cc >> Tom Zinnen: Welcome everybody
to Wednesday Nite at the Lab. I'm Tom Zinnen.
I work here at the University of Wisconsin-Madison Biotech
Center and for UW Extension, Cooperative Extension.
On behalf of our partners, the Wisconsin Alumni Association
and Wisconsin Public Television, thanks for coming
to Wednesday Nite at the Lab. We do this every Wednesday
night 50 times a year. Tonight I'm delighted to be
able to introduce to you Professor James Ntambi of the
Department of Biochemistry, who is going to introduce our
speaker. If you would like to come up
and say hello. Yes, this is you now.
>> James Ntambi: Okay, thank you.
>> If you stand right here. Three years of doing this,
and this is the spot. >> That's the spot right here.
Okay. My name is James Ntambi,
professor in biochemistry, Department of Biochemistry here,
and also Department of Nutritional Sciences.
I'm very glad to introduce to you Melissa Bruenig.
She was one of the students that traveled with us to Uganda
in December/January of this year as part of our
international program. So she's going to talk about
her experience in Uganda, and I'll tell you a little bit more
about this course. I think she's going to have to
show you the first and second slides, I'm assuming.
She's a major in genetics here in the College of Agriculture
and Life Sciences. And she's also involved in the
research, stem cell research, the Wisconsin Institute of
Discovery. So she's doing both research,
major in genetics and also, in addition, doing international
experience. So why don't you show the first
slide. >> Okay.
[applause] >> Melissa Bruenig: Like James
said, my name is Melissa. Tonight, we're going to talk
about HIV/AIDS education across Uganda.
So like he said, I was a part of the CALS Study Abroad
program. What's interesting about this
program is we don't just go to another university and take
courses. It's more like a field study.
And we get a chance to look at specific topics we're
interested in. So that's what I'm going to be
telling you about this evening. First of all, I thought we
should look at, where is Uganda?
So it is in Africa. You can see it is right here
in the circled red dot. We'll do a little blow-up of it.
So Uganda is central or the central eastern portion of
Africa. So that's where we went.
And you might be wondering why choose Uganda to study abroad
in? One of the reasons is the
university here has a really long-standing partnership with
Makerere University, which is in Kampala, Uganda.
It's actually where James did his undergrad and taught
for a while, too. Also, the program gives us a
better chance to understand the healthcare and nutrition that
is in the country, and I specifically looked at
HIV/AIDS. And the last is it's a
life-changing experience. Once you go, you come back and
you've witnessed things that you never would have seen
before, and it's actually made me reconsider a little bit what
I want to do with my life. Instead of just doing research
and genetics, I've decided that I want to broaden my horizons a
little bit more to the ideas of global health and it's sounding
like CALS is going to have a certificate program in that,
which I think I'm going to try and become a part of.
And with that, James is going to give a little history of the
program. >> Ntambi: Yes.
Let me tell you how this program started.
So we started this program about ten years ago when a
Professor Ken Shapiro was the Associate Dean of International
Programs. We decided that we should start
a program so that we could provide international
experience to our undergrads, undergraduate students.
We established a course entitled "International Health
and Nutrition." So the way we designed this
course was to teach this course in the fall and then have it
followed with a field experience,
as Melissa mentioned. So we would talk about aspects
of nutrition, public health, talk about HIV/AIDS,
talk about agriculture. This is College of Agriculture
and Life Sciences. Talk about culture.
Talk about education. Talk about women issues.
Talk about issues that affect the lives of people who live in
developing countries. So when we started this course,
we started off by recruiting 15 students at that time, and the
idea was to take the course here locally initially as I
described, and then during the winter break, take
a field trip to Uganda. And since this course was
focusing mainly on nutrition and public health, we would go
in there, and we were more interested in things that were
happening deep in the communities.
So that's some kind of outreach activity.
We have some understanding with Makerere University, the major
university in Uganda, and we have collaborators over there.
But when we go there, we don't really stay at the university.
We stay in the guest house, but then we do extension work.
We go deep into the villages to look at the real issues of
nutrition. And mainly we are interested in
looking at malnutrition. We visit our clinics,
children under five who are malnourished.
And so the idea is to show the students that I teach what we
teach here, the real-life experiences.
What is malnutrition? What is Kwashiorkor, which is a
protein deficiency disease, what is Marasmus, which is an
energy deficiency disease. These are some of the aspects
of nutritional biochemistry that we talk about in the
classroom. But I thought it would be
a good idea if I took the students so they can see the
real people who have these conditions.
Should sit around and talk about the biochemistry or the
nutritional biochemistry that is involved.
So this was the intent, to try and give the students
hands-on experiences. The other component, in
addition to doing or visiting these places, is that the
students would have a hands-on experience.
So they would also participate in making the lives of the
individuals that they see or they visit better.
How do they design good diets for the kids who are
malnourished. How do they improve the quality
of water that the individuals that they see drink.
So in the added parts of the course, I think in 2005, that
group, when they came back here, they actually set up the
nonprofit organization, which is called the Health Village
Project, that sort of is interested in extending what,
you know, the materials that we do over there.
They go back in and build water tanks, make water filters to
sort of improve or to -- so that the people over there can
have access to good drinking water.
So this project is a student organization.
The students run this organization themselves.
It's a nonprofit. They find ways, they write
grants, and they support other students who are interested in
going back to Uganda to look at these issues in public health.
So that was the idea behind this course, and we've been
running it for the last nine years.
And it continues. It also -- it also takes --
an exchange going on between the faculty at Makerere University
and the faculty here at UW, the students there.
It is really in a way, it's a two-way traffic.
So we're not only sending students from UW-Madison over
there, but we also want the people over there to come here
on short visits to see what this university is doing.
And, of course, our intent is to sort of better the lives of
people who live in developing countries.
So you can continue with the presentation.
>> Bruenig: Thanks, James. All right.
So as he said, we get to look at the topics that interest us
ourselves. So the reason why I chose
HIV/AIDS education was because the transmission rate is still
quite high and the epidemic is continuing.
I just thought it would be good to see how developing countries
are dealing with this. So the general question that I
asked while I was over there was what kinds of educational
or prevention programs are available to teach the public
about HIV/AIDS. More specifically, I wanted to
know what types of programs are they having.
What are they doing? Do they just have handouts or
posters? Are there group gatherings,
counseling, different types of government programs, or is it
more word-of-mouth between people?
So they have these methods of sharing with people.
What are they actually telling them?
Were they talking about the ABCs, which I'll explain in a
little bit, or what other type of prevention is actually being
taught? First, I thought we could
clarify, what is HIV/AIDS? According to the Mayo Clinic,
AIDS is a chronic potentially life-threatening condition
caused by the human immunodeficiency virus.
That's where HIV comes from. And it works by damaging your
immune system or your body's ability to fight organisms that
cause disease or other infections.
The disease is usually sexually transmitted, and it can even
take years before HIV weakens your immune system enough until
you get full-blown AIDS. I feel it's important to also
discuss that sexual transmission is not the only
way that HIV is spread. It can also be spread by
contact with infected blood or even from mothers to child
during pregnancy, childbirth and even through
breast-feeding. So what is historic about
HIV/AIDS education in Uganda? They were actually one of the
first African countries to successfully implement an
effective prevention program. This was done under still
current President Museveni, who was re-elected this February.
And what they did was they launched an aggressive campaign
that involved the media, teachers and community leaders.
The reasons why these all worked is because they
emphasized the ideas of waiting before having sex, staying with
a specific partner or no grazing, and for those who did
not abstain, they were encouraged to use condoms, and
that was actually targeted at the entire population and not
just those specific people who really indulge in risky
behavior. So one of the reasons why this
campaign works so well is because all of the things that
they incited in the people were ways to avoid risk or risk
behaviors. And what was great about it is
this helped reduce the rate of HIV in Uganda in the 1980s,
which was a little greater than 30% to the national prevalence
is down to about 6.2. So that's a really great
reduction. I'd mentioned those ABCs
before as one of the potential messages that they were
sharing. This billboard I didn't see
when I was over there in December.
It's from Botswana, which is another African country.
Is says, "Avoiding AIDS. As easy as ABC."
A stands for abstain. B, be faithful
and C, condomize. These are what some of the
early billboards looked like when they were doing that first
major push to help reduce the rate of HIV transmission.
The message of ABC can sometimes be worded slightly
different than what you see on the screen right now.
But it's all generally the same message.
It may depend on who is funding the billboard you're looking
at, too. Before I get into looking at
the different health centers and hospitals we went to, I
thought I would mention what their healthcare system looks
like because it's structured kind of different than our own.
So you can see here that the arrows are all pointing upwards
instead of down. So people start by going to
their local village health center.
Here it may just be one person, a nurse in a clinic that they
can go to. If they can't be treated there,
they get referred up and up. So we'll start the village
health, and then you go up to a Health Center 2, which is the
lowest, then 3, 4, and then finally you can be referred to
a district hospital or regional referral hospital or finally
the national referral hospital. The national referral hospital
is in Kampala, the capital city.
And at this hospital, they're going to see the worst of the
worst cases. You'll get referred all the way
up to the top if you can't be treated at any of the lower
facilities. Also interesting to note that
their healthcare system is free.
When you go to the doctor, you're treated for free.
Drugs are free if they're available.
Some procedures may have a cost, but most everything is
free. So the beginning of my
experience. Where did we start?
First, we flew into the city under the box that I have here.
But then we drove to Kampala, which is where we spent the
first few days. It's also home to Makerere
University and the School of Public Health which we worked
with closely and Mulago Hospital, the national referral
hospital I was talking about is also in Kampala.
So here's what Mulago looks like.
You can see the front of it right here.
And the view on the bottom corner here is from across the
street at Makerere up on a hill looking across.
So the facility is actually quite large.
I think this was one of the only hospitals we saw that was
multiple levels like this. >> Were they independent?
>> James, is it built since independence?
[inaudible] >> The question was,
was this hospital built before independence?
And yes, it was. Here we see a sign that says
Makerere University School of Public Health, which they also
have a medical school that partners with Mulago as well to
train the upcoming medical students.
Now, a little more information about Mulago.
In the picture here, we see one of the senior nurses in the
background with one of the doctors at the malnutrition
clinic located there. And this is the national
referral and so each physician sees about 500 patients at this
facility. HIV is treated in part of the
infectious disease ward here, and besides treatment, they
also do testing and counseling. And then something else
interesting to note about their healthcare system is that
families come with the patient to the hospital, and they stay
there and cook the meals and take care of them because
hospitals and health centers in Uganda don't provide more than
maybe a small porridge as a meal.
So then after we visited Mulago, we went to our first
health center, which is just outside Kampala.
This is one of the main buildings at this health center
complex. You notice that this one is
quite a bit shorter than Mulago, smaller.
The complex is outdoor, the buildings are separated.
Thankfully, it's nice in Uganda most of the time.
In Wisconsin, it wouldn't be nice to walk in between
buildings in the winter. But over there, that's not a
big problem. Inside of this building, they
were doing immunizations. And they were weighing babies.
We were lucky enough to speak with the one doctor at this
facility. And he told us that, besides
himself, they have six nurses. In the maternity ward, they
have an extra one midwife and four nurses.
They see about 100 to 230 patients, outpatients a day
here, and they usually have about 10 to 20 inpatients at
this facility. And they also serve a
population of about 72,000 people in the area.
So here we can see a picture inside of that main building.
See the nurses in green and the blackboard behind them.
You probably can't read on the screen, but it talked a lot
about HIV counseling and testing and how these were free
services available at this facility.
And then we'll blow up a picture of that poster on the
wall. These posters were quite common
at all of the health centers. It says "parents: it's your
role to educate your children about STD and AIDS.
Talk to them now." It was quite common to see
posters talking about facilitating a conversation
about how you can prevent HIV/AIDS and what it actually
is. The doctor also told us that
the rate of HIV in this area was higher than the national
average. It was 13%.
And mothers are also screened for HIV whenever they come in
for antenatal care during their pregnancies.
So now we had our first road trip.
So we started in Kampala and drove ten hours all the way
across Uganda to Queen Elizabeth National Park, which
is located in between or around, I guess, Lake George,
Lake Edward and the Kazinga Channel.
So this is a fishing region. A lot of these villages tend to
have higher rates of HIV because they are fishing
communities. The first health center we went
to was in Kazini, a Health Center 2.
So this is the smallest health center that you can find.
It only had two nurses. There were no doctors.
So a doctor would come from one of the local hospitals about
once a month to visit, and during these visits they would
bring HIV testing supplies and also do counseling.
The counseling, they would do pre and post test counseling.
And they would help the patients learn about how to use
the anti-retroviral or the HIV medication.
They would tell them to come in when they're sick.
Since HIV weakens your immune system you're more likely to
get infections. So they want people to come in
when they get infections so they don't end up dying from
the infection and not even HIV. They also provided condoms.
Here are a couple pictures from inside of this health center.
You can see in the bottom picture here this table.
That was their pharmacy. Not quite what we would
consider a normal pharmacy in the United States.
But for a small health center, they actually had some of the
drugs that they needed. So that was good.
On top we can see some of the medical utensils and a sink in
one of the examination rooms. Here's a picture of the fishing
community that that health center is located in.
And what they did for HIV/AIDS education beyond just the
counseling was that there was an FM radio station that talked
about the HIV/AIDS education. They focused on those ABC's
once again, and they really promoted getting tested.
Know your HIV status. There was a school across the
street from the health center, and they had posters at the
school that emphasized abstinence, don't get married
too young and get tested. In that same region again,
we have a Health Center 3. Again, it has sort of the open
forum and a blackboard, and we see the senior medical officer
who is leading this facility right there.
Again, the blackboard, it may be hard to read from the crowd,
but it focuses on positive living and positive prevention,
which are topics used in HIV counseling.
Here we can see the top left are some beds in the ward at
this health center. The picture on the bottom
corner, I wanted to point out. As we see right here, I told
you that the health centers and hospitals don't provide much as
far as meals go. So this is actually the kitchen
where families can come. This is a stove that they can
cook meals for their family that's in the health center.
So a little bit more information about it.
We see that they have one senior medical officer, one
nurse and one midwife. They see about 20 to 30
patients per day. And for what I was interested
in, this facility had family planning, HIV testing and
counseling, both pre and post testing.
Every Thursday they had an HIV/AIDS clinic.
That's a big step up from maybe the once a month
when a doctor would visit the Health Center 2.
And then during these clinics, they would talk about positive
living, how to cope with having the disease or someone in your
family with it, taking your anti-retrovirals, that's what
ARV stands for. Preventing infections and
prevention in general. Then a doctor does come once a
month to attend these as well. Then something I would like to
note, when we visited this health facility, the medical
officer told us that there was a box of condoms that was
always set out at his office. So like okay, that's really
good. The next day we stopped back at
this facility to use the restroom, and the box of
condoms was no longer sitting out.
So we don't know if they only put them out because they knew
we were coming or what happened.
So something to keep in mind. Next we visited
a Health Center 4. So this is the largest of the
health centers. It's in Lugazi.
We can see that this facility looked a little bit more
rundown than the previous two we looked at.
Here's a picture inside of one of the wards.
The beds look a little more worn.
However, we do note that they have bed nets at this facility.
With malaria at such a high prevalence, mosquito nets are
very useful in helping prevent malaria.
Even though the windows have large holes in them, so that's
not helping as much. But at least they have bed
nets. So a little bit of information
about this health center. It has a doctor.
One medical officer. Four nurses, two clinical
officers, which is a step down from a nurse, and one midwife.
They also have an HIV clinic once a week where they talk
about how to manage your disease, counseling and family
planning. Then I thought it was
interesting, this facility doesn't refer just to public
systems. So far I've only talked about
public health centers. But they also refer to a
private hospital because it's closer.
Over there, transportation can be a huge issue.
All the hospitals may not have an ambulance.
If they do have an ambulance, it may not have gas to get you.
It may be expensive to use the ambulance, and not all people
can afford that fee. So the closer a health center
or a hospital to a person, the better.
However, they would need to pay for their treatment at a
private hospital compared to the public.
And this center serves a district population of about
150,000 people. And, again, we see some posters
at facility. The one on the left is from
who, or the world health organization, and is four
stages of HIV and what symptoms you should see in each stage.
On the right there's a poster that says be a responsible man,
talk to a friend about family planning.
So they're really encouraging people to talk about HIV, not
for it to be so stigmatized, and then get tested.
Now we can't leave the national park without a few photos.
They were so beautiful. I had to share with you what
the country looks at. We just saw a picture of a
not-so-nice health center. I want to make sure you left
knowing that Uganda is a beautiful place.
If you care to travel to Africa, you should visit
Uganda. Our guide, Ronnie, liked to
call Uganda the pearl of Africa.
And I hope that these next couple pictures will help
instill that in you. I know I believe it.
This is looking out from our hostel and the national park
over the lakes. This is one of the lakes.
I believe this lake produced salt.
He has another picture of the lake.
These pictures can't do justice for what it actually looked
like. It's just so beautiful.
And you can't be in a national park without seeing some
animals. So we saw lots of elephants.
We've got a little baby elephant that is pretty cute.
In the bottom corner, we see a lion.
What you can't see in this photo is that the lion is
actually hunting a warthog. Our first day leaving the
national park, we sort of had a mini safari every time we left
the hostel to go out. We saw a lion and all of a
sudden we saw a warthog. I think we spent about a half
hour in our bus sitting there watching to see what would
happen. I can report the warthog did
get away. The lion went hungry for that
point in the day at least. And now we went to a different
part of the national park to Maramagambo Forest.
We walked around inside this forest, and here you can see
it's also on a lake and the vegetation is just beautiful.
It's time for another road trip.
Now we're going from the national park right around
here, we're heading down to Kabale.
So we're going to one of the southernmost points of Uganda
close to the Rwanda border. Now we finally come to a
hospital. We see the Kabale Regional
Referral Hospital. This is one step down from the
National Referral Hospital. So it's quite large.
And you see that this hospital has six doctors, but it should
have 36. It has an estimated two million
people in the four districts it serves.
So it's quite a few people for not a lot of doctors.
There are seven Health Center 4s.
These are the largest health centers that feed into this
hospital. None of them have doctors.
If these health centers are having, say, a once a month
doctor come, it can either be coming from Kabale or there's a
hospital lower than this, the District Referral, the doctor
may be coming from that hospital to visit these four
health centers. You'll see some pictures.
Here's in the children's ward. Those are the beds, and they
actually have bed nets and you can see that the windows don't
look broken either. This facility is quite nice.
Now, here we're talking about the family comes to stay with
the patients and cook for them. We can notice all the people
sitting outside, taking in the sun.
For us, we liked it. It was warm, you could walk
outside. It was a nice reprieve from the
Wisconsin winter. Now, I'll take a brief tour of
the laboratory at this facility probably a little messier than
a laboratory you would see on campus or in a hospital.
It was cool to see right here the purple and red stains.
Those are for gram stains which are used in identifying the
bacteria in malaria. The picture in the bottom
right-hand corner, you can see that these are malaria tests.
So I had the fortunate -- I was fortunate enough to be able to
sit down with John, who was the coordinator of the chronic care
clinic at this facility. And he basically told us his
life story and how he became involved in HIV counseling,
education here in Kabale. He lost both of his parents to
AIDS. He told us that he had to drop
out of high school in order to take care of his siblings.
But his story improves in that in 2004, he was able to go back
to school for counseling. Before he got the job as the
coordinator of this clinic, he actually volunteered here and
he's a pastor as well. He told us that by counseling
at this facility and being involved with it, it actually
taught him that people who have HIV aren't sinners.
He's now better able to relate that to his parish community
and other people that anyone can get HIV/AIDS, and it
doesn't mean that you're a bad person because you have it.
He said that this clinic, since its start in 2003, has served
6,782 HIV positive adults and children.
More females than males. And he said this is because
females are more likely to get tested, especially every
pregnant mother gets tested when they go in for antenatal
care. Males are more likely to
partake in risky behaviors and then not tell their wives about
it, so more women can get infected that way as well.
They have nine staff here and 16 community volunteers.
They serve approximately 30 people per day at this clinic.
Some of the counseling activities that you could find
here were group or individual counseling.
In their group counseling, they could get as many as 250
people, and they come and they share health talks on different
topics like tuberculosis or other infections you could get,
also talk about positive living stories, how they're living
their lives even though they're HIV positive.
They share about family planning, condoms and STIs
or sexually transmitted infections.
They speak of the nutritional aspects of taking ARVs.
When you're on the medicines, they work better if you have a
nutritional or a balanced nutritional diet.
They also talk about how to deal with testing results and,
again, the aspect of positive living.
This is a common sticker to see not only in this clinic but
also around the hospital. Some of the outreach programs
that this facility had was they shared a daily video.
They had kind of a little lobby area with some benches and they
had a TV. The video was playing
throughout the day. And it talked about HIV in
order to educate the people who came to watch it in sort of a
fun way and to help them learn and to prevent spreading HIV
themselves. What was really great about
this is John said that all those family members we saw
sitting outside, they would come over to the clinic, they
may watch the video or at least part it.
So the video is actually reaching a large audience to
share the HIV/AIDS education. They also have a community
drama or drumming group which I thought this was really
exciting. They would go out to the more
rural community areas who may not have a chance to get to the
hospital and see the video. They would do this once a
month, and they would do a song and praise to mobilize the
community and educate them about HIV/AIDS and try and
reduce the stigma. And all of the members in this
drumming group are HIV positive themselves.
They're going as a positive influence of I'm living with
this disease and you can too. They also have testing after
the different drumming events that they have so that people
can learn their HIV status as well.
In downtown Kabale, since the hospital is up on a hill, they
have an AIDS center and another ARV clinic to distribute the
drugs. Funding for the education.
It all comes down to money, right?
So two of the bigger funding organizations were the AIDS
support organization and reproductive Uganda.
The latter of the two, funding just stopped when we were there
in January. John was telling us the biggest
problem is sustaining funding so all of the really great
programming they have can continue.
He told us that without aid from the united states and
other developed countries, their programs wouldn't be able
to continue. He also shared with us some of
the testing numbers out of their clinic.
I thought it would be interesting for you all to see
tonight as well. In December of last year, they
tested 1,183 people just at the hospital.
This isn't including data from testing done after the drumming
groups. They found 58 people to be HIV
positive. 47 were female, and 11 were
male. So of that group, the
percentage was 4.9 people were HIV positive and 81% were
female. In September of last year, they
tested 1,509 people, found 90 people to be HIV positive or
about 5.9%, and 61 were female, 29 male.
So we had 68% were female this time.
Again, we can't leave the hospital without seeing some
posters. On the left we see one that
says "tell your partner about your HIV status."
they're really pushing getting tested and knowing your HIV
status. And on the right, it says "keep
your dreams alive, choose life."
Then here, the man in the middle, that was John who
graciously took an hour or so out of his afternoon to speak
with us. And you can kind of see there's
a calendar in the background. Probably a little hard from out
there. But it's filled with black
writing. That's a calendar for a month
of all of the outreach and education programs that they
were planning to do at that facility.
So they were jam-packed, and they did everything they
possibly could with the funding they had to help educate the
community, and I thought that was really great.
Time for a road trip again. We're going from Kabale and now
we're moving further northeast. This is the district hospital.
So this is the smallest hospital that you'll find.
It also says on the sign right here, we see it has Uganda
cares which is an NGO that funds their HIV/AIDS clinic.
And they have an ARV clinic there as well.
Little bit about this facility. It's a 100-bed hospital.
It served a district population of about 70,000 people, and
they only have 35% of the staff that they needed.
They have 80 staff members, but they should have 181.
They also do not have an ambulance.
A little breakdown of the staff.
The they have four doctors, 17 nurses and 18 midwives.
They also have a partnership with something called COBIN or
the Community Based Integrated Nutrition.
What COBIN is, is it's a partnership that has community
health workers that go out into the more rural communities, and
they weigh babies and they track the weights from month to
month so they can tell if the child is malnourished or not.
If they find the child is malnourished, they can do what
they can to get the child help or get them to the hospital.
We also see this picture, this pot, a pinkish-purple porridge
in it, that's used for refeeding for the malnourished
children that come to the hospital there.
Here we see some photos inside the clinic.
Again, look at all the posters on the wall.
This is our lovely group. We take up a good part of the
hospital. Then on the bottom right-hand
corner, we see one of the examining rooms.
For what I was interested at this hospital, we see HIV/AIDS
education. They talked about how to care
for those with HIV, counseling, both pre and post testing.
For prevention, they had outreach programs to take ARVs
to the community, and they did specific outreach to sex
workers at night. Lyantonde is located along a
major truck route. So with that being said, the
rate of HIV is higher in this community.
So it's important that they reached out to that specific
portion of the community, those at high risk.
They did that by providing condoms.
We can also see the rate of HIV in town along the major truck
route is about 10%, which is higher than the national
average of about 6.2. And in the village, it's quite
reduced at about 3% to 4%. Again, we see another photo
here from inside the outpatient clinic.
And it says, meet HIV and CD 4.
It went on to show about the different stages of HIV at this
clinic, they provided drugs, that was in part funded by
Uganda Cares, and they provide these five days a week.
They said they usually had enough.
Lyantonde is also situated in a portion of Uganda that can
have a severe dry season and water become an issue.
James talked about a group called Village Health Project.
They work a lot with clean water.
So they have donated bio sand filters and water tanks in this
region. In the top photo we see one of
the bio sand filters here. A can of water is being dumped
in. This water in this water bottle
came from a local water source, maybe a pond.
It looks kind of brown, kind of yellow.
I know I wouldn't want to drink that.
Once it's gone through the bio sand filter, we can see in this
bottle it looks pretty clean. I would maybe drink that if I
wasn't used to United States water.
It still may make me sick. But for them, that's a lot
better. It's a huge improvement.
So the hospital does have one of those bio sand filters for
people to use. I'm not sure how often people
actually use it, but it's there.
And then we also got to see one of the water tanks being built.
So these are a photo down on the bottom.
The men are using a machine that compresses dirt and cement
mix to make bricks, and what's cool about making these bricks
is they don't have to be fired. So they're saving wood because
they'll dry on their own and they have sort of the --
they're kind of circular in formation.
So they can build the water tanks.
They have a machine that makes the more rectangular bricks for
more conventional building as well.
We see that they're cementing it, putting it together.
The top right-hand photo shows us moving bricks and them
starting to build up the sides of the tank.
Here's what one of the tanks actually looks like completed
along with four of the students that came along with us this
December and January who are also a part of the campus.
The big photo we see is of a lake.
And we notice the cow feces and the cattle around the outside
edge of a lake. This lake actually tends to be
a major water source in the area in the dry season when
these water tanks dry up. And you might be surprised to
hear that one of those water tanks can actually hold 10,000
liters of water and it still may dry up during the dry
season. Another cool thing about the
water tanks is that the community members who receive
them do pay for a portion of it.
So they feel a little more ownership towards it and take
better care of it. A note on the local cuisine.
We ate a lot of beans and rice and something called ground
nuts. It's basically like peanut.
For me, you could usually find fish, chicken, beef or goat.
This yellow stuff right here is James' favorite.
It's a steamed plant, kind of a form of banana.
I didn't particularly like it. But James loves it.
You see that there's a menu underneath our plate here.
I thought I would point out that it may look like any menu
you find in the United States. The big difference, however,
not everything on that menu could be ordered.
You could say I'd like this or that, they could say we don't
have that available. You were safe to go with the
buffet, which was the beans and rice, some form of meat and
some kind of fruit. You weren't guaranteed they
would have the food available at the restaurant for other
things on the menu. The menu is more of a "I wish
I could serve you this." Now for another road trip.
Here's Lyantonde. We pass through Kampala
and over to Jinja. Now we went to the primary
school. This is actually where James
went to school. It has about 750 students for
Primary One through Seven. They can have as many as 100
students per class in P-1 or 2. They have about 18 teachers.
You see the outside of the building here.
The paintings on the wall actually show some different
lessons that varied from math, geography, I saw some human
organs on there. Over here is what the inside of
that building looks like. It can be segmented into three
chunks. You can imagine 100 students
per chunk, 300 people in that small building.
That could get kind of warm and be a little smelly and kind of
hard to listen. Some more pictures.
So myself and my friend Lauren on the trip sitting on a bench.
Granted, we're larger than elementary school students.
But they usually fit six to seven kids per bench.
Here you see James showing us his humble beginnings doing
lessons in the dirt. We also had the chance to talk
with the headmaster of this school.
You can see there are posters on the wall here.
One poster in particular caught my eye.
It said counseling and guiding pupils on HIV, to continue even
if HIV/AIDS has affected family and to accept people with it or
family members. So what they're trying to do is
to teach some health and HIV prevention lessons in their
class, and what they talk about varies based on the age of the
students and what level they're in.
And then, as some of you may recognize me, I also work for
BioTrek with Tom. So the color change pencils
and the DNA string that a lot of you have seen
on the table outside made their way to Uganda as well.
So here we're giving them to the headmaster.
Our group also donated solar light bulbs, other books,
pencils, pens, soccer balls and some money to help with
building renovations that were going on there as well.
And now, in Jinja is where you'll find the source of the
Nile. This, again, is too beautiful
for me not to share with you. You can see this cement block
is the zero source of the Nile. You can kind of see the ripples
in the water here showing where the Nile is spring-fed up.
This is along kind of the border of Lake Victoria.
And then further down the Nile we see the falls, which is a
really large waterfall that you can sit and watch it because
it's just amazing. You see all the water going all
around. I have a few acknowledgments
I would like to make. First, I would like to thank
John Ferrick and James Ntambi who put together the program.
Our guide in country, Ronnie. And professors from the
Makerere University School of Public Health, Imelda and John.
One of my fellow classmates, Chris, for some of the photos
he took that I've used, and the Daughters of Demeter, who
provided me with a portion of the scholarship to pay for
my experience. And with that, I would like to
ask for any questions. [applause]