Welcome to Mbale, Uganda
During your stay in Mbale, you might have questions concerning many of these items. Take a few minutes to read through the following information and then email Jan for clarification or further details.
Ugandans are warm and friendly. Young ladies may find the men too friendly and be distressed by wolf whistles/cat calls and marriage proposals! Children constantly call out “Mzungu!! Mzungu!!” (white person) and like to touch your skin and hair.
The easiest way to die in Africa is not from malaria, but by road traffic accidents! However, Plasmodium falciparum malaria is also a killer. Take the recommended prophylaxis (e.g. Doxycycline or Larium (Mefloquine)), sleep under mosquito nets, and consider wearing long sleeved shirts, long trousers/pants and socks in the evening and/or using insect repellent. Larium is expensive but is only taken weekly. It often causes vivid, sometimes unpleasant dreams. Doxycycline, a broad spectrum antibiotic taken daily usually causes nausea unless taken with food, and it can heighten sensitivity to the sun. Both can be bought here in Uganda cheaper than available in most Western countries. (Perhaps bring enough to get started.) Remember, no drug prophylaxis is 100% effective.
3. The House
The house is fairly large and set in a large compound. It is rented from the Bagisu Cooperative Union (which exports coffee). As a deterrent to thieves, an armed security guard is on duty from 6 pm to 6 am every day. There are 4 bedrooms and a study that can double as a 5th bedroom. The floors are cement with no carpets. All the beds have mosquito nets. There are two bathrooms, both having a hot shower. Unfortunately electricity is off 50% of the time (alternate days) and when the electricity is off the water is sometimes off as well. We now have a small paraffin/kerosene generator which runs the lights, DVD, and computer when power is off. Bring a head lamp to read in bed at night after it has been switched off. The tap water is NOT safe to drink. Drinking water at the house and hospice is filtered using a sterasyl ceramic filter. However, a water bottle with a built in filter or a camping water filter for bacteria, protozoa, and fungal spores is useful for travel to villages. We have a housekeeper, named Grace, who does our cooking and is willing to do laundry (minus underwear). There is no oven for cooking. We cook using gas rings, a paraffin stove, and a charcoal stove depending on fuel availability.
Visitors vary in their ability to cope with being alone. There is NO entertainment in Mbale and therefore little to do in the evenings, unless there are church activities. Please note: Drinking of alcohol and smoking are NOT acceptable under any circumstances or at any time—even in private. The clinic and hospice operate under the Medical Services wing of Deliverance Churches of Uganda, and smoking and drinking are not acceptable to Ugandan Christians. If practised, it can cause severe embarrassment and difficulty to the person concerned, Jan and Jan’s home church. We have a small selection of books and videos/DVDs and a few CDs but people need to be able to entertain themselves. Bring your favourite card/board games and teach others. There is only one local TV station which has very poor quality service.
Ugandan food is mainly carbohydrate rich — rice, chapatti (similar to tortillas), posho (maize), matoke (cooked bananas), millet bread, yams, and cassava. There are few locally obtained vegetables — mainly cabbage, dodo (spinach), sukumawiki (a dark green leaf usually shredded), carrots and eggplants. It is all rather bland. Fruit depends on the season, but includes pineapple, mangos, bananas, watermelon, passion fruit, oranges (usually bitter), avocados, and jack fruit. Apples are imported from South Africa. Ugandans tend to fry everything in cooking oil, and repeat meals over and over without much variance. Although we tend to have meat or fish on occasion, meat is considered a treat as many Ugandan’s can’t afford it. During your stay you may be offered Ugandan delicacies such as “white ants”, grasshoppers, and cow’s intestines.
In the villages, people theoretically use pit latrines/long drops. In town there may be flush, floor-level, Eastern toilets which necessitate squatting. Our house thankfully has Western toilets. It is a good idea to carry toilet paper around because most toilets do not have paper. Rural people use leaves. Also, 70% isopropyl or ethyl alcohol hand sanitizer is helpful for field work when water is unavailable.
Roads vary in upkeep, but many are dirt or tarmac (asphalt) in disrepair. Potholes can be enormous and numerous, making travel slow and frustrating. Even the main road from Kampala to Mbale (a 3—4 hour journey) is very pot-holed over large sections. The roads in Mbale town are similarly very poor. On the roads, matatus (minibus taxis), boda bodas (either bicycles or motorbike), semis/lorries, and buses are common. If you need a ride for short distances, boda boda drivers will give you a ride on their bicycle (cheaper) or motorbike (bit more expensive) for a modest price. Special hire cars are also available, but are more expensive and the fare must be clearly negotiated before entering.
Besides mosquitoes, insects are relatively very few. Some wasps and bees may be of concern if you are allergic to them. Cockroaches are common in some homes. Mango flies can lay their eggs on clothes laid on the grass to dry; the maggots develop in a small “boil” in the skin and are quite painful to remove. Hairy caterpillars burn the skin if you step on them. Jiggers are fleas that can only jump about 1 inch off the ground and are common in areas where pigs are kept. If you walk bare footed, they can imbed themselves in the skin of the feet and cause intense itching.
Each year, Uganda has two hot/dry seasons, and two cold/wet seasons. The longest hot season runs from about November to February. The longest cold season runs from about March to June. Hot seasons can be very dry and temperatures can reach upwards of 27—30 ºC. Roads become very dusty and nights can be uncomfortable. During the cold season, rain is seen almost every day for several hours, and comes as a torrential, tropical downpour. Mornings can be bit chilly in the cold seasons, but temperatures on average hardly drop below 20 ºC. The dirt roads become very slippery and muddy during the wet seasons and may need a 4-wheel drive vehicle. Malaria is also more prevalent during the rainy season. Some visitors find Uganda unpleasantly hot in the “summer”.
Clothing on the whole is very conservative, even in non-church circles. Women are advised to have shoulders covered and wear long (below the knees) skirts. Due to the hot climate, cotton slips are suggested and indeed a must for any skirts which can possibly be seen through. Unless you want to attract lustful stares from the local men, keep clothing conservative! We always wear skirts out in public; however, it is alright to wear jeans/pants around the compound at night to not get bitten by mosquitoes. Men should also dress more formally than at home. Ugandans tend to wear formal clothes all the time, especially for work and church. Bring cotton or cotton with polyester clothes (not synthetic — they are too warm and make you sweat), although you may find “poly pro” athletic clothes that wick moisture away also beneficial.
Along with the general market in town (open air market that sells local foods, second hand clothing, etc.), there are also several small “supermarkets” in town. You will find most items there, including toiletries, Western and Indian foods, and household goods. Poor quality stationary is also readily available.
12. Email/Computer services
There are two internet cafes in Mbale Town. These provide services at around 25—50 Ush per minute (depending on whether they have power or are using a generator). They are on a dial-up server, but are usually fairly reliable. Lately, we have been able to access more sites on Jan’s computer at home, but the cost is much higher per minute than that of the internet café because it can be charged at the standard phone-line rate of 125 Ush per minute.
13. Camera Technologies
There are some photo shops in town. However, you may wish to buy your film at home as it is rather expensive here. Digital camera users may find it difficult to take photos back home, and could bring a MP3 player or jump drive (i.e. memory stick) to transfer images home.
The easiest way is to bring money into Uganda is new, un-torn United States dollars (USD) or British pound sterling. They should be in $20s, $50s or $100s if USD or £10s, £20s or £50s if GB £. It is also important that USD bills are newer than the year 2000. Your ATM bank card MIGHT work at Standard Chartered Bank in Mbale, but don’t count on it. Don’t bother with traveller’s checks. Most places in Mbale won’t take them or will give you a very poor exchange rate. If you are comfortable to do so, just carry the money in a money pouch under your clothes). Everyone deals with cash, and essentially businesses do not have VISA capabilities. MasterCard not used at all in East Africa. The only place you can use MasterCard is at the Barclay’s on Kampala Road in Kampala where you can get money advances at a charge of $25 USD. Kampala is a 4 hour drive from Mbale!
Uganda has changed its policies on Visitors and Work Visas recently. They are creating a new category of volunteer, but at the moment, everything is rather ambiguous. Lately, immigration has been stamping all visitors’ passports with a 30 day pass at the airport, even if they acquired a longer pass from the Ugandan Embassy in their home country. You can get a visa at the airport when you enter. If you are staying longer than one month, you can renew your visa once here from Mbale. After that, you need to go to the Kampala immigration offices. The charge for a 30 day, single entry visitor’s visa is $30 USD. When filling in your visa application form, you will be staying with Dr. Janet B. White Box 1544, Mbale (Plot 12, Bufumbo Rd) Uganda. Home Tel: 045 34735.
Calls made around Uganda depend on the recipient’s telephone server. Most calls in Uganda cost around 300 Ush per minute. International calls are 1000 Ush per minute. Jan’s home phone number is 256 (country code for Uganda) 45 (area code for Mbale) 34735 and it is registered to allow international calls. When dialling internationally from Uganda, you dial 000 before the country code for the UK (44) or Canada/US (1).
Entebbe is the only international airport in Uganda. If you aren't concerned so much about cost, British Air has a non-stop from London that takes about 8 hours. We live in Mbale, about 4-5 hours drive from the airport in Entebbe. It is best to arrive on a weekday (especially Wednesday-Friday), so that we can collect medicine for the hospice as well as picking you up. It doesn't matter if you arrive early in the morning or late in the evening, because we have friends in Kampala (45 min from airport) who we can stay with the night before you come or the evening after you arrive.
The best thing is to check with your family doctor or an international travel clinic, keeping in mind your immunization history. Apart from malaria prophylaxis, you might be ok if you work in the medical field or if you have travelled abroad recently. Make sure you include vaccinations against the following:
Yellow Fever (Compulsory to enter the country. Carry your international
Typhoid Hepatitis A Hepatitis B Meningitis (meningococcal) Tetanus booster if not given in the last 10 years BCG against TB given 3 months before travelling! (Especially for
Childhood immunizations usually include diphtheria, pertussis,
measles/mumps/rubella, polio. Make sure your polio is up to date, and you may need a booster dose of adsorbed diphtheria.
Rabies, if you like remote villages or internally displaced camps in the north.
19. Housekeeping Contribution
Visitors who wish to contribute for their cost of living are told to ask the Holy Spirit! Other friends suggest £4 or $7 daily. Jan won’t refuse anything you give her though (and she usually uses whatever she can spare for her work at the hospice anyway and for drugs and staff salaries).
20. Preparation for Medical Work
If possible, get an idea of the history of Uganda, although Jan has tons of relevant books here. If you really want to do tropical medicine/nursing, read a basic tropical medicine book or do an internet search on common diseases such as malaria, AIDS, and tuberculosis. We are also involved in terminal care for cancer and AIDS.
ASA University Review, Vol. 7 No. 1, January–June, 2013 A Study on Drug Use at Upazilla Health Complex, Savar, Dhaka S.M.A. Sayeed Ibn Elias* Abstract A cross sectional study at Upazilla Health Complex, Savar, Dhaka for prescription analysis and assessment of drug dispensing in 30 patients revealed that the average number of drugs prescribed per encounter was 2.33. About 44.28% dru
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