Friday, 20 June 2008

Do African’s want Western style development?

Do African’s want Western style development?

During the past 5 weeks, I have had numerous conversations with mostly Europeans and North Americans about the problems in Africa. Most of the views were that African governments were corrupt and only spent money on weapons and fancy cars; and the people of Africa have a different work ethic and aren’t interested in development, but only to get rich. Fairly pessimistic. At the same time, I had been reading The End of Poverty by Jeffrey Sachs, an optimistic take on development and the future of humanity. He argues that Africans do want to pull themselves out of poverty. Depending on who you ask, they’ll give you different priorities.

“They are uneducated and don’t know what development means, so they need education”
“How can the survive without food or water?”
“Treat their health, and then they’ll be in a better state to work themselves out of poverty”

It’s many things, and it’s complicated. We oversimplify it when we speak of Africa, a continent of over 50 countries, and numerous ethnicities. Most may not know that there is no Ugandan person. There are Acholi, Baganda, Teso, Banyankore, Bateso and a lot more tribes, and clans, families. People from the Uganda are vastly different from people from South Africa, and Ghana. Some countries are democratic, some are considered failed states. The contexts are numerous.

Some people I was just talking to were telling me about how the people from the DRC were happy with their lot, didn’t want Western style development. They didn’t want to work themselves out of their situation because they're OK with it!

I don't know enough. We all need to seek to understand the situation of the people who we claim to be doing things on the behalf of, before we actually do 'good'. Similarly with patients, we need to seek to understand their backgrounds before we jump in with a diagnosis, let along prescribing drugs, ordering investigations etc. The same applies for those countries and populations which we deem to be worthy of our attention.

I'm only talking about Western style development. We only ever think of European and North American development, but let's not forget the emerging economies like India and China, who have already waded into the mess with their own style of development. Someone once told me "China is the only country building roads in the Democratic Republic of Congo". Chinese businesses are opening up everywhere. Perhaps this is an option preferred by many, the option to build businesses and make money, which is what a hell of a lot of people want around the world, thereby putting their own destinies in their own hands (with the help of their wallets).

And what of homegrown development? What role is there to play for the future strong economies of Africa in helping their neighbours?

Tuesday, 17 June 2008

Initial observations about the North

About a week ago, I headed up north to Pader district to do some interviews. It’s a different country up there, mainly because of the 22 year insurgency that’s been going on and the fact that up until a few years ago, 2 million people, that’s the vast majority of the population, were displaced living in internally displaced persons (IDP) camps. The insurgent Lord’s Resistance Army, led by the elusive Joseph Kony had been fighting government forces, with the aim of establishing a country based on the 10 commandments. They’ve abducted tens of thousands of children over the years to be used as child soldiers (who are now the LRA themselves after growing up), porters and sex slaves. They killed indiscriminately; they mutilated genitals, lips, noses and ears and cut off the limbs of many of those whose lives were spared.

Largely ignored by the mainstream media, the conflict was allowed to reach a peak in the early 2000s. The government had been criticised for ignoring the development of the north, and many many NGOs and UN agencies have taken root in the area known as Acholiland, made up of the districts of Gulu, Kitgum and Pader.

The security situation is much better these days as the LRA are in the border regions of Uganda, Democratic Republic of Congo, Sudan and the Central African Republic. They’ve recently killed civilians and troops in South Sudan, and the other nations along with Uganda and the UN are agreeing on coordinated military action against him. This is worrying in a way as he will most certainly up his own game of abduction, displacing many more in an area where there are so many war displaced already from Darfur, Chad, DRC, South/North Sudan conflict.

It’s a bit messed up really.

My journey up to the north wasn’t the smoothest. At one point, I thought I’d be staying the night in a very small town/IDP camp called Acholibur. There was little transport passing through and the rain was torrential. What struck me in the north at first, was the number of people who appeared to have abnormal mental states. You don’t come across them in Kampala, but in the little town of Acholibur, there were 3 people who were definitely mentally disturbed.

A result of the upheaval experienced by themselves, but also of experienced by the society as a whole?

I hitched a ride with a World Vision Landcruiser to Pader when it was dark, and got into the GOAL office quite late, and a little hungry, but the football was welcoming. There was no running water in Pader, which is something immediately in contrast with what I was used to in Kampala. I’m sure there are many areas in the south without water, but this was the capital of the district. Many of the buildings were mud and straw huts, which are what you expect in villages, but not towns. An example of the extreme inequality of development between Kampala and the rest of Uganda.

I conducted an interview in the World Food Programme compound the following morning, surrounded by 6 humongous tents that housed tons of sacks of flour, and rice, and cartons of oil. This was an indicator of the response that is needed to address the problems following the uprooting of your life to be transplanted into an artificially created camp with little opportunity to continue living, farming and trading the way they were used to.
I carried on to Kalongo town/IDP camp, and the base of operations for the emergency programme of GOAL NGO. The area was beautiful, with large looming mountain standing sentinel over the town. Actually, Ugandan Peoples Defence Force (UPDF) troops were based up there maintaining a look out post. A very strategic position as when I went up there, you could see the various hills around the town, and see the lay of the land for miles. My guide, Peter, who has been out of school due to lack of money, pointed out how the LRA made their way from the road to Kitgum, through fields, copses of trees, to a small ridge next to the town where they waited for night fall. Then they made their move. Usually a small number around 6, where half would raid, loot and burn buildings, and the other half would kill and abduct.

You could see how the town was laid out, with brick buildings lining the road, and just behind them were the huts where villagers and IDPs lived. Using the zoom on my camera, I could see other IDP camps dotted around the area. Children from these camps used to commute into Kalongo time to seek shelter at night. These smaller camps were more vulnerable to attack you see.

Peter also told me about how the IDPs and villagers would gang up on the Karamojong now, to defend their cattle. The Karamojong are armed nomadic cattle herders who have been carrying out cattle raids and killings in the area also.

With the programmes that GOAL and other NGOs are doing, people are gaining a greater amount of food security as they are farming again, although this is barely enough to survive, and little gets to market to be generated as income. There have been many water and sanitation projects too, but I can’t really speak of their impact. I have nothing to compare to, and I didn’t visit any projects due to time.

For sure, the NGOs have made a difference, but real change can only occur when the security problems are resolved and economic development is spurred on by the government. They are the ones who can credibly steer the vehicle of change.

That’s all for now. I don’t want you (or myself) to get eye strain.

Saturday, 7 June 2008

Interesting comments - tough questions

And before I hit the sack...

I got this comment (thanks Sunil) regarding my post about the roles of a doctor etc...

"Is your point that that doctor, or whoever, should be trying to change structures so that that person doesn't appear there in the first place? Getting the root of the cause? I'd love to hear some more of your thought!"

Perhaps this is asking too much of doctors, but shouldn't we be asking the rest of society? It's late. Hmm... I need to think about it after sleep.

I'm not mindlessly blogging now... shouldn't have started writing this at this time!

A long time no blog

Hi everyone, sorry for the lack of blogging recently. Data collection has finally started big time. I’ve done 2 and a half interviews so far, which will keep me occupied as I try to transcribe them. I have an interviews lined up for the next few weeks and I’m hoping to head to Pader Town and Kalongo IDP camp next week to interview some other contacts who are based out there. Not sure what to expect up there.

I’m really looking forward to getting away from Kampala and being able to put into context, where so many of these NGOs work. I’ve read so much about the war up there too, I’m looking forward to seeing it for real. I’m nervous about the recent announcement that the Ugandan Army is planning fresh offensives on the LRA with UN backing! I think these will be largely confined to the border regions of Sudan, DRC, and CAR.

After hearing stories from Charles, the security guard at Red Chili from Gulu, I’d like to see the places he was talking about, and I look forward to speaking to other people about their experiences.

Most of the other International Healthers in Uganda have pretty much finished their data collection and they’re all heading off to see the gorillas, head to Rwanda and make their way to Zanzibar over the next few weeks. I wish I could join them in Zanzibar, but I can’t really change my flight from Entebbe and to be honest, I don’t really feel travelling and roughing it on the road too much right now. Just not in that frame of mind… It’s gonna be lonelier at the Red Chili without them though!

In other news, I went rafting yesterday on some amazingly intense/insane rapids on the Nile yesterday! It was so much fun. The boat flipped several times, swam a few rapids, thought I was going to drown at some point. Ask me for the DVD when I’m back to watch me fall out the of the raft and flounder.

Friday, 23 May 2008

On the side of the road

You know that silence?

The silence when a group of you and your friends walk past a young girl, clearly underweight, ragged clothes, hand to mouth gesture.

Nobody says anything. Averts eyes from each other, but perhaps will steal a glance at the girl to see whether her gesture is well practiced or whether she really does need help.

What makes you decide to stop and give a couple of pence? The overpowering feelings of guilt? Because, surely, we all know that those few coins will not help her out of the situation she's in?

Perhaps you can justify not giving her anything. It only takes a few seconds of thinking, "I'm training to be a doctor. I will save lives. Stop people from dying of treatable diseases. That's far more than giving a few coins".

Is it?

Is that enough?

Do people really think that if you fed that girl, treated her for HIV, and gave her vaccinations, that her situation will be solved?

I'm not saying all doctors and medical students think that way, but some do. I did. But that's naive and egotistical. It takes more than being a doctor, and having good will, and giving a few coins.

Will you stop and ask why she's on the side of the road? And work with her to improve her condition and the many more who weren't so lucky to have been spotted by someone with money/power/knowledge?

A Rant

People’s ignorance is disgusting.

The obvious disrespect for other cultures and religions when they claim to be open-minded, modern citizens of the same planet is shameful. I am ashamed.

How people can knowingly work for industries that serve to perpetuate the violence carried out on people every day, that acts also to continually destabilise communities to leave them dying slowly from hunger, thirst, preventable diseases, is beyond me. It’s not like they don’t have a choice. They’re usually the lucky few who do have a choice in this world.

We have so much in common at so many levels. From the one who is suffering to the one who is reaping all the benefits. I bet they have a hell of a lot in common in many ways. Unfortunately, just because people get on, or care about similar things, doesn’t do away with the truth that there still exist those who don’t see the bigger picture. They get some of the connections, but not all, not enough to change the way they think or act. Most of us are all decent. We want to look after the ones we care about, we all want to be happy, but the problem is how we go about doing it so that we’re all cared for and that we can all be happy.

Perhaps making things personal forces us to compromise, to take a step back and say, “OK. It doesn’t have to be this way. Have some of mine. We’ll share a little. I forgive you. Let’s agree to disagree and have a laugh about it. Let’s make sure people aren’t unnecessarily dying from malaria/unexploded cluster bombs/dirty water/depression/giving birth”.

Launching a cruise missile isn’t personal. The President tells the general, to tell his lieutenant, to tell someone else to press the button. Nobody kills anyone. People just die.

Perhaps that's a bit of an extreme example, but it's the little inconsequential, "it's not going to harm anyone now, is it?" actions, that add up and conspire to make life impossible. These problems are so removed from the personal lives from those who hold power that change just seems to slow.

Tuesday, 20 May 2008

Me at my desk and other photos


Kampalan Market

Kampala Taxi Park by night

Another market picture

Monday, 19 May 2008

Setbacks

The interview questions are looking good. I need to go and practice them but annoyingly, I was meant to run them through today with two of the staff at the NGO, but they've been away/busy.

I need to get them looked at and then figure out who I'm interviewing with them before I actually start collecting data!! And it's taking longer than I expected!

Sunil Bhopal sounds like he's getting on just fine though... read his blog at http://maternalhealthresearch.blogspot.com/

Hmm, guess I'm just not in a fantastically creative mood at the moment. Sat in an office in a muggy atmosphere.

Yesterday was interesting however! Walked home from the city which took 2 hours because of a little first aid incident. My friend Laura and I were walking back when we saw a motorbike vs pick up truck accident. I thought it was gona be pretty bad but the motorcyclist just got straight back up and only had superficial wounds on his joints... When I say first aid, I gave him some wet wipes to apply to his wounds... the rule to never touch blood is all the more important when you know there's a lot of HIV/Hep B around!

In the meantime, while I'm remotivating myself for interviewing, I'll be keeping up with sorting out Medsin stuff (www.medsin.org), planning whether to do anything touristy, and thinking of more interesting blog entries!

Sorry readers... I'm flagging a bit right now...

Sunday, 18 May 2008

Saturday, 17 May 2008

Different perspectives

My middle finger on my left hand is a little stingy as I sliced it when cutting into a mango (they're cheaper than apples here!).

I've been thinking a lot. Unfortunately, too much to fit into a blog, or diary. You know what I mean? Really great ideas, observations jump into your head, and you think, "Oooh, isn't that clever/astute/profound?! Must remember it, or write it down."

Then you get distracted as you avoid being run over by a minibus.

Here's one of my thought trains.

When you travel as a backpacker, you see the country/world from a particular perspective which is very different from that of a Ugandan. For example, this Uganda would be rafting in Jinja, gorillas in the mountains, Murchison Falls and avoiding getting ripped off. Also, meeting other backpackers in fancy westernised hostels, discussing the relative merits of Nile Beer over Club beer.

For Ugandans, Uganda is home. It's different. They don't think of gorillas when they think of home. For me, I'm trying remain in the researcher frame of mind. I've not done anything too touristy yet. I'm reluctant to. I'm noticing other things like HIV in the headlines, the state of the health centres, the number of NGOs out here, how they're perceived etc.

This opens up lots of other 'Uganda's. There's the ex-pat Uganda who moved for who-knows-what reason. Then there's the development and humanitarian worker Uganda. What do they think/see?

I want to get into this world and explore it and really put my research into some context too. How do NGOs make decisions? How are they influenced? NGOs are big organisations, but they're made up of individuals, and I feel it's important to understand how these individuals are to add another layer to the picture.

Plus, it's fun because I've done the backpacker thing and it gets boring. Actual rafting may be exciting, but the idea of being able to go rafting doesn't excite me. Thinking and seeing a place/people from a different perspective is more exciting for me right now.

The Red Chili Hideaway is where I'm staying. There's such a hodge podge of people. I've met doctors working here because they just felt like it, young Ugandans earning money for their studies, ex pats who are now helping to run the place, 2 guys making a documentary, loads of 'overlanders' rocking up in massive trucks (merits of this form of travel? - Discuss), an anthropologist researching in a village for a year, volunteers, NGO interns....

Is this normal for guesthouses? I've never noticed anyone but the usual gap yearer back packer, lets get pissed/stoned/laid type.

Anyway, happy times. Loving it. Loving people, and I hope you're having a good time whatever you're doing after you stop staring at the computer screen.

Thursday, 15 May 2008

And today's air quality is.... crap again


In the 1990s or thereabouts, petrol in the UK went unleaded, thanks to the environmentalists! Woo, score one for the greenies! Incidentally, I was the proud owner of a green Blue Peter badge when I was wee until I lost it at a gig.

All the leaded stuff all got shifted to Kampala, and now I've discovered why it was banned in the UK.

As you breathe in the morning (pretty much all day actually) rush hour air, you pick up scents of red earth dust, unburnt petrol and probably loads of lead.

(The guy in the picture - tired after a long day? Or lack of oxygen from breathing in fumes all day?)

I certainly breathed a lot this morning as I commuted from the Chili to Tank Hill across town. This is where a lot of NGO offices are based. On my walk from Tank Hill Parade, complete with its own Italian gelateria - pronounced helataria (mispronunciation pisses me off), I passed little dented signs for Oxfam, MSF, Marie Stopes, and GOAL.

Wow... it's really amazing being here with all these people doing humanitarian work. Commendable for sure. I won't declare my reservations just yet.

All the work I've been putting into this research project led up to the moment I knocked on the massive iron gate that opened up into the GOAL compound. Storm clouds still loomed from this mornings downpours which added to all the other things that was making me feel nervous (or perhaps it was the espresso at the gelateria...).

The initial meeting with the Emergency Programme Coordinator went well. I met a few of the other staff, including the Assistant Country Director. No names I'm afraid. Not sure how they'd take it. Bad experiences of mentioning names in blogs before so I'll tread carefully.

(Oh crap, 15 minutes of battery left)

I feel really energised for this whole project now! What with the possibility of meeting Ministry of Health officials too. I sat down to work in the thatched, open walled hut in the compound, replete with replete large solid table and an ethernet cable. Free internet is a joy. I'm such a geek.

Well, best wrap this up before the battery dies and I lose the message.

Tuesday, 13 May 2008

Ki kate!

Short post.

Arrived safely and I'm loving the people! Traffic was horrendous coming into Kampala but hey ho, what do you expect?! Red Chilli Hideaway is quaint, a little plain perhaps. No mossies at least. Lots of monkeys though.

I'm with quite a few other folks from the course also doing their research in Uganda which is realy nice!

About to make contact with GOAL, get Ugandan SIM card, and assess security situation up north and figure out what I'm going to do with myself with the rest of my time here.

Things are looking up... possibilities abound!

Sunday, 11 May 2008

Blue, green, yellow...

Blue, green, yellow, green.... yellow.... house... green....

After an almost teary farewell to Claire (girlfriend) at the platform, I'm on my way down to Gatwick Airport on the train... It's just crept up on me! The sky's blue, the sun's out, the trees are green again, and the fields are jaundiced from the oil seed rape flowers. And they're rushing past all blurry very fast! I'm in the pleasant company of Sophie Unell, a fellow coursemate who's off to Buenos Aires for her research project.

A week to go has turned to a 4.5 hours to go and I've never felt this nervous before about going away! I feel like I'm about to fly into a big exam that'll last weeks. I'm sure those of you who are reading this with real exams will be disgusted that I think flying to Uganda for 8 weeks is a worse prospect than they're facing sat in some glum university back room huddled over their desks.

I don't think that. Sorry guys! I've got a better deal than you.

This trips a little different from my other overseas jaunts. I'm going armed with a few questions, a swish new Apple MacBook, a dictaphone and a big fat social research methods textbook. Not your standard bag full from a dash around Millets.

I'm going as a student researcher.

The questions may seem a bit dry to you:
  • How do Non-Governmental Organisations (NGOs), like MSF, make decisions regarding their health policies and programmes?
  • Where do NGOs find the information to inform their health policies and programmes?
  • How do NGOs decide which information to use?
I'm not sure whether to focus on the research much, or perhaps I should focus more on my experiences of research... we'll see how this unfolds!

Monday, 5 May 2008

One week to go...

I've got a week to go, before I arrive in Uganda and I've got lots of shopping to do. I hope my dictaphone arrives in time, and that I manage to get a decent quote for health insurance. Most insurers won't cover you if you're going to somewhere where the FCO advises against.

This isn't going to be another one of my get up and fly jaunts around a foreign land. This time, I'm going with a research project. I'm aiming to find out a little more about how NGOs make decisions regarding their health policies and programmes, and what sorts of information they use. How do they prioritise the information they get?

I still need to get round to finishing my interview schedule. Not entirely sure what this should be like, but I should get cracking on anyhow!