Assignment!

Received my assignment last week, I am working at the District Health Office in Kiruhura District alongside my counterpart, Innocent, who oversees the running and programming of all the health centers in the district.

To give a brief description of what that means, Uganda has a very structured system.  The land is divided and governed on five levels using the Local Council or L.C. system.  L.C. 1 is a village, L.C. 2 is a parish, L.C. 3 sub-county, L.C. 4 county, L.C. 5 district.  There are something like 110 districts in Uganda.  The health system is divided the same way, by 5.  Level 1 is has the Village Health Team.  Every village is supposed to have a group of people, voluntary or elected pending on the village, that go to each home in the village and give out health information and take down demographic information.  Level 2 is a health center that basically has a nurse and can do very basic things like hand out condoms, do HIV tests, maybe triage.  Level 3 and 4 are health centers that are able to offer more services such as minor surgeries, maternal/child health/deliveries, and short term hospital stays.  Level 5 are hospitals, and hospitals are not in every district but they are around.  So the gist is, 5 levels of government and health centers, they sort of go together in terms of scope and responsibility.

In Kiruhura District, there are some 300,000 residents.  There are just under 40 health centers and every VHT in the district that I will be working with.  My role and the goals of this assignment are varied.  For the first 3 or so months I am to observe and collect data and assess the needs of the "community".  From that point on we will continuously assess and try to address the needs throughout the district.  Examples of things Innocent brought up that we can work on: a district-wide database for collecting and recording health data; finding Income Generating Activities (IGAs) for people living with HIV/AIDS such as raising chickens, subsistence farming, etc.; dealing with water security (I have been told that water is the biggest issue district-wide); connecting VHTs to existing health centers, working on better training, addressing their issues, and on and on.  The beautiful thing is that my counterpart is very dedicated to his work, has many ideas, and we are on the same page in terms of working on projects by finding sustainable solutions.

I am going to be living in a duplex in Kiruhura town.  After a few days of bargaining and dealing, Innocent was able to secure me a nice living situation.  There is a common room, bedroom, bathroom, and kitchen.  There is no electricity or running water, but I am lucky to have such a fantastic space and the home is brand new.  It is in a very rural area.  Most people in my district raise cattle, and for this they need a lot of space.  Many people own 30 square km plots, so there are not a whole lot of people around.  Aside from the other half of my duplex, I cannot see another house from my porch (which is kind of nice), just rolling hills and countryside.  It sort of feels like I live in Montana.  On the site visit this week I saw impala, monkeys, and foxes.  My friend Jesse who lives further north in the district saw a herd of wild zebra, so that is something to look forward too.

Anywho, I am in training for two more weeks, then to my site on October 22nd for the next two years.  It is going to be exciting moving on to the next part of service, and right now many trips with other volunteers are being planned and visits to meet at people's sites are in the works.  It looks like the next closest volunteer to me is about 25km away, so it looks like I am going to buy a bike.  With a basket.  Oh, and I am going to get chickens.  And probably kill one every month.  Did I mention I killed a chicken the other week?  With my own two hands and a fucking butter knife, non-serrated.  That's right, it was one of the most terrifying experiences of my life.

That's it, this post is big, and it feels awkward writing such a one-sided conversation, but that is the point of blogs.  I really enjoy it when friends and family write me emails!  dan.d.imhoff@gmail.com, that way you can write me your own one-sided conversation and I get to enjoy reading about what happens to all of you!  Au revoir mes amis!