Day 8 - July 13

I think I like walking, especially here. I haven’t gotten a chance to run, so I’m pretty sure by the time I get home I’m going to have lost all of the training that I did for the half marathon this year! Maybe all of my toenails will be back to normal by the time I return so I can start running and ruin them again! For now I will settle for walking up and down hills in the hot sun. I had planned with Angella’s friend Gloria to meet at Angella’s houst at 7:30. Since it takes at least 45 minutes to get there, I needed to leave by 6:45!! That’s the earliest I’ve done anything since being here. Even though I see lots of people doing things early, the majority would tell me that is way too early! One of my neighbors and one really nice Indian family that lives in the next complex offered me rides in order to avoid the dust. I politely declined and continued to trek the huge hill. The dust gets worse every day and we keep hoping for rain, but it doesn’t come! After each car passed, a cloud of dust filled the air (and probably my lungs). The dust really is not that bad until a car comes and unsettles it, so the walk would have been much more pleasant if the cars would just stay away!

People think we are crazy for walking. I just assume that all the Ugandans walk because everywhere I’ve gone I see people walking. Even in the very rural areas there are loads of people walking. You know they’ve come a long way because you can see where one house is and how far it is to the next house or road and it’s at least a few miles! Apparently in the city people prefer a Mtatu or a Boda. Jozeph thinks we are crazy for walking. I think most people assume that Mzungu’s ride rather than walk. I would walk everywhere if I could. There is something so much more special about seeing a place from a walking or running perspective. You get to see so much more and actually take in your surroundings. Sure, it’s a LOT hotter and you sweat even more, but that’s what showers without working hot water are for! I appreciate them so much more in the middle of the day than in the morning! If I forgot to mention, the place we are staying has a broken hot water heater, so we take cold showers. Most people here don’t use hot water for showers, so they didn’t even notice until we arrived!

People were hustling about on the walk in. Tons of kids were on their way to school dressed in their uniforms. Each school has a different one. My favorite so far are the primary schools where the boys where sweaters and ties! They are so adorable! The other is a girls school where the uniforms are bright pink! I love pink, but it’s so much to take when every girls has a long bright skirt on! I think my friend Allie would have picked that one just for the uniforms! As I walked by the paper stands I saw more awful images of the bomb attacks. There was one that had pictures and stories of all of the victims. It’s really just tragic. Clearly not as big of a tragedy as when our Twin Towers were attacked, but it has the same impact on the people here. Lives were ended too early and fear has now been placed in the minds of many. I heard about one young man who died that was the only child of his parents. They had to try for over 8 years to conceive him and were never able to have another child. Now they’ve lost him! I can’t imagine how that would have felt!

I got to Angella’s at 7:30, but Gloria didn’t get there until nearly 8:00 because of a jam (I mean traffic jam). We arrived at Mulago and were late for the meeting, but after we arrived, at least 10 other people did too. TIA! It’s interesting how HIV cases are handled through these programs. The CDC and this program – Infectious Disease Institute (IDI) provide free HIV medication and counseling for their patients that have tested positive. The meeting this morning was to discuss 4 patients who were not improving or getting worse even though they are in the program. I didn’t quite understand everything for two reasons. First, we haven’t learned that much of the specifics of HIV other than things that cross over in other classes. Second, people talk so quiet! Seriously, it’s a huge room with at least 40 people, and the volume with which they spoke was only sufficient if you were in a coffee shop sitting 3 feet away from your friend! I must be hard of hearing because nobody else seemed to care! They look at all of the aspects of the person including a report from the physicians and from social workers. I am pretty sure that all of the patients were in polygamous relationships (which was not a shock to anybody since it is very common here, especially with the men) and many of them did not have the social network to support their treatment. Gloria explained later that the greatest reason a person’s treatment fails is that they don’t have a network at home to help with their treatment.

We had to drive across to the other side of town to get to the clinic site where we see patients. The clinic center is open two days each week and people come based on their appointments. Generally they are required to come once a month to get a re-fill on prescriptions and to make sure they are following what the doctors have told them. On top of the IDI program, there is another program that works with HIV positive women who are pregnant. One of the doctors in the same room as us was counseling women. They get put on different medications in order to decrease the risk of passing it on to their children. Usually, there is a blood count number (CD4 cells for those of you who care) that determines which medications to be on. In the US, if the number is below 500, people start the treatment. Because of a loss of funding and worry about the program being cut, the number is 250 here in Uganda. This means, that people’s ability to fight infections has to get much weaker in order for treatment to start. Both Angella and Gloria said that because of the change, there could be some major problems coming back that had previously been eradicated here. One of them is Kaposi’s Sarcoma. For some reason, I didn’t remember the link between HIV and Kaposi, but apparently it is very common for advanced HIV patients to get it if they are not treated properly. I won’t forget the connection now! Let’s hope it’s on the boards some day! Thank you Uganda!

It was simply sad to see the number of people coming in that are HIV positive. They are all age groups and both sexes, however we saw many more women than men. Some are younger than me and don’t know exactly how they got the virus. Almost all of the conversations happen in Luganda, so I don’t understand much, but sometimes based on hand gestures and tone I can pick up on an ear hurting, pain in the chest, or weakness in the legs. It’s amazing how much you can tell just by observing the patients. The saddest stories are when you see a child who is HIV positive because they parents are and did not come in for medicine when they were pregnant. How devastating is it that a little kid has to start out in this world with such an awful disease and they never did anything to get it??? It’s times like this that I feel like life is just not fair!! The parents genuinely care about their children and take them to get medicine, but it could have been so much different if they had made some better choices. Gloria says you can’t tell people here not to have children if they are HIV positive because having a big family is VERY important in the culture for many people. It’s just difficult when you know you can prevent the spread by taking precautions during pregnancy or practicing safe sex in the first place! A lot of times people are just no educated on these things so they don’t even understand how to prevent the disease. The IDI is trying to work hard along with many large organizations to help keep HIV from spreading. Many news reports have been telling us that although Uganda has a good track record of decreasing the incidence of HIV/AIDS, the number is again on the rise because people are apathetic or have decided that since there is medicine to take, they don’t have to worry. The Ugandan reports said there is complacency in the people which is causing the disease to spread.

Overall, it was quite a sobering day! I got to see how people must live in order to have their lives continue. The room itself was awful to be in! It is made of metal and only has one small window. There were three doctors seeing patients in a room that was at most 5’x 10’. In addition, I was there and generally each patient brought a friend. 10 people continuously in a room has a way of heating things up! Gloria dropped my off afterwards and then I got a Mtatu back to Ntinda. I walked the rest of the way home. It turns out the road is much steeper and longer on the hill that I walked down in the morning. It wasn’t impossible but with the sun beating down I was happy to get home!! When I got to our really steep hill, the children were out and yelled to me. A few of them came and grabbed my hand. They walked more than halfway home until I said goodbye and waved them home.

I needed a really long nap when I got back! I slept for over an hour and a half! I woke up and we decided to go to eat somewhere. Gloria (the other Gloria that lives next door) decided to come with us, which is great because she has a car! We told her we would go anywhere, but since we had discussed Mamba Point pizza, she decided that would be the place! I think Ross, Rach, and I went there at least 3 times last year because it is close and not too expensive. It’s delicious thin crust pizza from a wood-fired oven! The restaurant is outside under a roof covered in straw with a little water fountain in the corner. Dinner by candle-light with my mom and a great new friend was wonderful! Gloria did her medical training in England and was able to do some rotations in Chicago and New York, so she is no stranger to where we come from. She’s excited about getting married in 11 days and she should be! Weddings are a big deal here and from the sounds of it, there is a great celebration! She is getting married to a man she knew from the time she was little in the village. She didn’t have any romantic feelings towards him until a few years ago when the met up while they were both back in the village. They realized how much they had in common and how much they cared about each other and now they’re getting married! It was so sweet to hear her talk about how much she loves him and how excited she is to be able to spend the rest of their lives together!