About This Blog & Lois Pollock

My name is Lois Pollock. I'm an experienced social worker specializing in HIV/AIDS and frail aged care. Since 1995 I've been making regular visits to Uganda, and facilitating projects in rural and urban communities who are affected by HIV/AIDS. Despite troubles, Uganda is a beautiful country whose friendly and resourceful people have made me welcome time and again. I have friends there who have become more akin to family.

Thousands of HIV+ people in Uganda have their problems compounded by a total lack of life's simple essentials: paid employment, education,decent food, hygienic living conditions, and consistent supply of prescription medicines and access when needed to doctors. Social work is rendered profoundly difficult by a lack of funding and accessing basic resources for clients. This blog records the major projects I've undertaken over the past decade and a half and highlights the most current. I hope that the reports and photos here will encourage an interest in the problems faced by people with HIV/AIDS, other life threatening conditions and poverty in poorer countries.

I also hope it will inspire financial contributions to my future work in Uganda.

To date I have funded my own trips and bank-rolled each project from my very modest social work salary. Further generous support has come from a handful of benevolent friends and relatives, which has made a tremendous difference to lives thousands of miles away.

If think you'd like to contribute to a current or future trip, please click the tab at right >> labeled "How You Can Help". If you'd like to know anything more specific, contact me at

loispollock1@gmail.com

I have conceived and run most of the projects recorded here, but have also collaborated frequently with a local Ugandan group - The AIDS Support Organisation (click the tab at right >> to find out more about them) amongst others.

I hope you'll enjoy reading these accounts of my work in Uganda - and be inspired as I have been by the people I've been privileged to work for and with. The tabs at right >> will lead you to different project reports.

Thanks for your interest -
Lois Pollock, Sydney 2010

For those interested, the rest of this post presents a potted biography of my career as a social worker.

A Life In Front-Line Social-Work
a short professional biography of Lois Pollock

My entry into social work was somewhat unusual.

In the mid 1970s I was a Labour Party councillor in Hackney, East London. Hackney then was a socially deprived borough and I served on the Social Services, Environmental Health and Housing committees. As a councillor, I actively developed and promoted services for some of the most marginalised groups in Hackney including homeless, squatters and gypsies. I was a founder member of Hackney Traveler Support Group and organised peripatetic medical services and on-site schooling for the gypsy families. I also argued successfully for short term letting of empty Council properties to homeless people and organised squatter groups.

I was concerned by the poor standard of reports put before us - and the basis on which council members made decisions which would profoundly affect people's lives. I decided to undertake social work training to better understand the situations that confronted front-line social workers. After qualifying as a social worker in 1982 I managed a Family Centre on a high rise, high density housing estate in Battersea. There were frequent clashes between disaffected, marginalised Afro-Caribbean youth and over zealous police. Tensions escalated following the Brixton riots and I had to work hard to promote dialogue - and change in local policing practice. I was appointed as the first Lay Visitor in Wandsworth with the responsibility to make unnannounced visits to all the local holding cells and interview prisoners, ensuring their rights were properly upheld. Between 1988 and 1995, I held three social work positions - in Greenwich (generic & child protection work); Royal Borough Kensington & Chelsea (specialist HIV/AIDS worker) and finally in Newham, where I was appointed as a specialist social worker for the African community affected by HIV/AIDS. In those latter positions I gained a deal of experience working with people infected and affected by HIV/AIDS, at a time of ignorance and stigma in the wider community. Ever the community activist, I was one of a group offering alternative funeral services to the gay community when some religious institutions refused to perform services following the death.

While working in Newham I made my first visit to Uganda. I was working with the African community and had learned a lot about issues that face refugee communities - loss of family, children, security and uncertain futures.

In Uganda I wanted to learn about the situation facing children remaining there, who would become orphans when their parent in the UK died of AIDS related illness. At the same time I was introduced to various organisations in Uganda working around HIV/AIDS - and that visit in 1995 was the first of what has become regular visits. In 1995, I felt I needed a break from direct HIV/AIDS work, not least because numbers of close friends had died. I was appointed as a Senior Practitioner Social Worker at St.Christopher’s Hospice, London. For the next five years I carried an individual caseload, ran bereavement support groups with colleagues, offered training programs internally and to the wider community and continued facilitating residential therapeutic workshops for professionals working with the dying or those with life threatening illnesses.

Somehow in the midst of a busy professional and private life I also managed a four year Master’s program in Integrative Psychotherapy, passing my dissertation and completing course work in 2000. Unfortunately, by then I had taken up residence in Australia and did not take the final viva that would have awarded an MSc. It didn’t seem important enough to travel back to London for a 20 minute presentation. My interests by 2000 were leaning considerably toward developing programs in Uganda. Having completed and passed my dissertation, gaining the gown and the cap seemed totally irrelevant.

I'm not impressed by letters after a name, even if that name is my own. I have always been skeptical of the weight placed on academic credentials alone, and the professional merit over 'hands on' experience of many senior figures in social work hierarchy. Sadly most institutions I've experienced have not been meritocratic, but rather have promoted mediocrity.

I am determinedly a front-line social worker: as are the most impressive people I've had the privilege to work with throughout my career. I've learned that if you're searching for talent, creativity, integrity and achievement in the field of social work there is a certain pay-grade you needn't bother looking above.

As a 'career path' to a decent salary, professional status (or mere recognition) this attitude has not worked in my favour!

Despite having a fully recognised UK qualification in social work, having held a number of senior positions, and having had various articles and writing published I was surprised on moving back to Australia in 2000, to discover that the professional association for social workers here would not accept my qualifications. I found I could not work as a social worker with any statutory agency.

Although initially angered by that, my life has generally worked out as it is meant to. I was appointed as a social worker in 2002, in a not-for-profit organisation, JewishCare (Sydney) where I have been ever since (with a period out to complete my dissertation and to do some work in Romania in 2003/4). Since 2005 I have managed a team of social workers and community workers for frail aged, many of whom are Holocaust survivors. I've gained new skills and experiences from these clients, particularly in the area of dementia and built on previous experience of working with past trauma. Amongst a variety of duties, I facilitate a weekly art group for people with moderate dementia. In my private time,work continues with the Ugandan projects highlighted in this blog. I hope to revisit Uganda within two years and in the meantime am writing a training manual for The AIDS Support Organisation (TASO) to use in developing small economically sustainable projects for those living with HIV/AIDS.

Update on village projects

Updated news from Serere - email received from Denis Omiat 3rd January 2011

Dear Lois,

Here is a resume of the plans for the village projects for the coming year and update on existing projects.



1. Plan for this year is to harvest rain water for the clinic and chicken projects.

2. We have planned to construct a simple visitor's house that will provide decent accommodation for our vistors.

3. On closing our books at end of 2010, we had saved 700,000/= from the chicken project, and we were able to purchase two oxen for cultivation next season - by growing our own maize, we will produce our own high quality chicken feed, and possibly sell some of the excess feed to local farmers.

4. The health centre is doing well & we have been in a position to recruit one enrolled nurse and also a laboratory assistant to do a few essential tests. We expect support from the Ministry of Health as we continue with our work.

For now, I have been working on a project work plan for the next financial year and I will soon let you have a look when it's completed.

Thanks for now - I am taking a bus back to university, but will pass by to see Edith and John on Tuesday in Kampala, before proceeding to Bushenyi.

Stay in His grace.
Denis

Donor Successes!

This section is a record of donations received and what they have afforded in the field. Thanks to those who have contributed for your generosity, from myself and on behalf of my Ugandan friends and colleagues.

Vincent & Roger, London: Windows and Doors For Ojama Health Centre









Their £1000 donation also covered the first stages of flooring the interior, moving the crucial health-centre substantially further towards completion. See 'Project: Ojama Medical Health Centre' in the tabs at right for more info.


Gill & Tim, Winchester: An important operation








Modesta is one of the women I met when working on the new chicken farm (see the 'Project: Chicken Farm' tab, at right). Aged 12, her daughter fell from a ladder, broke her femur and had steel pins inserted to repair the break. Six months after she ought to have had them removed, but her parents couldn't afford the treatment. Now 19, she had been limping and suffering increasing pain. £150 from Gill and Tim afforded the operation and she can now walk without limping again.


Rob, from Sydney, & Jennifer, Port Macquarie, Australia: life-saving quinnine for children like Baby Po









Baby Po is Dr Denis's daughter (see 'Dr Denis Omiat' in tabs at right). Shortly after I left Uganda last, she contracted cerebral malaria. She would have died without essential hospitalization and venous medication.

40 children like her were given the chance to live with quinnine, infusing solution and glucose solution, purchased at a cost of $120AU donated by Rob from Sydney and Jennifer from Port Macquarie, NSW. That sum provided vital treatment for three days, by which time government supplies arrived at the village health centre. Had we not been able to provide the drugs, many of the children would likely have died.

Baby Po herself is now doing well at home. Her father Dr Denis and I are talking about ways in which to launch an anti-malarial education program in the village.

Aged Care in Ojama

Good news to report from the SECODI community group: after a discussion about the needs of frail elderly living in their community, five of the women have decided to form a volunteer group. They will find out where all old people are living, particularly those not well supported by family members, and will wash their clothes and clean their houses once a month.  Voluntary service is not a common practice - indeed when I mentioned this to various Ugandan friends, they expressed total amazement! 

The community group has also decided to explore the concept of a small income generating project to produce and market reusable continence pads: one of their members has completed a tailoring course but none of them currently owns a treadle sewing machine.  Two donors in Australia, Edith & Tommy from Melbourne had just informed me, having read the blogspot, that they would like to contribute $500: this will be sufficient to purchase a treadle machine locally, and some of the set up materials required.  The group will be encouraged by me to undertake a SWOT analysis and do some market research before they set up this enterprise.

25.4.2010

Aged Care in Uganda

Services for older people are virtually non-existent in Uganda and if there is no family support, it is exceedingly hard for frail aged individuals to manage. I was aware of this on my recent visit as I was directly involved with several old women. One - though only in her early 70's - like others of that age appeared physically much older, following a lifetime of physically demanding labour, poor nutrition and surviving periods of civil unrest.

As I traveled around I became acutely conscious of this generally overlooked problem. Older women and men who were suffering from eye diseases - cataracts are common - probably other eye diseases as well, causing sight impairment and blindness. Incontinence - particularly urinary incontinence in older women, exacerbated by multiple pregnancies/childbirth in a country where it is quite common for women to deliver up to a dozen children. (That trend is beginning to change with more access to family planning).

Where incontinence products were available I found they were both scarce and far too expensive for an average Ugandan to afford (25,000/- for 8 disposable pads on an average income of less than a dollar a day is totally unrealistic for many people). Women (and men) simply suffer their incontinence in very undignified fashion. Several women I encountered were also suffering from urinary tract infection making the problem worse - and skin rashes from constant contact of urine with their skin.

My friend Edith's 74 year old mother, Helina, was admitted overnight to a small private eye clinic in order to have her cataract removed. Post-operation, it was necessary for her to remain in the hospital - which was when Edith and I realised that she was incontinent. I hunted high and low for continence products in the large regional city, eventually finding the only packet available which I purchased; enough pads to preserve her dignity throughout her short hospital stay.

I set about finding a solution for Helina after she had returned to her village. Cutting a bath towel into strips and having a tailor stitch a soft water proof backing with long tapes that she could tie either side of her waist was my crude but effective creation. The pads could be worn at night then washed thoroughly and hung to dry. It cost approximately 5000UG/ for two pads ($2.7AU or UK 1.60). Helina, the recipient of those pads was delighted. 

Small Project Initiative:
It occurred to me that given the obvious need for re-usable continence products, one of the TASO support groups or a group from SECODEI could work up a small business proposal and mass-produce something similar to the pads I designed. This would serve them and the wider community.
Helina leaving the hospital, well again after her cataract operation

I will pursue the project further; as with all the projects outlined on this blog, support and suggestions from interested parties anywhere in the world are welcomed. You can find my email address under 'How You Can Help' at right >>>>

The only aged care facility that I came across was St.Paul's based just outside Mbarara and I am attaching a short amount of information from their website, together with a link for any who may be interested or wish to support their project directly. (Unfortunately I visited late one evening on my return journey to Kampala and did not meet any of the elderly residents. I did have a conversation with one of the key workers and was impressed by the services they are offering to isolated older people and the service is unique in Uganda and worthy of further investigation on my next trip!) 

www.stpaulsfamily

One of many activities run by St. Paul's Family is a project for helping the elderly poor. St. Paul's Family centre for the aged is a big beautiful home situated on 19.6 acres of land in Bwenkoma Ruti, 8 km from Mbarara town along Mbarara Kabale road. This land was donated to the family by Rt. Rev Paul K. Bakyenga, the ArchBishop of Mbarara Archdiocese. It was officially opened by Arch Bishop Christophe Pierre, the then Papal Nuncio to Uganda on May 7, 2005.

The centre's main development objective is to improve the quality of life for the elderly in Uganda. The beneficiaries of this project are poor men and women aged 65 years and above who have no one to look after them. The centre has the following immediate objectives;

To establish an outreach programme to cater for the elderly

To improve access to medical care for the elderly

To provide income generating opportunities for the elderly.

The centre provides basic needs such as shelter, beddings, clothes and a few household items. It also offers assistance such as repair of houses, provision of household items where beneficiaries decide to remain in their own homes. To date thirty seven elderly poor people have been assisted through this project. In addition the centre provides healthcare services through an operational clinic run by a trained medical doctor.

All are welcome to visit this project and to contribute to its growth and sustainability. Looking forward to receiving you.

Contact us: Email: project@stpaulsfamily.info

Tel: +256 772 672 527/ +256 772 826 832

How You Can Help

Even relatively small sums of money can be of real assistance to the projects and people discussed in the blog. If you're interested in helping, please contact me (email at foot of page) to discuss how you can donate or get directly involved with any of the projects.

See below how you can contribute and where your money would go. Current viable projects include:

Ojama Health Centre

When current building is completed and operational this will operate as a health centre for approximately 7,500 local people and will offer blood testing facilities; HIV screening, testing and advice - together with administration of ARV’s (anti retro-virals); treatment for malaria and malarial diseases; health checks on children; pre and post-natal care and health education for the entire community, including family planning advice.

If sufficient funding can be raised, land is already purchased behind the clinic to build a maternity ward. This would provide a safe delivery suite for pregnant women, together with after-care.

Right now:

$10,000AU or approximately 7000 UK pounds, would complete the clinic including provision of fittings and medical equipment and construction of eco-system toilets from which waste, the product can be used as fertiliser on a nearby community farm.

A further $20,000AU or approximately 12,000 UK pounds, would build the hospital ward.

All contributions to these projects will be administered by the legally constituted SECODEI - Serere Community Development Initiative.

SECODEI Chicken Farm

The demonstration farm built and managed by the community initiative needs to expand now that basic husbandry skills have been acquired by the group. Money is needed to establish a bigger farm using day old chicks to create a viable number of birds for sale either as egg producers or for their meat.

The community has demonstrated its commitment to this initiative and determination to expand their farming skills into another area, including a goat breeding program. Land already in owned by them has been identified for an expansion of the chicken project. Another would be suitable for a goat breeding project.

The village savings scheme has been in existence for more than five years. It's a proven method by which this group save money and use it for the betterment of the entire community. The scheme encourages me to think they will succeed in expanding the existing project and initiating a new one.

Right now:

$2000AU (1000UK pounds) would enable erection of housing, including heating, for a chicken farm to accommodate approximately 150 day old chicks; offer free ranging safe land for the birds; vaccination as they grow; advanced commercial feed products; consultancy from a local agricultural adviser on growing the birds to their optimum level in terms of egg production or meat.

Goats are more expensive to purchase than chickens but if successfully reared, have a higher sell-on value as meat: a goat costs approximately $85AU (200UK pounds). Seventy goats would provide income for a whole community of 30 families.

Initial target: 10 goats at a cost of $750

THE AIDS SUPPORT ORGANISATION

For the past 15 years TASO has been providing practical advice, HIV testing, education around prevention and distribution of ARV’s (drugs) in its clinics throughout Uganda. It is a highly organised and efficiently run, receiving funding from a number of agencies outside Uganda, and limited funding from the Ugandan government health department.

However, due to the high numbers of Ugandans infected and affected by HIV/AIDS the funding is constantly having to be “reassigned”. Vital community programs - like economic self-sufficiency programs for people living with HIV/AIDS or some of the youth peer group programs - have suffered from income loss.

Income-generating programs for 21 support groups of men and women who are HIV positive need financial support; either for set-up funds or to encourage expansion of existing viable projects. There is also great need for ongoing training of the support groups in how to manage small businesses including evaluating existing projects; SWOT analysis for proposed business; purchase of equipment and in some instances, small amounts of land on which to manage a project.

Right now:

Any amount between $1000AU (500 UK pounds) and $5000 AU (2,500 UK pounds) would dramatically increase the probability of either expansion of a business or provide total set up costs for a support group (membership of each approximately 20 HIV infected people) to begin their own income-generating business and include costs of local advisers to ensure a successful outcome.

Any contributions toward the work of TASO would be managed directly by TASO in Kampala, Uganda.

Aged Care

Aged care in Uganda is woefully thin on the ground. From my most recent visit, I identified two immediate areas of need: funding to begin a small business manufacturing re-usable continence aids and access to commodes and walking frames.

Right Now:

I am seeking a specific commitment to fund a TASO support group to undertake a SWOT analysis of the continence aid and set up a small business to manufacture and distribute them: estimated costs $3000AU (2000 UK pounds)

Right Now:

Purchase of up to 100 commodes and similar number of walking frames and shipping costs from either Australia or UK to Uganda of those equipment items that would then be distributed through a number of health centres to frail aged.

Costs for these would be approximately $150AU for each walking frame and $175AU for each commode.

Shipping costs would be determined at time of shipment but would probably cost a couple of thousand dollars. (These items are not available to purchase in Uganda and difficult to come by in neighboring countries although it may prove cheaper to ship them in from South Africa)

School Fees

Although the Ugandan government provides Universal Primary Education at no tuition cost there are several problems: parents are still required to find the cost of uniforms; school books and food. Those requirements alone can amount to between 30,000 - 65,000 Ugandan shillings per term. (Approximately $120AU per annum - money that many families cannot afford and particularly not for more than one child).

Universal Primary education in rural areas is of mixed quality: the standards of education are very low and this acts as a disincentive to struggling parents to ‘bother’ sending their children to school. Teachers in primary education qualify to teach from a very low education base themselves - equivalent in some to having passed Year 10. When a parent is assisted to put a child through a privately funded school, the standards of education are greatly enhanced and the child has a real chance of graduating and going on to tertiary education.

$500AU would fund a child’s school requirements for lodging, books uniform for one year (most children attend boarding school).

$3000AU will fund a year of tuition and associated costs for a university student - accommodation costs would probably be approximately $500 per year extra.

Because of my long association and contacts within Uganda, I am constantly meeting young children and teenagers who would enormously benefit from financial help to complete their education. Denis Omiat - the young doctor establishing the Ojama Health Clinic of his own initiative - is a shining example of what a difference can be made by ‘educating’ one professional to then serve an entire community.

GET INVOLVED

Please contact me directly at loispollock1@gmail.com if you are interested in supporting any of the projects and remember, even a small amount will go towards something bigger!

If you are not in a position to assist financially but feel you have skills to share, please contact me anyway: I can always use skills in ongoing teaching, training and development work. Specific skills that would contribute greatly would be a practical knowledge of microfinance; creating successful small businesses; making grant applications. I plan on returning to Uganda in late 2011 or early 2012.

Lois Pollock

Lois in Uganda, 2010

Ojama Medical Health Centre – Under Construction

Ojama Medical Health Centre – Under Construction

Ojama village has a population of about 8,000 inhabitants. Situated 24 kilometres from Soroti town, health care in the village is currently non-existent although in Serere twelve kilometres away, there is a limited public health facility and maternity services are available.

It is not uncommon for someone requiring a blood transfusion to have to access the hospital in Mbale (98 kms away) as Soroti Regional Hospital more often than not, has no blood supplies available. Health services we take for granted are not available within the public sector – ultra-sound, some X-rays, can only be accessed in private medical clinics which are out of financial reach of most patients. An ECG for example, costs 50,000/- UG (approximately 60 UK pence) but most people in Ojama earn less than $1US per day!

Currently, there are no qualified doctors in Ojama: nationally there is 1 health worker to every 2000 and in Ojama, Denis and Catherine are the two health workers. When Denis qualifies in 2012, he will be the first qualified doctor for a population of about 7,500.

Above: Denis, Catherine and young Baby Po

Catherine and Denis have begun the construction of a Health Centre with the intention of providing a comprehensive range of facilities: the building has so far been erected with spaces for an examination room, a laboratory, dispensing room, injection room, community meeting space and a resting room. At a later stage, land they already own at the back of the centre will provide for a maternity unit and in-patient facilities with a fully equipped theatre.

Interior of the clinic, as of February 2010

Maternal mortality rate in the whole of Uganda stands at 200:100,000 women and this high figure is due to poor anti-natal care; lack of awareness about the importance of delivery in hospital; rudeness of health workers who frighten many pregnant women away and men who don’t support their wives: women are expected to perform all their normal chores including digging and planting of crops while pregnant. There is a high incidence of pre-eclampsia, while pre and post-partum haemorrhage is common.

There are numbers of clearly defined diseases common amongst the village population.

In children, the major problems include malaria, diarrhoea, vomiting and anaemia.

Poor hygiene results in cholera and worm infestation and pneumonia is common as a cause of admission to hospital.

There is an incidence of Burkett’s Lymphoma among children.

Most mothers do have their children immunized.

While HIV is an issue in Ojama, public campaigns and constant education provided by Catherine in the Serere clinic has resulted in most mothers “declaring” their status and accessing anti-retroviral medication. The new rate of infection is stable although every week, the clinic shows up one or two new cases.

Amongst adults, the primary diseases are Malaria and lifestyle diseases such as diabetes; raised blood pressure and, as with the children, due to poor hygiene, worm infestation.

Sexually transmitted disease is very common, especially among women who are infected by their male husband/partners who, on the whole, are reluctant to attend the existing health centre in Serere.

Alcoholism and cannabis use cause a high level of domestic violence.

Cancer of breast and cervix is common.

Unsafe water - which the majority of the population is forced to use - is the major harbinger of Cyclops organism and a cause of corneal ulcers. HIV infection is the cause of glaucoma.

Many of the diseases prevalent in the community are a result of ignorance caused through poverty. A major focus of the clinic under construction will be the development of outreach programs to combat this.

In addition it is hoped that funding will make possible the acquisition of two neighbouring pieces of land on which SECODEI (Serere Community Development Initiative) would develop a co-operative chicken farm using high quality stock and employing modern farming methods to increase output and income – creating a sustainable economic venture for the community, together with a citrus fruit orchard producing quality fruit that could be sold to restaurants in Kampala and beyond.

Recognising the hardship for families who live below the poverty line, Denis and Catherine are planning, together with the Village Savings Scheme already established, to develop a private health insurance scheme. It is likely that this scheme would encourage each family to pay some 15,000/- annually, entitling them to access the medical services of the community health centre. Limited financial support will also be available once the clinic is finished and running, from the Government of Uganda who offer a small fee for each immunization undertaken.

Denis feels that the current construction will become a workable space as soon as the flooring, windows and doors are fitted, possibly with the addition of some plastering to the walls and purchase of equipment. There also need to be eco-system toilets constructed at the back. The waste from those toilets will eventually be used as fertiliser for the nearby farming projects it is hoped to establish.

(Since my return from Uganda, generous donors in the UK contributed £1000 and this has already enabled the purchase of doors and windows for the clinic and for the floor to be laid. Further donations approaching £10,000 would ensure ceilings, construction of the eco-system toilets and construction of the maternity facility and purchase of equipment. This would bring forward the date when this clinic would be completely viable and servicing the needs of up to 7,500 individuals, although Denis will not be able to be the doctor until he completes his medical course! In the interim period, the clinic would operate as a health centre, managed by Catherine, with full medical services being rolled out when Denis qualifies.)