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The moment I first felt fully immersed in my Policy Analysis Exercise (PAE) project coincided with the moment the Ugandan children began to call me by my Baganda name — Nanyanzi — rather than referring to me as mzungu (colloquially, "white person;" literally, "crazy person running around in circles"). To the extent feasibly possible, I had become one of them — walking the dirt roads, fetching water from the stream, and eating supper by a kerosene lamp.
I spent the first three weeks of January in rural Uganda surveying 800 households about their health behaviors and interviewing several dozen community health workers, chairpersons, and health center staff about health care capacity in the area. My PAE client is Omni Med, a Boston-based NGO that has partnered with local health officials and local community-based organizations in Mukono District to train Volunteer Health Teams (VHTs). VHTs are Ugandan community health workers who conduct home visits, educate villagers about various health issues, and refer patients to local health centers. They are relatively new across the country; in Mukono District, the first ones were trained in 2009.
My client is interested in knowing whether the VHT program has had an impact on health behaviors in this area, and how the organization might be able to improve the program going forward. The data I collected in January has certainly proven to be valuable. But what was even more valuable to me was the time spent talking to the community members and learning about the subtleties of village life that binary variables and logistic regressions cannot capture.
I learned that many villagers savor the “sweet” taste of un-boiled water and prefer it to the "bland" taste of boiled water. I learned that many consider water from a stream to be cleaner (and hence safer) than piped water (nonexistent in the village but common in the capital city, Kampala) because the former “is filtered by the roots of the trees” while the latter “comes from the places where people soo soo and poo poo.” But most importantly, I learned that VHTs and community members shared a general perception that fewer people were falling sick to malaria and fewer children were suffering from diarrhea since the beginning of the VHT program in late-2009. With my PAE, I hope to quantify this general perception into something more tangible.
I’d like to return to the area to carry out follow-up projects with the VHTs and see this program develop further. Maybe on my next trip, I’ll find out what happened to Sibu’s cow. This cow had been arrested for roaming onto a neighbor’s peanut patch and eating a handful of peanuts, taken 1.5 miles to the nearest police station where it was tied up appropriately, then bailed out on personal recognizance by Sibu himself. When I left, the matter was still unresolved.