specifically, we might be able to get a machine called a Niton XLp 3 which analyzes soil for lead, marks it's gps location, connects to a laptop via bluetooth, and constructs a grid of all the samples...basically half the work. I might be able to get one in South Africa when I go visit my family on Thursday... don't worry, the blog will continue (I know you're all relieved).

After the emails, we rushed back to St. Stephen's Hospital and took the MU medical students out to lunch (7 people ate big meals, it cost about $4) and then walked over to St. Stephen's Primary School, which happens to be next to St. Stephen's Church... all affiliated. There we had a focus group. I don't know what everyone knows about focus groups so here comes the long winded explanation; nerds can skip to the next paragraph. A focus group is a quarum of people from different walks of life put together in a room to represent a community or target audience. They answer questions intended for the community and basically help researchers flesh out good questions from bad ones, important information from the not so important, etc.

So this focus group helped us go through all of the information in the study documents and discuss it’s cultural applicability and clarity. I am going to go through the issues from least to most interesting (to me).

1. Risks and Inconveniences

In this section of the consent document we discuss the possible negative outcomes that could happen to study participants; perhaps getting the venous sample could cause an infection, bruise, or some pain, or maybe getting identified with a high lead level could be stigmatizing to the child. However, the focus group said that when muzungus talk about risks they mean small things, but when Mugandas talk about risks, they mean broken bones, death, and blowing something up. They said that they don’t want to be told about risks when there are none. They said instead we should write “This might happen to you.” Like I said, least interesting first.

2. Privacy

I know that many of you have either heard of or perhaps signed a HIPPA document explaining that all of your health information is safe and that nobody besides those treating you will know any of your private information. Well, the largest section on the consent form, mostly because it was made in the USA, was the privacy section. People in the focus group laughed at this section. They explained that they all lived in the same community and everyone takes care of everyone else, why should other people not know? How can they help if they don’t know something is wrong? People have no privacy here.

But now that I think of it, they are wrong. People do have privacy and know that it matters. You see, when someone signs up for an HIV test, nobody else finds out about it. And I don’t know how ready everyone is to share that information. Though, when we visited a lab at a hospital which will remain anonymous, they showed up the monthly record of HIV test results. Maybe they thought that because we were medical students, it was alright to show us other peoples’ results.

3. Rights

“We don’t have rights.” Was that clear? When we were discussing the fact that signing the consent form does not make them sign away their legal rights, they said they had no rights. When I pressed them for more information, they said that there were actually legal rights, but in order to get them you have to be well connected and rich. So basically, regular people, those without any major connections or wealth, in Uganda recognize that they have no attainable rights… and they don’t have the resources to fight for them.

At MSSM we had an exercise during the last 2 weeks of medical school where we discussed rights. We were asked what rights we believe that we have. We listed things like the right to vote, fair trial, privacy, legal protection and action, etc. Everything good Americans know they have in their arsenal. When we discussed what people in the third world believed should be rights, we found out that they were more focused on the right to food, healthcare, and other basics. We take those things for granted. We don’t really think about those things as rights as much as we see them as things that are available (to most, if not all).