Field Visit to Kyegegwa & Kyenjojo: The Immunization Mobile & Beyond

The UJL Immunization Mobile

The Uganda Junior League (UJL) is the epitome of social mobilization. Any Ugandan, young or old, knows when the UJL team has arrived to their village by the catchy rhythms of the “Immunisation Song” by popular Ugandan rap artist Bebe Cool and the reverberating voice over the loud speaker announcing in the local language to “Protect your child from killer diseases like polio, measles, and meningitis. Go and immunize today!” Small children, some without even their pants on, emerge from within their homes on the side of the dirt road, women tilling the ground freeze in their tracks, and even little ones as young as two years old start shaking their hips, only to discover that all of this enticing raucous is coming from nothing else than the UJL Immunization Mobile—a big red van painted with logos of UJL, WHO, and UNICEF and “Immunise Now!” messages. The Mobile never fails to catch the attention of anyone whose path it crosses.

I went into the field with UJL for one week of a three week social mobilization tour in the western region of Uganda. UNICEF Uganda has been partnering with UJL to conduct much of the essential social mobilization activities in support of routine immunization in 38 of the worst performing districts in Uganda. My role on this trip was to provide “supportive supervision” as a UNICEF representative, conduct surveys and interviews with everyone from the District Health Official to mothers and community members, and generally support and participate in the social mobilization activities, such as the Immunization Sports Competitions, Immunization Elder and Child Health Ambassador trainings, and community-based Immunization Outreaches. Now, I wrote a very lovely six-page Field Visit Feedback Report with all of my observations and recommendations from this trip. But I don’t want to talk about that.

Me with most of the UJL team on my first day in the field in the Kyegegwa District.

Supporting the UJL team at an Immunization Assembly in a Kyegegwa primary school.

Using my "African English" to speak to the children about Immunization.

The mamas playing a game of "net ball" in a local trading center.

Children playing a spirited game of "foot ball" in a Kyegegwa trading center.

My life in Uganda really started when I went into the field with UJL. The UJL team was young, fun, and energetic. Our days in the field were long, hot, and very tiring. We often started at 8 a.m. and worked until 8 or 9 p.m., often without even having time to stop for lunch. We typically stayed in humble accommodations, at best with running cold water (no hot water), along with swarms of mosquitoes (which apparently loved feasting on my foreign blood), no internet connection, and barely a cell phone signal. But nobody whined or complained. We just looked forward to the evenings when we could kick back, eat our second meal of the day, and enjoy chatting about life. And it was during these relaxed parts of the day that I got to know my fellow companions and become friends. I mean, real friends. Not the courteous and obliging “hellos” and “how are yous”, but rather those moments of woman to woman connections, goofy jokes, and big belly laughs. After a month of being completely friend-less in a faraway foreign land, this was one of the most refreshing moments yet. I never realize more how completely human I am until I become so hungry to connect, to laugh, to hug. And you know what? Even in Uganda, people need the same things.

Rachel taking a moment to play dress up at a
local market before a sports mobilization event.

Doreen joining in the fun with for a moment
of laughter.

Children watching the "net ball" game at a local market.

Wycliff and me in the field in Kyegegwa.

Me with Edith and Dr. Cassim from the Ministry of Health.

Some of my favorite parts of being in the field with UJL were the opportunities to see and talk to children at schools, reminding me of my days as a school teacher, and getting to know Nurse Daphne, the Expanded Program on Immunization (EPI) focal person in the Kyegegwa District. I was drawn to her genuine and kind-hearted nature, and I truly enjoyed interviewing her about the work she does in her district to carry out immunization outreaches in the community. My supervisor at UNICEF had asked me to collect a couple human interest stories from the field, and I knew that Daphne would be an ideal person to interview. I recorded our interview on my iPhone, and a week later when I was transcribing the interview from the UNICEF office in Kampala, a smile came to my face as I listened to myself ask her questions and listen to her stories as she spoke in a warm voice with her Ugandan accent, which I find so endearing.

Me with Nurse Daphne at an Immunization Sports Competition in Kyenjojo.

School children performing traditional dance and singing songs that promote immunization.

Children singing at an immunization performance.

As strange as it may sound, I think this field visit with UJL and their infamous immunization mobile reminded me of how human people are. Despite our differences, we all have so much in common. We instinctively start dancing at the sound of catchy music, we want our babies to be healthy, we aspire for our work to be meaningful, and we strive to have happy lives. Much of the messaging that is used in Uganda to promote and encourage immunization plays off of these very human desires. One of my favorite quotes from the story I wrote on Nurse Daphne focuses on that very theme: “[Mothers] have seen live examples [of immunization]; families which have immunized, their babies are doing well. And these ones which were not immunized, their babies have gotten measles and have died. When we go down there, people are informed of the killer diseases. Once a baby is not immunized and contracts such a disease, like it or not, it has to die. And, I ask the mothers, ‘Do you want your babies to die?’ And they reply, ‘No, we can’t let our babies die.’ Because first of all, this vaccine is free, and the treatment is expensive, and it is not there.”

Interviewing an LC Chairman in the Kyegegwa District.

An Immunization Outreach at a trading center in Kyenjojo.

Nurse Daphne vaccinating a baby at an Immunization Outreach.

Nurse Daphne vaccinating a baby against polio at an Immunization Outreach.

Since I got back to Kampala, the capital, after the field visit with UJL I have been working on writing my reports from the field and crafting my human interest stories. One of these stories may come out in a newspaper center spread that I have been working on with one of the media relations specialists at UNICEF. The center spread is focused on Africa Vaccination Week, which is from April 21-28 and aims to increase awareness and demand for immunization services in Uganda. If one of my stories does make it into the center spread, which will go into the three major Ugandan newspapers, I will be sure to share that as well.

Working at the UNICEF Uganda office in Kampala.

Next week is gearing up to be quite busy and eventful. I have been working on coordinating for the Africa Vaccination Week campaign all month, and I've even coordinated my first media briefing to take place on Tuesday, April 22nd. I have been diligently navigating my way through the bureaucracy of not only UNICEF but also the Ugandan government, organizing meetings with the Ministry of Health to plan and organize all of the media events for Africa Vaccination Week. As in all my work, I do not rush, I just take my time and put one foot in front of the other until, often to my own amazement, I reach a successful end. Through this technique, I have been able to form positive and collaborative relationships with my colleagues at UNICEF and the Ministry of Health, and I am hopeful that next week will be a big success. Here’s to immunizing every Ugandan child!

School children watching the girls' "net ball" Immunization Competition game.

The Good Samaritan

Kampala, Uganda

Loneliness is a familiar companion during long travels far away from home. After the excitement of preparing to go abroad and the hustle and bustle of traveling, there comes a time when I find myself sitting alone in this new and strange place wondering what I will do next. After returning back from the field, I went to stay in a hotel by myself close to the UNICEF offices. I had the whole weekend ahead of me and no colleagues, friends, or familiar faces to go around with. It was really my first time in Kampala, as I had left for the field just two days after arriving to Uganda. I found myself in this big, bustling city, not knowing a soul around and realizing that no matter how I dress or what I do, I will stick out like a sore thumb. There was no escaping, only embracing. But sticking out in an unfamiliar place was not foreign to me—I had experienced it so many times before when I traveled and lived in Mexico.

On Sunday, I decided that my adventure for the day would be locating a Catholic Church where I could go to pray and attend Mass. I did a Google search the night before and located a parish called St. Jude Thaddeus Catholic Church, about 2 kilometers away from my hotel. I figured a good 30 minute walk to the church would allow me to see what was around as well as give me some exercise. However, the complicated walking route, coupled with the complete lack of road signage and my notoriously bad sense of direction, meant that one hour later I was still wandering around the streets, trying not to get run over by a vehicle and wiping the beads of sweat from my forehead. I was pathetically lost. I silently prayed, dear Lord, please lead me in the right direction.

I continued walking and walking. Finally, I decided I would surrender and accept a ride on a boda boda (motorcycle taxi). The first driver I spoke with knew little English and had no idea where I was asking him to take me. Then another driver approached me who spoke better English and I showed him on my Google map where I wanted to go. Even though I had negotiated a price that was one third of what he initially offered me for the ride, I later came to find out that I had still severely overpaid. Oh, the plight of the muzungu. Within just a couple minutes I was in front of the small Catholic Church on a bumpy dirt road. Praise the Lord, I made it! I paid the boda driver the extravagant fee, and then made my way into the church. The Mass had already started, but I was still in time for the communion. There were about ten rows of simple wooden benches on either side of the church that were filled with people. I found a spot in the back and sat down. A couple of chickens waddled in after me, but no one paid them any mind.

The priest was standing at the altar, which was covered in a green cloth for Ordinary Time, and featured a small wooden crucifix on the back wall, with two pictures of Jesus on either side. The Mass was given in the local language of Luganda. I didn’t understand anything that was being said, and I was clearly in a local part of town away from the urban sprawl. But at the sight of the cross and the face of Jesus, I immediately felt at home, and a sense of comfort washed over me. I also rejoiced in the fact that although I didn’t understand the language, I still understood everything that was happening in the Mass. Whether in Africa, Latin America, or the U.S., we are all united with the same order of the Mass, the same Scripture readings, and the same rituals. When the time came to receive the Eucharist, I proceeded to the altar. A few small children scampered in front of me. When I arrived to the priest he said, “The Body of Christ.” I received this spiritual food and I immediately felt nourished.

At the end of the Mass, the priest spoke in English to say that they welcome all their visitors to the church. He looked over in my direction and gestured as he said, “Including this one.” He asked my name and where I’m from, and then declared, “You’re most welcome.” With one more spirited song, complete with clapping and energetic singing accompanied by a variety of drums, people began to process out of the church. I intended to stay and pray, but I soon found myself surrounded by a small crowd of children. They smiled and stared at me as I spoke to them. Then two older men approached me to say hello and welcome me. One was called Emmanuel. He chatted with me and introduced me to the choir singers. We exchanged telephone numbers, and then I was about to leave when he invited me over into his home to meet his family.

I followed him through a narrow walkway behind the church and then entered into a small cement structure where there were two cushioned chairs and a small couch squeezed into this tiny space. A young adolescent girl sat on the couch cradling a chubby baby with bottle. Emmanuel invited me to sit in one of the cushioned chairs. Two younger children entered this space and sat on the floor next to me. Then another older man who called himself Moses entered the room. He was one of Emmanuel’s old friends from when they studied in the seminary together in Nairobi, Kenya. They both had gone to seminary back in the ‘90s, but neither finished. Emmanuel said he left after realizing it was not his calling to be a priest, while Moses had to drop out after becoming extremely ill from malaria and typhoid. Now Emmanuel is a caretaker for the small Catholic Church and works for a local travel agency, while Moses tends a small cocoa farm in a village about two hours away.

In a spirit of true hospitality, Emmanuel invited me to stay and have lunch, which I gladly accepted. His daughters served us the meal, which consisted of white rice, matooke (a popular Ugandan dish of cooked, mashed plantain bananas), and some broth with teeny tiny fishes inside. And, of course, a glass bottle of soda with a straw, a staple mealtime drink here in Uganda. I ate everything on my plate, both out of respect and hunger. I was happy to not be eating alone, and I was glad to have made a new friend. Of course, Emmanuel invited me to come back again, and said that he hoped I’d come back to Mass the next Sunday. He and Moses walked me back out to the street to catch a boda boda, who of course gave me the most fair price I’d been offered yet, thanks to my new friends who were standing nearby. With a warm handshake and a smile, I was off on the motorcycle back to the solitude of my hotel room, but with a smile on my face for the company with whom I’d just spent my Sunday afternoon. My new Ugandan friend, who had extended a hand of kindness to me, could not have known how his simple gesture had brought to an end, even if for just a few hours, my feelings of loneliness.

Field Visit to Adjumani

Sunset at the Fishing Lodge in Adjumani.

Following the weekend at the Fishing Lodge, we packed up our things and headed back into town to begin a week full of site visits in Adjumani. While we moved from hotel to hotel every couple of days in search of a place that would adequately accommodate all three of us, each day nonetheless began in a similar way. We stayed at rather humble places, so each morning started with a meager breakfast of instant coffee and toast, and maybe an egg if I was lucky enough to find one. We first stopped by the Adjumani District Hospital to pick up the district EPI (Immunization) Focal Person, Sunday, and then headed to our first site visit destination. We visited various health centers (HC), which are designated by levels I, II, III, or IV. A level I HC is the most basic and is run by the government-sponsored Village Health Teams (VHT), which are made up of lay community health workers. A level IV HC is typically larger and provides more services. Regardless of the level, however, each facility that we visited was run primarily by nurses and clinical support staff. The only bona fide doctors that I observed were at a HC III that was run by an outside NGO with support from the Ministry of Health (MOH) and provided foreign doctors on short-term contracts. In later discussions, I came to find out that doctors are a rare commodity at these public HCs, as the health workers are severely underpaid, and trained doctors typically opt to open their own private practices for a more lucrative business.

Conducting active case finding by reviewing patient registers
at a Health Center for potential missed AFP and measles cases.

AFP surveillance poster at a Health Center in Adjumani.

During the first part of the week, I observed my more experienced colleague, Joseph, as he went about the tasks of sensitizing (educating) the health center staff, reviewing patient registers, conducting active case finding for acute flaccid paralysis (AFP) and measles, and assessing the vaccine cold chain (i.e. vaccine storage and maintenance practices). Though my colleague is a Field Consultant and I am a Communications Consultant, my goal was to learn what is done in the field and begin to assess the current situation on the ground pertaining to routine immunization (RI) and vaccine-preventable disease (VPD) surveillance. Per my supervisor’s advice, I also conducted some brief surveys to assess at various levels (district, health facility, community, etc.) whether communications and social mobilization activities around RI and VPD surveillance are occurring.

A father and his children at the Nyumanzi refugee camp. 

The HCs were normally open outdoor structures constructed of cement. The walls were often painted half blue on the bottom and white on the top. I spied groups of women with their young children waiting outside, seated on the floor by the entrance or under trees with a blanket on the ground. A few men also lingered around. When I entered the HCs, I would normally see patients sitting quietly with children swaddled in their arms or sitting on their laps. Some children were fussy and crying, and others just stared as the strange muzungu (white people) walked by. I was surprised by the uniforms of the staff, often feeling as if I had been transported back into the 1960s, as the women wore white knee-length dresses with white nurses hats pinned to their heads. I imagined that’s what my grandma looked like when she was a nurse many decades ago.

Discussing AFP and VPD surveillance with Adjumani Hospital
staff at their weekly CME meeting.

By the end of the week, I felt more confident in my knowledge of the material, and my colleague Joseph handed over the task of conducting the AFP surveillance education session to the HC staff. I attempted to speak slowly and enunciated every letter I spoke so that the staff would understand my American English, and also to avoid the blank I-have-no-idea-what-you’re-saying stares. As a side note, I am still working on my “African English,” which consists of speaking a lot (I mean, a LOT) slower, and pronouncing every single letter of every word. Words with the letter “t” really get me. I also chuckle to myself when I hear Ugandans say “cloth-es” and “Wed-nes-day”. Nonetheless, the HC sessions went very well, and the staff were very appreciative of our efforts to provide them with some additional support.

Me leading the discussion on polio and AFP surveillance at
a Health Center in Adjumani.

Me discussing the correct method for collecting stool samples
for suspected AFP cases.

I was glad to have had the chance to go into the field with Joseph. I learned a lot not only about making field visits, but also about how to move about the small towns, negotiate hotel accommodations, and find places to purchase water and cell phone air time. And little did I know that these small lessons would come in handy on future field visits without my experienced colleague.  

Weekend at the Fishing Lodge Hotel

After a day-long journey and an eventful two days working in the field, my two colleagues and I had the rest of the afternoon on Saturday and all day Sunday to enjoy our time in the Adjumani district. We located a nice accommodation about 15 miles outside the center of Adjumani called the Fishing Lodge Hotel. When we arrived, there was a young man who greeted us in the lobby who called himself James. He showed us around the property, including the main “lodge” area equipped with a rack of fishing poles, the pool (which looked more like a murky pond) but which James insisted was cleaned and treated daily, and the two individual cabanas made of cement and a grass roof. We were informed that there was no electricity in the cabanas, and later we came to find out that there was hardly more than a few drops of water that trickled out of the shower heads.

My cabana at the Fishing Lodge Hotel.

Nevertheless, the lodge grounds were very picturesque with big trees and a view of the Nile River. As I sat in the outdoor area of the lodge facing the river, I saw small herds of goats and cows migrate through as they grazed on the grass and leaves, as well as groups of small monkeys casually scamper across the grounds in the same way squirrels do in the U.S. There were also lots of small to medium size lizards that scurried all over the place, even popping up in my cabana bathroom. Despite the rugged conditions, it was a quiet and peaceful escape. We also enjoyed the fresh food. And fresh it truly was. When we ordered lunch on the first day of our arrival to the lodge, James told us we had the option of fish or chicken. The fish came directly from the Nile River outside and the chickens were raised right there at the lodge. When one of my colleagues discovered that ordering chicken meant they were going to slaughter one of the animals right then and there, he opted for the fresh fish instead.

Spotting monkeys in the trees at the lodge.

A view of the Nile River from the Fishing Lodge.

Fresh fish from the Nile River.

On Sunday we decided to go on a boating tour of the Nile River. James and his companion who also called himself James were our navigators. We took a small wooden boat equipped with two paddles and a motor. One James situated himself on the front of the boat while the other posted himself at the back. We had to push our way through the green vines and floating plants to get to the open water. Once there, we toured the river for three hours, stopping once to climb up a rocky mass, where we discovered the skin of a snake that must have been about 6 feet long! I was glad we only found the skin. We spotted lots of different kinds of birds as we moved about the river and waved at the small fishing boats where people cast nets into the water. It was a relaxing ride along the river.

Our little river boat for touring the Nile.

Spotting birds along the Nile River.

The remnants of a former inhabitant.

My colleagues, our boat guides, and me on the Nile River.

In the evening, the night sky was absolutely amazing. When I looked up, I saw a vast array of brightly shining stars scattered across the sky. This was certainly in contrast to the smoggy view of the night sky in Los Angeles! James gave us battery operated lanterns to guide our way from the main lodge area to our cabanas in the evening. I appreciated the starry sky even more as I utilized the outdoor shower by the pool to bathe. The water pressure was significantly better than that of the shower in my cabana, so I sneaked across the grounds from my cabana to the pool, turned off my lantern, and enjoyed the hum of the insects as I showered under the stars. It was a strangely freeing feeling to shower outdoors. I suspected that I shared my sleeping space with a variety of lizards, spiders and mosquitoes who managed to find their way into my cabana. Fortunately, I had a mosquito net around my bed for protection from all the critters. By the end of the weekend I was sun burnt and bug bitten, but ready to start the busy week ahead.

You are Most Welcome

The first morning I woke up in Kampala I was greeted by the sounds of a busy city street outside my hotel window. There were boda bodas (moto taxis) buzzing by, as well as cars and pedestrians going to and fro. I had only slept for a few hours the night after my arrival, but I had a busy day ahead to take care of administrative matters so that I would be ready to head out into the field with my colleagues the next day. After a nice breakfast made of fresh pineapple and mango, fresh-squeezed passion fruit juice, scrambled eggs and coffee, I headed with my STOP colleague, Scott, to the United Nations Department of Safety and Security (UNDSS) office to be outfitted with my official United Nations (UN) badge. Then we went over to the World Health Organization (WHO) offices to receive a security briefing on Uganda. In addition to the information presented on potential security risks in the area, I also received a hand-held alarm with a string attached, which I could pull in case of emergency. I was informed that these alarms are provided for female staff only.

A boda boda in Kampala.

 

After the briefing, we went over to the UNICEF offices where I was to meet my in-country supervisor, Sheeba. She is the lead coordinator for immunization services at the UNICEF Uganda office. Sheeba maintains a very busy schedule but I was able to catch her for a few minutes to receive a brief introduction to the office and receive some quick guidance on what our objective would be as Communications Consultants during the field visit that week. We were instructed to take this trip as an opportunity to observe a specific district in the country, take note of the current immunization situation, and gather ideas of how we could focus our work throughout the next couple of months.

The next morning a fellow STOP consultant, Joseph, who has been working as a Field Consultant in Uganda for the past year, picked up Scott and me with his driver, Amos. We embarked on our long 7-hour journey from the capital to the northwestern region of Arua. The roads were very rough and rugged, and of course it was sweltering hot. Despite the hot and bumpy ride, I was able to observe many interesting sights along the way. When we passed through town markets, there were people bustling about selling fruit, bread, and chickens, women walking with baskets full of goods on their heads, bicyclists balancing large bundles of reeds and other items, and children scampering about, often stopping to stare at the muzungu (white people) in our vehicle.

A local market center on the way out of Kampala

Even beyond the town centers, there were various men, women and children trekking alongside the road, carrying various types of goods and women carrying babies on their backs. It was an adorable and peculiar sight to see a woman walking with two tiny feet poking out from either side of her body. Then as we passed by, I could see a baby cradled across her back with the legs splayed on either side of the mother’s body. I noted how the women here in Uganda carry their babies differently than the women in southern Mexico, who often have their babies hanging diagonally in a cocoon across the mother’s back. We were also very lucky to come upon a safari of wild animals during the stretch of the trip through the national Uganda park reserve. We spotted exotic birds, hippos, monkeys, and even elephants roaming through the grass, only a few meters from our vehicle. It was miraculous! This was not like watching animals at the zoo; these were majestic wild animals roaming freely.

Stopping to feed bananas to the monkeys on the way to Arua.

Wild elephants in the Uganda national park reserve.

The long day trip to Arua went smoothly, except for the flat tire we experienced at one of the military check points. Fortunately, we had a spare tire that Amos was able to change on the side of the road. The sun was beating down on us and poor Amos was completely drenched in sweat after changing the tire. A few hours later, we finally arrived to the Arua district, in the region of Arua. Like Mary and Joseph looking for a place to stay at the inn, we went from hotel to hotel searching for accommodations that night. By the fourth hotel, we finally found a place with available rooms, one double for Scott and Joseph and one single for me. Many of the local hotels had only 7 to 10 rooms, and we speculated that they were full with refugees from Sudan, fleeing the current struggles for safe haven in Uganda.

My hotel room on our first night in Arua, complete with mosquito net.

The next day was Friday, and we took advantage of the opportunity to meet with leaders at the Regional Health Office in Arua. We met with the regional Health Officer and the regional Surveillance Focal Person. Our goal was to inform them of our presence in their region, explain our mission as WHO/UNICEF STOP consultants, and describe our intended efforts to support their work in communicable disease surveillance and routine immunization, with a focus on polio, measles, neonatal tetanus, and adverse events. We were received very positively and instructed that of the 8 districts in the region, we should focus our work on the districts of Arua and Adjumani because those districts are the most densely populated and host large refugee communities, which are known to have some of the lowest immunization coverage rates.

Meeting at the regional health office in Arua.

With the support and recommendation of the regional health officials, we then headed to the neighboring district of Adjumani. While the distance between the two districts is not great, the rough roads extended our trip to almost 4 hours. Once we finally arrived in Adjumani later that afternoon, we met with the District Health Official (DHO) to have a similar discussion as what we had at the district, as well as to ask some questions to quickly assess what is currently being done for communications and social mobilization around immunizations. We learned that there are roughly 60,000 refugees in the district, both in camps and integrated into the community, and that they have the lowest immunization coverage rates in the region. In addition, they are currently experiencing a meningitis outbreak with confirmed cases in two different counties. After a very productive conversation with the DHO, we agreed to meet the next day with a community health leader at the only hospital in the district to make a plan for various site visits during the upcoming week.

Woman carrying chickens on her head and a baby on her back
on our way from Arua to the Adjumani district. 

The ferry to get across the Nile River to the Adjumani district. 

Me on the Nile River ferry to the Adjumani district.

The District Health Office in Adjumani. 

The next day, Saturday, we headed out in the morning for the district hospital. The community health leader we went to meet with, a nurse, was busy seeing patients when we arrived, so we toured around the hospital which was constructed as an open outdoor structure with a courtyard in the middle. The various sections of the hospital had open waiting areas where people were gathered waiting to be seen. There were various posters on the walls encouraging people to get tested for HIV, avoid getting infected with malaria while pregnant by sleeping under treated bed nets, and family planning options such as IUDs, which were referred to as “coils.” We even encountered a laboratory with a plaque on the wall recognizing the “American people” for their support through the U.S. Centers for Disease Control and Prevention. Once the nurse was free, we sat down with her to discuss our plan for the next week to visit various district health centers, local schools, and two refugee camps. After completing our plans, we headed on to find our next place to stay for the rest of the weekend in Adjumani.

Sign outside the lab at the Adjumani District Hospital. 

All in all, my experience so far has been very positive. During my first few days in Uganda, I have found the people here to be very kind, soft-spoken, mild-mannered, and courteous. From the district health officials to the local merchants, I have felt warmly welcomed by all. Many of the Ugandans I have met have greeted me and kindly stated, “You are most welcome, madam."

A Whole New World

The journey from Los Angeles, California to Entebbe, Uganda was a long one. I left LA at 1:50 pm on Monday, February 17th, and then arrived to Amsterdam 10 hours later the following day. From there I ran through the airport past life-sized blue and white teacups and a kettle formed into tables and sitting spaces to arrive at the departure gate for my next flight. I left Amsterdam at 1:00 am PST on February 18th and arrived to the airport in Entebbe 10 hours later that day. From the time I took the shuttle to LAX on the 17th to the time I arrived in Uganda on the 18th, I had been traveling for 26 hours straight.

A view of the Netherlands during landing in Amsterdam.

I must make a brief note about my travels on the KLM Royal Dutch Airlines. First, I realized that there is this whole culture of Dutch people that I have only seen glimpses of in the U.S. in the form of tourist traps (e.g. Helen, GA) with little shops selling mini tea sets and tiny wooden clogs. But, I came to see that these are actually real people with life-sized cups and shoes who speak multiple languages and take great pride in treating you with courtesy and good customer service. When I entered the airplane in LA, I was greeted by attractive flight attendants in matching royal blue suits. Some wore pant suits and others wore skirt suits with panty hose and pumps. I couldn’t remember the last time I saw a flight attendant wearing panty hose in the U.S. Then, as I proceeded to my seat past these nice-looking flight attendants, I passed a staircase to a second level. Wait—a staircase? Yes, that’s what I said.

 

The airplane was humongous. Surprisingly, however, those 10 hours passed rather quickly. Between dozing off for several minutes at a time and waking to watch Captain Phillips on my personal TV and read my Immunization Essentials booklet, the time seemed to fly right on by (no pun intended). In addition, we were served not one but two meals by these blue suit-clad women, along with several snacks and multiple beverage offerings. My flight from Amsterdam to Entebbe was similar, except for there was only one rather than two levels on the airplane. And on this flight I had the misfortune of being seated in the center row of seats next to some oafy-looking European guy who was all but sleeping on me by the end of the 10 hour flight. Not to mention his snoring and constant coughing all over the place.

 

Anyhow, my arrival to Uganda was very smooth. It was an amazing feeling when I realized that I had planted my feet on a whole new continent for the very first time. I began to feel nostalgic of a similar sensation I experienced when, after so much yearning and planning, I finally had the joy of stepping onto Mexican soil in my new home where I lived at the time in Ensenada. In my jet-lagged, sleep-deprived, and disoriented stupor, I rejoiced silently within. I made it! Finally, I am out of North America!
 

 

Fortunately my fellow STOP colleague and the hotel driver had arrived punctually to the airport and were already waiting for me when I landed. I went through customs quickly with my Ugandan visa already in hand, pulled my two bags off the conveyor belt, and then purchased a new cell phone for local use—a Nokia phone no less. Talk about nostalgic. When I arrived to Entebbe it was late at night, and outside it was already dark and cooled off. My colleague invited me to sit in the front seat of the car, and so I made my way to the right-hand side of the vehicle, only to realize that there was a steering wheel there! Ah, yes, in Uganda they drive on the left side of the road and the driver sits on the right. I felt certain that this was just the first of many more cultural snafus to come.

 

The drive from Entebbe to the capital city of Kampala was about one hour. After zooming along the two lane highway that connects the two cities and dodging dozens of pedestrians, motorcycle riders, and boda bodas (moto taxis), we finally arrived to the Golf Course Hotel where I was to stay for the night. I was so relieved to finally be in the same room with a bed. But I was only going to have a few hours to rest, because my colleague informed me of a busy day ahead, starting at 9:00 am the next morning. After showering and unpacking some of my things, I collapsed onto my firm hotel bed, with the A/C running that seemed to produce no cold air, and rested for the first time on African soil.