Welcome to the world, S.O.U.L. Antenatal Education Center!

By Andrea Koris

Operations, Monitoring and Eval. Officer

It’s 9:00am on Monday morning. I start down the red dirt path to the S.O.U.L. office, eyes to the ground in effort to keep my shoes reasonably dust-free. The twinkling of women’s laughter drifts through the banana trees to my ears. “What day is it?” I think to myself. As the answer hits me, I abandon my careful trek and tear off wildly towards the sound. I turn right at the sweet potato garden, scurry down the trail between the maize fields, and with a flourishing swipe of the matooke fronds in my path, I land among the most beautiful sight: 60 Ugandan women, bedecked in their brightest kitenge, patiently awaiting for the opening of the S.O.U.L. Antenatal Education Center.

Today is not just any other Monday in the sleepy town of Bujagali where S.O.U.L. is located; it is the official opening of S.O.U.L. Foundation’s Maternal Health Network. It’s a labor of love that has gestated and grown over the years. The idea of building a program to address rural maternal health issues in this region, originally conceived around a table between S.O.U.L. and community leaders, has been tended to with collaborative care ever since. And as I walk into the S.O.U.L. schoolyard this morning, wading through the women’s excited hugs and morning greetings, the love and hard work of everyone who molded the foundations of this program is abundantly evident.

 

In the past 5 years, substantial progress has been made across the world to meet the Millennium Development Goals (MDGs); and while significant improvements have been made on accounts to global health and education, progress is far from sufficient in regards to global maternal and infant mortality rates. The Sustainable Development Goals (SDGs) as a result demand a more exacting requirement of the global community, to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030.

 

Here in Uganda, 360 women die per 100,000 live births. And that statistic only accounts for women who decide to give birth in public health facilities. Considering that only 42% of births in Uganda are attended to by a qualified health professional, maternal morbidity statistics fall short in capturing mortality rates and health indicators for women and newborns who cannot access public care. S.O.U.L. wanted to know how this overwhelming statistic played out in the lives of the mamas that make up the lifeblood of our beneficiary communities, many of whom decide to deliver with Traditional Birthing Attendants instead of qualified midwives. To answer these questions, S.O.U.L. conducted a year long research assessment investigating the barriers that influence women’s maternal health choices and behaviors, and the challenges government health workers face in trying to provide quality care in rural settings.

 

The Maternal Health Network is a result of the findings of this groundbreaking research. The program houses several interventions, each of which attack a different ‘delay’ that contributes to maternal mortality in rural settings: 1) Delay in decision to seek care; 2) Delay in reaching care; and 3) Delay in receiving adequate health care at facility. The Antenatal Education Center, housed within the Maternal Health Network, aims to reduce maternal mortality by disseminating Safe Motherhood and Birth Preparedness education and encouraging male involvement in maternal health for women and their male partners.

 

As I follow the line of mamas into the sunny colored classroom, being pulled along in the tide of excitement, I can’t help but feel a wellspring of joy. The opportunity to walk with the women and men of this community as they invest in their right for health for themselves and their families is a gift; to witness the birth of this program, a blessing; and to be part of its creation, the highest honor.

Let's talk about sex

by Devin Faris
S.O.U.L. Foundation Global Health Corps Fellow

“S…E…X…” I read the letters aloud as I scrawl them across the poster paper taped to the wall behind me, and the room erupts with a cacophony of laughter.

I am standing in S.O.U.L. Foundation’s weekly Youth Mentorship Programme, which brings university and secondary student leaders together with younger students, providing them with a safe space to discuss their goals, challenges and ideas with their peers. Today, my co-fellow and I are taking on something that has never been done at S.O.U.L. before: we are talking about sex.

The laughter is to be expected. Placed with a women’s empowerment organization, my co-fellow and I recognize the pressing need to engage youth, particularly males, in constructive discussions about sex and gender relations. Yet in my six months in Uganda, I have never heard the topic of sex broached in conversation without the concomitant meltdown into youthful giggling or boisterous laughter, no matter the age group, which makes constructive dialogue a bit of a challenge. But we press on.

We start our mentorship session by asking everyone to write down what “sex” means to them and why it is important to talk about, followed by asking them why it is always met with laughter. They say that there is never a circumstance where they can talk about it in a group, that it is uncomfortable and awkward so they cannot help but laugh. As one frustrated student later informs me, “no one talks to us about sex…not our mothers, our fathers, no one. We only learn about sex in school…even at school the female teachers tell us it is not our mothers who should be talking to us about sex, that it is not their job.”

I think back to elementary school in America. I remember watching sex-ed videos in my 5th grade classroom, giggling with friends to animated dramatizations of male puberty. The group of 16 promising students under S.O.U.L. Foundation’s education bursary program sitting in front of us say they have learned about it in their classes – about HIV, about STDs and the risk of pregnancy – but in this district it is hardly, if ever, discussed beyond designated sexual education sessions moderated by a local NGO once per semester.

I am quickly reminded that sex is often a very uncomfortable conversation topic for most. Perhaps that is why at a meeting I attended recently that convened local health policymakers and religious leaders, that same laughter was omnipresent as we spent hours discussing why Uganda’s Busoga region boasts the highest rate of teen pregnancy in Uganda (30.6%). Religious leaders blamed moral decay in Uganda fueled by social media; some public officials cited the absurd belief that women’s provocative clothing “forces men to want to have sex with them.” I viewed some opinions with disbelief, others with genuine interest, but I left the meeting feeling that something quintessential was still left out: the lack of opportunities for safe and open dialogue about sex for youth around the world.

My mind returns to the open dialogue that is happening right in front of me, and through the smiles and laughter, these teenagers are really engaging in this issue. Though, I am troubled when that laughter fails to subside once the issue of sexual consent is brought up.

“Let’s say a boy and a girl meet at a party, and the boy wants to play sex but the girl does not. The girl says no. Should the boy and the girl both have the same power to make the decision about whether they play sex? Raise your hand if you think they should.”

My question is met with smirks, silence, and a room devoid of raised hands. I repeat the question. A few hands rise into the air. A few boys laugh and shake their heads, and the heads of the other girls are bowed in what appears to be an amalgamation of embarrassment, uncertainty, and fear. I probe for explanations. One boy claims that the decision making power is not equal, that if the girl says no, God has given men and boys the power to convince her that it is a good idea. Other boys echo this sentiment. The girls are silent.

We break into small groups and discuss the same scenario, thinking through the decision making process for both parties. I find myself having to remind one bright young man, “if a girl says no, it means NO.” I repeat the mantra, and the unabashed confidence and wry smile with which he answered the question turns to a look suggesting he is considering my words as a novel truth. We drive this point home to everyone and dismiss them, hoping the dialogue continues beyond the session. Suddenly, their continuing laughter is actually encouraging.

GHC is my first professional opportunity to research and advocate for women’s issues, from maternal health, to preventing mother-to-child transmission of HIV, to working to prevent sexual and gender-based violence through discussions such as this.

We must commit ourselves to involving males in the global discussion about women’s rights, sexual and reproductive rights, and about treating women with basic respect. Without involving males in these conversations, men who have been raised to believe that they have more power to make decisions than women will always view gender relations in a detrimentally one-sided manner, potentially acting upon archaic norms in ways that harm women. Without frank and open dialogue, the pandemic of violence against women will never end.

Let’s talk about the things that make us laugh, things that make us cry, things that make us afraid. Let’s talk about the things that make us cringe, things that make us uncomfortable, things that make us question what we believe, and things that make us question who we are. Let’s talk about the things that divide us, and let’s talk about the things that bring us together.

Let’s talk about sex. If we don’t, there will be far too many lessons learned the hard way for far too many youth in this world, and for far too long.

It’s not that simple…

by Devin Faris
S.O.U.L. Foundation Global Health Corps Fellow

There are few tools more powerful in development work than the art of listening. However, moving one step further and channeling this tool through rigorous research offers us the unique opportunity to see inside high complex sets of issues. Through our research, we are able to capture reality in a way that no amount of informal observation allows us to do. My co-fellow Viola and I live and work in a situation that allows us to appreciate this contrast in quite a striking way. We wake up each morning in our simple, sleepy house in the middle of our village near Jinja, Uganda, greeting the families outside and walking the muddy roads to our offices at S.O.U.L. Foundation, and are able to observe each family’s struggles, innovations and unique realities. While we can engage deeply with each of these families who continue to accept us into their homes and lives, we cannot adequately compare their stories or experiences in any kind of meaningful and measurable way that can be responsibly manifested into community-based programming. So we turn to our research…

We interview mothers and pregnant women, some as young as 14, about what deters women in the community from delivering their newborns in Uganda’s health centers, what drives them to continue to deliver with traditional midwives (known more commonly by the increasingly taboo label of Traditional Birthing Attendants, or TBAs) and put themselves at risk (granted some of the most skilled and talented midwives I have met are among these traditional midwives – they are miracle workers), and what they wish would change about the Ugandan health system. They say the nurses abuse them, shout at them, even slap them, often failing to serve mothers who have just spent an hour and a half on the back of a boda driving up a muddy road through littered trading centers for their ANC visits, only to have to return home to come back the next day, having not received the care they needed. The mothers are chastised for not bringing the materials they need to deliver in the health center can even be sent to the back of the line while those with the requisite ANC book, kitenge, plastic sheets and gloves get pushed to the front. So we say to ourselves, “the main problem is the attitude and behavior of the health workers.”

But it’s not that simple…

We visit each of the 16 health centers throughout the health sub-district to listen to their workers, the midwives who work tirelessly, short-staffed and overburdened, to meet the explosive maternity needs of this country. They say that when mothers come without the supplies they need and the health center lacks the provisions, they just can’t help them. They say they do everything they can, but they simply do not have the supplies to be able to give to the mothers themselves. They lack the staff to provide care to the dozens of mothers that come for ANC every day, lack adequate supplies of immunizations to offer the women who bring their children for PNC visits, and must break the news to these mothers that they all need to come at once on a designated day when the medicines are available so that everyone can receive these services at the same time. The mothers, they say, are not well enough informed or mobilized to be able to interface with the health system. So we say to ourselves, “the main problem is that women lack the proper information and mobilization to make the most of their health center visits.”

But it’s not that simple…

We hold focus group discussions with the Village Health Teams in each of our 11 sample villages across the health sub-district. These are the community health workers – the first level of the Ugandan health system – charged with the task of mobilizing women to attend ANC visits, to bring their newborns in for postnatal care and immunizations 6 weeks after delivery, and for supplementing the information given to them at the health centers. The VHTs express how they are supposed to be coordinating for these women to come to the health facilities on the designated days in order to be properly served, but since the inception of the VHT program in 2010, in-service training for each team has been minimal at best. The required 10 VHT members in each village has dwindled to the 2 most active, known as Community Medicine Distributors, leaving the rest of the VHTs out from any trainings or continuing medical education opportunities from the Ministry of Health or NGOs like Marie Stopes or TASO Uganda. Without training, without means of transport, without any sort of compensation or incentives to keep working in the community, the VHTs are barely able to do the work that they are intended to do. So we say to ourselves, “the main problem is that every level of the health system lacks the appropriate training, supplies and resources to be able to adequately assist the women in the community.”

But it’s not that simple…

We go to the District Health Officials and ask them about how they are addressing the issue of limited supplies, poor attitudes of the health workers, low staff attendance, and limited training opportunities for VHTs. They tell us that each district only gets a certain lump sum each quarter from the Ministry of Health, and that it is in no way enough to meet all the needs expressed by the health workers throughout the health sub-district. They tell us that the amount they receive depends on the needs conveyed through district reports, but these reports have to come from the lower rungs of the health center and have to be submitted in a timely manner in order for any action to be taken. Reporting mechanisms throughout the district are weak, and their ability to properly advocate for what the district needs remains limited. So we finally say to ourselves, “Clearly there is no main problem, but rather a complex set of interwoven issues that are holding women in Uganda back from accessing the care that they need.”

It’s never that simple.

Simply talking to women, or merely listening to health workers, or observing the work of VHTs, or reading reports of the performance of the district health system will never offer the full picture that such comprehensive data collection can provide. Each challenge leads to recognition of a new challenge altogether. This is the driving reason why data must be the first step in quality programmatic efforts in any context. Without such a robust study, we would never be able to provide S.O.U.L. Foundation with the full picture of what women are up against in the health system in eastern Uganda. And of course, it’s still not that simple…

While our data measures these various maternal health indices, it does not measure the sheer breadth of the myriad challenges and epidemics that women face all over this country: domestic and gender-based violence, sexual abuse, workplace discrimination, sex work, trafficking. These are hurdles that women continue to confront the whole world over, and we know our research is only the tip of the iceberg. For now, for what we cannot measure, we know that all we can do is observe, and observe deeply, as these women open their doors, their hearts and their worlds to us each and every day. We believe that our conversations with them empower them to speak their stories, their truths, their voice. All we can hope, through programming or through that very simple act of listening, is that those voices are amplified. The more we listen, the more we learn, and the more we learn, the more we can work together to change this country, and this world.

Home Away from Home

After a gruelling flight to Uganda through the night, I drowsily stepped out of the car at the end of the inbound journey with very little going on in my exhausted mind. Immediately, I was greeted by swarms of grinning children outside the S.O.U.L. Shack, who sang to welcome me – undoubtedly the most surprising wake-up I’ve ever received. Yet the incredible hospitality remained as enthusiastic and genuine until the moment I left Kyabirwa, not just from the children but from the entire community, which included the S.O.U.L. volunteers.

The village in which I stayed seemed infused with a positive dynamic; I had anticipated a place with little expectation for the future other than maintaining the status quo of feeding a family and grinding out as much additional output as possible. However, the village was vibrant: young children had the opportunity to learn through the pre-school set up by S.O.U.L. with the aid of incredible local teachers; older children were able to attend local schools through generous donations and S.O.U.L. scholarships and dream about the possibility of university; local women were actively involved in production of textiles, jewellery and crafts. Additionally, sustainable businesses have been developed – namely chicken breeding, goat breeding and fish farms – which not only offer economic incentives for villagers but also instruct them about long term economic planning. I believe that whereas, before, it seemed evident that the villagers lived just in the present, the input from the S.O.U.L. Foundation has instilled a plan for the future in the minds of these people, which allows for emancipatory and empowering work within Kyabirwa.

On a personal note, I devoted a lot of time initially to teaching in local schools, which are attended by many S.O.U.L. sponsored children. I was able to engage the primary school children in the study of Charlotte’s Web, using the book to attempt to improve their reading, writing and communication of English. I had great fun teaching these kids who had such a voracious appetite for learning; whether or not they understood what was going on in parts of the book is up for debate, yet they seemed to enjoy it. I also lectured A-level history students about World War Two in a local boarding school; I felt that was an instructive and rewarding topic to teach. On certain evenings I was able to teach IT skills to teenagers in the village such as word processing and drawing.

Later I was excited to involve myself with the digging of one of the sustainable fish ponds in Namizi. I liked the fact that I could see the palpable and immediate input I had in the project, and being able to do it while joking and chatting with the workers. I picked up the nickname ‘Kityanka’ which apparently means ‘Mud’, which I hope was an endearing name!

I stayed with one of the families in the village for the entire month, and became extremely close to them all within that space of time. They accepted me as one of their own; in return I tried to learn the language and assist with chores. I was able to eat incredible traditional Ugandan food (in huge amounts at that), and spent time not only with them but with other families who were equally as welcoming. One of the best parts of the experience was just to converse with them and learn about their culture and beliefs.

The inclusiveness of the community was such that it often made me forget the huge disparities of wealth and materials. Nevertheless, there is so much more to do. More kids need to be funded, more teaching materials need to be donated, and more work needs to be done on the burgeoning projects. I, for one, will treasure the place and endeavour to support S.O.U.L.’s work; hopefully it can expand to aid a greater area.  Although the red soil has now washed off me, the memories won’t.

By: Tom S., S.O.U.L. Volunteer

To learn more about volunteering with the S.O.U.L. Foundation, visit our website 

http://www.souluganda.org/get-involved/volunteer/

The Gift of Education

The following letter was written to S.O.U.L.’s CEO and Co-Founder, Brooke Stern, from one of the university students we sponsor.

Hi Brooke,

How are YOU and every thing you’re doing?  I know you’re spending so many sleepless nights working so much for S.O.U.L. so on that note please allow me to say that THANK YOU so much.
So, Mama Africa, every one is missing you here in Bujagali.  I got this modem from a friend and that's why I have decided to wake up this early morning to write to you before you go to bed.

Really I do not know how much I can thank you for the good things you have done for me and for my family so far. I together with my family are indeed so much happy ‘cause when I remember the situations I was passing through in order for me to get my school fees, indeed, I know I could not have made it to the university. Brooke, I only wish you the best for your life.

I don't have money but you deserve something so much better.  I will at least make sure that I do something small, not as a return for the tuition but for just appreciating.

I know that money given as school fees is so much more valuable than any other money simply because it is what makes up one's future.

I PROMISE I WILL NEVER FORGET S.O.U.L. AND I WILL NEVER LEAVE S.O.U.L.!
LONG LIVE S.O.U.L. LONG LIVE BROOKE AND LONG LIVE EVERY ONE WORKING HARD TO SEE THAT S.O.U.L. GOES AHEAD!

By: Richard, S.O.U.L.-sponsored university student

A Volunteer's Experience: Four Weeks that Changed my Life Forever

Jitters, nerves, excitement and anticipation—so many feelings running through my body as I boarded a plane from Nairobi to Entebbe. I knew I wanted to go to Uganda during my stay in Kenya, but I had no idea I would fall in love with a country and its people.

As a university student from the states (St. Lawrence University, Canton NY), I was studying abroad in Kenya when I approached Brooke about coming to volunteer with S.O.U.L. for a month in April. Part of my semester involves an independent study whereby students research an organization and eventually spend a month with that organization volunteering and learning. After constant emailing back and forth, my school approved of my stay with S.O.U.L.

I arrived in Bujagali not really knowing what to expect. I knew I was going to be near the Nile River and in a village working with locals, but I did not realize how incredible my life would be for the next four weeks. When I finally arrived at S.O.U.L. I stepped out of the car and received the biggest embrace from my host mother (Mama Robina) and immediately, both of my arms were consumed by children—I knew I was going to love it here.

Having a bit of experience living in Africa and traveling throughout Kenya (I arrived in Kenya in January, so by the time April came I was feeling a bit more immersed in African life), my time in Uganda topped my entire journey in Kenya. I would call home once a week to check-in with my family and my parents could tell from the tone of my voice how excited and happy I sounded. Every day was filled with smiles, laughter and adventure—my face has never hurt so much from smiling and laughing. Each night, I could not wait to wake up for the next day, eager to see what Bujagali and S.O.U.L. had in store for me. Being around my age-mates (Oko, Safa and Muganda), I learned so much about life in Bujagali and life in Uganda—it was a true cultural experience and I wish I could have stayed for 10 months (or even forever—paka paka paka)! 

The best part about my experience was undoubtedly the people—I may have been over 7000 miles from home, but I have never felt more at home than during my stay in the village. My best friends consisted of 10, 12 and 13 year old boys. Every night I would hang around the S.O.U.L. shack with so many kids from the village. I joined in their football matches (even though I am HORRIBLE) just so they could laugh at me. Eventually, I was the receiver of mangos and bananas- children would sneakily hand me something they picked for me. I even received my own Lusoga name: Nakato (first-born twin since I happen to have a twin brother). I have never felt so happy in my life and I could not imagine leaving these beautiful people.

When the children went on holiday, I partook in some of the hardest work I’ve ever done: the making of mud balls. I traveled to the fishpond project in Naminya and worked alongside so many KANYAMAS (strong men). I absolutely loved it—mud smeared all over my hands, sweat dripping down my face. During my last week with S.O.U.L., the fourth pond was finished and filled with water and tilapia—it was such an accomplishment and I felt so fortunate to have been a part of something that will improve the lives of a community displaced by the construction of a dam.

Returning home each night, I could not help but smile and reflect on the day’s activities. I felt so immersed and so in-touch with Bujagali life (and my Lusoga was slowly but surely improving day-by-day). Although I did take advantage of the recreational activities that the Nile has to offer (such as rafting), the most exciting and happiest times of my stay involved the children and spending time at S.O.U.L. My last Friday in Bujagali was filled with sadness—I kept trying to think of plausible ways to extend my stay—such as giving Oko my passport to hide or throw in the river. And then Saturday came—the day I would return to Kenya. From the moment I awoke, tears drowned my face. I could not help the waterworks from forming and saying goodbye was the hardest task of my life. I did not expect to fall so in love and I definitely left a huge piece of my heart at S.O.U.L. and in the village. I kept telling myself I would return after I finish university (2 more years—over 700 days) in order to ease my sadness. Without a doubt, I do plan on returning. At 20 years old, I don’t know how I’m going to pay back my student loans or what kind of career I’ll have, but I do know that I will be back to Bujagali, back to S.O.U.L.

The happiness I felt at S.O.U.L. could not be replicated anywhere else. Whenever I tell stories about my visit to Uganda, my face lights up and everyone can tell how insanely happy that experience made me. Two years seems like eons away, but I am so so confident that I will return to Bujagali—I cannot picture my life any other way!

I am forever grateful to Brooke and the S.O.U.L. community for welcoming me into their family. I have gained a new set of friends and family members and I think about them every single day. It almost feels like a dream—like I discovered the world’s best-kept secret—the wonderful village of Bujagali Falls. I constantly picture myself with Muganda, Oko and Safa (the boys of Bujagali, my age-mates, my brothers) drowning ourselves in laughter and jokes. I dream of the mornings I walk to S.O.U.L. and hear “Allison-y!” or “Nakato.” And the nighttime walks back to Mama Robinas, the perfect time of day for omulogos (the Bujagali version of the boogie-man). Every moment I shared with these beautiful people remains in my memory—crystal clear. These people have changed my life forever and words cannot express the true happiness and gratitude I feel.

Webule eno eno eno! I love and miss you all!

NAKATO Allison

Welcome to the New S.O.U.L. Blog

As they say in Uganda, "You are most welcome" to the S.O.U.L. Foundation blog!


This is a forum we will use to share personal stories and experiences from a variety of S.O.U.L. stakeholders. Our first post, written by our Founder and CEO Brooke Stern, recounts her experience delivering a baby for the first time after stopping by to visit the local midwife in Bujagali- a day she will never forget!


We will continue to share stories from our staff, volunteers and the community members with whom we work in Uganda, so keep visiting to learn about our work through the personal reflections of the individuals whose lives are impacted by S.O.U.L..


Sincerely,
Jenna Rogers, Executive Director