Ssemwange Mirazimu update

Remember the little boy with the hole in his skull? Ssemwanga Mirazimu? Well, before we get too far from Uganda and things get lost in the shuffle, i wanted to give an update about our little adopted boy.

I think the last time I wrote, he was sitting in Mulago hospital waiting for surgery and we had bought the supplies. This was back in January. There was a week delay from the original time we were supposed to show up because the operating room for the neurosurgeons, which are only available to them 2 days each week, was closed because a visiting team of cardiac surgeons were coming to the hospital. So, everyone was put on hold. We did get admitted, but unfortunately, during that hospital stay, after about a week, our boy was sent home from the hospital, actually, because he got a fever. I mean, why would a kid with a fever stay at a hospital to get treated?! He was told to return in one week's time, and after being treated for malaria by an outside clinic, we all trekked back to the hospital. When we arrived back, the pediatric neurosurgery ward was completely full with the aforementioned types of tragic patients, all waiting. This is the theme. I met mothers who had been there for 3-4 months, hopeing to at some point get a chance to be operated on. The problem is, the docs are only there a few hours each day (because they are otherwise at their private practices that actually pay them money) and the operating room time is so infrequent and the neurosurgery cases can be so long that only 1 or 2 kids get operated on in a day. Then there are the emergencies. Given that Mulago hospital is the only referral center for a country of 30 million people, it begins to make sense why so many are just sitting around.

The long and the short of it is that we were not admitted the next time we showed up. The ward was full. The nurses balked. My doctor friend (the surgeon) was willing to squeeze him in, but his partners were upset and when push came to shove, when I finally confronted them, it became clear that the surgery was never going to happen there. Our kid has a big problem, yes, but he is healthy, he is not in any acute danger, and he could not just jump the line of those who had been sitting for weeks. For many reasons, this would not work.
All this took several hours to sort out, up and down stairs from the ward to the clinic, talking to all the doctors on the team, being as graciously pushy as I could. But we were not finished. I was not about to give up...
Our surgeon, Dr. Kiriabwire, who had become my go-to person and seemed to be responding to professional courtesy and praise, thought that there might be a plan B when I asked if there was ANYTHING else we could do. He said he would contact the hospital where he has his private practice, International Hospital of Kampala (IHK), to see if there as any way to do the surgery as a charity case. We had a few more weeks of phone contact (ie, Rusha calls every few days to politely ask how things are going) and lo and behold, he said that his partners were in agreement that they could do the surgery at IHK!
The last week of our time in Uganda, really drawing it out to the very end, Ssemwanga and his mommy Sarah and I met at the taxi park in downtown Kamapala, easily the craziest, most crowded place I have ever been in my life. We found eachother and made our way to this fancy private hospital. Sarah could not believe how organized the place was: you registered and had a card with your name that could be found again, you were sent to a triage area to get vitals done, you met with a doctor who did a basic history and physical, you got labs done right there, and finally you went to the ward. We were put on the Hope Ward, a place for the hospital to care for patients who would otherwise not be able to afford their care. The hospital was quite modern with nurses on the floor full-time (unlike in Mulago where no one is there at night) and the capacity to take vitals, meals for the patients, bedsheets and clean bathrooms, doctors on call and reachable should anything happen... She was in total disbelief and was obviously uncomfortable in that environment. She had spent the only money she had to get her hair done before the hospital stay--one cannot show up at such a place without a new hairstyle! After a full day of logistics, we established that the surgery would take place on Saturday (the day before we were leaving for the west of Uganda) and I left Sarah to wait for a day. She did not want me to go and called often to ask for help. One time, when I asked he what was wrong, she said that she needed sugar for her tea. I fear I created a bit of a dependency problem. (She also asked if Guy and I could pay for the school fees of her other boy.)
So, the story ends happily. The surgery actually did happen. I swear, we were not sure it would until it did. We got a nice gift for Dr. Kiriabwire and we went to see him post-op and it was really one of the best overall experiences I had in Uganda. To see something through and have it work was so rewarding and rare. It will be hard to follow up on this guy. I talked to the mom, Sarah, on the phone from western Uganda and found that he was home and had already had a follow up with the surgeon and that all was well. She has no email and wanted my phone number in the US, but hopefully through some of our friends at the clinic at KCCC, we can follow her a bit and see how she and Ssemwanga are doing. He will not remember much, but we hope that this helps him to grow up and have a full life.

Bwindi impenetrable Forest, the Mountain Gorillas and Lake Bunyoni

After a well deserved and well needed night of sleep in Kasese, we re-packed our now lighter back packs and set out for 160 km trip to the southwest of Uganda, and Bwindi Impenetrable Forest. We decided to take the "long way" which took us through the heart of Queen Elizabeth National Park. After the usual Ugandan delays of waiting for a taxi etc... we finally arrived at an intersection with the main road and the Ishasha road which is a 100 km dirt road through the middle of no-where. As we arrived, a car packed to the hilt, topped by mattresses,bags and chickens was getting ready to leave. However, when the driver saw two Mzungus reaching his intersection, his face lit up with dollar signs and he approached us. We haggled for a price, knowing that on this remote road, on a Sunday, this may be our only chance to cross to the other side of the park. Then not knowing where he was going to fit us and our big bags into an already overstuffed shit-box, he told us to get in. There were already 8 people and a baby in the car, we made it 10!Two people were in the driver seat, 2 in the passenger seat (and a baby) and 4 people sat across the back seat, with 2 grown adults on the passengers laps. All this in a small Toyota sedan! This may have been the worst ride of our lives: 3.5 hours of dirt road in the midst of a stench of humanity that is uniquely African. We eventually arrived in Buhoma, our destination after a day of traveling and spent 2 days recovering, doing laundry, popping foot blisters and resting up for the next leg of the trip, which was to be a walk through Bwindi Impenetrable Forest NP. The park was established on the border of DR Congo to protect the mountain Gorillas, a group of about 700 animals left in the world that live in this park and another one..

On a clear morning, we met our guide/owner of the walking safari Asgario and, after the usual fee/guard/tip/checkpoint fee/NP fee/Walking fee/breathing fee... we set off to cross Bwindi NP from the north to the west walking 10 km in a beautiful primary rain forest. We saw blue, Colobus and vervet monkeys and some rainforest fauna. We emerged on the other side and climbed a substantial hill through the farmland that starts within feet of the park borders and crested to the village of Nkoringo, where we spent the night. The hilltop camp where we stayed had stunning views of Bwindi to the north, and the Verunga volcanoes on the border with Rwanda to the south. We went to sleep in great anticipation of the next morning, when were to track the Nshongi gorillas, one of 4 gorilla groups in the Bwindi park.

We awoke early in the morning, broke camp, and headed to Nshongi. The mountain gorillas, made famous by the movie "Gorillas In The Mist", number about 700 in all, and are divided among several groups in Rwanda, Uganda, and DRC. About 5 of these families are habituated in Bwindi, and can be tracked by and interact with people. The gorillas exist only in these 3 parks, and so intensive efforts have been undertaken to secure their home environment, including the relocation of the Batwa pygmie peoples from the forest. The gorillas are tracked by sending scouts ahead to follow the path of leafy destruction they leave after their previous night’s nest. They rarely move more than a km or so a day. After a short briefing we walked to the forest's edge, and after 45 minutes, and barely into the primary forest, we came upon the gorillas. Our first sighting was a big silverback, the dominant male of the group, pickily eating marion fruit and farting. Slowly we encountered gorilla after gorilla, most lazily sitting, totally surrounding themselves with yummy vegetation, gorging themselves. Ohers were in trees. All were eating.

The group had 2 silverbacks, some new babies and all in all about 35 members. We spent an hour with the critters, which is all one is allowed. Sometimes, the views of the animals were amazing, being only 3-4 meters from the great apes. Mostly, though, it was through thick brush, or up in trees, or on the move. As someone said, you get to see lots of gorilla butts up in trees. The hour went by fast and it was time to leave and say goodbye.
The experience was interesting, and when you look into their faces and eyes, they do look like hairier version of us, however, in the long run, both Rusha and I thought that it was a bit over-rated at $500 per person for 1 hour. While you get to watch them closely and intimately, there is no real interaction with them and they could care less that you are there—you could almost be just another tree.

Our next destination was Lake Bunyonyi, landlocked amidst the fertile and steep hills of southwestern Uganda and bordering Rwanda. This is Uganda's deepest lake, and rumored to be the only Bilharzia-free water (we hope so). We arrived and stayed at a beautiful lakeshore camp that caters to overlanders - trucks of youngsters, heading across the African continent in an open air truck, stopping along to see the sights, usually from Cairo all the way to Cape town in South Africa.The camp was beautiful and manicured, with nice food and docks, and dugout, left-turn-only canoes. It even had an 8 meter high platform to jump into the lake from! We sunned ourselves, ate crayfish from the lake and hung out in the local market, to which farmers bring their wares in canoes from across the lake. We rested, swam, ate, and drank after the many kilometers of walking the week before.

To get back, we took a very long bus ride back to Kampala, during which the incidents included a bit of mob justice on a man who crossed the road on his bike in front of our careening bus, and almost caused an accident. Men from the bus jumped out, caught the poor guy, and whipped him with branches and punched him a few times. This is justice in the bush and I bet that guy will never anything like that again. After running a girls foot over on the way into Kampala (really the bus ran over her foot!) we arrived safely in Kampala where we spent a couple of days frantically packing, saying our goodbyes, and enjoying some decent food and coffee after 2 weeks of bush coffee and chicken and chips.

Our time in Uganda has been amazing, and a growing experience. We have met unique and wonderful people and friends, seen amazing things, and heard and experienced amazing stories. Uganda, you will be missed!

We are off to Nairobi, to climb Mt Kenya. After that we are on to Cairo, and then overland, via Jordan to Israel. We will keep every one up to date as often as we can, thanks for coming along with us on this journey.

Mwebale Nyo (Thank you very much)

The Rwenzori Mountains

Our first adventure as fully unemployed travelers was to head west from Kampala to the border of Uganda and the Democratic Republic of Congo to hike in some of the most remote mountains in the world, the Rwenzoris (the Mountains of the Moon.) The Rwenzoris house the highest non-volcanic peak in Africa and the 3^rd highest peak overall, Margherita Peak on Mt Stanley. The Rwenzoris have been in a conflict zone for so much of the past 30 years that they have very little traffic and these days see about 500 visitors each year, making them extremely isolated and untouched and pristine. We signed up to do the “Central Circuit” which is a 6 or 7 day hut-to-hut trek that follows two rivers, the Bukjuku and Mobuku Rivers, in a circuit that passes below the 3 highest massifs in the range. As with most East African expeditions, a guide and porters are required and we met up with Peter, our guide, who has been taking clients into the Rwenzoris since 1971, and our 3 porters: Matthew, Gideon and Bonfast. Peter is from the Bakonjo tribe, the people who are native to the Rwenzori mountains, and while he is a bit past his prime, at 48 years old, he rocked the hike and put us to shame on the downhills.

The hike starts at the village of Nyakalengija at an elevation of about 1000 meters and climbs from there. The hike is a trek between huts that are 7-8 km apart, but covers elevation gain and terrain that make the distances seem far more challenging. Most of the hike is through bog, which if you haven’t encountered it, is thick mud, up to your knees or even thighs, that must be negotiated by walking on logs that have been placed in it, or by hopping from tussock pads or patches of grass, or basically anything that can keep you out of the deep mud. The mud us negotiated in rubber boots and waterproof pants and if you happen to land in the mud, you have to be very careful to keep your boot on.

Day 1 climbs 1600 meters of vertical and put us at the start of the circuit, a hut called Nyabitaba. On that first day we got our first glimpse of the intense greenery that can only come from one of the wettest places in the world, the Congo basin. The flora is enormous and moisture is everywhere, hanging on the leaves of huge, broad-leafed plants.

Day 2 is an introduction to the bog. After crossing the Bujuku River, we slogged uphill to 3500 meters, crossing kilometers of wet, sludgy, bog and neon green carpets of moss. If you didn’t get a walking stick at the start (as Guy did not,) your balance is truly put to the test as you negotiate little branches and rocks in the mud in order to progress. On the second night we slept at a hut that allows the first views of the glaciated peak of Mt Stanley as the clouds cleared for some minutes before dusk.

Day 3 we entered the surreal landscape of the Rwenzoris, walking through thigh-deep mud and little tussock hills (grass mounds that offer a chance to hop and avoid the mud,) the plants are unlike any we have ever seen and are endemic only to this range: purple cactus-like plants and bizarre trees. We were supposed to stop at the Bujuku hut, but we asked our guide if we could instead divert to the highest hut, Elena hut, that also happens to be the staging ground for climbing the highest peak in the range, and he obliged. So we trudged straight uphill to 4550 meters (about 15,000 ft) thankfully leaving the bog behind and entering a range of boulders, rocks, and sheer cliff faces at the base of the Stanley glacier. Now, here is where Africa works well: our guide, seeing our strength and interest in the peaks and Guy’s particular interest in mountaineering, suggested that if we were to compensate him appropriately, he would lead us up to Margherita Peak, the highest point in the mountains. We gladly obliged. We had been paralleling our hike with a couple who had plans to climb Marghertia Peak all along. Our job was to convince them that they wanted us to join them on their summit ascent and share their rope; our guide Peter’s job was to convince the other guide, who happened to be his nephew, that he wanted to share the equipment with us. Luckily, our hut-mates were

game for us to accompany them.

Day 4 started after a mostly-sleepless night of nausea and headaches due to the altitude, we were up at 4 am to attempt the peak. After several hours of hiking to reach the base of the first glacier, we roped up and put on whatever motley equipment

was leftover: Guy had a homemade harness and Rusha had ill-fitting crampons. Our guide was missing both and was hiking the glacier i

n rubber gumboots and a walking stick. Thankfully this sketchy situation was ameliorated after our companions decided to turn back after a semi-technical down-climb, and we were lucky enough to continue with their equipment: ice axes, crampons, harness, and rope. Our guide also got sunglasses from the other guide which made his life much nicer and made us feel safer that he could actually see. We proceeded to climb 2000 vertical feet on a crevasse-strewn glacier, then a short technical rock climb and summited 16,763 ft margherita peak (5109 m) in the clouds and gale-force winds, with enough time to document the moment and revel in our accomplishment: the highest Rusha has been in her life and the highest non-volcanic peak in Africa. We finished the day by returning to the hut and descending to Kitandara hut, at a much nicer elevation of 4000 meters to rest up.

Day 5 started with a climb to 4300 m (the highest point on the central circuit) and then descended steeply to a hut at 3900 meters, Guy Yeoman hut. We enjoyed not suffering from headaches or nausea but Rusha managed to touch some plant that caused her to have a major allergic reaction with some angioedema. Luckily the reaction was limited to eye and lip swelling and was improved with some Benadryl and Prednisone in the trusty first-aid kit.

Day 6, our last day, was an amazing amount of downhill. We dropped 2500 vertical meters (about 8000 feet!) Most of it was clambering over the usual Rwenzori terrain of rocks, roots, bog, and mud. It was steep and directly straight down. After several doses of Alleve we arrived back at our starting point in the village where we said our goodbyes to our group of porters and guide and hopped on bodas down to the town of Kasese, where we took our first shower in a week and fell exhausted into a real bed. The next day we left for Buhoma, the entrance to Bwindi Impenetrable Forest where we were to track the mountain gorillas.

what is rusha up to??

So, as our time in Uganda comes to a close, I thought I would update you all as to what exactly I have been up to at our work, Kamwokya Christian Caring Community (KCCC). Mostly, I have been learning to be patient, to tolerate having things happen very slowly or not at all, to understand that not everything is fixable (in fact very little is) and I have been seeing a bit about how medicine is practiced in Uganda. Our mandate from AJWS was that we were not really sent here to do direct service and that we were to come up with something that would be self-sustaining so that it could continue when we are gone. Although KCCC sees many children in their general clinic, the staff was not particularly interested in feedback from a pediatrician, unfortunately. I do see kids once a week on my own and often make it up as I go along, learning about malaria and many other tropical diseases. I also help out in the weekly immunization clinic, mostly weighing babies and plotting their growth as well as trying to help the staff with lessons on normal growth and development or breastfeeding or nutrition. The clinic is held on the side of the church that the organization is founded from and up to 100 women cram into wooden pews that have been brought outside. They have immunization cards given to them by the ministry of health where their growth and shots can be tracked if they are lucky. Some women instead carry around a little paper notebook where things are recorded. None of the weights are ever plotted so its very hard to tell if the kids are growing properly or not, but this is the extent of well-child care for most Ugandan children and the immunization campaign is fairly successful. Although we see plenty of adults on the street with polio, it is rare to see a child with the disease. The babies are delicious and most of them, thankfully, are fat and healthy looking. We weigh them from a hanging scale similar to the one in the grocery store on which you would weigh fruits and vegetables. So amazingly cute!! Usually it is so chaotic with 100 women and babies that no teaching gets done, and the language barrier is hard, but we have been able to do some sessions and hopefully the community health workers will continue with the teaching.

The main bulk of my time here has been helping KCCC start a program for the prevention of mother-to-child transmission of HIV, or PMTCT. If PMTCT works properly, it can be 99% successful and babies can be born to HIV-positive women and themselves be HIV-negative. The basic steps are different than they would be in the US where we would do a cesarean section and tell the mom not to breast feed, as those are 2 ways to avoid transmitting the virus. Per the WHO in a developing country where most women deliver at home or in a random clinic and clean water and formula are a dream for most people, there process here is that: 1)the mom is on the proper HIV medication during her pregnancy to get the amount of HIV virus in her body as low as possible, 2) during the delivery the mom is given HIV medication if she was not previously on drugs and the baby is given HIV medicine directly after birth and then for one week afterwards to decrease the risk of having passed through the birth canal, and 3) the mom breastfeeds exclusively and continues on her HIV medication and does not mix in other feeds.

The program at KCCC was supposed to have started several months ago and was limping along with no direction, no clear understanding of what they were doing, no records or tracking and no buy-in from the staff when we got there in November. It was not until January that I had any clear sense of what to do, how I could help. Up to now I have written a budget and designed numerous work plans for the year. The organization is required to compile masses of reports for their donors on a monthly basis and everything is supposed to be accounted for, down to any notebook purchased. The bureaucracy is such that everything happens REALLY slowly (as those of you who know me, you understand that this is hard for me!) and there is often triple work to make all the reports. The donors dictate everything they want PMTCT programs to be achieving at all their funded sites, regardless of whether the activities are relevant for the community or the particular clinic. Most of what we are doing at KCCC is mobilizing in the community, spreading the word that we can prevent mothers from passing HIV along to their children during pregnancy, and making sure that our clients who are HIV-positive are on the proper HIV medications and that the babies get the drugs once they are born and that breastfeeding is done safely. It is actually a huge task and many things fall through the cracks, but here it is more about the general direction a program is taking, rather than details--which is, again, hard for me.

On a daily basis, this means that I am sometimes doing something as simple as making labels and cutting them and sticking them into a book that is used to record the names and information about our pregnant clients and babies. (Everything is recorded in these massive books and using an Excel sheet on the computer is a totally foreign and impossible concept, so information is missing or re-recorded and it makes it challenging to know what you are really doing.) Other times I am seeing clients with the doctor who is the head of the project, counseling mothers about medication and breastfeeding or the importance of delivering their babies in a medical facility as opposed to at home or in a "clinic" somewhere in the bush. Other times I am running a workshop or a training session about PMTCT with the staff of community volunteers that go daily into the field and meet with clients. I have been connecting with other local organizations, the Ministry of Health, the main hospital, Mulago trying to connect KCCC with these other resources for nutrition and pre-natal care. My favorite thing has been starting a monthly support group for mothers and pregnant women. The concept of a support group as we know it where people share their experiences and self-direct is not here, and it is more like a lecture session. The first group was awesome: 18 women and their babies or pregnant bellies attended, the counselor talked about disclosure of HIV and then we all had snacks (the staff ate before the clients) and watched 3 of the community volunteer staff members lip synch to some Christian songs in Lungada. In between, the women did get a chance to talk about how hard it is to disclose their HIV-positive status to husbands or partners who will leave them or beat them or stop supporting them, even though the likelihood that their partners are also positive is almost 100%. They also talked about giving their babies tea because they are not breastfeeding and cannot afford milk or formula. It was both amazing and heartbreaking, like so many experiences we have had in Uganda.

Three times I have been told that the funding for the project would be cut and I have visited the local offices of our donors to see that the money can be secured. The budget for the entire year is only $2500 (not including the drugs that we provide for clients) but the expectations of what we are supposed to do with that little money are pretty large. My low point was when the doctor who I am helping (or some might say pushing into doing this work) told me that he was relieved when they thought that the funding might not come through. I realized that maybe I want this program to work more than they do. The staff who were assigned to work on the project are already busy and a bit difficult to motivate. But the truth is that this place has gotten over 2000 people on HIV drugs and now these clients want to have babies and one of the best ways we can be effective in preventing new infections is through this project and I think that when we leave, even if they only hold onto a few things that we have started, maybe, just maybe, we will prevent some.

Mbale, Sipi falls, and the Abayuday

we just got returned from a weekend out east in Mbale. Mbale is a town close to the Kenyan border, about 4 hours by public taxi from Kampala. the trip was a consolation prize for not having the time to climb mount Elgon, the 4th largest mountain in Africa. Our first stop was Sipi falls, a series of tall waterfalls that cascade down the side of mt Elgon.

The trip to Sipi falls involves a public taxi toMbale, the 4th largest town in Uganda, but really just an African trading center. From Mbale we got into a random van. As you get out into the Ugandan bush, taxis become less frequent, and so anyone with a car becomes a taxi. Unfortunatly, as Guy was getting out of the van, his phone fell out of his pocket. Once we were sitting at the camp in the middle of a huge rain/hail storm and guy realized that he did not have his phone, we of course called it and an African man answered and promptly hung up when he heard a mzungus's voice. We played a game like that, texting that there would be a reward if the phone was returned with no answer. Eventually, a kid who works at the camp came by and knew the guy who was driving the van. He called him and lo and behold, the guy knew where the phone was. Apparently, after dropping us off, a boy had picked it up but that boy was then dropped off at the hospital in town and the driver needed to pay some policeman to help get the phone back. the driver was able to accomplish this task in all of 5 minutes and it was quite clear that he had taken the phone and was trying to save face while making a buck. The phone eventually came back (with some airtime still left on it, surprisingly) and Guy gave him 40,000 shillings ($20) to pay for the "policeman". Ah Africa....

After that small adventure, we had a great time in Sipi. The falls are beautiful and we hiked through small villages, matoke groves, and bull-plowed fields to reach all three of them. The water was fresh and cold and we had a good swim with some local boys (seems to be the theme) and drank some local beer with local farmers made of corn (disgusting and pulpy). Along the way, in the middle of a very steep downhill including rickety wooden ladders and no switchbacks, we came across a Ugandan farmer walking up the same trail balancing 3 bunches of matoke and a hoe, weighing upwards of 80 lbs. on her head. She was walking up the steep hill, including the ladders with her amazing load!

We left Sipi without any phone delays and carried on to spend Shabbat with a community of Ugandan Jews called the Abayudaya. This community was founded in the early 1900s by a Ugandan who was given jurisdiction over the eastern region of Uganda by the British while it was still a protectorate. He decided that Christian practice had strayed too far from the original intent of the bible and decided to rewind and follow the old testament, forming a group of followers that began to practice Judaism. Today Abayudaya have about 1000 members spread over eastern Uganda and focused around Mbale. They have a Ugandan rabbi who studied in Los Angeles and Israel and they read and speak Hebrew during services, keep kosher, wear Kipas, keep Shabbat and follow conservative Jewish traditions. Apart from that, the place is totally African: naked babies, chickens pecking the earth, laundry drying on bushes, women carrying things on their heads, kids chasing us and calling us mzungu, boda bodas etc... We were invited to attend Friday night services which started with drums and songs but continued as evening services would in any conservative synagogue. We met Itzchak Byaki, Samson Shadrak, Israel manumbamba, and Yael Gadongawe, what a trip! We did Kiddush at Israel's house using a local made Challah and Kosher grape juice imported from Kenya. Unfortunately we did not get a chance to hang out with the rabbi or any of the other community members because we had dinner with Isaac who runs the guesthouse. Shabbat dinner was "food" with fried fish.
The experience was surreal: Authentic Jewish service, discussion of the difficulties of being a Jew in this foreign environment and reading and reciting Hebrew with word for word translation into Lugandan. They focused on the ancient Jewish theme of strangers in a strange land, and of the meek holding the light of truth against the strong tide of the many. The Abayudaya run a Jewish primary and secondary school that is open to all and is reportedly the best school in Mbale. They appear to have support from western liberal Jewish institutions. They even have a Torah donated by the state of Israel. We were fascinated and found it hard to get our minds around the crazy contradictions of their life.

We made it back to Kampala in one piece and had an evening with my friend Rachel who was also a resident in Oakland and is now working in Malawi doing HIV/TB medicine through Baylor university. She was in Kampala with her mom on a vacation and it was really fun to catch up.

we have 2 more weeks of work here in Uganda and then the traveling really begins. stay tuned for more posts...

Click here for the link to more pictures from Mbale and the abayudaya.

more pics

hi everyone, as time is getting nearer we have so many blog ideas but so little time. We are trying to entertain you with as much stimulus, both visual and intellectual as we can. You never know, before we leave we may bring you such blog entries as "museveni's favorite hats", "how many people can you fit on a boda?", and "ugandan english: quite really good."

for now, you will have to satisfy yourself with some links to some of the pics we have put up on picasa: just click the paragraph to link to the pics.

• the first is an album of my buddy brady, who's a carpenter, and I building prototypical crutches over at Kamwokya vocational training center (KVTC). We hope to make a super cheapy design ( hopefully for under $3-4) and teach the carpentry teacher to teach his pupils to make them, both to help the students get jobs at local assistive device workshops and to sell to the community. We have also been working on other devices such as CP chairs, standers, hand/feet paddles etc...

• next is an album with shots from the malaria infested slum we call home, and you can see why. Some great shots of great fish at the busega fish market. A series of shots of our buddy james walking on our devised hand paddles. James has polio and has lost the ability to walk. he now walks on his hands. There are other random shots from our time here.

• this album has shots from our weekend rafting the nile with nice morning and evening shots of mist rising off the great river. No shots of actual rafting as we were to busy SURVIVING to take pics.
  

• Once a month our KCCC runs a clinic deep in the bush at a fishermen's village on lake victoria. this is the birthplace of one of our co-workers, peter, and so we went with some docs and nurses for a saturday clinic in the bush. We also got to meet peter's parents, his brother, and play some serious soccer.

• As you, and many bugandans know, we ran the buganda road race. while i merely survived, rusha took second, got to shake hands with buganda's #2, and take home a cash prize. The next day we went over to KKs beach, an african hang out on the shores of lake victoria. Keeping with africa's theme that there is no separation between anything, while people were getting drunk, kids were playing, fish and meat was a grillin' and ear splitting music was playing, a group of the faithful performed a baptism and an exorcism..it all makes sense over here.

• more random shots. some shots from walking around kamwokya, especially on friday market day. other shots from my clinic on thursday, seeing some of my peeps. there are also pictures of walking with the KCCC team that i am training in rehab around Katalemwa Cheshire home. a kids rehab facility that does amazing work, including therapy, education, outreach, advocacy, workshop for orthotic, prosthetics, wheelchairs, and hand bikes, and much more...check it out.

hope you enjoy the links, we will put more blog entries up this week, we only have a few weeks of work left, and then off to travel. see you soon!

Food glorious food, part II

For anyone who knows Guy and I, you will not be surprised that there is not one, but two entries on food. We love to eat and are eating our way through Uganda, both trying to eat traditional food and we are lucky in that Kampala has a large enough foreign population that you can actually get pretty good food that is not Ugandan as well. There are some amazing Indian restaurants, Ethiopian food, Chinese food, a Turkish place, some okay Italian places, a Thai restaurant that was not half bad, an amazing steak restaurant and we have heard that there is a Japanese/sushi restaurant, although we have not been brave enough to try it.
We are not starving out here, have no fear.

What is even more fun than sitting down in a restaurant to eat food and your favorite sauce, is eating street food. Some warn against this practice while traveling as it is probably the most likely reason to suffer gastrointestinal distress. We have found, however, that some of the best delicacies come from the street and they are dirt cheap and really fun to eat. Guy is more adventurous than me and has subsequently had 2 experiences with the wonderful antibiotic Ciprofloxacin, but overall we have been spared much in the way of problems and have gotten to know what people really eat.
Most people eat lunch and they eat a LOT of food--so much so that work in the afternoon is close to non-existent as everyone settles into a coma after consuming several pounds of starch. For breakfast and dinner, many Ugandans simply snack on the street. Almost everything you can get is fried in a pot or griddle over a coal fire b.b.q made of an old car wheel and is served in a flimsy clear plastic bag:

-chapati: a staple snack food made from flour and water and then fried in oil on a flat griddle pan and served plain or mixed with other snacks.
-samosas: filled with peas usually, but for extra - special occasions they are filled with meat.
-chips: (french fries), in a wok of boiling oil right there on the street
-banana pancakes: there are about 5 or 6 different varieties of bananas here and these ones are less sweet and mashed into a little patty and fried)
-fried dough that is slightly sweet, like a donut called mandazi
-chaps: thick chapati filled with some meat and then fried again....mmmm double fried
-kikomando (pronounced chicomando) which is chopped chapati with red beans mixed together
-other fried dough sweet treats that sort of resemble muffin-scones, but fried
-fried chicken or whole Tilapia, of course, served with chips
-and when in season, sauteed grasshoppers (ensennane)

But the king of the streets, the quintessential Ugandan street food is the rolex, called so because it is a rolled up chapati with an omelette inside. Though innocent before found guilty, it is probably the culprit of Guy's food poisoning both times. However compared to how much he eats the stuff, the odds are on his side, and well, its worth the risk. The rolex man mixes eggs with sliced tomatoes, cabbage, onions, salt and pepper and make a thin omelet on a griddle pan. The omelet is then married with a chapatti and rolled up like a burrito and served in a plastic bag.

In the late afternoons and evenings, the streets in Kamwokya where we work are lined with boys grilling meat. You can get a meatsicle, as we call it: a charcoal grilled skewer of salty gristle and beef cubes. You can also get decent, albeit scrawny and sometimes chewy, chicken breasts. Little sausages are very popular, either grilled or fried. All of the above come with chips and some cabbage of course.

In the morning, people take tea which can be "dry," meaning black or "milk tea" which is mostly milk and a bit of tea mixed together. Tea is accompanied by chapatti or a dry, corn-flour based, muffin-cake, or fried cassava sticks.

For most of this food, you need only to walk a few feet in any direction and you will find whatever you like for anything from 100 to 500 shillings (5-25 cents). People will set up a kiosk or booth under an umbrella and happily prepare your favorite treat all day.

My favorite type of food in Uganda are the fruits and vegetables. This place is so amazingly fertile, all you have to do is throw a few seeds in the ground and things grow like weeds. Almost every square inch of free land in the city ( not to mention the countryside) has something planted on it: bananas, potatoes, yams, sweet potatoes, tomatoes, spinach....you name it. And the markets are amazing: massive avocados the size of a baby's head, cucumbers, egg plant, onions, various mangos, papayas, watermelons, pineapples, passion fruit, the list is endless. Fruit is sold as snack food as well. A pineapple can be peeled and quartered for you right there with a machete for 800 shillings (30 cents).

My very favorite new fruit is called jackfruit. Its about 2 times the size of a large watermelon with a spiny green rind. It grows on massive trees that grow like weeds in this country (and much of southeast Asia, I have heard.) When the fruit is ripe, people bring them to the street or market to sell, usually on the back of a bicycle and cut your choice of a piece on the spot. The tricky thing about jackfruit is that it has a very sticky sap inside that needs to be cleaned off your fingers or you knife or anything the inside touches with paraffin or something oil-based, which makes opening and cleaning them an art form. Once open, it is a yellow fruit with tear-shaped seed pouches that you tear out. The taste is a mix between banana and melon and it is sweet and unlike anything I have ever tasted. I eat a piece almost every day and even made a jackfruit cake the other day, much to my co-workers surprise. No one ever thought to make cake out of jackfruit before!
There is so much more to tell, stay tuned for our next food entry: things you eat that still move!