My Research and Some Epiphanies

I'm going to start out by talking about my Independant Study Project and some of the specifics of what I am doing. Please read to the end of this post (or skip to the end if you want). I have realized some really important things in the past two weeks and want to share them with you all.

The first seven weeks of my program were devoted to classroom work and site visits. Yes we travelled around, but we were still working from a curriculum and writing assignments for class. Two weeks ago started the portion of the program called the ISP, or Independent Study Project. Each of us has picked a development topic we want to research in depth for six weeks and write a 25-50 page IRB-approved research paper. So we hugged our homestay families goodbye, packed our bags, and spread out across the country on our own, like actual adults....crazy, huh?

For my ISP, I am staying in Kampala, working in two of the cities largest slums on the risk perceptions of typhoid and challenges to hand washing in a community with such limited resources. Back in March, Kampala had the largest typhoid outbreak the country has ever seen, so I decided working with typhoid would be particularly interesting and relevant to study. There is a small excerpt from my ISP about the background of typhoid in the paragraph below if you want to know more about it:

• Water-borne diseases (such as typhoid) are the largest killer of children under 5 in Uganda, with a mortality rate of 28%. Despite this astronomical number, a much greater focus of health among Ugandans is the prevention of Malaria and HIV with death tolls in under 5’s of 19% and 4% respectively. Annually there are 17 million cases of typhoid worldwide and a fatality rate between 13 and 20%, if untreated, this can cause up to 3.4 millions deaths per year. The World Health Organization gives this description of typhoid’s cause and transmission: Typhoid and paratyphoid germs are passed in the feces and urine of infected people. People become infected after eating food or drinking beverages that have been handled by a person who is infected or by drinking water that has been contaminated by sewage containing the bacteria. Once the bacteria enter the person’s body they multiply and spread from the intestines, into the bloodstream. Hand washing with soap is the strongest preventative measure against typhoid and other sanitation diseases.

*There are pictures below that some may not wish to see*

The largest percentage of these water-related deaths are from the slum areas of the country. This is where the most significant sanitation issues lie. There are open water pipes, heavy amounts of fecally contaminated water, and huge economic barriers to boiling water and purchasing soap for hand-washing.  Here are some pictures from the area I work in.

Above is one water supply that runs through the community. When someone does not have money to use the public toilets, they will often relieve themselves near this water supply. Very very few use this water for bathing or cooking, but I am sure there are some that do. The biggest worry is that because it is the rainy season, flooding is common so the contaminated water can come up to the doors of houses and leak inside.

These are two of the houses in the area. The residents do not own the land they live on so almost no one chooses to build permanent structures.

Working within the slums has already taught me a lot about public health limitations that I never would have considered on my own, such as the importance of covered shoes, and the economic barriers to boiling water so it is safe to consume.

It has also again reminded me to stop myself from staying within the walls of my fears. I have looked upon these slums for the past two months and never once considered entering before I chose my research topic. I was afraid. Just like I was to come to Uganda in the first place. The people living in the slums were in a closed-off bubble that did not touch my life, so I did not have to think about them. In my few weeks working in the slums, I have been reminded that people are people, and are nothing to be afraid of. It is that same revelation that keeps coming to me in my time here: everyone's reality is as big as my own.  

Reminding myself of that helps when a boda boda driver cat calls me and I get angry. It helps when Ugandan english makes it sound like someone is ordering you to do something. It helps when women my age ask me why I'm not married yet, and if I am planning on being an old maid. It especially helps when I am berated for having no religious convictions.

I can't think of people as stupid or ignorant. That's not a fair judgement. People are very much the sum of the cultural environment in which they learned to form their identity. In a world where people are deemed "good" if they attend church and believe in a God, I have to forgive them for being slow to figure out where I fit in that paradigm.

So, remember this in your lives too. I sit on the bus and imagine a fog surrounding each other passenger's head, representing the reality that is entirely theirs. Just because I can't see it in real life, in no way means it's not there. How can all of these worlds possibly fit inside that crammed box of metal, or to extend the metaphor, to the society we live in? I can't answer that. All I can do is remember that no person has any smaller a reality than my own, despite the struggle I may have to understand their motives, and be mindful of that when I pass judgements.