Winners is really hit and miss. Sometimes you can find a great pair of Levis for $30 but otherwise, you’re left with jeans that have barcodes, skulls, guns and anthropomorphic animals all over the ass pockets.
Back in Canada for a couple of days at this point and upon reflection of our time in the UK, Sarah and I both regretted not doing our graduate work there. The sights are wonderful and one cannot help but be caught up in the history that permeates everything. It’s an incredible contrast considering that most Canadian institutions are less than 200 years old.
After leaving Beccles, we headed down to London to stay with Sarah’s aunt’s sister at her beautiful home in Winchmore Hill, just north of central London. After a feast of Chinese food on Friday night (there are definitely a lot more ethnic casual dining options in London than in Hamilton) we headed to central London to do the usual touristy things on Saturday. This included the picture in front of the Houses of Parliament, staring through the gates of Buckingham Palace, getting coffee in St. James Parks, commenting on how young and pasty the Royal Guards are, shopping in Covent Garden and getting crammed into the smallest subway cars in the world. It was a whirlwind tour of just two sections of the UK, but I loved it.
Upon landing back in Canada, I couldn’t help but reflect on our experiences in Uganda. Our time in the UK was definitely a great transitory period to get us acclimated back to global north culture, but I found myself missing both the warmth and caring nature of northern Ugandans and actually having something to do that felt worthwhile. Being a twenty-something in Canada waiting for more education holds similarities to the modernized pop culture idea of purgatory - you simply just float around. Instead of waving and smiling to everyone on the street in Gulu and making a small difference in the lives of the disenfranchised and overlooked, I now just go from point A to point B flipping through my phone. I’ve read before that travelling a lot while you’re young makes you an insufferable asshole to your friends because all you’ll talk about is travelling and how you don’t want to be back home. I haven’t fallen into that trap (yet) but there’s definitely truth behind those words. Seeing my family, knowing I’ll see my friends in a few days and seeing snow has helped with not turning into a pretentious traveller.
As for now, Uganda will remain as the most fun and challenging three months I’ve had in my life. I’ll be back - eventually.
However, for now, O Canada.
This is our second day in England, staying with my aunt Serena at her marvellous home in Beccles, the quaintest town I’ve ever seen. Yesterday we arrived at Heathrow early in the morning, bought a winter jacket for Casey, and drove back to Beccles. Casey offered to make spaghetti with minced beef. The three of us ate dinner with wine and when we were finished, we headed off to a local pub and to Casey’s delight, were served pints of locally brewed beer. This morning I had what seemed like the most luxurious shower money can buy, seeing as how in the last three months, I bathed with cold water and often it was from a jerrycan. Vanity got the best of me when I realized my aunt had a blow dryer and straightener, commodities I had not even touched in Uganda.
When the three of us were clean and had eaten until our heart’s content, we headed to town. Aunt Serena needed to go to her bucher’s so Casey and I took the opportunity to have a gander. The narrow streets were lined with local shops and there were remnants of earlier times such as a 400 year old bell tower, where the previous night had the bells harmoniously ringing throughout the night in preparation for Christmas. The entire experience was, in our eyes, quintessentially English. I’ve also decided that I’m living here at some point in my life.
We spent the afternoon in Southwold, a beautiful (and rather posh) community right on the North Sea. The community’s architecture was breathtaking and obviously found no where in Canada. The most interesting part of the community was actually not the 400 year old manors, but instead, small beach huts lined up around the beach. Aunt Serena told us that these colourful huts were meant to store beach supplies and serve as a shelter in the day. They had no insulation, were not big enough for a bed, and had no bathroom. They literally looked like colourful garden sheds on the beach. What I found alarming was that the average price for one was anywhere between 40 and 60,000 pounds. The owners of the huts, therefore, instead of looking like fools carrying an endless amount of chairs, beach toys and children from the car, can leisurely and effortlessly walk to the beach in four inch heels and sit in front of their beach hut.
Though it was quite windy, we had a fantastic day. Tonight aunt Serena is making a traditional British dinner, toad-in-the-hole. I just finished two mincemeat pies and my third tea of the day. Britain is great. Oh and I saw two pheasants.
There’ll be a lengthier wrap-up later on but in less than 24 hours, we’ll be on our way to the UK!
Oh. The bus ride from Gulu was quite sad. :(
You live in northern Uganda. You may have HIV or you suspect that you have it. You will more than likely make your way to TASO Gulu for Voluntary Counselling and Testing (VCT), the Community Drug Dispersal Point (CDDP) to refill your anti-retrovirals, attending group counselling, receiving medical or psychosocial support and receiving some of the best overall HIV/AIDS care in all of east Africa.
Your first stop at TASO is triage where you will pay 1000 shillings (roughly $0.25), get your file retrieved from the mountain of patient data and get weighed which is paramount in monitoring a HIV/AIDS patient’s progress through the World Health Organization’s HIV staging metrics. You’ll speak to a TASO staff member (usually a registered nurse or clerk) who will determine whether you need medical or counselling attention.
If you need counselling attention, TASO’s unbelievably dedicated staff of sixteen professional counsellors will listen to you for at least 30 minutes about how you are handling life with HIV from the personal, family and community perspectives. Women in northern Uganda face tremendous amounts of challenges with their husbands not wanting to get tested or to seek medical or psychosocial care for HIV.
Medical care at TASO is amongst the best in Gulu. There are a dedicated team of medical officers and clinical officers (physician assistants) who see over 500 patients on clinic days. A treatment plan is made and they are either referred to St. Mary’s in Lacor (neighbouring Gulu) for further diagnostics (especially the use of their X-Ray machine) or to the TASO pharmacy.
The TASO pharmacy is stocked with most first-line treatments for viral, fungal and bacterial infections as well as the whole gamut of anti-retrovirals currently being provided by the USAID and the Centre for Disease for Control (CDC).
The photos don’t show the amount of idling for the clients (I’ll never complain about ER wait-times ever again) but the care a patient receives is amongst the best they can get in Uganda. Nevertheless, It’s disheartening after seeing the public health care system (more to come later), that it seems that to get quality medical care, you need to be HIV positive.
Casey and I have run out of internet on our dongle, so I apologize for the lack of posts recently.
Today is our last day at TASO, and I can honestly say that I am incredibly sad to leave. It has been an amazing, eye opening experience that I will carry with me my whole life. I came here looking for a research idea, but I am leaving with more questions. I’ve realized that life here is not something that can be written down as a thesis. Still, I will try to give the graduate schools what they want, and hopefully I will have the opportunity to return for a longer period to carry out my accepted research proposal.
In 4 days Casey and I will be in England, visiting my aunt for a few days. Until then I have to say goodbye to everyone I’ve spent the last 2 1/2 months with (except Casey). I absolutely hate goodbyes. There was an intern at TASO in September who said “The reason I have to leave is because I arrived.” Rarely will people live and work in the same place their entire lives, and for me, I feel the desire to keep moving and to keep learning. A problem with arriving somewhere is that one day you’ll have to leave, as is the case with TASO. This morning I had my final report presentation. I included lessons I’ve learned and recommendations I have, as well as pictures I’ve taken throughout my time at TASO. Casey and I also splurged and bought two cakes as a thank-you. I think it acted as a good incentive to come to my meeting because within 5 minutes of ending the meeting the cakes had disappeared.
The rest of the week we were kept fairly busy. We finished and printed our reports, we had another hospital visit, and we biked 65 kilometres in the blazing heat. I’ll say now that I haven’t as much as sat on a bike in almost 3 years. Casey and I were persuaded into riding with other TASO staff around Uganda to support prof. Wolfgang Lenzen (A German National) in riding across Uganda to raise money for TASO. His team started early again this morning. They’ll ride 105 kilometres today. I was asked if I wanted to join again. hell no. By the end of yesterday my butt hurt so much I felt like I was sitting on razors and my legs didn’t work when I tried to get off. I just fell over onto the dusty road. I also came within inches of two transport trucks and a coach bus as they sped past, driving me off the already patchy road. At least I was wearing a helmet. Besides almost getting killed, the scenery was beautiful and it was quite peaceful when I wasn’t suffering trying to pedal my one-gear bike up a hill. The children were cute enough and I thought I was going to be overrun as I road past a school just as the bell was ringing and hundreds of children ran towards me from all sides. The day’s lesson: I need to exercise.
For the past two days, Sarah and I have followed TASO’s medical staff into Gulu Regional Referral Hospital for follow-up care for any of TASO’s clients that have been referred into the public health care system due to an emergency or worsening chronic conditions.
Our first day at Gulu Referral was spent on the Internal Medicine (IM) and Tuberculosis (TB) Wards. The first thing I noticed upon entering IM was the overwhelming smell of urine. It’s quite understandable that hygiene flies out the window considering that I did not see a single orderly or support worker and the nurses, medical students and single attending physician were all too busy to care.
Given that the patient load was too much, the TASO medical staff was able to step in and order X-Rays at another facility for two patients with suspected TB as well as ordering a blood transfusion for a ludicrously anemic patient. Upon finishing in IM, we headed next door to the TB Ward where, frankly, I wasn’t prepared for what I would see. I’m pretty certain that most people reading this blog have seen images of emaciated Africans on WorldVision commercials asking for money. It’s even worse when you see it in person. TB weakened her and made her lose weight but intestinal parasites have literally wasted her down to an emaciated shell of what I thought a human could look like. The hospital was out of Loperamide (for her diarrhea) and Albendazole (for her worms) so the situation was pretty bleak. Thankfully, TASO had blankets and oral rehydration salts to provide the nursing staff to make her more comfortable.
The next day, we visited the Pediatrics and Nutrition Wards where I had probably one of the most depressing and angering experiences of my life. Children who are admitted to the Nutrition Ward, for reasons unbeknownst to me have to spend their day on concrete floors. Kids are often less than three years old but barely look like newborns due to their horrendous cases of malnutrition and parasites. I saw a rail-thin child barely breathing on a concrete floor with a single blanket covering her all because the hospital was woefully ill-equipped to handle her case. What infuriated me even more was when Rebecca (a TASO physician) told me the story of how the former director of the hospital was arrested for stealing 2 billion Ugandan shillings (approximately $750,000 which would go a long way here) and the only reason why he was thrown in jail was because he wasn’t sharing his new found wealth with those that turned him in. Furthermore, the Ugandan Ministry of Health is keeping most of its operating budget in Kampala and isn’t spreading it out to the rest of the country – especially the north.
It’s obvious that corruption is rife in the world in all public institutions, but the damning situation that’s happening in Uganda’s public health care sector needs drastic change from its own citizenry. The work that TASO is doing is obviously making positive changes on a patient-to-patient basis, but I think that most of my time in Uganda has been spent on the fortunate side of life. Uganda needs a change and even though it can’t start with me (as a non-Ugandan), my compassionate, caring and downright amazing co-workers can start to make this difference.
This weekend was the most exhilarating and terrifying experience of my life. Casey and I along with 7 other expats from Gulu travelled to the beautiful city of Jinja to do some extreme grade 5 rafting at the source of the Nile. Friday, we caught the Post Bus to Kampala and stayed over night in a guest house directly beside one of the most popular clubs in the area. Early the next morning the Nile River Explorer shuttle picked us up and took us to Jinja. Jinja is located East of Kampala and is best known for hosting the source of the Nile. Jinja also has the Nalubaale Hydroelectric Power Station, also known as the Owen Falls Dam. I’ll assume that Jinja gets far fewer power outages than poor Gulu. Even as I type this post our compound is running on a generator.
When we arrived at the Nile River Explorer camp the employees told us to grab a helmet, a life vest and some breakfast to eat on the road. There were about 25 of us in total and we all fit on 5 rafts (6 people max per raft). Our guide told us that during June and July they often bring over 20 rafts to accommodate everyone. I was glad that we had such a small group. It made for a more intimate experience. We drove through rural villages set up along the Nile in an open lorry type vehicle. Children ran along side the truck waving and smiling. Some others flipped us the bird or worse. I don’t blame them though, they probably get sick and tired of seeing us ugly mzungus drive through their village every day.
When we got to the launching site I loaded on the 60 SPF. It definitely didn’t last long. As I type I am nursing my lobster legs and face with cream. I was asked today if I was sick because my face was red. “No,” I replied, “That’s what happens when I am in the sun for too long.” “Oh! I am so sorry!” was her response. “You are just too delicate!” As I count the number of scrapes, bumps and bruises on my body from rafting, I guess I have to agree with her.
Once all 7 of us, including our guide, Peter, were out on the raft, we were drilled in what to do during certain situations that were bound to come up during our excursion. As he shouted commands and gave instructions on what to do when our boat flipped over or if you were thrown out of it, I remember thinking to myself, “Sarah, you may die today.” It didn’t help that Peter also told us that we may die.
The first rapid was a grade 4. That doesn’t sound all that scary but when you have a 5 foot lethal looking rapid flowing much faster than you care to imagine right above your head, it is the most horrifying millisecond of your life… made that more terrifying due to the fact that this was the very FIRST rapid within 5 minutes of paddling down the Nile. As you probably guessed, our raft tipped over and we all flew out. Me and Phillip, a friend from Germany, got the worst of it. We weren’t able to hang on to the rope on the raft and we tumbled like a washing machine under the current. I didn’t know which way was up or down. Luckily my life vest did. That first crash into the rapids was definitely the most life threatening experience I’ve ever had. Though it lasted less than 5 seconds, it felt like I was under the water trying to find my way for hours. Casey was also unable to hold onto the rope. Though he ended up on the other side of the river. One of the rescue kayaks got a hold of him before he crashed into the rocks and while the rest of us were able to get back on the raft for the remainder of that set of rapids, Casey had to hang onto the back of the kayak as it tried to maneuver the safest way possible so Casey didn’t get mushed to pieces by the rocks.
While the rest of our team was feeling an adrenaline rush from having been thrown off, I just felt dread. We still had 5 hours to go and 7 more rapids, some much larger than the one we just went through. All I could think about was losing my contacts and having to sit on the rescue raft the remainder of the trip. I forgot to bring an extra pair so if they were lost to the Nile, I am much too blind to try and finish without them. The next set of rapids occurred very similar to the first, except along with the sense of dread that was always at my core, I also felt an adrenalin rush and a sense of adventure. I was beginning to enjoy being thrown off. My contacts had a knack for sticking to my eyes, so I let that fear slide a bit.
The final rapid before our lunch break on the Nile was called “The Bad Place.” And for a good reason. Most of the rapids were grade 6 and therefore much too dangerous for us to manage. Going into them would mean certain death for those of us without any previous knowledge or skill at maneuvering rapids. Therefore we got off our raft and walked, to the amusement of the locals washing at the banks, around an island to a much safer but still potentially lethal grade 5. Peter told us that we would most definitely get thrown off these rapids so when he shouted “GET DOWN!” We’d have to throw our paddles away because there was no chance that we’d actually hang on to them during these rapids. When I saw what lay ahead I felt like throwing up. For 100 meters (or 328 feet) it was just gigantic, menacing, roaring rapids flowing extremely fast. Why else were we there if not to challenge these beasts? We jumped in the raft, paddled to just before The Bad Place swallowed us up, threw our paddles away and got down. Our raft miraculously made it over the first one and we surfed in between two rapids for 2 seconds, but our shouts of joy were cut short. We were overpowered and lost to The Bad Place. I tumbled left, right, up and down under the current and eventually bobbed to the surface. While everyone else travelled the remainder of The Bad Place without a raft, I was pushed to the right and headed straight for big rocks. I was fortunately snatched by the rescue raft. Unfortunately I had to sit there and wait until all 5 rafts were through. It was quite funny to watch the rest of the rafts get swallowed up and I laughed with the locals watching from the shore.
After The Bad Place we had only 4 sets of rapids to go. The worst of them was over though. We ate fresh pineapple and glucose biscuits and enjoyed the amazing view. The remainder of the day went very much like the first half. Falling off and getting back on. We WHERE able to make it through one grade 3 rapid without falling off. It was pretty exhilarating to see what goes on ABOVE the water for once. I felt like we were flying. Needless to say there were a few Titanic jokes thrown around that day.
After the very last rapid, which happened to be the last tumble out of the raft, we floated down the warm waters of the Nile relaxing as our life vests did most of the work. The day ended with a delicious BBQ beside the Nile of sausages, baked potatoes, garlic bread and not to mention free beer. I decided on a Nile Special, seeing as it was quite fitting.
Our group decided to stay in the Nile River Explorer’s hostel. While Casey and the boys went out in Jinja, the girls and I decided to stay in and get a good night’s rest. The next morning I was very, very sore. My muscles ached from paddling and getting thrown around on the Nile and my skin ached from the severe sun burn I couldn’t escape.
In the end it was both one of the best and worst experiences of my life. I say worst because I don’t know if legitimately fearing for your life is a necessarily “good” experience. Anyway, Casey and I both would suggest white water rafting to anyone and everyone.