Mission 1 Accomplished

What a great last couple of days.  We’ve had some very productive wrap-up meetings and have now begun meeting with potential partners.  We couldn’t have asked for more vibrant collaboration with our stakeholders nor had more enthusiastic endorsements for our work and proposed program designs.

As TGF’s founder and president, I didn’t really know how this trip would leave TGF.  What we found out was that TGF’s proposed models are perfectly in line with Uganda’s strategic plan for health and desperately needed.  I won’t go into boring details but we’ve been told over and over again that we’ve really done our homework and many have not been so excited about a proposed plan in a long time. 

Of course the time for talk is over, and now we have to align ourselves strategically for funding. That means finding the right partners and fine-tuning the program concepts.  We can be very proud of our current successes; eight graduates with 22 in line to be diploma and baccalaureate-educated nurses. But, we have big plans for nursing in Uganda, and we hope that when done right, and with precious lessons learned, we can go global.  Remember, crippling nursing shortages undermine health initiatives around the world.  So, we have a lot to do when we get home but we are excited and reenergized. 

11:30 tonight we get on the first of two flights back home.  We are happy to get back to family and friends and share more stories of our phenomenal trip.  Thank you so much for following us.  We are most grateful for your interest and support.

Keep posted and sign-up for eblasts on www.grettafoundation.org.  All the best from both of us to you and yours.

Happy Holidays with love from Meg and Janet!!!

Sim Sim and Scholars

We met some of our Gretta Scholars at IHSU today.  We visited them at what they have now called, “The Gretta House.”  Acio’s mother had worked very hard to make ground nut and sim sim for us.  It was so beautifully wrapped and delicious.  It’s tastes similar to peanut butter and is great on meat and any number of things.  We enjoyed some with cassava; very good but kind of like eating peanut paste with superglue.  She must have made about 20 pounds worth for us and must have used a hector’s worth of groundnuts.  Acio’s wonderful mother is so grateful for the support given her daughter.  She is so proud of the impact her daughter is having on her community.  We will cherish the memories of this gesture always.

Five of the Scholars are in their fourth and last years with one having just completed her research project.  She, and we, are eagerly waiting for her results.  Next she will be placed in one of three chosen hospitals for her one-year internship: Masaka, Jinja and Mulago.  When completed, she will be fully licensed.  It’s wonderful to think of her only four years ago and now she the empowered woman and change agent that she is today.

Well, we ended with taking countless pictures and enjoyed some laughs and nice good-byes.  Good-bye until next time that is.

What they don't tell you in the guidebooks.

Hello Everyone, just a quick greeting from Janet.  Everything is going very well here. This trip has been enormously productive and points us where we need to go to achieve our upcoming goals for The Gretta Foundation. Meg just finished blogging about our meeting with the Minister of Health (himself!) as well as our Thanksgiving dinner with Sr. Cathy at her convent. These were both awesome experiences.

 A less awesome experience happened the other morning when we got to visit yet another health clinic. This time I was on the opposite side of the bed...this time as the patient. I had woken up with what I thought was numerous mosquito bites. However within a very short time my body overall was covered with nasty itchy welts and my face was swelling up. Eyes, lips and ears all swelled up and it was very alarming. The hotel took us quickly to a clinic frequented by Westerners. I received excellent care and with the help of prednisone I was on my way within a few hours. It slowed me down for a day or so but I'm back to full speed now.

Meg and I are still reflecting on our last road trip to Lira last week. We blogged already about the good things that came out of that time for our foundation. I'm still shaking my head though at some of the non-health healthcare experiences we had. The road stop was for one something! It was a somewhat sophisticated affair with gas and a grocery store. It had a large set of restrooms for travelers. I waited in line with other ladies and was pleased to see that the toilets were of the flush variety even though they had no seats. However, I was quite unnerved to see that the flushing water was brown. And then when I went to wash my hands I was even more so when I saw that that water was the same. I'm afraid to wonder why it was that shade of brown! (JP)

Rubbing Elbows and Thanksgiving

Today we had more meetings at the Ministry of Health (MoH).  The MoH has become like a second home to us on this visit.  They are our most important ally and collaborators.  We have the direction that we need in the final design of our two proposed projects.  The MoH will be reviewing our concept note for the larger of the two. This way we know that it is in line with their strategic health plan.  We are certain that it will be, as we have really done our homework throughout these last 6 years.  There is not a rock unturned…until of course I trip over it. 

Our last meeting with the MoH was with the Minister of Health himself, Dr. Ruhakana Rugunda. Our dear friend and long-time colleague Dr. Nelson Musoba, made it all happen. It was very exciting.  He has a fantastic reputation here in Uganda and is very well respected. He is known to have a great mind and be a good and measured thinker.  We were very impressed.  Turns out we have Bay Area connections.  He is a Cal grad. Go Bears!!  We gave our history and he asked intelligent questions.  In the end, we got his enthusiastic support and endorsement.  This will be very helpful as we look for funding for our projects.  We feel it is so important to have local buy-in and support; one of the many reasons that we have been speaking with so many stakeholders over these years.

Next we went to our beloved Sr. Cathy’s (Gretta Scholar) convent for dinner.  She is in charge of nursing and nursing schools for the Ugandan Catholic Medical Bureau.  This is a big job as they have a huge presence in health.  We stood around the table, filled with local food, and realized that it was Thanksgiving!!  It was a wonderful moment and wonderful evening. We ate pork grilled on sticks, fish heads, sweet and Irish potatoes with ground- nut gravy, cabbage salad and dandelion salad.  It was the best dinner we’ve had in Uganda.  The Sisters knew of our holiday and they made sure that we were well taken care of.  It was another moving moment and another productive day.

We only have two days left and they will be filled with wrap-up meetings.  Woo hoo!  The final stretch.  (MS)

A Day to Remember

What a wonderful day; a real highlight of our trip. After more meetings at misc. ministries, we went to meet our Gretta Scholars at Nsambya SON.  They were so gracious and kind.  They gave us warm introductions and then sang to us and gave us beautifully wrapped handmade presents.  We will treasure them always.  It is so clear that our Scholars are so appreciative and you know that their lives have been so greatly affected and empowered. As they told their stories, some would get emotional…and of course, we did too.

We got a tour of the school and then a long visit in the pediatric ward, their current rotation.  We started at the nurse’s station and met the nurse in charge.  While there, a little hand took mine, and when I looked down, I was welcomed by a precious little face and a bright smile.  This little boy had been in the pediatric ward for three months with two months in ICU.  His head had been crushed between two cars and his head showed the scars. We were joined at the hip for the rest of the visit.

We watched the Scholars interact with all the patients and their parents.  They seemed so natural and comfortable in the role of nurse and caregiver.  The patients warmed to them and appreciated the care.  They were knowledgeable and bright and caring.  We were just radiating with pride for our hardworking Scholars. 

It was a sad ‘good-bye’ especially with our new little friend. It took all the Scholars to pry him from my hands.  I could hear his cries throughout the hospital grounds.  It broke my heart…but I knew he was in good loving hands. 

 

Days like this remind us again why we at TGF do what we do.  Through the work and dedication of our Gretta Scholars, lives are touched and saved every single day.  (MS)

More from Alebtong and Lira

Greetings here from Janet! I'm here resting this morning in the hotel sending this message and doing some laundry in the bathtub.  Meg left at dawn for a series of ministries' meetings including among others with the Ministry of Education and The Ministry of Health. There is still much work we need to do in these next five days before we leave for home on Saturday night.

It feels really good to be back at our base hotel here in Kampala. Our last road trip to Hoima and Lira were very grueling and at the same time so very worthwhile. We drove west for several hours to visit a hostel of girls who come from extremely disadvantaged backgrounds and still aspire after high school to become nurses. We met with the group which sang beautifully for us and then met with girls individually. We examined their grade reports and exhorted them to keep up their dreams and work very hard in school.

The next day we had an arduous all day drive on poor roads northeast to Lira. We were lucky to be able to break up the day by viewing rhino's in a sanctuary and then later we viewed some beautiful waterfalls and rapids. The government is working on a hydroelectric dam to create more much needed electricity for the country. It was a sight for sore eyes after a long journey. I know Meg wrote more in detail about these stops so I've only mentioned them briefly here.

In Lira, as Meg has written, we visited our scholar Acio and traveled out with her on a dirt road for an hour to the health clinic where she works part-time in addition to her studies in Kampala. The conditions at the clinic were truly shocking. No running water and only a little electricity powered by solar in the whole clinic. Staffing for all these in- and out-patients was extremely minimal. People were being treated for malaria, TB and HIV. There was also a maternity ward on the premises but no provisions for emergency c-sections.  We were so proud to see this great scholar of ours taking on such an immense job.

Signing off until tomorrow.  (JP)

The Line Begins Here and Ends.....

Acio is a striking woman and a remarkable nurse. She works full time at the Health Center IV in Abeltong, one hour outside Lira.  Then once a week she travels 6 hours to Kampala to attend her bachelors conversion program and then come back and start all over again.

She toured us through the health center’s multiple wards where we got to meet many lovely and brave people. People here come for any number of serious illnesses like TB, malaria, AIDS-related diseases, intestinal parasites and so on.  The maternity ward had approximately 10 women in active labor with two in the delivery room. There are so few nurses that the women depend of their attendants (family members) to aid them.  We believe that the women come here in case of an emergency because most have to go it almost alone. The nurses here are spread too thin to offer the kind of attention and care many of us are used to and blessed to receive.

Acio showed great knowledge and warmth.  She introduced us to all the patients, both large and small, both young and old.  She touched and talked softly to each and every one of them.  It was an honor for us to meet them and shake hands. They were all so gracious and would light up at the simplest gesture of kindness.  It was indescribably moving and I’m brought to tears as I write this.

Acio was in charge of admissions and the line when we arrive was probably 20 families deep. It grew and grew and we knew that we needed to go and let Acio get to work.  She sees on average 100 people a day!  That is the embodiment of human impact.  Here she will meet with each that comes in, do an initial exam, order lab tests, and determine what additional care will be needed.  Many will fill up the beds in the wards.  She was so very proud to have us there.  Her big boss, the District Health Officer even came to give his regards and thank us for supporting his treasured nurse.

It was a proud day for us. This is a rare moment for us when we get the see our scholars at work.  Keep us the great work Acio. (MS)

Road to Lira.

Breakfast here is usually bread, hard-boiled eggs, bananas, and my favorite, African tea.  I never tire of this morning ritual. Today is Sunday and we can hear what must be hundreds singing at the church next door. With a warm cup of tea, a beautiful view and a lovely serenade, it’s a great start to the day.

Today was all about travel but we did take a couple of stops to enjoy this beautiful country.  Our driver, Moses, convinced us to visit the Ziwa Rhino Sanctuary.  This park works tirelessly to protect these precious and endangered species. Armed guards stay with the rhinos 24 hours a day to protect them from poachers.  Before our walking tour in the bush, we viewed a story of a young couple next to two rhinos, the same two rhinos that only a few seconds after the picture was taken, almost fatally gored the woman. Well, lesson for us learned the easy way; don’t get too close. (I have to mention that happened in South Africa.)

They have 13 rhinos in total and I had to laugh when I saw one named Obama.  According to his bio, his mother was from the USA, and his father, from Kenya.  Poor Obama had been turned away by his mother when she became pregnant again.  Fortunately, Bella, another female, took Obama into her family. It was fantastic being only a couple dozen yards from these enormous creatures.  Even when they’d exhale, it felt like the earth and the sky together was letting out breath.  It was a powerful experience.

Next up more bumpy roads for another hour or so and we stopped at Karuma Falls.   We hiked a little bit past a large family of baboons, over huge trails of marching safari ants, and a pit with a python.  The falls aren’t falls as we know it, but rapids.  They are hundreds of yards from river bank to river bank with a torrent of water rushing over ancient boulders and surrounded by lush jungles.  When I stand at the water’s edge feeling the power of the water rushing by, the words that come to mind are wild, untamable, enormity, majesty and unparalleled beauty.

Next stop was Lira where we met one of our Gretta Scholars who works in rural Uganda.  Lira and the surrounding areas had been the epicenter of Kony’s Lords Resistance Army’s reign of terror for over 22 years.  The stories shared are beyond description but I can share a particularly eerie detail.  As told, people here would be fearful of strangers because the rebels masqueraded as one of them during the day, but at night, would carry out unspeakable acts of terror upon them.  Imagine that kind of detestable cunning.

So the scars can be seen and felt, but overall, Lira is a bustling town where people here are moving past the past, and getting on with life.  We met our Acio at the modest but lovely guest house she had arranged for us and then shared meal of Africa chapatti and goat stew.  We are very excited about tomorrow where we travel to Acio’s place of work. (MS)

Girl Power!

Today was the first day of a long three-day road trip.  Today’s destination was a town called Hoima where we toured a hostel for young girls ages 14-16.  These girls are primarily from Northern Uganda, Sudan, and the Democratic Republic of Congo (DRC).

We traveled here because we wanted to determine if this organization might be a potential candidate pool for future Gretta Scholars.  We are interested in getting to know our scholars earlier on and follow their progress through secondary school.

We met 30 beautiful, bright girls.  All have different stories and backgrounds but all are here to live in an environment that supports their education and a future beyond early marriage and motherhood.

We were entertained by a wonderful performance with song and dance; songs filled with hope.  Next was a little like career day. We sat with the girls and introduced our work and why we love nurses.  We told them what marks they would need in subjects like physics, math, biology and chemistry in order to get into nursing school.  Then we had a Q&A and the girls asked so many intelligent questions.  One had asked, “What is worse, low blood pressure or high blood pressure?”  A Gretta Scholar in the making if you ask me.

Regrettably, many aren’t close to having the marks needed, but, we hope that we planted a seed that if they worked hard over the next two years and get better marks, that they have a chance for a bright future in nursing.  We only hope that a few of those seeds will be cultivated.  We’ll be watching them.

Next we did what I love best, taking pictures of little ones along the street, and then showing them their images.  They are often shy at first, but when the first child lights up with laughter at the sight of their face in a little black box, the rest come running.  It is like witnessing joy at its purest.

Tomorrow we get up early for our long trip to Lira…so off to bed, after a nice cold Bell Beer of course. (MS)

Scholars, Traffic and Baboons, Oh My!!

Well, we are back in Kampala after a very stimulating trip out to remote Kisora. This is the hilly forested area where tourists come to see the gorillas. That would be fun but we are here only to work so no gorillas for us! We did see baboons along the roadside and that was fun. We traveled with Sr. Cathy from the Catholic Bureau out to Mutolore to see our scholars Immaculate and John .

We left for this 39 hour trip at 6:00 am and reached Kisoro at 5:00 pm. We were met by the head of the Nursing School Marcella and proceeded straight into meetings. After this we met our scholars who proudly shared their report cards with us. They then led us all on a tour of the nursing school and hospital. We were impressed with everything we saw and we are very happy our students are studying here. We finished the evening with a welcome dinner of African food prepared very lovingly for us.  We had no problem sleeping that night!

 We had breakfast and said our goodbyes by 7:00 am the next morning. We were sad to leave our scholars after such a short visit and they were very sweet and asked us to return soon. Before leaving, they had presented us with posters that they drew for us along with presents from local basket weavers.  We were so very moved by their gratitude and thoughtfulness.

We then took a deep breath and our driver started us back on the very very bad road! It's hard to describe to you just how bad the road out there is. Half of it is under construction and there were long waits and incredibly teeth rattling bumps and potholes of unbelievable size. We were very relieved that we had hired such a skilled driver and he really earned his wages in these two long days.

About midday, we arrived at the University of Mbarara's School of Nursing.  This visit was a follow-up from one we made in 2010. We are extremely pleased to see the improvements the government has made by adding on a modern hospital wing and we hope to send some of our future scholars here as funds permit. After meetings followed by a tour of the school and hospital, we returned to Kampala and arrived at 9:00 pm. We hit our beds exhausted but extremely pleased with the success of our journey and its findings. (JP)

Road to Kisoro

Today we are on an 11 hour journey to Kisoro near the Rwandan border.  It is nice to get out of the city.  Goats and cows are tethered to stakes and eating grass all along the roadside.  We see la ot of very poor children wearing little more than rags sometimes sitting along the road just inches from traffic whizzing by.  Not far from them will be children nicely dressed in school uniforms; the lucky ones who can afford the supplies needed to attend primary education. 

There are little shops after little shops selling anything from sodas to caskets.  Grownups tend the stores and sit and talk together while children, chickens, goats, and an occasional dog, play and eat.  The large fruit stands can be so beautiful with an impressive array of vibrant colors. Except for the major highway, the roads are all dirt and you find women engaged in what must be an endless exercise of sweeping. Many will have a baby cuddled on their backs with what they call a kangaroo wrap.  All the while she is working going about her day and/or carrying heavy loads on her head.  It doesn’t take long to realize women do the heavy lifting here.

They burn a lot of leaves and trash or use charcoal for cooking; all of which pose dangers to little ones.  It scares me as I’ve seen countless horrific sights in the hospitals wards here.  As we’ve been told, 11% of all pediatric hospitalizations involve burns. 

Some people live in very rough huts and others live in nice mud brick homes.  The bricks are pressed into form and then stacked together and baked from the inside to cure.  There are a lot of bikes here but we don’t see a lot of them being used for riding but for transporting loads of leaves, wood, bananas and jerry cans. 

Just as I’m just about to sign off, a boy with his goat and the end of a rope kicks him in hind quarters to get him out of our way.  I imagine that goat means a great deal to that little boy and his family.

We’ll be checking in again after our voyage.  (MS)

Yuck!

Baby ankole...just for clarification.  :)

Today was busy with setting up meetings and getting ready for our road trip tomorrow.  We leave for an 11 hour road trip to a town called Kisoro which as close to Rwanda as one can get without being in Rwanda.  We will be visiting some of our scholars there and touring the nursing school and the affiliate hospital.  After a night in the hospital guest house, we'll be traveling back to Kampala while visiting Mbarara University and hospital along the way. 

We may not have internet so we'll say "good-bye" for now.  (MS)

Kampala

Yesterday was another great day.  We did get out from the ‘office’ and out about town a little.  I always love to watch the comings and goings of life here in Uganda.  There is so much going on and you see all walks of life.  Some more privilege drive by their luxury cars but regrettably most work hard to just get by or are just very very poor. 

In the pictures here you’ll see a typical street corner where the boda bodas line up waiting for their next brave fare.  These are very dangerous modes of transportation.  Our taxi driver told us they are looking to make them illegal as so many accidents involve the boda boda.  I stupidly took a long ride on one once, once!  It was a hair-raising experience driving on bad roads, dodging crater-sized potholes and trucks and other cars.  I’ve seen too many horrific injuries in hospitals all around the country to ever try again.  But for a lot of people here it is a necessary and affordable way to get around.

Often you’ll see men, women and children selling things like food, airtime for cell phones, misc. trinkets, toilet paper, you name it.  You watch and wish the children could be in school but no more than their mothers I’m sure.  Empty dirt lots will often have squatters resting.  There are very few traffic lights here with cops doing most of the “directing” such as it is. Even though there is so much poverty here, I do want to share that Kampala does have a great deal of infrastructure and it is a comfortable place to visit if you have the means.

Most importantly, everyone here is so incredibly friendly.  We have really chosen a great place to work.  They call Uganda the “Pearl of Africa”.  To me, the real pearl is in its people; gracious, warm and generous by nature, precious like a pearl.  Where ever we go, we are always received by a warm, “You are welcome and  you really feel the sincerity in those simple words. 

We met with our friends at the national nursing association (UNMU) and they proudly toured us through their new Wellness Center.  It is a center built to provide health services to nurses and other health workers.  Nurses are often the last to get care.  Their jobs are so hard. Often working long hours, with too many patients and too few tools, they are one group that is 100% exposed to communicable diseases like HIV and TB. They often suffer from hypertension and strained backs.  It is good to see an effort solely geared to the care of these miracle-working caregivers.

We ended our day with an important meeting with the Ministry of Health, which gains us access to others in the ministry while we continue our collaboration.  We are now at the point where after almost 6 years of needs assessment and extensive collaboration and fact-finding, we are in the final stages of the designing of two TGF projects.  These are exciting times and we have great hope. (MS)

Acronyms

With a lovely view and a hot pot of African tea, we had a great start to a busy Sunday.

Today was a long day at our hotel with long back-to-back meetings.  It was important because we were reconnecting with old friends in nursing while collaborating and fact-finding.  

First we met with nursing commissioner of the Ministry of Health (MoH).  She is the head nurse of the country and a very vibrant and assertive nurse leader. Next we met with representatives of the Ugandan Nurse and Midwifery Union (UNMU); the national nursing association (NNA) which advocates and champions for it profession.  We’ve working hand-in-hand with UNMU from the beginning and they are one of our most important partners-in-crime.  Next was the Ugandan Private Midwives Association.(UMPA)  They are under the UNMU umbrella representing private practice midwives (PPM).  (If one is not careful, one could choke on all the acronyms in this line of work.) 

We have two exciting project designs we have been developing over the years; one has the potential to create a paradigm shift for the nursing profession in Uganda, and the second, develop the PPM practices.  The PPMs are real heroes in their communities, most often working in the most rural areas.  They are true entrepreneurs.

We received enthusiastic support for both potential projects. “I must be dreaming, “ said the president of UMPA.  We feel terrific having this caliber of buy-in. 

Next we meet with members of UCMB, UNMC, AMREF, MoPS, MoES, MoH, MoEB, UCP, etc. to talk about BNS, EM, RN, ECN, MSN, RM, EN and PMTCT, HIV and TB.  Remember, I warned you about the acronyms.

Until tomorrow…(MS)

Picture of Kampala Hillside

We wanted to share this picture of a hillside in Kampala as viewed from Mulago Hospital.  There is a great deal of poverty in Uganda; both in rural and urban areas.  Shanty-like towns are throughout the City at large. Here you see some next to high-rise office buildings.  It's quite beautiful in its own way. (MS)

            WE MADE IT!!!

Well after 30 hours of being in transit, four flights, 8 hours of sleep in the last 60, too many mosquito bites to count, we have come to the conclusion of our first day in Uganda.

But before getting into business, we should share the crazy that is getting to the hotel from the airport.  The traffic in Kampala is usually congested, even at midnight when we arrived.  On either side of the roads are little business where you’ll see bottle shops (make-shift bars no bigger than a small closet), barbers, food stands, and the like.  Everyone drives on the left side which can be a little disorienting for American tourists like myself.  But between the lack of street lights, countless boda bodas (little motorcycles transporting persons…yes, plural at times) dodging in-and-out of traffic, headlights coming in from all directions and persons walking just inches from speeding cars, including one’s own, it is mind-blowing that more people don’t die.  It never gets routine I tell ya.

So on to business. We got an early start. Why I never learn NOT to schedule appointments right after arriving, I’ll never know.  We went to meet our Gretta Scholars at the International Health Science University. 

We took lots pictures and interviewed each one.  They are all passing and doing very well.  Each and every one took time to give their humble thanks to TGF and all its supporters.  It is so heartwarming to hear their stories about how their lives have changed and the see the great sense of pride and satisfaction they feel in their chosen profession. The pride is palpable.  What a great start to the day. It is a powerful reminder of why we do what we do. 

Next we traveled across town to meet our two new graduates, Agnes and Martha, at the Mulago National Referral Hospital where they are interns.  I can’t begin to tell you how much joy I felt seeing Agnes, our very first Gretta Scholar, walk out of the main entrance in her nurse’s uniform.  She looked glorious. We got to meet her supervisor and hear her acclaim of Agnes’ work.  Her current rotation is in the pediatric ward where we saw her care for a tiny little person with pneumonia.  She reminded us that HIV and/or TB often first presents itself as pneumonia. We left hoping that this precious case would be an exception. 

Next we joined Martha in the oncology ward. Mulago has the only oncology ward in Kampala, we are told, all who need treatment are referred here.  We surprised Martha on her lunch break where we found her pouring over her patient’s charts.  Her drive and commitment to nursing continues to be a source of awe; just so proud we are.

With another scholar Doreen joining us, we enjoyed some girl-time and got to hear how proud they are to be independent…and also share their plans for the future. How wonderful.

Tomorrow will be another full day!  (MS)

Uganda - Ready...Set...GO!!!

Well Janet and I are at SFO awaiting the first of four flights to Uganda.  We'll be in transit for 28 hrs stopping in LA, Amsterdam, then Kigali Rwanda and finally arriving in Entebbe, Uganda.

We are very excited about our trip and we have an aggressive itinerary ahead of us. We'll first be meeting with our scholars and having the chance to witness them hard at work.

Our travels will take us to remote areas where Internet will be intermittent. So please bear with us. We will be blogging daily but a few may come all at once.

So they are calling our plane now. Take care and thank you for following our trip.

Off we go!!!

Meg and Janet