Thursday, July 16, 2009

Trip to Assess Distribution on Damba Island

It was my third full day in Uganda – and my first on Team TAMTAM – and I was off to Damba Island. Damba had been described to me as a place where the local fishermen make lots of money from their daily catch and spend it on the classic pastimes of seafarers everywhere – drinking and carousing. Needless to say, this meant that there would be lots of people – and, to be specific, lots of babies – on the island. Given TAMTAM’s mission of distributing bed nets to particularly vulnerable populations, Damba Island would seemingly fit the bill.

My mission in Damba was to understand how TAMTAM could potentially plug into the existing health infrastructure to distribute bed nets on the island. In particular, I would be assessing the feasibility of working with two organizations: The first, VOLSET, is our current partner in Ntenjeru, one of our two existing sites. VOLSET has a network of VHTs – Village Health Teams – that includes three workers on the island. They visit local houses and could potentially distribute nets in the course of their daily activities. The second organization, Damba Clinic, is a government-run provider that offers basic outpatient services, immunizations, and family planning services.

I headed to Damba Monday morning with the VOLSET team from Ntenjeru via a wet-ish two-hour boat ride across Lake Victoria. We arrived on the island to find that it was certainly rough (though less explicitly “pirate” than I had been warned), but that the hospitality of the residents was overwhelming. Joseph, one of the island’s three VHTs, welcomed us to his home with tea, a full Ugandan meal, and a can of dill pickled-flavored Pringles. We settled into his homestead to plan our next few days (see picture to right). Tuesday would be a day of HIV-testing (for the VOLSET volunteers) and checking out the island clinic (for myself and a small legation). Wednesday would be a day for household visits and pulling together our thoughts.

The days were both productive and insightful. While we could speculate about the challenges of island distribution from afar, hiking the two hours through the jungle and over mounds of safari ants to the clinic gave me the first-hand experience of how difficult it would be to move kilos of bed nets across the island (see picture of clinic to left). Similarly, meeting the VHTs and seeing how integrated they were into the community gave me a better sense of their ability to deeply impact the people they served.

Currently, we are hopeful that distribution of nets to Damba will work and we continue to try to solve the logistical issues that beset our work on the island. Now we are focused on getting a distributor to deliver to the island, finding a location for secure storage of the nets, and creating a distribution system to spread nets as broadly as possible while still encouraging crowding-in of immunizations through the local clinic.


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