I love this photo for so many reasons. The focus is off, the exposure is wrong, and there’s a blemish in the bottom right corner of the full print. Still there is just so much going on here. This intersection led up to our house and to this day I still can’t tell you what it’s called. All I know is that there is a large building there called ‘Corner House Suites’ and somewhere around there is a ‘Mawanda’ and an ‘Upper Mawanda’ road. If you say enough of these things together people figure out where you are. This is just how things go in Africa…none of it makes any sense and you are better to bend to its will early than to try and fight it. In the foreground is a ‘gang’ of ‘boda boda’ drivers who are a feature or perhaps flaw that accentuates the city at every turn. Throughout the trip I had trouble visually capturing just how oppressive the noise, fumes, and constant motion of these two-wheeled maniacs can be. Are the throngs of motorcycles convenient or just insanely dangerous? Are the drivers friendly or annoyingly persistent drunkards? The answer is probably yes.
Medical students go to Africa for all sorts of reasons. You can get exposure to resource limited medicine, build upon your procedural experience, learn about a new culture, and even mix in travel if you so desire. In addition to this discussions with Casey and Chris seemed to always bring up three very important sub-themes which we each approached differently:
- How much do I try to recreate the comforts of home vs. embrace third world living?
- How does one best adapt to the widespread suffering and different ‘standards of care’ you are likely to find within the hospital?
- How do I hold myself accountable to show up when no one cares if I’m there or not?
The first question is not as easy to approach as you might initially presume. Hot running water, wireless internet, online food delivery, and 3d movies are all things you expect to leave at home when you head for Africa, but to my surprise each of these was available in Kampala and just as accessible as home.
Our gated apartment was arranged by our classmate/local fixer/all-around-good-guy Danny Low who took a year off of school to do research in Kampala because he’s the bessst. The price was something around $750/month which when split between three and a half people represented a great deal from our suggested guest housing. It offered fairly consistent electricity, hot running water (for 3/6 weeks and with bonus electric shocks), three bedrooms, the world’s least comfortable couches, and what probably amounts to 1 and 3/8’s bathrooms.
Within one day we had cell phones and a wireless internet router set up allowing us to be as connected as we were at home. The area was walking distance from the hospital by way of a small adjacent ‘slum’ that supposedly offered less than ideal safety late at night. That being said once we learned that the local dog pack was in fact friendly and not rabid there were almost no sketchy moments. On one occasion Chris did get picked up by the police late at night on his way home, but only as they did not believe he should be alone so late and WWW (walking while white). Oh how the tables had turned on my tall Caucasian friend…
One of the biggest surprises about Kampala was the ease with which safe and even tasty food was available. My memories of Ghana were filled with trips where searches for the food dominated. We quickly learned that you can order from most any restaurant in the city via a website called ‘HelloFood’ and have a boda deliver it to you in less than an hour for a $1 surcharge. The food itself was varied and surprising in its quality. We ate Indian, Chinese, Mexican, burgers, local food, basically whatever you wanted for between $3 and $7. If you chose to stick with hospital lunches then you could have beans, rice, and chicken for about $1.50. For Casey who was trying to fund quite a bit of travel and other home expenses this was an easy choice. Chris on the other hand had little reservation about ordering HelloFood on the reg and generally being on some king shit…(see below)
Coming from America it is hard to not experience Africa as simply ‘less.’ You are less comfortable, you have less amenities, and things are just harder. Your initial reaction is to try to buckle down and suffer through it, but soon enough you find yourself at the local bourgeois cafe for an all inclusive breakfast. It is especially tempting when it costs less than $8 which barely gets you a latte and a croissant at home. This is a luxury that most Ugandans simply can not afford. I’ve never known what it is like to be economically privileged so this was a weird experience for me. As a brown kid who grew up poor I am very aware of wealth disparities and I have spent a lot of time figuring out how I can help address the underlying causes or at minimum just shaking my fist in the air at privilege. In Africa the wealth gap feels more like a canyon. There are no boots to pull up the proverbial straps and no rungs on the metaphorical ladders.
Everything starts with this man Yoweri Museveni. He has been president of Uganda since 1986 which is an impressive length of time trailing only a few world leaders with longer tenures such as the indomitable Robert Mugabe of Zimbabwe and the ayatollah. The most recent election in March was marred by frequent jailing of opposition leaders, voter intimidation, and all of the other tools within a dictator’s playbook. Among the people I sensed a belief that political change is impossible and that career advancement without political connections is an unlikely phenomenon. Uganda also exposed me to old school propaganda for the first time. These cards lay strewn on the ground under similar giant billboards of Museveni always with his stupid hat. At first impression it can all be very unsettling and then you meet the people and realize that their hope will simply never be extinguished…
“If I ruled the world, imagine that
I’d free all my sons, I love ’em love ’em baby
Black diamonds and pearls
Could it be, if you could be mine we’d both shine”
– Nas, Illmatic