Uganda

Kate Patterson awarded CIHR's Michael Smith Foreign Study Supplement

Congratulations to PhD Candidate Kaitlin Patterson for winning one of the CIHR's Michael Smith Foreign Study Supplements! With this award, Kate will be hosted and supervised by Dr. Shuaib Lwasa at Makerere University in Uganda, and supported by the Batwa Development Program, the Bwindi Community Hospital, and the Ugandan Ministry of Health to continue her research, working with Indigenous Batwa to characterize maternal health. During her award tenure, she will: 1) continue her investigation to identify maternal health opportunities in Kanungu district, including the mobilization and dissemination of these findings, 2) collaborate with Indigenous partners to co-produce and co-write two journal articles, and 3) formalize an international health research network between Canadian and Ugandan students.  Congratulations Kate!

Vivienne Steele selected to serve as a Young Leader for Women Deliver

Congratulations to Vivienne Steele (MSc Candidate) for being selected as a Young Leader in the Women Deliver program!  "The award-winning Women Deliver Young Leaders Program provides youth advocates with opportunities to take their work advancing gender equality to the next level."  The Young Leaders are selected "for their potential to have a lasting impact on the lives of girls and women. As a group, they have already driven tangible progress on a wide range of issues, including sexual and reproductive health and rights, LGBTQ+ rights, peace and security, water and sanitation, gender-based violence, education, maternal health, and political participation."

"This was the program’s most competitive application process yet, with nearly 3,000 applications for 300 spots. It is also the largest and most diverse cohort to join the award-winning program: the group hails from 121 countries and collectively speaks 98 languages. The Young Leaders also include people from communities too often marginalized, including 66 people affected by humanitarian emergencies, 29 self-identified indigenous persons, and — for the first time — 18 adolescents."

Congratulations Vivienne!

Community-based Research Update: Nia & Kate in Uganda

Written by Nia King, Research Associate About two weeks ago I arrived in Uganda to work as a research assistant alongside Kate Patterson (PhD candidate), investigating rural maternal health and working to develop a knowledge translation strategy for IHACC Uganda. We are staying at the Monkey House, and have been joined by a wide variety of interesting visitors, including a group of external hospital auditors, tropical health students from the London School of Tropical Health and Medicine, two Americans who have spent the past two years driving in a camper van across Africa, and Dr. Kellerman, founder of Bwindi Community Hospital. This has made for a very lively and fun living environment!

With the quantitative maternal health surveys having been completed this past summer, we are now working with local research associates Seba, Charity, and Grace to conduct qualitative focus group discussions and individual interviews with mothers and fathers in Batwa and Bakiga communities throughout the Kanungu District. As the primary focus of Kate’s research is Indigenous maternal health, we are conducting repeated weekly focus group discussions with women in three Batwa settlements, chosen to capture the variety in geographies and access to healthcare. By spending approximately six hours discussing with each group of women, we are starting to capture and understand many of the nuances related to maternal health in rural Uganda. In addition to these focus groups, we have conducted focus group discussions with Batwa men and Bakiga (non-Indigenous) women. Kate has also been working with 9 Batwa women conducting repeated individual interviews to gather personal narratives surrounding maternal health. Through these various engagements, we have met many amazing women throughout the past couple weeks and look forward to providing them with a platform to voice their challenges and concerns. Our findings are intended to inform maternal health programs and delivery at the Bwindi Community Hospital and surrounding healthcare facilities.

When not in the communities, we have had the opportunity to partake in several hikes, including one that leads to a ridge overlooking the Ugandan and Democratic Republic of Congo border. Kate was also amazing and arranged a birthday party (including a homemade banana-nutella cake) for me last week, which made spending my birthday away from home extra special.

Overall our work is progressing smoothly here. I am so lucky to have the opportunity to live in this amazing part of the world and to learn from all of Kate’s experience. I look forward to the next two weeks—the time here is flying and pretty soon I’ll be hopping on a plane back home!

Indigenous Maternal Health Research in Uganda

Written by Julia Bryson, Undergraduate Researcher PhD Candidate Kate Patterson and Research Assistants Julia Bryson, Mackenzie Wilson, and Emma Windfeld, along with two core IHACC students Grace Asaasira and Phiny Smith of Makerere University, have been working in Uganda researching maternal health among Indigenous and non-Indigenous communities in Kanungu District. Here is an update on their work and adventures!

It is hard for us to believe, but we have officially completed our work in the communities of Kanungu District and are back in Kampala! It seems like it was just yesterday that we arrived in beautiful Buhoma. We will miss its rolling green hills, and even the mischievous monkeys that frequented the appropriately-named Monkey House we called home.

The past few weeks have been busy as we approached the end of our time in Buhoma—finishing data collection, sharing preliminary findings with our local partners, and saying many, many goodbyes to all the amazing people we have worked and lived with for the past six weeks. In total, we visited twenty communities over five weeks and surveyed approximately 600 women about their maternal health histories. Mackenzie and Julia also conducted sixteen focus group interviews to learn more about maternal nutrition and antenatal care in the area, and Emma spoke with several groups of community members about climate and food security associations.

The weekend before our departure, we took the opportunity to celebrate our amazing team of local surveyors, including students from our partner Makerere University, with some delicious local food and dancing. None of our work would have been possible without their time, effort, and enthusiasm!

We were also excited to have the opportunity to share about our research with one of our key partners in Buhoma, Bwindi Community Hospital (BCH). We presented our research methods and preliminary findings with over thirty BCH health care workers and administrators and had fruitful discussions about future steps as we work together to use the information we have gathered to improve health in the area. The knowledge and expertise of our BCH partners is integral to the success of our work, and we are so grateful to be able to collaborate with them and continue to build these important relationships throughout the project.

The drive back to Kampala was lengthy, but full of adventure! We drove through the gorgeous Queen Elizabeth National Park and were lucky enough to spot one of the elusive tree-climbing lions, thanks to the sharp eye of our driver, Maddy. We also saw antelopes, baboons, monkeys, buffalo, and even elephants! An unexpected safari on the way to the city was a great way to cap off our time in the south of Uganda. We look forward to exploring the city of Kampala and meeting with our key partners at Makerere University over the next two weeks as we wrap up this stage of the project and look ahead to the future. There’s never a dull moment!

Indigenous Maternal Health Research in Uganda

Written by Emma Windfeld, Research Assistant Kate Patterson, a PhD student at the University of Guelph, is completing her thesis on maternal health among Indigenous and non-Indigenous populations. Kate and three research assistants—Julia Bryson, Mackenzie Wilson, and Emma Windfeld—are conducting fieldwork in Buhoma, where they will spend a total of five weeks. When they arrived in Buhoma two weeks ago they were welcomed into the "Monkey House," which they are very happy to call home for their time here. The Monkey House is a quiet and welcoming accommodation built on a hill above Bwindi Community Hospital. It is named after the mischievous red-tailed monkeys that scamper around the roof and swing through the trees that surround the house, and that occasionally cause a stir by fighting with the chickens that roam the backyard. Kate, Julia, Mackenzie, and Emma often enjoy working on the back porch but have to be careful that the monkeys don’t snatch their pens or phones.

For the past two weeks here in Buhoma, the four researchers have traveled by car or on foot to nearby communities in Uganda’s Kanungu District to gather maternal health data through surveys of the local women. Half of each week is spent in Batwa settlements and half is spent in Bakiga settlements. The Batwa are an Indigenous people who lived as hunter-gatherers in the nearby Bwindi Impenetrable National Forest until they were evicted by the government two decades ago. The Bakiga are the local inhabitants of the Kanungu district. Two core Ugandan Indigenous Health Adaptation to Climate Change (IHACC) team members from Makerere University, Grace Asaasira and Phiny Smith, have been instrumental partners. In addition to helping with the community surveys, Grace and Phiny have helped the Canadian researchers get to know the local area and shared a lot of interesting conversations about cultural similarities and differences. Overall, the fieldwork has been progressing successfully so far and everyone is looking forward to the next three weeks of working with the communities.

At the Monkey House, Kate, Julia, Mackenzie, and Emma have enjoyed sharing yummy meals, stimulating conversations, and fun movie nights with the doctors and nurses who work or volunteer at Bwindi Community Hospital. On their days off, the four researchers have gone gorilla trekking and hiking in Bwindi Impenetrable National Forest with its rolling mountains and lush vegetation. They have also enjoyed a day at one of the many local coffee plantations, where they got to learn about coffee making from picking the beans to drinking the freshly roasted brew.

 

How does seasonality and weather affect perinatal health?

Congratulations to Sarah MacVicar on her recent publication that examines how seasonality and weather affect perinatal Indigenous health in southwestern Uganda! Click here to access the abstract. 

Citation: MacVicar, S., Berrang-Ford, L., Harper, S.L., Steele, V., Lwasa, S., Bambaiha, D.N., Twesigomwe, S., Asaasira, G., Ross, N. and IHACC Research Team, 2017. How seasonality and weather affect perinatal health: Comparing the experiences of Indigenous and non-Indigenous mothers in Kanungu District, Uganda. Social Science & Medicine. 187: 39–48.

Abstract:  Maternal and newborn health disparities and the health impacts of climate change present grand challenges for global health equity, and there remain knowledge gaps in our understanding of how these challenges intersect. This study examines the pathways through which mothers are affected by seasonal and meteorological factors in sub-Saharan Africa in general, and Kanungu District (Uganda), in particular. We conducted a community-based study consisting of focus group discussions with mothers and interviews with health care workers in Kanungu District. Using a priori and a posterioricoding, we found a diversity of perspectives on the impacts of seasonal and weather exposures, with reporting of more food available in the rainy season. The rainy season was also identified as the period in which women performed physical labour for longer time periods, while work conditions in the dry season were reported to be more difficult due to heat. The causal pathways through which weather and seasonality may be affecting size at birth as reported by Kanungu mothers were consistent with those most frequently reported in the literature elsewhere, including maternal energy balance (nutritional intake and physical exertion output) and seasonal illness. While both Indigenous and non-Indigenous mothers described similar pathways, however, the severity of these experiences differed. Non-Indigenous mothers frequently relied on livestock assets or opportunities for less taxing physical work than Indigenous women, who had fewer options when facing food shortages or transport costs. Findings point to specific entry points for intervention including increased nutritional support in dry season periods of food scarcity, increased diversification of wage labour opportunities, and increased access to contraception. Interventions should be particularly targeted towards Indigenous mothers as they face greater food insecurity, may have fewer sources of income, and face greater overall deprivation than non-Indigenous mothers.

The Harper Lab welcomes Teddy to Guelph!

Written by Chloe Zivot, Undergraduate Research Assistant It’s with great pleasure that we welcome Teddy Kisembo to the Harper Lab as she completes a course in EcoHealth at the University of Guelph this summer. While she has only been here one month, her energy and knowledge have brightened the department since her arrival, and we look forward to having her here with us until July!

Teddy has a BA in Urban Planning from Makerere University in Kampala, Uganda, and is currently a Masters student at Makerere University, pursuing a degree in Land Use and Regional Development. Her MA research is centered around the effects that flooding has on the livelihoods and health of urban residents, specifically in regard to the impacts of relocation. Teddy explains that relocation can take many forms, whether it is permanent or seasonal relocation, or relocation on a weekly or nightly basis according to rain patterns. While flooding has serious health and safety impacts on the residents of informal settlements in Kampala, her research suggests that these may not be the primary force behind relocation, nor the primary source of concern for members of these communities. For many, the disruption of day to day social, cultural, and economic activities (which may heavily affect household income, education, and religious life) is considered a larger barrier to well-being than the flooding itself.

In regard to future plans, Teddy has expressed that she is passionate about staying in research. She believes that to do research is to “get into the minds of people, and see what knowledge can come out of that. It’s putting a voice to the people that can speak to policymakers and planners”. Teddy’s work is very interesting and critical in the face of climate change, and we look forward to seeing the direction in which both her current and future research it take her!

The EcoHealth course that Teddy is taking part in here in Guelph is taught by Dr. Harper and other EcoHealth researchers from across Canada. The course teaches innovative approaches to better understanding the complex factors which influence health. (More info is available at http://www.copeh-canada.org/en/key-areas/training-and-capacity-building/course.html). Teddy says she enjoys the multidisciplinary nature of the class and finds the content refreshing, stating that is has re-provoked her interest in land planning. She is enjoying her time in Guelph so far, despite the weather being far cooler than she is accustomed to at home in Uganda!

We are thrilled to have Teddy here in Guelph with us this summer; we look forward to getting to know her better and showing her around Guelph in the upcoming weeks!