Monday, February 1, 2010

Kids, Emotions, and Medical Care in Uganda


It takes so little for me to feel useful. (Only on some days is that true.) Yesterday I tagged along with Carol to her research project site at a public health outpost near the Aboli displaced persons camp, just outside of Gulu town. Carol is a child psychiatrist and pediatrician from New Mexico who is on a Fulbright grant here, working with the Gulu Medical School. She is interviewing children ages 5 to 17 to assess how they have been affected emotionally by Northern Uganda's 20 years of rebel warfare that destroyed family life as we tend to think of it.

Many of the children in her study have witnessed horrible atrocities, lost a parent, or been forced to escape with their family to live in the displaced person camps where residents had no way to earn a living, their lives basically 'on hold.' Some mental health professionals fear that the 'forgive and forget' advice so widespread in the region during the current reconciliation process will, in fact, take its toll on the emotional well-being of people of all ages, with the fallout still to show itself.

Since this was Carol's follow-up interview, an attempt to gain greater trust and openness from the children, it wasn't appropriate for me to sit in on the interviews. Instead I sat down on a shady porch where about 10 children were awaiting their turn to be called over to a huge shade tree where Carol had set up her table. I took out my kid attractors and waited until the young people got past their shyness and came to play, with me or each other. I didn't have much but it was enough -- a well-used set of pick-up sticks, crayons, paper, a coloring book, and my ESL workbook, the one I had used in the States to teach English to immigrants.

It was fun for me to see them enjoying a new diversion -- any diversion for that matter -- as they were otherwise just sitting there, silent and bored. Some of the older kids were quick to figure out strategies for picking up just one stick without moving another. Several boys and at least one girl showed off their creativity by drawing pictures of me -- the mzungu woman wearing glasses. (I see very few people wearing glasses in Africa.)

I was surprised how interested a couple of them were in the English workbook, filled as it was with images they could not possibly relate to – a cutaway view of an American two-story house, for example, with attic, basement, 2-car garage, kitchen with sleek appliances and several bathrooms with all the things bathrooms have; they are more familiar with one-room round huts, cooking outside on a charcoal fire, pit latrines, and a cold bucket shower. But they looked, pointed, and even listened as a taught a few English words or urged them into speaking the English they had learned in school.

The saddest part of the day was when several older boys showed up in the late afternoon. They were not part of the survey – just adolescent boys looking for something to do. They eagerly pounced on the pick-up sticks and quickly became playfully rowdy and competitive. I noted one boy in particular. He was slower. He was not as good at picking up one stick without moving the others. He had a slightly scared look in his eyes, but also gentle. Soon an administrator of the Clinic walked up to chat with me. (He thought I was from the Medical School since I came with a doctor and he started telling me his equipment needs.) He was quick to point out loudly, in front of him, “That boy has epilepsy!” What saddened me so much is that in the dialogue that followed he informed me the boy’s condition cannot be controlled with medication and that he is not able to attend school. Not at all. That boy, his gentleness and his eyes haunt me. (In the photo, he's the one on far right.)

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