At 8 a.m. when we set off for Ruhungu parish in SW Uganda for the Volunteer Health Team training workshop, the roads are already full of traffic. In the road to the village, we pass the milkmen on their bicycles carrying cans lashed on the back with strips of rubber inner tires selling the days milk along the way. Heading out from the community we pass bicycles heavily laden with huge bunches of matooke, a green cooking banana which forms the basic staple in the area. For people in Ruhungu, matooke is not only their staple food but also a source of income. The fields are bright green, glistening from the recent rains.
We are the first to arrive. I am travelling with an interpreter these days which is helpful for following in detail the training and also with a pediatrician on a short visit to the area as part of her London School of Tropical Medicine course. She is Portuguese and makes a connection between what we are trying to do here with what is needed for African migrant populations in Lisbon.
Surprisingly enough, she was, prior to coming here, totally unaware of community-based child health program and their potential for getting health education and prevention efforts mobilized in rural areas. Her enthusiasm is contagious allows me to see it with fresh eyes.
Once again we are training without manuals. This doesn't seem to diminish the effort that participants put into training however. To put across the health messages and make them more memorable and thus more easily recalled, participants are encouraged to report back using drama, songs and poems. The whole group so likes the immunization song that it is repeated several times until I too am able to catch the Runyankole words.
After the session about diseases, the whole class moves to the front of the darkened room, to copy into their scribblers, the key points the facilitator has written on the newsprint posted at the front of the room. Electrification, which was such a game-changer in rural Canada in the Fifities, has not yet reached these rural parts of Africa, more than 60 years later.
During small group work after tea, huge thunderheads unload a torrent of wind and rain on the tin mbati roof of the small hall. The cacophonous hammering makes it impossible to hear a person yelling in your ear, yet through it all, the participants stuggle to hear and make themselves heard. There are very few places left where one still sees such dedication to learning.
The pediatrician is amazed at this. I realize I am no longer even surprised. Such is the desire for learning here in the rural areas that training is almost always given as a top motivator for the volunteer health workers.
The dense rains has been expected so the mid day meal preparation has already begun indoors when we arrive. The woman organizing the huge sikiri (tin pot) full of banana leaf-wrapped matooke can hardly be seen thru the smoke eminating from her fire atop three stones inside the small room. She sits happily on her small stool with groundnut stew in one corner and the huge mound of matooke covered with banana leaves in the other. We have not yet even addressed the indoor air pollution as a cause for ill health, so busy are we with infectious diseases. Another challenge!
Here at the village level one thinks how interrelated things are. I suspect if we were able to reduce the level of air pollution /smoke that women and especially children are exposed to in these closed spaces we would see a great reduction in the pneumonia.
I am pleased to see the woman has sent her small child outside, away from the heavy smoke in the room at least for now before the rains come down. I am only able to tolerate the smoke long enough to take a quick photo. But it is a lovely photo even thru the dense smoke.
Photos: man with matooke on bicycle; parish room; windstorm beats matooke trees; VHTs copy down notes; cook with matooke on 3 stones