Well, I arrived 2 weeks ago, on March 18th, and, although I’ve had a running conversation in my head of observations on conditions here, I have yet to put any of it in writing and post it, as I had planned. So, with an unexpected weekend back in Kampala, with reliable electricity and internet connectivity, I’ll try and catch up on where I’ve been and what I’ve seen.

On arriving in Kampala, after spending most of the last year in Kenya, my impressions were so different from the first time I saw it more than a year ago. Traffic in Nairobi is chaotic, but I had gotten used to it, and had been thinking that the next time I was in Nairobi, I would rent a car and drive myself. One hour in Kampala cured me of the fantasy of trying to drive myself here….even walking around this city is a challenge. The element(s) that make Kampala traffic about 10 times more ridiculous than Nairobi is the boda-bodas (guys on scooters who serve as cheap taxis for most residents) and bicyclists who also transport people, furniture, food, and merchandise of all varieties. These guys weave in and out of the traffic, which has no sign-posts, stop signs, and far less traffic lights (I saw my first working traffic light today, on our way back into town!).

The other major impression from last time, which again strikes me on this visit – the Marabou Storks. They are like rats here in Kampala, and throughout much of the southern part of Uganda. In Nairobi, I’ve only seen these ugly birds in one short stretch of road on the way to the airport, but here in Kampala, there are hundreds of them. They nest in the trees (in huge 1m diameter nests!), they perch on the rooftops, and they stride around the streets and parks. In flight, they look like Pterodactyls…..really prehistoric. And, then, to watch them actually land on the tree branches, when they’re over 1 meter tall, and with a wingspan of nearly 3 meters!! You wouldn’t believe that a branch could support the weight, or that they could manage to balance on their long spindly legs (which are white in color because they poop all over their naturally dark-gray – yuck!). These birds are basically equivalent to pidgeons in NYC, or sea-gulls on the shore, and Ugandans pay no attention to them – everyone lives amicably side-by-side. The storks feed on carrion and garbage, so they serve a valuable purpose in Kampala, keeping the streets relatively clean.

After spending the weekend in Kampala, adjusting to the time difference, and recovering from a bad cold I picked up just before leaving the US, I took a prop plane, seating approximately 20 people, up to Kitgum, which is in the north of Uganda, towards the border with Sudan. This is where the LRA – the Lord’s Resistance Army – headed by Joseph Kony, who claims to be possessed by the spirit of Alice Lakwena, the leader of the former rebel army, the HSMF – Holy Spirit Mobile Forces. Lakwena, born Alice Auma, took the name Lakwena when she claimed to be possessed by the spirit of an Italian soldier (the Italians have been a major presence in the north of Uganda for some time, and the Acholi language has similarities I am told to Italian). At the present time, President Museveni states that the rebels number only 120, and, certainly, there are no reports of active ambushes, killings or kidnappings now, and there is talk of moving people who ar currently living the IDP (internally displaced persons) camps back to their villages. Most people, however, express a lot of anxiety about moving back, and worry that the violence will resume. Sadly, the IDP camps are crowded, and many people I spoke with report that the people in the camps are losing their culture and their pride, from dependency on foreign aid, and from lack of privacy and normal societal structures. It’s really amazing to me that this civil war has been sustained for more than 20 years, and it all seems to be based on either psychotic delirium on the part of these leaders, Lakwena and Kony, or a truly cynical manipulation of their followers – either way, it’s so sad that the people there have suffered so long…

I stayed in the Bomah Hotel, a very minimalist lodging. Electricity was mostly dependent on a generator, and came on at about 6pm, and until past bedtime. In the morning, usually there was no power. There was no hot water, and not even little on-demand heaters that you find attached to some shower heads in these remote areas. But that was OK, really, since it was quite hot, and a cool shower was nice – just a little bracing in the morning. Food was basic….because of the war, produce is scarce, and all the fish, meat and vegetables have to be brought in from outside.

The airstrip is, of course, gravel and mud, with the trees and bushes cleared away. As the plane comes in, children stand on either side, and watch the plane land. When I arrived, I looked around for the CRS jeep, but they hadn’t yet arrived. After a moment of anxiety, I called the Kitgum CRS coordinator, and he told me the car was on the way! A very welcome piece of news. In a few minutes, Wycliff drove up, and we bumped over the mud roads to the Bomah. Wycliff had two bananas on his dashboard, and offered them to me. He told me about his two children. His first-born daughter, 6 years old, is at boarding school in Kampala. There are government-funded primary schools, but everyone says that they are terrible quality, and children learn nothing, so every parent that can afford it (and even those who can’t) stretch every shilling to send their children to the best private schools possible.

The hospital, St Joseph’s, where our HIV/AIDS clinic is located, is at the other end of town from Bomah, and took about 20 minutes of bumping over muddy roads and potholes each day to get there. The first day, I worked with a wonderful, caring Ugandan doctor, Pamela Atim, who has twin 13-month-old daughters, and is expecting her third child soon (she’s not sure when, since she’s been too busy to get an ultrasound!). She invited me to have lunch every day of the week I was in Kitgum at her home with her family. She cooks everything from scratch over a charcoal fire in a stone “stove” just outside the kitchen door. She lost her maid a few weeks ago, and is desperate to find a replacement. For the time being, two young girls, relatives? cousins? nieces?, live with her, and help her with housework and with watching the twins. Until a maid is found, they stay home from school to provide daycare. Her husband is a nice guy, and is great with the kids, but he laughed at the suggestion that husbands might help with cooking and cleaning. He comes home every day for lunch, and plays with the kids while Pamela cooks food for everyone. Feminism is a long time coming to Uganda! Even though now many professionals here are women.

All the patients we saw during the week, as with most of the other clinics I have visited, are incredibly poor, by Western standards. One young woman came in with a small infant….she knew that she had to bottle-feed the baby, and she had been until about a week previously, when she ran out of money, let alone food for herself and her other children (she had had her first child when she was 13 years old). She is a second wife, and her husband only comes around for sex, and provides nothing to her and the children. She had been supporting them, along with her two younger sisters (they are all orphans), by brewing the local alcoholic drink for sale. But she had gotten too weak to work, and had sold the last of her maize (corn) to earn the fare to bring her to clinic. It was a desperate situation, with no long-term fix. We could refer her to the therapeutic nutrition programme run at the hospital, but that would only provide her with a few days of food for her and her baby. And nothing for the rest of her family. This level of hopelessness can be overwhelming…..the program that I’m working with can provide expensive medications to HIV-infected people in Africa, but without food, the medications are almost worthless. It’s always a problem. Fortunately, we do see enough recoveries with people who were ill, some on death’s door, who can pull through, with help from relatives and the community, and gain strength so that they can return to work, and contribute to pulling up the economic recovery of these impoverished areas. But, in Kitgum, achieving this success is complicated by the social upheaval of the rebels threatening the population, in addition to the multiple other threats: poverty, poor sanitation, illiteracy, and the superstitions that allow people like Lakwena and Kony to control people in this area.

So, at the end of the week, we flew back to Kampala, in our little prop plane (the take-off from the airstrip, just after a windy rainstorm, was a bit bumpy!!). By the time I got back into town that Friday afternoon, I was hot, and feeling grubby, but wanted to get to the grocery to pick up some food for dinner. I walked down to the Uchumi (means “bargain” in Swahili – it’s a chain grocery store throughout East Africa), and at the checkout register, the cashier commented that I looked tired. I agreed, and said that I’d just gotten back from Kitgum. His eyes widened, and he said with wonder in his voice, “You were up in Kitgum? I’ve never been there!” Implication – he would never want to go there!

OK, so that takes me through the first week……the second week was Bushenyi! That’ll be the next entry.