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Unsung Heroes

Changing Uganda’s Public Health Landscape One Flash Mob at a Time

By Elizabeth Futrell

In 2011, a group of Ugandan public health students at Kampala’s International Health Sciences University began learning to salsa dance in their free time. When they mastered salsa, they learned other dances, over time becoming some of the best dancers in Kampala. In a small room on campus, across the courtyard from the hospital where their classes were held, these students escaped the stresses of school and city life by losing themselves in Uganda’s dreamy beats. The music and dance were intoxicating, the energy infectious.

When the aspiring public health practitioners began working on initiatives to raise awareness about critical health issues like contraception and HIV/AIDS in local communities, they knew music, dance, and performance art would attract the attention they sought. Six years later, this informal group of amazing dancers and dedicated students has matured into Public Health Ambassadors Uganda (PHAU), a respected and rapidly growing youth-led public health organization that uses music, dance, poetry, and drama to communicate health messages and connect communities with vital sexual and reproductive health information, services, and products.

I met PHAU founder Segawa Patrick in Bali, Indonesia, when I interviewed him for the Family Planning Voices initiative at the International Conference on Family Planning in early 2016. Several months later at the Women Deliver conference in Copenhagen, Denmark, I watched as Patrick organized and led an international flash mob — a focal point of the conference and one of PHAU’s signature approaches to public health messaging. As dozens of young people from around the world danced through the convention center in Copenhagen, my colleagues at the Knowledge for Health (K4Health) Project and I knew that PHAU was an organization we wanted to get to know. In late 2016, we flew to Kampala to share storytelling and knowledge management techniques and learn more about PHAU’s unique approach to entertainment education, or “edutainment,” for public health.

I was warmly welcomed to Kampala by Public Health Ambassadors Uganda staff. Clockwise, from top left: Elizabeth Futrell (me), Amase Diana, Kasaija Joseph, Segawa Patrick, Guntesse Catherine, , Gimugu Daphne. Photo credit: David Alexander, CCP/Family Planning Voices

Public Health Ambassadors Uganda has focused their boundless energy on addressing several pressing sexual and reproductive health issues in Uganda: menstrual hygiene management, the lack access to which keeps contributes to millions of school absences in Uganda each month; HIV and AIDS, which afflicts 7% of Uganda’s adult population; and access to contraceptive information and services, a pressing need in a country whose fertility rate is nearly six children per women and whose maternal mortality rate is 24 times that of the U.S.
Whatever the health issue, common threads in PHAU’s work include passion, creativity, and an uncanny ability to connect with their young audiences. After all, the oldest person on PHAU’s staff is in his early 30’s, and the majority of the PHAU staff are in their mid-20’s. During our visit, I watched their youthful energy, magnetic personalities, and knowledgeable professionalism attract community members of all ages to the health information and services they were offering. In the short amount of time they’ve been operating, they’ve made a difference in thousands of lives, and they’re just getting started. Here, six Public Health Ambassadors Uganda staff members tell their story.

Segawa Patrick, Founder and Program Coordinator, Public Health Ambassadors Uganda (PHAU). Photo credit: David Alexander, CCP/Family Planning Voices

Patrick: I have three sisters, and I was raised by a single mom. It’s a big source of motivation that I have to make sure I work hard and support them, especially those young sisters of mine — make sure that they finish school and they have better opportunities as well so that they can take care of themselves…. We have a strong focus on young women and girls, in terms of reaching them with the right information on sexual and reproductive health and HIV…. If you find a 15-year old engaging in risky sexual behaviors, then it rings a bell that even your sister who is just 15 could be going through the same.

Amase Dianahritah, Project Officer and Administrator, PHAU. Photo credit: David Alexander, CCP/Family Planning Voices

Diana: My brother died of HIV, but we did not know until we grew up, and then they told us, “Ok, yeah, he died of HIV.” There was a time when we were in school, and he was bedridden — that was in 2002, actually. We were still very young, and they brought us from school, because they wanted us to see how HIV kills. It was such a painful thing. We did not know the disease, but afterward, they told us, “If you mess up, that’s how you will end up.”

Mubuuke Felix, Monitoring and Evaluation Consultant, PHAU. Photo credit: David Alexander, CCP/Family Planning Voices

Felix: I come from a humble background. Most of what I am doing is shaped by what my home setting is or was. My father is a judge. My mother is a midwife, so there was a mixture of careers at home. My simple story was that our home had two mothers and so many children in that home. We were forced to be able to survive for the fittest, meaning whatever resource was available had to be shared by so many of us, and we had to ensure that we struggle to become persons of importance in the future…. Today I don’t have so many children from my home or from my body, because I don’t have so much to share. That’s why I advocate for family planning, and I also advocate for healthy families…. If you don’t have so much in your home, you can use the little that you have in your home to make you better and make you also be able to better your future family. Simple as that.

Kasaija Joseph, Program Manager, PHAU. Photo credit: David Alexander, CCP/Family Planning Voices

Joseph: I was a peer educator while I was still in college. People still call me from my college for information about sexual and reproductive health. They always tell me, “When are you bringing us condoms?”… At college, people have a lot of sex. Many of them have unprotected sex. For example, when they’re coming from clubs, having fun, sometimes they are too drunk or too tired. They just pick up a girl and go back home, and in the morning, they are like, “Oh my God, what happened?” … They’ll call me like, “Hey, where are you?” They meet me, and we talk.

Patrick: I studied at International Health Sciences University in Kampala, and I was very passionate about music, dance, drama. With a couple of guys who were my colleagues, we started a dance club. We were teaching people how to do salsa and Latino, those kinds of things. Usually we’d have classes on Wednesday, Thursday, and Friday. Guys would come after classes, you know, after those boring lectures, or on weekends when they have nothing to do, they come and they dance, you know, we sweat….

One time, we had a production at university. It was called The Twist. The Twist was a play that was focusing on sexual and reproductive health — in particular, issues of male involvement. Have you ever imagined what it would feel like if a man became pregnant? That was the “twist”! The other side: What if a man became pregnant? Because usually, in African settings, men love giving birth to boys. So he’s always on your case: “I need a boy. I need a boy.” Now, just imagine it’s your turn, asking him to give birth to a boy. We managed to incorporate that kind of acting, so we got the skills. We started mixing the dancing and the acting.With time, we started conducting community outreaches, using that component of music and dance.

Guntesse Daphne, Program Manager, PHAU. Photo credit: David Alexander, CCP/Family Planning Voices

Daphne: We started with nothing. We were just students in school. But if we were able to come this far, I can only talk to the people out there who have this beautiful idea, and they have the knowledge of how they think it can be done, and they’re just afraid to bring it out because of resources. I can just tell them, “Go out there, work hard, and things will fall in place somehow. You just have to work hard and climb well and bring your idea to the table, and things will fall into place, and you’ll be able to impact a life.”

Diana: [When] I started, they just wanted to pay me not even a single cent. But I said okay, because I love it…. We cover just a little percentage — it’s just like a drop in the ocean, the people we reach out to. Uganda has over 100-something districts, but we work in only two districts. With the other one we just got, three districts. And in those three districts, there are very few people…. But every person matters, so we try as much as possible so that the world will be a better place.

Patrick: If you compare the time of inception, where we had only one grant worth $1,000 to a point where we have been about to attract funding from different international donors…at this moment I should say that the annual income for Public Health Ambassadors Uganda is up to around US$50,000, which is quite an impressive achievement since 2014. It’s just a span of two years, but there is a lot of growth that has taken place.

Felix: I’m the oldest staff of Public Health Ambassadors Uganda…. Our staff have exposure to projects, but they might not have experience reporting to different donors, so I love it most when I’m giving feedback after the day’s activity, after quarterly reporting, or after we have won proposals, when they are attentive and they are noting down a few issues that worked well for the project, for the activity, and, of course, the challenges.

Joseph: Being in the field is part of getting the chance to do what I love most. For example, I love being with young people. When I’m at the office, I’ll be doing the paperwork, but when I’m in the field, I get a chance to meet the people I love so much…. You can’t do behavior change when you’re just in the office. When I get a chance of going to the field, I get a chance to interact with people and try to find a way of enhancing them or influencing them to have positive behavior change for their health.

Kitzo Ruth, Program Manager, PHAU. Photo credit: David Alexander, CCP/Family Planning Voices

Ruth: We’ve conducted some outreaches, we’ve taught people how to use condoms, and we’ve distributed condoms to prevent STIs and unwanted pregnancies. I was shy at first because it is something that society looks at differently. They look at it as a private thing. So coming out to demonstrate causes questions. But they have to get the proper information so that they can use them properly. Doing it over and over again gave me the courage to continue doing it.

Felix: I used to accompany my mother to do her family planning visits. Back then, she had a job title of Village Health Team Member. She was given a bicycle, and she would carry me to accompany her to the villages, and we would find the women in the shade and the men, and she would talk about family planning, sex, and HIV…. I loved the way she talked to clients. Her talk didn’t stigmatize those who were positive. It would have those who haven’t yet gone for testing rush to go and test to be able to know what their status is. That has made an impact on me. When we were in Luwero for our outreach, several clients came out for a test but were scared of what the result would be. My info to them was, “It doesn’t matter if you’re positive today as long as you can live for tomorrow and be able to raise your children and be able to fulfill your plan.”

Daphne: There is a project called Ensonga, for menstrual hygiene management. And I cannot speak enough about Ensonga. I see these girls who go through what I go through, and I used to think it was just normal, but it is not.

Diana: I heard a story of a girl in some district in Uganda that was in Mukuno who said she in order not to buy those pads, she preferred to get pregnant for nine months to save that time. That hit me badly, and I was like, “Yeah, this is something to talk about.” … When you’re pregnant during the nine months, you’re not menstruating, so it’s like someone is saving [money] for the nine months instead of buying pads every month, every month.

Daphne: I listened to this one girl — she’s called Patricia…. Patricia lives with her grandma, and she has siblings who also live with her grandma…. Patricia told me, “You know, grandma struggles to put us in school, to make sure we have something to eat.” It was very hard to ask her for pads every single month. She was getting frustrated, because she wouldn’t ask her grandma, because her grandma did not have enough.

When her grandma couldn’t provide, she had to use cloth — pieces of cloth. And she has few clothes. What she has is precious to her, so cutting it to fend for this monthly thing that she knows is going to come back another month was frustrating to her. She didn’t know what to do. And, you know, the pieces of cloth she would get were not absorbent enough, so she would use them, but she wouldn’t be confident going out, so she would have to stay indoors or around home…. She said she flows for at least six days and at most seven. So she would miss a lot in school, because she said she would not go to school because she always stained — she always soiled her dress, her school uniform…. And it happens every month, so imagine you’re missing school seven days a month.

Reusable AfriPad. Photo courtesy of David Alexander, CCP/Family Planning Voices

You should have seen the smile on her face when she got [the AfriPads]. She was very happy. She kneeled down. In Uganda, we kneel down to show a sign of respect or appreciation. She kneeled, down, and we were like, “No, no, don’t kneel down,” because in school you don’t really have to kneel. But she kneeled down, and she was like, “Thank you very much,” and she was telling me how she was going to keep them, and how she was going to get somewhere to keep them safe, how this is a life-changer. And we only gave her a pack. It was a small token from us, but the smile we brought on her face — she had a lot of hope…. She knew she would continue in school without missing, and she knew her grades were going to get better instantly…. I saw the smile on her face, and I saw hope.

Patrick: One thing that I want people to know about Public Health Ambassadors Uganda is basically that whatever they see us do — we do it because we love it. We are passionate about it, and as public health practitioners, we always want to make a difference in the communities where we live. And we always want to leave an impact in a fun way. Not these conventional lectures or the normal status quo. We want to always do things in a unique but youth-friendly manner. We love what we do, and it’s what we have been doing that has given us various opportunities to reach where we are. It gives us reason to move. It has provided a sense of purpose…. I’ve never figured out what would I be doing if I wasn’t doing this.

This blog first appeared on The Exchange and has been reproduced here with permission.
*Elizabeth Futrell is a Global Health Writer. You can follow her on Medium.

The Exchange is a K4Health publication. The Knowledge for Health (K4Health) Project is supported by the United States Agency for International Development (USAID) Office of Population and Reproductive Health, Bureau for Global Health, under Cooperative Agreement #AID-OAA-A-13–00068 with the Johns Hopkins University.

The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the U.S. Government.



Collective Good

He Grew Up in Bwaise Slum. Today, Kisirisa has Educated and Empowered Young People like Him

Muhammed most commonly known as Slum Ambassador, was born and raised in Bwaise, the most deprived and perhaps largest slum area in Kampala. At the tender age of 11, he found his first job as a tap water operator. He would also carry water and pick garbage from people’s homes. On some occasions he would sell metal scrap all in an attempt to get an education, put clothes on his back and get something to eat.

“I picked interest in Computers when I was 25 years and began to teach myself at various internet cafes. I focused on creating profiles for HIV orphans and trying to see if I could link them up with potential sponsors for fees and assistance.” Mohammed says

Later, in 2009, together with 3 other young people, he formed Action for Fundamental Change and Development (AFFCAD) a community based organization set out to transform Kampala’s poorest areas by empowering the young people, children and women through health, education and economic empowerment programs like vocational and entrepreneurship training.

A vocational training for youth underway at AFFCAD. (Photo by AFFCAD)

Since its establishment, AFFCAD’s primary focus was supporting orphans and vulnerable children and making awareness on health issues including HIV/AIDS awareness and adolescent sexual reproductive health. In June 2011 they established a community nursery and primary school called Excel Education Center that supports 200 children from Bwaise slums.

Todate, it has graduated 1,047 youth. This equates to a completion rate of 90%. Of those who have graduated 697 are female and 350 are male.

“AFFCAD’s Youth economic empowerment program provides the hands on skills that enable the disadvantaged youth in Kampala’s slums to transit from lives of crime and poverty to lives of productive occupation. “ He explains.

Through AFFCAD’s Bwaise Business and Vocational Institute, the targeted youth between 16-25 years participate in a 6 month vocational training program in applicable skills like Computer Graphics Design, Photography and Videography, Cookery and Bakery, Tailoring and Fashion design, Electronic installation, Hairdressing and Cosmetology, Decoration and Ushering among others.

Women during a graduation after completing the Women Business and Financial Access course (Photo by AFFCAD)

“As part of the program, the Youth are also equipped with entrepreneurial skills, financial literacy, soft and hard skills for career and professional development (How to Make it in the Contemporary Business World) and they Youth take on one month internships at the end of the training to expose them to working environments.” Muhammed explains.

In addition, the project also provides IT Training to the youth on how to strategically use ICT (including internet, social media, Web 2.0 and mobile technology) to market and sustain their business ventures.

Each year AFFCAD runs The Youth Entrepreneurship Challenge and Award, to support the business ideas developed by the youth in the program, a mentoring session and a scholarship to attend a 5-day entrepreneurship foundation course at the innovation entrepreneurship boot camp. Every Friday, AFFCAD invites successful youth and other leaders to motivate and inspire our youth.

Muhammad standing next to one of the entrances at AFFCAD. (Internet photo)

AFFCAD runs the Youth Entrepreneurship Challenge and Award, 15 winners have received micro start up grants between $1500 to $2500 to develop their business ideas, a mentoring session, and a scholarship to attend a 5-day entrepreneurship foundation course at the innovation entrepreneurship Boot Camp.

In August 2017, Muhammad received the 2017 Young Achievers Award for Social Entrepreneurship in recognition for his work with AFFCAD.

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Unsung Heroes

Being HIV Positive, Diagnosed with Cancer & Tuberculosis Has not stopped this Superwoman From Looking After 150 Kids in Slums

“A strong woman doesn’t give up even though her heart may feel heavy. She courageously takes one more step, then another and then another.” –Anonymous

Stella Airoldi first met Susan laker in 2009 when she first came to Uganda while doing research about post war victims and witnesses.

“I visited her house, where she was living with her 3 teenage kids. Back then I was 24 years old and Susan 26 years, so just two years older than me.  But her kids were already 9,10 and 13 years old.” Stella says.

Because Susan got pregnant for the first time when she was only 13, her kids didn’t go to school and neither did she. A soldier was responsible for her first pregnancy while she was living in a military barracks which by then, was the only safe place for her to go to escape the insurgency caused by the Lords Resistance Army in Northern Uganda.

“Getting pregnant when I was 13 years old was so traumatizing. I lost my childhood life. I wasn’t able to go to school which made me lost my hope for living a good future. I hated my parents for forcing me in to early marriage, my growth was totally destroyed and I segregated myself from people because I felt inferior.”- Susan notes.

Susan with some of the beneficiaries of 22STARS. (Photo credit: Stella Airoldi)

When Susan was 15 years old, she conceived again but got a miscarriage when she received a message notifying her that her uncles, nieces, a brother and sister had been mutilated and killed by the Lord’s Resistance Army rebels.

“I was shocked and lost the pregnancy. After a few months, I conceived again and gave birth to a second child at the age of 16 and when the baby was 6 months, the father died and since I had nowhere to get financial help from, I was forced to  remarry another soldier from the barracks to get protection and when I was 19 I gave birth to the third child.” Susan says

In 2007, her husband was deployed to Somalia on a peacekeeping and never returned, a thing that left Susan very frustrated. It was shortly after that, that she found out that she was HIV positive, had cancer and Tuberculosis (TB). It was not until an organization called Reach Out Mbuya came to her rescue that she was able to start cancer chemotherapy and TB drugs for six months and now am on ARVs treatment for life.

She then fled with all her children to Kampala which were (and still remain) her main reason and motivation to keep going in life. Her kids were tested negative and she wanted them to go to school. She started making jewellery, which initially her kids would sell in the streets.

Susan and some of her children (Photo credit: Stella Airoldi)

“It was then my pastor introduced me to Stella. I was making paper beads jewellery and Stella decided to buy me jewellery on a yearly basis. At the end of 2012 when she came back to Uganda to see how I was doing, she was surprised to learn that I was going back to school by myself and I had improved.” Susan notes.

Susan has been able to buy land and built a bigger house for her family. She completed high school and did a couple of short courses to improve her skills and knowledge for example a  certificate in Clearing, Forwarding and Shipping management, Certificate in Electronics, Certificate in Counseling People Living with HIV/AIDS.

“At first, all my friends and family thought I was completely crazy starting with women who cannot read and write and I cannot even communicate with. So true, things didn’t go that smooth the first 2 years. So end of 2014 I came back to Kampala and since 2015 I am here myself 2 to 3 times a year and things improved a lot.”- Stella says.

Stella (left) and Susan during one of the jewellery making sessions (Photo credit: Stella Airoldi)

Susan is now managing the whole team of at 22STARS jewellery that comprises of over 20 women and supporting 150 children in slums. Thanks to recurring monthly donations, she (Susan) has been cooking in Acholi Quarter every Sunday since October 2016 ( so more than 14 months!) with the help of other 22STARS group members. The group started back then to cook for 50 kids and that is now 150. They get a hot meal with either fish or meat.

22STARS is a team of artisans made up by strong women living in the slums of Kampala and Jinja in Uganda making jewellery for a living. The platform is giving women in slum areas like Susan to sell their jewellery on the international market and earn a living, and in addition war running small social programs on the ground.

“Our choice for environmentally friendly products is a very conscious one. By using 100% recycled paper, the jewellery you wear does not only look good, but it also feels good. Our beads are hand made from paper and varnished with natural products.  This makes each peace uniquely different, lightweight and waterproof.” Stella says.

Some of the 22STARS women that make jewellery (Photo credit: Stella Airoldi)

22STARS also uses education and entrepreneurship to empower children and their families to rise above poverty by creating long-term sponsorships for children in Uganda, and also run several community development initiatives including a nutrition program, basic needs program, small business training and micro loans program and our holistic educational program with extra-curricular activities.

“Without the help of Susan this all would not have been possible. As she knows how it feels like to sit in the stone quarry with your kids, crashing stones all day, not being able to send them to school, she is pushing very hard to help all the families over there to send their kids to school. She is so amazing how she is managing everything. Susan is a true superstar and really the strongest woman I ever met.” Stella concludes.

Stella and Susan at the 22STARS office. (Photo credit: Stella Airoldi)

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Uganda Innovates

Athieno Mary Lucinda is changing girls’ lives one sanitary pad at a time

She stood up in class, her classmates laughed at her. The boys said that she had slaughtered a chicken. They made fun of her for a long time. She couldn’t afford sanitary towels, the anxiety of the monthly period coupled with the embarrassment she had faced which would have destroyed her self-esteem as a young girl instead stirred her resolve.

Meet Athieno Mary Lucinda a YALI fellow, the founder of Eco-Pads a social enterprise dedicated to the production and distribution of reusable pads and environmentally friendly to girls in Uganda.

“That experience kept me wondering what I would ever do to save a girl the embarrassment I had gone through. While at university, I went to volunteer with Kadama Widows Association where I am the Executive Director now and as I interacted with the girls, they had similar challenges. I then started saving part of my stipend to make the pads and that was my aha moment.” Lucinda says.

The sanitary pads are distributed to young women in rural Uganda. These Eco-pads are Menstrual Kits that are made from very high performance fabric and provide comfort and supper protection for a period up to 12 months.

“The Eco-pads project started in 2008 as a local thing trying to just help girls in the community. In 2014 we realized we can improve on quality and start selling for sustainability and we have been growing daily from just the local community to many parts of the country with over 20 full time  and 35 part time employees.”

“I am most proud of last year when we reached 50,000 girls with Eco-Pads, the feedback from the girls attending school daily is heart-filling. The involvement of parents and the whole community in the cause is great. We have reached over 75,000 community members on Menstruation being an issue and how they support. Mentored over 10,000 girls” Lucinda says.

There are challenges that are still to be overcome. Being a local product, Lucinda’s biggest challenge has been in marketing and getting the product to be known, convincing the clients that it is a good product since it is new. The very first money that they used was grant money that they used to buy equipment and set up and buy some few materials.

Despite the challenges, she has mentors that encourage her when things are going down hill. my “Atuki Turner the ED of Mifumi, Tracey the founder of glad rags U.S, Mary Mosinghi the ED of KwaAfrica. They remaind me that I need to remain a learner and humble in whatever I do.”

At the heart of this project is the desire by Eco pads that every girl child remains in school. Eco-pads give affordable sanitary pads for girls, because many miss out of school during their menstruation. They are competing against appalling statistics 80% of Girls in Uganda are absent from school during their periods. 70% of female students reported difficulty of attending class attentively due to menstrual related problems. 90% of the poor women and girls do not use (off-the-shelf) sanitary pads, but instead improvise with unsanitary materials. Prior to their first period only 51% of girls had knowledge of menstruation and its management

“We educate girls on MHM, conduct mentorship sessions and educate the parents and teachers on the need to support girl child. We shall continue to do something regardless of the tide. One sanitary pad at a time.” Lucinda says

lucinda-1 lucinda




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