Life in Uganda

My first week felt full, warm and welcoming by people and climate, and tiring, so I was relieved it was a Public Holiday on the Thursday (May 12th) - announced, well, confirmed only a couple of days earlier ... to celebrate the swearing in ceremony of President Museveni. Here, the majority of Ugandans I talk with are ok with his re-election ... Goodluck John, the Nigerian President arrived along with several others on the Wednesday night.  I was out with some new friends to celebrate Joan's 50th birthday when several times our conversation was interrupted by the sounds of heavy armoured vehicles going up Gaba Road accompanying the various Presidents and dignitaries to the Speke Resort where they stay.  No one seems fazed and we carried on eating lovely french food.

I met the Board of Directors (we would call them trustees) on the Friday and they too welcomed me, and the work begins!  To give a sense of my location, here is hospice in Makkindye and my office ... everyone is keen to see my 'family' on the wall of my office and I like the feeling of introducing the Oasis 'family' to the Hospice Africa Uganda 'family'. I feel at home already and blessed to have this opportunity to make a contribution here.



This is Merriman House - housing the International Programme



My office - with all that tecnology you'd think it'd be easy to communicate :^) !



The new building ahead houses the clinical department and administration

We are coming into the dry season but still have rain and thunderstorms at night ... the sunrises are awesome just now ...

Uganda - location and some key issues

Just to locate where I am, Uganda is part of East Africa, a land-locked country, that has been called 'the pearl of Africa' for good reason with its welcoming peoples and largely fertile lands.  Lake Victoria, to the south of Uganda is the size of Wales, which puts its size in context. 

It has the second highest rate of growth in population in the world at the moment (3.3%) with 50% of the population being under 15 years of age and the population doubling every 20 years. So it is no surprise that much of the forthcoming development money is going into family planning, maternal and child health, and alongside is a focus on agriculture; coffee, maize and beans being of key importance.  Climate change is taking its toll with less predictability in the rainy seasons with its knock on effects on production and every step of the supply chain.

The prevalence of HIV/AIDS has reduced from about 30% in the early 1990's to between 6-7% due to President Museveni being willing early on to acknowledge the condition, seek international help, and develop an Emergency Plan to tackle the issues it has brought.  Still, about 80,000 people die from AIDS each year and the ART is not accessible to all, and for those who can access it, there is not a consistent supply as yet.

As people live longer with HIV and AIDS here, HIV-related cancer rates are increasing, as are particular kinds of cancer in the general population.  Due to the lower standards of health care here, people suffer greatly from the tumours and the open wounds that often develop when there is no treatment and of course, incredible levels of pain then are experienced. Uganda was the third African country to change legislation to allow oral morphine to be used which is the cornerstone of palliative care in Africa - attention to pain and symptom control allows holistic care into people's lives at a personal level as the levels of pain otherwise severely limits the ability to have any quality of life.

As you can imagine, and it may be coming over, I am in a steep learning curve about palliative care in Africa and in Uganda particularly.  Uganda is seen as leading in mainstreaming palliative care and yet, even here, there is a long, long way to go.

The other key development is that Uganda has oil reserves, and a lot .. . 2.5 billion barrels.  Exploration actually started in the 1920's.  55 wells have been drilled.  26 developed into exploratory wells with only 4 having no oil. Tullow Oil, originating as an Irish company has been exploring oil and it expecting to start bringing oil to the surface later this year but production on any scale is estimated to start in 2015.  There is much excitment and almost as much concern in relation to the potential riches the oil may bring.  The legal framework is poor and resources for Uganda will most likely come from the processing of crude oil.  A baseline assessment of the environment is needed urgently.         

Arriving in Uganda

I arrived via Rwanda ... a touch down and pick up stop in Kigali ...and back up and across a little to Entebbe arriving late Sunday evening.  Every time I visit there are new developments - no more walking across the tarmac, the terminal has been upgraded and we stayed 'inside' the whole way ... I was pinching myself, I am really here, to work here for 13 months, with an organisation I admire and respect the achievements of?  So, once my visa was sorted, and luggage was collected, I was free to walk through customs and be greeted by the heat of the night and the smells and sounds that are so uniqely Ugandan. 

John, the Head Driver and Betty, my PA (shared with Dr Anne) were there to warmly welcome me.  They shared news on the way - everyone eagerly waiting to greet me ... we would have to be careful on the roads the next morning as it was a 'walk to work' day - a protest at lack of action by the government on rising fuel prices and inflation - at least the security forces had calmed down and were hosing people rather than using rubber bullets and tear gas ... inflation is definately with some staples having doubled in price since January.

I stayed my first night at Dr Anne's home - she is the founder of Hospice Africa Uganda (her book 'Audacity to Love' is well worth reading to get a feel for the effort, stamina, and love it takes to establish such an organistion).  There are additions to Anne's home since I last visited, both in pets ... cats and dogs and children, Hannah and Ryan.

The next day is my first day at Hospice ... and as well as being welcomed by the whole 'hospice team' at prayers where we start the day with a hymn, a blessing and announcements, a rainbow greeted us ... as we dispersed for the day ahead. 

It is a couple of days of meeting many old friends and meeting new 'team' members ... and mixing of names and faces, although there are several Harriet's and Rosemary's and Godfrey's which helps me out a bit!  And Betty briefs me on administrative matters.

Betty and Zena

The day passes quickly and I'm taken to my apartment which feels indulgent to live in, yet at the same time, it is a lovely place to retreat to after the long day.  And I am grateful to be able to focus on the hospice durung the day, and simpy return home in the evenings.



Lovely ground floor apartment



my verandah!



view from apartment

Getting to Uganda

Clare and Zena

Getting to Uganda felt like a whirlwind in May with so many aspects of life to consider - the last couple of weeks were somewhat surreal as I said 'farewell' to many people in many places ... and belatedly realised there were people I feel close to ... who didn't even get a farewell from me! 

From first being asked if I would consider being the Chief Executive Director by a dear friend who introduced me to Hospice Africa Uganda 12 years ago; to my colleagues and friends at Oasis, who, realising I would not think it were possible myself, said to me 'consider this opportunity'; to my wonderful, transformative trip around the world in January 2011; to an interview in Kampala in March with the Board of Hospice Africa Uganda; to marking the year 's anniversary since Bryce died and the challenges lived through that year; and to then, before I knew it, being on my way...felt incredibly fast - like the white water rafting experience I literally had on my first visit back to Uganda in 1998 ... what an opening chapter of this new phase of my life.

A lovely surprise was created for me in the few days before I left, with colleagues arriving for lunch and a group photo taken to mark the occasion - it was very special ... and you'll see it later! 



Mike, Zena, Tony

 And managing to have time with both my brothers is a rare treat ...