Family Visit

My family finally made it out to visit me. We had to rearrange the visit a little, but we had a blast. They arrived late Thursday night and I let them sleep for about 5 hours before we were headed north to Jinja to go rafting. Luckily, despite some car troubles, we made it to the rafting site just in time. Rebecca, Zack, Jake, and I headed out to conquer the Nile. I tried not to spook them too much or ruin the excitement for them, but I certainly did throw in a couple stories that got them a little nervous. We also placed a friendly bet on who the first to be tossed out of the raft would be. We had a great time, despite the fact that both Zack and Jake are incompetent and unable to keep any sort of a tempo with their paddling. Zack lost the bet as he was tossed out on the 2nd major rapid, although naturally, he blames Jake.

Mom, Dad, and Leah took a less exciting, but still enjoyable boat ride to see the Source of the Nile River. They had a great time and were happy to see that we had survived.

The next morning was another early departure as we were driving the 8 hours down to Mbarara. Rather than put the family up at the one nice hotel in town, we stayed out in Nsiikye at the Montfort (where Connor, Brian, and Annie lived). That afternoon was filled with playing soccer with the local kids, meeting the families, and naturally being asked to help sponsor kids for school. While the rest of the family got to rest a bit, I had a bit of surprise planned for them that night and was scrambling to get things together. It had just been my Dad’s birthday, my mom had had her birthday about 3 weeks before, my sister graduated from Wake Forest, and Jake was about to graduate high school. I was throwing a surprise goat roast for them. I had arranged for goats, beer, music, and dancing. I invited all my co-workers and friends and we had a blast. The family was pretty tired so we didn’t make it out to the discotheque, but we did have a great time.

After sleeping in a bit Sunday morning, we were invited over to one of the villager’s home. We sat down in the living room of their comparatively large two-room mud-house. We were served plenty of delicious black Ugandan tea and G-nuts. Then came the main course of matoke, fried cassava and potatoes, beef stew, and rice. It was all topped off by some fresh paw-paw (papaya). We then gathered for some great family photos outside and played a little soccer. We then toured the small banana plantation behind their cluster of homes. We were given some freshly cut sugar cane.

The rest of the afternoon was more hanging out with the kids and another soccer match. It was fun playing soccer with the family, because Zack and Jake are just as cocky about their soccer skills as they are with their bball skills (which they actually have…). Watching them playing was funny, they held their own just fine considering we were playing with only 2 kids older than 12. It was a lot of fun for all of us and all the kids.

Monday morning we went over to join Miss K at Mburara International. We were warmly received and after a nice talk over tea with Miss K, the kids put on a bit of presentation for us that culminated in a large dance circle. Next thing I knew, Steve-o had on a grass skirt and was dancing around like a little kid. The rest of the family joined in no time and the students and teachers were all very pleased that we were participating. After the dancing, we moved down to the play area to partake in some competitive volleyball and soccer matches. The teachers (primarily male) can get pretty competitive when it comes to sports. We had a great time and the students who weren’t playing, we sitting around watching and enjoying watching the Mzungus play. We had a great time at the school and it definitely left a lasting impression on everyone. Mburara is a very nice school, but it is over-crowded and my family couldn’t believe that they had 3 different classes operating out of one living room with only 1 wood wall in between that only went ¾ of the way up to the ceiling.

I then took the family into the central market in Mbarara to have a walk around and to buy some fabric. My sisters are getting bags and dresses made. We also bought some delicious avocados for 100 schillings each (5 cents). That night we had a delicious feast at the Montfort with the seminary boys (Jailos, David, Dido, and Gideon) and Father Charlie. It was a good way to go out of Mbarara as the next morning it was off to Ndali Lodge in Fort Portal. The Montfort has been great to me and very welcoming over the past 6 months and I know the family felt very welcomed and comfortable there.

We left for Ndali early the next morning and got there early afternoon. It is a beautiful set of “bandas” situated right on the rim of a crater lake with a view of the Rwenzori Mountains and the rolling hills. We had some delicious steak and chips for lunch (quite a treat for me to say the least) and fresh fish for dinner. We had a nice relaxing afternoon and soaked up the scenery and enjoyed some sugar cane and Cuban cigars in the evening. The next morning we went off to Kibale National Park to go Chimpanzee Tracking. We had to tell a little white lie so Leah could join as you have to be 12 years old to go. No problem though and within 45 minutes we were watching a family of 4 chimps eating fruit and hanging out in the trees above us. We had a great time and I was very pleased we got to see the chimps as I had had 2 bad experiences before which you may remember (as I got attacked by some African Killer Bees… (killer is just for effect)).

That night we headed off to Amsterdam for the weekend. I had mixed feelings about leaving for 4-5 days because I am going home so soon, but it was a great time and it was nice to be with the family. We went to a bunch of museums, ate some GREAT food (at least compared to Uganda), biked through the park, walked through town, and other stuff…but I must keep this PG. I did crash pretty hard and did some catching up on sleep. I didn’t really realize how draining working and organizing the family trip was.

Anyway, I am back in Mbarara now after a joyful chicken-piss smelling and overcrowded bus ride back. Gotta love it. I have two weeks left and I am shocked. It has snuck up on me fast. I am working to transition my project to Dr. Kigozi Isaac. It should be a rather smooth transition, but things always pop up. I will be taking advantage of my remaining time here and spending a lot of time with my friends and people in the village.

I will try to make one more post before I get home, but I might not get around to it. If not, I will write a wrap up post when I get home reflecting on my time here. It has been a remarkable and rewarding experience. I have made some truly great friends and definitely have a different take on a lot of things now. I look forward to getting the chance to come back to visit as I know I won’t be able to stay away from this place. The people have welcomed me more than I could have imagined – not to mention they love my dance moves.

For those of you in the Boston area, I will see you soon. Now it is off to enjoy my last two weeks.

Kigali and Soccer Match

I was finally able to make it to Rwanda. My friend Connor and I left early Friday morning, May 1st just as Brian and Annie were about to make their trip back home to the States. It was very sad to see them go, but I was also excited to see Kigali, the capital of Rwanda.

We ended up catching a ride from a guy who was driving all the way to Goma (DRC) for work. He was taking materials to them to help build a school. It was a much safer, cheaper, and comfortable way of getting to Kigali. It worked out great.

Connor and I, after getting yelled at for taking pictures of the Rwandan border crossing, met up with my friend Max in Kigali. He has spent almost 18 months since 2004 working for the Millennium Village Project and living in Rwanda. He has done a great job picking up the language and was able to show us all around Rwanda. It is a stunningly beautiful country with huge green hills and mountains surrounding the town. On our drive into town, we saw prisoners from the Genocide working on the hills. I started to worry that we would be overwhelmed the entire trip by reminders of the genocide.

We went out for a delicious lunch where I splurged for an amazing hamburger (hard to come by in Mbarara). We then visited Max’s home and spent the rest of the afternoon hanging out there. It is much different from where we are in Uganda as it was a true suburb of Kigali. Unfortunately our plans to head out to the village to visit a church in Nyamata that is a memorial to the genocide were foiled because it turned out to be Labor Day and everything was closed.

We went to grab some drinks at a bar / restaurant called Executive Car Wash were the principle is simple. You drop off your car to have it washed and while you wait, you go have some beers. Pick your car up, and drive home. Wouldn’t exactly go over well in the states. We then went and had some Italian food for dinner, which was delicious and met a handful of the other Americans working in Kigali (many work for Paul Farmer as part of Partners in Health). Definitely gave off a bit of a snotty vibe, but I am sure they are good people.

The next morning Connor and I went over to the Genocide Memorial Museum in Kigali. It was an extremely depressing and eye-opening experience. I still remember seeing clips on TV back in 1994. I don’t remember any details or anything. Walking through the memorial center, it was one disheartening fact after another. I struggled and continue to struggle to understand how something like that was allowed to happen, even though I know similar massacres happen around the world today. There was so much tension culminating and it wasn’t even close to the first time there had been a considerable massacre carried out in Rwanda. The most difficult section was upstairs where they had short biographies about children who had been murdered and how it had happened. They did not hold back details. It was especially difficult because I kept thinking about all the kids in Nsiikye and that these kids were no different than those kids. We had planned to go out to Nyamata afterwards, but we both agreed that we had had enough for one day.

The rest of the trip was fun and relaxing. We continued to eat delicious food, but it was much more expensive than Uganda. However, Max was able to put us up at his place, so we saved money on accommodations. It was a nice treat to get to eat some good food. The other striking thing about Kigali is how clean and organized the city is. Boda boda (motorcycle taxis) drivers all wear uniforms and have helmets for themselves and passengers unlike in Uganda. The streets are spotless and there are very few street vendors. NGOs are all monitored and even kicked out of Kigali if they are not doing what they are supposed to do. It is amazing to see how far the country has come since 1994. Although, I do have my concerns about how restrictive everything is.

It was a great weekend and Max ended up coming up to visit because of work later in that week. It was good to catch up with him and see how different everything is. Although, it was nice to get back to Mbarara where things are much less expensive (although still expensive relative to Africa).

That following week was intense as the last of my partners in crime was leaving. Connor and I made the most of the last week he was around and had a great time out in Nsiikye with all the kids. I actually started taking Runyankore lessons from one of the local Nsiikye girls in return for me teaching her some Spanish. It is going on well so far. Kinda tough because neither of us really know how to teach a language, but I am trying (ninjezaho) which is what matters to all the locals.

This past weekend, Danny and I were finally able to pull together an event we had been trying to pull together for about 2 months. As I had mentioned in a previous blog, too lazy to figure out which one, Danny has been coaching a girls soccer team out in Nsiikye and I will sometimes go out and help him with that. Also, the Mburara International school has enough girls to field a soccer team. We figured, none of these girls have ever had a chance to play a full 11 v 11 soccer game because really, there are very few opportunities for girls to play soccer at all. On Sunday, May 17th we were able to arrange for the two teams to play against each other. It was a mismatch in terms of age as the Nsiikye girls are almost all in secondary school, but the Mburara girls were skilled and had shoes…

We had a great turn out and had an extremely successful game. The Nsiikye girls won 1-0, but everyone had a great time. Danny is leaving soon, and I am as well, so we have put the coaches in contact with each other and hopefully they will be able to arrange another game in a month or so. It was great to give the girls this opportunity because really it is the boys who always get a chance to have matches and play. It was a lot of fun.

Anyway, that catches us up for a while. My family is coming out this Thursday and we will be going rafting on Friday, then back to Mbarara for the weekend before heading up to Fort Portal to do some Chimp Tracking then flying to Amsterdam for a long weekend. Should be a blast. I am really excited about them coming out and happy the finally got around to it. Will update you when I return from Amsterdam. I will only have about 2.5 weeks left after that as I fly home on June 19th. It is going to be reallllly tough to leave.

Magahinga

About a week after the study started, I also had to prepare the new MGH Guest House for visitors. Dr. Bangsberg was coming with the President of MGH, Dr. Bruce Walker (who is doing amazing HIV research in Durban, South Aftrica), the VP of MGH, two development officers, and one of MGH’s major donors, Mark Schwartz. It was a very hectic week as I had to deal with many Ugandan businesses to get furniture delivered, curtains made and hung, caters arranged, and everything else that goes along with furnishing and preparing a house. While it was not the most fun I have ever had, it was a very interesting experience dealing with Ugandan businesses. It required a lot of micro-managing and follow-up, but in the end everything came together and all the guests were very pleased.

The following weekend (Easter weekend), I was up for another adventure. This time I went with 6 others to the very south-western tip of Uganda (at the border of Rwanda and the DRC). We went into Magahinga National Park. It is the smallest national park in Uganda, but it continues into Rwanda and the Congo and is known for its extinct volcanoes. The countryside is absolutely breathtaking. In Magahinga there are three extinct volcanoes on the Ugandan side; Muhavura (The Guide), Mt. Gahinga (Small Pile of Stones), and Mt. Sabinyo (Old Man’s Teeth). Muhavura is the highest and peaks at 4,500 meters. However, we were climbing Mt. Sabinyo which is a series of peaks. There are 5 peaks in total, but 3 are on the Ugandan side and the middle one is the highest of the 5 at 3,650 meters (~12,000 ft).

We started off on the hike nice and early as it was supposed to be an 8 hour hike up and back. We were starting at about 2,300 meters. The region is very rainy and it being the rainy season, we knew we were going to get muddy and dirty, but that was part of the fun. The hike started off very gradually as we moved through the hills. When we finally reached the base and started our ascent, the trees around us turned into a bamboo forest, which was very dense and beautiful. As we continued up, the bamboo gave way to trees again. This time, however, the trees were covered in moss that looked very much like an old man’s beard to go along with his teeth that was comprised of the 5 peaks of the volcano. Very well names volcano.

The hike up was cold and rainy, but the fog from the clouds added to the mysterious feeling of the dense forest. As we reached the first and second peaks, the clouds refused to give way. Going from the second peak to the third and final peak, things got a bit hairy as the ascent was almost exclusively on wooden ladders that were not soaking wet and cold. The whole way along the ridge is actually the border between Uganda and Rwanda which was a pretty cool feeling. At the very top, we were actually standing in all three countries at once (Uganda, Rwanda, and DRC). Definitely a cool experience and would have been a bit better if I could have seen more than 20 feet in front of me… It was interesting to think about all those three countries have been through in the past 30 years and to be standing in all of them at the same time was something else. Uganda suffered in the late 70s and early 80s under Amin (Last King of Scotland movie) and Obote; Rwanda had its troubles in the early 90s with the genocide, and DRC has been having problems more recently.

On the way down, the clouds broke briefly and we were able to take in the amazing views of the countries. Absolutely breath-takingly beautiful with large green rolling hills, volcanoes, lakes, and valleys surrounding us on all sides. The clouds were creeping up over the steep drop-offs of the mountains from the Congo side maintaining the mysterious and rather creepy feeling. Made it all worth it.

It was a great trip and I am now back in Mbarara. Brian and Annie are leaving on May 1st so the next week will be hanging out with them and having a going away bash for them. After that, it is off to Kigali (Rwanda) to visit some friends.

Catching up...

I apologize, I have been awful about blogging this time out here. It has been about 2 months since I have written anything and I doubt many people are still following this (which boldly assumes people were at one point). Anyway, I will do my best to summarize the past two months in some detail, while keeping the length to a minimum...

So I left off with Lake Mburo, I spent the following weeks getting caught up with Mbarara life and everyone here. Continued to teach the Health and Life Style class in the local primary schools and played a bunch of soccer on the weekends with the local kids in Nsiikye (where Brian, Connor, and Annie live).

The first traveling excitement that occurred thereafter was a trip to Tanzania. Connor and I flew to meet Brian and Annie and a friend of Connor's in Zanzibar. For those of you not aware, it is an island about 70 km off the coast of Dar Es Salaam in the Indian Ocean, and it was absolutely beautiful. We arrived in Stone Town which is aptly named for it is an old town with stone buildings, stone roads, and crazy streets. Zanzibar is known for Stone Town, its assortment and quality of spices, and its unbelievably beautiful beaches. We headed up the West Coast to our destination, Kendwa Rocks. We spent the next three days enjoying ourselves on the beach with snorkeling and spear fishing. The snorkeling, unfortunately, underwhelmed us all because we just went using one of the beachfront shacks. Spear fishing was quite an interesting activity as well. We expected the guy would come out with us and show us what to do. Nope. He handed us three spear guns (Brian, Connor, and me) and some snorkel gear and told us to go shoot whatever we wanted. So we did. We swam about 25 meters off the shore to basically the same spot we went snorkeling in the day before, and began spear fishing. Problem, was, we didn't know what the heck to shoot at. There were tons of 4 inch long zebrafish, but who shoots those? We occasionally spotted some larger fish, but they didn't like to venture out of their holes too far. On top of that, people were snorkeling near by. Finally, after about 45 minutes, Connor had had enough and in his frustration during a dive, shot blindly at some zebrafish. Next thing I know, he is calling me over saying he shot one and was cracking up hysterically. I dove down to see that he had, indeed, shot a 4 inch zebrafish, right through the stomach. Soon some snorkelers came over, just as he pulled it out of the water and the woman let out a terrifying scream. It was quite an entertaining series of events as Connor immediately became ashamed and embarrassed. But I was able to convince him to bring the fish ashore, albeit in his bathing suit pocket to show Annie and Connor's friend. It really brightened up our day (Connor and Brian had things stolen the night before).

The next day we went back to Stone Town and just got "lost" wandering in the streets. It was great. Ate some delicious and well-spiced food, which is not readily available in Uganda... The next morning I took the ferry over to Dar and met up with Authman. Authman is a teacher at Kwala Secondary School which is the school that my friend Ross has been working with (www.newtontanzania.org). I decided to use my free day to go check out what Ross has been doing and the progress he has made. I traveled with another teacher, Comfort, up to Kwala, about 2 - 2.5 hours outside of Dar by public transport. I was welcomed by the headmaster, Mr. Ernasto Lulandala and was showed around the school and town. It is a very remote village with many Mesai (herders) people in the area. The school is in need of quite a bit of help and Ross is doing some great work there. Most recently getting a second computer for the school and internet! He will be traveling out there with a group of volunteers this summer to help build new latrines for the students and teachers. Right now they have 4 latrines for over 400 students and 10 or so teachers. Good work Ross!

Shortly after returning from Tanzania, I found out from Dr. Bangsberg that he had discovered he needed to start collecting data using the wireless devices sooner than he had realized because he would need the data for his grant renewal. This meant pushing forward with the approval process, which had stalled, and meant pressuring the company in South Africa to get the devices ready. Surprisingly, and very much welcomed, I got informed that I "had" to go down to Cape Town to meet with the company and pick up the devices so that they wouldn't get stuck in customs. I got flown down to Cape Town and put up in a nice little bed and breakfast. Met with everyone I needed to, ironed out some details, and got flown around in one of the guy's two-seat, single propeller plane. We spent close to 2 hours flying around Cape Town, getting an aerial view of the mountains, coast, Robinson Island (where Nelson Mandela was imprisoned), seal island (great white territory), and the surrounding vineyards. It was absolutely awesome.

The next day I went into Cape Town proper (actually Sea Point) to meet up with a friend, Rob Rosenbaum, from Colby. He has been in Cape Town since graduating working for an organization called CHOSA that helps the children of South Africa. It is a great program and he is really enjoying what he is doing, which is great. We spent the afternoon preparing a sunset beach picnic for his roommate's birthday. We had a blast hanging out at the beaches at Clifton and we got to watch a beautiful sunset right out over the ocean. Unfortunately, I couldn't stay any longer because I had to get back to Uganda to implement this study.

The study finally began about 2 weeks ago after I spent about a week getting everything functioning. We are now collecting data for 10 participants which is serve as the "proof-of-concept" for Dr. Bangsberg's grant proposal. Dr. Bangsberg's work will focus on this new wireless monitoring (and other new wireless technologies) over the next 5 years (at least that is his hope). It is really exciting to see that it is working and that this study will really help him get the funding he needs. This technology has not been widely used (if at all) in such a rural and developing setting. There are still a lot of obstacles to overcome before it is scalable, but it is a start.

Last tid-bit, as we were consenting patients to participate, I had a really interesting and rewarding experience. I went with one of the Research Assistants out to the individual's home and was told that this particular individual (a participant of the parent study), was devastated when she learned that she had graduated from the parent study and was not going to be visited at home anymore. When she found out we were coming back, she was thrilled. When we got there, she was living in the middle of nowhere, in a tiny mud house, surrounded by a banana plantation. She had old calendars on the walls as posters and they all had large pictures of Jesus in the middle. It was obvious she was happy to see us, but I still didn't fully understand why. Then she told us that she loves participating in these studies because it makes her feel like there is someone out there who cares about her. She has an educated Research Assistant visit her every month and she knows that if she were ever to take a turn for the worse, there would be someone there to support her and help her along. She said that everytime she gets a call or a visit, she has a renewed sense of hope and that is what keeps her going much of the time. This would have been enough to blow me away, but then she heads into the back (separate by mud walls) and comes back with half a dozen fresh chicken eggs and gives 3 to me and 3 to the Research Assistant. I couldn't believe that this woman, who had absolutely nothing compared to what I have was here giving out her eggs to me because I happened to pick her as a potential study participant. I learned from the Research Assistant that she never leaves that home empty handed. Sure enough, I was back there a week later and I was given a bundle of delicious bananas (not the typical yellow ones, but some enormous purple ones that are delicious).

Anyway, I still have a bit more to fill you all in on, but this is all the blogging I can handle for right now! Hope everyone is doing well and I will try to be a bit better about keeping everyone up to date. Take care and as always, feel free to shoot me an email if you want more details or anything.

Back in Uganda

Hello alllll and Happy (belated) Valentine's Day,

I am officially back in Uganda as of last Sunday, Feb 8th. I will be here this time until early June. I am excited to be back. It was great to see as many of you as I did while I was home. To those of you I didn't get to see, I hope all is well and expect to see you sometime this summer. First things first, if you didn't notice on the right side of the page there is a slideshow of some pictures! I was finally able to get that to work. So please enjoy. Here is a link to my Picasa web gallery (http://picasaweb.google.com/Josh.Kahane). This is where I will keep any albums I am able to post. If there are any requests for pictures, feel free to write a comment on the blog or send me an email and I will try to get some pics up.

Anyway, I am back to help implement the studies I was working on before. The approval process is underway, and now we need to get things in place. I will be responsible for helping to set up the necessary technology as well as help train the local staff and doctors. I am excited to get things moving, but so far things have been a bit slow. The test wireless device I was sent over with hasn't been working and the integrated voice response (IVR) project is moving slowly as the company we were working with in the States, has been slow to provide us with the assistance we need. I will also be putting together a business proposal for Mass General Hospital and the Uganda Research Initiative because MGH has fronted the money to lease a guest house here in Mbarara. I will be speaking with the head of URI and people at MGH to figure out the best way to run a guest house and hopefully make it profitable for URI.

It is good to be back. It was a little weird because I didn't expect to be so comfortable getting back. Everything was already familiar. It felt just like a brief holiday away. I immediately went out to dinner for some delicious roasted goat at Lord's Bar with Brian, Connor, Annie, and Jacquelyn (Connor gf who is visiting). It was great to be back and hanging out with them again. It was also great to see my co-workers and Ugandan friends as well as some of the other docs and American friends I became close with.

On Wednesday I got a call from Brian telling me that they just bought two baby goats. It wasn't until Friday that I got to check them out, but Brian, Annie, and Connor then had two baby goats (Thelma and Louise) they were bottle feeding and letting roam around their compound. Thelma wasn't able to "bah" so well, it sounded more like some sort of sick bird. They wouldn't let me too close to the goats for a while because of my slaughtering experience. But soon they realized I wasn't actually going to try to slaughter their baby goats, they don't have enough meat on them yet...

Thursday night I discovered that one of my friends, Dean (American), has decided to run a pizzeria out of his apartment on Thursday nights. He ended up making 24 pizzas out of his 6x6 kitchen for all our friends. About 15 of us all ate, drank, and listened to Dean play guitar together. It was a good way to celebrate my being back. Dean also needed to practice because he got himself a music gig at Lakeview Hotel for Valentine's Day. He thought it was going to just be a small thing, but then found out they were advertising it all over the radio. I wasn't able to go to the show, but it sounded like it went well.

This past weekend, Brian, Connor, Annie, Jacquelyn and I all went to Lake Mburo NP to go camping for a night. Unfortunately, we got a little delayed because one of the goats got really sick. Thelma woke up Saturday morning and wasn't able to walk or hold her own head up. After trying to feed her milk, ORS (oral rehydration solution), walking around town asking for help, and taking her to the Vet, Thelma passed away. All of the Ugandans were surprised that Annie was especially sad, because the goat only cost them 20,000 shs (10 bucks) and was so young. It was interesting to really witness this because it seems like it should be such a sad thing, but it is just far too common and inconsequential for people here to really worry about. On a brighter note, Louise has benefitted from the extra attention and is fattening up quite nicely. I was even allowed to feed her last night.

We spent the night camping right on the shore of Lake Mburo. We had a good time lighting a camp fire and drinking some boxed wine to celebrate Valentine's Day. The next morning we woke up and went on a nature walk that didn't really end up being very exciting. We didn't get to see many animals by the lake side because it is the rainy season and the animals had all moved inland. However, we then went on a game drive and saw a whole bunch of Zebras. Lake Mburo is the only place in Uganda that has Zebras. It also had been without Lions for a long time because during the Idi Amin era, they were all hunted. However, within the past month, there have been a couple viewings of a small pride of Lions. This has spooked a lot of the animals that seemed to still be far more comfortable with the car approaching them than in the other game parks.

Anyway, it was a good first weekend back and I am looking forward to what's to come (trip to Rwanda, trip to Murchinson Falls, and possibly a trip to Tanzania).

Touring the South-West

As I had mentioned, I planned a short tour of south-western Uganda. It started way back in early November when I was able to get my hands on a Gorilla Tracking permit. It is a pricey and difficult permit to get as they limit the number of people who can see the Gorillas each day to only 8 per group of Gorillas. The permits cost a staggering $500 and I had very high expectations of the experience given the price. However, I had been told it was worth it. The permit was valid for one day only, December 8th so I had to plan the rest of my trip around that day. Luckily I was able to get the time off from work to make it happen.

On Sunday Dec. 7th I got driven by Ibra, the same driver who had driven me to Mbarara from Kampala and would be with me the rest of the trip. Normally I would have taken public transportation but Bwindi Impenetrable Forest (where 340 of the 700 Mountain Gorillas remaining in the world reside) is off the beaten track and hard to get to by public means and given the investment I had already placed in seeing the Gorillas, I decided the extra cost of having a driver was worth it. After 2 hours on paved roads and 3 hours on crappy dirt roads, we finally reach Bwindi. Absolutely beautiful. It had a lush green valley floor with scattered trees and a river winding through it. This quickly transformed into a dense forest with the dirt road continuing through a very touristy town in that both sides of the road were lined with little shops selling Gorilla carvings, t-shirts, and pictures.

The next morning I woke up early to register and attend a briefing on how the day would go. We then hopped back into a car and drove to the other side of town where the road got too step for the car so we got out and started our tracking. We walked straight up hill for the next 45 minutes and it was mainly on road and country side. I was a little disappointed because I wanted to be using the machete and making our own trail. Finally we arrived at the forest's edge and got word that the trackers who had left an hour or 2 before us had found the Gorillas and we were about an hour hike from them. I was hoping for a slightly longer hike through the forest, but at least it meant we would see the Gorillas, which is not guaranteed. 

The way they track the Gorillas is that they take note of their position the day before using GPS. The trackers then leave early in the morning and return to where they were the previous day and follow their path from there. Some days the Gorillas move far, others they stay nearby. They may move closer to the edge of the forest or deeper in. There is really no way of knowing until you start looking for them.

Anyway, we hiked through the forest, mainly on a path, although there were definitely some sketchy areas. We then met up with the trackers who had found the Gorillas. We left our bags with one of the guides and proceeded to machete and crawl our way through the forest for about 10-15 minutes. Jim, a guy I met at the hostel the night before who is traveling with his sister and her friend and who happened to be in my group, and I took the lead with the guide as we were very anxious to see these Gorillas. All of a sudden they were right in front of us. We were within 8 feet of one of the females who was sitting on the ground munching on some bushes. We slowly made our way past her and there was an opening in the trees and sitting up in the branches about 20 ft up, right above us was the immensely large and intimidating male Silverback Gorilla. As males mature, they develop a very distinct patch of silver hair that wraps around the middle of the back. This tends to happen when they are around 15 years old (L.E. is 50 years or so). This male dictates what the group does from where they eat, sleep, and when and where they move to. Any arguments among the group, the dominant male Silverback ultimately has the last say. There can be more than one Silverback in a group, but the eldest is the leader. The group we were observing only had one Silverback, but also had another young male around 10 years old who will soon begin to develop the silverback distinction. There were a total of 9 Gorillas in the group, including a very new born baby who was being carried around by his mother.

Anyway, while I was being mesmerized by the large Silverback, the other Gorilla Jim and I had just passed decided to feign a charge at Jim will beating its chest. Whoa... The Gorilla then backed off and scooted up into the tree to continue eating. We spent about an hour watching and observing the Gorillas as they ate, climbed, descended, played, and produced some very impressive flatulence (which, despite my level of maturity...i found utterly amusing as did most of the group).

Just as our hour was wrapping up, the Gorillas started to climb down their trees. The Silverback stayed put for a minute and we followed the others to get a closer view on the ground. Getting up close like that was great, then I noticed that the Silverback was starting to come down from his tree. I immediately realized we were now in between the Silverback and the rest of the group. I stood there watching him, thinking about how mad he might be. He continued to walk right up to us. We were slightly obscured from his view behind a fallen tree. He turned the corner around the tree, no more than 8 feet from me and only about 4 feet from Jim's sister, Bailey. Upon seeing us in his path he let out a terrifying growl-like yell right at us. I wish I could say I wasn't terrified, but the video I was taking at the time reveals everything as the video zooms in on the ground... The guide in the front was very calm and we quickly realized that the Silverback wasn't actually going to charge at us, but was just pissed he needed to find another way around us. He proceeded to saunter right past us, so close it felt like we could have touched him. It was really an amazing experience, especially when you realize there are only 700 of these Mountain Gorillas left in the world and the only place they are located is South-Western Uganda, Rwanda, and the DRC.

In conclusion, it was 100% worth the expense and I will never forget that experience. Truly amazing.

Later that afternoon, I departed from Bwindi to head up north back into Queen Elizabeth National Park. This time I would be staying in Ishasha to make an effort at seeing tree-climbing lions. There are very few areas where this occurs, but the lions, after having a morning meal will climb up into the large Acacia trees and just lounge in the shade and breeze. No one could really tell me why these lions climb the trees while just 70 km further north, they don't. Anyway, I stayed in a sketchy hostel in the middle of the park that night and fell asleep to the sound of hippos munching on some grass outside of my room. I woke early in the morning to go on a game drive. We quickly spotted a large herd of Ugandan Kobs standing at attention, all facing the same direction. We made our way over there and sure enough, there were 2 enormous female lions who happened to be enjoying a fine meal which consisted of one of the unfortunate Ugandan Kobs. The driver took me right up to the lions. I was within 5 feet of the lions (but still in the car) and got a great view of the chunk of meat one of them was enjoying so thoroughly. Unfortunately the lions didn't make it up into the trees while I was there, but it was still awesome to see the lions up so close and enjoying just a fresh meal.

After a brief breakfast back at the hostel, I departed for Kyambura Gorge, further up north about 70 km north (2 hour drive because of the road) where I would attempt to go Chimpanzee tracking at a much more affordable $30. I had called ahead and they said they had just gotten back from the morning track and had found the chimps and left them close by while they slept. The odds were good that I would get to see them. We left and walked down for about 15 minutes to where the chimps had been left, but they weren't there and we had noticed some elephant tracks on the way down that looked relatively new. The guide had carried a rifle down with us, just incase we came across any lions (didn't, but did find their dung), buffalo, or elephants. Sure enough, after walking around for another 20 minutes, we came across an elephant. The guide cocked the gun and the elephant turned right at us. I found myself thinking that there was no way the gun the guide had would actually take down the elephant. Fortunately I didn't have to find out. The elephant turned and walked away. However, this was not a good sign for us to see the chimps as apparently the elephants will harass the chimps just to show their dominance. Sure enough, we walked for 2 hours and saw nothing. Quite disappointing, but they are wild animals.

That evening I drove up to Fort Portal, another 2 hours north and then headed another 30 minutes our of Fort Portal to a crater lake, Nyabikere meaning Lake of Frogs. My god, the sound was deafening. I even ate my dinner with ear plugs in, and I never use ear plugs. You really couldn't hear yourself think. Fortunately once you were in your room you couldn't really hear them too loudly so I was able to sleep just fine.

The next morning I was taken on a hike to "Top of the World" which was about a 3 hour round trip hike up to the top of a nearby hill that was situated right in between 3 crater lakes and had a view of a fourth. I was led up there by a 70 year old local man who kicked my butt up that climb. We then sat up on the top for a while and took in the beautiful view and talked politics, both US and Ugandan. It is always interesting to hear what people here think of both Bush and Obama as well as to hear about the local politics pertaining to Museveni. Museveni has been in power for about 25 years now and has become very corrupt. There was a limit to two terms as President, but as that time approached, he bribed officers and changed the rule. Now it appears he is going to remain in power until he dies. The margins of his electoral victories have declined from 96% when he was first elected to a very questionable 51% in 2007. He threw his most recent competitor into jail 2 days before the elections and had now charged him with treason. It is not looking good for 2011... There is a lot of concern.

Anyway, the crater lake region was also extremely beautiful and if the weather is nice you can see the Rwenzori mountains. Unfortunately I only got a very brief glimpse of them as I drove by. The rest of the time they were blocked by a cloudy haze.

Instead of spending another night up in Fort Portal, I decided I would drive back towards Kyambura Gorge and give the chimp tracking another shot in the morning. Found a cheap hostel in a local town and spent the night dominating the pool table which had a mean slant to it. Pool is very popular here and bars typically only have one outdoor pool table that gets a lot of action every night. The locals were very impressed with my game, little did they know I was getting absurdly lucky all night long. But it was a lot of fun.

The next morning I got up to do the morning chimp track. We found them up near the community, but they were on the move and very shy. I got about a 30 second glimpse of them from across the gorge which was about 100 meters at that spot. We drove around to the other side to try to follow them. It was looking good when all of a sudden there were some bees flying around the guides head. Figuring they would just fly off I took little notice. Next thing I new one fly right into my forehead and soon enough they were around my head and would not leave. The guide told me to cover my head with my long sleeve shirt and I abided. They swarmed and swarmed. Got stung on my hand holding my shirt and then right in the middle of the back through my t-shirt. The guide then grabbed my arm and started leading me blindly away from the area as I couldn't see much through my shirt. We were not on any path and the grass and bushes were about 3 ft high and really wet. As he guided me away, a bee managed to get into the shirt over my head so i threw that one the ground and then started high-tailing it through the long grass zigging this way and that. I am sure it was quite a sight but these freaking bees were extremely persistent. After running around for a couple minutes I settled down, thinking I was in the clear. Catching my breath for a minute turned out to be a bad idea as one landed on my pants. I squashed that bugger with much satisfaction. However, that satisfaction was short-lived as soon they were swarming my head again. The guides were now also high-tailing through the grass and I followed suit. Soon enough we were a ways away and took it easy. Soaking wet up to my waist from the tall grass, we made our way into the nearby banana plantation and walked back to the car. I discovered another bee-sting and proceeded to pull the centimeter long stingers out of my hand, arm, and back. The guide had gotten stung right on his eye-lid. Needless to say we did not see the chimps there and were glad to be back in the car.

We then returned to the main gorge area and decided to go try to find the other group of chimps. We hiked for another 2 hours, mostly in the rain. Scooting and crawling across the rushing river on soaking wet trees. Unfortunately we didn't find anything else. Despite only getting a glimpse of the chimps early in the morning, it was definitely a memorable experience that I will not forget. After all, I was attacked by African Killer Bees (well, maybe not Killer, but it sounds better).

While it was only a 4 day trip, it was extremely eventful and enjoyable. I then returned to Mbarara for my last weekend in town. I am heading off tomorrow to head up to Bujagali and Jinja to go white water rafting on the Nile River with Brian, Connor, and Annie. I will then spend a day in Kampala before I fly out on Friday, assuming I survive the half dozen class 5 rapids I will be going down on Wednesday. I head off to Vienna, Austria to meet up with dear friend and college roommate Chris "Toast" Hoffman. We will be in Vienna for 2 nights, Salzburg for a night, Munich for a night, and then back to Salzburg for 2 nights. Hopefully we will be able to work in a day of skiing. I will make one more Uganda post either in Austria or when I get home to wrap things up. I won't know if I am coming back to Uganda until after I get home from my trip. I feel I have had an amazing experience here, definitely one I will never forget and hopefully one I will build on going forward. I am going to make sure to enjoy the last bit of time I have here. If I come back, I will pick off right where I left off.

As my next post my not be until after Christmas, I want to wish everyone a Happy Holiday (Christmas, Chanukah and the like). I hope to see as many of you as possible while I am home around New Years. Take care!

MVP, Mburara Intl School Presentation, and Fresh Goat

As I mentioned, I am in the process of figuring out whether or not I will be returning to Uganda in January. Basically the issue lies in the fact that the research project I have been working on and would come back to oversee requires a lot of paperwork and desk work behind a computer and that is what I was hoping to get away from. In talking to Dr. Bangsberg, he does seem open to the idea of me coming back in a part-time capacity. This would mean that I would work 20-30 hours a week doing work that pertains to the research study, while the rest of the time would be for me to allocate as I see fit.

Quick side-note, for those of you who are not familiar with the research project I am working on, here is a brief run-down. Currently Dr. Bangsberg is monitoring how well HIV infected patients are taking their medications. He is doing this in a couple of ways. The main ways are by distributing a pill bottle that has a special MEMS (Micro ElectroMechanical System) cap that records when the cap is opened. The data is stored in the cap until a Research Assistant travels out to the participant's house and downloads the data onto a laptop. While the RA is at the participant's house, they also manually count how many pills the participant has left and compares that to how many they should have which is based on what type of medication they are on. The RAs also verify that the participants have continued to pick up their medications from the pharmacy. The MEMS data is then brought back to a data manager who compiles all of the data. As part of my study and using some of my super sweet excel abilities (passed on to me by a Mr. Jeremy Beck of Chatham Partners) I was asked to analyze some of the data collected to see what types of interruptions are occurring for participants as they take their medication. I found, as expected, that there have been many short interruptions of about 2-3 days and a handful of long interruptions, some lasting up to 100 days. The issue with these interruptions is that the HIV virus has an opportunity to rebound and become resistant to the drugs being administered. This is a problem all over the world, but especially here where there is a limited number of drugs that patients can switch to. It only takes 15 days of missing ones medication for there to be a 50% chance that the virus has become resistant. And in as little as 5 days the likelihood is around 20%.

My study will attempt to find a way to identify patients who are missing their medications in real-time, as opposed to identifying the patients and the interruptions only after the fact, during one of the home visits by the Research Assistants. To do this, we will be attempting to use a new pill cap that not only will record when the cap is opened, but will also send a message back to a computer server in the office. We will set up alerts to inform us when someone has missed their medication for more than 48 hours and will then send someone (not me) out to find the participant and interview them about the past few days, with the goal of figuring out what exactly is causing these interruptions (transportation issues, money issues, food, water, religious...). This study, however, will only be a pilot study. This means we will only be recruiting 50 participants. The reason for this is because it relies heavily on the phone towers and technology, we want to make sure it is feasible and can be done out here in rural-Uganda. If anyone has any questions about this, feel free to shoot me an email or we can discuss when I am back in the States on Dec. 26th.

So, back to the update. While the research is pretty exciting and cutting edge, I again want to get out of an office and see the villages and communities and to work with the people there to help build local capacity so that projects and work can really continue without the supervision of American volunteers. In searching for such projects, I have been able to get in touch with the Director for the local Millennium Villages Project in Mbarara who is in charge of the MVP projects around South-Western Uganda. For those of you not familiar with MVP, it is Dr. Jeffrey Sachs' (a one time Newton Resident) approach to helping to reach the Millennium Development Goals which are long and I will leave to you to look up. A simple google search will give you enough info. Basically the projects aim to help build infrastructure and local capacity. They are still within their first 5 years and are now starting to think about the next 5 years, which will aim to include an exit strategy to hand over the management of these projects to the local governments. There is a lot of debate about the approach and many people think it is all baloney. I will spare you my thoughts for now, but it definitely has a lot of issues it needs to sort out.

My friend is working for them here and is actually based out in a small community called Ruhiira. He is working on setting up an electronical medical records (EMR) program for the health clinic there. He invited me out to see the clinic and see what is going on out there. The clinic is the most beautifully situated health clinic you can imagine. Positioned on the top of a hill, looking out over banana plantations and many more hills and green countryside. It has a beautiful garden and clean facilities. The health clinic, however, is lacking a lot of supplies and only has 3 in-patient beds. It is currently classified as a level 2 clinic, but is operating as a level 3 clinic as they do have a maternity ward (by ward I mean concrete room). Things are operating smoothly though, and the doctors have been very welcoming of the EMR system as prior to that, the only way of tracking patients previous health history was through blue journal books that I used to take final exams at Colby. Patients were told to carry these around with them whenever they were going to the clinic and theoretically, doctors would be able to look through the books to get the patient's history and the patient could take it to any health clinic. However, not surprisingly, patients would typically buy a new blue book before going to the clinic and then would pass the blue book onto their children to use in school and the doctor's notes were lost. Now, it will hopefully all be on the computers...if only America could get their act together and actually do this a bit faster...

Anyway, in talking to the people at MVP, they did say that they could definitely use some volunteer help 1-2 days a week if I was available when I come back, so right now this is a possibility for other work I could come back to work on. 

Another big event last week was the end of the semester at Mburara International School. As such, last week was filled with games, movies, and presentations. The presentation for the parents occurred last Friday morning. Each class put on a presentation covering a different topic. Each class had been working on it all term. Junior Kindergarten presented about farm animals, Senior Kindergarten along with P2 presented about the importance of water, P1 presented about games and sports, P3 - Scouts and Scouting (like Boy Scouts stuff), P4 - the eyes, P5 - importance of a balanced diet, and P6 - Circulatory and Respiratory Systems. They were all great, but I think Junior Kindergarten "won". How can you beat 2-4 year olds miss pronouncing the names and sounds that farm animals make. Not to mention the performance of hoola-hooping they put on. They stole the show. Afterwards, the teachers gave out several awards and presented me with a beautiful African drum for having helped out at the school. Extremely unexpected and I was very grateful. I really had a great time at the school and will miss the kids and teachers a lot. They are now on holiday until Jan. 5. A full month.

(Warning: The below my be a little graphic for people, especially vegetarians like Ross Lohr)

However, it wasn't quite goodbye to the teachers yet. Saturday morning I woke up at 6 AM and caught a ride over to the school. We were having a goat roast and I had requested that I help out like all the other teachers. This meant I got to slaughter a goat. It was ridiculous. They wouldn't let me make the first slit in the throat, but very soon after that I was down there slicing the head off. Next, I was skinning the goat. I caught on pretty quickly and the Ugandans were pretty impressed with my ability to not leave much meat on the skin. They are very careful to use every part of the goat. I soon found out they meant every part of the goat.

Once the goat was skinned, one of the guys began chopping up the goat with a machete while I went over to help clean out the stomach and intestines. That's right, plenty of undigested grass and everything. We squeezed the feces out of the intestines, rinsed them with water, and then tied them so they they would cook more easily. I was given a brief tutorial and examination of the heart and just about everything else. Just when I thought we were done, they realized they had forgotten the tail. They quickly cut the meat of the tail. Normally they would also get the meat out of the head and use the hooves, but there are 3 or 4 dogs that live at the school so they were going to let the dogs enjoy the head and hooves.

We chopped up all the meat and passed some of it onto the women to prepare stews and such, while the majority of the meat was slightly seasoned and thrown onto skewers over the grill. The afternoon consisted of consuming large amounts of goat meat and plenty of beers. There was a short dancing session as the meat and beer started to wind down. Some rain moved in, so we moved inside and chatted and listened to music for a little while. It was a great afternoon and a final goodbye to many of the teachers. At least a temporary goodbye. I got a ride home and was all ready to have a relaxing evening when Connor and crew called me up and invited me to a wedding reception, which I actually mentioned in the last post. I met them at the wedding, not knowing who had just been married. We then proceeded to have some more drinks (including some Waragi which is the local gin produced from the bananas. It isn't too bad actually.) We danced with Ugandans all night and took over the dance floor and had a great time. The weddings here really are just about celebrating. Anyone and everyone is welcome really. They don't have open bars or food at the reception party, but they apparently did at the actually wedding part.

It was one of the best Saturdays I can ever remember having and I am sure it will stay with me for a long time to come. The next day was to be the beginning of my short tour of South-Western Uganda including tracking the mountain gorillas. The next post will cover that trip and probably my last few days in Mbarara. Until then, take care.