Experiences from a Refugee Camp

Children at the Mutanda refugee camp just north of Bwindi Inpenetrable Forest.








One morning about two weeks ago Scott Kellermann walked into the guesthouse dining room and flipped my whole day upside down (as he so often does). He asked me if I was ready to visit the Congolese refugee camp about an hour and a half from here and test their water.

A little background on the refugees here: The war that has been raging in the Congo for the last ten years has seen some recent flare-ups. General Laurent Nkunda and his rebel group continue to attack the Congolese army and the Hutu militias that are holdouts from the Rwandan genocide. As is always the case war takes it’s greatest toll on the civilian population indigenous to the country. Both Nkunda’s forces as well as the Congolese army have been implicated in mass killings of civilians, raping, and looting in Eastern Congo. It is estimated that around 5 million people have died since 1998. For more information on the current crisis check out this link. (http://www.guardian.co.uk/world/2008/may/16/congo)

At present, fighting from Goma all along the Uganda border up to Rutshuru has sent eight hundred thousand refugees into Uganda. Uganda probably has the most advanced and efficient system for accepting refugees as they have sheltered refugees from Sudan, Congo, Rwanda, and even Kenya during the recent election violence. Most of the refugees are being taken to well prepared camps at locations inside the borders of Uganda however some remain nearby to the south of us in Kisoro and to the north near the small town of Kihihi.

My answer to Scott was ‘let’s go check it out.’ Scott, Richard Magezi, Dan Skeen, and I piled into the truck and headed out. After driving for about an hour to the small bustling town of Kihihi we veered off the main road down a rugged dirt track. We knew that we were on the right track because of the steady stream of land cruisers with UN emblems rolled by us. The steep hills characteristic of Southwestern Uganda quickly gave way to the Savanna Forest and warm temperatures of the Great Rift Valley. Suddenly there it was, 3000 dome shaped huts sitting about five hundred yards away from us in a massive field. The huts looked strangely like igloos because of their white coloring and I only later realized that these were white tarps wrapped around wood structures to keep out rain and reflect the suns rays. A line of people extended from the huts towards the water taps that had been set up. It’s hard to describe the feeling of seeing so many displaced people removed from their homes not by choice but by necessity to protect their children and loved ones.

Refugees collecting water with a backdrop of huts made from collected wood covered by standard issue tarps.

As we came closer to the camps one sight that struck me was the huge presence of the UN and NGO’s at the camp. Brand new Land Cruisers and off-road Toyota SUV’s crawled all over the perimeter roads of the camp. Workers wore shirts with their various NGO names printed on their shirts and hats. Names like UNICEF, OXFAM, Save the Children, Medicins Sans Frontiers and others all advertising for attention while providing services to the refugees. Trumping all others was a massive red banner with Save the Children Printed across it in white 8ft tall letters. It gave the camp an almost amusement park feel, that is until you looked deeper. Sitting nearby was a mountain of jerry cans wrapped in plastic and waiting to be handed out. Several hundred women with children on their arm or wrapped against their backs waited to receive their jerry can, blanket, and tarp. This was standard issue for every family at the camp. Also on site were 55 gallon drums welded together in order to support latrine holes. The sandy soil in the area was susceptible to collapse.

A mountain of jerry cans passed out to families to collect water at the refugee camp.

We linked up with MSF (Medicins Sans Frontiers) and found them to be very receptive to us… after we explained ourselves. MSF is a group of medical volunteers in charge of running the medical clinic for the camp. Scott was able to find out what medicines that the clinic was lacking and we took off to check out water sources with a Congolese volunteer named Matau. Because of a lack of coordination among the NGO’s MSF was stuck in a position to provide the water to the camp as well as medical attention to the refugees. We actually found the OXFAM guys still writing their budget for pipes for delivering water to the camp. With the help of local villagers Matau had located the largest spring that I have seen yet in all of my assessments (6 liters per second) in the region. It was just dumb luck that the camp turned out to be located so close to this spring source as there had been no previous knowledge of the spring beforehand. The water was being pumped about 300 yards to two 15,000 liter bladders which looked like giant waterbeds. I had the inappropriate urge to get up and jump on the bladders and was surprised that more children from the camps had not been trying themselves.

Each time a bladder was filled it was treated with a single spoonful of chlorine powder. I was skeptical of this amount but my test results revealed that the water in the bladders had no evidence of fecal coliforms even though the source water had elevated levels. The source that the district had recommended was a cattle watering reservoir that was extremely contaminated (I later found out that this was the source of water for 300 local villagers). It was really impressive what Matau had put into place to provide water to the refugee camp and with what the MSF volunteers had accomplished in general. I think it says a lot that the volunteers getting paid a lowly stipend of several hundred dollars a month appeared to be getting more accomplished on the ground than any of the other paid NGO workers combined.

MSF volunteer Matau looks on as a Unicef worker checks the chlorine levels int the water. If the chlorine is too low it can be contaminated by bacteria and if too high people won't drink it because of the taste.

After testing the water we went out to the water taps to take photos and hang out with the children and women collecting water. When we approached, the refugees were reserved at first but soon the children were laughing and smiling and demanding to see the digital images on our camera view screens. At one point Dan Skeen was absolutely mobbed with children and I was concerned that they were going to pull the tattoos off his shoulders. Even at refugee camps kids are still kids. I have found no better example of people experiencing joy and happiness under difficult and transient living conditions.

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December has brought many interesting developments. Our recent focus has been on coordinating the building of latrines in four Batwa settlements. In previous meetings the Batwa have agreed that the latrines are necessary in their communities. In order to make the projects cost effective and to involve the community we asked the Batwa to provide the labor for digging the pits and for providing roofing thatch (speargrass or banana leaves). One thing that you quickly notice walking around the communities here are brick making operations utilizing the high clay content of the soils here. In cases where households want more permanent latrines the people are going to make bricks for building the walls of the latrines. Labor intensive but requiring only a moderate level of skill, making bricks is a great opportunity to get the community involved in providing sanitation for their families. Where households do not know how to make bricks we are providing that instruction with the assistance from local brick-makers.

During the initial meetings with the four Batwa settlements we had no takers for permanent latrines due to the increased level of commitment that those latrines required. Slowly by slowly over the last two weeks households are deciding to commit to the longer lasting latrines and as of last week nearly a third of households have upgraded to permanent latrines. However, the Batwa are still vehemently against the idea of composting latrines. The composting latrine is the most sustainable choice because wastes are removed from them every 6 months and then they are refilled. The pit latrines deposit wastes deep in the ground and have the potential to contaminate local springs as well as the shallow aquifer. If maintained properly, pathogens are eliminated by allowing the feces to biologically breakdown over a 6 month period before they are removed.

I can’t necessarily blame them for not wanting to remove their own feces from the chamber because I myself would bock if I was asked to do the same thing. Despite this roadblock I am greatly encouraged by the community support in these latrines and feel like we are making solid headway.

Coordinating perfectly with the latrine projects has been the arrival of my lifelong friend and contractor extraordinaire Tor Erickson. His skills as a builder and manager of construction projects have had an immediate impact on the projects. Together we have begun to come up with the designs for latrines that are cost feasible and built to last. Being able to consult Tor with his experience with concrete and his skill at estimating costs are providing a key consultant where without him I would be inquiring from local contractors who may or may not be trustworthy. Local contractors will be a necessary element in these projects as we are slated to build over 100 latrines and protect 40 springs but determining initial costs and designs will set the stage for this future work.

Tor with some new Bakiga friends in the field testing water sources.

I want to wish everyone a merry Christmas and to let my friends and family know that I miss you all very much. It feels so strange here that Christmas is just around the corner and I’m still getting sunburned on a daily basis. The celebration for Christmas here is a goat roast that is held on Christmas eve followed by a 4 to 5 hour church service on Christmas day. Not exactly the usual turkey dinner with present opening and conversation with my grandparents, aunts, and uncles. Well, wish you all a happy holiday and will be posting more adventures in the new year! Dan and I standing with Congolese children chased out of the Congo two weeks prior.A Chameleon hanging out on a fencepost. Bizarre creatures!A waterfall seen from a stroll through Bwindi Impenetrable Forest.Goat roasting party at my new Banda. I've got so much going on I didn't even describe the big move. It was rather uneventful but I did get to slaughter the goat. Which was...pretty disgusting.

Visiting the Batwa (and Murchison Falls)

I want to apologize first off for not writing for so long. In the past month since the last blog post Kristen and I have been incredibly busy testing water sources and beginning sensitization of communities for the water, sanitation, and nutrition projects for the Rotary International 3H Grant. When we have not been busy we have been seeing some of the incredible wildlife and landscapes that Uganda has to offer. Many interesting and exciting plot twists have occurred since the last blog post, foremost among these are our new vehicles purchased through the Rotary 3H Grant! Rotary member Stephen (Blackie) Gonsalves went through great pains to purchase one gray double cab 1990 Toyota pickup truck and two brand spanking new Suzuki 125 cc motorcycles in Kampala. Purchasing vehicles in Uganda as a Mzungu is just asking for a tooth and nail battle to come to a price that even approaches market value. Blackie did an admirable job and increased our mobility by orders of magnitude overnight. Our original plan was to buy a new Toyota Land Rover but soon realized the reality of our situation here which is that the dollar has been shrinking and fuel prices have skyrocketed to $6.50 per gallon. Thus we decided a used pickup and two boda bodas (motorcycles) was the cost effective way to go and to use the leftover funds for transportation costs. This suits me fine because I've come to love Toyota pickups from learning to drive in my father's 1994 Toyota pickup. As for the motorcycles, though deathly frightened of having an accident on one, I have to admit I can now better understand how people become so fanatical about riding them after my first couple training sessions. It is such a relief to have transportation now so that we can widen our assessment to areas outside of the Mukono Parish (primarily to Batwa settlements).

Our first line of action with our new wheels was to visit Byumba, a Batwa settlement about 15 kilometers away. Behind the wheel for the first time in over two months I greatly enjoyed driving the rutted and stony road leading up to Byumba. Battered by the road we arrived on a high hilltop that looked down onto the Batwa settlement that extended from the top of the hill down into a verdant green valley so commonly found Southwestern Uganda. Moving down into the settlement we passed houses and cook stations built with mud and waddle or in some cases the built using banana fibers supported by eucalyptus logs. Our water team of Paul Mawhezi, Kristin Whitcomb, and I as well as members from the newly formed NGO, the Batwa Development Projects, greeted the Batwa and were graciously welcomed. The Batwa are the indigenous forest people of Uganda, Rwanda, and Congo. In 1994 the Batwa were removed from the Bwindi Impenetrable forest National Park in order to protect the gorilla populations in the forest. The people were given no compensation by the governmnet and have been suffering ever since. They are the primary reason Scott Kellermann began the hospital here in the first place. Batwa women tend to wear extremely colorful cloth wrapped around their bodies and head and more often than not with a child strapped to their backs. The men were wearing beat up second hand clothes often with rips and tears and no shoes. Some shirts you could see more skin than shirt and begs the question why wear a shirt at all.

Paul, Kristen, and I were led to the two water sources that provide water to the 15 home settlement. The first was a gravity fed water system that originates from a spring further up on the hillside and is piped down to a concrete box that collects the water and delivers it through a six inch length of pipe. Lifting the top off the spring box to examine the source I found that the water was cloudy suggesting that it was full of fine particulate matter. This is often a bad sign suggesting that the water is contaminated because bacteria are often associated with fine particulate matter. Indeed our test results of 36 cfu/100mL indicated that the source was contaminated. Now we will need to do a follow up investigation to determine where the water is becoming contaminated. Is it at the waters source further up the hillside, is it picking up bacteria in the pipe on the way down, or is it getting contaminated in the spring box. All information that will have to be gathered before a decision can be made on remediation. The other spring was an unprotected source that emerged from the hillside then flowed through an old hollowed out log. Results for fecal coliforms were 120 cfu/100ml also indicating contamination. Photos of Batwa women weaving baskets and men at a water and sanitation meeting.

Unlike the spread out communities of the Bakiga people that we have tested the Batwa have fewer people and live in tight knit communal settlements. Because of this we were able to gather together almost the entire Byumba settlement for a meeting to describe the projects and services that the Rotary 3H grant can provide. This was a much more effective means for communicating our message to everyone and was also an opportunity for individuals to have their questions answered and their concerns addressed in a group setting so that no one would be left out. One woman asked if one of the goats provided by the grant could be killed and eaten in celebration of Christmas as is customary for most major holidays. This question addressed previous incidences where NGO's havd provided goats to the Batwa for rearing for economic development and to the donors dismay finding out shortly thereafter that all of the goats had been eaten. Our answer was that the goats could not be eaten in the first couple years until they were established and had increased their goat populations through effective animal husbandry. Another woman asked about the sanitation projects and wanted to know if, since she didn't have a home could she possibly live in her latrine. And her follow up question when we told her that that was probably not a possibility was why do I need a latrine if I don't even have a house. That was a very difficult question to answer and reminded me that the Batwa are truly the poorest of the poor here. My answer was that without a latrine, with or without a home, you can still contaminate your water sources and spread water borne illnesses through fly dispersal. I think that one fell on deaf ears. Photos of Batwa children below.

Shortly after our visit to Byumba Kristen and I set off on the ten hour bus journey back to Kampala to pick up Dan Skeen, our second intrepid Rotaract volunteer! We found Dan at backpackers making himself at home in the chaos of Kampala. The day after he arrived he had already walked several miles to downtown checked out some of the local eateries and had been granted a personal tour by the Mu-azhin (the man who calls everyone to prayer five times a day) at the great mosque that overlooks downtown Kampala. Dan’s curiosity about his surroundings and his willingness to jump into a new culture with both feet immediately made him a welcome companion and an asset to our small water and sanitation team. Both Kristen and Dan had never traveled outside Canada and Mexico before this trip to Uganda kind, which is the exact same situation I was in when I first arrived in East Africa in 2006. Together we hoped on a bus and made our way up to the heart of Uganda to visit Murchison Falls National Park. Below is a photo of Kristen, Dan, and me at the top of Murchison falls. A spot where the Nile is constricted into a 7 meter channel and then drops 145 ft. Talk about power!

The trip to Murchison was absolutely incredible. We really rode this trip on a shoestring and luckily the trip just fell into place. Our need to be frugal was fully expressed when we decided to hire our taxi driver to take us on a game drive in his Toyota Corolla. We picked up a guide for around 20 bucks and we were off. We kept bottoming the car out on the rough game drive routes but managed to see quite a bit of the wildlife without scaring too much of it away. We saw tons of antelope primarily African Kob but also the slender Oribi, the Hartebeast, and the majestic long haired Waterbuck. It's always interesting to me that all of the wildlife you see here in the national parks seem to be as interested in you as you are in them. At one point we drove into a group of about 60 Cape Buffalo all rolling in the mud to cool off. Immediately they stood up and began making a semi circle around the vehicle. Apparently they don't see well so they just kept lifting their heads to catch our scent and angling their ears to hear what we were up to. They continued to get closer until I really started to feel uncomfortable. Could a buffalo really hurt us in the vehicle especially in a Corolla? What about 60 of them? The Buffalo kill more people on land than any other animal in Africa with their counterpart the hippo in the water. At one point early during the game drive our guide stopped the driver so that we could get out and view a Bushbuck which is a nondescript but rare species of antelope. Just about to open the door our guide exclaims “wait!” On the other side of the car was standing a mud-caked buffalo. The muddy visage made the hulking beast seem murderous. So we happily stayed in the car, and I clicked the following photo and we moved on.

By far the highlight of our trip was taking a boat ride down the Nile to the delta formed with Lake Albert. The 1km wide Nile gives way to a maze of papyrus lined channels that weave and interconnect. The banks where the papyrus was absent teemed with wildlife. The bird life was incredible with several types of heron and egret, huge quantities of shorebirds, fish eagles, and massive storks including the Saddle Bill and even the almost extinct Shoe Bill. On the shore we watched lions lethargically chase warthogs with antelope carefully looking on and large populations of Buffalo feeding and rolling in the mud. In the water hippos could be counted in the hundreds making their low guttural calls and blowing water out of their nostrils. Although the hippo kills more people that any other African animal they are extremely shy creatures that appear deathly afraid of being caught out of the water. When we surprised them on the banks the 2500 kg behemoths will run full tilt parting a massive wake with its chest before torpedoing into deeper water. It’s almost as if they are embarrassed by their naked bulbous pink-purple flesh.

For me the wildlife wasn’t the most wonderful aspect of the boat trip but just the overall pristine quality of the delta. Sitting out on the boat it felt as if it was a system un-fouled by human presence and a place that could have been the 20^th century or the 1^st century without the clues to tell the difference. It made me sorry for our poor San Joaquin/Sacramento Bay Delta back home on the verge of an ecosystem collapse. Although, no natural system can truly be without some human influence, I could not ignore the patches of invasive water hyacinth growing among the papyrus.

Well I suppose that’s all for now. The assessment is moving along very strongly and I’m looking forward to getting the projects off the ground here in December. As I’ve said earlier we are struggling to meet our transportation cost needs and I predict that it will continue to be a struggle throughout the 4 year grant period. I estimate that by the time all is said and done we will need another $7000 to $10,000. If you are feeling generous please donate to the Kellermann Foundation and write in the memo ‘Water Projects.’ Thanks everyone for your continued interest and support in these projects.

Kellermann Foundation
PO BOX 1901
Penn Valley, CA 95946

Photo of Murchison Falls from the side view. This is one of two massive water falls that the Nile flows over. The other one is out of the picture to the left.

Photo of Kristen hanging out with her new warthog buddy at Red Chili Rest Camp. Persistent little guys that don't take no for an answer if you've got food on you.
Hippos hanging out in the Nile.
An elephant seen from our boat journey down the Nile.

Moving forward

A photo of me holding Bright, the healthiest child in Uganda. Bright rarely smiles but chooses to show his affection in hugs and high 5's.

It’s been a couple weeks since my last posting and it is difficult to find where to begin. I guess I will start with our new volunteer Rotaract member Kristen Whitcomb who is assisting me in the assessment phase of the Rotary 3H grant! I picked her up at the airport in Entebbe on October 14^th at 7:30 am and took her on a whirlwind journey to begin her month and a half long stay here in Uganda. I began by taking her through the streets of Kampala to get some last minute items before heading back down to Bwindi (the dreaded 10 hour bus ride). Being with Kristen I began seeing Uganda and Kampala again for the first time to understand what she was experiencing so that I could explain this place that I am calling home for the next year. Just crossing the street in Uganda is a cultural experience. One can wait for 15 minutes without finding a break in the traffic or be forced to weave between a maze of matatu busses and jostle with motorcycles to find your way to the other side of the street. Walking down in the market area of Kampala I was stunned by the sheer volume of stuff being hawked. Small 10ft X 10ft cubby hole stores line the streets for as far as the eye could see. Second hand clothes, blankets, “rolex” watches, candies, jerry cans etc etc etc. Looking up I could see the market reached four stories high with trinkets and clothes of all shapes, sizes, and colors hanging from the exterior of the buildings swinging in the wind. It was just a solid wall of junk with nothing solid or stationary to focus on. Eventually we found all of the supplies we needed and headed back to the Backpackers hostel for a much needed rest.

Kristen and I woke early the next morning and caught the 6 am bus to Bwindi. Two breakdowns and 14 hours later we eventually arrived back at the guesthouse to BBQed steaks and peanut butter cookies prepared by the Danish med students Nadia and Karin and the IT expert Der (I guess its not all roughing it out here). I think Kristen was absolutely wiped out but I shall let her explain in her own words.

Kristen has quickly taken to the role of field/lab technician processing the bacteria samples and generating data that will drive project implementation. Her quiet and supportive demeanor has been a very welcome change from juggling the finances, testing, and project planning for the Rotary 3H grant (the 3 H’s stand for Hunger, Health, and Humanity all directly related to clean water). She has even begun setting up her own experiments for UV treatment of contaminated waters as a possible at home measure to ensure clean drinking water (see photo on right). Kristen has also wasted no time in getting acquainted with the multitudes of children here that sing at the top of their lungs "hello, how are you!" over and over again when they see a Mzungu. At this point I am thinking that a month and a half may not be long enough to have Kristen, I may have to keep her for the rest of the year!

To date we have collected fecal coliform data on 34 community drinking water sources including springs (protected and unprotected), surface water sources, gravity scheme sources (water piped from protected springs), and rainwater harvest sources. Thirteen of these sources were found to be under 10 cfu/100 ml. Sources greater than 10 cfu/100 ml is the contamination standard used by Life Water International. Our primary focus will be on those springs greater than 10 cfu/100ml. Obviously the most difficult situations are where there are no springs to protect and surface water is the only alternative.

Once again the major issue appears to be available land. Driving back from a weekend away at Lake Bunyonyi we spent 5 hours driving through the valleys and up over mountainous passes which characterize the region. During the entire drive there was not one strip of primary rainforest to see, not one native plant. The hillsides are all cultivated and the most common tree found is eucalyptus, which is an Australian native, used for building houses and other structures. The houses of the Mukiga (plural: Rukiga is singular) people here are spread out over every square foot of the land to be near to their crops. Unfortunately this often sets families and in some cases whole communities long distances from protected drinking water sources. The women and children in charge of fetching the water often resort to the nearest available sources that are often surface water sources that are always contaminated. The photo above is a child collecting 20 liters of water, equal to 40lbs!

Just one anecdote before I leave you for another couple weeks. As I stated earlier I visited Lake Bunyonyi this last weekend with the Danish med students Nadia and Karin for canoeing and relaxing (see photo below Karin to the left and Nadia to the right). The lake is a ten thousand year old lake and is the deepest lake in Uganda. It was created when a lava flow dammed a river and the river valley filled with water. On our return trip we hired, Patrick, a taxi driver to take us on the five hour journey back to Bwindi. The day was beautiful and there were no storms threatening to turn the roads into the muddy mess that can delay travel for days. Although a bit bumpy I thoroughly enjoyed driving through the lush green valleys and up over the mountain passes with stellar views.

Just 30 minutes outside of Bwindi I was confident that we would arrive at our destination without delay despite darkening clouds overhead… Just after we crossed the river we found that a ten ton truck had lost its brakes and drove up onto the embankment and turned over on its side blocking the entire road. Our driver, insistent on delivering us to our destination and heading back to his home that night decided he would drive across the nearby meadow, bypass the accident and get us back onto the road. The crux of our short detour was a steep ascent on slick muddy ground right before getting back onto the main road. The nearby onlookers viewing the accident were more than happy to assist us. As our driver approached the slope no less than 40 men and boys threw themselves against the back of our vehicle, rocking it up the incline and finally pushing the car up onto the road. It makes my heart ache to think that I didn’t have my camera with me to capture the moment. When we were back on the road it was time to settle up and I had a sinking feeling that the situation could get nasty. How do you pay a group of 40 people, I didn’t have any small bills on me better yet 40 of them? Is there any recourse if they ask for too much money? The group crowded around our driver arguing what the price should be. Thankfully the price that was demanded was 15,000 shillings which is about $10 however if they had demanded $100 I probably would have had to pay it. We left the scene of 40 men and boys cheering their good fortune at having landed such a prize. Nadia, Karin, and I could only smile in amazement at our good fortune and at the strength of Uganda which lies in its numbers.

Water water everywhere

Boda Boda driver riding through a flooded road

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10-14-08

I was caught in an incredible storm today. It was the first time that a hard rain persisted for several hours turning the roads into rivers of red brown water. Three med students and I were on our way to a local garden to get strawberries, basil, and some other hard to find fruit and veggies. Powerful gusts of wind began blowing and soon after drenching rainstorms accompanied by lightning strikes followed almost instantly by thunder. We took cover under a broad leafed tree but it was soon saturated with water and poured down through the leaves and drenched us. We held banana leaves over our heads in a feeble attempt to prevent the inevitable soaking. Finally we were as wet as we could possibly be and decided to make a run for it amid the lightning and rolling thunder to find a drier location. In the back of my mind was the local Batwa pygmie three weeks ago that was struck and killed by lighting and the newspaper article about how a strike killed 50 cattle in a neighboring district.

We finally found cover under an awning and waited for the worst of the rain to stop. When we returned to the guest house Der (the computer tech) told me that Dr Scott Kellerman was stuck across the Manyaga River at a fundraiser auction at the local church because of high water. I’ve never been one to miss high volumes of water so I quickly dried off and picked up my camera and ran down the road to see the flood waters. What I found was that the river had undercut one side of the bridge that linked the village of Mukono (where Scott’s fundraiser was) to the hospital and it had collapsed. People returning from the auction were trying to pick their way across the collapsed bridge with their families dressed in their nicest Sunday church-service clothes (see photos to the right). Boda Boda drivers were pushing their motorcycles up over the stones that were piled onto the collapsed bridge to assist crossing. I took turns taking photos and helping folks across the stones. Children descended upon the floodplain as the waters receded to catch mud fish (something like catfish) that were trapped in the grass and rocks. Just think, all of that clean water raining down every single day. So much potential! Quite a day!

One Thursday Paul and I visited Mukongoro, a settlement consisting of both Batwa Pygmies and local Mukiga people. This site was highlighted during my first visit in 2006 as having poor sanitation and no access to protected drinking water sources. Mukongoro resides in a narrow valley perched above the hospital just a couple kilometers from the Congo border. Villagers grow their crops in the wetland at the base of the valley and raise livestock of goats and pigs. Being that we are well into the rainy season here (September through December) there is water spilling every where over the footpaths and through the wetland though unfortunately non is potable and most is just a seasonal source of water. A local leader explained that during the dry season up to 150 families come down into the valley to collect water from a small fissure at the base of a bedrock outcropping. The water source during the rainy season was a muddy pool of water at the base of the wetland draining the area where the all of the houses are located.

We tested this source as well as the spring at the base of the bedrock. The testing kit determines the concentration of fecal bacteria in colony forming units (cfu) per 100 milliliters. A result of 20 to 100 cfu/100ml is considered high risk for fecal contamination. The rainy season source could only be estimated there were so many colonies. Estimates suggested that there were over 20,000 cfu/100ml in the source (the highest source recorded yet!). The dry season source was considerably cleaner (14 cfu/100ml) but lacks the necessary volume to provide for the number of families in the region. It seemed apparent to village members that contamination of their drinking water is an issue but the only alternative option for clean water is a 2 km walk up a steep grade of about 800 vertical feet. We realized that it would be highly unlikely to convince the village members that this is even an option at all. Currently we are looking into the potential for a large rainwater harvesting system. More later on this. In the meantime we will continue to test local water sources.

1st Outreach!

Strangler fig towering over a tea plantation

Our first outreach for the water and sanitation assessment began this week on a very positive note. The outreach coordinators at the BCHC, Rev Sam and Godfrey Abaganya invited the village health promoters to the hospital for a meeting on clean drinking water and sanitation. The village health promoters are village members assigned to track the health and well being of designated families in their community. Many traveled up to 4 miles on foot to attend the meeting. Our region of focus for the projects is the Mukono Parish, an area designated by the Anglican Church. This area includes approximately 12 villages although some are quite spread out. Villages are generally centered on trading centers but in some cases they are centered on churches or schools. Those attending the meeting were 22 health promoters that represent most of the villages in the parish as well as three members of the local sub-county government. As always prayer and introductions were the first items on the agenda. Reverend Sam facilitated the meeting introducing the topic of water and sanitation in the local Rukiga language. He translated for me intermittently and allowed me time for me to ask questions to the health promoters.

Rev. Sam effectively used story to make his point about the importance of community participation in the projects. His story was about a stork building a nest in a tree and refusing to ask for assistance from the ant people below. When the stork became caught in a storm shortly thereafter the nest was blown to pieces. The message of the story was that anyone from outside a community can build a project but without the local knowledge about where those projects should go and how they should be built the projects will fail. The story was very well received. Rev Sam used an effective mix of humor and serious discussion that held the attendees attention throughout the meeting that ended up lasting for 6 hours. After introductions the health promoters were asked to create a map of the parish describing protected and unprotected spring sources, villages, roads, and other key landmarks (churches, schools, crops…etc). To accomplish this they used plant stems to designate the roads and leaves for the rivers (see photo on the left). Sticks were bound together in the form of a cross to show churches and sticks planted in the ground marked protected springs, broken sticks were failed springs and so on. At that point the debate was on. Arguments broke out left and right about the placement of key landmarks and at one point I thought two traditional bath attendants were going to start wrestling to decide the placement of a spring. After an hour the maps were complete and we analyzed them and critiqued them together. Not only did the exercise give Paul and me a better idea of where the springs were located in the region and the layout of the villages but it promoted awareness about water sources and the importance of clean water. One goal of this project is to create a persistent voice in the region reinforcing the importance of clean water and hygiene to protect families from water borne illness.

On Saturday we went out for our first outreach to the village of Iraaro. Paul, Godfrey, Rev. Sam, Christine (one of the Ugandan outreach nurses), the driver, and I all packed into a Toyota pickup with an extra cab and navigated 10 km of incredibly rutted and rocky road. Noticing that I kept smacking my elbow against the window Christine stated “you are dancing” to which I replied “we are all dancing together” as we jounced and jostled our way to our destination. When I visited Iraaro two and a half years ago it was a village site with 98 homes and no protected water. This put it at the top of our list of sites needing protected water. To our great surprise we found that the local government, the district of Kanungu, had recently protected a new spring near the trading center that delivered an adequate supply of water (up to 20L/min). The average water usage for drinking and cooking is 5 liters per person per day and for bathing and washing clothes 20 liters per person per day. (How many liters do you use during a single shower?)

The new spring basin now provides clean water for up to 40 families. This means that 58 families are still without protected water. Most of these homes cling to steep slopes so that they can grow matoke (a type of banana), millet, cassava, beans, potatoes, and tea. Unfortunately this puts them in a position where they must collect surface water for drinking and cooking. In this area we tested the protected and unprotected springs as well as the surface water sources in the streams at the base of the slopes. The surface water sources were hundreds of times higher than the protected sources as we would expect. Protecting a spring source nearer to the other 58 homes will be a primary goal for the project.

As for the weekend I got a chance to get out and go to church on Sunday with a group of about 15 American students visiting from a program through the Uganda Christian University. We took great hike up two steep miles of beat up road past wide eyed children and their stunned parents. We climbed to a spot where we could look out over the lush green beauty of Southwestern Uganda. About halfway to our destination we stopped in the shade to catch our breath and realized that about 40 children had followed us up the path. They ranged from 3 to about 10 years old and stood in an amorphous group staring at the rare site of 20 Mzungus in their back yard. For some reason the UCU students decided it was time to perform a choreographed version of the Christian song “River of Life.” (see left) Cringing slightly at the exuberance at which the song was performed I gladly took snapshots of the children’s reactions. When the song finished the children stood there open mouthed and silent for about 5 seconds as if waiting to see if something else was going to happen and then all at once burst into raucous cheers and clapping (See photo on the right). The UCU students could only blush and smile and laugh. The children returned the favor belting out several songs and shaking their hips and hopping in the trademark Rukiga dance. It was a true delight. I'll leave with you a couple images of the future of Uganda.

Settling In

Red Tailed Monkey hanging out near the guesthouse

It has been a long week of settling in here at the guest house as well as working out the first details for the assessment of water sources. My banda hut is still being constructed up near the park so I spent my first couple of nights here in the guest house. It’s a pretty sweet deal with meals prepared daily, a solar shower (that I have yet to catch a warm shower in), and toilet- all of the 1^st world amenities are accounted for. Scott realizing that I was pretty cramped for space with my testing kit, supplies for 800 tests, pressure cooker sterilizer, as well as my personal belongings offered to let me stay in the “mud hut” that is down below the guest house (see photo above). Walking through the guest house garden of pineapple plants and Matoke banana trees the mud hut is secluded from the hospital and nearby road by a wall of tropical vegetation. A nice big lawn with an outside gazebo for working makes it a great living area. The building itself is a spacious two room structure, kind of reminiscent of my cabin back home though when the sun hits the corrugated metal roof it really starts cooking inside (which I guess is also a little reminiscent of my cabin back in Nevada City). Of course Scott failed to mention the minor rat infestation until after I had moved in. I guess some of my down time will be dedicated to designing primitive rat traps. If anyone has a prototype for a trap, let me know please! The photo to the right is my gazeebo office and bird watching vantage point.

On the water project side of things Scott Kellermann has assembled a solid team that will be managing the Rotary 3H grant (among many many other projects) to reduce malnutrition and to improve water sources in the region. The malnutrition portion of the grant involves providing sustainable goat herds to several villages in the area. My focus will be primarily on providing sustainable water sources as well as sanitation to villages with the greatest need (I will do my best to stay away from the goats). My first task is to determine where the greatest need is. To get started Paul Mahwezi and I visited Godfrey Abaganya and Reverend Sam who are the outreach health officers for the BCHC. They have been coordinating community health projects and providing vaccines to the villages in the Mukono Parish (encompasses about 14-15 villages) for the last 4 years. Among other things they have been collecting specific information on the number of households with access to sanitation and to protected water. Using this data to guide our assessment Paul and I will begin at those villages with the poorest sanitation and access to clean water.

Godfrey and Reverend Sam have also designated “village health promoters” in the villages in the region. These are community members in charge of visiting designated households to follow up on if individuals are taking their medication and knowing the status of sick individuals. This type of community follow through will be absolutely necessary for sustaining the water and sanitation projects when they have been implemented. Boreholes, protected springs, and rain-water catchments that are built by the government or NGO’s for communities very often fail because the community is not involved in the projects and not educated on how to maintain their water sources. If people are asked why they have not maintained their clean water supply their answer is often that the ones who implemented the project are responsible for maintaining it. To avoid this situation we want to involve the community as much as possible in the implementation of the projects. The village health promoters should be a great way to facilitate this community involvement.

The first step of the grant is to complete an assessment of drinking water sources in the villages to determine where the projects should be implemented. To practice I just went out into the neighborhood with Paul to find some drinking water to test. My trusted bacterial testing kit gives a measure of fecal coliforms in water in a measure of colony forming units/100 milliliters. To get a result you filter water through a 45um membrane that collects fecal bacterial cells then the membrane is placed on a nutrient medium and incubated at 44oC for 18 hours. Each bacterial cell is then able to grow into a visible colony that can be counted. Of which the yellow colonies are fecal coliforms. The photo on the right is the result of a contaminated test from a local spring contaminated by a pit latrine. Each yellow glob is a colony of fecal coliforms.

Many of the people around the hospital are lucky enough to have access to a piped gravity fed water system that originates from large springs within the Bwindi National Park for a small monthly fee. One would expect this local area to be pretty well-off when it comes to access to clean water. Unfortunately the preliminary information we gathered and the data we collected this week paint a far more disturbing picture. The gravity water system and selected protected springs had the lowest counts of fecal bacteria and the surface water (streams) displayed heavy contamination. One protected spring, suspected of being contaminated by a pit latrine up gradient from the spring was heavily contaminated.

Talking with the local villagers Paul and I discovered that many families refuse to pay the 500 Ugandan Shillings per month (about 33 cents) for the gravity fed water and drink this contaminated water instead! Even more disturbing was the conversation we had with several girls from 5 to 9 years old that admitted to collecting water from the river for drinking. During the conversation I watched a herder guide his cattle into the river for watering. Not only is surface water contaminated by poor sanitation in the villages but cattle, goats, and pigs are another major source of fecal coliforms. This trip once again hammered home the point that education is the key here. No amount of money or implementation of clean water systems or new technologies mean a thing without the basic education that clean water is life. Children live and die by the choices that are made regarding water everyday. In many cases it is not the lack of access to clean water but the choice to not walk that extra distance to collect clean water or the choice to refuse to pay a fee for clean water. I’m going to look into outreach to the local schools and churches here to talk about these choices. The photo above is of children collecting water at a protected spring. Each jerry can weighs over 30 lbs!

Although some of these issues are pretty hard to stomach my spirits remain high. I’m really looking forward to heading out to the communities in the Mukono Parish to start figuring out where the projects should go. The rain forest here continues to amaze. Every time of day and night has a different collection of bird and insect calls. There is even a set of calls during the heavy downpours that occur daily. Red tailed monkeys are always looking into the guest house most certainly contemplating a mad dash into the house to raid the banana dish. It is such a rich and beautiful place to be and every day there is something new to see or hear or taste. I gave Jack Fruit a try just this weekend. A giant oblong fruit that weights about 30lbs with a rubbery flesh that I can best describe as a bubble gum flavored. I’ve heard rumor that it is related to the Durian Fruit of Southeast Asia but smells about a thousand times better! I look forward to sharing more experiences with you all as they occur. Hope you are all doing well. This photo to the right is me with my prize. Stay away from my Jack Fruit!