Category Archives: Uganda

Living the best day ever

This is a cross-post of an article that I wrote for the Africa edition of ehospice news reflecting on the lessons learnt from Hendri Coetzee’s book ‘Living the best day ever’. 

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Palliative care, by definition, is both a science and an art form that involves accepting the reality of death. What you have left when you accept this is what the profession calls ‘preserving or improving the quality of life’.

Never before though, have I been challenged to re-examine the concept of ‘quality of life’ than when reading Hendri Coetzee’s book: ‘Living the best day ever’.

Hendri Coetzee was a South African living in Uganda perpetually searching for the best day ever. This search led him to become a legend throughout the extreme sports and exploration world.

In 2004 Hendri led the first ever complete descent of River Nile from source (Lake Victoria) to sea (the Mediterranean). The 4,160 mile trip took four and a half months and crossed two war zones.

Coetzee was also the first person to run the rapids above the Nile’s Murchison Falls, a section of river filled with some of the biggest white water in the world, and holding one of the highest concentrations of crocodiles and hippos.

He would go on to complete this section of river a further seven times and he remains the only person ever to run the section by himself. He also ran large sections of the upper and lower Congo River, walked 1000 miles along the Tanzanian coast and was the first person ever to snowboard the glaciers in the Ruwenzori Mountains.

In short, his résumé was one of the most impressive in the business.

It was not, however, his outlandish adventures that makes Coetzee’s book such a challenge for anyone to read, but his burning passion for life. Deep within all of his adventures was an intertwined journey to accept the fullness of life – to be able to appreciate it to its full. Only by understanding and ultimately accepting one’s death, Coetzee believed, can we truly experience a ‘quality of life’.

Speaking to some, and by no means all, palliative care patients I have come across a stillness – a deeper happiness – that I have rarely seen elsewhere. It is a happiness that comes fundamentally from within, a spiritual or psychological wellbeing.

Does this come from an acceptance of one’s own death?

Early on in the book, when undertaking the Murchison Falls section of white water, Coetzee writes: “In our society we avoid the thought of death as if recognition alone could trigger the event. Thinking about your own death is seen as a sign that mentally, all is not well. Some people live their entire lives with the sole purpose of minimising the chances of it occurring to them, instead of preparing for the inevitable. After avoiding the issue for so long, it is almost soothing to invite death on my terms.”

Reflecting on this, I wonder how many palliative care practitioners spend their professional hours encouraging patients to think about their deaths, to make preparations and to become comfortable with the idea whilst then perpetuating the myth in their own lives that life is infinite?

I only speak for myself when I write that I am too often guilty of this self-delusion.

To live a truly high ‘quality of life’ do we have to be comfortable with the idea of our death? I don’t know.

For Coetzee though, this acceptance was clearly linked to the life he chose to lead. Writing about his desire to keep going on clearly dangerous expeditions he wrote: “Psychoanalysts may diagnose a death wish, but missions like these enhance the appreciation of life. It is no coincidence that death and rebirth are related in all forms of religion and spirituality. When you accept that you are going to die, and it will be sooner than you think, it becomes impossible to merely go through the motions.”

Even the acceptance of my own inevitable death cannot push me to actions that so invite the prospect of death earlier than it otherwise would arrive. There is too much to live for to put my life on the line in search of living just that one day to the extreme – in the search for the best day ever.

That said, it is imperative for the palliative care community to understand the full spectrum of thought that exists out there. Just as there are people who are terrified of the concept of their own passing so there are people like Coetzee that can write the following words:

“Death is coming for us all…the day we will have to face the crossing will come sooner than we think. I hope my day is many many years away, but… I don’t want to make the greatest leap in life in a vague dream. I want to have the chance to look it in the eye, to say: ‘You have had me in your sights all your life, but it’s on my terms that I come.’ Tibetans believe that one can find enlightenment at the moment of your death, as long as you prepared yourself for it during life…I have had the best day ever more times than I remember. So yes, I believe I am ready to die if that is what is needed to live as I want to.”

Hendri Coetzee was pulled from his kayak by a crocodile deep inside the Democratic Republic of the Congo and his body was never recovered.

At the end of his last ever blog entry though, after completing a section of river that many assumed impossible to kayak, he wrote: “We stood precariously on a unknown slope deep in the heart of Africa, for once my mind and heart agreed, I would never live a better day.”

I have no idea if – when it came – Hendri Coetzee was prepared for his death. It is clear though, that he lived life to the full and died in way he had to have expected.

Not many of us can say that and for that alone ‘Living the best day ever’ is worth reading. I think we can all learn something from Hendri Coetzee approach to both life and death.

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Does drinking urine cure joint pains?

Hynd’s Blog reported before on how Uganda’s New Vision asked the question – ‘Is Panadol made from dead people’s brains‘.

Not to be outdone the Daily Monitor – the main rival paper to the New Vision – today asked – ‘Does drinking urine cure joint pains?’

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After offering a slightly cyptic answer which included the phrase,  “People have eaten cattle hooves for backache” the article does finish with the relieving (geddit) suggestion:

“Please seek medical treatment for your knees instead of contemplating drinking a waste”

Once again, a hat tip for some wonderfully obscure journalism.

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On international media representation of Uganda

The international media today picked up comments from Uganda’s President, Yoweri Museveni, saying that Uganda’s tourism industry should rival that of Spain’s.

His comments, made in Uganda’s ‘New Vision’ newspaper were then picked up by Agence France-Presse (AFP) and published in global news platforms such as The Guardian.

After reading The Guardian article I did something I very rarely do – I read the comments section.

The first comment came from one Herman Lategan and said:

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Other early commenters followed a similar theme in their comments:

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Whilst I find the hateful and widely misinterpreted rhetoric of anti-homosexuality in Uganda deeply worrying I equally find it sad to see a country lumped with such a characteristic as its one defining feature.

Equally, I am not convinced that by choosing to not visit Uganda (let alone leaving comments under Guardian articles) you are doing anything to help alter this hateful and misunderstood rhetoric that is a much larger than just Uganda.

What I do know though is that Uganda faces a huge image problem in ‘the west’ and these comments, at least in part, are a symptom of this.

This image problem is one exasperated by painfully fictitious portrayals in the media such as the one in Series 2 of the Newsroom that I have just finished watching (other than the lyrics of Band Aid 30 I struggle to think of anything recent that is so crass).

Or, closer to home, try searching Uganda on the Guardian’s home page. All you will find are articles about the anti-homosexuality bill, the hunt for war-lord Josef Kony or bizarre novelty pieces quoting some supposedly hilarious thing an official once said.

Whilst all legitimate issues to cover they are, by themselves, playing into a mainly false perception of what Uganda is like.

In short, it’s crass, it’s unhelpful and it represents a form of low level journalism that I dislike. And importantly it’s all people in the UK (my home country, the place I love most), hears about Uganda (my home, the place that is pushing for that top spot in my heart).  

I find that really fucking sad.

I was about to write something along those lines in the comments section when this well-intentioned comment, one which many in Uganda would see as a balanced response but many in the UK will read like trolling, popped up.

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I wasn’t sure I had the stomach to ever enter into the comments section of The Guardian let alone on a subject like this and so I headed back here to the safe shores of Hynd’s Blog.

Sane and respectful comments welcomed!

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70 years of mountaineering in Uganda

An edited version of this article was published in Saturday’s Daily Monitor – Uganda’s best selling independent newspaper. 

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As the late afternoon mist draws down the valley the spectacular peaks of the Rwenzori mountain range are left tantalising exposed, reaching high up into the bright warm sky. The image of snow packed glaciers glistening on rocky mountain tops so close to the equator is one of the many wonders of mountaineering in Uganda and is cherished by those lucky enough to witness it.

Standing atop these majestic snow covered peaks is an experience that only a few have managed and perhaps, due to melting glaciers, only a few more will have the chance to see. Many perceive these peaks as too cold, dangerous or difficult to reach, but since its inception in 1945 the Mountain Club of Uganda (MCU) has been accessing and documenting the foothills and the peaks of this magnificent mountain range.

Soon to celebrate its 70th birthday, the MCU has undertaken renewed efforts to expand the Club and to fulfil its core mission: to encourage everyone in Uganda to enjoy, explore and celebrate the outstanding natural beauty that Uganda has been blessed with. This inevitably includes the mountaineering jewel – the range of the Rwenzori Mountains, but goes beyond this to cover all areas of the country.

Charlie Langan, the current President of MCU, talks keenly of the diversity of mountaineering in Uganda, saying, “Although the Rwenzoris provide an impressive challenge for anyone, Uganda has so much more to offer. From the hills of Agoro in the north, to the spectacular peaks of the Virungas in the south west, from the crater lakes of Fort Portal in the west to the peaks of Kadam and Napak in the East, Uganda has something for any level of fitness, enthusiasm and experience. At MCU we are here to help people get out and enjoy the outdoors in this incredible country.”

The MCU was first founded in the Geography Room in another of Uganda’s long standing institutions, Makerere University in Kampala.  The Club was originally founded as the Uganda section of the East African Mountain Club by Rene Bere along with students and lecturers but soon developed into the ‘Mountain Club of Uganda’ – a name that it still proudly bears today.

Indeed, it was in these early years that the MCU laid down the foundations for mountaineering in the country. Deo Lubega, the Club’s Patron who has been active in MCU for over 25 years, reminds newer Club members that it was the MCU who between 1949 and 1958 built a circuit of six huts on the Rwenzori Mountains as well as a hut on Mount Elgon and on Mount Muhavura. At the time the Club was dominated by expatriates but very early on decided to offer training for interested Bakonjo porters to offer formal porterage services on the Rwenzoris as an alternative source of income.

As such in 1960 Timothy Bazarrabusa became the first Ugandan to climb Margherita peak, 5,109m above sea level – the highest point in the Rwenzori range and Uganda. Bazarabusa went on to become the President of MCU and later its Patron and a key advocate for mountaineering in Uganda.

In 1972 MCU Presidents Henry Osmaston and David Pasteur published the “Guide to the Rwenzori’s”- a definitive guide to the range and its history and peoples. Along with Andrew Stuart and James Lang-Brown, these were some of the key figures in the history of mountaineering in Uganda who have documented and explored the mountain areas of Uganda.

Since that time the Club has held a commendable but somewhat discontinuous existence, due to political instability and restricted access to the mountains due to civil unrest. Today, as the MCU turns 70 it continues to build on its proud history and to open its doors to members old and new.

Langan, the current MCU President, commented, “In the last few years the Club has grown from a handful of people interested in mountaineering to a vibrant and diverse community of people eager to enjoy the outdoors. We have spread beyond simply walking and climbing and now regularly kayak on the river Nile, mountain bike through forests and villages and of course, meet up regularly to socialise with like minded friends.”

This ethos of encouraging others to enjoy the outdoors has also driven the Club to try and document the potential for climbing, walking and other activities in Uganda. Just as the Club proudly published a ‘Guide to Rock Climbing’ in 1963, so the Club is today editing the final draft of an updated guide to encourage others with a sense of adventure to leave the comfort of Kampala to head out and explore the extraordinary outdoor environment that Uganda has to offer.

More information:

Web: www.mcu.ug
Facebook: www.facebook.com/groups/mountainclubofuganda
Regular events: http://www.mcu.ug/?page_id=19

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Some reflections on learning to kayak on the River Nile

Paddling past 'The Bad Place' on the River Nile

Paddling past ‘The Bad Place’ on the River Nile

I have always loved the outdoors and growing up I occasionally ventured out onto the flat waters of the River Wye, close to my parent’s house in the UK, to do some paddling with my local scout group.

As much as enjoyed these ventures out into the pleasant surroundings of the Wye valley, kayaking remained for me a sport that failed to conjure the passion or excitement of other sports I loved in my teenage years such as mountaineering, football or skiing.

When I moved to Uganda then, it took me almost a whole year until I was persuaded by friends into trying my hand at white-water kayaking on the River Nile.

In retrospect my biggest regret is that I waited this long to try it. Equally though, it was far from love at first sight, or perhaps a more appropriate axiom, all plain sailing from the start.

Getting off the water at the end of the first lesson I knew that a seed had been planted that had the potential to grow into a real passion. I made a conscious choice, despite feeling apprehensive, to give this seed the best chance possible to grow and booked myself onto an additional four lessons with the kayak school ‘Kayak the Nile’.

At that stage, I can remember distinctly feeling that my enthusiasm for kayaking could go either way. As much as I enjoyed the adrenalin of kayaking my first rapid, I also remember a few hours earlier the less pleasurable spluttering for air as I first attempted an upside-down ‘t-rescue’.

Looking back on the last 10 months of padding, I can see though that it was as much the spluttering for air moments, the times I had to work hard, to persevere at practicing skills as it was the exciting splashing down rapids that have helped grow my initial excitement into a real passion.

The hours I spent alone in mate’s swimming pools practising, sometimes successfully and sometimes not, my flat-water role and the sense of achievement at now rolling in (quite) big white-water stands as just one illustration of this.

Unlike some friends that I see now out on the water I don’t feel like kayaking came naturally to me. It took me a bit longer than what I have observed to be ‘normal’ to start feeling relaxed out on the water and especially upside-down.

Even now, 10 months after starting this sport, I still feel panicked when I move into territories that are new to me. Just last weekend I went to surf a wave that was much larger than I was used to and this filled me with an apprehension that, at least in part, dictated how I kayaked on the wave.

It only seems fair at this point to give a virtual hat-tip to the instructors of ‘Kayak the Nile’ who seemed to instinctively know that when I said my goal was to ‘feel in control on the wave’ I was not just referring to the physical challenge of staying up-right but the psychological one of staying relaxed and confident.

Without the careful and consistent guidance of the instructors I am convinced that my seedling of passion planted on that first lesson could easily have been flushed away at any moment.

For as much as I am grateful to the instructors though it is an interesting reflection to note that learning to kayak is also a lot about learning to understand and control yourself. It is not just about taught new skills.

It might sound like an exaggeration to say kayaking teaches you to ‘learn about yourself’ but from a personal experience I can say that one of the most rewarding parts of learning to kayak has been the journey of learning to stay psychologically more in control (for I still don’t feel 100% in control) out on the water.

My passion for kayaking on the Nile though goes beyond all of this.

There is something really profoundly special about being about being on such a huge powerful expanse of water.

Out the Nile I feel something comparable to how I do in large mountain ranges. I feel a sense of my own size and vulnerability in the grand scheme of nature, I feel a sense of wonder at the amazing beauty that surrounds me and a sense of profound appreciation that I am lucky enough to have experienced it.

Even the experience of being near the Nile the night before feels magical. I love waking up after camping on the banks of Nile to see the strong sunlight breaking through the trees with the sort of intensity you only really get on the equator. I love lying in my tent hearing the powerful sound of the water in the rapids carving itself through the rocks in the Nile. I love the, admittedly quite hippy, idea that kayaking is about harnessing the amazing power of nature and working with it.

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Most of all though I think enjoy sharing this passion with people. I love seeing friends do their first lesson, first roll, or first trick on a wave. I love watching those with less experience than me and seeing them progress as much as I love watching those with far more experience than me and feeling that mixture of aspiration and dread about what I might, or might not, be able to achieve in the future.

When I move away from the paddler’s paradise of the River Nile I have no idea if this passion will stay with me but I do know that at this moment I really hope it does.

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My guide on how not to prepare and run a half marathon

In pain after my latest 21km of badly prepared for running

In pain after my latest 21km of badly prepared for running

‘A specialist in failure’ is how would so far sum up my running career. Three half marathons spread over 5 years and each one has, in its own way been a gigantic disaster.

Firstly my running history…

At the 2009 Brussel’s half marathon I undertook some serious training and at the nimble age of 23 I thought I might have a good chance of running it in a half decent time. I have since learnt that pints of gin and tonics the night before are not the best preparation for a 21km run.

Despite the hangover I stumbled round the course in 2:10.

Of course, the 2009 Brussel’s half marathon was meant as a warm up 5 weeks before the Stroud half marathon in the UK. Sadly, after literally stumbling over the finish line in Brussels and then starting a new job, my training schedule essentially ceased to exist.  I stopped running.

Again, I have since learnt that doing no exercise 5 weeks before a 21km is not such a good idea. However, hangover free and with a good night’s sleep behind me I managed to cut 10 minutes off my time and sneaked in just under 2 hours (notably 7 minutes slower that my to be father in law who is in his 50s and was running his first half marathon at the time).

On this latter occasion though I was running to raise some money for CLIC Sargent – an organisation that provides care for young people with cancer. So the money raised for a good cause provided a nice silver lining in Stroud.

For the last 5 years though I have dwelled slightly on these two relative failure of runs and always thought that I could, if I avoided being drunk and kept to a training schedule, manage to run a half marathon in a way that I was proud.

And so, 5 weeks ago I decided to sign up for the ‘Run for Fun’ race between Entebbe and Kampala here in Uganda.

I haven’t really run (let alone for fun) since 2009 and so the observant amongst you might have spotted a flaw already – 5 weeks really is not long enough to prepare for a half marathon.

However what I lacked in time, fitness and basic training I made up for in optimism. I not only signed up but also decided to start fundraising for the ‘The African Palliative Care Association’ (see ‘Why I am running for APCA’).

The problem with fundraising for a great cause is that it means you have to go public – you have to share your fundraising page on facebook, twitter and your blog etc. In other words, in my mind at least, there was no backing out.

2 weeks into my inadequate 5 week training I hit a rather painful stumbling block. Once again alcohol was at the root of the problem. Rather drunkenly on a Friday night I fell off the top of a moving Land Rover (spare me the ‘it could have been a lot worse’ comments, I quite realize this).

Luckily I did nothing more than land heavily on my bum – although it could have indeed been a lot worse.

This little alcohol induced stumble though did cause a lot of swelling all round my hip which took about 2 weeks to go down and left all of my muscles feeling rather tight.

For the last week before the date of the half marathon then I did not (could not) run. All I could do was a lot of stretching.

By the time the run came about my leg was feeling ‘OK’ with the exception of my groin that was still feeling tight on my right side.

In retrospect I had my doubts but spurred on my fiancé who was also running and who had also missed weeks of training due to a throat infection I thought I would ‘give it a go’ on the basis I could always stop if it started to really hurt.

16.5km and 1:45 into the race I was a feeling a bit tired but generally OK before sharp pains started shooting all down my left leg. This resulted in me limping the last 5km over a 45 min period brining me over the finish line at around 2:29.

To say that it was hurting at the end is an understatement (see above photographic evidence of me just over the finish line). This was, by far, the most pain I have been in after a half marathon! I guess not too surprisingly.

Despite this third failure our fundraising efforts once again provide the silver lining. 22 people donated a total of £332.69 to the African Palliative Care Association (You can still donate to this exceptionally good cause by clicking here).

So thank you to each and every one of you who donated!

And there it is, my running career, how I am slowly becoming a ‘specialist in failure’ and a few hints and tips on how not to prepare for an run a half marathon!

The only question remaining is…have I got one more in me? Will I manage to run a half marathon, sober, fit and well prepared?

Maybe.

 

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Stroud News and Journal: ‘Couple to embark on gruelling charity run’

This is from last week’s Stroud News and Journal about my up-coming charity run aiming to raise money and awareness of the African Palliative Care Association.

It is not too late to sponsor us – just click here

Click on the article to enlarge:

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Thanks to the SNJ for their support!

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Why I will be running for the African Palliative Care Association

APCA_logo final_NEW STRAPIt is important to state from the start, I don’t like running and nor am I any good at it. You would be right then to comment that it seems just a smidgen odd to decide to run 21 kilometres, out of my own free will, however good a cause it is for.

Well let me assure you that it is for an exceptionally good cause. I am fundraising for the African Palliative Care Association (APCA). APCA has been my employer now for the last 18 months. I am not too proud to say though that when I started working for them I knew little about palliative care – let alone palliative care in Africa.

I guess I was a little naive but I never expected the raw reality that I was met with on day one of my job. Literally millions of people suffering the most debilitating of pain because they don’t even have access to basic elements of palliative care such as access to pain medication.

I started to grasp the magnitude of what this actually meant when I went with staff from Hospice Africa Uganda on home visits. I met patients and their family who benefited from having access to oral morphine and who had grappled back a sense of normality in their life.

I remember meeting Bruno on the outskirts of Kampala. I remember how he had said to me that “You cannot be happy to see your dad suffering”. But most of all, I remember how deeply sincere he was when he thanked the hospice staff for coming, for caring and for bringing his monthly does or oral morphine.

This realisation though of how important palliative care services are only truly sunk in when I met someone who, like most Ugandans, did not have access to this service.

That person asked me not to publish her name and I can understand why. She spent 6 months nursing her mother who died of cancer as the rest of the family refused to let her seek medical help because of the financial implications. She watched her mother everyday lie in bed unable to move because of the pain she was in. With tears in her eyes she said to me one of the most powerful sentences that I have ever heard: “When I die, I don’t want to go like that.”

This is what APCA campaigns for. To ensure that no-one in Africa dies without access to palliative care.

Over the last 18 months of working for APCA I have almost every day had a realisation of some sort. Sometimes it is still about how dire the situation is in many parts of Africa. Other times it is about these faceless numbers impact on people lives. But increasingly these realisations come through meeting the varied and wonderful volunteers and staff who working to change all this.

Because of a small band of committed people there are now policies, projects and pain killers popping up all over Africa. The staff and volunteers I have met have at times humbled me but more often than not, they have inspired me.

In South Africa the national association is supporting the training of traditional healers in palliative care. In Uganda they have been training journalists and editors. In Zambia they are engaging the HIV AIDS community. All people who used to see themselves as separate to palliative care all now working to ensure everyone has access to these services.

When the palliative care community reaches out – others cannot help but to respond seeking out what they can do, how they can contribute to helping to end this perfectly preventable humanitarian disaster of untreated pain.

It is a natural response that I too felt.

But what can I, as a non-medical professional, contribute? And that’s when it struck me that even if I was already over stretched professionally, I could always do something that anyone of us could do…run a half marathon to raise money and awareness for APCA’s work.

And so, not only do I want you, if you can afford to, donate to APCA through my ‘Just Giving’ page. I would also love you to help me raise awareness of palliative care in Africa. Can you share this article on facebook, visit APCA’s website, or share this video?

Together I know we can do this – there are already hundreds of talented wonderful people out there doing the most amazing work. It might not be obvious how you can help but believe me, just by reading this article you have taken your first step.

There is a long-way to go and my half-marathon is really just the first few steps but together we can make a real difference.

You don’t have to believe me, just go and listen to patients both with and without access to palliative care and you will soon see the difference it can make.

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Video: ‘This is Uganda’

There are lots of reasons why I love living in Uganda. Equally, it never ceases to frustrate me the distorted and perpetually negative way Uganda is so often portrayed in my home country of the UK.

It is partly because of this I wanted to share this video I have stumbled across. Not because it encapsulates ‘Uganda’ like the title suggests but because it gives just the smallest of glimpses of some of the many wonders that Uganda holds.

If nothing else I hope that it will entice more people by to come and see for themselves everything this place has to offer.

This is Uganda – 2014 from Anne und Björn Fotografie on Vimeo.

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Ice Bucket Challenge: Pour a bucket of water over my head? Not in Uganda I won’t

This is an article that I wrote for The Daily Telegraph about why I didn’t complete my ‘Ice Bucket Challenge’ but did make a donation to Water Aid. 

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You can read the whole article in The Daily Telegraph by clicking here

You can watch the video below

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3 steps to improving Uganda’s education system

This is an edited cross-post from Anya Whiteside’s blog.  

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Education in Uganda is in crisis. This is not an exaggeration, it is a fact. Out of all the children who start school in Uganda, only 33% complete primary education. This is compared to 84% in Kenya, 78% in Tanzania and 81% in Rwanda. In addition, many of the children who do remain in school are not learning. In fact, less than half of children in P6 reach the defined proficiency levels in numeracy and literacy.

I could continue with the facts – 1 in 20 children of school going age have never enrolled in school at all, 84% of teachers want to leave their jobs and on average teachers are absent from the classroom an equivalent of 2 days a week – I could go on but you get the picture.

Uganda has the second youngest population in the world, with 49% if the population under the age of 15. This crisis in education is their crisis, and it is a crisis for Uganda. Given all of this, I have inevitably spent a lot of my time here trying to work out why education in Uganda is in such a crisis and what could be done to improve the situation.

There are many, many answers to this question. I could talk about the drop in education funding – the dilapidated classrooms and shortage of textbooks. I could talk about the plight of Uganda’s teachers – badly paid, de-motivated, poorly supported and badly trained. I could talk about the failure of Universal Primary Education – free education in name only as children have to pay for textbooks and uniforms and parents have disengaged from a process they have been told is now the state’s responsibility. I could talk about corruption, inefficiency and the politicization of education funding. I could talk about all these things and more and they would be true. They all contribute to the problem.

Yet the thing that is continually baffling the Ministry of Education, NGOs and big donors in Uganda is what to do about it. Because time after time after time ‘interventions’ , ‘solutions’ and ‘projects’ have been designed to improve education here, but things do not seem to be getting significantly better – in fact if anything they are getting worse. Books have been provided, teachers have been trained, all manner of stakeholders have been ‘sensitised’ over and over again. Vast amounts of money have been thrown at improving education in Uganda, yet the system keeps spiralling out of control with a will of its own.

Despite all this, I cannot feel completely hopeless about it. You can never feel completely hopeless in Uganda – the vivacity, friendliness and strength of the Ugandan people forbids it. But I do feel that Ugandan children – from my grinning, squirming neighbours’ kids to the children exploding with excitement at the Mzungu passing by their village – deserve better. This is why I continue to battle to try and understand what ways forward there can be in this bubbling bureaucratic melting pot that is education in Uganda.

One necessary step is to look beyond the dilapidated classrooms, lack of books and fed up teachers to try to unpick some of the systematic and underlying causes of Uganda’s broken system. There needs to be a public debate in Uganda as to what these are and some hard choices may need to be made on prioritisation of funding – both how much should be allocated to education, and which parts of the education sector the money should go to.

One underlying issue that hits me in the face wherever I look is the lack of accountability and incentive from top to bottom in the education system. In the government education system here there seems to be little benefit in doing your job well and little consequence to doing it badly.

Teachers face an incredibly difficult job in Uganda and teaching has become the last option that people choose when they can’t get a job anywhere else. Add to that the fact that neither promotion or pay are linked to performance and very few teachers are held to account for what they do, and it is easier to understand why so many education interventions are failing. In this context providing new books, building beautiful spangly classrooms or telling communities they ‘really should send their children to school’ will have a limited impact. After all it is not ideal to teach children under a tree, but it is possible if you have a teacher who really wants to teach, and a system that supports that teacher to do so.

Instead I would argue that money could be best spent improving some of the broken systems at the heart of the education crisis in Uganda. There are three I suggest should be particularly prioritised:

  • Creating a functioning scheme of service that links teacher (and all education officials’) promotion to performance.
  • Overhauling the entire teacher payroll system so that teachers are paid on time and so-called ‘ghost teachers’ (those teachers who don’t exist but are on the payroll, meaning the money being paid to them is going somewhere else) are removed.
  • Investing in inspection and ensuring that the follow up is rigorous – no head teacher should be allowed to rape children because he is mates with the right people. This also means working on how to ensure the Directorate of Education Standards at central level and school inspectors at the District level can work together to ensure proper follow up and accountability.

These are not the only issues that need to be addressed in the education sector in Uganda, but from my time here I feel they are some of the central ones. Mending Uganda’s education systems will not be easy, but it is the only way that education in Uganda will be improved. Without political will and funding to do so, we will continue to see sticking plasters trying to mend a gaping wound.

More information:

(Steve adds) If you are interested in education in Uganda you might also be interested to read:

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2014 Banff Mountain Film Festival comes to Kampala

The Banff Mountain Film Festival World Tour is being held in Kampala Uganda at the National Theater on the evenings of the 2nd and 9th September 2014. The tour consists of an incredible collection of short adventure films from across the world.

You can buy your tickets from the theater box office.

Not convinced yet?

Check out this preview:

See you there!

BANFF

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Breaking: Uganda’s anti-homosexuality law null and void after Constitutional Court ruling

Breaking news: Uganda’s Constitutional Court has decided that the anti-homosexuality law is ‘null and void’.

The Constitutional Court found that the speaker of parliament acted illegally by moving ahead with a vote on the law despite at least three lawmakers objecting to a lack of quorum.

Despite this ruling, homosexuality remains illegal in Uganda as it does it most other African countries. Section 145 of Uganda’s Penal Code, which remains in force, continues to criminalize “carnal knowledge of any person against the order of nature”. The harsher penalties that were introduced under the 2014 legislation though such as life-imprisonment for ‘repeat offences’ no longer apply.

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Is Panadol made from dead people’s brains?

The answer is of course, no. Panadol is not made from dead people’s brains.

In case there was any doubt though the New Vision, Uganda’s largest national newspaper, helped clear this up for us today. This is from page 24:

panadol
Wonderfully obscure!

A hat tip to my friend Malcolm who spotted this. 

 

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Film showing in Kampala: The Last Yak Herder of Dhe

The Mountain Club of Uganda proudly presents:

TheLastYakHerderPosterYou can see a preview of the film here:

Join the film showing facebook event page here.

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A visit to Mulago Hospital in Kampala, Uganda

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As we enter the long corridor a strip light overhead flickers for a final few seconds before finally joining some of the other lights in the corridor that have long since given up and now do little more than collect dust. The few remaining lights throw strange long shadows down the corridor next to the wheeled beds that rest head to toe along the side of the corridor. It reminds me of the Kampala traffic jam that stacks up outside the hospital in the choking city heat.

No natural light makes it into the corridor but somehow the faint smell of congested traffic makes it up onto the third floor of Mulago Hospital to intermingle with the smell of humans and disinfectant. Avoiding the few harsh strip lights that still work, patients lie either in the shadow of their own headboards or with their thin sheets pulled over their heads.

As I walk down the corridor I step carefully over the relatives, water bottles, half eaten meals and other day to day items that are dotted across the floor. The patients rely on relatives for not just company but also for a lot of the day to day care they need. The smell as you pass some patients makes it abundantly clear that some patients are not receiving the care they need.

I glance sideways making small talk with my eyes to some of the patients whilst trying to keep moving on and keeping up with the representative of Hospice Africa Uganda who I am shadowing. Dressed in the dark blue shirt with a golden collar that marks her out as a member of the palliative care team my host takes large confident strides that exposes her familiarity with the surroundings.  She doesn’t look down as she steps over brothers, books and broken bits and pieces. Instead she angles her thick note book that she is carrying towards the strip light above and looks over notes of the patients she is there to visit.

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We push through some thick wooden swing doors on our left into a room that has one of the young patient we are there to visit as well half a dozen others. The patient we are visiting has terminal cancer and relies on the visits of the Hospice Africa team to bring oral morphine to help her with the considerable pain she would otherwise be in. My host from Hospice Africa Uganda goes straight to her bedside and lowers herself and her voice as she makes confident but kind eye contact with the patient. Speaking in the local language, Luganda, my host subconsciously runs her fingers over the shoulder of the patient as she speaks.

I am told that they ask how bad the patient’s pain is and decide that the current level of morphine is suitable. The sister of the patient, herself barely out of her teenage years, looks on with the juxtaposition of her own youth intermingled with the inevitable death that rests so close to her own, and her family’s, life. Looking as though she is unsure of her role in the nurse/patient dynamic that plays out in front of her the sister reconciles her position by just being physically close to her sister. Both protective and supportive she leans on the bed side throughout the consultation.

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Selfishly my thoughts drift as the Luganda speech drifts around me. I start to think about how if I was diagnosed with terminal cancer I would want to be free, bathed in natural light and surrounded by fresh air not stuck in a overcrowded hospital. Almost immediately I catch myself and realise how ridiculous this thought is – all across Uganda there are patients who are dying of cancer in natural sunlight, surrounded by fresh air with their families who are also in insufferable pain because they have no access to the medical support they need. The pain medication, oral morphine, which the hospice team was there to deliver is little more than an aspiration to most cancer patients in Uganda – let alone early diagnosis and treatment.

Just before we leave, a colleague from the US organisation ‘Treat the Pain’ asks if the patient would like a Polaroid picture with her sister. For the first time a flicker of excitement crosses the patient’s face and she shuffles a symbolic couple of centimetres up the bed for the photo. Together the two sisters sit with their heads pressed together watching as their own images slowly appears in the Polaroid picture.

As we stand to leave we collect up our belongings leaving nothing but the sister, the patient and the Polaroid picture behind.

Speaking later when we are far away from the cluttered dark corridors of Mulago I talk to my colleague from Treat the Pain and we both reflect on how the photo felt like a symbol of how little we could offer as non-medical staff in such situations. The stories we write, the advocacy we engage in, and people we interact with will hopefully change the lives of many more patients to come, but for that one girl and her sister we could offer nothing more than a Polaroid picture – it felt useless.

I know in both my heart and mind that it is important to record stories, to take down testimonies, to photograph suffering. I know it, but sometimes it is hard to feel it in the intensity of the personal suffering you have barged in on, especially when you can offer so little in return.

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Click to enlarge the photos.

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One novel way to avoid paying a bribe to traffic police in Uganda

I got that all too familiar feeling in the bottom of the stomach that I get when faced with confrontation with authority. A traffic policeman waved me into the side of the road with a stern, if slightly comic, reproachable look on his face. Walking calmly up to the car I can remember hearing the heavy clump of his standard issue boots on the hot cracking concrete as he approached my car window.

Sat looking forward through my dusty windscreen I prepared mentally for the relentless burst of enthusiasm that had served so well before in dealing with traffic policeman. I had of course not done anything wrong but I knew from experience this was not enough to avoid trouble.

I knew the drill. The best way to escape either an arbitrary fine (an offense in Uganda is ‘the inconsiderate use of the motor vechicle’) or in many ways worse, being forced into paying a bribe, was to speak in a friendly, informed and most importantly, relentless way.

From previous experience I knew the subject matter wasn’t important, and so I rehearsed in my head…The weather, wonderful. The place I am going, I heard it is magical. The place I have come from, even better. My friends first experience of Uganda, perfect!

The policeman leaned on the passenger’s window:

Traffic policeman: ‘How are you today?’

Just as I was about to launch into my boundless tirade of optimism my fiancé started speaking:

My fiancé: ‘Ahh, I am well ssebo (sir), how are you? Today is the perfect day for being in Uganda I think. You know ssebo, I love you Uganda so much. I love it so much that I have learnt the national anthem. Do you want to hear me sing it?’

She then breaks out into the national anthem. I sit and watch. I try not to smirk at the ludicrousness of the situation. Most of all though, I try to read the policeman’s face. Looking on I am caught in a mixture of apprehension to what the policeman’s reaction would be and, utter awe for my fiancé’s formidable friendliness.

Questions started to swim to the tune of national anthem in my head…Is this pushing it too far, to literally and totally inexplicably start singing the national anthem?

Of course not.

Within a few lines the policeman starts to join in. The contort reproachable burrows that were resting on his forehead relax and before long he is positively beaming as the two of them are singing in unison.

With a big smile on his face, the traffic policeman waved us off wishing us a good day in English to which we subconsciously respond in unison with the Luganda, ‘bera bulungi’ (good day!).

At this point I glance in my rear view mirror I can see the policeman taking the concept of jollity to a whole new level.

I can’t guarantee this approach works with all law enforcement officers, but on this occasion on this particular stretch of road in Uganda, it worked a treat!

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An atheist’s reflection on a prayer meeting

As a de-facto atheist people often assume that I might be troubled by being asked to attend or even take part in religious events. This is rarely the case and indeed I often find the opposite to be true. 

Today I attended a joint prayer meeting for palliative care practitioners from across Uganda who wanted to pray for the palliative care resolution that is currently going through the World Health Assembly. At the meeting I was asked as a representative of my work to read out a short prayer asking God to offer the decision makers wisdom and compassion.

Not only did I not mind this but in fact I found the whole event a real pleasure to attend. Let me explain why.

To start there was a wonderful feeling of unity at the meeting. This sense of ‘unity’ is what I chose to highlight when I wrote it up for ehospice news. It was also what I tried to capture in some of my photographs.

*Click to enlarge*

It was wonderful to watch how different organisations came together in a moment to share a common aim – the furthering of palliative care. It also got me thinking about the potential that faith has to break down hierarchy.

Uganda is incredibly hierarchical as a culture but in this short meeting the focus on the presumed ultimate leader (‘god’) broke down the created hierarchy.

It was both interesting and inspiring to watch.

So even being a hardened (and let’s be honest, argumentative) ‘de facto atheist’ I have to admit to finding this event not only a pleasure to attend but also pragmatically useful.

It brought people together in a powerful and profound way.

In my work, often with NGOs, I often stumble across stupid and badly thought out ideas. Some of them stem from a religious perspective but many don’t.

For as long as a religious meeting or belief system passes J.S Mill’s principle of harm test I cannot see any reason not to let people get on with it. And, in cases like today’s meeting, I cannot see any reason not to positively celebrate it.

Today’s prayer meeting not only passed J.S Mill’s ‘harm principle’ test with considerable ease, but it also I felt contributed something quite profound to the common good – a chance for colleagues and strangers to come together on an equal footing and to focus on what they have in common opposed to their differences.

 

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Watch the first of the Al Jazeera series on access to medical morphine

aljazeera011613I occasionally link here bits of my work with the African Palliative Care Association that I think could be interesting to a wider audience.

Here is a short Al Jazeera report on access to morphine in Uganda that I helped coordinate. It serves as a nice introduction to the subject that leaves millions suffering from perfectly preventable pain.

The film was shown on repeat last week. On Thursday they had our Executive Director, Dr Emmanuel Luyirika, on to speak about the subject. You can watch the interview here:

In Uganda, a regional leader in terms of medical morphine availability, only one in ten people who need medical morphine have access to it!

For more information:

Help out:

At the moment millions of Africans suffer terrible pain because they don’t have access to really basic pain medication that many people in Europe take for granted. If you feel like I do that no-one should be left to die in pain then please consider:

 

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I have malaria, but so did over 2 million others last year alone!

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Yesterday I found out that I have malaria. For those of you who haven’t had malaria before I can promise it is no fun. The symptoms come in waves but yesterday I took myself off for a blood test because I had a driving headache, aching bones and muscles, felt like I needed to vomit and was having hot and cold flushes all morning.

As I say, it is no fun.

Here in Uganda though malaria is an alarmingly common occurrence.  90% of the country is considered by the WHO to have ‘high transmission’ rates. This is partly explained because it is a tropical country with lots of Anopheles mosquitoes (who pass on the parasite when they bite you).

But there are also sociological factors. Anopheles mosquitoes predominantly bite humans at night. If you sleep under a mosquito net this massively reduces your chances of getting malaria. There is a big NGO drive in Uganda to distribute nets (and research suggests that most people who get them use them) but millions in Uganda still sleep without the nets.  Only a few stupid westerns actually chose to sleep, without a net, under the stars on top of a rock after a day’s rock climbing!

But this issue is not limited to Uganda, over half the world’s population live in areas at risk of malaria.

In 2012 the WHO recorded 207 million cases of malaria worldwide. Out of these 207 million, 627,000 died. Although the disease affects large parts of the world, the deaths caused by malaria are an overwhelmingly African issue. 90% of malaria deaths in 2012 occurred in Africa.  African children are especially at risk – 460,000 African children died before their fifth birthdays.

But this is the real travesty of the situation – malaria, with early diagnosis, is completely treatable.  With early diagnosis and a simple course of medication malaria is treatable and leaves the patient (normally) with no long-term effects.

Because I went to the hospital quickly and started my medication within a few days of showing symptoms, in all likelihood I should be back to my old self in the next 2 to 3 days. So for the friends and family reading this, I’m fine, you’ve got nothing to worry about!

And there is some more good news, since 2000, the WHO has recorded a drop in malaria fatalities in Africa by 49% – this is largely through greater prevention methods (such as net distribution).

Malaria is one of the big killers. In the 21st century it doesn’t have to be like that.

For more information:

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