Public health reflections

I haven't posted enough about public health at Musana. The main reason I am here in Uganda. (White water rafting was awesome, though.) So here goes.

Public health lessons are only once a week, but we have been up against some challenges staying on schedule with the curriculum. Sometimes, Angela and I plan to a teach lesson only to find a half-filled workshop when we arrive because many of the women are at the clinic or in the hospital, either for themselves or their children. So lessons must be postponed. Or, sometimes there's a large jewelry order and they want to continue working on instead of participate in the lesson, which is hard to argue with. But I try. 

Another challenge is the chaos of the workshop - yelling children, large trucks roaring by on the road outside, and (one time) an obnoxious drunk who kept goofing off in the back. The women were too kind to tell him off, to my chagrin.

 

Harriet leads a group discussion during a lesson.

At the same time, we are also training the women to teach the nutrition unit they just learned to different women's groups in the community. This is part of Musana's "empowerment" initiative, the goal of which is to help develop the Musana artisans into community leaders.

Susan practicing giving the nutrition lesson.

A big challenge is convincing the women that teaching the community (and practicing to do so) is time well spent. In some ways, they view Musana as merely place of employment instead of an opportunity to develop skills and one day "graduate," or start their own business or self-sustaining initiative. But I take comfort in the fact that Musana is still a young organization that is constantly trying to improve its methods and welcome fresh ideas. Already, I am told, some of the women have made great strides in improving their lives in part because of what Musana has been able to offer.

Eve giving the lesson.

And I am confident that they find public health knowledge important. We held the first lesson in the women's health unit this past Tuesday, which focused mainly on sexual health and STIs. The women definitely paid attention. Eve made jokes, but you always get one of those clowns. The lesson morphed into a freer discussion about gender dynamics in Lugazi, which highlighted how little control women have over their own health. 

For instance, if her husband sleeps around, a woman has little means of protecting herself against anything he's picked up during his exploits. Asking him to wear protection or get tested is often laughable, so the only thing she can do is get checked for STIs like HIV herself. And then it might be too late. 

Harriet, and her granddaughter, Elizabeth.
Elizabeth is, thankfully, not HIV positive
like her grandmother and mother.

During this discussion, one of the women, Harriet, volunteered her own story (of which everyone was already aware because Harriet is very open) about how she contracted HIV from her husband nearly 25 years ago. She emphasized the importance of knowing one's status, saying that she might be alive today only because she had gotten tested early enough. 

I appreciated the dialogue because it means at the very least, Musana is been a safe place for women to come together and talk (often very frankly) about their lives. Before I came to Uganda, I was unsure if there were some health-related topics that would be sensitive or off-limits. While I am sure there are some things they are private about, they've surprised me about how much they freely share. This makes my job as lesson-giver much easier, but mostly it makes me happy to be a part of these conversations and start to understand the challenges these women face.

Nicole again. My favorite
days are when she wears hoods.