by Tim Butcher
Uganda, supposedly, has universal free primary education. In practice, even at the free schools parents are required to pay for uniforms, textbooks and meals, and anyway, most of the parents I met on my trip told me that the government-funded free schools are so poorly resourced that only the most desperate would consider sending their children there. By poorly resourced, what they mean is: few or no classrooms, desks, chairs, or books, and only the sporadic presence of teachers. At every school we visited there was an attendance chart on the wall of the head’s office, registering not pupils’ attendance, but teachers’. The wages are so bad that as often as not the teachers can’t be bothered to turn up. There’s little risk of losing their jobs, because there’s such a shortage of people willing or able to teach.
Primary schools in Uganda are typically attended by children between the ages of seven and fourteen, but schooling will be interrupted or terminated if parents can’t afford to pay the expenses involved, if they need their children to stay home and help in the fields, for illness, for menstruation, for pregnancy, and so on. Many children therefore do not finish primary school until they are older, if at all, and most will never go to secondary school.
The first thing I noticed at this particular school was a series of low blue and white signs stuck into the ground, of the type which you might expect to read ‘Do Not Walk on the Grass.’ These ones had the Plan logo on them alongside those of two other NGOs, and said things like: ‘Virginity is Healthy for Boys and Girls’, ‘Young Children Say No to Gifts for Sex’ and ‘Sex Does Not Make Breasts Grow’.
The training itself was going on in one of the classrooms, where a mixed group of staff, parents and representatives of the student council had gathered. The discussion was already under way when I got there, so I slipped in, sat down next to a Plan employee and asked him what was happening.
‘We are making girls aware of HIV and AIDS, so that they know the negative impact if male teachers make sexual advances.’
He didn’t tell me the positive impact of male teachers making sexual advances.
The woman running the training session was rather more impressive. She was a large, commanding woman, exuding authority, and I was instantly terrified of her. If she had said jump, I would have not only checked how high, but what style of jump she preferred. Looking back on it, we were probably about the same age. Stuck on the walls behind her were lists of girls’ roles and responsibilities in school and at home. At home, girls must cook and serve food, fetch water, clean the house, compound, clothes and cooking utensils, collect firewood and look after children and elderly relatives. I don’t do all that, and I’m an adult. Then, at school, girls sweep the buildings, look after the grounds, fetch water, serve food and welcome guests. That’s aside from their actual schoolwork, of course.
The room then started to discuss the attributes of a girl-friendly school. It became clear that one of the key concerns needing to be addressed was sexual abuse, and the moderator led us towards consideration of requirements such as female counsellors and private counselling rooms where girls can express their concerns, female teachers and senior girls acting as mentors, as well as more straightforward practical steps such as putting up fencing to protect girls from men on the outside. One of the fathers in the room kept interrupting to say that what girls really want is flowers, ‘because girls are attracted to beauty’, or attractive uniforms, ‘because girls will like the school with the best-looking uniform’. The moderator acknowledged these interjections politely before returning to the point. It’s important, she told me afterwards, that parents are part of the training sessions, and afterwards they are sent into the community to train other parents. It’s a laudable aim, but with the fathers so unwilling to hear the darker implications of the discussion, it’s hard to know how much impact these sessions can have.
After the session, the local Plan Child Protection Officer, who had been working nearby, hitched a lift with us back to her office, which is a hut in the centre of one of the Kamuli district villages. That she is enormously popular here was self-evident: every child that we passed smiled, waved and called out her name. There are hundreds of children in her area and she knows them each individually. That the Child Protection Officer would be on first-name terms with every single child of the region is both extraordinarily commendable and deeply upsetting.
The office walls were covered in posters, most of which are advice to children on how to avoid sexual abuse. As with the signs in the school, the key message is abstinence: ‘I Always Say No to Sex’ read one poster. I tried to imagine a campaign against child abuse in the UK choosing to focus so heavily on the child’s responsibility to say no. But the CPO told me that it is necessary there. Girls are so poor they will have sex in return for anything at all – for one chapati. Male schoolteachers are known to offer high grades in return for sex, and given the value of a good education here, many girls agree to it. I asked what happens if a male teacher is found to be having sex with his students. ‘He is transferred to another school.’
But sexual abuse is not the only thing that children here are vulnerable to. The CPO told me about a case in which a thirteen-year-old girl was abandoned by her father after she developed epilepsy. He locked her out of the house and refused to give her any food, making her sleep outside, alone, in the rainy season, for three months. With Plan’s support the father was arrested and successfully prosecuted, and the girl now lives with her mother. There are an overwhelming number of cases, the CPO said, and not enough resources to help them all. But she does her best, with the help of volunteers from the community.
Later I asked one of these community volunteers what has improved since Plan came to the area. ‘Child protection,’ he said without hesitation. What else, I asked. This time he had to think for a bit. ‘Nothing,’ he said.
I found out more about the ‘negative impact’ of HIV and AIDS the next day in a visit to a local hospital. The hospital comprises several buildings scattered around a compound, but only has one full-time doctor, plus a volunteer doctor and a number of midwives. This isn’t too bad, considering that country-wide there is only one doctor for every 23,000 Ugandans. I kept having to remind myself, looking at the patients sitting or lying on the dirty concrete floor, with no food or water, waiting for hours to be seen, that these people are lucky. There was one old woman lying on the ground, immobile, with only a thin cotton wrap between her and the hard floor. Right at that moment, as it happened, my own grandmother was in a hospital in France. A few days later, in fact, she would die, but to the last she would be in a comfortable bed, with clean sheets and blankets, and 24-hour medical care. I imagined her lying in front of me, on that floor. I am still imagining that.
The hospital workers I met were determined and positive about recent improvements in HIV and AIDS care. All pregnant women who come to the hospital are counselled about HIV/AIDS, and those who consent are tested. People are now also coming forward for voluntary testing, I was told – this is new, and reflects the decreasing stigma of the disease, and the growing understanding that treatment can help extend life expectancy. There has also been an increase in the number of people seeking treatment, and staying in treatment programmes. I was told that if a pregnant woman follows the whole of the PMCT (Prevention of Mother to Child Transmission) programme, it will successfully prevent transmission of HIV to their baby in all cases. Unfortunately, it is rare that any of the women here can successfully complete the programme, as one of the key preventative factors is not to breastfeed your baby, but the cost of formula is $9 a week, and the average Ugandan income is less than a dollar a day.
When I asked the hospital administrator where the funding comes for the hospital, he laughed and reeled off a seemingly endless stream of NGOs, as well as the local health authority. It’s hard to imagine just how much time is taken up administering and coordinating all of these separate income sources. And with so many different organisations with different priorities funding different services in
the same place, key areas of provision fall through the cracks. So, for example, Plan’s most notable contribution to the hospital is a machine which counts CD4 cells for HIV/AIDS patients – an invaluable piece of equipment, without which it is impossible to decide which ARV drug to prescribe, and at what dose. People travel from miles around just to have their blood tested by the machine. We are taken to visit the machine. I basically have no idea what I am looking at. It looks like a machine. But everyone is clearly very proud of it. Unfortunately, the machine needs specific reagents to make it work, and Plan don’t provide these, and neither does anybody else. Supplies of the reagent can come from local government, but are as often as not stolen, both before and after they reach the hospital – drug theft is a huge crime here, as the resale value is immense. So, much of the time, when patients come in to have their blood tested, the trip is wasted. And anyway, chances are that even if the CD4 machine is working, the ARVs will have run out, for the same reason – lack of funding, and fraud. But the theory of PMCT is very good.
Waiting for us outside under a tree were members of the PMCT group, all HIV positive themselves, who do outreach in the community. They had been waiting for hours, because we were running late. In fact we were two hours late leaving Kampala on the first day because of petrol shortages in the city, and we would be late for every single appointment from then on, and yet people would wait for us, sometimes for hours, and we never heard a solitary complaint about it.
As soon as they saw us coming, the PMCT group leapt to their feet and began singing and dancing. We thought it was just a welcome – the welcomes there are terrifyingly elaborate, often involving ululations, and it does feel slightly lame to then extend your hand and say ‘How do you do.’ But in fact they were singing for us some of the songs that they use to explain issues around HIV and AIDS to people in the surrounding villages. My Plan chaperone – like me, a visitor from England – danced along to the songs, but I didn’t, because I was too embarrassed, and then I was ashamed of being embarrassed, and then I was embarrassed of being ashamed, and all remaining hope of me dancing drifted away on a zephyr of British reserve.
The songs and dances are impressive, and an effective way of spreading the word, because in a village where there is no other form of entertainment, if a group of strangers turn up and start singing and dancing, you are going to go and have a look. They travel a long way to spread their message, up to 60km to some of the most remote villages, but although Plan have provided some bicycles for them, they need more. They also need money for musical instruments, for costumes for the short dramas they perform, and so on. As with the clinic, funding is piecemeal and comes from multiple sources. The group has been encouraged to raise their own money by making handicrafts, such as beads, baskets and mats, but there isn’t anybody around who wants to buy these things. The idea is to sell to tourists, but there are no tourists here. There are just other impoverished Ugandans who don’t give a toss about beads.
More disturbing was what the group told us about the home visits they make to AIDS sufferers who are too sick to visit the hospital. The project is so poorly funded that they can’t even afford plastic gloves or basins, which makes it dangerous to touch and wash the wounds of patients, whose AIDS-related illnesses often leave them covered in lesions and sores. Their families are too afraid to touch them, and the patients too weak to look after themselves, so the wounds fester. Many afflicted families will own only one bucket, which they have to use for everything, from washing themselves, to washing food and dishes, to vomiting into. Families also can’t afford separate bedding, which means that they sleep all together, so even where AIDS is not transmitted, AIDS-related illnesses, such as TB, are.
The next day I was taken to visit another school, one of the most deprived in the area. Why I’d come, and what was Plan’s involvement with the school, was not clear. But in any case, I was shown around. Almost two hundred of the youngest children were squeezed into the same classroom, which was also used for storing firewood. The headmistress’ office had also been divided into two so that half of it could be used as a classroom for the older kids. The buildings had pockmarked walls, heaped earth instead of floors, and holes for windows. Still, those that have classrooms at all are lucky, as many of the children have to learn sitting on the ground outside. On the day that I visited, the thought of having lessons out of doors in the sunshine seemed idyllic. It is probably less pleasant during the monsoon, when the dust beneath our feet turns to several inches of mud.
We’d been told that there was going to be an assembly, but what I hadn’t realised was that I was expected to give it. I was seated at a desk while all of the girls gathered under a tree, sat cross-legged on the ground and stared at me. I stared back. If I hadn’t known that they were girls I would not have been able to tell. School-age children in Uganda wear their heads shaved, and the girls were so poorly fed that they didn’t have hips or breasts. They had the sexless look of pre-pubescent children; I couldn’t even tell how old they were. I said hello, how are you, which seemed like a good place to start. ‘We are humble and obedient’, they chorused in perfect unison. Bloody hell. I tried to imagine this happening in a British school, failed, and would have got the giggles were it not for the terror that any moment I was going to have to say something to these children, say quite a lot of things, and I was completely unprepared. I was, however, reassured that a few of them looked neither humble nor obedient, especially those at the back. They were still children, after all.
My Plan chaperone spotted my discomfort – possibly from the way I glared at her, eyes wide with panic, mouthing HELP – and suggested that the girls separate into small groups and discuss the topic of what they did and didn’t like about school, choosing one girl from each group to present their findings. It was a brilliant idea and I wanted to kiss my Plan chaperone for sparing me from having to address a field full of Ugandan children on What It Is Like Being a Freelance Author in London – a topic which would have come as a particular surprise to the schoolteachers, to whom I had been introduced, bafflingly, as a ‘consultant’.
The girls were separated into groups and talked quietly amongst themselves as I enjoyed the shade of the tree and tried not to let my stomach rumble. We were so busy in Kamuli, and inevitably running so late, that for the entire time we were there we never found time to eat any lunch. It was hard to feel any self-pity about this, as many of the people we met there ate only once a day, and twice seemed about average.
The teacher called the girls to attention and asked each group to present the findings from their discussions. The spokespeople for the first four groups all answered the question ‘What do you like about school?’ by saying what they hoped to achieve by going to school – the jobs that they hoped to get. Either they liked school so little that they could only see it as a means to an end, or they were so delighted to have the opportunity to go to school and the chance to improve their lot in life that it outweighed all else. Indeed the two are not mutually incompatible. Anyhow, two of the girls voiced fairly predictable aspirations: to be teachers or doctors or nurses. Everywhere I went in Uganda and asked children what they want from life, this is what they answered. I wonder what they would make of surveys in the UK where girls consistently report that when they grow up they want to be ‘famous’. The other two girls had loftier dreams, though: one said that she wanted to be a pilot, and the other that she hoped to be President of Uganda. The entire group whooped, clapped and cheered at her audacity, and maybe it’s not such a wild hope: the current deputy speaker of the Ugandan Parliament is a woman from this very area, who grew up in exactly the poverty I was witnessing.
When asked what they didn’t like about school, each of the girls spoke about the problem of menstruation. Although it’s stating, as it were, the bloody obvious, its worth remembering that on average girls have their period for one week in four, and in a country where many girls can’t afford underwear and almost none can pay for sanitary protection, t
his is hugely debilitating. The girls told us that they use banana fibres (apparently fairly effective) or plastic bags (rather less so), as sanitary protection, but that the school doesn’t have adequate toilet facilities to allow them to change their protection or clean themselves up. They don’t even have any toilet paper. I tried to imagine dealing with my period with only plastic bags and no toilet paper, and, as so many times on this trip, failed. It’s no wonder that many girls do not attend school while they’re menstruating. Would you?
By the time the fourth girl was complaining about the difficulty of dealing with periods while at school, the head teacher was clearly embarrassed and interrupted to say that these distinguished visitors from England really didn’t want to sit around all afternoon hearing about menstruation, and could they please come up with something else?
So the girl who was speaking stopped, gave it some thought, and then said that some girls are mistreated by their stepmothers, who withhold their basic needs, such as food and soap, so they have sex with boys in order to meet those needs, and then they become pregnant and have to leave school.
The ban on talking about menstruation opened a floodgate of terrifying revelations about what it is like to be a Ugandan schoolgirl, all delivered in a matter-of-fact tone and received with no surprise by the other girls or the teachers. This, lest we forget, is what is considered by these girls to be the second worst thing about school, after periods. I wrote everything down as fast as I could in my notebook, trying to capture it all. When I read back over it later, I could barely believe my eyes. (6), I had written. Good: can become professional – doctor, nurse, teacher. Bad: boys disturb them because they are girls, take them into the bush and make them pregnant. Stepmothers don’t give them food. (7) Good: learn singing, athletics, sport. Bad: very vulnerable to men on way to school. Men grab and rape them. (8) Problem of child marriages. Parents force them into early marriage and they have to leave school. Likes: art and crafts. (9) Admires teachers and studies hard to be like them. Talks about other problem of being raped: ie catching HIV and AIDS.