Monday, March 22, 2010

Where There is No Light

In Uganda, electrical power slinks out from a dam on the Nile River located by the town of Jinja in the east. Power lines follow the tarmac highways north and west to provide electricity for major towns across the country. Approximately 300 megawatts serves the entire country, less electricity than is used by one large data center in Silicon Valley California. Some sources estimate only 5-7% of Ugandans have access to electricity in their homes.

That's not apparent to a visitor who doesn't venture to "the village". Because power follows the highways, an outsider is unlikely to encounter the reality just a few hundred meters beyond the roadway. With the vast majority of Ugandans living in a rural setting, vital public services - schools, health clinics, and churches - are without power. And every evening, most go to bed in darkness or by the dim, sooty glow of a kerosene lamp.

Maternal health is especially impacted by the darkness. Labor pain has no respect for the time of day. When it comes, a mother is in danger if their midwife is unable to see clearly during delivery. This week I had the opportunity to partner with WE CARE Solar to administer the installation of a small solar power kit in the village of Kitswamba, near Kasese in far western Uganda. WE CARE has developed a small, portable and simple solar kit to aid health practitioners save mothers' lives. The idea is to demystify solar and let the user focus on the benefits, rather than the technology. The kit includes a mobile phone charging station, small LED lights, a AA/AAA battery charger, and portable head-lamps. These head-lamps are perhaps the most important part because they provide a large amount of light in a small area, getting the job done without using a lot of energy.

Though WE CARE provided the solar equipment, I asked the Uganda Ministry of Health to contribute to the cost of installation. The purpose was to ensure that the ministry valued what was being provided. I have been pleasantly surprised at their cooperation and enthusiasm for the project. In quick order they approved several hundred dollars worth of funds. The money covers labor and materials such as wire, light-holders, the panel roof stand and nails.

The success of the project depended in large part on the work of the senior administrative doctor, who oversees 25 health clinics in the region. He selected the clinic to receive the kit, convinced the ministry to provide funds, and was instrumental as an advocate. I would not have been able to do it without him.

At the end of the day, the clinic now has a small system to provide a place for mothers to give birth. Success is not guaranteed however due to two on-going issues. The first is cultural: the majority of Ugandan women give birth using traditional birth attendants (TBAs) in their own homes. The ministry is conducting a sensitization program to encourage women to come to health centers for their own safety. That process is ongoing and will take a long time.

The second issue is water. When I interviewed the on-site doctor, he said in the classic Ugandan way, "we have a problem of water". The clinic has a large rainwater tank, but no connection to a reliable source of water. Without it, performing births becomes much more difficult. I'm not sure how this will affect the Kitswamba health center. Some follow-up will be necessary to judge what has worked, and what is failing.

Saturday, March 13, 2010

Change, change it's gonna come...

Those very words once left me numb.

I think most people's impression of Africa is of a place stuck in a rut - a place where war, poverty and corruption are the immutable facts of life. A place where children die of preventable diseases, and yet nothing can really be done because "some things never change".

All of these exist in Africa. But things are changing, and faster than most people realize. For example, I'm writing this blog post using a cellular modem from Orange on a brand new 3G network (and probably get better data rates than in NY or SF on AT&T!). This wasn't possible until just 3 months ago. Before that, I crept along on a mind-numbingly slow modem on the dominant MTN network. And even then, cellular modems weren't even available at all until just two years ago. Roads are improving too - the road to Kampala is still a complete mess, but large stretches are smooth asphalt. Each month it gets a little better. And the road to Kabale (2.5 hours away) has gotten much better since I arrived in April 2009.

Like in the developed world, consumer adoption of new products is spotty - but it's there. If something improves your life, there's a market for it. For example, the Uga Stove is an energy efficient wood or charcoal stove introduced a few years ago. I see them all over the place now, at least in shops. It appears to be a small part of the market, but there is definitely consumer demand there. And mobile phone adoption stands head and shoulders above any other consumer product - a 30% adoption rate in Uganda, a country with per capita income of $1300 (PPP, 2009 est.).

Things are changing across Africa - now is a time of opportunity. The continent's classic problems pose challenges, but are receding. Those of an adventurous sort may find their expectations far out of line with the reality they discover.

Wednesday, March 3, 2010

Live from Goma

Rushing home to beat the impending darkness, my Escudo was recently brought to a halt in front of a long line of Pajeros and Land Cruisers, the ubiquitous transport of Goma. My Suzuki emits a pathetic yellow halo of light in front of the car, making it barely adequate for travel after dark. I was in a hurry. The delay was exasperating and confusing, especially because this was not the normal location of a back up. We inched forward, and ten minutes later the source of the delay was found: a large power cable lay prone across the road. Now, in Congo any disruption to the normal flow of life is seen as an opportunity by enterprising individuals. This day that ingenuity was on display as young boys stood to hold the cable up on either side of the road - but only raising it up after the cars had paid a small fee, such as cigarettes. Thus, what elsewhere would be seen as a sign of municipal failure was here seen as a makeshift toll gate.

It's scenes like this that make Goma such a fascinating and exasperating place. One can only admire the ingenuity required to survive while at the same deploring the reasons such ingenuity is needed. But some people here are doing more than just surviving off of opportunity, they are creating hope for others. For example, my friends Pascal and Christine run a center for young people called Camme, which aims to build community and provide useful skills for children who otherwise have no chance to learn. The organization is completely home-grown and locally operated, with growing, enthusiastic support from the United States. Heal Africa, which I've mentioned numerous times before, is another example of a home-grown and operated institution that is working to bring healing and transformation to Goma and North Kivu.

Goma is a place in rapid transition, with a long way to go towards "normality". But it's clear, even over just the one year I've been able to observe, that things are changing for the better. It is a place on the fragile road to recovery, and a lot can still go wrong (and very much is still going wrong in the districts surrounding the city). But with hopeful, passionate people working to make their home a better place, things maybe can get better (as long as governments don't screw it up, but that's a tale for another day).