The Full Africa Trip in Pictures

Still a bit jet-lagged, but safely back home, we're finally able to post all of our pictures from the trip. Too wonderful to truly put into words, these pictures should help add some context and do our amazing trip justice. . . Enjoy!

Kenya

Tanzania

South Africa

Uganda

Uganda at Play

When Winston Churchill declared Uganda to be "the pearl of Africa" he pretty much nailed it. What a beautiful country and a beautiful people. Despite the fact that our hotel in Kampala had a metal detector and armed guard (as did places such as health care clinics), the capital city felt safe and friendly. The countryside even more so.

Walking around the village of Ishaka and through the lush, vibrant, tropical hillsides, the yell of "Hey! Mazunga (whitey)! How ah youuuuuuuu!" was always accompanied with a smile and was often sang more than simply shouted. Even in 2010 we were a novelty, only seeing 3-4 other whites the entire time we were in Ishaka, but the novelty quickly wore after a few days as we spent most of the time when we weren't volunteering being out and about and taking walks through the village.

We were also lucky enough to have our last weekend in Africa free of obligations. On Saturday, it took all of about 10 minutes to decide to hop in the car and cruise up to Fort Portal, the jumping off point for a series of magnificent, untouched crater lakes. This part of Uganda sits at an elevation of about 5,000 feet, and we rolled through the countryside (ok, jungle-side), enjoying the views, more shades of green than I've ever seen, and a quick dip in Lake Nkuruba - a lake surrounded on all sides by vegetation (and at least one side by colobus monkeys).

The rich, almost hidden, day-to-day life that unfolded before us as we wound our way through this remote area was as fascinating as the landscape. Children waving, entire families walking the dirt roads to church, bikes with more bananas than would seem humanly possible to carry bouncing along the uneven ground. . . we could have stayed in this scene forever.

We were a bit dejected when we finally hit a paved road after spending time in this enchanted forest setting, but we quickly perked up when we got to see a bit of Queen Elizabeth National Park. Already having had our fill of game drives and hours in the car in Kenya and Tanzania, we saw a bit of the park by boat and enjoyed a much different perspective as we once again witnessed some of the great animals of Africa.

Then it was a couple more days of volunteering, a quick trip to Nairobi where we spent our last day visiting an elephant orphanage and an open-air city market before an amazing last meal (we have no problem finding things to do to fill our time), and all of a sudden it was sadly time to start the 30 hour trip back home and say goodbye to Africa.

For now. . .

Uganda at Work

We spent a night in the bustling capital of Kampala before being picked up to spend a week in Ishaka, a rural area about a six hour drive west and only about 100 kilometers from the Congo border. Thanks (again) to Jennifer Stockert and Minnesota-based HealthPartners, we would spend the week working here with Uganda Health Cooperative (UHC), HealthPartners' local NGO affiliate.

Wow. What an amazing team. Led by Dr. Owembabazi Ndyanabo Wilberforce, UHC works to get community and village members enrolled in their prepaid health plan and faces many of the same health care questions that we face in the states, for example, "Why should I keep paying my 5,000 shillings (equivalent to US $2.50) every three months if I'm not sick? Isn't that money just going to pay for someone else?"

Never mind that a single incident of malaria could kill a child or bankrupt an entire family, but it is difficult to discuss the benefits of pre-payment and preventative health care when basic needs - food, shelter, clothing - are a constant concern for many within the rural areas of Uganda. In addition, the caregivers that are available are typically used to fee-for-service, curative care, so have less incentive to go into the communities and help prevent potentially more urgent treatment and care down the road (thereby reducing their revenue stream). Sound familiar?

To gain members, UHC mobilizes Village Health Teams (VHTs) and also works to identify Income Generating Activities (IGAs) for communities to help them pay for their health membership. The easier it is for community members to earn money and join and stay in the health plan, the easier it is to keep them healthy and keep premiums low. So while it's not rocket science, it's obviously much easier said than done since we still haven't figured it out in the states.

The UCH staff have all the knowledge and enthusiasm in place and their drive to bring members into the health schemes and help prevent malaria (rampant and a major issue in Uganda) and other communicable diseases is an important and ambitious one. I learn quickly that I'm a guide, a consultant, someone with a fresh perspective to an ongoing problem. In no way am I a teacher. To use a cringe-worthy workplace cliche, I'm simply there to sharpen the tools that are already in the team's toolkit.

Over the course of two intensive days (after a couple of days of orientation and a tour of one of the local clinics), we covered a number of areas. And while we might not have used such corporate speak, we broadly talked through stakeholder management, data collection, feedback and reporting mechanisms, communications messaging architecture, conducting difficult conversations, common communications tactics, and creating emotional and intellectual connections with your message.

I was also able to spend a full day with the local UCH Board of Directors covering similar topics (mainly fleshing out a plan of attack for identifying sustainable IGAs) and offered the team and the board ongoing consultative services which I very much hope they will take me up on.

Before we left, I was already seeing project plans being changed and updated - and being made more specific and concrete - so I hope it helped. For me, the experience was rewarding and frustrating at the same time. They are doing such great work with so little - and the people they are trying to help have even less - but there is so much optimism I know they will continue to progress and achieve improved health within the country.

We have so much more in the states, it would be refreshing to see things moving in the the right direction more quickly back at home (although we know that Kaiser Permanente is leading that charge and proving what can be done with thoughtful, integrated care delivery).

Courtney, in the meantime, spent some time consulting at a hospital and children's program in the area and was touched by the openness, wisdom, and kindness of the doctors, counselors, patients and students displayed despite the immense daily challenges they face.

A Week Around Cape Town

We wanted to write a quick entry before we begin a week volunteering in a remote village a few hours outside of Kampala, as we are guessing we will not have internet access. Since we last wrote we spent a week in South Africa that could not have been more fulfilling and beautiful.

After a “quick” re-route of our botched flight from Arusha to Dar, we only had to make three stops to finally get to Cape Town (Arusha>Nairobi>Harare>Johannesburg>Cape Town) but still arrived on

schedule.

We met up with our friend (and co-worker) Kim Cash and spent a couple of days exploring the beautiful Stellenbosch wine country outside of Cape Town. It’s like somebody picked up Napa and planted it in a mountainous valley in Switzerland. We hiked through the hills to a waterfall, enjoyed wine tasting, explored the town, and had fantastic meals.

The added bonus of the time in Stellenbosch was to spend time with our friend Songo, learning about all the great work he is doing in his township of Kayamandi just outside of Stellenbosch.

The township sits right next to a vineyard and serves as a very immediate example of the contrasts and complexities that are prevalent throughout South Africa. It's breathtaking and heartbreaking at once. Kayamandi is one of the nicer townships, but there are still squalid living conditions, lack of access to fresh water, extreme poverty, and it’s very hard to earn any kind of a living. Despite all of this, there is a great sense of hope and pride and possibility and community and Songo is leading this charge. He’s already collected over 100 bicycles to keep kids active and off the streets, and provides life skills and coaching in addition to the simple joy of just being able to ride bikes. We are just missing a fund-raiser he’ll be doing in about a week, but will be contributing to help keep this and other projects in the township going strongly.

We said goodbye to Kim and Songo and explored Cape Town for a few days. Court was able to visit Wola Nani, connect with her mentor and supervisor, Moira Jones, and will continue to stay connected by donating to Wola Nani and providing consultative services from the states. Unfortunately Nate wasn’t able to meet Moira, but he was able to finish his presentation for the Ugandan clinic.

This productivity allowed for some more adventuring and sight-seeing! Robben Island, Table Mountain, and Cape Point all offered unique perspectives on the history and surrounding environs of Cape Town.

We also got to catch up with an old (to Courtney, new to Nate) friend Vanessa and her new husband Sean. Their wedding took place about three hours outside of Cape Town in Cederberg – a rugged, rocky, sweeping, openness of land that has similarities to the Grand Canyon and the Canyon Lands of Utah. We made new friends from South Africa, Namibia, the UK, and Zimbabwe (including six adorable little flower girls who had been adopted, and in many ways rescued, by Vanessa’s cousins). We also got a chance to do a bit of hiking and see some amazing 6,000 year old rock paintings before saying goodbye to South Africa and heading off to Uganda.