Some Final Thoughts

When I got the email from Tom in February with a simple “!” in the subject line to inform me of my placement at Engeye, “!” was exactly how I was feeling. Nine months in rural Uganda? Working with an incredible organization in a field I’m passionate about? Sign me up. It sounded thrilling. I had become too comfortable at Union and I was ready for another challenge. When I graduated last spring, the hope of medical school was at least two years away. The prospect of working for those two years just to pass the time before school didn’t exactly get my juices flowing. The Minerva Fellowship on the other hand…that would be exciting. I was all in.

When we went wheels up from New York in July, nine months suddenly seemed to be an eternity. Was this the right decision?

One of last year’s fellows described to us the adrenaline rush of simply getting off of the plane. There’s a moment when you walk out of Entebbe International Airport, to thirty taxi drivers fighting for your bags in a language you don’t understand when you finally realize this is real. It was July 18 and we had a return ticket for April 17. There’s nowhere to hide at that point, so we might as well embrace the opportunity.

You get off the plane energized and ambitious, ready to save the world. Of course, we knew we weren’t going to be saving the world, we genuinely cared about the legacy we’d leave here.

And while we’ll get plenty of attention at Union, we took pride in fitting in here as much as possible: not simply respecting the culture, but living the culture. We planted trees in Eddie’s garden; we went to weddings; we played soccer barefoot; we spoke Luganda when we could. We caught the pigs when they escaped, earned the respect of the boda drivers, and cut the heads off of chickens. We visited the local waragi brewery nestled in the matooke. We worked our tails off at Engeye. We visited friend’s houses to get to know their families and we never turned down a chance to try a new, often exotic food.

One of our accomplishments, and I truly believe it’s an accomplishment, is leaving the people of Ddegeya with a positive impression of Americans. Thankfully, it was really just carrying on a legacy left by over a decade of other incredible Minerva Fellows. Because whether or not they advertised these activities, they have all done them, and done them well.

I loved having strangers come running up screaming Matayo (the name a lot of Ddegeyanians used for both Nick and me), excited to have a conversation. It was almost validation that the local people respected us. Because I had never told this person my name was Matayo. I’d never even met them. But someone else in the village I talked to must have. And judging by their excitement, the first person left with a positive impression, because it wasn’t simply the cliché “hi mzungu,” but more like we were friends. One of my favorite memories was when I was riding a bike with Jeff, John’s son, in the outskirts of Nakateete, the neighboring village, and running into person after person I knew. After an older lady stopped us to talk, Jeff finally said, “how do all of these people know you?”

We didn’t accomplish all we had hoped to and some of our projects never came to fruition, but I am proud of what we did achieve. Some other highlights include: Innovation Camp for the scholars, our Humans of Ddegeya project which will be featured on Engeye social media over the next year, hosting the visitors, fixing the borehole five hundred times, fundraising, summiting Kilimanjaro, learning some Luganda, and above all, becoming helpful at the clinic day in and day out.

But there were plenty of hiccups along the way. From having a total of fourteen little jigger parasites cut out of my feet with a scalpel to being in bed with an IV in my arm for Thanksgiving, it hasn’t always been easy. I was tired of rice, beans, and posho for lunch by October. I hated doing laundry by hand and definitely missed being home at certain points. But no one ever said nine months in a developing country would be a walk in the park.

So while our time at Engeye officially ends tomorrow, this chapter in my life will never really end. I don’t know if I can say how living here has “changed me” exactly, except for my beautiful new hair, but it is no stretch to say I will carry this experience with me for the rest of my life. While some memories will fade with time, the way I see the world, the way I treat outsiders, and my appreciation for other people and cultures will never fade.

Without question, I will miss the people the most. Our friends and coworkers became our Ugandan family and for me, this was the key to the entire fellowship. We were lucky to have amazing friends and it is a weird feeling leaving them without a designated return date. When I sat in my interview well over a year ago, Sarah, our now American liaison, explained that being a fellow at Engeye was more than just working 9-5 at the clinic. It was a commitment to becoming part of the Ddegeya community. Without this, our work at Engeye wouldn’t have had the same meaning that it did. But when the clinic treats the woman who sells us avocado on the side of the road, or our friend from the borehole, or even our own Engeye Scholars, well, that has a different feel.

I will especially miss the kids. I wish I could pack the Engeye kids Joseph, Maria, Colo, and Trinny up in the suitcase and take them home with me. Everyday, without fail, one of them managed to put a huge smile on my face. From Jamidah, the sweet girl who gave us our first taste of jackfruit, to our little neighbor Carol who ran to the road to say hi for nine straight months, to the pack of local kids who showed up at the scholars center every afternoon begging to read…I will miss them all. And, the other Engeye kids: the scholars. It will be exciting to follow their careers and see the impact they are able to make in the community. Just a few days ago, one of our oldest scholars and a good friend of ours, Wilbur, left for university to pursue a degree in pharmacy. It just seems like fate that he’ll end up working at Engeye in some capacity one day. In a few months, Hamza, Josephine, and Harriet more will head off to their own universities in pursuit of their dreams.

For Nick and me, the absence of the stress-filled hustle of day-to-day life in America has been welcome. Life here moves at an enjoyable and leisurely pace and we have come to appreciate living on “African Standard Time” (do it when you feel like it). In fact, this leisurely pace may be what we enjoyed most here. I never dreaded the next day and it made time fly by. But it would be naïve to think that the population as a whole feels this way. Most are worried about the stressful things we left behind in America, but seriously magnified. How will they pay school fees? Or afford medication? Or even put food on the table? Remarkably, we think that coming home to the face-paced life in America will be about as much of a culture shock as coming here was in the first place.

Thanks to everyone who followed my fellowship. I’m excited to share more stories, but it will inevitably be difficult to put nine months here into words. When the medical team was here, we often talked about how to sum up the experience in a few sentences. As much as I would love to share everything that I experienced here, most people are going to want to know “how was your trip,” in thirty seconds or less. And I’ll tell them that it was amazing. Because all in all, it was amazing. But living here was so much more than just amazing. It was challenging, thrilling, humbling, tragic, inspiring…the list goes on.

The biggest thank you goes out to my partner in crime, Nick, otherwise known as Musisi. Everything I’ve experienced and everything I’ve written about hasn’t just been me. It was always Matayo and Musisi. Some of our best memories won’t just be the crazy stories or the amazing trips we got to take, but how we navigated and came to enjoy day-to-day life in Ddegeya. We grew to love a good stick of roasted goat in Mbiriizi and we weaseled our way out of a few uncomfortable situations. We spent weekend night’s playing cards and chess, drinking alcohol out of a bag, and following soccer. And somehow, there was a beauty to the simplicity of it all. We became Ugandans together and it wouldn’t have been nearly the same experience alone.

But sadly, it’s time to say weraba to the pearl of Africa. I’m still not sure what’s next for me, and as much as I’ve enjoyed the past nine months, there’s no feeling in the world like coming home. And I can’t wait to be back.

 

“If I’m an advocate for anything, it’s to move. As far as you can, as much as you can. Across the ocean, or simply across the river. The extent to which you can walk in someone else’s shoes or at least eat their food, it’s a plus for everybody. Open your mind, get up off the couch, move.” -Anthony Bourdain

The Boda-Boda

There are plenty of interesting aspects of living in Ddegeya, so why this became worthy of a blog versus all the other insignificant details of our day-to-day life, I’m not sure. But the boda-bodas, or just bodas for short, have captivated me since day 1.

Bodas are simply motorcycle taxis and since most people don’t have any personal means of transportation, these bodas are everywhere. They are the only practical way to navigate the one-lane dirt roads that lead from village to village and are able to cut through the paths of the matoke fields. They flood the city streets and are estimated to be the second largest employer in the nation behind agriculture. And for a price, they will bring you anywhere.

Boda drivers themselves are a different breed and they seem to live their own unique lifestyle. As they travel all over the area and spend most of their day sitting under a tree waiting for their next ride, they are the kings of gossip and function as the local news reporters. They play card games with enough intensity to make it seem like life or death and will argue for hours about the littlest things. They tend to like waragi and are expert negotiators. Want to know what’s going on around town? Ask a boda guy. And when we say boda “guy,” we mean an actual guy, because out of the thousands of bodas we have seen, we have seen only a woman driving once.

They are inherently dangerous and there aren’t really any laws that apply other than having a license plate. For example, one of our friends named Nasser started driving one full-time when he was 14. But what fascinates me the most about bodas isn’t boda culture, or the actual boda guys, but rather the things that bodas manage to transport and it is this this phenomenon that inspired a blog. I have been on a mission to take pictures of some of the crazy things that bodas haul around. Unfortunately, for some of the best ones I haven’t had my phone or didn’t have enough time to snap a pic. Recently when Nick and I were hanging out at Eddie’s shop, we heard a yelp like someone was in distress. But worry not, it was just a full-grown goat tied down on the back of the passing boda.

So without further ado, enjoy some of my favorite boda pictures. First, the ones that have no regard for anyone else on the road.

Then there are the ones that put enough stuff on the back to load up a pickup truck.

I don’t have any good pictures, but it is common to see as many as four adult passengers on a single boda. Here’s one from the Engeye Facebook page to give you an idea.

And last but not least, the ones where the passengers are carrying absurd things.

 

Stories…

I’ve struggled with what to write about recently. I want to write but it’s hasn’t come as naturally as it did when we first arrived. Maybe it’s because things don’t stand out as new or different the way they did at first. Still, every day is a new experience, a new story. But living the stories and figuring out a way to tell them isn’t always easy.

The past two weeks we were fortunate enough to have a visiting medical team from the US. Without question, it was the best two weeks at Engeye so far and I learned soooo much from them. On the last day I travelled with them to the fancy hotel in Entebbe they were spending the day at for a few nice meals and an afternoon by the beautiful pool. At dinner, the team held their final “talking stick,” in which each member of the group reflects on an experience or responds to a prompt when holding the talking stick…usually a beer bottle of course. I was trying to think about what I would share…whether it would be a story from when the team was here or an experience from the past seven months. After spending a significant portion of the week shadowing and getting more personalized interaction with patients and their stories than normal, combined with the stories dating back to July, I was almost overwhelmed by the library of touching, often heart-wrenching stories I had amassed and didn’t know what in the world I was going to talk about.

From these two weeks alone, there is a story about a home visit I went on for an elderly man who was nearing his final days and how we could have an honest conversation with the family in a culturally sensitive manner. There is a story about a woman who came in with numerous complaints and hours later the doctors managed to comb through the details and cultural barriers and realize she was in fact suffering from depression, the first diagnosed case of depression at Engeye since we arrived. There is a story about removing a bot fly larva from a woman, stories of gender violence, a story about the rejection and eventual acceptance of an albino man by the local children, and even a story of how a bat crawled up Theresa’s leg in the middle of the night. But for now, I haven’t processed them all well enough for my writing to do them justice.

The leader of that final session at the hotel was Dr. Maryjo Fink, who was beloved by the Engeye staff for her vibrant personality. She began by reading a quote that I think sums up my feelings in a better way than I am able to, so I will let it stand in place of them:

“So many stories, and to choose which ones to tell and how to tell them. The words, they will tap me on the shoulder and they will speak to me: Tell me! Tell me! The stories choose me.” –Eduardo Galeano

It’s been a while…

The past two months have been undoubtedly the busiest stretch of our fellowship, as we had expected they would be, and I’m going to try and touch on everything Nick and I have been up to since my last blog around Thanksgiving. Nick already wrote a similar blog, so apologies if this is repetitive…we try not to write about the same things, but I’ve got a lot to catch up on.

In early December, we had our first visitors! We had a group of seven, some of whom have been to Engeye countless times, with others making their first trip. It was the first taste of feeling like Ddegeya was truly home for us. As the visitor’s informal hosts, we got to witness some of them experience same awe and curiosity for the village and its people that we first experienced in July. We hadn’t realized how comfortable we are here, how many people we know, or more accurately how many people know who we are, and how normal everything has become. And for the highlight of their trip, we pulled some strings to get fresh grasshoppers for them all to try. Look at those eyes!

I really haven’t felt homesick at all, but I figured the holidays would be the hardest time to be away. Initially I was planning on hanging around Ddegeya for the holidays, but Nick’s family so generously invited me to join their family vacation in Tanzania. We spent Christmas on the beach sipping on a Tusker Lager in Dar es Salaam, which as you can imagine, makes for some strong immunity to any kind of homesickness.

From there, we took off for a pretty long safari spanning Selous Game Reserve and Mikumi National Park. From a boat ride to see hippos and crocs to a nature walk with a traditional “bush man” who drank water from a pile of elephant dung like he was Bear Grylls, we did it all.

The highlights were of course the game drives, where we saw all kinds of famous African animals, and four of the “Big 5.” Here are some pics, courtesy mainly of Nicky Wills Photography.

After the safari we spent the last few days of the trip relaxing on Zanzibar off of the Tanzanian coast. The island was absolutely beautiful. We stayed in the main city, Old Stone Town, and trekked up to the north part of the island for some stunning beaches. We celebrated New Year’s Eve at a party on the rooftop of our hotel overlooking the ocean and had our best meal since July.

Nick and I arrived and left separately from his family and we found that traveling around the city and navigating the ferry was difficult. It was weird for us to be so uncomfortable…almost as if it was Day 1 in Uganda again. Knowing no Swahili beyond hakuna matata and not knowing how much things should actually cost, we felt out of place as tourists, which is a feeling we haven’t had in Uganda in a long time. It was also interesting to be able to compare Uganda and Tanzania. For the most part, we were in tourist areas, but there were a few days of significant driving that allowed us to see some of the rural villages, which were pretty similar to the ones we’ve come to know in Uganda.

Again, HUUUUGE thanks to the Williams family for an incredible trip.

But when we got home, there was no rest for the weary, because it was time to meet up with the next two Engeye visitors, including our “boss” and former Minerva Fellow Sarah, and the president of the Engeye Inc. board, Jessica, who designed our beautiful new maternity center…oh, and time to get read for the party!

I distinctly remember receiving the famous email from Tom last February with nothing but “!” as the subject informing me of my placement at Engeye and immediately reading through Justin’s blog to try and get an idea of what I was in for. I had read through it a few times before; once before deciding to choose Uganda as my preferred destination and another before my interview, but it was wildly different knowing that I would actually be going, trying to imagine what things would be like here. Of course, many aspects of the fellowship excited me, but his blog about the annual children’s party stood out and I kept thinking how cool it would be to actually experience it first hand. Well, last Saturday was the party and it didn’t disappoint.

Every year around the New Year, Engeye throws a massive party for all of the kids in Ddegeya and surrounding villages. The kids look forward to the party all year and had been talking about it for a while. The agenda was simple: good music and plenty of food. Engeye hires a local DJ and even a crew of talented beat boxers and entertainers from Kampala to make it a true spectacle.

But why is it such a big deal?

Because being a kid in rural Uganda is tough. Because if you’re old enough to walk, that means you can walk to the borehole and lug a jerrycan of water up the hill. If you’re strong enough to pick up a hoe, you can work the crops and help with the harvest. If your family has animals, you’ll probably be herding them once you’re old enough to chase after them. If you’re a girl with younger siblings, you’re responsible for them by time you’re old enough go to primary school.

These kids don’t worry about wearing the new LeBron shoes versus the new Jordans. They worry about things like if their family will be able to pay school fees for the next term. Most eat one or maybe two meals a day.

But for a day, none of that matters.

The Engeye party lets them forget about their chores, leave their worries, jerry cans, and hoes at home and simply have fun. And boyyyy do they have fun. Incredibly, it doesn’t take a whole lot to put a huge smile on their faces on even a normal day. Plastic bags rolled up into a soccer ball, a tire to push down the road, or even a big tree to climb will put a wide smile on their faces throughout the year. But this party is the pinnacle. It’s like Christmas in Ddegeya.

As for the preparations for the party…there were a million. Food prep was probably the most time consuming for everyone. Scholars, local women, and Engeye employees alike all spent hours peeling thousands of little onions and potatoes. As a small way to give back to Engeye, each scholar’s family donates a bundle of matoke for the party. Some local men slaughtered a cow and masterfully butchered it, with absolutely nothing going to waste. The catering team arrived around 7pm the night before and worked through the night to be able to feed all 1,100 kids. Each kid gets a healthy portion of rice, a scoop of matoke, some potatoes, a piece of beef, a soda, and a candy in what is certainly one of the better meals everyone eats all year. Even in pictures, it’s hard to understand the scale of the operation it takes to feed 1,100 hungry kids without actually experiencing it firsthand.

Reflecting on the party, I realized this single day sums up my fellowship pretty well so far. It was busy, even hectic at times; it was fun, surrounded by kids and their smiles; it was exciting, exhausting, and meaningful; it was an experience unlike any I’ve ever had before and very well may be one I never experience again. All in all, life is still good.

Day of the Ssekoko

Happy (belated) Turkey Day!

It’s the first significant American holiday since we’ve been in Uganda, so Nick and I made our best attempt to bring Thanksgiving to Ddegeya. A little party on the back patio was our way of saying thank you to the Engeye staff for all that they’ve done welcoming us into their organization, helping us transition to life in Uganda, and really just being amazing people in general.

The menu: A turkey! Plus mashed potatoes, gravy, green beans, carrots, corn, and rolls. And of course, some fine Uganda wine.

First things first: finding the desired turkey (ssekoko in Luganda, kind of like chicken or nkoko). I was skeptical that it was even possible. We’ve been here more than four months and seen people eat all kinds of things. We’re talking ants, grasshoppers, rabbit, mudfish, goat intestines, but no turkey. Still, Eddie and others insisted there were in fact turkeys to be found. After striking out at the market in the nearby city, Masaka, last Sunday, we returned home to Ddegeya for a more traditional way of shopping. We walked down the road and Eddie asked the first person he saw if they knew of anyone selling a turkey. From here we bopped from house to house, calling this person and that one, until we found a pretty large house nestled in the matooke that supposedly had one. The woman opened the door and alas, a fat turkey! Undoubtedly, our turkey would put the “organic” ones from home to shame. This bad boy was eating matooke when we showed up!

We returned Wednesday afternoon to pick it up, which turned out to be the most difficult part of it all. The woman opened the door and pointed at the turkey: “there it is,” at which point we realized she expected us to catch it ourselves. Half an hour later of the three of us unsuccessfully chasing, cornering, and snatching at the damn bird and we still didn’t have it. Side note: I’ve had great success catching the pigs that frequently escape from their pens, proudly earning myself the nickname “taata mbizzi”… literally translated as pig daddy. What a name, huh. But let me tell you, I’m no turkey daddy. I tried to make a lasso out of the rope we brought to tie it up…horrible idea. The turkey was quite literally running circles around us. Finally we cornered it in an abandoned structure in the back of her property. Nick and I kindly offered to block the door and let her get it. This is where we finally trapped him:

But the fun was not over because it was time to bring the turkey home and doing so made for an absolute scene. Picture two mzungus walking through a relatively rural area, just as school was getting out, clinging to a turkey that was making quite the fuss. Think of an impromptu parade. The kids were hooting and hollering. Old ladies were screaming ssekoko. Our favorite village drunk even put down the waragi bottle long enough to try and figure out how much it weighed. Boda drivers slowed to nearly a crawl as they drove by. It was a full-blown spectacle.

After we got it home, the next challenge was figuring out what in the world to do with it. If the two of us were in the US and could go to the grocery store and pick out a turkey with a fully stocked kitchen waiting at home, I’m still not sure we would know how to cook it well. Add in the challenge of tying it up, killing it, defeathering it, cleaning it, and then somehow cooking it with our two gas burners and things didn’t look promising. Among the ideas of how to cook the beast was to make a homemade oven out of some bricks piled in our backyard, make a fire and find a pole to stick through it to roast it whole, cutting it into pieces and deep frying it, and finding something resembling a grate to put over some bricks with a fire underneath. Here’s a picture of the “grill” we made in the backyard as a test run:

Clearly not suitable for a large turkey.

As my dad so kindly predicted, it would be a “shitshow.”

But if we’ve learned anything in four and a half months, it’s how to make some edible food out of limited ingredients and we weren’t going to let the only turkey in Ddegeya go to waste. Thankfully we had some help from some animal butchering experts, like Engeye maintenance men Sula and Caleb, who helped us turn the clucking turkey into something resembling what you’d find in the grocery store.

Overall, the day was a big success, but I was unfortunately too sick to be involved in the actual cooking. Nick, with some help from Emma and Sylivia, did an incredible job feeding twenty people and an even better job cooking the turkey, which ended up in a seldom-used charcoal oven that we had forgotten one of the clinicians owns. To bring the ssekoko’s life full circle, Nick even stuffed it with a matooke leaf, surely the way a Ugandan turkey would want to go out. The transformation of our ssekoko, without the slaughtering part of the sequence:

As for the day itself, I think the actual idea of giving thanks applies today more than ever before. This year, I’m thankful for everything I’ve taken for granted for the last 22 years. From amazing friends and family, to clean water and quality healthcare, to even the shirt on my back, I’m thankful to have lived a privileged life so far.

Although Ddegeya has become home and life here has become normal, I’m still not immune to the poverty that surrounds our daily lives and honestly, I hope I never get to that point. To sum it all up without making an essay out it, I’m thankful to be here to experience all of the good and the bad Uganda has to offer and to see the world in such a unique way.

~

In other news, we finally checked off a Minerva Fellow tradition and made it to the “hilly place.” It might be Eddie’s favorite place in the world. From Minerva Fellows long ago, to his former girlfriends, and his now significant other, they’ve all been treated to his special place. Ask him why it’s special, and it’s because of all the memories he’s made there with so many of his favorite people. After finally getting there, it’s easy to see why.

Watching the sunset atop a picturesque hill with nothing other than Eddie’s throwback tunes and a lone eagle soaring above made for one of those cool, “whoa, I really am in rural Uganda, having the time of my life,” moments that I’ve cherished.

Somehow, our fellowship is halfway over. It’s difficult to describe, but the days have turned into weeks and weeks have blended with months in a way I’ve never experienced before. With visitors, Innovation Camp, and the holidays all on the horizon, I know the second half will go even faster than the first. Nine months looks like an eternity on the calendar, but it hasn’t felt that way in the slightest. In April I know I will be thrilled to go home, but it feels like our time here will almost be too short. Whether that’s good or bad, I’m not really sure. But I’m still having an incredible experience and not missing home all that much, so it can’t be all that bad. Happy Thanksgiving!

Snakes!!

To think less than I week ago I was bragging about not seeing any snakes. We’ll I’m here to tell you that I saw a snake this week. Not even just one! Two!

My first snake encounter couldn’t have gone any better. We were away for the weekend at Lake Bunyonyi and while we were hiking someone ahead of us in the group spotted it and alerted us. It was a few feet off of the path and posed no real threat. The best part was that snake was 5 hours away from my home. Who cares if they have a bunch of snakes down there! I thought once I got back to Ddegeya I’d be safe from the monsters.

The Bunyonyi Snake:

And a few pictures from the weekend because the lake is beautiful:

But the second encounter wasn’t nearly as easy. Last night, I was going to pick a lemon off of the tree in John’s front yard to use for dinner. As I stepped on the first stair up from the driveway, what I thought was a stick started twitching and I froze. Yup, there’s snake number two and snake number two had caught me totally off guard. Thankfully, it was on deaths door when I came across it. It probably hadn’t even noticed that I had stepped 3 inches away.

The Ddegeya snake:

So after our hero Emma stomped on its head, we went to work trying to figure out what exactly it was, mostly so that I could sleep soundly knowing it was harmless. He insisted that there was a possibility it was a baby black mamba. Gasp. We were prettttttttty sure it wasn’t a mamba; this isn’t exactly their terrain. And it wasn’t very big and we didn’t see any fangs. But it doesn’t take much to scare us (mainly me). Because, as Emma so kindly pointed out, we had only killed the baby; the big mama snake was still out there somewhere. Drumroll…………….

Sorry to disappoint, but it was just another nonvenomous one. How’d we know? I have my favorite herpetologist, Prof. Pytel, to thank for preparing me for this defining moment. The scales on the underside of the snake told the story.

Notice how on the tail the scales change from having one large scale covering the width of the snake to having two scales meet in the middle. Those are called divided subcaudals and they mean it belongs to a snake family that doesn’t have the venom to kill me :).

Okay, sure, both snakes were small and probably nonvenomous. But that’s beside the point because big or small, they’re still scary.

UPDATE: Prof. Pytel was kind enough to reach out to me and alert me to the fact that methods for identifying snakes in upstate New York aren’t the same as the methods for identifying venomous African snakes. (Looking back on this oversimplified identification thinking duhhhhhhhhh, of course they’re different Matt). Anyway, was it a type of cobra? Or a mamba? Or something worse? I guess we’ll never know until I meet mama snake.

The Peril of Africa

And just like that, we’re three months in!

Going in to the fellowship, I had expected September-November to be the slowest stretch of the nine months. The scholars are away, there aren’t any visitors, and I was worried that the excitement and newness of being here may fade. It has been a quiet month, but in no way slow. The beauty in this is that we have been able to devote nearly all of our time to working in the clinic, which, after all, is the reason that Engeye attracted me in the first place. Plus, our assistance has been especially valuable because a few regular employees have been away for extended periods of time over the past month and a half. So let’s talk about some Ugandan healthcare!

Not that this is in any way surprising or unexpected, but our work at the clinic has been both extremely gratifying and at times incredibly heart wrenching.

For example, the other day clinicians managed to diagnose a patient with Brucellosis and treatment has started to reverse the paralysis he has endured in his lower half for over three years, likely due to the progression of the untreated Brucella infection. He has regained the ability to sit up on his own and we are hopeful that his improvement will continue and he will ultimately regain to the ability to walk again.

But the next day, I practically carried a pregnant, HIV-positive woman about in her early twenties from the grass in front of the clinic where a boda had dropped her, to a room to take her vitals…the same room where she passed away only a short time later due to gestational diabetes.

Another day, I went on a home visit with Emma to see an elderly patient who is unable to make the trip to the clinic and was came away impressed with the progress his wounds had made in the past month that Emma has been going out of his way to visit him.

Just this week, we successfully treated two suspected poisoning victims. Purposely poisoned, you ask? Quite possibly. Yet the mystery and intrigue surrounding these patients were quickly overshadowed by the agony of a very young girl suffering from dysentery who came in with what seemed to be the onset of tetanus. But after failing to identify a cut or open wound, understanding that she is up to date on her vaccinations, and many tests later, clinicians concluded that her nervous system was most likely being affected by the spreading of an H. pylori infection, typically associated with stomach ulcers, and recently shown to have the ability to impact the central nervous system if left untreated for a substantial period of time.

Time after time, I am left wondering how it is possible that diseases are able to progress infinitely further here before people seek treatment than what we are used to at home. Some of the hardest parts about seeing these patients is knowing full well that had they been treated in the earlier stages of these diseases, their prognosis would be much, much different. While each individual case is different, it is evident that the underlying causes to many of these cases are the same.

People simply do not have access to healthcare or cannot afford the care they need. Yes, government healthcare is “free,” but often they are severely understaffed, overpopulated, and lacking essential resources such as even running water. These factors, combined with what seems to be a general distrust of government institutions, cause many people to seek alternative options.

I think this conclusion about the difficulties of accessing and affording quality healthcare is best understood with a recent, eye opening experience we had. Last weekend, our neighbor and one of our good friends here, Caleb, invited us to go home with him for the weekend up in Sembabule District. We didn’t have anything planned and thought it would be a great chance to see more of rural Uganda, meet his family, get away from Ddegeya, and best of all, we knew he would love having us. We had an incredible day exploring his village and meeting his friends, his family was delighted to host us, and perhaps most importantly I had some good matoke. Yes, good matoke!!! I’m coming around Michelle! Check out some pics from the day…

After we were finished eating and were sitting outside with his family, one of his neighbors, in fact the only person we had met in the village who spoke good English, came walking up. “Doctor! Doctor! Please take a look at my wife and see if you can help her.”

There was no need to ask what the problem was. We had seen it from 25 yards away. On the side of her neck was a growth a little larger than a softball. Of course, I can’t diagnose this woman. I couldn’t diagnose her in a hospital with the best equipment in the world, never mind in the middle of the matoke fields, half an hour away from town. But that just isn’t an acceptable answer, so I was going to examine her and recommend she seek real medical help no matter what. Playing a good pretend doctor, I started feeling the growth and asked how long she has had it.

“Probably about eight years now.”

EIGHT???

“Yes, doctor. She has had it for eight years.”

First thought, uncensored: it must not be that serious if it hasn’t killed her in eight years.

Second, more thoughtful idea: again, how in the world can you go eight years without getting medical attention. Ahhh but I was making a big assumption. He proceeded to tell us that she has been on homegrown herbal medication the whole time! In fact, only a short time earlier, we had seen a six-year-old boy with a skin infection. But as the family explained, transportation to the clinic is simply too expensive, and that doesn’t even include paying to have the boy treated or for medication. So they were hopeful the issue would resolve with herbal remedies. As Coach Murphy often reminded us on defense, hope is not a strategy, but unfortunately, hope was all they really had.

Interactions like these are not uncommon. In fact, every example from this blog has taken place in the last two and a half weeks. But every time we come across someone badly in need of medical care, whether it be at the clinic or in our outside lives such as in Caleb’s village, Katoma, I am reminded what an incredible place Engeye is and how important the work is. In fact, Ddegeya is not dissimilar from Katoma, Caleb’s home village. Had these patients lived in a village like Katoma, far removed a clinic with the resources of Engeye, his paralysis would have most likely continued to progress. Engeye can’t change all of the healthcare issues in Uganda, but it is undoubtedly making an impact.

To sum it all up, so far, so good. Three months in and the experience has been everything I hoped it would be when I signed my life away to Tom and Hal last winter. Inspiring, exciting humbling, fun, sad…it’s been a little bit of everything. As always, thanks for reading! And, I know everyone is wondering…still no snakes!

PS: One last thing. Nick wrote a great blog a while back that highlights a lot of the good about Africa. It would make for great supplemental reading to this one about some of the more difficult aspects we’re experiencing… Highly recommend:

http://nicholas-williams-uganda.blogspot.com/2018/08/breaking-stereotypes-82518.html

 

Luganda

Here in the country of Uganda and kingdom of Buganda, we speak the language Luganda. Got all that? Good…

So far, Luganda has been one of our biggest challenges. It’s not just that the words are long and all sound the same at first, but the structure of words, specifically verbs and going from singular to plural is very different from any language I’ve been exposed to. For example, when I was in Sicily, Italian came relatively easy because of the similarities to Spanish, which I had studied from middle school through sophomore year at Union. But Luganda is very different from all of them.

What’s hard about Luganda? Let’s look at a few examples.

The word for shop: dduka. The word for run: duuka

 And there are lots of examples like this. But there are also cases where similar words aren’t all that similar. Take grandparents.

Your grandparent: jjajjawo. My grandparents: bajjajjange.

But possibly the hardest part: figuring out when someone says yes or no. It seems so simple but it drives us nuts. What does yes translate to? Any of the following noises:

Nnnnn

Ehhhh

Ahhhh

Mmmmm

No can be nedda or more often, a similar noise to yes with a different tone and facial expression.

In the clinic it sometimes helps us when people give more complex answers, like saying how many times they have been to Engeye because we can understand enough of that. But Mmmmmm still puts my brain in a pretzel.

Nevertheless, we’re actually happy with the progress we’ve made so far. But as with learning anything new, there have certainly been a few bumps in the road. Some of these bumps create funny interactions, like one from this afternoon that inspired this blog.

I’m sitting at the desk waiting to check patients in. A young woman around my age comes in and sits down. Initially, I’m pumped. It seems like in general, young adults have the best English. In my mind, if our Luganda conversation breaks down or takes a detour away from my very regimented line of questioning, I can resort to English to fill in the gaps.

So after a basic greeting, I start:

Bakuwandiise nyabo? (Have you checked in yet, ma’am?)

Expecting some variation of ehhhhhh, I got just a head tilt and a rather confused look. Hmmmm. It’s okay, that wasn’t an essential question anyway. I’m pretty sure she hasn’t been seen. Moving on.

Wali ozeko wano? (Have you been here before?)

It might not seem like it, but this is the single most important question I ask all day. This determines if I can search her in the EMR, or if I need to figure out how to spell her name exactly and create a file. Huge difference. If someone’s been here before and I catch even one part of either their first or last name, I can usually find them based on village and age which has much less variation and is much easier to understand at this point.

She replied with a monotone “ehhhh” and no facial expression. Not even a head nod. So I have no clue. Great. She’s from a neighboring village, so I’m hoping she’s been here before.

Bakuyita ani? (What’s your name?)

Silence. Just the two of us staring at each other. She’s confused, which is relatively normal, but not for this question. Some words are harder for people to understand with my accent, but this isn’t usually one of them.

Nyabo, bakuyita ani?

Clearly more confusion, but this time, she answered. And a minute of rambling later I didn’t catch a single word she said. If I cant get this, how in the world am I going to understand what her medical issue is?? Anyway, there we are staring again… so I ask in English. Nothing. Finally, my last ditch attempt to ask her to speak slowly before I call in reinforcements:

Bakuyita ani, mpola mpola.

No silence this time, but just more and more of her talking and me not understanding. In my head, I’m thinking a name is two or three words, not a whole conversation, right?

Then, a savior. Olivia, one of the lab techs heard some of the conversation and chimed in:

“Matt, she’s speaking Kinyarwanda.”

Ahhhhhhhhhhh. Turns out she was from Rwanda and just happened to be staying around here.

So here I am, knowing only basic Luganda trying to talk to someone that doesn’t even know Luganda. I had to hold in the laughter until she went back outside to wait. What a scene. It made me realize I don’t even understand enough Luganda to tell when someone isn’t even speaking it! I guess that explains all the staring…

Which brings to mind another memorable Luganda interaction:

One afternoon after being here only a few weeks, Nick and I went to Mama Jackie’s shop for a chapatti, which is part of the daily routine. Feeling a little more comfortable with my slowly improving Luganda, I asked for a water. Mama Jackie knows what water is in English, but I was practicing. My simple request sent the boda drivers into a frenzy. The guy sitting on the bench nearly fell off of his seat laughing so hard. But all over water??

Something’s not right. Little did I know the double letters were back to haunt me, kind of like the duuka/dduka example from before. You see, amazzi means water. And amazi means shit. Emphasizing the wrong letter and you’re saying something totally different.

So, in perfect Luganda and a smile on my face, I had asked for: “one shit, please!”

Whoooops….

At the time I couldn’t pronounce the difference between amazi and amazzi. Now to be safe, it will always be amazzzzzi when I need some water. Live and learn.

But don’t worry there’s a happy ending; Eddie gave us Luganda names. Instead of Matt, I am now Kaliisa Matayo and Nick is Musisi. It gives us some street cred with the locals and they think we’re fluent when we introduce ourselves as Kaliisa and Musisi. As they say, fake it ‘til you make it.

Introducing Engeye Innovation Camp!

I’ve only touched on it briefly, but Engeye makes an impact on the community that extends well beyond providing quality, affordable healthcare.

The Engeye Scholars Program is the second main branch of the organization. With the help of some very generous donors, Engeye sponsors 25 local students to go to private boarding schools in the city where they can get a quality education and continue on to college, a dream that is essentially unrealistic from the local public schools. The hope is not only that these kids will grow up to be successful, but maybe even use their knowledge to give back to the local community, conceivably in a similar way to how the Engeye co-founder John grew up in Ddegeya and used his education to build the Engeye we know today.

Part of our responsibilities as Minerva Fellows at Engeye is to help them with schoolwork and run enrichment programs for them while they’re home on break. To read the amazing story about how the Scholars Program was born, check out this link:

http://www.engeye.org/education/engeye-scholars/

Continuing with the background info…Ugandans seem to be naturally entrepreneurial. Someone we know described it as the “hustle.” Everyone seems to sell something; even if it’s not their main source of income, it’s a side hustle. Really anything that can provide a small source of supplemental income, which makes for quite the entrepreneurial culture. In fact, in 2015 Uganda was named the most entrepreneurial nation in the world. Here are the countries with the highest percentage of the population who are business owners. It’s not even close.

When Nick and I landed in Entebbe and were on our way to Engeye for the first time, we were blown away by what we thought were endless MTN and Airtel (cellular) stores. Every town we passed through was filled with them. We now know these were just advertisements painted on the buildings of other businesses. Sooo, how do you know what the stores sell? Well, its easy, actually; they pretty much all sell the same stuff so there’s no sign necessary. In the villages, the typical store will sell soda, chipatti, rice, eggs, laundry detergent, bread, tomatoes, cooking oil, onions, toothpaste, pens, tea, padlocks, waragi gin… the list goes on. At first it seems like a random assortment, but it’s every common household essential. Some stores in the village have their specialty, like Eddie’s, which sells the boda drivers their gas, and Mama Jackie’s, which sells some fireeeee passion fruit juice. Often these stores will be right next to each other, selling the same products at the same price. We joke that when we are looking for a store, if you find one, you’ve found them all. On our third trip to Masaka, we finally found a large grocery store. And then we found another right next door! And then another…but you get the point. Moral of the story, lots of businesses, not a lot of variation.

One of last year’s Minerva Fellow’s at Engeye, Justin Salm, recognized this ironic intersection of entrepreneurial spirit and a relative lack of innovation.

So during this period when the scholars are home on break we’re introducing Engeye Innovation Camp!

Justin developed and planned for an eight lesson mini-camp that we would facilitate in December and January during their longest break, exposing them to different ways of thinking and social entrepreneurial ventures. We’re hoping to broaden their horizons, spark creativity, and help them see problems as an opportunity to create a business that solves the problem. Social Entrepreneurship! (Sup Hal).

For now, Nick and I decided to add to his original plan and try to use this break as an introduction to innovation and creative thought. Part 1 (this break) consists entirely of hands-on activities and Part 2 (winter) will be the more educational aspect of the course.

Anyway, this longwinded introduction is due to the fact we just finished our first week! So far, two classes designed to promote creative thought and what we know as outside-of-the box thinking.

Day 1, the Egg Drop!

For our first “class” we decided to do an activity we had both done at some point growing up. It seemed like a fun way to get to know the kids, while simultaneously introducing creative thought and innovation. What is the egg drop? It’s a challenge where you give a group of students a raw egg and a seemingly random collection of materials that they must use to protect the egg from breaking when dropped from about 10ft. The height is gradually increased until there is only one egg left standing.

For our version, each group was given 6 straws, 10 Popsicle sticks, 3 rubber bands, 5 cotton balls, 2ft of duct tape, 2ft of yarn, and a thin foam sheet in a paper bag. We gave them the bag and simple instructions: be creative and don’t let the egg crack! Now it wasn’t all smooth sailing, as the wind had its way with everyone’s tape, so we ended up replacing a limited amount of tape with pretty much unlimited tape, which made it much easier for them. But if that’s the biggest hiccup, that’s a win in our book.

Some of the varying designs:

The winning group, with Wilber proudly holding the only surviving egg right before chugging his victory soda:

Did they have fun?? Check out the reaction when Hamza’s egg didn’t stick the landing and decide for yourself. Sorry, no videos on my free website. So heres a silent GIF. Imagine lots of screaming…

Day 2! The Spaghetti Tower!

A classic team-building activity, (shout out NT and senior seminar for this one), the students are given 25 sticks of raw spaghetti, a yard of tape, and a yard of string to build the highest free standing tower they can. The catch is that it must support a marshmallow at the highest point, so it needs a decent amount of structural integrity. The only problem…smores haven’t made their way to Uganda yet. So for a Ugandan twist, we substituted a small grape for the marshmallow. And this time we did actually limit the tape to make it more challenging.

More action shots! The good, the bad, and the leaning…

Wilber and Waswa made an ambitious attempt to repeat as champions by building a vertical tower to the sky. It was all fun and games until the grape went on top.

But they’re scholars for a reason…here they are well after everyone else had gone home, redoing it from scratch in search of a better design.

The winners, Harriet, Josephine, and Immaculate with a 22-inch tower! Their tower was actually higher than the ones Nick and I built in a test run!

Overall, we had a great time and the week was a huge success. The laid back activities allowed the kids to warm up to us and it should give us a great foundation moving forward. After today’s lesson was over, one of the younger scholars, Jackie , asked when the next class was. I told her Tuesday afternoon, the same schedule as this week.

“Nope. That’s not soon enough. Some scholars go back to school Sunday. Let’s do Saturday.”

Alright then. See you Saturday!

PS: Here’s a really interesting article about all this, courtesy of Justin:

https://www.theguardian.com/global-development-professionals-network/2016/feb/16/uganda-is-a-land-of-entrepreneurs-but-how-many-startups-survive

1/9

My phone randomly stopped working last night. For the first few hours I thought it was spotty MTN service in rural Uganda…understandable. But no. In fact, my social media tax had expired. The official signal that it’s been exactly a month in Uganda since we got off the plane and bought a month of free apps.

Looking through some pictures I want to try and summarize some of the noteworthy things we’ve done and the way of life here since I haven’t really addressed much of that yet. So from the aspects of Uganda life that I’ve loved to the ones I’ve hated and everything in between, here goes.

First: Street meat is GOOD! Before we came it was one of the things we were told to be weary of for food poisoning. We thought maybe a few months in we’d try it when we were missing meat. By now I’ve probably had it ten times. Meat on a stick. Doesn’t get any better than that, huh. Going to the nearby town Kinoni on Friday for some chicken on a stick and a beer is already becoming a tradition. And I’m sure this little addiction will catch up with us eventually. But for now…give me the street meat! (Except for the gizzards. Emma loves them, but as some may know, I’ve had enough gizzards to last me a lifetime. And I prefer them in soup anyway…so for now, I’ll pass.)

Speaking of Kinoni Friday’s! When we order a beer we always get the same question. It’s not “bottle or draft?”, but, wait for it….“Do you want it hot or cold?” Ummmm as cold as you’ve got please. But it actually makes sense. Most villagers don’t have access to refrigeration so they probably grew up drinking it warm. We’ve tried to assimilate with as much of UG culture as we can, but for this is one, we aren’t ever giving in.

While we’re on food, I hate matoke. It’s everywhere. The funny thing is it really isn’t a strong taste, but I just hate it. It’s pretty much a starchy banana boiled to mush. And the more I think about it, the more I don’t like it. It’s going to be a long 8 months because it is an absolute staple. If you’re a guest at someone’s house, matoke for breakfast, matoke for lunch, and yup, matoke for dinner. If there’s a good sauce or broth over it, well, it’s manageable. If you can’t tell, it’s the yellow blob of mash in the picture. Luckily, there was a nice fish stew to mix it with this time.

Last weekend finally made it to Kampala, the capital. There’s really no other way to describe it other than that it’s pure mayhem. Just people everywhere, all selling something, and all of them trying to sell something to the mzungus. We’ll be back, but only when we absolutely need to be.

Next was Jinja, the source of the River Nile! We were lucky enough to have Giana introduce us to an awesome tour guide, Ivan, who showed us a few cool waterfalls along the way. We also got to stop at Sylivia’s house for a night to celebrate her sons birthday! Of course, lovely Ugandan hospitality again. Interestingly, the Nile runs right through the heart of Uganda, but if you ask anyone here, the Mississippi is unquestionably the longest river in the world (it’s not). The legend of ‘Merica I guess. Here are some pics from the trip.

Time works differently here. At first we were antsy and looking for things to do, but now we love the way people view time. A 3 hour ride already feels short and the 40 minute ride to Masaka feels like we’re just going down the road. It’s weird how fast it happens, but time feels different already. Activities do come up frequently, but we’re getting much better at just relaxing and losing some of the American hustle and bustle in us. As Nick said, no “program” (plan or agenda) is the best program.

The kids! There are four young kids around whose parents work at Engeye. So, Joseph, Maria, Trinity, and Nicole are always around and always looking to play. Here’s my dude Joseph:

We slaughtered a chicken! And we is used lightly, because the Engeye grounds keeper Sula actually did it. But my turn is up next! I have an AWESOME video of its head getting sawed off and flopping around but some Snapchatters didn’t appreciate it so I’ll leave it to your imagination. The kids loved it though and clearly Trinity isn’t afraid of a little blood:

I also don’t like the pigs. They’re insanely loud, they smell, and we just look at them dreaming about bacon. Tough combo.

We’re training our bodies to go to the bathroom less and less. The latrines aren’t all that bad when you get used to them, but they still aren’t fun. Things like the latrine and our cold showers twice a week are a grind, but you quickly realize they have no impact on your happiness.

We’ve had two major outings with the Engeye staff, which have definitely been highlights. The first was a surprise birthday party for Bridget, the head clinical officer here, and the second was a trip to Club Ambiance in Masaka. Both were a great time, although the 5am ride home from the club with 13 adults stuffed in a 7-person car was forgettable.

With these outings comes some Ugandan music, which we’re getting more and more familiar with. It’s pretty cool how everyone listens to the same music here. Check out our new anthem, Didadada:

We’ve been trying to convince people to adopt casual Friday’s…to no avail. But we brought shorts and have to wear them eventually, so the fight lives on.

We learned how pineapples grow! Not something you think about until you almost kick one walking through the matoke fields.

Nick has been an awesome partner. No question I lucked out in that aspect of the trip. Having him here with me for the nine months changes the entire fellowship. We found old pictures of us playing on the same team in a Connecticut all-star baseball game six years ago. At the time he was throwing 83 and I was throwing 76, in case anyone was wondering why he played college baseball and I played college basketball. What are the odds we both would have ended up here…

The landscape and sunsets/sunrises are beautiful. Here are just a few:

If you’ve made through all this, thanks for following along! But that’s all for now. It’s Friday night here, which means I have a date with some street meat…

And for those asking, I’m 1/9th of the way done without seeing a snake. Call it a good month.