With love from Tanga

Hej!
Det har varit lite blandat med internettillgången (trots 60dollar/person och månad) så får försöka tajma bloggande så gott det går.

Idag är det jag, Hanna, som skriver. Jag är alldeles sönderstucken och bränd men glad ändå. Det är regnperiod här så hela helgen har det öst ner, men idag tittade solen fram! Det ledde givetvis till lite strandhäng under tiden vi läste och kommenterade uppsatser hemifrån.

Arbetet med vår uppsats går sakta med säkert framåt, har fått till två riktigt bra intervjuer och kommer förhoppningsvis att få någon mer under veckan. Imorgon och på onsdag ska vi vara på programmen School health och Elderly home. Jag är mycket taggad på det! Blir himla ensidigt att bara sitta och skriva på dagarna.

Här kommer lite bilder från dispensaryt vi var på förra veckan. Ett dispensary är första ledet i vårdkedjan. Det är endast enklare vård som utförs där så man kanske kan likna det vid en vårdcentral kombinerat med mödra- och barnavårdscentral med plats för förlossning.

Förlossningssal
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Stickvagn

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Vi var på fotboll i lördags. Det lokala laget Coastal union spelade och vann! Det var nästan som att vara på en MFF-match, bara lite bättre trumspelande och lite mer enformiga sånger. Samt att målvakten som svimmade efter en kollision fortsatte att spela när han vaknade till liv.

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Legs or hotdogs heheh

Det bor väldigt många djur här på området, bland annat världens gulligaste hundar som, liksom jag, trivs bäst i skuggan.

 

Det var allt för idag, hoppas på bättre bildkvalitet nästa gång. Badai!

Safari

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Förra helgen var det dags för Safari som vi planerat sedan vi kom hit! Och jag har verkligen sett fram emot det eftersom att jag ju är löjligt fascinerad av i princip alla djur (utom råttor). Dag ett åkte vi till Arusha tidigt på morgonen, där vi mötte upp vårt safari-gäng, folk från Malmö högskola, Lunds universitet, en från Stockholms universitet och även en från Sydafrika. Första dagen var vi i National park Lake Manyara. Vi, i alla fall inte jag, hade inte speciellt höga förväntningar, då det är lågsäsong och tydligen inte lika mycket djur, eftersom att det är i slutet av regnperioden. MEN ack så fel. Redan första timmen såg vi lejon, giraffer, elefanter och en massa andra djur. Följande timmar såg vi en massa djur på nära håll och även om det egentligen är lite konstigt att komma åkande i en stor jeep och kolla på djur, så var det inget annat än helt fantastiskt. Trötta och fyllda med intryck och söta djur (speciellt elefantbebisar) åkte vi till våra lodger som var något av det mest lyxiga jag sett. Två badrum lika stora som mitt vardagsrum, och två dubbelsängar med sänghimmel. Kontrasten mot allt annat vi sett.. Men bestämde mig ändå för att njuta av att sova i en skön säng och vila huvudet på en kudde som ej är uppdelad i hundra olika hårda klumpar OCH duscha i varmvatten och en stråle med tryck och en duschstråle bestående av mer än tre vattenstrålar, LYX.

Safari-dag två var vi i Ngorongoro Crater. Tänkte att ingenting kunde vara mer överväldigande än gårdagen, men detta var faktiskt ännu bättre. Eftersom att parken var en Krater så hade man översikt över så långa avstånd och det var ju djur överallt. Huvudakten den här dagen var när en Masai gick med sin koflock rakt emot en lejonhane, helt iskallt. Turen bjöd på många lejon och lejonbebisar!! Mycket Zebror och zebraföl, vilka nog mina favoriter.

Mitt djur-behov är stillat för några dagar framåt nu. Annars saknar jag hästar ganska mycket hela tiden.

Hoppas folk som är i Sverige njuter av våren, för den saknar jag lite lite. Johanna också vet jag:)

/Linnea

Intervjuer och chockerande insikter

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Inte så regelbundna blogginlägg.. Har haft en del att stå i. Delar upp den senaste tidens händelser i några inlägg nu i ett par dagar framöver, så håll utkik!

Som nämnt i tidigare inlägg hade studenterna här påsklov i två veckor, så vi besökte skolan Msiriwa secondary school, där vår studie äger rum, förra tisdagen när eleverna kom tillbaka. Vi började med en kort introduktion i form 4, motsvarande vårt första år på gymnasiet, där vi presenterade oss och vår tänkta studie. Vi delade ut formulär med påståenden om hälsa, som eleverna fick ranka dem, med det viktigaste först. Båda våra tolkar var med och vi märkte snabbt att Hyacinta var en heelt fantastisk människa och tolk som hjälpte oss jättemycket under hela tiden på skolan. Flickorna hade jättemycket frågor till oss, om allt mellan politik och kvinnors inflytande i Sverige och våra favoritmaträtter, väldigt intressant och kul.

Vi fick även en rundvisning på skolan av rektorn (som är en kvinna, för övrigt var det bara två anställda kvinnliga lärare, resten män…) och blev presenterade för alla lärare. Hon var jättepositiv till hela vårt projekt och ville gärna se hälsoformuläret, som hon även fyllde i med stor entusiasm. Vi blev bjudna på läsk och Hyacinta och rektorn hade en ganska hetsig diskussion med vår manliga tolk om hur det är att vara kvinna i Tanzania, chockerande hur vissa män här ser på kvinnor alltså.

Dag två på skolan var det dags för intervjuer. Vi började med tjejerna och första intervjun var något trevande, med en blyg flicka och en ganska nervös intervjuare (jag). Det kom dock fram en hel del givande svar och nervositeten släppte något från båda sidor efter ett tag.

Följande intervjuer gjordes vidare under samma vecka samt veckan efter. Vi använder oss av så kallade flash cards, där vi har tjugofyra olika påståenden om hälsa, skrivna på Swahili och Engelska, där vi låter den som blir intervjuad plocka ut kort som de associerar med hälsa och sedan ranka dem. Sedan har de fått prata ganska fritt om varje kort och vi har ställt en del korta följdfrågor. Flash cards var tänkt som ett hjälpmedel, dels för at överkomma språkbarriären och även som en bra hjälp eftersom vi är ovana intervjuare, där något fysiskt att “plocka med” och gå tillbaka till om det blir tysta stunder kan kännas tryggt, vilket det gjorde.

Vi har ännu inte börjat analysera det insamlade materialet, men efter att ha transkriberat har vi nog ändå snappat upp en del teman, som antagligen kommer att visa sig i resultatet. Bland annat att många ungdomar tycker att stress är ett problem som påverkar hälsan väldigt negativt. Många uttryckte stress för att inte klara slutproven i slutet av terminen och även en stress för att föräldrarna skulle bli sjuka och gå bort. Många tjejer uttryckte många starka känslor som “Skam”, “självmord” och “rädsla för övergrepp och våldtäkt”, vilket såklart chockerade oss.

Även om tjejerna berättade saker som gjorde en väldigt ledsen och nedstämd, så var vissa delar av samtalen också väldigt givande och roliga, eftersom flera frågor till oss ställdes efter intervjun, där de öppnade upp sig mer och samtalet blev mer naturligt och på en mer avslappnad nivå.

Långt inlägg, mer kommer. /Linnea

Broken ceilings, Sipi and dancing.

It’s been a while since we last wrote.

Two weeks ago we came to Jinja after travelling in a bus for 17 hours… Matilda did not pee for 17 hours! Quite amazing. Of course there are no toilets on the bus. If you’re going to pee you have to do it roadside outside the bus while everybody is staring at your bum.

Jinja is the second biggest city in Uganda and is located just by the Nile. We have been hanging out with Madeleine and Linnea, having a really good time. We’ve also been out dancing, which we’ve missed while in Kisoro, was loads of fun. We’re enjoying the music here! After a night out dancing we came back home to our hostel, realising there was a hole in the ceiling. We started laughing as we thought the ceiling had just broken. After cleaning up we’re realising there are things missing. A music-player, some money and an Iphone. Not as much fun. But at least we still have our computers, so in a way we were lucky. The manager of the hostel called the police. Two policemen came to have a look, only to come back an hour later, at 6.30 am. Knocking the door to wake us up, wanting to check the hole in the ceiling once more. After simply chucking around various stupid explanations to what might have happened, one policemen turned to Matilda and asked if she was the leader of the group, we started laughing uncontrollably, in his face, oops, and Linda started to sing “follow the leader, leader, leader, follow the leader”. Then the police asked us what we thought they should do about the situation, Matilda answered: “I don’t know, I’m a student, you are the police. You figure it out”.
Still not loving police…

Also, we’ve been horse riding by the Nile, which was really amazing. We were cantering a lot. We are still sore in our muscles after five days. But it was worth it. After that we spent Christmas at Sipi falls. We went for a walk to see the three beautiful waterfalls, swimming in the Sipi river (really cold, but nice) and having Christmas dinner on a fancy restaurant – the best food and wine we’ve had here.

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Of course we are studying some too, almost done!

We do not miss home very much, though we miss vegan cream and tofu a lot…

All interviews done

… and now it’s all efforts towards writing, writing, writing. Last week we went to Kabale, saw the hospital and interviewed four more nurses. We took a Mutato (sorta communal taxis) which was a bit puzzling… Squeezing seven people plus driver in to a tiny car is the way to do it (kids doesn’t count, you can easily chuck in a few of them as well), the driver had a little hard time gearing. This seems to be not quite legal. Going to Kabale we were seven people in the car when the driver stopped and made sure we were sitting four in the back. He told one man to get put and jump on the back of a bike, so that they were only sitting two people in the front. We didn’t understand why this was happening until we had driven like 500 metres further and there was a policeman standing by the side of the road. He was checking the drivers’ license and looked in to the car. He didn’t mention anything about the seatbelts and the fact that we were still too many people in the back of the car. We drove on and stopped again to let the man who jumped on the bike earlier in to the front seat of the car again and then we continued towards Kabale. Everything in Kabale was bigger than here in Kisoro, the streets, the hospital, the shops (there were such things as clubs and bakeries), basically we felt like we were finally in something resembling a city. Linda was more than pleased with having proper soft bread! Spent most of our time in Kabale at the hospital and at our hostel, transcribing. This while people where playing monotonous drums next-door for three hours in a row. Enough to drive anyone insane…

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Creative chaos

 

Now we’re back in Kisoro after five days at Lake Bunyonyi. We were staying in a 12-bed dorm on an island surrounded by nothing but water and mountains. It was pouring down when we went there, the boat ride was wet and unpleasant, as was the first freezing night. We quickly realised electricity were even more of a rarity on the island than in the rest of Uganda, charging our computers were only possible when the sun was shining (only solar power available here!), was not exactly free of charge and took F O R E V E R. Now we might not now much about technically shit like electricity but something’s sure off when it takes five hours to charge a computer. Great for us, since we were there to get a lot of writing done… But then the sun started shining and things picked up. Turns out no electricity makes for brilliant concentration and no communication with the outside world was actually kinda relaxing. We spent most of our time swimming, canoeing (the effin thing was totally impossible to steer, so we didn’t get very far, though we had some fun…), eating, drinking wine, reading non-school related books and playing cards. And still we got a lot of writing done. Great success!

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Study view
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Out door showers after lake swimming
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Giving up……

We just came back from Kisoro Hospital, having said or good byes we are now ready for a weekend of writing, washing clothes, taking walks and hiding from the never ending rain before heading to Jinja in the beginning of next week. It’s definitely time to get a move on.

Delivery rooms and gorillas

Kisoro Hospital has no locked doors, no bells to ring and there’s no authorisation needed to get into a certain ward.

As there are a lot of patients in the always overcrowded wards and many of the patients has relatives around to cook, collect water and clean their clothes for them, we doubt that the staff knows who belongs there and who doesn’t. We can go through the whole hospital area and into all the wards without anyone asking anything or wondering what we are doing there, people are simply saying hi. We’re guessing that’s a privilege the white colour of our skin gives us.

 

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At our fav restaurant. No jokes, it’s brilliant.

 

 

Thursday morning we spend some hours in the maternity ward. There is one delivery room at the hospital, it contains six beds separated by drapes. The women delivering are not allowed to have a partner, relative or friend around, only patient and midwives allowed in the room.

The on duty midwife, Erina, took care of us, showed us around and answered all our questions about the maternity care in Kisoro Hospital. We got to witness a woman delivering her first child. One newborn baby had difficulties breathing and needed oxygen, but no oxygen was available. Erina did what she could and the baby started screaming, went on breathing and were fed, all good in the end. However lack of important material is a fact. Though, the midwives in the delivery room seam to do a great job. According to Erina the newborn babies chances to survive are good. According to WHO the infant mortality rate in Uganda is 44 out of every 1000 live births. Equivalent number in Sweden is two.

In general the women in the room made very little sound. Being used to the somewhat noisier Swedish delivering rooms this was a bit surprising.

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Also, WE MET GORILLAS!!!

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Outreach and interviews

On Wednesday we went with some of the nurses on a women’s health outreach to a nearby village. After waiting around for some time (had to collect some tea and self evident; a spare tyre) we set off. Drove west (I think?) on small roads. Beautiful scenery along the way consisting of lakes, rivers and hills with field after field of beans, corn and tea bushes. Everywhere people where making bricks out of the sand/clay, piling them up roadside. Seems like a lot of hard, dirty work.

We got to the health centre where some 50 women were waiting. After introducing the outsiders, the nurses had health education. They talked about cervical cancer screening and family planning. Afterward the women interested in getting screened registered and lined up. Quite a lot of women wanted the screening. We had a chance to observe the screening. It was really difficult to see what they were looking for, not being familiar with what a normal cervix looks like… But very interesting! Felt a bit odd not being able to communicate with the women and not knowing if the nurses asked if the women were okay with us being in the room. Not so sure about how I would feel about having a stranger (with whom I’ve got no common language) looking up my vag trying to spot abnormalities… It seemed to us like the women here are quite shy when it comes to their vaginas but not at all bothered by showing their breasts. Also, breastfeeding is not an issue here. Women are feeding their babies wherever, whenever. Different from Sweden and very refreshing to see.

After hanging around more women we’re finding that is it a lot easier to talk to them than to the men. Seems to be less misunderstandings and less uncomfortable silences. The men we’ve spoken to seem more eager to explain things to us or teach us what they know, preferably twice even if we’ve already said we got it the first time.

The nurses we’ve met so far all seem to have a profound knowledge and are teaching us a lot (including some very tricky medical terms…).

On Friday we had planned to do interviews with two nurses. We where there at 9.30, as agreed. When we came to the women’s clinic there was only one nurse working, and there were loads of patients waiting, so we couldn’t interview that nurse. We decided to try to get in contact with the other nurse that we were supposed to interview but she was apparently off duty. Anyway we decided to stay and wait around the hospital to see if maybe we would get the chance to interview at least one nurse. After three hours of waiting while children screamed Mzungu (white person) like thousands of times we got to interview both nurses. Lucky day!

Friday evening was all about transcribing the interviews, eating noodles, drinking tea and trying to cure a cold. Meaning Linda sat bent over a pot of hot water trying to get back to breathing less like Darth Vader.

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Also, last night there was an amazing sky full of stars, it looks very different from here. Positively beautiful.

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Actually getting shit done

Yesterday we visited Kisoro District Hospital, first day of actual field work. The government finances the health care system in Uganda. Everything from health talk to medicine to surgery is free. This includes dental care, mental health care and vaccinations. Suck on that, Carema!

We got introduced to the hospital by a nurse who works with the women’s clinic and the cervical cancer screening project. She took us for a walk around the hospital and we got to see a caesarean trough an open window and a lot more. The hospital is divided into an outpatient unit and an inpatient unit. The inpatient unit is always overcrowded. The two wards (one female, one male) for medical and surgical patients with 30 beds each, all in the same room, are always over crowded. With a normal number of patients being 60, half of them are sleeping on the floor.

The cervical cancer screening project in Kisoro was introduced by the American organisation Doctors for Global Health in 2007. It seams to be the only, or one of very few, screening projects in Uganda. It is great for us to be able to see how it works here in Kisoro and what difference the screening makes. But it is also sad to see that there is way to few screening projects, as the prevalence of cervical cancer in Uganda is one of the highest in the world. The prevalence is shown to dramatically decrease with preventive measures like the screening project. Introducing national prevention schemes in Sweden in the 70’s has cut the incidence in half.

Also, we had our first interview yesterday. We were a bit nervous as we have never interviewed before, but it was very interesting and we got a lot of information. We are now transcribing the interview, cringing at the sound of our own voices (will get used to that) and realising how much time it actually takes, but we’re still in a good mood. It wasn’t raining yesterday, not a single drop all day, which makes us in even better mood. All other days the rain has started at 5 pm and after that it simply does not stop.

Tomorrow we’re joining some nurses in the outreach project. We very much look forward that. Even tough one of the people working in the laboratory clearly stated that the outreaches basically mean walking in mountains for two hours. Guess we’ll have prove that we got our walking shoes on.

LIFE IS GOOD

Tar här våra första stapplande bloggsteg. Varma hälsningar från Entebbe, Uganda! Idag har vi haft vårt första möte med översjuksköterskan på hospitalet i stan. Det var sannerligen intressant och givande. Imorgon klockan halv tio ska vi åter sammanstråla för att i gemensam trupp bege oss till den medicinavdelning där våra observationer ska äga rum. Vi ser fram emot dessa veckor med spänd tillförsikt. När vi så åter kom hem (DEFINITION: lägenhetshotell i “villaförort”, atmosfär: lugnt och fridfullt) fortsatte uppsatsförberedelserna i en rasande fart, dock utan el vilket försvårade det hela en smula. MEN! Människan är ju typ världens mest anpassningsbara djur, därför anpassade vi oss efter omständigheterna och valde en annan väg, dock mot samma mål (viktigt att ha i åtanke). Det sägs ju ofta att ju längre tid en spenderar i en kultur, ju svårare blir det att beskriva dess särdrag, dvs. det som är annorlunda mot det vi själva tar för givet. Efter en knapp vecka skulle således listan kunna bli tämligen lång. Och tråkig etc. Några underbara aspekter kan dock i detta skede icke passera obemärkt. Älskvärda aspekter: (enligt underteckande, återfödda i Uganda sedan en vecka) Tempo, alltså rytmen i förehavandena. intermänskliga närheten, om en kan säga så? Självdistans och autoironi hos härliga individer som redan blivit vänner. ( HAV ÖVERSEENDE MED THE MASTER OF KLYSCHOR)

Nu är klockan snart kvart över fem och det är dags för en liten joggingtur.

All vår värme och kärlek,

Maddo & Linnea

Straight outta Gorilla Land Guesthouse

After a whole day of walking around Kampala, seeing most of the central parts of the city we spent our first night with Emmanuel, a friend of Denis who is helping us with practical things. We were sitting in our hotel bar, us sharing a coke, the three men all drinking hard liquor. We had some questions about the school system and higher education in Uganda after visiting the girls school where Emmanuel is a teacher.

According to Emmanuel the statistics says that there are four times as many women as men here in Uganda. In the university there are more women then men but not as many as four times more. He goes on explain why this is so, which leads us into talking about bridal prices. A man who wants to marry a woman has to pay her family a bridal price. After the wedding the bride becomes a part of her husband’s family.

A daughter’s futures income benefits her future husband’s family while the son’s future income will benefit his own family.
That’s why parents rather educate their sons then their daughters. Basically a woman’s income is never her own. It goes from being beneficial in terms of bridal prices to benefit the future husband’s family.

The following day we reached Kisoro after 10 hours on a bus. We met with Denis who took us to the guesthouse that will be our home for some time. So far we are very happy with it. We’ve not spend much time in Kisoro yet, just enough to take a walk around town, trying to locate ourselves, the market place, the bank, some stores and all that jazz.

We spent our first night in our new home talking to three Swedish social work students who’s been here since august and are about to leave. They’ve spent their time doing work placement at a school for disabled children. We were talking about the way social work is conducted here and what they’ve done. They said talking about feelings is frowned upon and that they were expected to teach during their stay here.

The only social worker they’ve met had counselling sessions with married couples regarding domestic violence. These sessions are meant to identify what within the woman’s behaviour provokes her husband to beat her and therefore make it possible for her to change, make her husband happier and the marriage will thus be saved.

During workshops with the children one of the topics were alcohol. Every boy in the workshop said the same thing – Wednesday, Friday and Saturday the fathers goes out drinking, come home late, drunk and in a bad mood. They beat the boys’ mothers and sometime also the children. The mothers and children run away from the fathers, sleeps in the woods with the other families and in the morning the boys go to school together. This is something the boys easily talk about and chare with each other. There is no stigma, no shame and no self blame.

We tend to ask a lot of questions. Stay tuned – next week hopefully more about health care system. Might actually be related to what we are here to write about (being preventive interventions regarding cervical cancer).