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Navigating a strange healthcare system and the importance of self-care

I was struggling to think of a topic for this blog post. Part of the reason is that I came down with the flu over the holidays and that flu turned into bronchitis. It hit me so hard that I ended up in the hospital for a few days, and I haven’t been able to do much more than lie down and sleep since Boxing Day.

Navigating an unfamiliar hospital system is something that strikes fear into my heart. Talk about terrifying. Until recently, I’d never been to a private hospital. I learned that it’s really difficult to think about payment when you’re that sick, but they wanted payment up front since I don’t have local insurance. Luckily, everything worked out and I got the care I needed. Many thanks to the staff of Life Vincent Pallotti Hospital in Cape Town, South Africa. They got my back on my feet and time will take care of the rest.

Which brings me to the real topic of this blog post: self-care and knowing when to rest. Self-care means different things in different contexts, but in this case I mean making time to rest, recover and take care of yourself so that you can get or stay happy and healthy and put in your best effort. This has always been very difficult for me, especially over the past couple of weeks, partly because I have been eager to make the most of my time here in Cape Town, and partly because I know I’m better mentally and physically when I’m active and out of the house every day. Finding a balance between rest and activity that will let me recover has been challenging, especially since this is the first time I’ve been this sick while away from home and my usual support networks.

Learning to rest when I need to isn’t a skill that I managed to develop in the Canadian context, but it’s an important one, and one I think I’m glad to have been forced to learn, even if the situation is far from ideal.

Taryn Husband is working as an Intern in sexual and gender-based violence and criminal justice with Gender, Health and Justice Research UnitUniversity of Cape Town in South Africa.


Young female parlimentarians

Women empowerment initiatives are a major focus of NORSAAC and represent a key advocacy area for organizations in Ghana’s Northern Region. Aimed at promoting confidence and capacity building, the Young Female Parliamentarian (YFP) program helps young girls to participate in decision making roles and foster leadership skills. In collaboration with the Ghana Education Service, this platform gives young girls a voice within a broader system. I asked my colleague Nancy and two former YFP (Younf female parlimentarians) members to explain the program, and shed light on the impact it has had on promoting the inclusion of young women in leadership roles in Northern Ghana.

Yeri Nancy, Project Officer under the Gender and Governance unit at NORSAAC, explains the YFP program and its importance with former members Issah Bintu and Adam Mariam.


What is your involvement with the YFP program? https://youtu.be/RgemkWPJVTY

What does it mean to be a YFP member? https://youtu.be/H2YGr_VyPcg

Have you used your experience as a YFP to benefit your community? https://youtu.be/yCfMMMUHzpk

How has being a YFP member impacted your life? https://youtu.be/Ae6vYE4vseg

How does the YFP program contribute to female empowerment initiatives in Northern Ghana? https://youtu.be/hs38MAQmjbQ

More information on NORSAAC and the YFP program: http://www.norsaac.org/gender-and-governance/young-female-parlimentarians/

Natasha Mooney is working as a Resource Mobilization and Management Specialist with Northern Sector Action on Awareness Centre (NORSAAC) in Tamale, Ghana.


Musings of a dietitian in Kampala

As a dietitian, food is often top of mind whenever I travel somewhere new. I make a point of visiting grocery stores and markets to compare prices and check out the range and diversity of products. Uganda has a completely different food culture to Canada, specifically Northern Canada, where I was living prior to this internship.
These are some of my observations.

Cost of Food
Coming from Baffin Island, where store-bought food is either flown or sealifted in, to Kampala where Ugandans everywhere are growing food, you would expect there to be a bit of a cost difference. Here are a few food items where I could find data for all three regions.

* This is for the small, scrumptious finger bananas (the larger yellow bananas are cheaper by weight)

1,2: 2016 Nunavut Food Price Survey, Comparison of Nunavut & Canada CPI Food Price Basket Items,accessed from Nunavut Bureau of Statistics

3: The prices I was charged the other day, not representative whatsoever

While there is a dramatic difference in the price of food (you have to wonder just how much the farmer is getting for their harvest!), salaries and rent in Uganda are also less. For example, the median monthly salary for the average male is 132,000Ushs and 66,000Ushs for females (UBOS, 2011-2012). This is the equivalent of $47.85 and $23.92 respectively. Another major expense to factor into the cost of living in Uganda is education. While Universal Primary Education is now available, I’m told that public schools can have classes with as many as 200 children so anyone who is able, sends their children to a private school which can cost as much as $600 PER TRIMESTER. Many people can’t afford food prices to rise.

Quality and Quantity
The local food is simple, pretty carbohydrate heavy and delicious! It is mostly boiled or steamed. Breakfast for most people is often quite small, maybe a tea and chapatti when you get to the office. Lunch is a BIG meal which is I’m most productive in the morning. Dinner can be more of the same from lunch.

For lunch at my office, we pick our ‘sauce’ which is the main protein; you can have beans, cowpeas (mung beans), meat or fish in a broth, groundnut (peanut) sauce or pasted meat which I understand to be meat or fish mixed with groundnut sauce. Then you get to order ‘the food’ (everything else) and you can have any combination of rice, matoke (mashed plantain and quintessentially Ugandan), sweet potato, Irish potato, pumpkin, posho (a cornmeal mixture), cassava and greens. I’m sure I’m missing some sauce and food options, but this gives you a good idea.

I should also mention that Kampala has a great international food scene; so on days when I want to shake things up I can go out for a great Indian or Thai meal. I’ve really enjoyed the seemingly endless supply of fresh fruit, eating fried chicken and Rolexes from street vendors, and trying my hand at cooking over a charcoal stove (lots of practice still needed). Food is just one part of what makes exploring another country so fun, but as a dietitian it’s definitely the part I enjoy the most!
My standard lunch order (clockwise): beans with rice, sweet potato, greens, pumpkin (aka any type of squash), and ‘Irish’. This costs me $1.20.

Emily Murray is working as an Intern in Food & Nutrition with Food Rights Alliance in Kampala, Uganda.


Jamaica and the Sustainable Development Goals (SDGs)

In October 2016, the Jamaican Administration began the process of creating a roadmap to guide the implementation of the SDGs on the Island. Over the week of October 24-28, the government in partnership with the United Nations Development Programme (UNDP) Mainstreaming Acceleration Policy Support (MAPS) Mission Team led a series of consultations with private sector, government institutions, and civil society organizations, to collectively assess the most pressing needs of the Jamaican people, obstacles to social, economic, and environmental prosperity on the Island, and solutions to overcoming them. I was fortunate enough to attend and contribute to the consultations representing Jamaica Family Planning Association (JFPA), a local NGO I have been working with since September 2016.

So what are the Sustainable Development Goals (SDGs)? Officially known as Transforming our World: the 2030 Agenda for Sustainable Development, the SDGs are a set of 17 aspiring ‘Global Goals’ and 169 targets adopted on September 25th, 2015 in New York by 193 UN Member States. This new agenda, which is preceded by the Millennium Development Goals (MDGs) aims to end poverty, protect the planet, and ensure prosperity for all. This mission’s aim is to operationalize these goals, as Mission Head Nik Sekhran explained, “We have really ambitious targets, we know where we want to be – now we have to figure out how to get there.”  

The process was extensive, divided into 6 phases: Alignment, Coordination, Prioritizing Accelerators, Financing, Monitoring and Reporting, and Advocacy Action Campaign. This blog will discuss highlights of my experience during the series of consultations.

The first step in the process for the MAPS team was to conduct a Rapid Integration Assessment. The purpose of this phase was to assess how closely the local planning documents align with the SDGs and to outline any gaps between the two. A total of 41 documents were assessed including Jamaica’s National Development Plan – Vision 2030. Overall, Jamaica’s vision aligned fairly well with the Global Goals, with the exception of the goals relating to the environment. Discussions in the room supported this finding as many reiterated the lack of respect for the environment among the general public. Actions such as the burning of garbage and littering of plastic packaging have been common sightings in my time in Jamaica thus far.       

As one of my primary roles with JFPA is to conduct a Monitoring and Evaluation exercise to assess Quality of Care of our clinics, the Monitoring and Reporting phase was especially interesting to me. The consultation referred to it as the ‘data revolution’ whose management is especially important for the success of the SDGs. The collection of reliable data will be necessary to inform policies, monitor progress, and ensure accountability, participation, and empowerment. Jamaica is a member of the Inter-Agency Expert Group on SDG Indicators, which is in the process of finalizing the SDG Indicator Framework. In January 2016, the working group adopted 230 indicators organized into 3 tiers according to agreed upon methodologies and availability of data. This is an area in need of great focus by Jamaica. There are 224 indicators that apply to Jamaica. Of these 26.3% have produced data to measure progress. Data is available but not yet produced for 32.6% of indicators, and 41.1% of the indicators have no available data yet.

A key area of focus in this endeavour is the disaggregation of data in order to ensure ‘no one is left behind’. The mission recommends “indicators should be disaggregated, where relevant, by income, sex, age, race, ethnicity, migratory status, disability, geographic location, or other characteristics.” The most disadvantaged groups, which within JFPA’s work in sexual, and reproductive health (SRH) include women, adolescents, and the LGBTQ community must be recognized and mainstreamed into all stages of the program life cycle. This is a consideration that cannot follow a ‘one size fits all’ model, and must be individually crafted based on geographic location, culture, and regional realities.  

These consultations were an important first step in the right direction towards a better Jamaica. Continued collaboration across the public, private, and non-profit sectors will be crucial to the success of these goals.  

Manal Rajan is working as a Health Administrator intern with Jamaica Family Planning Association/FAMPLAN in St. Ann’s Parish, Jamaica.


Improving livelihoods through coffee production and trade

Coffee, a major and leading cash crop in Uganda has not only been seen as a means to raise the growth of the economy but the incomes and livelihoods of farmers and rural households across the country as well. Indeed, coffee production and processing provides employment to over 1.5 million people and constitutes over 60% of annual export revenues. Its value and export potential is currently expected to rise over the next several years.[1]

The growing of coffee has been able to help many afford to feed their families, pay for their children’s schooling, buy homes and own small businesses. With such a prominent role in the economy, this has led me to question what problems currently exist in the coffee industry and what are means we can work towards addressing them? The drought that the country currently faces demonstrates that farmers everywhere are being affected by the realities of climate change. Yet I have learned that despite this, Ugandan farmers are incredibly innovative and resilient and have implemented ways to combat the effects of dry spells. Through various training initiatives by different organizations, climate smart practices are being implemented in order to save crops and yields. The planting of banana trees between the coffee plants for example, helps provide the crops shade from the heat as well as food for consumption. In addition, the recycling of plastic water bottles, filled with water and then inserted into the ground are just one of the methods to help to keep the soil moist.

Improving coffee production is not only tied to improving yields but also how coffee is being grown. In many small-holder farms, I have learnt that it is women who are often faced with a large burden of the work in both the field and household. As women in the villages are often denied opportunities to own land, they are subsequently denied opportunities for empowerment as loans and the benefits of their work (e.g. income) are often not available or shared unequally. As such, establishing women’s empowerment and gender equity are vital in the development of coffee trade and driving the growth of East African economy.

As my current placement has allowed me to do much work in helping to achieve agricultural standards and compliancy (for maize and sesame), I have also been applying this knowledge outside work and thinking lately about ways coffee production can be improved not only through better social practices but through value addition as well. Value can be enhanced through training, awareness raising and the export of processed rather than unprocessed product but these initiatives have yet to be as widespread as they could be. Improving quality and production of coffee is vital as it will help to drive exports and growth for the country. My plans to visit coffee plantations and processing plants in January will be sure to provide further perspective on these issues.

[1]  “The Ugandan Coffee Industry”. Uganda Coffee Confederation. <http://www.ugandacoffeefederation.org/ resource-center/uganda-coffee-industry/>

 Jessica Chen is working as an Intern in Rural Livelihoods with South and Eastern African Trade Information and Negotiations Institute (SEATINI) in Kampala, Uganda.

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