My name is Sinéad. I am a student from Ireland currently studying a Masters in Public Health at EHESP Paris. I have been given an amazing opportunity to complete my first internship with Health Nest Uganda. I will be working closely with the team here in Entebbe for 2 months on community health projects focusing on elderly people and youths.
I am writing this blog to promote the work done by HENU and to share my own experiences exploring this breathtaking country. Hopefully my stories and advice will offer guidance to anyone considering an internship here with HENU.
I arrived here in Uganda at 3am on Tuesday the 30th of May. Arthur and Irene, 2 of HENU’s volunteers, kindly collected me at the airport, despite the inconvenient time! We made the short journey from the airport to Entebbe town and I arrived at what will be my home for the next 2 months. HENU kindly organised for me to stay with a host family. Arriving in a country for the first time is always a stressful experience, however, staying with local people helped me to settle in straight away and were welcome company in a country where I didn’t know a single person. From day one I got to eat typical Ugandan meals including matoke, which is cooked banana, tilipia, a fish from lake Victoria and the delicious fruits and vegetables that grow in abundance here. I have yet to walk down a street that doesn’t have plants or trees of some form growing bananas, mango, avocado and countless other fresh treats.
Travelling to work everyday really helped me to get to know my surroundings and to meet more people. During my first week, HENU staff kindly picked me up and dropped me home from work and made sure I had everything I needed. They brought me to the ATM machine to withdraw my first Ugandan Shillings and helped me buy a Ugandan sim card and data to contact my family and friends at home.
My first week settling in to life in Uganda has been effortless, thanks to the help I received from my host family and colleagues at HENU.
My first community health project meeting
On the 31st of May I attended my first health project community meeting with the Kabaale group. HENU staff attend these meetings to provide advice and information in 4 key areas; Nutrition, Hygiene & Sanitation, Exercise & Regular Health Check-ups.
I was warmly welcomed by Agnes, the chairperson of the Kabaale group. As we waited for the group members to arrive Agnes enthusiastically gave me a tour of her garden where she grows bananas, mangos, beetroot, dodo (a leafy green vegetable) and several other different fruits, vegetables and herbs.
Agnes shared with me the many benefits gardening has, especially for elderly people
- It is a sustainable, economical method of ensuring a healthy diet.
- It can play a role in keeping elderly people active.
- Gardening can be used as an income-generating activity as excess produce can be sold within the community
Hygiene and sanitation
One of the biggest, daily difficulties for elderly people in Uganda is access to pit latrines. A pit latrine is an out house where it is necessary to squat when using, which can be very challenging for older people. Agnes showed me how her pit latrine has been fitted with a ceramic toilet through HENU’s toilet redesign scheme. This project is a relatively simple way to improve the lives of elderly people in the area. In some cases here elderly people admit avoiding meals and drinks in attempt to avoid needing to use the pit-latrine and many feel like a burden when asking for assistance. Installing accessible toilets will result in health benefits both physically and mentally and improve the quality of life of elderly people. The group conduct home visits in the community to check that pit-latrines are adequately covered, there is water nearby for hand-washing and to locate individuals who are eligible for the toilet redesign project.
Exercise is important on the agenda for this group. They start their weekly group meeting with stretches. Many of them incorporate this into their daily routine to maintain their physical health and fitness.
Regular health check-ups are an important part of the health project. The group expressed difficulty regarding access to blood pressure monitoring for the group members. In their local health centre they experience long queues for doctor appointments. Their suggestion to HENU to combat this would be access to ‘old age cards’ that could be used to skip the line at the doctors. Mosquito nets were another issue of concern, many elderly people in the community do not have one. They requested whether it could be possible to distribute free mosquito nets to elderly people.
Income Generating Activities
A savings scheme has also been set up by the Kabaale group. Weekly payments are made and a raffle is held where one member wins some money and the rest is saved to reinvest in the group’s projects.
I had a very positive experience at this health project meeting. It was a great learning experience from me to experience an alternative to the top-down approach frequently used in health projects and policy making. Here, the community members are the experts, and rightly so. They know better than anyone the challenges present in their communities and the best course of action to resolve them. Groups, like this one in Kabaale, bring the community together and allow the voices of the elderly people to be heard.
I started my day with a walk to the beach on Lake Victoria close to where I am staying with my host family. I stopped at one of the many cafés for an orange juice and Wi-Fi to get started on some work for the day. It is so peaceful by lake and a beautiful place to get some work done.
Reproductive Health Program Proposal
Currently I’m writing a proposal for a reproductive health program for adolescents to be implemented in local schools. In Sub-Saharan Africa, HIV is the leading cause of adolescent deaths. There is also a high incidence of adolescent pregnancy which is associated with increased maternal mortality, unsafe abortions and leaving school early. Our program will aim to educate youths and empower them to take control of their reproductive health.
We are designing a mentor program where students will be trained to advise and discuss issues related to sexual health with their peers. The students will be able to take ownership of the project and play a role in influencing the topics covered, implementation and evaluation of the program. It is my first time working on a project like this so it is a bit challenging but I am very excited to watch it progress!
Toilet Redesign Project
After lunch, I joined the HENU volunteers on some home visits. These were conducted as part of the toilet redesign project. Many households here in Uganda use pit latrines which can be difficult for elderly people to use. The toilet redesign project assesses individuals in need and arranges for them to have a ceramic toilet fitted in the latrine which will allow them to sit instead of squat. During these visits, we meet with community health project members to help us locate people who would benefit from a ceramic toilet. We assessed the pit-latrines to check whether they would be suitable for the project and offered advice to the families on how to improve them. The pictures below show pit-latrines before the toilet redesign project. The second picture shows how some families have tried to overcome the problem themselves by using cement blocks for support instead of squatting.
We visited those who have had a new toilet fitted to check that it is going well for them. A new door, roof and lock are provided to keep the building secure and clean. Improving access to toilets for elderly people has a profound impact on many areas of their health especially in terms of nutrition and sanitation.
The home visits today gave me the opportunity to observe some of the challenges people face in their daily lives and to learn about how to work with the community to overcome them. It’s also a great way to explore the town and learn about other aspects of life here.
During this visit, I was shown around one of the family’s gardens. They were growing so many different fruits and vegetables, such as bananas, avocados, mangoes, coffee beans, cassava, pumpkin and sugar cane to name just a few. We arrived at a good time, as it was raining avocados from the two tall trees in the garden. I have never seen so many in my life!
White Water Rafting in Jinja
After a busy week working with the HENU projects I decided to take a break for the weekend and venture beyond peaceful Entebbe to see what else Uganda has to offer. I went to Jinja, a town located at the source of the river Nile. Here I joined White Nile Rafting and spent 2 days with their amazing team rafting and kayaking for 30km along the world’s longest river. It was a beautiful experience that I would recommend everyone to add to their bucket list, especially if you’re feeling adventurous!
On the calm, flat water you can admire the amazing scenary as you pass by islands, forests and local fishermen in wooden boats. Wildlife is abundant, open-billed storks, fish eagles and weaver birds flying overhead, otters swimming and bats hanging from trees. You can even take a break from the boat and have a swim in the warm, clear water.
Thrilling rapids with drops of up to 4 meters and crashing waves add a huge adrenaline rush to this otherwise serene journey! Surfing the waves, flipping and falling overboard in the middle of these rapids is terrifying at times but the experienced team are on hand to get you back on the boat and make sure you enjoy every minute of it. I only intended to do it for one day but I enjoyed it so much the team kindly took me tandem kayaking the next day. I was worried that the second day wouldn’t live up to the amazing experience I had the first time round but I had even more fun and definitely pushed my limits by letting my instructor bring me through the roughest parts of the grade 5 rapids!
The appetites we built up were satisfied when we returned to the camp to a barbeque buffet followed by fresh watermelon and pineapple washed down with a few bottles of Nile Special, a local beer brewed on the outskirts of Jinja town.
The beautiful Jinja is a must-stop in Uganda and I’m already thinking of returning to see what other adventures it has to offer. My only advice, don’t forget your Mzungu Medicine (my new favourite word for sun-cream) be brave and get splashed around the river Nile on a trip that will be one of the best experiences of your life!
Elder Abuse Awareness Day 22nd June 2017
Today we celebrated elder abuse awareness day. This was the first time the day has been celebrated in Uganda and HENU was given the opportunity to host the national celebrations in Entebbe. The HENU team and community groups put a huge amount of work into ensuring the day was a success and I’m glad to say it payed off.
The meeting point was at Children’s Park. The elderly people came out in force to march for their rights and to raise awareness for the many forms of abuse that they face. These people have contributed a lot to the community, they are retired (but not tired!) teachers, nurses and civil servants. Their contribution continues through tireless work aimed at improving conditions for elderly people, not just to benefit themselves, but for the benefit of Uganda’s future elderly population.
Local school students joined us at the Children’s Park to support the march. Their presence will hopefully have educated them on the issues faced by older people and how, if not addressed now, those issues will be passed on to them when they reach old-age. Uganda has a very young population with 78% of Ugandans under the age of 30. In the next 40 years the number of elderly people in Uganda will have significantly increased. Financial, medical and social issues faced by the current elderly people in Uganda will be exasperated if a defined structure for support is not implemented now.
The congregation of elderly people, school children, Uganda’s national council for older persons and HENU volunteers set off, marching to the music of the Airforce band through Entebbe town to our destination, St Mark’s Church. As we marched we attracted the attention of the local people and received cheers from school children as we passed by. The sight of so many elderly people, coming out, proudly carrying posters displaying important messages and the atmosphere of the occasion was something that will stay with me for a long time. It shows what an important issue this is for them, their desire to let their voices be heard and the urgency they have for improvements to be made.
At St. Marks Church, we were met by our guest of honour, Hon. Rosemary Tumusiime Bikaako, MP for Entebbe municipality. Speeches were given by community members, representatives from Entebbe’s council for elderly persons and the national council for elderly persons outlining the current issues and possible solutions. An important point was made by Gaudince Imalingat, councillor for older persons in Katabe town, regarding the Senior Citizens Grant (SCG) that was introduced in 2014. This grant makes monthly payment of 24,000 shillings ($6.50) to people aged over 65 who do not receive a pension. The problem here is that it has only been implemented in 14 out of the 111 districts in the country. The people here in Wakiso district are left feeling excluded and often bear resentment towards counselors, especially those working in the best interests of elderly people, as they fear their grant is being embezzled and not enough work is being done to ensure the service becomes available to them. The SCG has many advantages for the community. It will provide a boost to local businesses where elderly people will spend money on goods and services, it will be used to support grandchildren attending school and it can be used to support elderly people to access medical care and initiate income-generating activities such as gardening and craft-work. Mr. Imalingat appealed to the Minister to recognise this issue and ensure progress is made in making the SCG available to all older persons in Uganda.
Throughout the day a free medical clinic was set-up for the elderly people. This included blood-pressure testing, malaria testing, doctor consultations, counselling sessions, dental check-ups and free distribution of medication. This service is invaluable to elderly people. Many of those who suffer from illnesses such as hypertension are unable to access medication due to shortages and financial constraints. People came from all over Entebbe, many were weak or had mobility issues and required assistance to get around. The fact that so many people attended, despite difficulties in reaching St. Marks, shows the necessity for accessible health care for the elderly, to allow them regular access to check-ups and medication. The dedicated medical staff remained working until everyone had been attended to and received the care that they needed.
Our appetites, built-up from the events of the day was satisfied with a lunch of Uganda’s staple foods, matoke, rice, peanut sauce, meat and peas. As the guests began to head home many stopped to admire the display of different items, such as woven hats, embroidered purses, leather sandals and jewellery. These are all handmade and sold as income-generating activities for the elderly people’s community groups.
The success of this event is a great step forward in promoting the rights of elderly people in Uganda. It highlighted the medical, social and financial difficulties faced by elderly people in the community every day. These people are often forgotten about and their needs overlooked. This day will hopefully be the beginning of progress in the rights of older people and finally allow their rights to be recognised at a governmental level.
Places to Visit: Entebbe
The Botanical Gardens in Entebbe is a beautiful park that stretches along Lake Victoria. It has small beaches where you can relax and listen to the lake and the birds. The numerous trees are home to families of Vervet monkeys that will appear in instant if you’re brave enough to bring some sweet bananas. They are surprisingly tame, no doubt used to the parks any visitors, and I spent hours watching them playing with each other and jumping from tree to tree. I even got to see a new-born baby monkey that was clutching closely to its mother. I walked a little bit further and came to some stone steps that lead down to a forest of trees, with huge vines hanging from the branches and a small stream flowing through. This is the location of the first Tarzan movie. Walking through this forest, it is easy to imagine Tarzan swinging through the trees! It’s an ideal place to wander around, with plenty of places to stop and relax in the sun, a perfect spot for a lazy afternoon.
Kigongu is a small fishing town located about 20 minutes’ drive from Entebbe. It is buzzing with activity from the fishermen preparing to head out for a day’s work on lake Victoria to the markets along the port selling fish, fruit and vegetables. The famous Nile Perch is a regular catch here. Some fishermen kindly allowed me to take my picture with this catch, weighing almost 30kg, however some weigh upto 60-70kg!
Kigongu is also the landing site of the first Catholics in Uganda in 1879 and a monument has been erected to mark this event.
Things to do: Gorilla Tracking Bwindi Impenetrable National Park
Bwindi forest located in South-West Uganda, close to the Rwandan border is home to ***** of the world’s population of mountain gorillas. Uganda Wildlife Authority is working hard to protect this endangered species. 8 of the *** gorilla families living here have been habituated to allow people to come and observe them in their natural habitat. On arrival UWA team briefs everyone regarding safety precautions and divides us into groups. Each group consists of a maximum of 8 people and we all head off to see different families. Trackers set off early in the morning to locate the gorillas and communicate their location with the rangers to allow us to reach them without too much difficulty. We arrived at the area where the gorillas were feeding after about an hour and a half of hiking through the forest. The hike is never the same route as gorillas change location every day. Sometimes it can take 4 hours or more to reach them. The hike itself wasn’t too challenging, even for an inexperienced hiker like myself but I’m grateful we found them early!
The gorillas were very peaceful and happily eating lunch as we arrived. They occasionally would look up from the plant they were munching to look at us, it felt like they were observing us just as much as we were observing them. In total, we saw 10 different members of the family including the great silverback and a female with her 3 week old baby. It’s really a great experience watching them go about their daily routine and the forest is beautiful too. It’s also home to a herd of elephants however we didn’t get to sight them, several types of monkeys and many other animals.
We spent one hour following the gorillas and taking photos and then we had to leave them. We hiked some distance away and then ate our packed lunch. Be prepared and make sure you pack enough water (at least 1.5 litres) and food, especially when there is the risk that you could be hiking for 6 hours or more. The hike back was a lot more strenuous as we climbed the steep hills back to the centre. When we arrived at the camp we were presented with certificates and thanked for contributing to the conservation project.
When I first arrived to Uganda I wasn’t sure whether or not to do this or not, mainly because it is so expensive. However, I don’t think anyone who has experienced this has regretted it. The money you pay for the permit ($700) funds the conservation project and research that UWA is conducting. It also supports the local community by creating jobs for local people, such as porters who will carry your bags and assist you while hiking for an additional $15.
On an intern’s budget, this is a lot of money but you can save in other areas of the trip. A friend of mine recommended a tour guide who I contacted and he helped me to plan the trip as low budget as possible. I used public transport to reach Kabale. I took a matatu (taxi) from Entebbe to Kampala (3,000sh) and then a bus from Kampala to Kabale (30,000sh). These buses go on to Rwanda and they fill up quickly so my advice is to get early. When I arrived the only seats available were at the back of the bus. My advice after this experience is to sit as close to the front of the bus as possible. The journey takes 6 hours and Ugandan roads have a lot of speed bumps on them. I was lifted off my seat countless times the whole way! Other than that, it is a good, cheap way to get from one part of the country to the other and a fraction of the price of hiring a private car. From Kabale I got a private car to drive to the UWA camp, this took about one hour and thirty minutes. Using public transport definitely enabled me to have this trip and I now realise how easy it would be to travel further afield. It may not be the most luxurious mode of transport but it will get you from a to b!
Places to Visit: Lake Bunyonyi
Lake Bunyonyi is just 8 km from Kabale. It would be a huge mistake to come to Bwindi without at least spending a night on one of the many, beautiful, islands on this crater lake. There are many resorts on the mainland at the edge of the lake and on the islands. The accommodation ranges from camping and dormitories to private cottages and open front eco-dormitories where you will have an amazing view of the lake without even leaving your bed!
Lake Bunyonyi means lake of many little birds. At all times, day and night, birds can be heard chirping and tweeting from the trees. The grey crowned crane, Uganda’s national bird also resides here. You’ll see them around the island, usually in pairs as this romantic bird mates for life.
I stayed in the lovely Byoona Amagara on Itambira island. The resort was very eco-friendly with compost toilets and powered solely by solar energy. The food available was all tasty, fresh vegetarian and fish dishes. It was a beautiful place to escape and relax. The lack of wifi allowed me to detox from my phone for a few days and their library with a wide variety of books kept me entertained. During the day, we went on a tour of the other islands. Bwama is the largest and the location of a former leper colony. It now hosts a primay and secondary school and a medical centres with people travelling from other islands and even the mainland to access these services. **** also known as Punishment island is one of the smallest islands consisting of swampy grass and a single tree in the centre. Previously this is where unmarried pregnant girls were abandoned as punishment and many died from starvation. Some were rescued by night, illegally, by poor men who could not afford a dowry for a wife. This practice was finally stopped in 1961. We then passed by another island that is home to some zebras, cobs and other wildlife which we saw from the water. As well as the tour, you can rent a traditional wooden canoe and roam the lakes by yourself (it’s a lot more difficult than it looks, I didn’t get very far!). The lake is safe to swim in and there’s plenty of sun-loungers and benches around Itambira where you can relax, snooze or do some reading.
On my last evening, I joined 2 other tourists staying at my camp and we went to a local bar, which we were told was just across on the mainland. We left in darkness around 8pm in a wooden canoe, thankfully being steered by a member of staff. We got to mainland and discovered it was a 10-minute uphill hike to reach the bar! We arrived to a small place occupied by locals, some drinking jugs of sorghum obushera, a local drink with an acquired taste. We stayed for a while and then began the descent back down to the canoe. We paddled home under the light of the bright half-moon and the stars.
Uganda has amazed me again with its beauty. These places seem to be missing from all the travel blogs and magazines I’ve read before. Don’t miss out on experiencing the peacefulness and tranquility of Lake Bunyonyi.