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         I always complain about blogs that stop before people get home but mine almost turned out the same.  It's so hard to go back to writing once you get home.  I've been home 2 weeks and it now feels like I was gone a long time and that I never left.  I am glad I took lots of pictures so I can go back and look at them when it feels especially unreal.
         I had to write final reports for my experience for 3 differernt organizations so thought to make it 4 I would put a "final evaluation " up here too:

GHFP Final Report

Accomplishments

I participated in the following community and center activities at The Aids Support Organization (TASO) Mulago Center:

·         Three day orientation with the TEACH attaches (3 week internship program for professionals from any African country),

·         Five Outreach clinics,

·         One day of home visits,

·         Four staff trainings,

·         Two visits to USAID and the US Embassy, one with the Ambassador to Uganda,

·         Three  Community Awareness/Mobilization Drama Events with free HIV Testing and Counseling  available,

·         Two School visits,

·         One orphanage visit

·         Two  community CD4 blood draws and medical evaluation clinics,

·         Seven  days at the Mulago Center clinic,

·         Two lab visits,

·         Ten Community Drug Distribution Point clinics

·         One day of home care visits

·         Two days in the childcare Mother/Child clinic

·         One day of medical visits

·         Three days participating in the pharmacy

·         One planning meeting

·         One job interviewer panel for Nanny position

·         Two community volunteer meetings

·         One day of Home Based HIV Counseling and Testing visits

·         Three staff meetings

·         One day of  Prevention of Maternal to CHild Transmission clinic

·         One day participation in a Gender Based Violence Training

·         One day visiting Sustainable Livelihood Projects

Through the above activities I gained understanding in:

·         How a low resource setting organization, TASO, functions as a model for low resource setting organizations throughout Africa,

·         How donors’ goals and  changing objectives enhance and restrict an organization and the process which occurs in the organization to meet it’s responsibilities to its donors,

·         The cultural values in Ugandan society which enhance or prevent the behavioral change needed to decrease and/or eliminate HIV infection,

·         The use of drama, song, and dance as a tool for awareness, education, and mobilization for HIV prevention, testing and treatment,

·         Traditional and evolving gender roles in Ugandan society and how these roles impact HIV/AIDs,

·         Strategies to move prevention, testing and treatment services to non-centralized urban sites to increase the availability and accessibility of these services to specified high risk groups, such as newborn children of HIV positive mothers,  adolescents, rural communities, and low poor urban communities, and  

·         The use of trained community volunteers to increase client access to educational, preventative, medical and counseling services and projects for sustainable living.   

Contributions to the Development of My Global Health Career

I gained a great deal of information on the projects and programs of TASO, and how TASO, as a system, carried out its mission and goals.   On a personal level I also learned or became aware of many challenges I will personally face in my goal of an international public health career.   I think a successful long term, in-country international career which has always been my goal is only possible if I can reflect, assess, and then change the situation, or change my attitude, or be more accepting of about these aspects of this choice. These include:

·         The length of time it takes to reach an understanding of a culture, not my own.

·         Problems in accepting some of these cultural values.

·         Problems in communication and understanding because of language barriers.

·         The physical and emotional stress and tiredness of working day to day in a culture in which you are an outsider

·         The transportation issues which exist in much of the developing world.

·         The knowledge and frustration of knowing that most projects treat the symptoms but do not address the underlying causes of global and local disparities and the issues of social justice.

·         My feelings, personally, at being perceived as old because the average age of death is low in Uganda and other developing countries.

·         The cultural differences in time sense values

Aspects of the Internship Which Were Beneficial

Almost all aspects of the experience were beneficial.  I learned from both the positive and the negative.  I think the most valuable aspects of this internship and the aspects which made it different from all other internships to which I applied were the length of time of the internship, and that the internship placements were in indigenous organizations such as TASO.  In other internships I would have been working for a short time, for an American organization with American goals, objectives and time frames.  I would have gotten little real information about the culture but would have brought my tasks and done my expected outputs in a framework that was superimposed on this culture.  I might have been more comfortable, more efficient and less confused but I would have learned far less.    

Aspects of the Internship Which Were Least Beneficial

The thing I found the most stressful, which is different from least beneficial, (see above) was the enormous amount of time where I just didn’t do anything, and that the not doing anything was not under my control.  Long commutes, work transportation issues, staff  work time be done before community clinics, all of this lead to a great amount of my time feeling wasted. I continue to believe that it was something I needed to learn about the Ugandan and perhaps all African culture but I didn’t enjoy that part of the learning. {END OF REPORT}

     Back to the end of my trip The flight home was fine. We stopped in Amsterdam for 6 hours and took a train into town for a few hours. We visited a coffee place and meandered around the canals. Nice to get out of the airport and walk around.  We arrived in DC hot, tired and without 1 of my bags Of course the 1 with my clothes in it and a big presentation to the high ups in USAID scheduled for Tuesday. I borrowed/bought /
clothes and we all got prepared. The security at USAID, the Ronald Regan building, was heavy, about the same as the US Embassy in Kampala.
     We finally got to the room, I got out my flash-drive out with my presentation on it and…….the room we were in, in the largest government building in the US, began to sway. The strongest earthquake in decades made the floor suddenly move. So we all evacuated the building and spent 1-2 hours in a small park close to the building and then were allowed to return to the building for 45 minutes to pick up our things and then went back to the PHI offices several blocks away. I’m glad I hadn’t put a lot of time into my presentation as I would have felt really bad. Oh well we ate well that night!

Kampala street, last day in Uganda



Sustainable Livlihood Program



Sustainable Livlihood Program

Saying goodbye to Patience

New Hairdo, Uganda style

visiting Santa Fe  Steve, Anita, Sharada, Anjali , and Anjali's partner, Noah

Wedding reception

I had an uneventfull trip back to Albuquerque and a great time with my family last weekend at a wedding of a family friend.  Here are some pictures of my last days in Kamplala and my first days home.  This is my last blog for this trip.  I hope you have had a good time reading about an experience that I'll never forget.   Love  Anita 

Last 2 weeks

 Well it's less than a week until we leave.  I can't believe it!  It seems like we just got here in some ways.  I do however miss Steve so part of me wants to go back strongly.  If he could just come here I'd be one happy camper.  At least for a few more months.  At some point I think I'd miss home.  Living in another culture is just so interesting.  I know, I know it's also confusing, frustrating, stressful etc etc.  I could look back in this blog and know it's not always easy.  I'm am truly appreciating the experience in a totally positive way becasue it's almost over.  I know though I'll always appreciate the experience as positive just maybe not 100% fun.  some of it has been hard work.  It fact I got tired enough that I got a nice cold.  Not anything serious but it seriously slowed me down for a few days.  I'm been off from work for Friday, Monday and Tuesday.  Tomorrow I head back.  I'm glad because I want to hang out with those people I put pictures up of last week.  They are amazingly nice people and I am going to miss hanging out with them and feeling part of the staff.  When I went to a program at an orphanage last week and the Medical Coordinator asked the staff to stand.  Then she introduced me as a volunteer from the States and I squawked.  In front of everyone I said loudly and indignantly, "No, I'm staff now,"
We went to an orphanage because the caretakers wanted the entire orphanage to be tested.  I spoke about this trip in my last blog but it was so memorable I will put up a few more pictures

 I also took some video of the kids and have other videos of the same "teen show" the drama group did here and at another place Plus some other videos of kids and gorillas.  Liz, another intern with a great deal more expertise in computer editing edited them for me and our joint product can be viewed at:
http://www.youtube.com/user/edaube1?feature=mhsn
Be sure on the right hand side of the screen to click on "see all" as there are 9 videos and I took most of them.  A couple are Liz's from her digital camera but even for those I was present so it's all stuff that I've experienced.  Pretty cool.  I'm glad Liz could do that.  I can point and shoot a camera but after that...........well it just sat on the camera till Liz did something with it.

Another interesting thing I've done recently is home based HIV Counseling and Testing.  I've never done it before becasue the counselor ususally goes out on a motor bike and with all the stuff needed there is no room for me on the back.  This time it was a big enough HBHCT that we took a car. We went to 2 homes and they were quite different.  They were both rural but 1 was a tiny falling down house which 8 people lived in.  I don’t know how they all slept inside.  Maybe some of them slept on the porch.  Very, very poor folks, very dirty, as was the home the grounds etc.  One of the counselors tried to tell me that it was a hard life but that they were happy because they didn’t know anything else.  I didn’t buy it for a minute.  I told him that they had eyes and could see their neighbors who had a lot more and TVs in the village and it was human nature to desire more when you didn’t even have the basics.  He had to agree, though he might be right that this particular family was not actively unhappy.  Neither he or I had a right to judge that.  They had food and shelter of a sort.  Anyhow, with kids and brothers and cousins we did 8 tests all which were negative. 

Here are a few pics.  This family strongly desired their pictures taken.  I had to take pictures of absolutely everyone which was great cause then I could take pictures of the lifestyle without making them feel exposed

            Then we went to another area which was a large compound with several families.  Still rural, still poor, but much cleaner and it felt much less squalid.  We did 32 tests among several families and 2 the middle aged men were positive.  People here are so quiet.  I have never knowingly seen someone get a positive result though it happened 2 times that afternoon.  I don’t see clients here react in the way I have seen people react to bad news in the States, and this is very bad news.  Some of the reason is the language barrier as noted before but I think the counselors are very good at creating a private confidential space without being obvious.  We must have had about 50 people around us watching with the 32 standing in line to get tested and all of them hanging around until we left.  I’m not sure how they create the space in the middle of circus atmosphere that happens in a village when TASO shows up, especially TASO with a Muzungo (me).  I am definitely a big draw in rural areas.  Here are some pictures at the start of the event.  It just got bigger but by then I was working.  Take care  Love  Anita

So here are some of the people I work with at TASO

 The first picture is Patience who is my day to day boss and the Assistant Counseling Coordinator, and standing next to her his David who is HR.  Next is Robert who is my next level boss (the Counseling Coordinator) talking politics to Charles from the Drama Group.

This is Godfrey a counselor talking to a client.

 This is Harriet. She is a patient advocate and runs the HIV+ Widows Craft Cooperative.

The first picture is Sarah and Nora both counselors and the next is Paul who is a counselor and also runs the Sustainable Livelihood Program.

This is Dr Christian in black who is the Medical Coordinator and Rebecca, another counselor.

Last in Essau, another counselor, conducting an educational session with adolescent boys

And last a very crowded van with 15 of us coming home from an outreach clinic.  Just behind me is Dr Ali the Field Supervisor and a very big- hearted, caring man.

I'm trying to get pictures of everyone I work with and putting them up here makes me realize how many more I have to go.  I believe there are 16 counselors!
One of the things we did this week was to go to an orphanage.  We tested all the children and some of the staff, about 80 people.  Because of transportation issues we had to use one van to take a large number of people so the van made 2 trips.  I was in the fist run and while we were waiting the children performed for us!  I'm going to put up a few pictures which may give you some idea how fun it was to watch.  The kids were all ages from just walking to 19 and they sang many songs which you can't tell from the pictures and performed many different types of dances from very traditional Buganda tribal dances to break dancing.  It was great.

     So I thought I'd start this blog with a view of the taxi park.  All those small white things are the minibuses we take most days to and from work.  We take one from the hotel to these steps then walk down into that mess to find a 2nd one to take to work and do the same in reverse in the evening.  It's a madhouse down in the park so it's always interesting finding our minibus.
     Next I thought I'd show you some pictures of an outreach clinic I went to on Monday in a small town called Semuto which is about 60 Km from Kampala.  To begin with here are some of us crammed into a TASO van which we ride to all the outreach areas.  Next is a picture of Mathias, a counselor, with a group counseling session in the back of the building, which we borrow from the community health center, and set up under the trees.  Counseling and medical care takes place under these big trees and inside the building we set up a pharmacy and a small lab.

TASO STAFF IN THE VAN



Mathias and a group of clients in a counseling session



Medical staff at the tables with clients sitting in front waiting to be seen

In the pharmacy drugs are handed out through the front window

This is the traveling pharmacy set up in the building

This is the lab

And here is our van at the front of the building which we use

I won't do much of a narrative this week.  I want to show you what I did this weekend which was a trip to Murchinson Falls which included a rhinoceros sanctuary, a jeep safari, a boat ride on the Nile, a climb up the path beside the falls to the top, and chimpanzee tracking.  This was all done in 3 days so lots of activity.

The chimpanzees were very hard to photograph as they kept moving away from us either in distance or in height!  They were pretty amazing to watch as they mostly played and ate in the trees above us.  That's it for now  I love you   Anita