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Village Health Visit

In April 2017 I was lucky enough (again) to go out to Uganda and spend time seeing how the work was going and pretending to support Yakub (though I'm sure that I got in the way as much as I helped). The Lugandan language is so alien to my ears and the little that I learn when I go out I forget by the time I return.

This trip also saw two lovely ladies join us, Chris who is a very experienced early years teacher, and Ang', a retired nursing tutor. These ladies were such a joy, taking things in their stride even though this experience was new to them, and offering valuable support, critical analysis and the sharing of their skills. As ever, the trip was varied, challenging, enlightening, heartbreaking and uplifting - that's Uganda!

One day late into our visit, we traveled to Kitimbwa, a long way from Jinja, and Yakub's home village. His grandmother was not well and there were also a family who had children with albinism that we wanted to link into SNUPA as we knew they would benefit from their support. It was also an opportunity to offer our limited skills to people who live far from where any organisations are based. On a personal level, it was an opportunity to visit the grave and pay respects to young Hanipher, a beautiful girl whose education had been sponsored by a TUSC friend and who sadly died in January, breaking many hearts.

Upon arriving, we found the three boys that have albinism (a condition where there is no pigment in the skin so they are extremely vulnerable to skin cancer and eye disease). Jovan (10), Ivan (13) and their eldest brother Keziron (16) were all showing signs of skin damage. Their parents were not around but their uncle was, and we talked to them about the importance of protecting themselves from the sun, covering their bodies, and the SNUPA programme, where people with albinism can obtain support, screening and sensitisation about living with albinism safely. It was agreed (after providing them with sunscreen, glasses and hats) that TUSC would send via mobile money, the funds for them to travel to the next screening day.

We then continued to Kitimbwa where we were met by Isma, a friend of Yakub's and a VHT (village health worker), and were hosted to lunch of cassava, tea, matoke and chapatti. Whilst we were enjoying our lunch, we heard a sound of brakes screeching and then much commotion and it appeared that a local drunk had been riding his bike straight into the path of an over-loaded sugar cane lorry. The villagers gathered around, lifted him into the lorry and he was taken to the nearest clinic - TUSC was made redundant on this occasion :-)

Deeper into the village the real work started. Ang and I set about listening to the health worries of a long line of people. There is no concern here for confidentiality, only ourselves speaking in low voices. Blood pressures were recorded, some simple dressings undertaken, advice discussed, mosquito nets distributed and self-care encouraged when appropriate. The people here (and I'm generalising I know) have very little insight into the normal 'health experiences of life', so eyesight changing as middle age approaches, period pains, stiff and arthritic joints,coughs and colds being just that, menopausal symptoms, are confusing to them and worry them. In contrast though, many of the villagers were suffering with very serious conditions; one man clearly had bowel cancer and had not been able to travel to the city to get surgery - transport being a major stumbling block but also having a carer who can leave the home and the gardens (which need to be tended if the family are to eat) to stay with him in the hospital where nothing is provided. Others presented with malaria-type symptoms - and people here are pretty good at knowing when they have malaria, HIV and TB that had not been consistently treated, again due to lack of transport to get to the clinics, raised blood pressures, signs of heart failure, and musculo-skeletal problems; and if you can't work then you don't eat, your children don't go to school and if you rent your home then you get into arrears - there is no 'safety net' here, only the kindness of friends and family if they can spare. The work went on into the dark, and whilst we were doing this, Christine was working away with the children, teaching them counting songs and action rhymes to help their English (the 'official' language that they are all taught in at school), and sharing a supply of clothes. Yakub and Martin (a local young man who volunteers with TUSC) translated and also helped to identify the most needy of people who were given items of clothing. Our supply of mosquito nets was soon over, and it was Yakub and Martin who talked to people about the correct use, encouraging them to try and prevent disease; it is much better that this comes from local people rather than the 'outsiders' and we just wished that we had more resources.

Eventually we packed up. We had worked into the dark, seen health problems that are endemic, exacerbated by poverty and lack of resources at every level. We heard the worries of parents for their children's health and opportunities, been at a loss to know what can be done to help old people who are getting too frail to garden and whose own children had died of HIV, leaving them to care for their grandchildren. And we had been made welcome, humbled by the thanks and smiles, had our western views of life and health challenged and learnt to be grateful for the gifts we have. It costs us a lot when we go to Uganda (all of us pay for our own trip in full) ..... but we return the richer for it.

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