Learning Runyankole

I've spent a good part of this week starting to explore the mysteries of Runyankole. I NEED to learn this language. Except in official meetings and when someone is speaking directly to me, all the talk (and lots of laughter) is in Runyankole so I feel like I'm missing so much of life here. Also, most people in the village speak no English so even to get my basic needs met I need the language. I have bought what I think are the only Runyankole grammar and phrase books and have a tutor in the village for Monday-Wednesday and a tutor in Mbarara for Friday-Sunday. Some of the things I learned this week: Most educated people don't read and write Runyankole. Despite spending their whole lives speaking it, they were taught in school only to read and write English, (This is changing and there is now some curriculum in Runyankole literacy) which I think explains some of the incredible variation in speech (some people say... and some people say..; also lots of variation in spelling). According to my grammar book, Runyankole is an 'agglutinative' language. It starts with root words and adds on prefixes, infixes (new to me- it's when you stick the extra part in the middle of the word) and suffixes. All the words in the sentence tend to agree with subject but there are 13 different classes of subjects and the agreement for adjectives, objects, etc. are each different so all very confusing. This is to say nothing of modified verbs and their tenses. I am learning more about parts of sentences than I ever learned for English. But, I think because of never studying Runyankole themselves, no one was able to explain to me why a word that meant the same was different in different contexts. The grammar book was written in 1957 and is a bit dated. Some of the phrases I'm meant to memorize are, "The smith forges spears", and "How fine the cows are!". I'm passing on the first, have committed the second to memory. I've been asked (by Americans) what the language sounds like. (Try to tell someone what English sounds like!) Here goes- There are lots of syllables and, because of the agreement of words and probably just because, there is repetition of syllables- e.g.'please to meet you' is "nashemererwa okukushanga". R's are rolled. There's a lot of "ch" sounds though it's written 'ki' and 'ky'. Most people speak very fast and, in sentences, connecting vowels are dropped. A lot of friendly chats are loud and sound urgent and there tends to be lots of laughter. There's about 6 ways each of saying 'ehhhhh' and 'hmmmm', ranging from 'ok' to 'are you kidding?' to 'how great!' to 'how terrible!'. Runyankole is a tonal language though I don't even know enough to understand when it makes a difference. I learned last night that to say noon, you say six. (1 o'clock is 7 o'clock and vice versa). No one could explain why but my trusty grammar book says time is counted from dawn so there's daytime hours- time from 6 am- and night time hours- time from 6pm. Since this is the equator, it's conveniently consistent! I have been ready to give up (it seems so impossible) but last night someone repeated word for word (a very short conversation) an interchange I had had with a shop keeper a week ago and told me how enthusiastic the shop keeper was about my attempts; and I can now pick out some words in conversation. Putting together the meanings of sentences will have to wait!

health care and elections

I've spent another week in the village and another week with failure of technology- this time my computer wouldn't even turn on! I have learned a lot about putting things in perspective since arriving here, though, so failure of this machine now ranks a bit lower on the list. In any event, it started working again and I am grateful. I spent the week observing at a hospital in one of the MVP villages. I watched deliveries, observed an HIV clinic, and went on hospital rounds in addition to interviewing staff and examining records. There is considerable drama in watching people care for serious illness in the context of profound poverty, understaffing and very low resources. Tests, treatments, and amenities that I've taken for granted are not present (x-rays, many blood tests, consistent availability of medications, water, electricity in some health centers, sheets on the beds, food for the patients). Since my task is quality of care, I've found room for improvement but what is being accomplished and the energy expended in trying to improve the system is impressive. Besides the drama, there's a lot of waiting- another life skill I'm learning about. Some random thoughts: In Ruhiira and throughout the country elections will take place at the end of August. On many days, trucks with singers and dancers pull into town to campaign (I have no idea if there's a political message but the music is great) for a candidate. The pictures are of my favorite candidate and Ruhiirans enjoying the music. Yes, the milky way is beautiful in Ruhiira. And I'm reading The Namesake by Jhumpa Lahiri that starts out at Mt Auburn Hospital (!) and Banana Cultures (of course) about the importance of the banana in history. I would appreciate any recommendations for books (especially that are available on Kindle since others will have to wait!)

Nights in the village

Nights in the village have taken on a rhythm. The main evening task is dinner preparation. Without refrigeration, the preparation begins with buying fresh food. There are a number of small stores in Ruhiira but most are unmarked so it requires peering inside open doors to figure out what's there (is it a store or someone's home?). The stores tend to be small, dim (no artificial lights and usually no windows), and crowded. Once inside I usually point and smile with a questioning look. Most people in Ruhiira do not speak English and I am painfully feeling my ignorance of Runyankole. My latest phrase is, "Nsassara, nimanya Urujungu rwonka" (Sorry, I know English only). I've also picked up the words for matches, eggs, and tomatoes this week and can now count to 9,999 (important to get past 100 since 2200 Uganda Shillings= $1 and the smallest coin is 100 shillings). A row of women sit on one side of the main open space every evening. Each has what appears to me as an identical array of small piles of tomatoes, garlic cloves, and avocados in front of her. The women and most other people are quite amused by me. A Ugandan I was with commented that people 'liked me so much' but I corrected him that I believe they are laughing at me- a bit different.

Cooking itself takes a long time. I now refuse to peel matoke as the resin made my hands so sticky it took an hour of scrubbing to get it off (I clearly don't know the right technique). The lack of any refrigerated leftovers, the one functional burner, and fetching water when needed slows the process. By the time we're cooking, darkness has fallen and light in the kitchen comes from a candle. Dinner is eaten either in the dark sitting on the concrete step in the courtyard of the 'intern house' or seated on low stools in the candle-lit kitchen.

The darkness is intense in Ruhiira. I find it impossible to walk without tripping though the villagers seem to do just fine without a flashlight. The stores remain open after dark and are lit with usually a single gas lantern so that the spaces become darker still. I find them a bit more foreboding (even harder to walk into unknown territory) but also find them appealing in their intimacy. The stars are predictably impressive. Nights are cold and windy by Ugandan standards so reading in bed (after great challenges I can now download onto my Kindle to Uganda!) with my headlamp is a cozy event.

First week in the village

I've spent my first days in the village of Ruhiira and liked it! (most of it- bathroom facilities take a bit of getting use to). It takes 45 to 60 minutes to travel from Mbarara to Ruhiira, so living in Ruhiira increases considerably the time available to be in the health centers. All my technology failed me this week so no working phone or internet and, at baseline, no electricity or running water. Water was delivered in jerry cans, though, and there was enough for washing (a very good thing since dust coats everything this time of year).

I spent most of the week in the Ruhiira Health Center (there are 5 others in project and I visited two others this week- In the next few weeks I'll be visiting each for 1-3 days to do a baseline assessment of the resources and clinical care). I observed births, watched patients evaluated and treated (in a 2 hour period, the clinician saw 16 patients and diagnosed (confirmed by testing) seven cases of malaria- everyone laughs when I tell them that I've treated 2 patients with malaria in 26 years of practice),and attended meetings with midwives, doctors, and community health workers where MANY challenges and many ideas were discussed. The photos are of the Ruhiira health center, preparations for my morning bath, our pantry (with 2 types of bananas) and the cooking area.

sounds of Mbarara

For those with an aural orientation: Light starts about 6:45 am and at 7am the roosters crow, goats bleat, the sound of tasks begin. Every morning there is brushing of the grounds for fallen leaves and dust, clanking of heavy metal doors,grates, and gates. It's Sunday morning so about 8, chanting, singing and clapping from the King of Kings church 300 yards away begins and continues on and off through Sunday. There is usually pounding of metal somewhere. Boda-bodas and cars occasionally pass on my narrow dirt road. Voices from passersby and nearby houses increase over the morning. When the wind blows, the palm and banana fronds click against each other, a rustle which I've mistaken for rain. Throughout the day and evening there is loud cawing from Maribou Storks (birds taller than small children which fly overhead, convene on a nearby sports field, and perch on an electric pole near my balcony). Other bird songs and chirps are present much of the time. At night, voices and songs from the radio and guest house TV (the one station is heavy on music videos) subside at about 11pm. Intermittent choruses of barking dogs continue through the night-not intrusive but making me glad I'm not out on the very dark roads.

Hope (and anyone else!) please email me(lindarpowers@gmail.com)- I'd like to respond to your posts.

almost in the villages

I think I'm finally on the runway for getting to the villages for a more concerted period of time. I was supposed to stay last night but my room wasn't ready, so it looks like it will be Monday. I went back to the villages yesterday though- the one I went to was an hour from the 'entrance' village Ruhiira, so my total time in the car to attend a 2 hour meeting with community health workers and midwives was 3.5 + hours! The meeting was, thankfully, run in English (most conversation between Ugandans here is in Runyankole) and was fascinating and worth the trip- people wrestling with trying to have very different levels of health workers communicate effectively with a final common goal. (which sounds pretty familiar, right?) Basic things like what the community health workers actually do was shared. What they do is a lot- the CHW's each have about 200 households that they're expected to see monthly. The CHW sees households more frequently if there's a pregnant woman, a small child, someone who's sick. They do a lot of counseling (nutrition, bed nets, antenatal care, encouraging health center births, encouraging family planning); they're being trained to give vaccines; they give oral rehydration solution for children with diarrhea and can give malaria medication if the person has had a positive rapid test. A fair amount of time is spent on recording information- they have a number of data entry people who put information into a computer when it's working (also painfully familiar?) but the information tends to passed up a ladder and is not necessarily shared. The first photo is a poster of a woman's daily work (looks like everything to me-notice she has 5 arms!); the second is the village center of Ruhiira.

lots of people visit Ruhiira

Everyone at the MVP office was immersed last week in preparation for the visit on Saturday of Jeff Sachs, the director of the Earth Institute and Josette Sheeran, the head of the World Food Program. In addition to those two, there were governmental officials, large staffs, armed police, and press people- maybe 50-80 people in long lines of UN white landrovers. There's thick dust kicked up with one vehicle so the line made an impressive cloud. On one particularly steep dirt road, our driver slowed (unusual as they are very confident and skilled drivers) as he couldn't see 3 feet in front of him. The visit was a combination of chaos and celebration. The tour of Ruhiira for the visitors was similar to the one I did last week. However, this time, there were children or community people at every stop lining the entrances, singing and clapping hands. At one stop there were long and many speeches (there's a lot of gratitude for what's been done and a lot of need left; also the WFP director announced ongoing purchasing of beans from the community which the WFP uses to feed people in disaster areas and Jeff Sachs announced ongoing MVP support phase 2 through 2015) so that by the end of the tour the group split in two and we walked/jogged to and from the site. There were so many people to move and it all happened so abruptly that sometimes my ride was there and sometimes not. However, people are generally very congenial about having one more person crammed into an already packed car. I also had the opportunity of meeting Sonia Sachs, who kindly arranged my connection to this project. I am very glad I was able to get here when I did as Kampala is, by their report, jam packed with people and security checks for the African Union summit taking place there. I'm hoping to go back to villages (far from security issues!)to start my assessment in the near future, but I'm waiting for the official green light. In the meantime I'm trying to use my time to learn about the enormous number of things I don't know (OB, Quality of care, Uganda, Runyankole (the local language- although I can count to 10, say how are you/thank you/water it doesn't get me too far). The photo is at the same water site as last time, now with with lots of greeters- no photos of the dust clouds!