Final week in East Africa

December 16, 2008

by Megan Yarberry

Megan Yarberry is Project Coordinator in Africa for RMF’s Team Whole Health, and has been facilitating acupuncture trainings in East Africa since 2005.  She shares her experiences here.

Our final week in East Africa held some challenges as well as some rewards.

I was able to attend the meeting that Beth had with the UNHCR and representatives of the refugee community my last day in Kiryandongo. It was interesting in that the information being provided by the various sources we have met with is often contradictory, and there are obviously some glitches and gaps in the communication lines.

It’s frustrating to be told that life-saving supplies like malaria medication can be delivered to the camp within 24 hours, and yet people we know (and many we don’t) have died from malaria in the past 6 months there due to lack of these medications at the pharmacy.

The UN fellows said that Real Medicine Foundation is making a big difference in the camp, because Kiryandongo is much smaller than some of the other camps in Uganda. As such, it is often overlooked by the larger relief organizations like Red Cross and World Vision. The Kenyan refugee community has said the same, as they have been told since their arrival that since the Kenyan crisis was so sudden and unexpected, there have been very few resources budgeted for their population since their arrival in the camp. These include school fees, pharmaceuticals, etc. – many of the items that Real Medicine was able to step in and provide.

Beth had been feeling poorly my last few days in Bweyale (the town we were staying in while working at the camp). She gradually lost her voice & gained a fever. I left Wednesday but remained in contact with Beth and Jane (Wen, a senior student from the Traditional Chinese Medical College of Hawaii) by phone, and was told that Beth had spent a day at the hotel trying to recover, and when her condition continued to deteriorate and her fever rose, she made arrangements to fly home early to get appropriate medical care.

The acupuncture training was still going on at this point, and the trainees weren’t quite ready to fly solo yet. There were also meetings remaining with various players, and some loose ends to tie up, like getting appropriate formula for the malnourished infants. I was already in Kenya, and with Beth’s departure there was some risk that some of what we’d worked so hard to accomplish would fall apart – or at least remain unfinished – at the last hour.

Fortunately, Jane – who is on her first tour with Real Medicine – very bravely stepped up and offered to stay on alone in this very remote locale and complete the work we’d come to do. Faith (our acu-trained nurse from Tororo who had travelled with us for this training) offered to stay on with her for the few extra days it would take to complete things. Beth and I are indebted to both of them, and especially to Jane, who has had to make decisions, collect information, and keep things in motion for the continued success of these programs.

Meanwhile, Judah and I had caught the bus south to Kampala on Wednesday morning. The cooks and their children came to the bus stop to see us off, which after some standing around was done in a rush and a crush to get on the bus. Because of overcrowding we stood for the first 1/3 of the trip, which was actually a lovely way to see the countryside.

In Kampala we got off at the taxi park – a place so congested with cars and people that it defies description – and caught a ride to the Entebbe airport with a very aggressive driver from Tanzania. From Entebbe we flew to Nairobi where we stayed the night at the airport, waiting for our flight to the coast. I checked e-mail, and Judah wrote his blog, after which we got hot drinks at the 24 hr airport restaurant as the temperature continued to drop.

Nairobi is located on high plains, and so can get quite cold at night. Fortunately we talked our way into the departure area to pass the wee hours of the night, made a little fort for ourselves, and slept a while before the early morning flight bustle woke us up and sent us on our way.

On the coast my goal was to connect with The Omari Project (TOP), who provide education and outreach around HIV and heroin, as well as rehabilitation programs for heroin addiction. We had done an auricular acupuncture training with their staff in May, and I wanted to see how things were going. They had also received approval from the Ministry of Health, and were interested in discussing with me whether, and how, the acupuncture services could be extended into their outreach work.

I met with Shosi Mohammed, the program coordinator the day after we arrived. We discussed TOP’s current activities and challenges, and how acupuncture is working for their clients (all signs point to “well”).

The next day I met with the entire TOP staff working in the Malindi and Kilifi districts (those in Lamu were too far to attend). Together we discussed acupuncture as it is being delivered, and client response. All of them reflected that the clients had significantly more equilibrium through their detoxification process than they had prior to the addition of acupuncture. Several of the counsellors said that for clients only 3 to 5 days into the detoxification process to be sleeping well and be able to focus on the counselling sessions, is remarkable.

We also discussed the potential for, and challenges of integrating acupuncture into the outreach work. Having received the Ministry of Health’s approval, the organization now has the option of expanding acupuncture services to non-program sites. The outreach workers have a lot of different duties, and different locales at which they serve. It was decided that they would begin using the acupuncture as part of the home detoxification programs (a program for those unable to afford the residential rehabilitation), and for group counselling sessions and educational gatherings at schools and the local prison.

I was very encouraged by the manner in which the staff work toward consensus, the thoughtfulness with which they consider how best to better serve their clientele, and the commitment they have to their clients’ best interest. Because their 40 hour week’s work is prescribed by the agencies who provide their funding, all staff members provide an extra day of service to perform necessary duties that do not fall within the funding agencies’ list of assignments. It is on this 6th “for the team” workday that staff provides acupuncture services.

I left the coast feeling great about the work TOP is doing, and looking forward to spending more time with them in 2009.

Judah and I have been in Munich for a few days now, and will be leaving tomorrow for Hawaii. It’s freezing here, and a world away from East Africa, but the people we have been staying with have warmed us thoroughly with their hospitality. Nonetheless, it will be nice to be home for the holidays, and to be with family again.


About Megan Yarberry

Megan Yarberry is Project Coordinator in Africa for RMF’s Team Whole Health, and has been facilitating acupuncture trainings in East Africa since 2005. She is currently in private practice in Hilo, Hawaii and Academic Dean of the Traditional Chinese Medical College of Hawaii. With degrees in Oriental Medicine and International Affairs, Megan now develops collaborative healthcare projects with educational intent.

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