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I spent my last day of the trip in Addis Ababa. I had a 24 hour layover and just relaxed at the hotel. I also made sure to have my favorite food-Ethiopian! I am pleased to report that Chicago's version is authentic. The long flight back wasn't too bad as I had the entire row to myself and could stretch out. We stopped to refuel in Dublin and I watched the sunrise over my ancestral home. Coming in to Chicago was a wonderful feeling and I am so happy to be home. I love this city and my place in it.

After dropping my luggage at home and treating myself to a mani/pedi, I met my sweet nephew Enzo for the first time. I love him so much.

Final week in Africa

Hello everyone!

Last Monday, I spent the day with the team from Gardens for Health. GH is a small non-profit that operates a 5 acre farm and nutrition program outside of Kigali. I met the country director Solomon at a conference last year and was thrilled to be able to see their work during this trip. The farm is a beautiful and productive testing ground for their work improving nutrition and preventing malnutrition in the communities they serve. On the farm they grow a variety of crops including mushrooms, fruit trees, amaranth, kale, sweet potato and corn. They share cuttings and seeds with the families they work with and also sell some of their produce to local hotels and restaurants for income. They also use the farm to test agricultural techniques to improve crop yield during the dry season.

In the community, GH staff partner with community health workers to enroll families at risk for malnutrition in a multi-week course on nutrition, cooking practices, healthy pregnancy, and sanitation and hygiene. GH created the One Pot, One Hour initiative which has been adopted by the Rwandan Ministry of Health. This is an intervention which teaches families how to make a nutritious, balanced and low cost meal using one cooking pot and time saving cooking techniques. I accompanied the GH staff on home visits with women who recently graduated from the course. One mother discussed how she learned the importance of prenatal care through the course and noticed a difference in both her health and her second child's health as a result of receiving more frequent care during her pregnancy. Another mother proudly showed off her chunky, happy infant and described the nutritional improvements she has made for her family as a result of her enrollment in the program.

Local people are hired and trained to run activities on the farm. These folks are tending to the fruit tree nursery.

The community table on the farm where the team shares a delicious meal together everyday.

GH also provides childcare for staff and local workers on the farm. The older kids were eager to impress us with their multiplication knowledge!


I spent Tuesday and Wednesday with Partners in Health. PIH's work in Rwanda has been supported for many years by CFP and it was a such a privilege to finally be able to see the work on the ground. I visited two sites that PIH covers in coordination with the Ministry of Health and was so impressed by PIH's commitment to excellence in healthcare, flexibility and ingenuity.  Far up into the Rwandan hills, PIH works with the government to run a state of the art hospital and cancer treatment center (one of the only cancer care centers in the country). They are also building a graduate school that will train Rwanda's next generation of doctors and public health professionals. At the community level, PIH trains and supports a cadre of community health workers who reach thousands of families each year providing basic preventative and curative care, education and support. I was especially taken with the mental health support that CHWs have been trained to provide. We went on a home visit with one CHW who has been working with a mother for many years who suffered significant trauma after her husband was killed in the genocide. Building a trusting relationship, this CHW was eventually able to get this woman to see a counselor and begin a course of treatment for depression. She talked about how she went from not speaking or being able to care for her six children, to being productive and able to integrate back into the community again as a result of the CHWs intervention. 

Entrance to Butaro Hospital

The PIH team, CHW and mom that he has been supporting towards greater mental health.

On Thursday I flew to the the western edge of Rwanda to visit with Heartland Alliance International's mental health team working in Buvavu, DRC. CFP has been supporting the Fikra Timamu ("of sound mind") program since 2012 and this was the first time we have been able to visit this amazing group of mental health clinicians. I crossed the chaotic border of Rwanda into DRC and spent the next two days with the team in the field. The South Kivu region of DRC has a long history of civil war, gender based violence, and trauma from the brutal and exploitative gold and coltan mining industry. The Fikra Timamu program is designed to address this trauma at the community level by providing counseling and linkage to care at hospitals and local health centers. The team took me to visit a local health center and meet with several government health officials that they partner with.

The DRC health system is in much worse shape than anything I saw in Uganda or Rwanda. Families who cannot pay for their child's care for instance, are not allowed to leave the facility until they settle the bill. At the health center we visited, there were at least half a dozen small children living there waiting to be released. Basic medication is often not available and advanced care is difficult to come by.  Sexual violence and its tragic results are very common. A young girl of about 15 was resting in the maternity ward at the clinic having just given birth to a  tiny infant. She had come in complaining of abdominal pain not realizing that she was pregnant and in labor. She had most likely been the victim of a rape. No family was present to support her. It is in these conditions that the HAI psychologists work and provide a comfort to those who would otherwise have no access to mental health care. As a social worker myself, I was moved beyond words by this amazing team of professionals and the work they are able to do in such challenging circumstances. I am so deeply proud to play a small part in supporting their efforts. Bukavu was also the most beautiful part of Africa that I saw on this trip. Lake Kivu at sunset is astonishing.


The HAI team. So joyful and welcoming to me!

The beauty and complexity of Kigali

Hello everyone!

It is hard to believe that my time in Africa is drawing to a close. The last two weeks have gone by so quickly! I am tired and a bit homesick, but also deeply grateful for and energized by this rich and invaluable experience. I have developed a much deeper understanding of the work supported by the Global Health Committee and built important relationships with potential new partners. My educational goals were exceeded in my time with Omni Med and I am hopeful that my final project will be a useful tool for them to use as they think about their strategic direction over the next few years. Personally I have been moved beyond measure by what I have seen here; the great challenges brought by extreme poverty as well as the incredible perseverance and ingenuity of the people who live here. I have also been heartened by the successes of the organizations (large and small) who work so hard to support those in need.

After I left Uganda last Saturday, I flew to Kigali for a few days. Kigali feels a world away from Kisoga and even Kampala. It is a very cosmopolitan city whose relative wealth, compared to its neighbors, is very apparent. I stayed at the Marriott which even by Chicago standards was luxurious. I'll admit to taking two hot showers the day of my arrival! Here again I was reminded of my privilege; moving seamlessly from bucket showers to high end toiletries. That said, I very much enjoyed my stay and appreciated the chance to relax and regroup.

On Sunday, I took a guided city tour which took us all over and provided a great glimpse into the city and Rwandan culture. The day ended at the Genocide Memorial. In 1994, over 1 million Rwandans were systematically murdered by their neighbors in the span of 100 days. The slaughter was encouraged by the government at the time and targeted at a maligned minority group.  In addition to the 1 million killed, over 2 million fled the country. Eventually, Paul Kagame (Rwanda's current president), leading a rebel group, stopped the slaughter. The country was devastated by the trauma, which makes it all the more remarkable the gains that Rwanda has made since that time. 63% of Rwanda's parliament is female; life expectancy has doubled; 91% of the population is enrolled in the government health system; and GDP growth is 7% per year.  I asked several Rwandans what they felt accounted for this astonishing recovery and all attributed it to political will and a strong government.

There is poverty in Kigali to be sure and country continues to struggle with high rates of maternal and child death and non-communicable diseases. That said, it was a good reminder (especially for an American) that Africa is not just one thing or one place, but rather a collection of beautiful countries with unique histories, cultures, challenges and successes.

View of Kigali

Eric takes us to a "milk bar". Cows are cultural currency in Rwanda and highly revered. Sharing a glass of milk together is an important custom.  The pastries were amazing!

A delicious Rwandan lunch. Similar to Ugandan food but spicier. 

We took a water taxi from this dock--just like Chicago!

Eternal flame at the memorial

My final week in Uganda

Hello everyone!

My last week with Omni Med was full and rewarding.  On Tuesday, we went into the field to accompany VHTs on home visits and learn more about the challenges that the families they work with are faced with, especially when it comes to sanitation and hygiene. Many families cannot afford to construct a pit latrine (approximately $400) even though it is one of the best prevention tools against diarrheal diseases. VHTs take a harm reduction approach for these families and encourage them to wash their hands with soap and water and use proper cleaning and food preparation techniques to minimize the spread of disease.

VHT talking with a community member about the importance of sanitation and hygiene.

On Wednesday, I shadowed another VHT who is assigned to work at the health center that serves Kisoga. Rosette assists the health center staff with organizing and packaging medicines, giving health talks to waiting patients, assisting other VHTs who come to the clinic to volunteer, and numerous other tasks. Her work is vital, as this health center in understaffed for the number of patients who arrive each day. On the day we were there for instance, the psychiatric nurse was also responsible for running the pharmacy and reception desk.

Adult male circumcision is a very common procedure at Kojja as it has been shown to be effective in the prevention of HIV

Main building of the health center

Labor and delivery room- only two beds

We also spent one day observing the construction of a safe cook stove. In partnership with the Cookstove Project, a number of Omni Med VHTs have been trained to lead cook stove construction for families who need them. Cook stoves burn less fuel which is better for the environment and more affordable for families and they also create less smoke which can decrease the prevalence of pneumonia in children and adults. The materials can be gathered for free from the community-mud from ant hills and banana leaves-so it is obtainable for most families. It takes a lot of work though and it was amazing to watch these older female VHTS cut into think banana stems and mold thick mud into a sturdy and functional stove. 

I left Kisoga on Friday and went into Kampala where I spent the day with Living Goods. Living Goods also supports and trains VHTs  but their model is quite different from Omni Med's. As an added incentive, VHTs purchase medicines and other supplies as wholesale from Living Goods and sell to the community for a small fee. This way, VHTs  can make a small profit and have the medicines they need to treat children for malaria, diarrhea and pneumonia. Families can  also purchase labor and delivery kits, fortified cereal, solar lamps, and other products they need at a fraction of the cost from a pharmacy or local shop. I spent the afternoon with a VHT in the field and observed her care of two pregnant moms. She showed me the prompts she uses to review good nutrition and health pregnancy activities as well as the data collection tool she has on her phone to enter in the information from her visits. 

Friday night I had dinner with the folks from LifeNet International. Working in Burundi, DRC and Uganda, LifeNet provides training, coaching and technical assistance to health clinics to assist them in improving their clinical and administrative practices. They design a curriculum that fits the specific needs of each center and works with them over a several year period to strengthen everything from accounting practices to hygiene protocols. I really enjoyed learning more about this work from Josh, LifeNet's Country Director for Uganda and his wife Nadine, over a delicious chicken curry at a rooftop restaurant overlooking busy Kampala. A far cry from rural Kisoga!

I said goodbye to Uganda on Saturday and flew into Kigali to begin the next leg of my journey. I'll share more soon about the wonderful experience I have been having in beautiful Rwanda!

Happy Birthday!

Good morning everyone!

It has been a busy few days since leaving Kisoga on Friday. I am in Kigali, Rwanda now and have much to report. But, I'll do that later when I get back from spending the day with Gardens for Health.

I want first to wish a very happy birthday to two of my favorite people who share this day. Today my mother Liz turns 82 and my nephew Joaquin turns 12. I still remember the first time I held him. I miss you both and hope you have a wonderful and fun filled day! Much love to both of you!

More soon!

The committed and hardworking staff of Omni Med

Good morning everyone!

Another quiet weekend at Omni Med. My fellow students went into Kampala for the weekend to explore, so I had the house to myself again. Over these last few weekends, I have really enjoyed the opportunity to relax, read, work and take in the sun. I will miss that when I get back to the faster pace of Chicago.

It has been a privilege over these last few weeks to get to know and learn from the Omni Med program staff. They are a small team of smart, thoughtful, hardworking people and the student volunteers have much to learn from their approach to the work. 

Edward is Omni Med's CEO and has been working for the organization for ten years. He started as a VHT and worked his way up to a full-time paid position as the leader of the team. His depth of knowledge of the communities served is invaluable and he has a wonderful way with VHTs and families. During home visits and trainings, he puts people at ease with humor and stories. He is also an excellent driver which in Uganda is no small task! He handles the rain, pitted roads, boda-bodas, and random livestock with ease. He knows everyone and is always waving to passerby from the van.

Elizabeth has been with Omni Med for nine years. She also started as a VHT, moved on to become a translator for student volunteers, and is now Omni Med's CFO. She manages the day-to-day budget with finesse and is responsible for negotiating with contractors and vendors. She has been so welcoming to me and the other students and I have enjoyed talking with her over lunch about her life in Uganda. 

Henry is the newest staff at Omni Med, having joined as VHT Coordinator a few months ago. Henry is responsible for communicating with VHTs-no easy task- about scheduling and logistics. He is kind, funny and patient with all our questions. 

In addition to their full-time work at Omni Med, Edward, Elizabeth and Henry each have other jobs. This seems very common here as folks have to work extra hard to earn cash for essentials such as school fees, medicine, and travel. Edward is a farmer and sells his crops at local markets. Elizabeth owns a hair salon. Henry runs a small store. The side hustle is essential. 

I sat in on their staff meeting last week. I am not exaggerating when I say this was the most engaging, lively, egalitarian and solution focused meeting I have ever attended. The meeting was opened with a prayer which had the effect of centering the group and bringing a sense of common purpose to the task. We then moved into a great discussion of the logistics of Jack and Jacob's plan to test the ORSTubes. Everyone had a voice in the conversation and sufficient time was taken to talk through the challenges and come to an agreed upon plan. There was a lot of debate and disagreement, but it was welcome- not something to be avoided or minimized. It was also enjoyable! Elizabeth had fun demonstrating the ORSTube process for us and we had a lot of laughs. 

Elizabeth demonstrates ORSTube at the staff meeting.

Last week, we also had a tour of several sites where Omni Med has built Protected Water Sources (PWS). In Uganda, 23 million people lack access to clean water. Those who do not have access must rely on unsafe sources such as rivers, lakes, and unprotected wells. One consequence of poor access and quality is that water-borne diseases are a major cause of infant mortality. PWS are a relatively cheap and effective intervention for improved sanitation and hygiene. When a VHT identifies a community that is lacking in a PWS, Omni Med assists in the construction of PWS in collaboration with the community. Omni Med has constructed 30 PWS, increasing access to over 8,000 people. 

Protected Water Source

Edward demonstrates how to retrieve water.  

A class perspective from an interesting vantage point

Good morning everyone!

My third week with Omni Med continues to challenge and inspire me.

I am no longer the only student volunteer at the house. I introduced you to Jack and Jacob last week. They demonstrated their ORSTube prototype to the Omni Med team on Monday. It was fascinating to hear the perspective of the local staff on how this tool could be used by VHTs and what the challenges will be. They will test it with a number of VHTs starting next week and gather feedback to make further improvements.

Four more students arrived on Tuesday. Three are second year medical students at George Washington University in D.C. and one is a senior at Bates College in Maine. The house is very full and it is interesting having roommates who are 20+ years younger than me. They are eager, kind, very accomplished, and well traveled. This morning, Christina introduced them to the work of Paul Farmer and Partners in Health. They dove right in to Pathologies of Power, Paul's famous treatise on health, human rights and the call for preferential treatment for the poor. I look forward to hearing their thoughts on his work.

Elizabeth and the VHTs

I had a second chance at training at the end of last week. Jack, Elizabeth and I drove out to a remote health center about one hour away and met with five VHTs for a training on healthy pregnancy. I felt a bit more prepared for this one as it is a topic I have more experience with from my time managing a home visiting program for new parents in the Rogers Park neighborhood of Chicago. It was also really helpful to have Jack as scribe. The VHTs took copious notes and asked great questions--many that I could not answer. All in all, it felt like a success.

Exam room in the health clinic

Training tool for VHTs in the field

Health Clinic

Hallway in the clinic. This is a weighing station for infants.

I've been thinking a lot about social class since I've been here. By Ugandan standards, I am wealthy and very privileged. By American standards I am middle class- thanks to a dual income, no children and a relatively modest lifestyle. I was, however, raised in a working class home. My father worked hard to support six kids as a delivery driver. My mother took care of us and our home. While we mostly did fine, we were on food stamps for a time and from a young age I was keenly aware of our status compared to some of my friends from wealthier families.

College was not something that we were expected to do or something that my parents could have afforded to help any of us with anyway.  I was a pretty good student in high school and wanted to pursue college. I moved out when I was 18 and often worked three jobs to support myself and take occasional courses at the community college.  Later, I took out loans and eventually got a BA from a public university at age 29.  There were times in that eleven year period, where I couldn't afford to fix my car or eat a full three meals a day. I cringe to think about the moldy, roach infested studio apartments I have called home. A few years after my BA, with the help of loans and work, I received a MSW.  It is through the generosity of my employer that I have the privilege of pursing this second graduate degree and this amazing field experience.

Thinking about class from an American perspective in a place where many, many people live on less than $2 a day is an exercise in gratitude and discomfort.  I am deeply appreciative of the opportunities, support, and sheer luck I have experienced in my life. I am also made deeply uncomfortable by the persistent and tenacious injustice and economic violence in the world that allows so many to have too little and a few to have too much.