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Summer 2011

Cover Story

Students Ryan Cooper (left) and David Campbell leveling the floor of a house they're helping local residents build in Kabale in southwestern Uganda. Photos in this story by Christopher Pearce

IT WAS A SHORT WALK FROM the village of Biwolobo, deep in the Ugandan countryside, to the pool where villagers got water for drinking, cooking and bathing. But the trip, a mere daily errand for locals, would have profound consequences for the CALS study abroad students who accompanied them.

After a few minutes they arrived at the narrow pool, which was set in a rock with steep walls on three sides. Slippery dirt stairs led down to the water’s edge. The water was brown and murky, with scum and bits of garbage floating on it. In a country where few people know how to swim, the pool invited tragedy. In the past month alone, two children had drowned while fetching water, then-student Jenna Klink BS’07 recalls learning.

Klink was shaken. “In spite of the drownings, kids were still fetching water from that pool. It was the only source of water for their village,” she says. “And the water didn’t look at all safe to drink. We later found out that it wasn’t.”

A traditional healer explains how he works with patients. The spears represent the spirits of ancestors, and in front of him are samples of plants used for medicinal purposes.

It was but one of many stories that would change the way Klink and 13 other UW students saw the world. Most of them came from small towns in Wisconsin and had never before left the country. They were part of a new CALS study abroad program in Uganda, in its third year when Klink’s group went in 2005. There they would spend three weeks over winter break experiencing things seldom seen by tourists.

Two nine-hour flights took them to steaming, bustling Kampala, the nation’s capital. There they attended lectures on such topics as AIDS and malnutrition at the Makerere University School of Public Health before heading out to rural villages to see how people dealt with those problems. In one village, Lyantonde, they observed and learned from a Ugandan nonprofit that was planting vegetable gardens, building rainwater collection tanks and getting mothers and infants off to a healthy start with nutritional education.

The entire time they soaked in the sights, the sounds, the smells—sometimes the aroma of foods they’d try for the first time, other times the stench of human waste and illness. They were delighted by people’s disarming friendliness—so different from the guarded stance of people at home—and by the children who would wave at their bus from the roadside. There were lush, rolling hills, the beauty of zebras and elephants in the wild.

And there were moments of despair. During a visit to Mulago Hospital—the nation’s referral hospital, meaning it offered the best treatment in Uganda—they were jarred by the dilapidated beds and equipment, the reek of urine, the open windows letting in dust and insects, the understaffing, and, above all, the suffering. The AIDS/HIV wards were full to bursting; children with extreme malnutrition and other conditions were waiting long hours to be seen.

Eric Monroe BS’05 was struck most by the malaria patients, many of them small children. They lay dying, a sense of futility engulfing patients and caregivers alike. “It made you sad but also angry because there are effective treatments out there,” says Monroe.

A mobile outdoor weigh-in: Infant weight monitoring is a crucial aspect of public health in rural Uganda.

The weeks flew by, the students flew home. Small wonder that the world they returned to didn’t look quite the same. “We were shown all these things, then we came home to our beautiful Western lives, with our showers and toilets and sinks and washing machines,” says Kim Isely.

Around Madison, the students met up often and talked about their times in Kampala, in the villages. They reminisced about sitting around at the end of the day sipping Nile Specials, laughing at their mistakes and trying to make sense of it all.

And they started thinking of ways they could give back to Uganda, a country where people had much to offer but also needed many simple things. There must be something they could do. As they tried to resume their lives, they found that something had changed. They had left Uganda, but Uganda hadn’t left them.

That was exactly the kind of impact CALS had hoped for when starting the program in 2002. Biochemistry professor James Ntambi had been talking about undergrads in the life sciences with Ken Shapiro, then associate dean and director of CALS International Programs, and John Ferrick, then director of CALS Study Abroad. Sure, students were getting a top-notch education. They were learning all about cellular cycles and endocrine function and gene expression.

But the students needed more. They needed to know not just how biochemistry worked, but how the world worked. “It’s not just the biology of health,” says Ferrick. “There are many, many other factors that influence people’s decisions about health. Nutrition. Economics. Politics. Culture. All of those things are what we were trying to get at.”

Moreover, they wanted to respond to student demand. Students were eager to learn about conditions in the rest of the world. They wanted to get beyond their classrooms, beyond their borders.

Uganda seemed like a good way to get them there. Ntambi, a Ugandan native, had grown up in a small village and still had many connections at Makerere University, where he’d arrived to study science in 1971—the same year that dictator Idi Amin took power. Ntambi kept his head down and moved through the university system as Amin grew more outlandish in his rule, as people around town began to disappear.

By the time Amin was overthrown in 1979, Ntambi was finishing his master’s degree and working as a lecturer at Makerere. The following year, out of the blue, he got a Fulbright scholarship to do his Ph.D. at the Johns Hopkins University School of Medicine, an opportunity that brought him to the United States.

At one point he ran an exchange program with Uganda that he thought could serve as a model for CALS. As it happened, UW–Madison and Makerere University had recently renewed a Memorandum of Understanding for such partnerships. Shapiro, a CALS professor of agricultural and applied economics, had done research in East Africa and Ferrick had extensive experience in Africa as a Peace Corps volunteer in Lesotho.

A district hospital outside of Queen Elizabeth National Park in southwestern Uganda. Many healthcare facilities do not include mosquito nets despite the widespread prevalence of malaria.

The trio hammered out the program. A fall semester class about global health would be followed by a trip to Uganda over winter break. During the trip each student would work on a health-related research project. Ntambi and Ferrick would teach the class and accompany the group to Uganda.

Uganda study abroad was an immediate success—so much so that Makerere set up similar programs with other universities. In Madison, each year the program was improved upon—and each year it got more popular. By 2005, Ferrick was getting three and four times more inquiries than he could accept. Before long, he stopped publicizing the program. Word of mouth was more than enough.

After returning to Madison, the students from ’05 continued thinking of ways they could help the people who had opened their homes and lives to them.

And it was here that the local link provided by James Ntambi proved crucial. Several of Ntambi’s former colleagues at Makerere University were committed to improving health and nutrition in Uganda’s rural communities. The students realized they could have the greatest impact by contributing to those efforts.

The most impressive was the work they had learned about in Lyantonde. The Community Based Integrated Nutrition program—CoBIN for short—was led by John Kakitahi, a physician and professor of community health at Makerere. CoBIN had trained 150 volunteer “family care workers” from various villages around Uganda to provide basic health services and education in their communities—an effective, low- cost way to address key public health challenges. Activities included health and nutrition counseling, garden planting and distribution of vegetable seeds, basic infant care and weight monitoring and building rainwater collection tanks.

The group surveys building improvements UW students have made through the Village health Project and Uganda study abroad.

The water tanks struck the students as especially important. Jenna Klink remembered the children drowning in Biwolobo. Eric Monroe recalled the many stagnant pools that were breeding grounds for mosquitoes carrying deadly malaria. The collection tanks being built by CoBIN often offered rural communities their only reliable source of clean water, especially during the dry season.

Even better, the tanks were conceived of and designed by a Ugandan. Engineer and Makerere University lecturer Moses Kizza Musaazi, through his company Technology for Tomorrow, specialized in simple inventions using local materials, all aimed at improving living conditions in rural Uganda.

In order to raise money, the students began selling necklaces made by Reach Out, a group promoting awareness about AIDS in Uganda. They gave some profits back to Reach Out and the rest to CoBIN to build more water tanks. It was a good start, but more was to come.

“We’d never talked about forming an organization,” says Klink. “Then we heard about the Wisconsin Idea Undergraduate Fellowship program, and we decided to apply.” Soon the group found themselves with $7,000 and a growing list of things they wanted to do. They formed a student organization and incorporated as a 501(c)3 nonprofit.

The fledgling Village Health Project (VHP) took on a life of its own. Fueled by passion, Klink, Monroe, Isely and the other founders applied for more grants and hit up friends and family. Their parents caught the fever and helped the group network in their own professional circles. Soon the students were visiting Rotary clubs and other service organizations and making their pitch.

With CoBIN as their boots on the ground, VHP started sending over funds. The projects they supported grew to include:
• Provision of natural water filters for use by village households. The filters use gravity to move water through layers of organic matter that absorb or kill many water-borne pathogens.
• Provision of “MakaPads,” affordable sanitary napkins made from papyrus—a simple innovation (also by Musaazi) that allows girls to attend school while menstruating, a barrier that impedes young women’s education throughout much of Africa.
• Building repairs and school supplies for Lweza Primary School in the village of Mukono, where Ntambi began his education.

CALS biochemistry professor James Ntambi began his education at Lweza Primary School in rural Mukono, central Uganda.

The Village Health Project had an early opportunity to prove its mettle. In 2006 CoBIN’s funding from USAID dried up, and suddenly a group of undergrads in Madison became the organization’s sole source of revenue. Not surprisingly, CoBIN’s funding went from some $75,000 a year to around $15,000, which is roughly what it gets now, depending on donations. But CoBIN continues to thrive with its fleet of family care workers providing vital services in rural communities.

The Village Health Project, too, continues to grow and works in an easy exchange flow with Uganda study abroad. Study abroad students work on some VHP projects in Uganda, and many get involved with VHP after coming home, replacing students who graduate and move on in their lives. James Ntambi and John Ferrick sit on VHP’s board of directors to help make the flow even smoother. A half-dozen years after VHP’s founding, one thing seems clear—students returning from Uganda will continue feeling the need to do more.

Students who perform service abroad hope to make positive changes in that country. Less tangible, but just as real, are the ways in which the experience changes them.

Susan Mawemuko, a program officer with the Centers for Disease Control and Prevention at Makerere University, sees those changes in the waves of UW students who come in and out each year.

“When you meet them again at the end of the program, you think they have been living in Uganda for a very long time,” Mawemuko says with a smile. “It’s just three weeks, but it changes them forever—and you can see that on their faces.”

There is much evidence for the benefits of study abroad. Living in other countries helps students in everything from their general maturity to self-reliance and their ability to tolerate ambiguity, holds one study by the Institute for the International Education of Students. And spending time in another culture increases a person’s baseline creativity, found a study published in the Journal of Personality and Social Psychology (2009).

Employers increasingly recognize not just the value but the necessity of having a globally experienced workforce.

“A significant portion of our growth will come from international markets, whether through expanding the exporting of our products from the United States or establishing manufacturing bases overseas,” says Joel N. Krein, vice president–operations with Leprino Foods Company, Inc., a Colorado-based company that recruits CALS graduates. “The key to our success will be in recruiting and developing our future leaders with the skills and knowledge to excel in this international market.”

Building a water tank in rural Lyantonde (James Ntambi, right, and student Ryan Cooper, center).

Certainly students are mindful of the job market when they opt to study abroad. “I recognize that to get the kinds of jobs I want, I need international experience and I need to know how to interact with other cultures. And I think that’s true of all students at this point,” says Rebecca Gilsdorf, who went to Uganda in 2009.

But what students experience runs much deeper. It’s a transformational experience that changes hearts as well as minds, and it’s not unusual for students to choke up when they talk about it. “Almost every single day I teared up,” says Liz Hill BS’09, recalling her trip to Uganda in 2009. “Just seeing how with so little they can give so much, and still be happy. I feel like they gave more to me than I gave to them.”

“It was one of the most pivotal experiences of my life,” says fellow ’09-er Douglas Stewart, who now works as a medical researcher and plans to go to med school. “You think you have a sense of what it will be like. But once you’re actually there, the visceral experience is much more powerful than simply reading about it.”

The experience has changed life plans for many students. “Before the trip, I was pre-med,” says Jenna Eun BS ’07, who now serves as president of the Village Health Project while earning her doctorate in biochemistry. “But afterward I realized I didn’t need to go into medicine, that a lot of what people need is not getting drugs or seeing a doctor. The issues there are usually more fundamental. It’s water and electricity. It’s public health issues. It’s civil engineering.”

Eric Monroe, from the 2005 group, had the opposite reaction. “I’d been kicking around the idea of medical school, but I wasn’t quite sure. I was thinking about maybe going into research or business,” he says. “But Uganda was one of the things that sealed the deal for me.” Monroe graduated from medical school in 2009 and is now a resident in radiology at the University of Washington.

Abby Stepaniak, also from 2005, was drawn to Africa for the long haul. After graduating she did the Peace Corps’ Master’s International program in South Africa and then shipped off to Sudan, where she works as a partnership coordinator with GOAL, an Ireland-based nonprofit. Study abroad continues to inspire volunteering for Peace Corps. Elizabeth Chadwick, who went to Uganda earlier this year, has signed up for a posting in West Africa after graduating this summer.

(Left to right), students Tae-Young Nam, Elizabeth Chadwick, Aneela Alamgir and Molly Overby pose in front of a water tank built by the Village Health Project during an earlier visit.

As for Jenna Klink, the Village Health Project’s first president, she took her community service gifts to post-Katrina New Orleans, where she earned a master’s degree in public health and serves as a program evaluator with the Louisiana Public Health Institute.

This year, Klink and Kim Isely returned to Uganda to assess impacts of the Village Health Project so far. They evaluated use of nine of the 13 VHP water tanks, and found that they are serving about 340 people, including 43 households and a school. Residents say the tanks save them up to four hours a day they would have spent fetching water, and that they are grateful to have water that tastes clean, gets their clothes clean and is free of water-borne diseases. This is an impressive achievement, especially considering it was the spare-time work of undergraduates.

But many of the group’s accomplishments defy quantification, Klink notes. “A lot of our impact can’t be measured. For example, the number of malnourished kids brought to the hospital and lives saved because of the family care workers’ presence in the villages.” Not to mention village children who have not drowned while fetching water.

Another thing that can’t fully be measured: the program’s impact on the students themselves. Because one thing no class can teach you is that when you set out to help others, the life that you change may be your own.

For more information, please visit dev.cals.wisc.edu/ip/ProgramTypes/Uganda and www.villagehealthproject.org.
Some material in this story comes from the documentary “Destination Uganda,” produced by the Big Ten Network in association with UW–Madison and CALS. The video is posted at www.youtube.com/watch?v=V5SQK29DtFU.

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