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Tuesday, 19 August 2014

Why increase in new HIV infections and deaths whilst increased access to ARVs in Uganda?

By Sam Agona

This question was postured by the Daily Monitor. I found it worth responding to.

Some of the issues discussed in the article is voluntary HIV testing as shown in the photos below:
                                              A young girl testing for HIV in Iganga Town

                                                A friend, Liz Cho testing voluntarily

                 Two Health workers ( Liz and Claire) demonstrating to the author how to use female condoms

                                           Author and Liz Cho doing a wrap up discussion

An HIV test strip which shows someone’s HIV status; its advisable that everyone is aware of the status.

Humans are fast bored by mainstream life

By Sam Agona
A serie of events in the recent past have triggered my mind into thinking that humans get bored of a mainstream life but they just don’t know it. Human beings have a high propensity to look out for a something different within life than live within confines of day to day routine. I am sure I am not thinking crazy and some of these scenarios will shed light to my imagination;
University education has become too mainstream and will soon be dissolute. It is about some system of education like 7-4-2-3/4/5 like it is in Uganda. But what is all this about? Going to school getting a few documents, looking for jobs here and there or starting up some business of your own, need not to mention vying for a political seat, over time, school completion looks to be a baseline of success, I find this just too mainstream and boring.
Mainstream life is boring. People out there construct houses, and blame it on vanilla life. The roof will always be asbestos, tiles, dry grass thatch and or iron sheets. Why is it this way? Can’t we think of a life less boring than iron-sheets sort? Can’t we?
This is dynamism..
Social behavior; around 2009 – 10, Pastor Male and Pastor Martin Ssempa, opened a case against Pastor Kayanja of Miracle Center because of what they called “Sodomy”. In the subsequent weeks, Dr. Hilary Bainemigisha (whom I consider one of the best writers in Uganda) elaborated it all this way. People do great things and get bored. They can actually get bored of their success, thus rendering life unchallenging. Its human nature that they always seek for something outside the normal way of living, therefore it was understandable if a man who has close to 10,000 people forming part of his congregation one day chooses to have a sexual relationship with young boys. If you asked me, what is this? This is nothing but getting out of the mainstream way of living.
Marriage life; Man identifying a woman or woman identifying a man, marrying them, living happily ever after and spending all your nights with only them until death. This sounds so terminal. People have been doing this sort of dating as back as the BC days. How, however does this happen today? Plenty a people are bored by such “mainstream-ism”. My advise, is date.. date and date till you cant date no more..

Yes only one, but till when?

Women with their body sizes; why on earth do women stress over slimness and slenderness in the name of something as fictional as body figure; So many women are bothered by the level of estrogen generated by their body. Who really wants and or cares about this? Almost every woman out there is bothered about her size, how mainstream can life be? 
She is perfect in her own world..
Mainstream in Ugandan media, the best man at the end of the year will always be Museveni, worst man will be Dr. Kiiza Besigye, on the first of January; pages will always have pictures of fireworks. After releasing results, it’s the rule of thumb that a bunch of students will have their pictures on the pages following their results. This has become so mainstream that possibly newspapers that ignore pasting pictures of a few students on their pages won’t get enough sales for the day. Lately even TV stations show students based on results.
Working from 8am – 5pm; to begin with who said stamped the rule that people have to work from 8-5pm. Why can’t people change and start dressing up at 1 am or even 4 pm and go open office to attend to the day’s business? This is very mainstream; it may probably change one time in life.  
Related to the above, who hard coded it that night is meant sleeping? Dying with the rule of thumb that night is meant for sleeping. This could be changed as well including how you sleep, the stress on putting on heavy clothes on your body in the name of a nighty is just not the thing, why not sleep how you were born? Life needs some dynamism than what it is right now. 

Take the simple way please.. avoid being mainstream..
 Birthday gifts and messages are too mainstream. Over the last so many years people write on each other’s Facebook wall, wishing them a happy birthday. This is great but till when? When I began finding this too mainstream, I stopped writing “HBD” or “Happy Birthday” on people’s Facebook wall just because I got bored by it, it’s just too mainstream.
To some people, life itself becomes too mainstream; this normally happens when challenges outweigh the reasons to be alive; such people normally do the obvious.
“Don’t be too blind to see that you need a change” – Justin Timberlake, 2002

Ugandans should embrace child adoption and be proud of it

By Sam Agona
Statistics from the population secretariat show a population growth rate currently at 3.21% and a crude birth rate of 43.09 per thousand, which according to UNDP has profound implications on development. The direly pronounced challenges are evinced on social life sustainability, urbanization, access to health services and youth empowerment given the fact that the population is exceedingly young. 
Children like this need somewhere they truthfully call home
Against the above backdrop, it is important to note is that we already have a bulging population of over 36 million with  48.9%  being between 0-14 years  old, and a greater percentage of them being infants. Among the infants, several do not have people (parents or guardians) to take care of them. This is caused by high maternal deaths estimated at 138 women out of every 100,000 according to the U.S led Global Health Initiative (GHI). Some of the children are abandoned by their mothers shortly after child birth due to an array of reasons, according to the Mengo Hospital based Sanyu Babies’ Home’s Barbara Mutagubya; this is due to moral decadence as a result of poor parenting. There are over 2 million children abandoned in Uganda. This leaves the role on babies’ homes to take care of the children or they have to be adopted by noble hearted people, this includes you.
 Services offered by Ssanyu Babies’ Home : Photo adopted from Ssanyu Babies’ Home
Against the above backdrop, it is important to note is that we already have a bulging population of over 36 million with  48.9%  being between 0-14 years  old, and a greater percentage of them being infants. Among the infants, several do not have people (parents or guardians) to take care of them. This is caused by high maternal deaths estimated at 138 women out of every 100,000 according to the U.S led Global Health Initiative (GHI). Some of the children are abandoned by their mothers shortly after child birth due to an array of reasons, according to the Mengo Hospital based Sanyu Babies’ Home’s Barbara Mutagubya; this is due to moral decadence as a result of poor parenting. There are over 2 million children abandoned in Uganda. This leaves the role on babies’ homes to take care of the children or they have to be adopted by noble hearted people, this includes you.
Children playing at the Babies’ Home : Photo adopted from Ssanyu Babies’ Home
The few Ugandans who are willing to adopt come with excessive demands for instance, they tend to prefer girl children, they always want a child not older than 1 year; they are not always willing to take up children with special needs such as children with sickle cell, cerebral pulse, HIV, disabled children among others. Also importantly, Ugandans are not willing to undertake the formal steps of adopting a child by giving information about themselves; their families, their crime record, financial status yet this is the only ways a babies’ home can be sure that the child they are entrusting a prospective guardian with is in safe hands. It is against this background that we have more foreigners willing to adopt Ugandan and African children formally while the rest of us are less bothered. 
                  Children playing under guidance of a caretaker: Photo adopted from Ssanyu Babies’ Home
As Ugandans, it is important that we started taking responsibility of the society we live in. It is understandable that, times have incalculably changed, everything comes at a cost, however, the onus is still on us to make the world what you want it to be thus the statement “Be in the world, not of the world”. It is therefore paramount that well-intentioned people go out there adopt children and raise them responsibly. There is immense satisfaction in every act of nobility, producing one or two biological children, then adopting one through the right procedures and raising them with the desired values is both an act of grace and gear towards national development.
Twitter: @samagona 
The original of this piece was published in the New Vision on 11th March, 2014. 

National IDs; Kenyan Lessons; Ugandan questions

By Sam Agona
On another attempt, citizen registration for National Identity Cards is imminent in Uganda. National IDs are very important in any country, Kenya already implemented this, Rwanda as well as farther neighbors like Ethiopia all issue national IDs to their citizens.  Having been suspended twice in Uganda due to an array reasons, the practice this time looks on course to commence. In 2011, anti-corruption court halted the process due to flaws in procurement. In 2013, the same process was halted again reportedly due to inter-agency fights over the project.
A national identity card is a portable document, archetypally a plasticized card with digitally-embedded information, that someone is required or encouraged to carry as a means of confirming their identity. It can also a basis for determining who enjoys what rights in a given country, including access to services, other documents like a passport and possibly enrolment to jobs. In Uganda, stakeholders in this project include NITA-U, Ministry of ICT, Ministry of Internal Affairs, URSB, UBOS and the Citizens among others.
                       One of the few Ugandan citizens with a national ID; Adopted from Red Pepper 
The challenge in Uganda is determining who rightfully deserves a national identity card and what procedures shall be taken to determine who gets an ID. I choose to discuss these questions that Ugandans should be asking, drawing a few experiences from Kenya.
In Kenya, a vetting process was undertaken to determine who to issue a card, also lineage is followed and some considerations such land ownership deeds, follow-up with local authorities as well as ethnicity. This however raised questions when it came to issuing cards to groups that have been in Kenya for over 100 years but are not considered bona facie Kenyans such as the Nubians, Kenyan Arabs, Asians and Caucasians. In Uganda, how shall this be handled? Not that there are no contestable groups in the country.
On noble grounds, it is well-intentioned pointing out that there are very many Congolese, Rwandese and even Kenyans who have lived in Uganda for over 7-10+ years. They have bought land, built houses and live harmoniously with people in their communities but does this make them Ugandans? I don’t think so. By the fact that Kenyan officials find it hard issuing IDs to Somalis who have been in the country for over 20 years, what justifies Uganda to do so.
Essentially, the proof of citizenship and age were the most important documents in Kenya. A registration officer would ask for a birth certificate. On some occasions, a medical officer would be required to carry out an age assessment process and issue a certificate. In Uganda, the same can work, enrolment officers (as shall be called) will ask for this, but how accurate are our birth certificates when it is on record that only 4% of Ugandans have genuine birth certificates.
In Kenya, the process is handled by National Registration Bureau (NRB) in conjunction with Electoral Commission of Kenya (ECK), thus raising question of duplication of roles between ECK which registers voters who have attained the age of 18, as well NRB registering citizens for IDs, this process was viewed as a double burden on tax payer’s money. Therefore, Ugandans should be asking whether they shall have to register again to be able to vote in 2016 or the records shall be shared.
In Kenya, some registration centers did not even have the basics. In the districts of Turkana, Teso, Wajir, Mandera and Kajiado, Amukura division the office facilities were in a deplorable state. Yet to register a citizen, a photo may be captured; thump print or toe print may be captured, details including name, age, parental lineage among others. This therefore means a center needs paper, computers, cameras, biometric scanners among others. Some centers did not have these, assuming the process was well planned with knowledge of an estimate number of citizens to be registered. In Uganda however, census have not been conducted thus knowing the number of citizens is a challenge but the stake holders were able to come up with an estimated amount of money needed to roll out the project for all the citizens. This calls for questions from Ugandans.
In Kenya, IDs are produced through a process chain, registration was/ is done from all parts of the country and cards are printed from Nairobi before sending them back to points of registration. Turukana is the largest district in Kenya but has very few divisional offices, Tana River district over 300 kms wide deserved to have its own ID printing center. Experience has shown that regionalized ID printing is much more successful. Through regionalization of printing centers, there is a reduction in both acknowledged and unacknowledged delays that come during the processing, producing and dissemination of IDs. For instance in Ethiopia, all states manage their records and print their own national IDs, this has made the process faster and better understood by citizens. This explains why in Kenya, several times staff members of NRB complained of the system being centralized and concentrated in Nairobi.
The question of who incurs the cost of processing the ID. Just like simcard registration, at some service centers, clients had to take their own photos, it will not be strange to see some citizens in some parts of Uganda being asked to carry passport size photos and yet having a camera at the registration center would allow for homogeneity of records. While Kenyans in the diaspora pay to be issued an ID, those in the country do not pay, this is understandable. However, some groups of people were being made to pay to be able to get registered, this was very fraudulent. Something we cannot rule out in Uganda, citizens of Uganda need to informed on who meets the cost of the service so that Ugandans in far to reach areas are not duped.
In homogeneity of documents required. Some parts of Kenya like in Nakuru, registration officers asked for copies of parent’s ID, proof of age and Letter from an area chief. This highly contrasted with what was being asked from citizens in Northern Frontier District (NFD), the Nubian communities in Nairobi among others who were being asked to produce as many as Birth certificate, Baptismal certificate, school leaving certificate, age assessment certificate from a medical officer, child health card, notification of birth, letter from the Provincial Administration Chief, sworn affidavits (for late registration) among others. What harmonized process does Uganda have for registration? Even earlier projects like sim card registration, in some places, subscribers were asked to present photos while others had their photos taken at other registration points.
Some IDs used by Ugandans to identify themselves, photo by Abubaker Lubowa
A fact worth rethinking is that, often than not, registration of persons is seamlessly linked with elections thus wholly or partially watering down the value of ID cards, since a Voter’s card would serve the same purpose without having to issue another document.
Ignorance of the citizenry, public ignorance on procedures of application and entitlements contributes greatly to exploitation by officers in the field and or failure by citizens to meet the requirements. In Kenya, elderly citizens in Garsen were asked to pay the registration officer before receiving their identity cards once the cards had arrived from Nairobi. The elders accused the respective registrar of having his drawer full of ready IDs but would only hand them over for “something small”, locally known as “kitu kidogo“. Such a situation can occur in some parts of Uganda.
The question of Ugandans living in diaspora; Kenya through some of its missions, issues IDs to its citizens living in those respective countries, this is however done at a cost determined by other the mission or the NRB. Uganda can probably handle is with time but needs to be in plan.
Sample of a Kenyan ID issued from their mission in London; adopted from Misterseed
Does a national ID need to have an expiry date? I do not think so, probably a renewal date. An expiry on a document that determines your citizenship means your citizenship has expired. This is not practical. The Kenyan IDs do not have expiry dates, a leaf Uganda ought to borrow. 
Excerpts from KNCHR report ” An Identity Crisis? A Study on the Issuance of National Identity Cards In Kenya” 2007

School in a Box: Cloud e-learning Solution for Contemporary Schools

By Sam Agona
In the last few weeks of 2013, a project team from CLS Uganda has been tirelessly working on a teaching solution for elementary and secondary school which is called “School in a Box” meant to aid learning in collaboration. The Project Lead, Ken Stober thought of a self-contained system (the box) that could aid education both on interactive instructional and non – interactive instruction basis. Our thought was further compounded by the strike that has rocked primary schools in Uganda. If we had a system that was self-instructional, probably our children would have the chance to sit in class while learning something on their own, as their teachers and their organizational bodies sort out the impasse they are embroiled in with government, though caution is important that this system is not a replacement for a teacher but rather a supplement to a teacher’s input. The system is organized in such a way that we try to keep it in a state where the teacher does as little as possible before launching a class, this is save time and also to allow technology enhance rather than impede their work (conducting lessons/ classes). 
                       L-R Mildred, Sam and Ken, the School in a box team in a brainstorming session
Our solution introduces a learning suit-case. This document looks to highlight on the technologies and the “wins” in deploying this solution in your institution:
The system enclosure has a mini-laptop which is used to present the content and or play the audio-visual content both on and offline (internet). Typically a windows mini laptop, 11” display, 1.66 GHz and 1 GB RAM system is sufficient.
Server (C3 – Cloud Classroom Content)
The C3 works as a connection point, file host, access server and access point, it has a motherboard, power supply, it contains memory that can be used to store and retrieve both curriculum and local content. It has a cloud management interface onto which a user is given rights to once they purchase the C3 server (hardware). Cloud academic packages like RACHEL (Remote Access Community Hotspots for Education and Learning), School Wikis among others.  The server provides for high speed access to educational content sources for schools, ranging from encyclopedias to custom designed school content. C3 works with low bandwidth connections, 3G, satellite and Wi-Fi (hotspot capable), thus allowing access and administration of cloud material. C3 runs on SSD (solid state drives) which regulates the temperature of the system, and not getting unnecessarily heated since SSDs don’t use moving (rotations) parts on their drives, explaining the high speed during I/O processes and high startup speed. The C3 is configured to update whenever it gets connected to the internet, this enables users to access up-to-date content as much as possible. Through critical links, content cloud server checks for updates and downloads them automatically. Other services offered by the server include routing, DHCP (thus no need for cabling it to a computer), security services, web-service, email among others.
Portable projector
The system is designed to run on a small portable projector for display of pictorial and video content. It stands on a tripod stand when in use, and can be remote controlled like any other projector. It can work on any machine with 1.8 MHz speed and 512 MB RAM and with an nViDIA or ATI graphics card. It has networking capabilities both on wireless and through cable and can also play content straight from a USB drive.
Used for audio output, normally small speakers that can fit as part of the encasing and consuming not more than 5 watts of power, does not require any sound amplification.
Power adapter
In the box, we have a 4 plug power adaptor which accounts for the computer, server power input, speakers and projector power inputs.
Lay out of the final system
Power requirements
The unique aspect of this project is that it considers the need to keep the environment green. The whole box runs on power of 82 watts, when system components are powered simultaneously, wattage may increase to 120 watts. In a rural environment without electricity, this system can run on solar with as little as: one 30 watts panel, 1 battery of 100AH, a 20 amps charge controller and a 180 VA inverter at basic.
Minimum running power
In conclusion, this is such an efficient and cost effective system that needs to diffuse in both urban and rural learning environments, it can enable education with minimum input from the instructor, local content can also be incorporated easily; it gives the instructor a better opportunity to demonstrate what they are teaching. Content comparison between institutions of learning can be done more easily using the cloud as the host. And importantly, areas with challenges of access to electricity can use this system very cost effectively through solar power as shown above. 

Woes of an ordinary road user in Uganda

By Sam Agona
With certainty, if you have ever used an archetypal Ugandan road even for 5 kms, you will somehow have a tale to tell. Every year the parliament apportions a lot of money to the transport sector, some roads have been fixed, other are in a dire state partly explaining the high death toll we have on our roads. Uganda adopted the British road standard which dictates that a road should be 12 meters wide and 100 millimeters, tarmac 75mm while smaller roads are supposed to be 6 meters wide. Besides that, a standard road must have a main lane (overtaking lane, normal lane), rider’s lane, a walking path and designated drainage channels. 
A smooth road stretch away from Soroti towards Dokolo District (Photo by R. Kavuma)
However even our best roads are not anywhere close to that. West Nile and Karamoja regions of Uganda probably have the most untold roads any user would risk using. Between Pabbo ( in Amuru district) and Yumbe, the number of trucks that spend nights on the road just because they cannot move due to road conditions is preposterous. Some of the roads in dire state include Jinja – Kamuli road and seemingly the same contractor who worked on it is working on Mpigi – Kanoni road.
This happens against a backdrop where Ministry of Finance in the last read budget, allocated Ushs 2,395 billion to the roads and works sector for the current financial year, a marked increase from U. Shs. 1,650.75 bn this year. The additional allocation to Roads and Works budget totaled to Shs 744.7 billion over the last year’s provision.
Such a scenario summarizes the quality of material used in building this road

In the last read budget, Minister of Finance stated that 845kms of national roads were completed. She also stressed how much government would scale up external borrowing for infrastructure particularly roads. This makes it worrying to note the state of Kamdini – Gulu road, and roads within Gulu Municipality itself, one of the fastest growing urban centers in Uganda.
Representative road in Gulu town, route from Pece Stadium to Watoto Gulu
The traffic question; there is traffic everywhere in the world; however the level of jam in Uganda and majorly Kampala city is appalling. It underlines the level poor planning and deliberate acts to avoid creating solutions.
Latent traffic in Ntinda, Kampala on an evening 
While in some parts, a vicious circle of poor policing and policy implementation in housing, road construction and maintenance of gazetted areas such as wetlands and forest reserves has been manifested when floods take over roads due to construction in low lying areas deemed to be wetlands.
Flooded road in Bugolobi due to poor drainage and building in wetlands
In the inauguration episode of Turning Around Ugandan a TV show on NTV Uganda, Andrew Mwenda talked of how roads spiraling out of Kampala are “good”, it made me realize that he has probably not used Matugga – Kafu, and probably not seen the size of the roads. A naked fact is roads in Uganda are small and narrow. So many accidents occur in Mabira forest and are not reported. 
This accident was a head-on collision by two speeding vehicles on a 7 meter wide road
Several stretches that are smooth, tend to be narrow, this leaves speeding drivers with no room for error, and in case of erring, they can either go off-road or head-on with the vehicle coming opposite. I strongly believe, if the road between Karuma via Migeera towards Luwero was wider, the accident below that involved MTN workers would not have occurred. We have an alarming road carnage rate as the Observer recently reported that nine people die in road accidents per 100,000 of the population per year in Uganda, compared to 23 per 100,000 in South Africa which is a bigger country. 
                                              The state of Uganda – South Sudan Highway
On roads, there are parts that need bridges and parts that can be ramped and raised, but because our contractors are either not monitored properly or because they spend too much of the contract budget on the bureaucracy, you will find parts which need culverts like in the picture below ramped to form a raised road. These stretches are later on affected by flooding. 
Author helping a charcoal dealer cross overflowing River Aswa
On highways, trailers are the most fragile vehicles; this explains why they don’t seem interested in leaving way for other vehicles using the road. It is because once they lower one side of the vehicle at a bad spot of the road, there is a high chance, it will not return to the main area of the road. 
Two vehicles sharing a road
In such a scenario as above, the trailer would not risk having any of its tires land into the potholes by the roadside lest if trips off, meaning the trailer will stay entirely around the center of the road, this road is barely 7 meters wide, therefore exposing vehicles to head on accidents within such narrow roads.
A “lake” in the middle of a road in Lamwo district
Abrupt notices of broken bridges after driving 45 kms from Kitgum town towards Lamwo town, you find a notice of this kind leaving you with one option. Making a U- turn and using another road.
An abrupt notice of a broken bridge 
Uganda has some untamable drivers on its roads. On high ways, bigger vehicles are never willing to pay way for smaller vehicles (ceteris paribus). On urban and peri-urban roads, commuter vehicles have their own rules; they stop where they want, when they want and how they want.
It is important to promote private sector in a capitalistic economy like Uganda’s but some social services and amenities cannot be left entirely in the hands of private sector. Activities such as planning, developing and regulating transport system should be a function of a government.

A typical warning of what they do often! Stopping unexpectedly
Some roads are simply impassable, anything short of a 4 wheel drive will not be of help.
This is the road to Lwala Hospital in Teso region (Photo by Joseph Angole)
We claim to be promoting the tourism sector but if a tourist will have to go through this to access a tourism site then I am not sure we are planning the right way. Neither am I sure we have prioritized tourism in this case.
This is the road to Kidepo National Park on a rainy occasion
Still on promotion of private sector, for factors of production to move, they need to arrive where they are needed not only on time but also in good shape. I am not sure such a road can deliver as desired.
This is Gulu – Kitgum Road (Photo by Alex J. Otto)
Below is a road in Apac district. Local government cannot have such a road and yet central government claims to be heightening private sector and at the same time pumping money into infrastructure specifically roads, PSVs cannot use such roads. A vehicle that uses such a road breaks down in record time thus disheartening investors.  
This is a road in Apac district
At some point of every year, some personalities are awarded medals for one reason or the other. I am not very keen on the beneficiaries but if asked, I would front that every driver who goes to Nimule and or uses Moyo road and does not lay down his truck deserves a medal without question. Those are the patriots.
This is how an improved area on Moyo Adjumani road looks when it has rained
One interesting thing is that citizens in some of these places have resigned to living this way and they think this is the best they can have. I describe that as well-crafted poverty of the mind.
Recent photo of Kamuli residents demonstrating over bad roads
More time and effort is spent clumping down political rallies but if we used these resources in fixing our social economic infrastructure to desirable levels, we would not experience demonstrations like the above.  Ugandans need to demand for accountability from the respective authorities.