Exchange report - Student at KI
Home university: Makerere University
Study programme: Public Health Sciences (Master's)
Exchange programme: INK
Semester: Spring semester 2016/2017
Name: Ina Schäffner
Email address: ina.schaeffner@gmx.de

Pre-departure

My master thesis project in the fourth semester of the Public Health Sciences program was to evaluate a health information system in Uganda. This required field research in the country for two months in order to collect data for the evaluation. I wrote my Master thesis together with a classmate who also travelled to Uganda with me. We collaborated with non-governmental organizations that helped making contacts but we were not associated with a University in Uganda.


In order to enter Uganda, a visa had to be applied for online prior to departure and pay a 50 USD fee at entry. Additionally, one is required to show a proof of yellow fever vaccination. The international office at KI was helpful providing me with comprehensive medical insurance for my stay abroad. I also bought malaria prevention which is recommended for travels to most African countries. For this, it is good to go to a consultation early in order to test the medication prior to the trip and adjust the prescription in case of side effects.

Arrival and registration

After our arrival in Entebbe we spent a few days in Kampala in order to organize phone cards, transport and get in contact with some people who supported our research. Coming from Swedish winter, it also took us some days to assimilate to the climate. We had the privilege to have a Ugandan classmate who showed us around and helped with arrangements during the first days. After this we travelled to Lira, a small town in Northern Uganda where we were based during the majority of time during our data collection. Generally, having contacts and creating a network was incredibly helpful in order to organize almost any kind of matter since information is often not available on the internet.

Economy

In order to cover the costs for this research trip I received a grant from a private foundation. I spent around 20000 SEK during this trip including flights and medical precautions. I usually shared a double room with my friend which cost around 10-15 USD per night. Local meals which were typically mainly based on carbohydrates cost about 2 USD. However, living costs may vary a lot depending on where the country you are located at. Tourist areas are usually more expensive. In order to reach local clinics during the days of data collection we hired a driver who knew the area well and had a private taxi. Travelling with public transportation is less comfortable and usually takes more time but is very cheap.

Acommendation

We stayed at local hotels that were of rather low standard as Northern Uganda is not a typical tourist destination. Most important for us was that the hotel had a generator for electricity and good hygiene standards including working water supply and mosquito nets. Internet was often not available or very slow. Electricity was sometimes only available during certain hours so that it was not possible to use which could make sleeping or working inside difficult, especially in the first weeks which were the end of dry season and temperatures exceeded 35 degrees Celsius.

Cooking outside.

Studies in general

For the purpose of our master thesis project, we visited 15 primary care clinics in Dokolo and Bukedea district, in Northern and Eastern Uganda.

Courses during the exchange period

Courses corresponding to semester 4 at KI

Collecting Data for Master's Thesis

During the first four weeks in Uganda we prepared the days of data collection by meeting the local district health officers, obtaining ethical consent to conduct the study, translating consent documents to local language, contacting responsible persons at the clinics and arranging visit times and pilot testing and adjusting the prepared research tools. It was very good that we conducted a pilot study since the service delivery was organized in a very different way than we are used to.


Thereafter we went to one health center per day to observe vaccination services. Many of the health workers lived next to the health center so it was always quite easy to find the person in charge. The health workers were very welcoming, helpful and thankful for us visiting them. The aim of our study was to evaluate a new health information system, the MyChild system. We did this by measuring the time spent on documentation at the point of service, assessing the proportion of correctly scanned vouchers, and by interviewing one health worker per facility. The data collection days looked different every day since the number of children receiving services varied between 17 and 113 per day. The health centers we visited were in rural areas so most places did not have electricity and basic equipment was missing. Overall the data collection went as planned, but if we would do it again we would like to have a translator with us since most of the patients didn’t speak English.

Language and Culture

There are 39 different languages in Uganda and English is the official language. English works most often but it is valuable for social contacts to learn the basics of the local languages.


In one way everything is different when it comes to culture, but in another way it is quite same as home. Most people were really social and it was easy to get friends.


The differences:

  • Food is bought at the market or at the street, and if you want to eat meat you by an animal alive.
  • Religion is very strong and influences their daily life a lot. Everyone goes to church on Sundays.
  • Clothes: We used clothes that covered our knees and shoulders, mostly longer skirts and t-skirts.
  • Power cuts happen frequently and most people have to fetch water from water wholes.
  • Poverty, sometimes it felt like everyone lives in extreme poverty since many don’t even have money to buy a bike for transportation

Leisure time and social activities

There was not so much to do in Lira since it is a smaller town. We spent our leisure time mostly by reading books, shopping second hand clothes at the market and walking around to find new restaurants and explore the surroundings. There was only one swimming pool I Lira but it wasn’t that clean so we went there only once. However, in Kampala there is a lot to do e.g. movie theatres, shopping malls, restaurants, bars, theatres and dance shows.


One weekend we went on a safari to Murchison falls national park. It was amazing, the trip included two game drives and a boat trip on the Nile. We also went to Sipi falls once, which was also nice especially because it was a bit colder up in the mountains. Jinja is also a very nice place to visit. It is a town next to the Nile and offers a lot of activities for tourists like rafting on the Nile, bungee jumping and kayaking.

Water Buffaloes.

Summary

My general experience of Uganda was very positive, people were kind and helpful. Personally, besides the academic aspects, I learned what the elementary challenges for a health care system in a low-income country are and how important it is to change perspective, visit a country, work with locals and understand the context well before implementing new systems or changing existing structures. As a student, I learned how to set up a study through all steps from planning to final write up. I learned how important a network and personal contacts are in all situations and I was reminded how important it feels for me to use my skills and knowledge in a meaningful way.