Matoke and Malaria
Here begins the chronicles of my trip to Uganda. At the end of the first week I have quite a bit to talk about…
Let’s see, first why I am in Uganda in the first place. I am doing research with a Notre Dame graduate student who is doing her dissertation on the genomics of Plasmodium Falciparum (the parasite that causes malaria). We aren’t here to do any DNA work but we are here to do some research on malaria–think policy not parasites.
The Research
Rural home–proximity to facilities can be a deterrent to effective and timely malaria treatment
Intent of the project is to interview healthcare staff at various levels of the healthcare system here in Uganda about the implementation of the National Malaria Control Strategic Plan. I would explain further but I have learned A LOT about Uganda’s healthcare system in the past couple of weeks and have learned that to explain this would take muuuuch more space than I’ve got. The targets of the plan that we are most interested are 1)Increasing the percentage of children under five with access to ACT (the first line treatment for malaria) within 24 hours of symptoms, and 2)Increasing accessibility of ACT to all (including through the private sector, so private drug shops and pharmacies). ACTs are relatively new in Uganda, and expensive outside of the government supply. It used to be a different medicine (chloroquine/sulfadoxine/pyrimethamine if you interested in long chemically type names) was the recommended first line of treatment, but the wily parasite has become resistant to these drugs. As for the age specifications in the targets, children under five are most affected by malaria as their immune systems are not as strong as an adult’s. Malaria kills a child under five every thirty seconds. An unbelievable statistic. Malaria is a huge problem in sub-Saharan Africa and in Uganda it accounts for 50% of all illnesses and 20-23% of all mortality. We are working in conjunction with the Ford Family Program (http://kellogg.nd.edu/ford/who.shtml) which represents a partnership between the University of Notre Dame and various international partners. In our case the partner is Uganda Martyrs University in Nnindye, Uganda. It is our hope that our research might help the program work with those in the Nnindye community to first focus on areas within the malaria policy that need attention, and then find ways that they might work towards positive change in these areas. Currently, there isn’t any information available about implementation of malaria policy in Nkozi sub-county (where Nnindye is located) so the information we find could be very useful for officials and others working towards community development in the area.
The other component of our project has to do with the antimalarials themselves—we want to collect them and take them back to the US for analysis. There is a problem in East Africa with substandard antimalarials so we will be testing the drugs to see if they have the correct amount of the active ingredient.
Heading South
At the equator with some friends
So in the process of this we get to explore Uganda! We arrived in Kampala, the capitol, but didn’t stay for long (long enough to pass out after hours of travel only to discover that Kampala is in a consistent state of partying ALL NIGHT on the weekends. Oh well.). We headed off to Nkozi sub-county in Mpigi district to the west of Kampala (still the central region of the country) to Uganda Martyrs University (UMU) where we are stationed for the duration of our stay. On the way we passed the equator (see photo)—first time south of the equator EVER! It was a very nice drive through the country—there are many hills and it is very green, but in a much more rubbery way than back home. A lot of the trees are banana or sorts of palms (some leafy trees as well, and even some evergreens).
We settled into UMU quickly—the campus is very pretty with lots of flowers and many exotic and beautiful plants I have never seen before (including droopy pink cattails—see below). More importantly the people have been great. We eat all of our meals in the cafeteria here, so it is easy to walk right up and start a conversation with a student. There are a lot of agriculture students here who are very curious about agricultural practices in the US. Unfortunately all I can say is “uh…I live by a lot of corn?”
Awesome flowers at UMU—I like to call them droopy pink cattails
SHLOP—matoke. Or–dinner.
So the food here needs its own heading. Matoke, the main dish here is a staple for every meal. Try to think of really thick mashed potatoes. Now pretend the mashed potatoes are mashed bananas that don’t taste anything like bananas you have had before and you have matoke. A starchy blob of banana-y goodness. I am currently working on my matoke tolerance…right now there is only so much I can take at one meal (usually about half the amount shlopped out to me in line). I’ll keep you updated though. Other foods we eat are not so foreign, beef, fish, beans, rice, a kind of corn curd brick called pocho (very tasty) pineapple, and BANANAS! They have bananas for everything here! I never knew there were so many types—bananas for matoke, bananas for snacking, even bananas just for making the “local brew”! Haven’t tried it yet, but I hear it is potent…
Countryside near UMU
Out and About
Yesterday, we went out with a community leader, Matteus, to do some scouting for where we might be able to do interviews/collect anti-malarials. We took a “bodaboda”, basically a motorcycle taxi (very fast, very fun!). These are a bit problematic for women wearing dresses… We wore long skirts to the villages as it is polite to dress more formal, however, to ride a boda in a skirt you have to sit “side saddle”. So here we have one driver and two women sitting sideways on a motorcycle! I was holding on for dear life most of the ride. And to top it off as we were chugging up a hill, the bike came to a jerky stop.
Yup, we were out of gas. So we pushed the bike up the hill and waited while our driver hitched a ride to go pick up gas.
On the side of the highway.
In the middle of rural Uganda.
It was good to see more of the area and get a feel for how people live outside of the University (which can be very sheltered). I think waste management is the largest problem here—there is a lot of trash burning and just trash in general. It seems that working to improve in this area might help improve many other areas like health and the environment. Anywho, with the first week finished we await drug collecting for next week!
Signing off,
Alison
This post was written by alison.case
