An Honour To Meet and Work With Dr. Ambrose Katwiire at The Rakai Community Based Health Project and the Kyotera Medical Center in S/Central Uganda

Interviewer:?

Doctor Ambrose, tell me please, what made you come to work in Rakai when there could have been many other places you could have gone to?

Dr. Ambrose:?

I came to Rakai at a time when not so many medical doctors or qualified health workers were deployed here. We came to work in Rakai at a time when many medical doctors could not think of a deployment here. Many perceived a deployment here as a punishment. This was one of the most-hard-to-stay, most-hard-to-work-in and most-hard-to-reach-areas.

I came at a time when if a child had malaria convulsions, the village members could inform each other and prepare to bury the child. For children who were below five (5) years this was a death sentence and most, if not all, died.

It was a traumatic time and communities had devised ways to cope as well as make it normal. They had come up with practices that normalized pain.

Interviewer:?

How so? Please make it clearer to me. I note far many phenomena were taking place and people had got "immunized" against traumatic events.

Dr. Ambrose:?

I came two (2) decades after Dr. Kyagaba and a team of many other medical doctors had described a "slimming disease" that was making people get slimmer and slimmer and eventually die. This slimming disease, said to have been around for as far back as the late 1970s and early 1980s, followed in the heels of a myth that all people who were dying of the slimming disease must have engaged in illicit business across the border that Uganda shares with?the Republic of?Tanzania.?

Recall that there is so much inter-border business taking place in these areas. This fueled the myths around people dying in retribution for not paying for goods taken on credit from Tanzanian business persons.?

There were other myths such as the ones narrating how girls eloping with boys or men came with curses from the families they run away from. It happens that most of these girls were employed in the bars and entertainment places. These were in Mutukula, Kasensero, Lyantonde, Lukaya, Kyotera, Bisanje, Nyendo and Matanga Long Distance Truck stop-overs which had also become pockets with tales of bed-ridden persons with the slimming disease.?

This was the same slimming disease that people were dying of in Rakai. In most cases, it spared children many of whom had lost their parents and the extended family members were dying in big numbers too. Around the mid-1990s, El Nino struck and cut off parts of the then Rakai (out of which Isingiro, Kyotera and Lyantonde were carved).?

Large swathes were cut off and people had to use boats to move from one part to the other. I set up camp and was determined to work here.

Interviewer:?

What were the unique approaches you were to use in order to tell a story encouraging people to seek healthcare services?

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Dr. Ambrose:

The trick was to use health education, set up an admission clinic or health center, engage with communities and train them to use prevention methods. This area still has a higher infant malnutrition despite of the fertile soils where food crops grow. But the food crops are sold off to earn money, or households instead grow such crops like pineapples, passion fruits, coffee, pulses like g-nuts and others out of which they get money.?

The prevalent neglect of nutritious food gardening has left children in many households under-fed or not fed well at all. Our clinic worked around the clock to address the malnutrition using the Clinical as well as Community/Public Health specialist approaches. This helped to debunk myths such as the "Namunye" myth where a?child presents with wasting, stunting, underweight, and deficiencies in vitamins and minerals?all in one.

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Interviewer:

Dr. Ambrose, as we wind down this inaugural interview to be used to launch the Rakai Community Based Health Project (RACHEP) Social Media Platforms, give us tips on running an organisation of this calibre at a time when the largest part of funding capital has to be resourced privately.

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Dr. Ambrose:

Thanks for bringing this up. Running the Rakai Community Based Health Project has been a combination of so many other factors. I am a believer in God, so God first in everything I do. There is an arm of God in everything we have done at the Rakai Community Based Health Project. Secondly, is the science and art approaches. We have a medical center that addresses the clinical needs through social-psychological-behavioural-medical interventions (The Kyotera Medical Centre). Rakai Community Based Health Project (RACHEP) is the community outreach arm that meets, talks with people, engages in surveys, comes up with social-cultural-transformation and risk mitigation services for the whole person and community (ies).??Thirdly, are the allies, friends, teams, networks and the government of Uganda’s deliberate investment in peaceful endeavours out of which we are able to be secure and safe. These and more are the reasons I can give to the readers out there to keep them motivated to engage in activities promoting healthy living practices. This is the game-changer.

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Interviewer:

Dr. Ambrose, wow! Game-changer indeed! Now, this is the first interview you have given us that is structured. However, you also gave us insights into what you plan for this place 20, 30 or 50 years from now. We are going to produce articles for you and share them over all Rakai Community Based Health Project Social Media Platforms. Is that okay?

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Dr. Ambrose:

Yes, I hope this starts another phase of health promotion, good health and wellbeing advocacy work by the Rakai Community Based Health Project (RACHEP).?

Thank you.