Stories From the Field

Announcing the First Winner of the Volunteer Educator of the Year Competition! 

This year, HCU has launched an exciting new ‘Volunteer Educator of the Year’ competition.  Each Volunteer group (normally including about 20 Volunteers from 10 villages) votes who they believe is worthy of the title, ‘Volunteer Educator of the Year’.  HCU team members then chose from the selected volunteers, one winner for each of our three project health sub-districts.  The story of our first winner, Janipher is shown below.  The remaining two winners will be revealed later in the year.  The three winning Volunteer Educators have all shown exemplary volunteer spirit and have gone above and beyond what is asked of them in their role as volunteer educators.  Aside from bragging rights, each winning volunteer will receive a certificate and have their story and picture featured on our website and in our newsletter.  Congratulations to Janipher our first Volunteer Educator of the Year! 

Janipher Agumusiriza from Kitongore village in Mitoozo parish is married and blessed with four children. She has been working since February 2007 as a Volunteer Health Educator. She has also been trained as a trainer of volunteer educators.  So what makes Janipher unique enough to deserve the title of Volunteer Educator of the Year?

Before Janipher volunteered to work as a health educator, immunization was only a dream in her village. Today, her village has the best Immunization coverage in Mitoozo parish.She identified and mobilized her village to support one of the poorest widows to renovate her house using local materials and in addition constructed other basic sanitation facilities at home like, a pit latrine, an energy saving store, a dish drying rack and a bath shelter to mention but a few. This widow has emerged as one of the best during the home hygiene competitions. This household of Ms. Kyantamba, the widow had never dreamed of such a status in their community.Janipher works tirelessly towards development in her village, she has formed a women’s group and they are involved in making handcrafts like mats and baskets, which they sell to earn a living. Some percentage of the money that comes from their hand crafts is loaned to members.  Her positive attitude,  zeal, and willingness to work,  are contributing factors towards her success.  She never uses statements like “this is impossible”!  She is often found saying things like ‘let’s try it out’!For example she organized a group of men and women to work communally. This group started off putting up pit latrines for people in their village who didn’t have them.  Her suggestion was adopted and presently 6 pit latrines have been constructed.       

Towards sustainability, she formed a group of children aged between 7 –18 years called “Young Community Owned Resource Persons (Volunteer Educators)". These children formed a drama group, through which they pass on key messages on Immunization, HIV/AIDS , nutrition, sanitation, growth monitoring, breast feeding and other topics found in the volunteer educators manual.  Group members who come from better off families make monthly contributions to the group fund, which is used to buy exercise books, pencils and pens for children from very poor families.  At least every Sunday they move out to churches of different doctrines to carry out health education. Hopefully these enthusiastic young Volunteer Educators will be the ones to teach the next generation in the years to come!  

 Child Friendly Health Centres

After a long walk on a hot day to a strange, gray-walled place where an unknown person rewards them with an injection or examination, no one blames children for having negative impressions of their local health centres. Healthy Child Uganda wants to promote the centres as havens of health, recovery and prevention, and so started a campaign to make them more child-friendly. Local artists have started painting the health centre walls with lively, vivid pictures. Now, nearly all the health centres in HCU areas have been painted with cheerful colours, cartoon characters, pictures of common scenes and objects, and images to promote health. Kenneth, a trainer from the Kibale Health Centre reported that some of the local children were fascinated with the pictures and spent a few hours at the centre on the day it was painted.  He added that even children who were unable to read were able to garner lessons from the paintings.  

Energy Efficient Stoves: Health and Environmental Benefits

Acute respiratory infections kill approximately 4.3 million people per year. In particular, the delicate respiratory systems of children are hit hard by the indoor pollution that comes from the high levels of wood smoke and kerosene fumes in homes in the developing world. As well as causing respiratory problems, these fuels often cause eye infections and burns, as well as considerable environmental damage. The traditional three stone cook stove is not well insulated (ABOVE LEFT), which contributes to higher consumption of firewood, and only heat one pot at a time. Many studies show how energy efficient stoves have significantly cut back indoor air pollution (ABOVE RIGHT). CORPs and local leaders are promoting the use of these stoves, which can cook up to three pots at the same time, use less wood and create less smoke. Reduced smoke in small homes creates a safer environment for everyone and helps to combat the respiratory illnesses common amongst children.

Health Centres: Small Effort, Big Rewards

There are three levels of health centres in rural Uganda. Every political district division has a Health Centre IV, which is usually staffed with a doctor and a few nurses. Most health centre IVs have an operating theatre, out-patient care, a maternity ward and general ward, as well as services such as family planning. Further afield, a Health Centre III usually has a nurse and some care aides, and has more basic health care services. Health Centre IIs are spread out in very rural areas, with a health practitioner available to vaccinate children, deal with simple health problems, and refer patients to    bigger centres when necessary.HCU is working on an initiative to improve the health centres. A health centre competition, scheduled for judging in February 2008 will reward the best and most improved health centres with infrastructure or equipment needed at that location.  The health centres, local government, CORPs and HCU will be involved in creating the criteria by which they will be judged. In order to not be biased toward better equipped centres, the competition will focus on accessible standards such as cleanliness, helpful staff, government standards and positive patient feedback.  In all the centres, these small yet important improvements will create safer and healthier spaces for everyone.

Clean Hands & Healthier Children with Tippy Taps

In areas of water scarcity, it is easy to omit hand-washing after using the latrine. However, this step is critical when it comes to preventing diarrhea, a leading killer of children under the age of five. A 2003 Lancet study showed that washing hands after using the     toilet and before handling food reduces the likelihood of diarrhea by approximately 45%. Consequently, HCU promotes the use of the tippy tap—a simple device for hand-washing—as part of its rural health education. The tippy tap is a creative solution that was originally designed in Zimbabwe. Made with local materials, it uses minimal water. Built near the latrine, a sturdy stick supports a plastic jug of water with a small hole pierced in it. Attached to the jug is another stick, at foot level, which is used as a pedal. The pedal can be pushed down to pour water without contaminating any of the tippy tap equipment. CORPs are community leaders in introducing tippy taps to their villages, and strive to have it as a standard feature in every home. Gender roles and family structure are important to consider when teaching communities about the tippy tap. With the support of both parents, the family will be more likely to use the tap.  Although it does require fetching extra water in order to keep the jug filled, this simple technology is revolutionary in promoting better hygiene, and helping to keep children healthier.  

A Simple Plan: No Bites, No Malaria

Since mosquitoes that transmit malaria are largely active at night, a simple and effective method to prevent malaria is the use of a bed net.  On average in southern Uganda, only one in ten families has a net, and they are normally only used by adults.  In recent survey in HCU project areas, only 1% of children under five were found to sleep under a bed net.  HCU and BUY-A-NET, a Canadian non-profit, have agreed to coordinate their efforts to fight deaths due to malaria. This collaborative venture aims to provide bed nets to almost 10,000 homes with children under the age of five registered in the 174 HCU communities.  The program not only will distribute the nets, but will also deliver training and education regarding malaria and the proper use of nets.  Expectations for community participation and input will be clear with the villages that choose to participate in the bed net program.  Distribution of nets will be combined with community efforts to clear bushes and standing water.  Volunteer CORPS will be involved in monitoring families who receive a net to ensure that it has been properly set-up and that the children are able to benefit from its use.  Receiving families will be taught that in order to realize the biggest benefit and reduce deaths, pregnant mothers and children under five must sleep under the net; these assures the protection goes to those with the most delicate immune systems.   

Building Capacity at MUST 

The Community Health Department of Mbarara University of Science and Technology (MUST) is an active partner with HCU. Science, Medicine and Development Studies students have opportunities to do placements with HCU staff and volunteers in the rural communities. They spend several weeks living at one of the rural health centres, where they can do outreach, research and get hands-on experience with rural community health programs. It is an eye-opening experience for many of the urban students, and provides valuable information for the university and the project on rural health practices, improvements and statistics. 

Income Generating & Micro-Projects

HCU supports communities in income generating projects, which contribute to a better quality of life for everyone. From goat rearing facilities and piggeries, to model gardens that provide crops to feed the family and to sell in the market, HCU encourages villages to make sustainable changes. Four women’s groups (with a few male members) from rural villages within the hills of south western Uganda meet regularly to make baskets and other handicrafts. Each group is comprised of mothers who seek to improve the health of their young children and a number of group members are trained as CORPs. HCU follows a mandate of building on success of initiatives that are already working.  Instead of offering grants, in the up-coming year HCU will work with village members to develop and implement community action plans.  Communities will determine their own priorities and work together to address issues that affect all.  HCU will focus on providing training on leadership and skills that are identified as necessary by the communities such as book-keeping, market analysis and writing business plans.  HCU will also provide and facilitate connections with micro-credit organizations, training organizations and may provide in-kind (rather than cash) contributions to successful projects where a need is identified.   

Lydia: Finding a Home

(Left a CORP and Child)

CORPs in *Lydia’s parish found her malnourished and living with her step-mother, after her own mother died. Her new caretaker was unable to afford healthy food for Lydia as well as the many children in the family. Not only was Lydia not getting enough to eat, she was also confined to one space of the compound, and wasn’t allowed to leave even to use the latrine. Her head was scarred from where her stepmother had burned her with hot metal. Lydia weighed only nine kilograms at four years of age; her skin was loose, eyes were sunken and belly bloated.The CORPs notified HCU staff. When Angella, an HCU facilitator went to visit the community, no family or neighbours were able to care for Lydia. The community was concerned that Lydia would be killed by her stepfamily. In an unusual, but desperate act, Angella took Lydia to her own home to live with her until her health stabilized. A year and a half later, a chubby Lydia is healthy and outgoing, with an impish grin, friendly hugs and looking forward to starting school.

*Names have been changed  

Gloria, the woman who was dirty

In her quiet but candid way, Gloria recounted to me the story of her life. Gloria was a disgrace in her village; she was unconcerned about her four children, her family, or even aspects of her own life. Her husband spent most of his time drinking, and they argued all the time. Visiting is common in Uganda, but Gloria’s neighbours never came over to chat or drink tea because her house was chaotic and dirty. The animals roamed about the compound; defecating where the children played, and the chickens scratched for food in the kitchen area. The compound was untidy and there were never clean dishes. Moreover, her children were not fed well, and one was beginning to develop kwashiorkor (a disease caused by extreme protein deficiency). Some CORPs from her village visited her home. Admonished, encouraged, taught and assisted by the CORPs, Gloria’s home was transformed within a week. In the interest of her children and her own life, her small home became organized and clean. Everything had its place. She began to boil her water and carefully prepare better meals, especially to offset her children’s malnutrition. The change was so complete and so quick that Gloria was awarded a prize of a new set of cups and two mosquito nets in the HCU healthy homes competition. Gloria’s husband became more involved with life at home, and stopped drinking. She and her husband even acquired two small sections of land where they now grow their own seasonal crops. Now, as an example to the community, she knows she can never go back to how she lived before. Visitors will come to her home, knowing that the drinks she offers are prepared in a sanitary way. She also became a CORP for her village just three months ago. Her children are healthy, her home is healthy, and Gloria smiles shyly, saying that she just feels free.    

The CORPs of Katyazo

Katyazo is a parish that is several kilometres from the main road. Before HCU became involved in the area, few of the village children were immunized, and malaria and diarrhea was rampant. HCU trained twenty women as CORPs in the Katyazo villages, and the group quickly bonded, and became united in their struggle to make changes. The CORPs quickly decided that they wanted to create a group that would be sustainable and productive, even after the project left the area. With only the standard HCU training, they then took every idea that was presented to them, and developed it far beyond the imaginations of anyone in the HCU office. They registered themselves as an organization at the sub-county level. They pooled funds, contributed from their own pockets and started a goat-rearing business. Today, the twenty women own more than one hundred goats. The CORPs also donate to a monthly fund in order to buy items like mosquito nets, dishes, mattresses, clothing and other needs that individuals required. They started visiting other villages to promote health education, as well as to encourage CORPs from other nearby areas. They have eagerly become involved in puppet-making to make interesting health presentations for their children, and have ensured that all the children are immunized. Recently, the women saved enough money to buy matching skirts for the whole group to wear when making health visits and presentations. The Katyazo CORPs have truly excelled in all areas of their work. They quickly took responsibility for their situation and worked, creatively and tirelessly, to make changes. They have now moved to the stage of being able to also teach others how to create sustainable, healthy and ongoing changes that benefit the whole community. 

Justine: making a difference in the life of a child

Justine is a young woman with several children of her own from the hilly region of Ilhunga. While out visiting neighbouring families in the course of her CORP volunteering, she found one family that quickly caught her attention. A dirty compound, with small mud-walled buildings was shared by a family of about ten people. In the midst of the dirty dishes and clothes, the freely roaming animals, and scarce food supply, Justine immediately noticed four year old *Eunice. After her mother had died, Eunice had moved to live with grandmother, and a variety of other relatives. The family was very poor; Eunice was unwashed and malnourished.Justine was concerned, and visited the family often to check on Eunice, and to advise on her care, but the family was too poor and busy with many other children to feed Eunice who required special care.  At a local Child Health Day, Eunice looked even weaker, with the weight of a one year old and signs of kwashiorkor. The community was concerned and discussed what to do. Moved by the plight of the little girl, Justine offered to take her home, knowing that there would be no financial recompense for her sacrifice. Despite having her own family to look after, she welcomed Eunice into her home.Within a few months, Eunice lost the wasted, weak look, and her health improved drastically. Justine put Eunice in school and paid the fees out of her own pocket. Eunice thrived in the nurturing environment.A year passed. With Eunice’s healthy appearance and school uniform, her father was surprised when he saw her one day. Eunice’s father brought her back to her old village where she continues to thrive and attend school.Justine’s generous spirit is just the type of trait that characterizes so many CORPs. With a willingness to make personal sacrifices to protect and cherish the life of a child, this is the kind of action that makes a difference in the world. And it certainly changed Eunice’s world. 

Dennis: Walking towards recovery

CORPs in one remote area found 12 year old Dennis living with his family. His leg was so swollen and sore that he was unable to walk and was in excruciating pain. The family had taken him to see many different traditional healers who diagnosed him as bewitched. However, the condition continued to worsen, even though the family had sold most of their cows to pay for all the herbal medicines. Having exhausted all of their funds to try and heal him, the family finally had left him to either survive or die. CORPS suggested taking Dennis to the health centre, where he was assessed as needing attention in the main hospital. Mary, a CORP trainer, asked Dennis’ mother to sell two bunches of bananas to pay for the transport to the city. There, Dennis was brought to OURS, a children’s hospital. HCU followed up on the case, and provided support for his stay in the hospital. Dennis’ bone infection was quite developed and required immediate surgery. He spent some time in the hospital before returning to his village.  Visiting Dennis now, he is comfortably recovering. The swelling has decreased, and the family is vigilant in caring for his leg. He is able to walk again and no longer requires painkillers. Dennis is well on the road to complete recovery from a problem that could have easily killed him.  

Tashobya: Learning to Smile Again

Tashobya started life as a normal and healthy baby. When he was one year old, he contracted malaria, from which he developed blisters in his mouth and around his lips. The blisters were left untreated, and the lips on one side of his mouth closed up, although this was attributed to witchcraft. He was operated on in Mbarara in 2004, but due to poor care, the lips closed again. A Healthy Child Uganda facilitator visited Tashobya, and worked with the family to decide on a plan of action. To ensure that the post-operation care would be successful, it was important to have the support of the whole family, especially the child’s father. Tashobya’s father was encouraged to seek another operation, which he agreed to do. HCU referred Tashobya to OURS, a medical facility for children with disabilities, where he underwent another operation. HCU and OURS assisted the family with the medical expenses.Tashobya has returned to school again, as he stopped attending when the children teased him, and because of the time he spent away at the hospital. His gentle smile is now expressed both in his eyes as well as with his mouth. 

A Second Chance for Kato and Kakuru  

Nalongo is a single mother of six, with two sets of twins. HCU staff visited the family at the direction of the local CORP who was concerned. At that time, the older twins were two and a half years old. The younger ones, called Kato and Kakuru, were fourteen months old and weighed only three and four kilograms respectively. The youngest twins often would spend a whole day without any food; the others ate when the community could spare extra food. Even their mother didn’t eat enough to have energy to work all day and breastfeed the youngest twins. The project started supporting the family with emergency food aid. Assisted by the CORPs, HCU monitored their development closely. Recently the community banded together and built the family a house, which is almost complete. The intervention has been successful; the children have gained weight and are becoming healthy and strong. The community is working together to care for the family, and assisting them to become independent from the food aid. Nalongo has also recovered hope, and is dedicated to working hard to improve all of their lives.  

It takes a village to raise a child: the story of Natamba

Natamba lives with her mother and five brothers and sisters on a small piece of land. When Natamba was eight months old, her mother became pregnant and following local tradition, she stopped breastfeeding. To make matters worse, the father deserted the family. Natamba’s mother struggled to feed, care for the children and get them to school. But things were difficult, and the family didn’t even have money or energy to construct a latrine or a kitchen. With two small infants, Natamba’s mother felt defeated.She turned to the traditional healers in the village, who convinced her that Natamba was bewitched. They encouraged Natamba’s mother to spend money on herbal concoctions rather than on food for the weakening child. Justine, a volunteer CORP, found the family and advised on how to feed the children. She continued to visit and encourage the family. However, further intervention was required. When Natamba was two and a half years old, she was severely malnourished, and weighed only seven kilograms. The lack of food made her weak, and despite her age, she could not stand or walk. The HCU project team held a meeting with the village elders and relatives. It was decided to combine efforts and construct a latrine for the family. HCU supported Natamba with a litre of milk every day for nine months. Volunteers visited the child regularly to monitor the children and assist the mother. Today, Natamba runs, plays and likes to make toys out of the materials she can find. She is excited to start school. Her father even returned to the home which has help to stabilize the financial situation. The family and the whole village had lost hope, but now can be congratulated that their efforts have made a difference in the life of a child.