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.