Success in Uganda

This week I start working on a project to help gather medical information in villages throughout Rwanda, so the project I’ve been working on for the past couple of months is officially over.  I’ve written my postmortem and had a chance to recuperate from the travel (including the airline losing my baggage in London and a screaming three year old on an eight hour flight — horror stories best only hinted at). But this last project looks as if it was about as successful as I could hope for, so indulge me a few moments while I tell you what we did. While medical information is gathered throughout Uganda, reports are regularly written, and analysis is frequently done, sharing information between health care workers and officials is problematic. Until now, there was only one small central library at the Ministry of Health which held only a single stand-alone PC for accessing and reading electronic documents. To make matters worse, the proprietary software for storing and accessing the electronic documents only accepted PDFs, so anything a doctor wrote in, say, Microsoft Word had to be converted before it could be used in the system. With the help of the Knowledge Management (KM) team at IntraHealth, a few of us on the Informatics team put together a Joomla+KnowledgeTree combination that would allow health care workers and officials to upload any Office document, collaborate around them, and easily access them from any networked computer. My work centered on the integration and initial set up of the software — putting it all together in a way that made the KM people happy. And, frankly, much of that work isn’t any different than what I could be doing in almost any Tech Shop or corporate environment.  And for a while, it was like any software project, full of frustrations and delays.  While KnowledgeTree was an obviously mature piece of software, I found some of its idiosyncrasies irritating and some of its capabilities anemic. The real difference — the real satisfaction — came when I was finally able to sit down with the librarian at the Ministry of Health in Uganda and I heard him say “This is great, it is so much better and easier to than our current system!  And we don’t have convert all our files to PDF first!” It was a relief to hear those words.  Until then, doubt still lingered.  But after that meeting, while there was still a lot of work to be done and a lot of work that I wouldn’t be able to complete, now I knew that we had a successful, even worthwhile, product. Even better, the technical people I worked with and trained as well as the Ministry workers all understood the usefulness and had the same goal in mind: fostering adoption of the new “electronic library” throughout Uganda. Now, back to the work.  Hopefully I’ll have another success story in a few months.

Hey, Mzungu!

mzungu t-shirtAs you walk around many African cities, you’ll hear one word popping up over and over: Mzungu. It means “White Person” and comes from a contraction that means “Person who moves around.” Earlier this week, I bought myself a T-Shirt with “Mzungu” emblazoned on it.  It seems pretty obvious that people don’t realize you understand that when they say the word they’re talking about you.  Wearing the T-Shirt gives them a clue. Tonight, I wore the shirt down to dinner.  Several of the wait staff and the manager of the restaurant made comments about my shirt. “Interesting shirt” “Like it?” “Yeah” One man asked me if I knew what the word meant and how I knew.  We had a lengthy conversation where we talked about culture, movies, and the way people act.  During this, one of other men came up and said “How are you, Mzungu?”  “Fine, thank you.” That was all he wanted to say, but we both got a kick out of it.

Riding the Nile

  Yesterday, I almost died.  It was well worth the $75. Friday, I took one of the local people we work with up on his offer. When I mentioned I wanted to go raft the Nile, he said he would be happy to take me down there.  I called him to confirm and we arraged to meet at 10 on Saturday morning. When Saturday rolled around, something came up and he couldn’t make it.  Determined not to miss another chance, I found a rafting operator who was willing to pick me up at the hotel, take me rafting, feed me 3 meals and drive me back home.  We were to leave Sunday morning. I woke up and met them bright and early.  We drove around Kampala picking up other people who wanted to go rafting: a couple from Holland, an Italian and his Ugandan girlfriend, and half the crew of a Chinese telecommunications firm.  I started talking to the sales manager for the group.  He told me that China is funding over a billion dollars worth of telecommunications projects in Uganda.  The company he works with is one of the construction firms that bids on projects to build cell towers. As we drove the 80km (50mi) or so from Kampala to Jinja, I was struck by how different the area was than what I saw of Rwanda.  The area I saw looked more developed, more exploited.  In the middle of fields, hulking factories sat belching smoke from their stacks.  Rwanda, by way of contrast, seemed to be filled with only terraced farms. Before we even started down the river, a bad omen popped up.  A chinese woman stepped on a nail and it went straight through her foot.  She hobbled away, but her determination brought her back at lunchtime. So, anyway, we hopped in the raft and sat through 20 or 30 minutes of introduction to how to ride a raft.  The guide made sure we knew how to respond when he told us “Forward”, “Back”, “GET DOWN!” and “HARD FORWARD!”  We all needed it.  It was the first experience riding rapids for all of us — even more amazing was that two people on our raft couldn’t swim!  The guide didn’t seem to have a problem bringing them along even after we practiced what would happen if the raft flipped and they both freaked out. We started just before our first bit of rapids.  Only a Class 3 or so, it was plentwy of fun.  After that We drifted and paddled downstream to where we came upon some rapids that our guide called “Class 5 and half”.  The other side of the Nile at that point was being damned up for a power station and the volume of water over the already-Class 5 rapids was increased.  He gave us a warning and a few pointers and then we went into it. On the first bump, almost everyone went over.  On the second bump, idiot that I was, I thought “I want to go in the water!” and didn’t hang on.  Into the water I went. It was here that I learned why it is important to hold onto the rope that runs around the edge of the raft. I was under the water but knew I was coming up soon, so I didn’t worry too much.  When I came up, I took a breath… But not a deep one.  The water didn’t let me.  I moved into the 2m (6ft) pile of water at that point.  I didn’t have enough air and I was struggling to breath and I was scared.  I saw the light, but air was suddenly very far away and the river was pushing me along.  The river ignored my life jacket’s desire to surface and pushed me along under water forever. When I finally surfaced I tried to get the attention of the crew with Kayaks.  Still struggling to get any air into my lungs I began to panic more and felt very weak. When a kayaker finally came with distance, I grabbed on for dear life. After this experience, when everyone was back in the boat, our guide made a point of telling us to grab the rope with both hands and, more importantly, DON’T LET GO when we he told us “GET DOWN”.  Even when we hit more Class 5 rapids, we had no trouble staying in the boat from then on. We hit more rapids that morning but spent some of the time just drifting in the water, sometimes jumping into the Nile and swimming or floating along side the raft. When we reached our lunch spot, the food hadn’t shown up, so I got to spend some time just floating on my back watching eagles high in the sky or diving beneath the water, all the terror from earlier almost totally forgotten in the beatific surroundings. (Not all was total bliss, though.  I missed the spot to get out of the river and walked through what I thought was some mud.  Turns out that was the spot the local cowherds brought their charges to drink.  And the cows did a bit more than drink in that water.  The local people laughed when they saw a Mzungu with dung from their cows all over his legs.  I found the right place in the water and rinsed off.) After lunch, we hit the water again for more rowing and riding. We saw many a pastoral scene where women and children were washing clothes by the river … a few were even bare-chested, National Geographic style. The wildlife was amazing.  This was the first time I saw a kingfisher in action.  I’ve never seen a bird hover quite so effortlessly. We saw fish eagles, monkeys, egrets and men punting their bike across the river.  Unfortunatly, I wans’t able to capture any of these since my camera isn’t waterproof. The trip over 27km (17mi) of the Nile was amazing (though I’m sure I wouldn’t have enjoyed it as much had I died).  It was about the best $75 I’ve ever spent. (Pictures when I get a chance.)

Apologies to the TSA

A couple of days ago, I insinuated that someone at the TSA had stolen my camera.  I hereby apologize for disparaging the character of such a fine American institution. Today, I put on my boots for the first time and found my camera.  I had forgotten that I tossed it in my boots when I was hurriedly rearranging my stuff just before going into the airport.

Couple more thoughts on Health and Traveling

Just before leaving, I dropped my bike off at the shop for a “tune-up”.  One thing that I did ask them to do was put new tires on it since I have 1500 miles on those tires and I’m trying to be a little pro-active. Still, I did fllirt with the idea of packing my bike to Uganda.  I would be the only white cyclist out here.  I did see one black roadie and while there are a fair number of people riding beaters , but Boda Bodas and cars seem to be what most people use for transport (if they aren’t using their own two feet).  And believe me, you can see it in the air. While my next trip to Africa might include some road cycling, I have to improvise this time around for my exercise.  I’m on the 6th floor of the hotel (which makes it the 7th floor since they use European floor numbering).  So I run up and down the stairs several times a day.  Instead of getting a driver to take me back to the hotel (c’mon! I can’t be that posh all the time!) I’ll walk the mile or so back uphill. I doubt I’m burning the 1500 calories/day I was at home, but if I can just remember that I don’t have to eat EVERYTHING I’ll be alright.

Hurry up and wait + Drugs

Today, I spent most of my time waiting on a server. I couldn’t get Ubuntu to install on a Dell Poweredge server. Suse worked fine, though.  (It looks like I might have avoided some of the problem by changing a bios setting from “I2O” to “Mass Storage” but there doesn’t seem to be a good reason that Ubuntu wouldn’t work where Suse could.) This meant even more waiting for downloads over a very slow, African satellite connection.  The installation CDs I had for Suse didn’t have Java 1.5 and, joy of joys, I couldn’t find Java RPMs Suse 10.  So I’m downloading an installer from Sun.  17MB. Oh, and did I mention that KnowledgeTree needs OpenOffice running in the background?  Another 170Mb download.  (And why is the OpenOffice download finishing before the Java one?) While I waited, I sympathized with a fellow American suffering from a recurrence of Strep.  She had used up her pennicilin just before we left on the trip.  She was fine when we got here, but then seemed to have a flare-up. Of course, being used to the American medical system, we didn’t realize that you can purchase pennicillin (and most other drugs) over the counter here after talking to the pharmacist/chemist.  Even though my brother and brother-in-law are both pharmicists, I’ve often wondered what exactly they were supposed to be doing besides complaining about drug-ignorant doctors.  Seems like the Ugandans (and many other countries, for that matter) have the right idea. Instead of treating doctors like health-gods who are supposed to know everything (when the evidence clearly shows how ignorant many of them are about drugs), it would seem like they could work more closely with the dispensers of the drugs to make sure they get the right drug and dosage to a patient. In a related note, I had to get an anti-malaria drug, Malarone, for my trip to Uganda.  I knew I was up-to-date on all my other meds since I traveled just south of here a few months ago.  So, instead of going to the Travel Nurse again, I went to my family doctor.  (He had been bugging me to come in anyway when I saw him at church.)  He gave me a perscription for Malarone that the pharmacist was willing to fill, but forgot to put down a dosage. That’s the perfect situation for getting the drugs directly from the pharmacist without requiring the bother of a scrip-writer as the middleman. Still, it was gratifying to see my doctor.  I hadn’t been in for 3 and a half years and, in the meantime, had dropped 30 lbs.

God Bless the TSA

So, I arrive in Kampala and find a little love note from the TSA: “We rifled through your things.   Carry on, citizen!” In fact, I could tell they had before I even saw the note.  Everything had was shuffled around.  Not the “settles during travel” sort of shuffling but “you pack like an idiot, let me show you better” sort of shuffling.  Well, thank you very much.  I suppose I can be glad that not only am I learning better ways to pack my things, but I’m also being protected from bombs and such being smuggled aboard planes. I mean, at least they’re successful at that, right? (If you don’t click the link, it points to a news article from earlier this year about TSA failing to spot explosives.) No, I could tell they had searched my bags even without the note.  Whoever searched them decided to pocket my camera and bluetooth headset.  I suppose this is just another perk of working at the TSA and I shouldn’t begrudge them this small compensation for their wonderful work in protecting us from terrorist shoe bombers. (At least these things are easily replaced.  Unlike this guy’s experience with custom-made equipment, I can go to the mall to replace them.) (Update: I found my camera and apologized.)

Uganda Arrival

We arrived in Uganda last night.  I’m here to finish installing the Knowledge Management Portal (Knowledge Tree + Joomla) that I put together over the past few weeks and help train the local staff. Following are my first impressions of Uganda.  Keep in mind that I arrived after sunset and am staying at a nice hotel so my first impressions are especially limited.   Still, using my time in Rwanda as a frame of reference, I do have a little insight. During the drive from the airport in Entebbe to Kampala, I kept thinking of how I could describe what I’ve seen so far here in Africa.  My first thought was that much of it is like many rural areas of the U.S. during the early 20th century.  But there are a lot more cars and more electricity. Then I thought about the government in Africa.  The “Wild West” seems to work a little better, then.  The West with electricity and cars.  And paved roads. Of course, I wasn’t yet in Kampala when I was thinking about all this.  What I saw of Kampala last night, and from what I can see today, Kampala is fairly modern.  Short, modern office buildings, plenty of paved roads.  We’ll see if my impression changes once I actually get a chance to drive around today. Speaking of roads: In Uganda, they drive on the left.  In Rwanda (the other land-locked country just south of Uganda), they drive on the right.  I wonder what happens at a border crossing.  Oh, and they use yet-another-power-connection.  I had to pay 15,000 UG Shillings for a new adaptor today.  Highway Robbery, I tell you! I suppose you can tell exactly which European country colonized which African nation by looking at their power plugs and on which side of the road they drive.  Uganda is clearly a former British colony — left side driving and British power plugs — wheras Rwanda, with its power plugs and right side driving is clearly a former Belgium colony. One more thing before I start work.  International flights are about the most fun you can have (if you don’t sense sarcasm there, let me point it out for you here). Take Amsterdam, for instance.  I hopped off my flight from Philadelphia, went through customs once to enter then country and then again to hop on a flight to Uganda.  Hurrah!  At least this was better than transiting the U.S. where they make you grab your luggage even if you’re just catching the next flight out of the country. Customs (long lines, lots of waiting) and switching flights (long layovers, long lines, lots of waiting) mean that I left Philly at 6:30pm Tuesday and, after hours in airports and whatnot, arrived in my hotel in Uganda at 9:00pm Wednesday.  Not much jet lag, though.  I seem to have a knack for sleeping on planes — even in the cramped economy class conditions.