Kath and I went on a work adventure this week! But first an explanation….Kath and Kate are similar names and people here find it very confusing to remember which of us is which especially when we live and work together so are often in the same place. At work, our team often accidentally call us by each other’s name (which has led to some confusing WhatsApp conversations!) so they decide to nickname us the KKs which soon became the “special KKs” after the cereal!
This week we had the opportunity to travel to the North of Uganda to take part in a research project. The team we work with in Kampala have links to Peace Hospice in Adjumani and have done work together before. Adjumani is in the north of the country near the border with South Sudan. Uganda hosts the most refugees of any African country and many are settled in the north near the borders with South Sudan and the DRC. This project is looking at the palliative care needs of both the refugee and host (Ugandan) populations living side by side in the region. There is currently little evidence about this so increasing the knowledge and data will hopefully allow advocacy for increasing the palliative care services in the area (which are currently only provided by the small Peace Hospice team), particularly through greater funding.
So we got up at 4:30am on Sunday to travel to the bus station where we travelled the 8 hours to Adjumani with Toko, our team’s social worker who was coming to help with data collection. The bus left from a disused petrol station in Kampala in a place called Bat Valley. And as the sun rose we saw why, as we watched lots of bats fly in and out of the trees above us looking for fruit or to find somewhere to sleep, a bit of an eerie start! It was great to see some of rural Uganda as we travelled, spotting baboons looking for food near the road or looking at the mountains in the distance in the big African skies. Stopping in towns was always interesting because hawkers would come and surround the bus, holding high their wares on the top of their heads and shouting prices, including fried chicken on a stick, whole pineapples or chapattis. When we arrived in Adjumani, us and our belongings including our suitcase were somehow attached to bodas and we were taken to Peace Hospice, where we were warmly welcomed with drinks, food and information about the local area.
The next day our adventure continued as the data collection we were taking part in was in Obongi town and the surrounding area which was across the Nile. So we were driven to what looked like the middle of marshland and stopped by a small stream which we then waded through to find our way to a small canoe. We piled in to these and then were pushed along until the water became deep enough to transfer to a motor boat which drove us into the Nile and across to Obongi. This included us, our luggage, paperwork for the research and a motorbike which was coming with us to help us get around. Such a cool experience and an interesting way to travel! On the other side, the changing water levels meant the road was not useable to back to walking through mud, one more boda and finally we were at our hotel for the week.
It was time for us to get to work! Our team consisted of Kath and I, Toko, Chris (a researcher from the UK currently staying in Adjumani) and Godfrey (a Peace Hospice nurse). Uganda have VHTs (Village Health Teams) who are voluntary and with often limited training are the link between communities and health centres. They are a cost effective way of improving access to healthcare particularly in rural or less-resourced settings, and are involved in helping with vaccinations, managing childhood illnesses and referring to health facilities. Their knowledge of their local community, even if they are responsible for over a hundred people, is really impressive. The VHTs had been given a checklist of people who might be suitable for our study and Kath, Godfrey and I’s job was to do a medical screening for everyone the VHTs had identified to see if they were suitable to be recruited. If they were, Toko and Chris (helped by us) would then collect data by interviewing them to establish what the main needs of patients in the area are (physical, psychological, social and financial).
Each day, we would meet the VHT we were working with and then set off on foot, boda or car to meet people and conduct the screening. It was amazing to spend all day outside, sitting under mango trees or outside people’s houses hearing about people’s lives here, and then walking through the bush or on dirt tracks to find our next person or family. We saw so many adults and children who hadn’t been able to have investigations or get a diagnosis or treatment for their condition due to lack of money to afford them or the appropriate facilities being toon far away. Refugee families currently get given the equivalent of less than £5 a month per household to live on and most Ugandan families in the area didn’t earn much more, so if they needed to buy food or buy shoes for a child, they often couldn’t afford an X-ray or blood test. This meant that we were often the first healthcare professional people had seen in years so often were giving diagnoses, explaining conditions or giving advice about what they needed for the first time. Although difficult, this was a great part of the work for me as people were often really grateful to understand a bit more about their symptoms, what they were facing and what to expect. The days were long but rewarding, finishing with us doing data entry into a laptop as the sun went down, and then were treated to lots of great Ugandan food! Eating whole fish with our hands, lots of Rolex for breakfast and fresh avacado and mangos were highlights.
Friday night we crossed the Nile again and Saturday continued our journey back to Kampala. Unfortunately an ill-timed stomach bug meant the journey home was a pretty grim experience which I will spare you the details of! But this didn’t take away from a great week away. We had such a good time working with the team, all enjoying working together to get the job done in beautiful surroundings and debriefing over dinner at the end of the day. Getting to visit this part of Uganda and being part of this project was a real privilege. It was a humbling experience to see how well people got on with life with so little but also really sad to see how much people suffer and struggle due to the lack of things which we would take for granted. Definitely an experience I won’t forget and I am grateful to have been part of it.
Kate in Kampala! 
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