Monday, January 17, 2011

Clinic Work

When we weren't "testing God" as our host, Charles, would say with our daredevil stunts, we working at the clinic locations or from Candy's house (as transportation is kind of a nightmare during the work day).

Throughout our two weeks, we spent quite a few days at the Kasubi clinic, and one day at the rural Ndejje clinic. We conducted 1 on 1 interviews with staff and led a marathon brainstorm at the Kasubi clinic. There were so many cultural implications on the way the clinics operate, that I felt the time we spent with families and going around Kampala was extremely useful to any recommendations we could make.
Here are some pictures of the clinics:

The Kasubi Clinic
Interesting side-note: The very nice facilities give some community-members the perception that the clinic is very expensive (when it is actually priced more affordably than competitors). The other misperception is people see Americans at the clinics fairly often (many people from St. Thomas and Minnesota have visited) and they associate Americans with charity, so they think services will be free. These are just some of the barriers the clinic has to overcome in order to bring clients in the door.

Me and kids outside the clinic... rounding up potential patients:)
Ann, Bruhani, Vincent, Daphine, Rita, and Sean

Marathon brain-storming session. People must have a lot to say if they will discuss ideas and opportunities for over 4 hours!
We concluded our time in Uganda by compiling a situation analysis of all aspects of the clinic & the environment in which it operates. We narrowed down to 4 areas of recommendation, and promised a lot of deliverables we now need to create!

Kudos to Charles and his staff for their great work. After visiting the free government clinic and a private clinic in the area, we truly understood the need for Hope Medical Clinics Uganda & hope we can help them continue to provide their services and expand to improve healthcare standards across Uganda!

Saturday, January 15, 2011

Jinja: The Source of the Nile

After returning from our Safari, we spent a few days at the Kasubi and Ndejje clinics (see next post for pics and more info on the work we have been doing) and then took a day-trip to Jinja. This town is about an hour north of Kampala and is where the Nile starts, flows through Murchison falls (where we went on the safari) and then all the way to Egypt. Who knew that the Nile flows from South to North? I sure didn't remember that little factoid from 5th grade geography!

My friend Morgan highly recommended using Adrift, one of many outfitters for whitewater rafting, adventure sports, etc. along the Nile. They picked us up in Kampala early Wed. AM and we rode with new friends from Estonia, Russia, Kenya, and Norway to the Adrift base-camp. Nearly everyone we met who was traveling in Uganda was in Africa doing either missionary or volunteer work, which made for great conversation and more learning!

I talked Sean into joining me in bungee jumping, and Kristoffer and his brother, Ola, from Norway opted for the bungee and whitewater combo as well.

I decided to go first and did not look down at all before jumping out like I was doing a big belly-flop, then flying downward, and finally feeling the bungee stretch as I came close to the water. It was such an incredible feeling- not scary at all - and no stomach lurch, like I thought it would be. Though I am excited to cross it off my 'bucket list' I will do it again at the next chance I get!

After the four of us jumped, all 15 people rafting that day got our gear (helmets, life-jackets, and oars) and were divided into 2 rafts and given our marching orders. I had no idea how intense this rafting would be. To keep it brief, we completely flipped and lost everyone 3 times, I was bumped off a total of 5 times, and I would rate the rafting as three times more terrifying than bungee jumping. It was a blast, but terrifying!

The day ended with a BBQ and bus ride back to Kampala. Sean, Olivia, and I ended up meeting up with our Norweigan friends and their host, Jimmy, in Kabalagala for a fun night with new friends.

Sunday, January 9, 2011


Friday, Saturday, and Sunday we went on a Safari trip to Murchison Falls National Park. We went through a group, Red Chili, that was recommended by a woman Ann met at the airport (her friendliness to strangers is really helpful!). The trip included a 6 hr drive to the park, sleeping in tents (beds included, don’t worry!) with warthogs, hippos, and baboons wandering around the campsite at night, a sunrise game drive, Nile boat cruise, and hiking to the falls.

We were a little unsure of the warthogs literally wandering around the campsite at first, but got quite used to their ugly little bodies hanging out everywhere after a few hours.

Some key highlights of the trip:
1) Animals: Even though I don’t really like animals at all (I know, I am a horrible person), the coolest things we saw were:
a. Lioness (only seen every 2-3 weeks in the park). She was FIERCE!

b. Elephants
c. Hippos- everywhere
d. Giraffes (and the crazy spiky cassia trees they were eating)

e. Crocodiles (largest I have ever seen)
f. Water buffalo (and the old ‘bachelor’ buffalo who were kicked out of the group)
g. Warthogs (quite possibly the ugliest animal I have ever seen)
h. Monkeys- all shapes and sizes
i. Lots of things that all looked like deer to me:) (Ugandan Cubs, antelope, water bucks)

2) Scenery: It felt like we were in the Lion King (minus the elephant graveyard part). The grasslands were beautiful, the Nile was ever changing, and the waterfalls were extraordinary!

Murchison Falls is an extremely powerful waterfall, sending around 300 cubic meters per second of water tumbling through a neck only 10 meters wide. Hiking up to the falls Sunday morning was very humbling. The power and strength of the falls make all else seem pretty insignificant.

3) People! We met some great people on the trip- many of whom were actually great resources of information for our project. (Who said a safari cannot be a working trip?) Some of our new friends include:
a. Abby: the fortunate soul to join the van with Ann, Sean, Olivia, and me. She is a 6th-year medical student from New Zealand, doing her international rotation in Uganda. Great to hear about the nonprofit hospital where she currently works & their systems and processes.

b. Linda: A physician affiliated with Columbia University who is in Uganda for 6 months working with the Millennium Project, the brainchild of contraversial economist Jeffery Sachs. She works specifically with maternity care in rural villages. She had great insight on community interaction and labor and delivery systems in Uganda.

c. Tamoka: Masters in Public Health student at Harvard currently collecting disease data in Kampala. Great knowledge of disease prevalence and advice on not having things stolen in Kampala (her laptop was stolen early in her trip, but the thief was nice enough to take out her passport & US apartment keys, as she might need those).

d. Jacob: A marketing major from Memphis, TN who is volunteering with a Christian school in a village near Jinja. He had about the worst travel experience getting here, and made us realize how fortunate we were to fly out a week after the snowstorm in Amsterdam.

e. Medy: Our bus driver/rock mover/ tour guide/wealth of knowledge. He does contract work for a number of different safari groups throughout East Africa. He was really interesting and helped us learn so much about the animals, history of the park, and other interesting tidbits. If anyone comes to East Africa, let us know. We got his contact information and would highly recommend him!

f. The Phionas: 2 women working in the parks were named Phiona. One was our very friendly bar tender, who we loved by the end of the trip. The other, a guide on the boat cruises who also makes homemade jewelry and other crafts. She brought her supplies up to the campsite Saturday night and taught us how to make beads out of magazines. Of course, we all ended up buying lots of her beautiful crafts too!

One of the most memorable parts of the trip was driving out of the Park on Sunday. Roads across Uganda are notoriously awful, but we hit a spot where they were ‘re-grading’ the roads, but had only pushed a bunch of new rocks and dirt onto the road, not yet sorted or smoothed it. At first Medy tried moving rocks so we had a path to get by, but eventually we just sat and waited 30 min for the grading crew to make their way to the vans that were stacked up waiting to pass. It was an affirmation of why time is so much more fluid here, stuff like this happens, and you just have to go with it! I happened to be listening to the song "Craving pavement" when we hit this area of the park, so I narrated my video:)

We came back with lots of stories, hundreds (literally) of pictures, and great appreciation for the many opportunities we are having here.

Sorry so long- there was just so much to tell! Here is to hoping for a great and productive last 5 days of our trip. We leave at 1AM on Saturday (Uganda time) and will be back in Mpls by 5pm, if all goes well!

-Kelsey (check out the rest of the photos on my facebook page)

Dinner with the Yigas

Thursday we worked all day (on the porch, of course). Sean and I are both big whiteboard-people, but we made do with lots of post-it-notes stuck to posts, as we tried to sort out all of the information we have learned in the past week. An interesting staffing issue also came up at the clinic, which we think is a symptom of some HR opportunities for improvement that we started to identify. Maybe that HR stuff that Lauren Wilson loves so much and I had to force myself to study last fall is actually legit:)

For dinner, Joseph Yiga and his wonderful family had us over for a delicious dinner. Joseph and his wife are good friends with Candy and her family. They have 12 fabulous children, most of whom were at the house when we came over. Two of their daughters currently go to school in Iowa: one at Iowa and one at Iowa State. We had great wine, great food, and fabulous conversation. Like I said before, the learning here is constant! The family systems are so strong, it is no surprise that the divorce rate is virtually zero! Get with it, United States!

One of the most fun things for Sean was playing soccer (football) with Joseph's 3 youngest boys. When we were first planning the project in March, Sean told me he was going to bring tennis shoes so he could play soccer with any little kids he met. He got his chance Thursday and had a ball - even though he should have opted for wearing his new Uganda soccer jersey!

Wednesday, January 5, 2011

No-no to the Boda-boda from here on out....

The last few days have been a lot of fun and it is hard to remember what all we have done! We spent all day Tuesday at the Kasubi clinic doing 1-on-1 interviews with staff. Amazing how much information we gained and how many ideas the staff have to make the clinic better. It was a great reminder of how much the people on the front-lines of an organization know it best, and it is so important to have open lines of communication with them to incorporate their ideas!

Last night we had a great dinner with Candy at her house, then stayed up playing card games with Olivia. Today we had a rather lazy morning, worked a little, and then Olivia took us out. We went to 'Hakuna Matata' restaurant for lunch - pork roasted on a skewer with plantain and avocados. Then we went to a shopping area of town (very 'clutch-your-purse' overwhelming, but lots of great deals) and to the 'African village' where we got lots of gifts for family and friends (if you are lucky, you might be getting something...:).

We were quite a ways from the house by the end of shopping, and it was rush hour (4-8pm is rush hour here- I will never curse at 394 again!). We took boda-bodas which are motorcycles that weave in and out of traffic and can get you home much faster, though more expensive. (Though transit here is quite cheap- I paid 6,000 shillings, which is about $2.50 for a 20+ min. ride home). Scary thing though, and I am not totally sure why I am writing about this, except to ask for prayers.

As my boda-boda driver was getting through downtown, we drove past an accident where another boda-boda driver must have crashed into a car. He was not wearing a helmet, and, well, the head injury was obviously lethal. I yelled at my driver and told him to slow down and be safe the rest of the way- which he dutifully did. Olivia said she had never seen anything like that her whole life (and she lived here for 20 years), but it really scared us a lot and made us all thankful when we each arrived home.

Please keep this unknown driver and his family in your prayers.

We scheduled our weekend plans today- a 3-day safari to Murchison Falls! We are also hoping to fit in a day-trip to the Jinja: the source of the Nile, to whitewater raft and bungee jump!

Next week we will visit the other clinic, meet with leaders from the church and USAID (hopefully), and assemble and present our final recommendations. The cultural experiences we have had the past week have been so incredibly informative (and fun) and we look forward to incorporating them into our deliverable.

I have posted more pictures on facebook (or am trying, if it ever posts) at the same link as the last post.

Thanks for reading and blessings to all of you and yours!

Monday, January 3, 2011

78 and sunny!

Note: this is Ann with all of her plastic baggies at the airport (after we nearly missed our flight)!

Roman reminded me with his comment that it is a cold and blustery 10 degrees in MN (actually probably warm for MN in January) so I thought I would let you all know that it is a gorgeous 65-83 degrees here EVERY DAY YEAR ROUND.

Not much of an update since yesterday, but I'll fill all of you waiting in anticipation for the next post :) in on today's events, then try to add a few pictures.

Today we spent most of the day at the Kasubi Hope Medical Clinic, meeting with staff and learning more about processes and the market. It was really inspiring to hear about how passionate the staff are about the mission of the organization and we spent much of the evening brainstorming how we can incorporate their spirit to help the organization grow.

This is Candy's house where we are so blessed to stay during our trip. Gorgeous!

Candy treated us to a wonderful dinner tonight at a nice restaurant near the American Embassy. I have found that pork and fish here are good everywhere. I had pork in a pickle sauce- which I loved (but was thinking of the face my mother would make the whole time, knowing I ordered her least favorite food!). It was delicious. We are starting to plan our weekend excursion - we are going to a National Park and on a safari for a few days- hooray!

Well shoot, I can't get the pictures to add very fast into the post, so I will upload them on facebook- here is the link (for you, Dad:)

Hope all is well!

kale nenze (bye in Luganda, the tribal language of Candy and Olivia's tribe)

Sunday, January 2, 2011

Kabalagala = Pancake City

Well, we made it!

Despite nearly missing our flight from Detriot to Amsterdam (you know those annoying people who don't switch time zones when they land and the flight attendant ends up announcing their names over the loudspeaker and that their flight is ready to leave without them.... we were those people), we made it to Uganda intact, with all of our luggage, and found Charles and Henry to pick us up!

Though I likely won't get pics in this post as I'm at an internet cafe with 14 min left and slow as snails internet, I wish I could show pictures! We are staying at Charles' sister Candy's house, which is gorgeous and has plenty of room for all of us. Her daughter Olivia, a St. Thomas student, has been our saving grace by guiding us around, translating, and making sure we don't get ripped off!

As a brief run-down of what we have done thus far, our activities have included:
- fresh tilapia from Lake Victoria, cooked right there, consumed over a working luch overlooking the lake
- tour of Hope Medical Clinics- Kasubi location
- New Year's Eve fireworks overlooking the lake
- Family clan gathering - they use an amazing extended family system here, which I'll try to describe later, but it was a fascinating afternoon
- boda-boda ride - mini-motorcycle ride weaving in and out of traffic, used like a taxi
- dance clubs in Kampala - and yes, I stood out just a bit on the dance floor, but it was a blast!
- 3AM Chicken Tonight stop- Uganda's version of late-night McDonald's
- Mass in downtown Kampala- an amazing number of people in attendance, streaming onto the street it was so full
- Lunch at Cassia restaurant with the most amazing view of the city.

This week we will be at the clinic locations M-Th, interviewing staff and patients to start looking at recommendations we can make. It is amazing how many cultural implications there are on the operations of the clinic. Great that we are here to experience it and hopefully provide lots of assistance.

The amazing division between the wealthy and poor here has been so fascinating - there is no middle class- and has probably been my biggest learning thus far. Overall I have been overwhelmed by the hospitality and welcoming nature of everyone we have met - othe than the taxi drivers and clubs who try to make Sean and I pay more because they know we are suckers. Good thing we have Olivia and her brother John to set them straight!

Happy New Year and hopefully I'll post pictures soon!