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!
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!
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!
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.
Congratulations to Kaitlin Patterson on her publication in Public Health Nutrition! Her article examines the sensitivity of the food system of an Indigenous African population, the Batwa of Kanungu District, Uganda, to seasonal variation. She used mixed qualitative and quantitative methods to characterize one of the highest food insecure populations in the published literature. Her results are being used by local Ugandan NGOs to prioritize development-related decision making in the region. Access the article here (free, open-access).
Climate change is projected to increase the burden of food insecurity (FI) globally, particularly among populations that depend on subsistence agriculture. The impacts of climate change will have disproportionate effects on populations with higher existing vulnerability. Indigenous people consistently experience higher levels of FI than their non-Indigenous counterparts and are more likely to be dependent upon land-based resources. The present study aimed to understand the sensitivity of the food system of an Indigenous African population, the Batwa of Kanungu District, Uganda, to seasonal variation. A concurrent, mixed methods (quantitative and qualitative) design was used. Six cross-sectional retrospective surveys, conducted between January 2013 and April 2014, provided quantitative data to examine the seasonal variation of self-reported household FI. This was complemented by qualitative data from focus group discussions and semi-structured interviews collected between June and August 2014. Ten rural Indigenous communities in Kanungu District, Uganda. FI data were collected from 130 Indigenous Batwa Pygmy households. Qualitative methods involved Batwa community members, local key informants, health workers and governmental representatives. The dry season was associated with increased FI among the Batwa in the quantitative surveys and in the qualitative interviews. During the dry season, the majority of Batwa households reported greater difficulty in acquiring sufficient quantities and quality of food. However, the qualitative data indicated that the effect of seasonal variation on FI was modified by employment, wealth and community location. These findings highlight the role social factors play in mediating seasonal impacts on FI and support calls to treat climate associations with health outcomes as non-stationary and mediated by social sensitivity.
Keywords: Seasonal variation, Food security, Indigenous populations, Social determinants of health, Mixed methods