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!
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."
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.
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.
Written by Kaitlin Patterson, PhD Candidate This week I attended the Canadian Network for Maternal, Newborn and Child Health Conference in Montreal. The focus of the panels and discussions was the 3 Ps: Partnerships, Policy, and Progress. Discussions ranged from how and which policies can support the achievement of the sustainable development goals (in particular those related to maternal and child health, and gender equality), successes and lessons learned in programming and partnerships, and pathways for the future. I was also delighted to run into an IHACC and CCIFS3 collaborator Dr. Cesar Carcamo from the Universidad Peruana Cayetano Heredia. It was really great to connect with him and take a token IHACC pic!
Two key themes stood out/impacted me most. The first was the neglect to identify adolescents as a priority population in many of the global health priorities and targets. Maternal mortality is the highest cause of death among adolescent girls. They have the least amount of education, money, health services or access to contraception, further exacerbated by the continuation and propagation of child marriage, and the highest rates of HIV acquisition in Africa. The second theme closely linked with the first was the need to ensure sexual reproductive rights including access to safe abortions and post abortion care, contraception/family planning, feminine hygiene products, and putting an end to child marriage.
A refreshing aspect of this conference was that it was not self congratulatory. The speakers and panelists were not self-deprecating, but they were critically reflexive. They openly discussed how as a global community we are failing women. We have not decided that women’s lives are worth saving. We need to be better. It was an impassioned call and a resolve to meet these global challenges.
Nyaradazayi Gumbonzvanda (Goodwill Ambassador of the African Union Campaign to End Child Marriage & World YWCA General Secretary) ended the conference with a poignant reminder for anyone doing research or working with communities, “[y]ou are not going to the field. You are going to someone’s home, the totality of their world”.