I have meant to update you all sooner about my trip to this island, which happened a few months ago, but I had kept on putting it off till now. Better late than never, I guess. Well, I went there with Kathleen, who is a fellow M from AIM, and a large group from Milmday to do HIV/AIDS outreach in the island of Kitobo. Kitobo is part of an archipelago of 84 islands called the Ssese in Lake Victoria. We left from the Entebbe sailing club in Entebbe (of course) and traveled for about 2 to 3 hours to get to Kitobo. Kathleen had initially noticed that she was getting a lot of patients who were HIV-positive coming from the islands—and so thought it would be a good idea to really see what the prevalence of HIV is in the islands. I had heard from a second-hand source before I got to Uganda that some believed that the prevalence to be as high as 90%, then 70%, but I’m not really sure if those figures are totally accurate. I still don’t think they’re true—that would be ridiculously high (though not improbable). Although I have to say that from what I have heard of the lifestyle of these fishermen—it is quite conducive to spreading STDs. Nonetheless, when I got there it was still a sight that needs be notice. It’s a shantytown that is totally dependent upon the fishing business. Most came here to become fishermen—since it seems that catching fish brings good money (although, I’m hearing that Lake Victoria is suffering from over-fishing). But most are singles or I’m thinking married away from home—and so you know how that goes around here. There were plenty children who would curiously clasp my hand as I walk around, which was wonderful—but I never found a school for them, sad. There was a church…if I remembered correctly, but how it is doing, I have not a clue. We set up our clinic in the local bar and that is where people get counseled and tested for HIV. I didn’t take too many pictures inside the town because I just thought it would be cause too much attention—and I just thought it would be disrespectful. Anyways, I did take some pictures in the outskirt of town near the shore. You know what’s interesting is that the island is mostly a plateau—but all of the people live on the sea level near the shore. I asked why they didn’t buil their houses on the high places—because I was thinking to myself, I would rather live where there’s a nice view, you know. But they said they don’t build houses there because they’re afraid of spirits that dwell there (too bad!). Which reminds me to tell you that a lot of traditional (aka witchcraft, haha) practices are still performed (i.e. child sacrifices) out here—so people here are still quite wary of the islands.

I typically do not take photos that would show people's faces during
VCTs, but this time I did, oops! Well, one of the staff told me to do it
anyhow, so I hope that was alright.

One of the Mildmay counselors giving pre-test group counseling in
the make shift bar-cum-clinic.

Two cute children playing by the shore.

At night, you can witness dozens of candle-lit boats out at sea--the time
men are usually out fishing. It's quite a site--I should've taken a shot,
DARN!

The town is built a few feet above sea-level near the shore on one side
the island. The rest the land rises up to a plateau that makes up most
of the island.

There is such a contrast between the white bird (don't know what kind)
and the pile of garbage that surrounds the village.

So we did the VCT for a day and a half and spent the night at a neighboring island called Banda (Bamboo) island where there is a hostel owned by a hippy-like British expatriate (alongside his German expat-cum-sidekick). Actually, he’s technically not an expat since he was born in Kenya and now lives in Uganda running an island backpacker’s hostel. Accommodations were fair, but the food was delicious. His pumpkin soup was incredibly good and his ratatouille was smashing (do I sound British, probably not, just corny, huh?). I was telling myself, ooh, ratatouille—reminds me of the movie, I’ll have to try and cook that one of these days. He also made his own banana liquor and he let me take a sip of his coffee spiked with the stuff. I think I tried some, but I forget now—but, if I did, I violated AIM policy not to take any alcohol. Anyways, even if I did drink it, I did it in front Steve (the regional officer of AIM) who, coincidentally was also the pilot of the boat. Oh well. Steve, I think said that Dominic, the owner, previously had a more negative opinion of Christians, but after meeting him and Kathleen, he has slowly changed his mind. One good benefit is that M’s from AIM get to stay there for free. Sweet, huh? If you had time to read his site, you can sort of tell how he is like. He’s quite funny.

The Ssese: Kitobo Island

I have meant to update you all sooner about my trip to this island, which happened a few months ago, but I had kept on putting it off till now. Better late than never, I guess. Well, I went there with Kathleen, who is a fellow M from AIM, and a large group from Milmday to do HIV/AIDS outreach in the island of Kitobo. Kitobo is part of an archipelago of 84 islands called the Ssese in Lake Victoria. We left from the Entebbe sailing club in Entebbe (of course) and traveled for about 2 to 3 hours to get to Kitobo. Kathleen had initially noticed that she was getting a lot of patients who were HIV-positive coming from the islands—and so thought it would be a good idea to really see what the prevalence of HIV is in the islands. I had heard from a second-hand source before I got to Uganda that some believed that the prevalence to be as high as 90%, then 70%, but I’m not really sure if those figures are totally accurate. I still don’t think they’re true—that would be ridiculously high (though not improbable). Although I have to say that from what I have heard of the lifestyle of these fishermen—it is quite conducive to spreading STDs. Nonetheless, when I got there it was still a sight that needs be notice. It’s a shantytown that is totally dependent upon the fishing business. Most came here to become fishermen—since it seems that catching fish brings good money (although, I’m hearing that Lake Victoria is suffering from over-fishing). But most are singles or I’m thinking married away from home—and so you know how that goes around here. There were plenty children who would curiously clasp my hand as I walk around, which was wonderful—but I never found a school for them, sad. There was a church…if I remembered correctly, but how it is doing, I have not a clue. We set up our clinic in the local bar and that is where people get counseled and tested for HIV. I didn’t take too many pictures inside the town because I just thought it would be cause too much attention—and I just thought it would be disrespectful. Anyways, I did take some pictures in the outskirt of town near the shore. You know what’s interesting is that the island is mostly a plateau—but all of the people live on the sea level near the shore. I asked why they didn’t buil their houses on the high places—because I was thinking to myself, I would rather live where there’s a nice view, you know. But they said they don’t build houses there because they’re afraid of spirits that dwell there (too bad!). Which reminds me to tell you that a lot of traditional (aka witchcraft, haha) practices are still performed (i.e. child sacrifices) out here—so people here are still quite wary of the islands.

I typically do not take photos that would show people's faces during
VCTs, but this time I did, oops! Well, one of the staff told me to do it
anyhow, so I hope that was alright.

One of the Mildmay counselors giving pre-test group counseling in
the make shift bar-cum-clinic.

Two cute children playing by the shore.

At night, you can witness dozens of candle-lit boats out at sea--the time
men are usually out fishing. It's quite a site--I should've taken a shot,
DARN!

The town is built a few feet above sea-level near the shore on one side
the island. The rest the land rises up to a plateau that makes up most
of the island.

There is such a contrast between the white bird (don't know what kind)
and the pile of garbage that surrounds the village.

So we did the VCT for a day and a half and spent the night at a neighboring island called Banda (Bamboo) island where there is a hostel owned by a hippy-like British expatriate (alongside his German expat-cum-sidekick). Actually, he’s technically not an expat since he was born in Kenya and now lives in Uganda running an island backpacker’s hostel. Accommodations were fair, but the food was delicious. His pumpkin soup was incredibly good and his ratatouille was smashing (do I sound British, probably not, just corny, huh?). I was telling myself, ooh, ratatouille—reminds me of the movie, I’ll have to try and cook that one of these days. He also made his own banana liquor and he let me take a sip of his coffee spiked with the stuff. I think I tried some, but I forget now—but, if I did, I violated AIM policy not to take any alcohol. Anyways, even if I did drink it, I did it in front Steve (the regional officer of AIM) who, coincidentally was also the pilot of the boat. Oh well. Steve, I think said that Dominic, the owner, previously had a more negative opinion of Christians, but after meeting him and Kathleen, he has slowly changed his mind. One good benefit is that M’s from AIM get to stay there for free. Sweet, huh? If you had time to read his site, you can sort of tell how he is like. He’s quite funny.

Gertrude

Happy endings are always—well, happy. Gertrude (maybe 2 or 3?) came with her dad today to get tested. She was quite healthy and happy as well—she kept on smiling. Her dad said that she’s probably happy because she doesn’t know that she’ll be prick by a needle yet—that is always an advantage. She didn’t even change her mood as I flashed the needle in front of her—usually, kids cry at the first sight of it. As I bled her (and her crying), I asked whether he (her dad) has been tested yet. I asked that question, because usually parents and children get tested at the same time and I noticed that he didn’t have a form to get tested. The he shared that he and his wife are HIV-positive—but they’ve accepted it as a fact of life. He said that there are some things that you could not change and you have to learn how to live with it—positively. I looked at him and asked, “are you healthy—do you take good care of yourself?” “Yes, I do (I forgot what he actually said, but you get the point).” And honestly speaking, he did look good—a bit slender, but in a healthy sort of way. At the get-go, I got to like this person—he was easy to talk to and quite friendly. He had a caring persona about him. Anyways, I only got about 2 mls of blood from Gertrude but she turned out to be negative—thank God. I ran some extra tests because one of them was inconclusive and I wanted to be right about her diagnosis. But after seeing the results—I was quite satisfied and quite happy. Later as I was cleaning up for the day, little Gertrude came by to the tent and I let her sit right next to me as I cleaned the table. She wanted to share her little beanie bear with me, too. Haha, I love it when I get to play with little kids—it really made my heart smile. One of my co-workers, Grace, said after noticing her sunny disposition that this girl is truly loved and taken care for at home. And, I do agree—you can definitely tell when I child is being taken care of by their parents. That made my day.

P Young Testing It Out

Getting tested for HIV at VCTs is quite quick, taking at most 5 to 15 minutes to find out whether or not you have antibodies for the virus. What you see P. Young doing on the right is placing 50 µL of whole blood or plasma onto an absorbant test paper. The filter paper has viral antigen in a specific area (a strip) attached to it already. So, if blood that travels through the filter paper has antibodies against HIV, the antibodies will then bind to the viral antigens along that strip and change color. The change of color means that the individual is seropositive and has produced antibodies in response to HIV infection. However, in the case of infants—they can produce a false positive since they might have residual maternal antibodies. I don’t want to get into further details. Anyways, there’s actually 3 types of rapid HIV tests used here—Determine, produced by Abbot Laboratories, Stat Pak by Chembio and Uni-gold by Trinity Biotech. Determine is supposed to be the most sensitive but not always the most accurate, while the Stat Pak and Uni-gold kits are a bit more specific. The protocol here is if you’re tested negative with the Determine kit—then you’re seronegative. However, if you test positive for Determine, a second test with the Stat Pak is done just to make sure—and if there is incongruous results from the first two tests, then Uni-gold is used to break the tie. Anyways, I wasn't really sure if I was allowed to have P. Young do some of this work. But I figured I didn't want him to be bored and just hang around and not do anything--besides, my co-workers didn't seem to mind and had a great time talking to him. I don't think he was in any danger--I made sure he wore gloves!

VCT Tent

(Left: My first victim of the day; Right: co-workers Paul and Grace at the VCT Tent)

I'm actually getting quite proficient in drawing blood these days. Actually, my skill has remarkably improved after P. Young left. Too bad he couldn't see me in my glory, haha (jk). Anyways, patient by patient I'm getting better, hee hee. Although I try to stay away from babies and chunky people (I CAN'T SEE THEIR VEINS!!--sorry don't want to offend anyone, but I guess I did). I'm not sure if I would have been allowed to do this if I was back in the States, I probably would've gotten sued left and right. I remembered my first time trying to stick my first patient, I kept on telling myself, "you can do it, you can do it, it's just like sticking a mouse...no problem." Yeah, the problem is when you miss a vein in a mouse, you don't have the feeling of two eyes searing into your skull...knowing that you'll have to pull out the needle and stick them again. Anyways, I think I can pull my weight these days and I don't have to ask someone to bail me out anymore. Although struggling babies are still a challenge--they just have so much fat around them! But they're all quite cute. So the VCT (which stands for Voluntary Counseling and Testing) tent is where new clients come to the center to get tested if they have antibodies to HIV. If they have it, then more than likely they are HIV-seropositive, although it's a different situation for babies under 18 months of age.

Which Leads To...

Putting it all aside, Jesus didn’t come to impress anybody. He came to reconcile us to God. He came through the periphery and went where there was lacking. And that has been what’s being impressed upon me these past few months. He loves the poor, the prostitutes, the addicts and the rest of the destitute that have been ostracized or forgotten by society. For instance, getting infected with HIV as a matter of fact is a life sentence. Not only physically, but may times socially as well—some of them get abandoned by their own spouses, parents and extended family. I personally wouldn’t know what I would do if I had it. Unfortunately, I see hundreds of people around me everyday. How they live with it, I can only imagine. It’s tragic to think that the people sitting in the waiting area are not really coming to see whether they have the flu or other diseases. They wait their turn to find out whether or not they’re HIV positive which I can tell them within 10 minutes of their bleeding. Fortunately, it’s not my job to tell them, since I’m not a trained counselor. Plus, I don’t speak Luganda well enough to be able to properly counsel them, anyhow. Nonetheless, Mildmay is really an amazing place. It’s a UK-based Christian hospital that specializes in HIV/AIDS palliative care. For the most part it’s an outpatient center but it has an inpatient ward for children who might need special care. But I think one of the more uplifting testimonies is the way they are being cared for by a mostly Christian staff that has a vision on how they want to serve their fellow countrymen. Their foremost goal is to reach the poor and the ignorant and to teach them about HIV/AIDS and if needed put them through antiretroviral therapy (ART) or highly-active antiretroviral therapy (HAART—as most of us know it out in the west). But more importantly, they teach them on how to live positively and see the hope in life in the case of HIV-seropositive patients. Conversely, they remind them of the consequences of their actions if they continue to live a certain type of lifestyle and emphasize abstinence, faithfulness and condom use. Some of you probably might notice the last emphasis—you know, preventive measures must still be practical. One thing that really encourages me is their willingness to bring holistic “healing” to their patients. I sometimes would sit in at one of their meetings regarding counseling problematic non-compliant patients. It’s interesting to hear how they would address the person—and if nothing else works, they would ask what their spiritual state is. And if it does need to be addressed then they would send their pastor or their imam to reach out to that particular individual. Yes, they have a resident imam on staff in order to reach out to the Muslim community—which I think is what any good Christian organization would do in this situation and I think Jesus smiles when he sees this.

Outside the Box

Jesus is such a clever person. I mean, really, he’s such a wise and creative guy. He is a master at answering questions and has the uncanny ability to perceive the real matter at hand. But, duh, I guess that’s a rather obvious thing to say. Anyhow, I would often chuckle to myself how he could leave someone quite dumbfounded and frustrated with all his parable talk. But as most of us know, they had a purpose and in the end, the people who needed to hear it heard it—and his message changed their hearts. It’s too bad that a lot of people stereotype Jesus’ ideology as close-minded, dull, unimaginative, boring and the list goes on. On the contrary, if you were to read about his adventures, he was quite innovative, funny, passionate, loving, fun-loving and against the grain (and yes, the list also goes on) sort of guy. I guess it’s partly our fault that at times non-Christians view Jesus through the lens of us. In fact, Jesus is the ultimate outside-the-box experience and we or I, actually, do not see him as such at times.

Where I Am

Unfortunately, due to my laziness and usual “dislike” to blog online, some of you might think that I’m still in Kenya somewhere. But I’ve been in Kampala, Uganda for the past four months (Hehehe….) working at the Mildmay Center. In total, I’ve been away roughly 5 months already, which is incredible. It doesn’t seem like that long of a time, but then again it seems quite long already if you to count the days. I guess the time adjusting to a totally new environment makes it seems as if each new day is another day to somehow “fit” and adjust…and when that happens, time flies. So by the time you know it, months have passed by and you’ve only gone an inch in trying to accustom your life in that place. So effectually, I am still adjusting to my new culture and I don’t think I’ll be fully adjusted…ever (haha, just degrees of comfort). It’s been fun in the beginning, hard when I can’t communicate and annoying when I’m frustrated. However, in the end, I really have to fix my eyes on what is on hand and constantly remind myself why I’m here. You often get distracted with the sometimes-mundane tasks of everyday life that you forget the bigger picture. But I’m figuring that that in itself is one of the greatest challenge on being a vibrant and joyful Christian. It’s sort of like just tending to the dirt under your feet and ignoring the wide-open spaces you pass by as you walk down the countryside. Then again, we’re all human in our failings, but God is gracious in His dealings with us. God can truly do great things through our apparent weakness and failings—and that, truly shows how amazing the God we worship and serve.