REMAINING HOPEFUL IN A DIRE SITUATION

A Sunrise symbolises birth and rebirth. New beginnings, new challenges and new possibilities. It gives us hope for a better day.

The invention of the Internet shrank the world into a global village. On the 7th April 2021 when I read from the Johns Hopkins Corona Virus Resource centre that Brazil had suffered 4000 deaths in 24 hours, a cold shudder went down my spine. Brazil has a new more virulent strain that runs a short clinical course than the original one. It has affected the youth in big numbers. Many video clips  of elderly parents wailing after the deaths of their children are making rounds on the Social Media. Their echoes keep ringing in my ears. The crisis is compounded by the country President’s continued rejection of public health restrictions such as mask-wearing, physical distancing and lockdowns. As a health worker , I have always believed that the greatest asset for each country is its people and these people must be healthy first to engage in economic activities and the growth of their country. 

This has reminded me of the period of the peak of the HIV/AIDS epidemic in Botswana in the late 90s.  The president then- Festus Mogae, made this bold statement: ” Botswana was threatened with extinction.”

Thereafter, he made HIV/AIDS a national priority and launched   Botswana’s Mass Antiretroval Therapy Programme- MASA( New Dawn) in 2002.  I was working there and was very privileged to be part of this comprehensive programme. With such a committed leader and a stable democratic government, we saw a dramatic drop in AIDS-related deaths from 21,000 in 2002 to 5,800 in 2013. The decline in numbers was sustained for the following years. There were many challenges but the results fired us to work even harder to overcome them.

The COVID-19 virus is not going anywhere anytime soon. This demands that wherever we are, we have to triple our efforts to fight it. Currently, USA, Brazil, India and Mexico are the countries most hit by the virus.

From the Johns Hopkins Corona Virus Resource Centre, as of the 20th April 2021,

There were 142,965,975 global confirmed cases and 3,044,492 global deaths.

Brazil had 14,043,076 confirmed cases and 378,003 deaths.

South Africa had 1,568,366 confirmed cases and 53,887 deaths.

Some encouraging news came in from Israel last week. Israel has had half of its adult population vaccinated fully against Covid-19 disease. As a result, the number of new cases and the number of patients developing the severe form of the disease has declined. They seem to have put themselves on the path of herd immunity by this campaign of massive vaccination.

The majority of us feel that the pandemic has gone on for so long that we have started suffering from Caution fatigue or  COVID-related fatigue. The fatigue is affecting our physical and emotional wellbeing.

 However, the numerous deaths happening around us during the third wave of the pandemic, prompt us not to relax until the transmission is reduced to the lowest level possible worldwide. This echoes what Dr. Tedros Adhanom Ghebreyesus, the Director- General of the World Health Organisation, has been telling us all along:” We are not safe until everyone is safe.”

 The vaccine offers us hope for attaining herd immunity but the public health measures of:

  • Frequent washing of hands using alcohol-based hand rub or soap and water
  • Proper use of Face masks
  • Physical distancing- maintaining 2 metres between you and other people.
  • Limiting social gatherings and time spent in crowded places.
  • Avoiding close contact with other people- no hugging, no shaking of hands.

These measures are still in place to reduce the transmission of the virus in our communities. Prevention is better than cure more so with this Covid-19 infection in the 60 plus groups of any population.

Here are some inspiring quotes to keep us going in this state of confusion, caution fatigue and uncertainty.

If there is life, there is hope.’’ – Stephen Hawky

” A little hope each day can fill rivers to overflowing. ”- Unknown

” Once you choose hope, anything’s possible.’’- Christopher Reeve

And sometimes, against all odds, against all logic, we still hope.’’- Ellen Pompeo as Dr. Meredith Grey

If the rhythm of the drum beat changes, then the dancer’s steps must adapt. – Kenyan Proverb

The best way to eat an elephant in your path is to cut her up into little pieces .- African Proverb.

The sun never quits shining. Sometimes , clouds just get in the way.’’– Unknown

”The forces that are for you are greater than the forces against you.’’– Joel Osteen

For those of us who have lost loved ones to the COVID-19 disease and are grieving, find a little comfort in the following:

”We grieve because we love. The intensity of the grief often proclaims the depth of our love.’’- Gary Roe

One of my favourites over the years: FOOTPRINTS IN THE SANDS by Mary Fishback Powers

One night I dreamed a dream.

As I was walking along the beach with my Lord.

Across the dark sky flashed scenes from my life.

For each scene, I noticed  two sets of footprints in the sand,

One belonging to me and one to my Lord.

After the last scene of my life flashed before me,

I looked back at the footprints in the sand.

I noticed that at many times along the path of my life,

especially at the very lowest and saddest times,

there was only one set of footprints.

This really troubled me, so I asked the Lord about it.

” Lord you said once I decided to follow you,

You’d walk with me all the way.

But I noticed that during the saddest

 and most troublesome times of my life,

 there was only one set of footprints.

I don’t understand why, when I needed You

the most, You would leave me.’’

He whispered, ” My precious child, I love you and will never leave you

Never, ever, during your trials and testings.

When you saw only one set of footprints,

It was then that I carried you.’’

Other than allowing ourselves to feel overwhelmed and distressed, let us re-evaluate the meaning of life and pick valuable lessons from this Covid-19 health/economic crisis. It will help our spirits grow stronger.

QUESTION:

How often do you count your blessings during this dire situation?

Has it helped you realise that things could be worse off?

TRUE TO MY WORD

One of the front line health workers receiving his first dose of the COVID-19 vaccine at his local clinic.

One of the virtues that my late father passed on to me at a very tender age is to keep my promises to God and to people. He believed that a person could only be as good as his word.

Words have power and when you do what you promise no matter how much it may cost you, you become a reliable and dependable person.  On the 11 th December 2020, I posted an article on this blog entitled: I will gladly queue up to receive the new COVID-19 Vaccine.

By the time I wrote that post, the COVID -19 pandemic had raged on for nine months and vaccine research scientists, pharmaceutical companies and clinicians were working together round the clock to develop and launch COVID-19 vaccines in their attempt to return the world to a sense of normality.

By my Ganda culture, I was sounding the ‘’war drums’’ to mobilize each one of us to prepare for participation in the raging COVID-19 war. It had caught us unprepared and had grown to become the biggest threat to the world since the Spanish Flu pandemic of 1918-1919.

As the Director- General of the World Health Organisation, Tedros Adhanom Ghebreyesus rightly said: “We are not safe until everyone is safe.”

The war demands for collective efforts and collaborative partnerships at all fronts.

On 20th March 2020, the President of Uganda declared the first lockdown in our country to prevent the spread of this new disease.

21st March 2020, Uganda confirmed its first case in the country, a male Ugandan

 citizen returning from Dubai.

From the Johns Hopkins Corona Virus Resource Centre, as of the 23rd March 2021, Uganda had reported 40,687 confirmed cases and 334 deaths while 123,778, 489 cases had been confirmed globally and 2,725,516 Deaths. We have all been touched by this COVID-19 disease in one way or another.

As a medical doctor, I have been all along reading scientific and medical journal articles to understand the COVID -19 disease to stay up-to-date on best practices. We are living in the Digital technology era and the management and control of the pandemic is driven by data.

By early November 2020, four vaccines had been developed. They included:  Pfizer-BioNTech, Moderna, OxfordUnivesrity /AstraZeneca, SputnikV and later the Chinese ones. In December 2020, WHO had approved  these  vaccines on an Emergency use authorization only.

On 8th December 2020, the 90- year- old Margaret Keenan of UK became the first person in the world to be given the Pfizer/BioNTech COVID-19 vaccine. She received her second dose of the vaccine on the 29th December 2020 and is still going strong.

On the 11th March 2021 with the assistance of COVAX, WHO and UNICEF,

 Uganda’s ministry of health launched the COVID-19 vaccination campaign giving the first priority to the frontline health workers: doctors, nurses in government facilities around Kampala city

and some senior doctors from the most vulnerable part of our population. True to my word, I quickly seized the opportunity to be among the first 200 or so who received the Oxford University/Astra Zeneca vaccine at the Women’s hospital in Mulago, Kampala. It was an informed decision and thankfully I have not suffered any side effects.

I took it for the following reasons:

  • From the available evidence-based medical literature, I am among the most vulnerable members of the population for the COVID- 19 disease. I am above 65 years of age. The cdc.gov website has co-related age and the risk of hospitalization and risk of death.

40-49 years of age have 3 times the risk of hospitalization and 10 times the risk of death.

50-64 years of age have 4 times the risk of hospitalization and 30 times the risk of death.

65-74 years of age have 5 times the risk of hospitalization and 90 times the risk of death.

75-84 years of age have 8 times the risk of hospitalization and 220 times the risk of death.

  • WHO has approved the vaccine I was given as safe and effective. All pharmaceutical products have some side effects, they may not affect everybody and could be minor or temporary. But in medicine the focus is on weighing the benefits of the product against the risks. In the new Covid-19 vaccine, the benefits in the most vulnerable group of the population outweigh the risks. The vaccine has been found to reduce the risk of acquiring the infection, reduce the risk of developing the severe form of the disease requiring admission and care in the ICU and reducing the risk of death from the disease. The final outcome- the health workers and the health care systems are not overwhelmed by numbers and deaths from the disease are greatly reduced.
  • A health worker of my standing has her own clientelle and followers who believe in her. Though she makes a purely individual choice to take the vaccine, it impacts and influences her group-

to take or not to take the vaccine. I had to take action. My conscience could not allow me to sit on the fence.

  • The effect of COVID-19 on me personally. Like the majority of us, I have lost many relatives, colleagues, friends to the virus.

I lost a niece in Arizona, USA in June 2020, she had worked there as a nurse for over 25 years. In December 2020, I lost some friends here in Uganda. January 2021, I lost one of my best friends of many years Dr. Sarah Namuli Yiga of Bloemfontein, South Africa, followed by a classmate, Dr. David Ssenoga of Durban , South Africa, family friends: Mr. and Mrs. Mikka Sematimba whom we buried within a week of each other! On the 19th March I buried a brother-in law, who died in London and the list keeps growing.

 These series of deaths have been emotionally and physically draining to me. Available scientific information tells me that the vaccine is safe and effective so I would rather take the vaccine other than allow myself to risk catching the disease and ending up in the ICU.

When at least 70-90 percent of our population is vaccinated against COVID -19 disease, we would have reached the level of Herd Immunity then we can control the pandemic.

It is crystal clear to me that the COVID-19 vaccine is not the solution to the COVID-19 pandemic and that I still have to follow the laid out health and safety rules  by the Ministry of Health:

Masking up in all public places and avoiding crowds.

Practicing regular good hand hygiene.

 Keeping physical distancing of 2 metres.

Being well informed about the disease.

Lastly I may also add eating nutritious foods, taking regular exercises and having regular sleep at night to boost the body’s immunity to fight infections.

Your health is your greatest wealth and it is your responsibility to safeguard it and to protect others in your community.

To help you understand how far we have come with vaccine-preventable diseases ( WHO has 28 on its list excluding COVID-19) I always use the example of the highly contagious and serious measles disease.

The measles vaccine was developed in USA in 1963 but was never widely available to poor countries like mine until around 1994 when WHO specifically developed and supported national Expanded Immunisation Programmes in the least developed countries of the world. By the time I undertook the Internship programme in 1978, at New Mulago, the only teaching hospital in the country, a minimum of ten children under the age of 5 were dying from measles. They were dying from its main complication –  Broncho Pneumonia, in the Acute paediatric admission department almost daily. My heart could not take it so I went into Internal Medicine instead.

Records from the Uganda Health Management Information System show that between 1999 and 2001, routine immunisation and massive Immunisation campaign for children aged 6 months to 5 years were consistent.

This paid dividends: the incidence of measles in this vulnerable group declined by 39 percent, measles admissions declined by 60 percent and the measles deaths declined by 63 percent. Currently, the Ugandan child receives her/his first dose of Measles combined with Mumps and Rubella vaccine(MMR) at 9  months of age and the second dose of MMR at 18 months of age. The vaccine uptake is yet to rise from 85 percent to reach the WHO requirement of 95 percent in any given population if we are to eradicate measles disease in the world. Botswana’s measles vaccine coverage was 93 percent in 2016.

Globally, between 2000-2018, routine measles vaccination had resulted in a 73 percent drop in measles deaths. Safe and effective vaccinations save lives.

Going by these historical developments, there was nothing to hold me from taking the COVID-19 vaccine unless if I had a serious contraindication. I would therefore urge each one of us to make the right informed decision based on scientific facts not Social Media half truths, fake new and misinformation.

Get the facts about the disease from the Uganda Ministry of Health website: http://www.health.go.ug and the WHO one: http://www.who.int/Diseases.

In this digital era, plenty of information is freely available but you have to decipher and you have to keep reading to keep up-to- date with new advances in science and medicine.

Knowledge is power only if applied to improve your quality of life otherwise it remains mere information.

For us the health workers, it is very encouraging to understand that anyone catching the COVID -19 disease today stands a high chance of recovering from it when compared to those who had it in the first 6 months of 2020 when the disease was completely new.

Scientific studies are putting the pathology of the disease together while the public health specialists are sharpening their skills in preventing the disease and the clinicians are gradually learning the best practices to help optimize patient outcomes.

‘’The best way forward is the blended comprehensive approach which puts containment as a major pillar.’’– Dr.Tedros Adhanom Gebreyesus. WHO director- general

Please do your small part perfectly that fits in this big picture.

QUESTION:

Has this post helped you make an informed decision about taking the new COVID-19 vaccine if you are in the most vulnerable group of the population?

CONNECT WITH YOURSELF, WITH OTHERS AND WITH NATURE

Man is by nature a social animal, thriving best in a small group. It goes back to the ancient times when men hunted wild animals and gathered plants, seeds, berries and roots for food. Even today, the family remains as the basic unit of a nation. A family can be defined as a group of two or more persons related by birth, marriage , adoption who live together.

The Covid-19 pandemic restrictions are designed to reduce the spread of the disease in a family, community, nation and the world in general.

Physical distancing reduces human contacts- no hugs, no handshakes, no gathering together to share grief or joy. Shared common experiences help us to address our fears, worries and every day problems. This emotional support is vital for our physical and mental health.

It is almost a year since the necessary COVID-19 restrictions became the new Normal but they have left many of us in social isolation and loneliness. We are all craving for social interaction the same way hungry people crave for food.

90 years-old Margaret Keenan, could not have expressed it better the day she became the first person in the world to receive the Pfizer/BioN Tech vaccine in UK on the 8th of December 2020. She received the second dose 21 days later.

She said: “Being the first in the world was the best early birthday present I could wish for. It means I can spend time with my family and friends in the New Year after being on my own for most of the year.”

Social communication is a core psychological need essential to our health and well being. Though we feel lonely and isolated from loved ones , we have to look for ways to adapt and become more resilient during the pandemic. By the look of things, the end of the pandemic is as elusive as the flower of the local Ugandan yam plant and yet life has to go on.

I for one have found the following activities helpful as I tried to increase social contact and engagement during the pandemic.

  • Enhancing social engagement with loved ones and the community. Thanks to Digital technology that has shrunk the world to a global village. I can instantly talk to family members on the phone, send text or audio messages, arrange virtual gatherings on Zoom or WhatsApp. There are many virtual meetings or webinars that I can join to share ideas with like-mined people locally and outside Uganda. Looking through old photo albums awakens the cherished memories I have so far created with family and friends. It helps to reduce my anxiety and stress.
  • Regular physical exercise- I take long walks in the evening and do light weight lifting to tone and keep my muscles strong. It reduces the stress and uplifts my mood while keeping me healthy and strong.
  • Prayer-for any genuine religious person nothing can be as comforting as having an intimate relationship with your Father whom you can talk to about anything and everything. Just like that simple chorus we used to sing in Sunday school donkey’s years ago: Take it to the Lord in prayer.
  • Reading or listening to audio books and music. Books engage our minds and imagination, enrich us , inspire us and increase our empathy and ability to understand others. For some years, I have been a member of Online Book Clubs like the Africa Book Club, Two Drops of Ink and Yours 2-Read. I have also been an

an active member of writing cartels like The Write Practice. It  is very beneficial for an emerging writer to bond with like-minded people.

  • Spending time in Nature- the environment you live in can either increase stress on you or lower it. Pleasing environments like water, trees, plants and animals improve our moods and stimulate our immune functions to work efficiently. Walking outdoors regularly for a minimum of 30 minutes significantly lowers stress, lowers our Blood pressure and increases our heart rates. Studies have shown that exercising outdoors is the best antidote for stress. The beauty of the surroundings, the scents and smells, the sounds like birdsongs, the different people you see, the animals, insects and birds awaken all our six senses of vision, hearing, taste smell, touch and proprioception and we become fully engaged with nature. Gardening offers the greatest benefits in that you are exercising as well as being immersed in nature.

You are never alone with your thoughts. For those who cannot go outdoors , you can bring the outdoors inside by caring for potted plants or pets and if the worst came to the worst then just look through books on gardening and nature.

Nature has been scientifically- proven to delight and heal.

Here are some photographs of nature from my collection.

A lemon orchard near Cape Town, South Africa

Last week, I woke up to find a crop of these tiny button mushrooms in our backyard. I had to invite the neighbours to harvest some for themselves as the culture demands.
The calm ocean calms your soul and invites you for a swim
My mother has been planting this type of pole beans along her fence since she picked the seeds from her late sister in Nairobi in the 1970s. Its beauty is that the more you harvest the pods, the more new ones are produced.

The mixture of old trees and shrubs and young ones in a garden, remind me of the mixed generations in our communities and nation.

The local small sweet bananas have a unique taste. It is etched in my memory
Ancient cities were designed for people and reflect what was important for the people at that moment in time
The barren desert has its unique beauty too.

Just as the earth has the power to renew itself more so after a drought or a bush fire, we too have the ability to rediscover our inner selves after the unprecedented disaster of COVID-19 pandemic and go on with our lives.

QUESTION:

In this unprecedented and prolonged COVID-19 pandemic quarantine, how have you managed to re-invent yourself and bond with like-minded people?

IT NEVER RAINS BUT IT POURS

Stock Image

I could have been ten years old when our neighbours went to the village to celebrate the festive season. They had a big family but among them was a girl, Rhoda. She was of the same age as me and we were friends; playing hide and seek, tap game and skipping together. To our shock and horror, Rhoda died of a snake bite a week later. Our parents had found it terribly difficult to explain to us what dying meant. They chose to spare us the agony of the funeral. I missed Rhoda and her face is forever etched in my mind.

Fast-forward to 2021; we are in the second wave of the COVID-19 pandemic and people are dying in big numbers in many countries of the world.

Yesterday, 10th February 2021, South Africa, the worst hit country in Africa, recorded 3159 new cases and 276 deaths in 24 hours! South Africa has a new strain of COVID -19 which is so quickly transmitted that the million doses of AstraZeneca vaccine that had been ordered for the health workers were put on hold. This is because the in vitro tests done on the approved vaccine had shown a 22% efficacy on the South African variant of COVID-19.

From the official page of the Ministry of Health-Uganda: https://covid-19.gou.go.ug, on the 10th February 2021, Uganda had reported 39,942 cumulative confirmed cases and a total of 328 deaths.

I for one have lost relatives, friends and colleagues here at home and abroad. I even fear to imagine what is next.  A combination of my being a medical doctor for four decades,  a senior citizen and having a wide network of friends is causing a big disruption in my life.

My colleagues are among the health workers on the COVID-19 frontline- they are exposed to the virus and other bacteria as a biological occupational hazard. Alex, a high school classmate, is working in the Rouder Bush VA hospital in Indianapolis, USA. Thankfully, she has not caught the virus but many times she sounds tired and overwhelmed when I talk to her. I pray every day that she continues to protect herself as she offers this vital service to her community.

She is among the exception, many have not been so lucky in South Africa. Yesterday I attended a virtual funeral service followed by a cremation of one member of our graduate class. He had worked as a paediatrician in Durban, South Africa for over 35 years! Many nurses have succumbed to the disease in the line of duty though they are invisible because not many people talk about them.

A senior citizen is by definition anyone aged 65 and above. By this age, many things conspire against us to rob us of good health:

  • Many of us are already on treatment for underlying medical conditions like High Blood Pressure and heart disease, Diabetes and cancer.
  • Our immune function diminishes with each year lived beyond 65.The immune cells known as B and T-lymphocytes, do not work as quickly as they used to.
  • We carry the highest risk of developing cancer in any given population- the immune system is fully developed and functional by the age of eight and will continue to function at its best till the age of 65. Thereafter, the immune function diminishes with advancing age. This explains why cancers and recurrent infections are common in our age group.

These factors combine to make our age group the highest at risk of catching the new virus and going on to develop the severe form of the disease which requires us to be admitted  and carry the highest risk of death.

The cdc.gov website has co-related age with the risk of hospitalization and the

risk of death:

40-49 years of age run a 3 times risk of hospitalization and 10 times the risk of death.

50-64 years of age run a 4 times risk of hospitalization and 30 times high risk for death.

65-74 years of age run a 5 times high risk of hospitalization and 90 times high risk of death.                                                                   

75-84 years of age run an 8 times high risk of hospitalization and a 220 times high risk of death.                                                                   

Senior citizens , we have to brace ourselves for the loss of loved ones; my mother who is close to 90 has just a few peers around. It is the natural progress of life except that the multiple COVID -19 – related deaths at this moment in time are almost throwing us off- balance. It is a huge disruption that has left us living on the edge fearing that any of us can fall off any time. We are living in a state of increased vulnerability but we cannot allow ourselves to be totally defeated by it. We have to take back some form of control.

George Bernard Shaw rightly said: “We don’t stop playing because we are old, we grow old because we stop playing.”

It is mandatory that we take the responsibility of reducing the risk of getting sick- first from COVID and the other common diseases in the environment like Malaria fever which could demand for hospitalization. We have to continue with our regular medical check -ups and regular cancer screening tests.

For COVID-19, we have to continue practicing the proved safety measures laid out by the Ministry of Health.

It is essential that each one of us considers the level of risk before deciding to go out of home.

It is also vital that we keep up to date with available scientifically – proven information about COVID- 19 disease.

We have to stay healthy- a state of complete physical, mental and social well-being not merely the absence of disease of infirmity by:

  • Eating a healthy and balanced diet
  • Living a healthy lifestyle- no smoking, avoid alcohol and drug abuse.
  • Being physically active- regular exercise at least for 30 minutes every day.
  • Regular medical check- ups
  • Adequate sleep- 7-8 hours of sleep to allow the body to repair and restore itself and to allow the immune system to function at its best.
  • Mental well-being- your thoughts and feelings and how you cope with the ups and downs of everyday life. We have to learn how to reduce stress in our lives.

Writing about being in a state of good health is easier than putting it into practice. I have been moving on a rough sea, waves breaking over me and feeling as if drowning due to the many deaths of relatives, friends and colleagues in a short space of time. Many times I have been left feeling helpless since I could neither control or prevent what was going on around me.

I would receive the news of death with a stab of fear and withdrawal into myself. I just stayed where I was; isolated and cut off. The total digital black out from the 12 th January before the general elections of 14 January to the 10th February 2021 forced me to hold things in. I became less motivated to do the most important things in life

 as I became consciously aware of my own mortality. Then I remembered to read through the basic coping skills needed to manage a difficult situation:

  • Do not blame yourself for the deaths.
  • Feeling sad, fear anxiety was a completely normal response to a tragedy.

        Allow yourself to grieve, acknowledge the loss and mourn.

  • Mourn for a season and move on otherwise you lose yourself and the motivation to do important things in your life.
  • Do something positive for yourself and others- toward making a change in your community.

At my  age I have suffered many deaths of loved ones including brothers,  a sister, my father , my husband , nephews and friends but the COVID- related deaths are following one after another. It hardly gives you time to feel the hurt, pain and grief. At the same time, it drains your well of empathy and compassion without giving you enough time to refill it. This could lead to burn out. The COVID-19 guidelines about funerals have introduced new ways of mourning. For our safety, we can no longer gather, cry together or touch one another for comfort. Virtual funerals, cremations and memorial services are the new normal.

 However, one thing stands out to me with absolute clarity: I am yet to fulfill my highest potential in life. This has to continue to direct my life.

Gradually, I am willing myself not to be defeated by the virus, I have to find a lifeline through all these random deaths and events that life is throwing at me. I need to create warmth and love once again.

I can do this by making the most of what I am left with: family, friends and social support systems.

I have to reach out for help from my trusted friends and to pick up my pursuits like Creative writing, gardening and voluntary work in my community. This is what has always kept me alive and fully engaged with life. I am daring to take back some control in my life. I have started feeling safe enough to easily fall asleep and wake up at my usual time despite living on the edge.

Saltos Altos Vermeltos said: “We are all a little broken. But the last time I checked, broken crayons still colour the same.”

And Aldos Huxley said: “ The secret of genius is to carry the spirit of the child into old age, which means never losing your enthusiasm.”

QUESTION: Are you resilient enough to brave the rain and get up for the eighth time?

THE LADY WITH AN INFECTIOUS SMILE

Dr. Sarah Namuli Mukasa Yiga(2nd from the left) with one of her sisters, Margaret Nagawa, myself and Dr. Faith Muwazi, another friend, celebrating Sarah’s sixtieth birthday in Bloemfontein, South Africa.

THE LADY WITH AN INFECTIOUS SMILE.

The COVID-19 disease started in a place that seemed so far away in Wuhan city, China in December 2020 . One year later, it has spread to all the 192 countries of the world, it is in its second wave and is right inside our houses. According to the Johns Hopkins University Coronavirus Resource Centre as of the 26 th January 2021, Uganda had reported 39,261 cases and 318 deaths.

In the last one month, I have lost relatives, colleagues and friends here in Uganda and abroad. I am in a state of emotional turmoil.

Two weeks ago, one of my godsons lost his mother and father  to COVID -19 disease within a space of two weeks! As if that was not enough, I lost one of my best friends to the disease on the 13th January 2021.

Dr.Sarah Namuli Mukasa Yiga had served as a medical doctor in South Africa since 1983. She was two years ahead of me in Gayaza High School. By the time I joined university in July 1972, Sarah was a third year student in the faculty of Medicine of the only University in the country, Makerere . We resided in Africa hall, the second women’s hall in the university.

Among the four first year medical students in that hall, I was the only one from my school but students from our school made up the majority of  female students in the faculty of Medicine.

This provided us a unique small family where we thrived and looked out for each other.

 We had gone through the freshers’ week but when the continuing students joined us, out of Sarah’s big  heart, she effortlessly reached out to my group to help us settle in smoothly.

From the beginning she advised us to dress and behave as doctors, we had to learn to be punctual by being the first group of students to take our breakfast in the cafeteria when doors opened just before 7 :00am. She empasised to us that everything else was secondary to our course work. Sarah and her team gave us tips on how we could stay on top of our work, about dating and about which societies and sports teams we could join so as to make the most out of our stay at the university.

As days went by, they would spare time to quiz us on the topics we had covered, pass on past papers and notes for revision and advised on the extra text books we could buy using our book allowance apart from the standard ones recommended  for each year.

After the quick breakfast, all the medical students would walk through the Katanga slum, a place with temporary shelters teeming with children and their parents. Whether it rained or not, the lectures at the Mulago teaching hospital started at 8:00am on the dot.

We became each other’s keeper and later when the first years came in , we felt that it was our duty to show them the ropes just as Sarah and her team had done for us.

On a normal day, most of us would come back together in time for supper at 7:00pm. We did this for five years and ended up forming strong bonds of friendship for a lifetime.

Sarah and I were quickly drawn together like a duck to water. We were top students, we were voracious readers, we were from close-knit families, we loved beautiful things and were always looking for fun and something to be happy about.

Franz Kafka said: “ Anyone who keeps the ability to see beauty never grows old.”

I was impressed by Sarah’s confidence and her ability to share her feelings and tears freely, allowing her friends to see who she really was deep inside. I was later to learn that she had inherited it from her loving parents.

Sarah was the ninth child in a family of ten while I was the third born in a bigger family. She became the big sister that I never had; guiding, nurturing and caring.

Her family became mine and mine became hers and this is how it has remained.

I used to call her a “work in progress” because she was always doing self-improvement on herself- the product and the packaging!

 Two years later, she graduated and soon after got married to John, a postgraduate student in Surgery.

She had to convert to Catholicism.  I was deeply involved in all the wedding preparations and in a similar manner, she took a central role in my wedding preparations and ceremonies in 1981.

Then we got wrapped up in the raising of our young families and in the progress of our careers.

During the civil strife of the early 80’s , Sarah and her family were forced to flee to South Africa They ended up in the Orange Free State in one of the ten black homelands of Apartheid South Africa.

They left their most precious items like wedding photographs with me

and I had to send them later through their sister in Kenya.

They worked at Moroka hospital , Thaba Nchu until the apartheid system was dismantled in April 1994.

They seized the opportunity of free movement of black people in a multiracial democracy and moved to Bloemfontein city, 70 kilometres away. It remains a white –dominated city up to today.

 My grandmother could have told Sarah and I that dogs had licked our feet when we were babies;  we were both passionate about travel- visiting new places and meeting new people. In 1996 I visited them in Bloemfontein. Sarah drove me to Thaba Nchu to see all her friends and the hospital where they had worked for a decade. Open farm lands owned by Boers.

In her quest to improve herself, she took up a master’s degree course in Family Health Practice. Later, she worked with the Orange Free State University.

In 1994, when my husband and I sought for economic exile in Botswana, our visits to Bloemfontein became more frequent and Sarah’s family visited often. Our children came to know each other well.

The biggest challenge to the two of us was getting the best education for our children. Sarah ended up sending her young daughters to a boarding school in Nairobi , Kenya. Sadly the youngest , almost eleven, died in a freak accident at that school. It was an extremely traumatic experience for the family.

For university, they took their three children to University of CapeTown and mine joined her youngest ones at the same university some years later. By sheer coincidence, none of our six children chose to join our profession. They had the ability and capacity to go into medicine but mine just hated our rigorous and unpredictable schedules of work.

Among the highest moments together were:

  • The graduation and celebration of our children’s achievements. We always celebrated together.
  • Sarah’s surprise 60th Birthday party in Bloemfontein in September 2009. Her husband’s surprise birthday present was her sister and great friend, Margaret, from Uganda!
  • Our pilgrimage to Israel in April 2011- Sarah arranged for me to join a group about 60 people from her Catholic Church in Bloemfontein. I was the only protestant in the group and had I bent to their wishes, I could have converted and been baptised in River Jordan.
  • My daughter’s wedding in Uganda in November 2014- Sarah was in it from the traditional give-away of the bride to the After Party. She delightfully danced the night away.
  • During her ten day’s visit with John to Uganda in the pre-covid-19 days, January 2020. She spent an afternoon and stayed for the night with me and my octogenarian mother. Sarah cared to carry a soft scarf for my mother. We spent the night reminiscing and planning future travels together.
  • Her last birthday of 4th September 2020- I sent her an Audio message mainly thanking her for being a rock solid friend for all those years. I told her that I admired and respected her for her strong faith and spirituality, her love and concern for others- always giving and loving more than she received, her integrity , passion for life and sense of humour. She replied by sending me a photograph of herself seated among her birthday bouquets. She was as colourful as the flowers.
  • Her daily Spiritual nuggets to carry me through the day, which sometimes came in as early as 5:00am! Then later in the day she would send me the funniest clips just for the belly laughs.
  • The unbroken connection between us- She always knew where I was and I knew where she was. When she first felt unwell on the 20th December while the two of them were visiting Helen , their eldest daughter, in Johannesburg, she text me and informed me that she was going for the COVID-19 test. She text me soon after receiving the results and when she was admitted to hospital, two days later. I had even suggested that her phone should have been confiscated from her to allow her to rest- easier said than done. The last message I received from her was on the 7th January which was followed by that most dreaded call on the 13th January 2021!

What made Sarah’s death most painful is having to grieve alone due to the COVID-19 restrictions. I felt safe not to tell mother; she knows Sarah as one of my best friends. I could not be near John and our children in their greatest time of need. Due to the Internet blackout during the general election in Uganda, I was among the few who listened in to the funeral service of the 16th January in Bloemfontein. I had to be connected through a niece’s phone in Nairobi, Kenya!

I have picked a few lessons from this huge loss: Life is the greatest gift that comes with each dawn and should therefore be celebrated and lived fully every day. I am only here for a while and I should consistently learn to love with no regrets- telling your loved ones every day how much you love and care for them and then strive to give of your best.

Last but not least, let each one of us go through the day knowing that COVID-19 disease is real, it has changed our lives forever. It is my responsibility to protect myself and others by masking up, hand- sanitizing often, physical distancing and keeping abreast with new information that becomes available from the Ministry of Health. While we await the new vaccine, let us stay at home and ensure that we stay safe and healthy.

Sarah Namuli, the amazing African multitasking woman, the unique human being, you touched and enriched our lives abundantly. You will live on in your children, in our hearts and in the treasure trove of memories that we created together.

May God Rest Her Soul in Eternal Peace.

ENJOY YOUR RIGHT TO VOTE FREELY

VOTE FOR YOUR OWN GOOD AND THE GOOD OF OTHERS.

Gifford Pinchot said: “It is a greater thing to be a good citizen than to be a good republican or a good democrat.”

  From the worldometers.info website, Uganda has a population of 46.486 532 million people and 50.8% of these are women.78% of the population are under the age of 30, making us the country with the youngest population in the world.

I first voted in 1980 when I was almost thirty years old. By then our population was 12.548 million with a median age of 16.4. 126 parliamentary seats were contested , there were 4.898, 117 registered voters and a voter turn out of 85.2% .

Forty years later, the population has grown to 46.486 532 with a median age of 16.7

 A hotly contested general election is due next Thursday, 14th January 2021.The Electoral Commission website shows that there are 17. 658 527 million registered voters of whom 77 % are under the age of 25. This is the group that will determine our country’s future in a free and fair election.

There are 353 constituencies seats and one women representative seat from each of the the 146 districts of Uganda.

The pre-independence elections were held early 1962, followed by Independence on the 9th October 1962. Then from May 1966, the country was embroiled in years of civil strife until April 1979 when soldiers of the Tanzanian Defence Forces assisted some Ugandan exiles to overthrow Idi Amin Dada’s military dictatorship.

The ruling military commission organized the December 1980 general elections that saw Milton Obote return to power for the second time. The elections were rigged and led to the protracted bush war in the Luwero triangle in central Buganda for five years. It ended on January 26th January 1986 when the then rebel leader , Yoweri Kaguta Museveni was sworn in as the 8th President of Uganda.

I have been in economic exile for almost 25 years so forty years after I cast my first vote, I shall be voting for the second time!

For those under 30, you could be taking the right to vote freely for granted and yet some men and women fought for this right. For the women in particular, you owe your vote to the progressive Women’s rights pioneers- they campaigned, lobbied the governments of the day, held demonstrations and protests to win the Women’s suffrage- the right of women to vote in elections. This opened up the women’s entry in the public arena.

After centuries of socialization that the women‘s role in society was motherhood and home- making while the men provided and protected them, it was a long and serious struggle. Almost all our traditional African societies believed that a woman had to first be protected and cared for by her father who then passed her on to a husband and if the husband died, her eldest son would take on the responsibility for her. By all intents and purposes, the woman was considered a minor.

It is therefore not surprising that even in Greece, the foundation of Western Civilisation democracy, the women had no voice in the democracy or governance of their country.

These women rights pioneers were fighting for the equality of the sexes in law and reality-to get half the country’s sidelined population into the democratic functioning of society. Their biggest obstacle was that feasible social changes were to be passed by men in an all-men parliament.

They struggled doggedly and recruited men on their side by proving to them that improving the position of women in society would also raise the quality of life for the average family and the nation as a whole. They believed that the problems of women were not theirs alone but they were problems for the societies they lived in.

The best example is Switzerland, it was the last country in Europe to give women the right to vote in 1984 after three referendums of 1968, 1971 and 1973!

The following list gives you an idea about the protracted struggle.

New Zealand –  full suffrage in 1893

Denmark – 1915

Russia – 1917

Britain- 1918

USA – 1919

Netherlands- 1919

Italy- 1925

South Africa- white women only – 1930

Philippines – 1937: the first in Asia.

Greece- 1930 but in reality in 1944.

Israel – since the establishment of the state of Israel in 1948.Little wonder then it had its first woman Prime Minister, Golda Meir in 1969.

India – full suffrage 1947

Ethiopia – 1955

Tanganyika – 1958

Nigeria – 1959

Rwanda- 1961

Kenya- 1963

Zimbambwe – 1978

South Africa- full suffrage in 1994.

Saudi Arabia – December 2015.  In 1957,women were banned from driving cars  and the right was restored after intensive campaigns and lobbying in September 2017!

Uganda as a British territory had its first woman member of the Legislative Council, Mrs. Florence Alice Lubega as early as 1957 and between 1958 and 1960 she was followed by a number of educated women like Pumla Kisosonkole, Joyce Mpanga, Sarah Ntiro, Frances Akello and Eseza Makumbi. At the time of Independence Florence Lubega, Sugra Visram Namubiru and Barbara Saben were members of Parliament.

As more women were empowered by good education – to university level, the number of female members of parliament increased.

The numbers surged after the United Nations End of the Women Decade Conference held in July 1985 in Nairobi, Kenya. The then Uganda government of Milton Obote- 2 sent a big delegation of Non Government Organisation and government officials for the three weeks conference. By the time they returned to Uganda the government had been overthrown but the members of the NGO forum went on to found ACFODE- Action for Development and the medical doctors among them founded the Women Doctors Association. They also fanned the activities of FIDA- UGANDA, the Uganda chapter of the International Women lawyers which had been founded in 1974 and other local organizations promoting women’s rights.

Later, in January 1986, when the new government headed by Yoweri  Kaguta Museveni was sworn in , these energetic members lobbied his government for a Ministry of Women in Development to be headed by a woman, mainly to develop social mechanisms to promote Equality and put it into practice. Over time it has grown and evolved into the Ministry of Gender Labour and social Development.

Creating the position of a Parliamentary representative of women from each district of Uganda was one of these social mechanisms and still stands today. Empowering women through education combined with these social mechanisms have changed the social position of women in Uganda forever. We never forget that the struggle for a better quality of life can only be fought by men and women together.

“In the face of impossible odds, people who love this country can change it.”– Barack Obama

 I was happy to see one female, forty years old Nancy Alice Kalembe , a mother of two, among the eleven Presidential candidates . She may be invisible among that crowd of men but she is a beacon of hope for the young generation of women and validates the efforts of those women who have waged the ceaseless battle to get the woman in the political arena.

“ No one is born a good citizen; no nation is born a democracy.  Rather, both are processes that continue to evolve over a lifetime. Young people must be included from birth. A society that cuts off from its youth severes its lifeline.”– Citizenship quote

Knowing and understanding clearly where the women are coming from, I will go out with enthusiasm and optimism to vote on Thursday 14th January 2021 and later be part of the selection of Local Authority officials. I am busy encouraging others to do the same. Politics determines our every day needs- healthcare, transport, quality of education and our livelihood, I cannot take democracy for granted, I have to play my role as a responsible citizen.

Gellhorn said: “Citizen is a tough occupation which obliges the citizen to make his own informed opinion and stand by it.

The wisest among us learn from others: the highly contested US election of 2000 between George Bush Jr. and Al Gore taught the Americans and all members of the Global Village that every vote counts.

It is extremely unfortunate that the general election will be taking place during the second wave of the COVID-19 pandemic- the new cases are surging and the deaths are increasing and yet we have to vote.

The best option is to strictly adhere to the Ministry of health safety guidelines and ensure that you are not in harm’s way as you fulfill one of your fundamental rights of citizenship.

Whom I vote for is my own business but I would want to vote for a leader with vision, integrity, accountability,humility to serve others, focused and inclusive and a strategic planner. He has to be someone who will inspire us to do things we never thought we could do.

“ Anyone who refuses to make a choice has already made a wrong choice by allowing his life for chance to rule.”- Myles Munroe

“ There can be no daily democracy without daily citizenship.” – Nader

QUESTION: Are you ready to be a good and responsible citizen by exercising your right to vote freely on the 14th January 2021?

SOME QUOTES AND PROVERBS TO ENCOURAGE AND INSPIRE US AS WE ENTER 2021

Three days to go to the end of the toughest and an unprecedented year in our lives!

Normally, a new year is celebrated with enthusiasm, hope and optimism. It give us the opportunity to reflect, look back, take stock, asses how we fared and resolve to do better. 2021 comes at a time when we are going through the second wave of the spread of the COVID-19 disease in our communities worldwide.

From what we know about such pandemics, the second wave tends to cause more deaths the first one.

 Of the 50 million people estimated to have died during the 1918-1919 Spanish Flue pandemic the majority died during the period of the second wave. As I write this, Britain and South Africa and Nigeria have reported a new strain of the virus which tends to spread faster than the original one. By the 29th December , UK  had reported 53,135 new coronavirus cases in one day!

 The health care workers and the health care system is overwhelmed by the number of patients.

From the Johns Hopkins Coronavirus Resource Centre, the total cases reported from 191 countries were 82,051,958 and total deaths of 1,792,251

As by 29th December, Uganda had reported 34,281 confirmed cases and 250 deaths.

Yesterday, two senior consultant doctors died of COVID-19 disease and many are reported to battling it in hospitals. In the last three weeks, I have lost relatives and friends to the disease and I know many who are down with it. One young medical doctor lost a mother, a paternal aunt and a father to COVID-19 in the space of two weeks! These happen to be the few known to me or who make it to the Media. Thankfully, a number of health workers and individuals who have recovered from the disease have come out to share their experiences- to alert us that COVID-19 is real and is a physiological and psychological torment.

 Our weak health care system is already weighed down by the big number of patients and it is no longer possible to trace contacts. Due to the cost of COVID-19 diagnostic tests, my country cannot afford Mass testing. A relative who had symptoms similar to those of COVID-19 disease, had to pay an equivalent of almost 100 USD to have the test done at a private hospital. She is among the privileged few who can afford it. She could not hide her relief and triumph when the test turned out to be negative.

As if that is not enough, a general election is due in 16 days time and what are labelled as “scientific” campaigns are in full swing.  The election-related violence going in our midst alongside the second wave of the pandemic can only be compared to the lethal mix of the hot volcanic ash from a volcanic

 eruption and the heavy rains that usually follow it and cause floods and landslides!

All in all, the major priority for each individual is to stay alive by staying home.

This will not go well for the 70% of our people in the informal sector who depend on a daily income – trading and providing services like welding, car repair.

It is a precarious  balance of lives against livelihood but then one has to be first healthy to go out and work to support himself and her/his family.

The Baganda have a proverb that says: Bwekataligyirya eribika amaggi.

Loosely translated it means that:  If the black-winged kite                                                             

does not prey on the  chick, the chick will grow into a hen and lay eggs.

Desperate times like these, demand that each one stops and recognises the significance of the moment.

Anything else can wait. I have decided to put myself into strict lockdown for the next three weeks and I am busy recruiting many others to this approach.

As  Dr. Tedros Adhanom Ghebreyesus, the Director –General of World Health Organisation,

Twitted from his UN Geneva office last November : “ We’re asking everyone to treat  the decisions about where they go, what they do, who they meet, as life-and –death decisions – because they are.’’

These days I find myself sleeping curled up in bed and it just reminded me of the patients I used to see in the mental hospital. Feeling overwhelmed and powerless, they would lie in the foetal position in bed- just like a growing baby lies all curled up in its mother’s womb. This position minimizes injury to the neck and chest of the baby. The uncertainty and the whirlwind change caused by the COVID-19 disease in all areas of my life, is forcing me to assume this position during sleep and I guess that I am not the only one doing this. It is a natural response to a hostile environment.

We are all in this together and have to work together to go right through it. I have collected some quotes and proverbs to encourage you, support you and inspire you as we enter a new year.

 By the look of things, it is going to be a long wait for things to return to a new normal.

  1. In times of pain, when the future is too terrifying to contemplate and the past too painful remember, I have learned to pay attention to the present.”- Julia Cameron
  2. Sadness flies away on the wings of time.” Jena de la Fontaine.
  3. Tough times never last, but tough people do.”- Robert.H. Schuller
  4. You are unique and amazing having been shaped by what life has thrown at you.”- Jane Nannono
  5. “In all things it is better to hope than to despair.”- Johann Wolfgang Goethe
  6. Hope is the last thing ever lost. – Italian Proverb
  7. Hope is the anchor of the soul, the stimulus to action and the incentive to achievement.”– Author Unknown
  8. He who loses hope may part with anything.”- William Congrene
  9. When there is no hope, there can be no endeavour.”- Samuel Johasen
  10. To live without hope is to cease to live.” – Fyodor Dostoevsky
  11. “Hope never abandons you; you abandon it.”- Gieng Weinberg
  12. When our hopes break, let our patience hold.” – Thomas Fuller
  13. Hope is faith holding out its hand in the dark.- George Iles

Some African Proverbs:

Hope does not disappear.

Rain does not fall on one roof alone.

When I think of other’s misfortune, I forget mine.

Lack of knowledge is darker than the night.

One must talk little and listen much.

Every misfortune has a hidden gem inside it.

If it were not for hope, the heart would break. – Greek Proverb

While there is life, there is hope. – Traditional Proverb

Only death itself can end our hope. – Arabian Proverb

Hope is the physician of each misery. – Irish Proverb

As long as you are alive, life never stops. You have to surrender your life to a higher power and learn to  dance comfortably with death every day as you go about your day-to-day activities. It is born out of a place of inner harmony.

Struggles and challenges in life make life interesting and worthwhile and help us to build the resilience and wisdom we need to handle similar challenges and bigger challenges in future. It is never lost on me that life will continue beyond me. Beyond all of us.

QUESTION:

Have the COVID-19 pandemic lockdown and restrictions in movement and association left you feeling lonely and abandoned?

What efforts have you made to adapt to the forced changes and to stay fully engaged with life, with your loved ones and members of your community?

May 2021 be a year of Restoration to you all.

A YEAR LIKE NO OTHER

YEAR 2020

Seven days to go to the celebration of Christmas to be followed a week later by the New year,2021.

The Christmas carols being played on the radio and in the streets have never sounded so distant!

This has never happened to me before even during the most difficult Christmas of 1985 when Kampala was swarmed with army men while the Peace talks –later referred to as “peace jokes” were going on in Nairobi , Kenya. They were between the Ugandan government of the day headed by Tito Okello and the National Resistance Army (NRA), a rebel group led by Yoweri Museveni.

My husband and our two young children made arrangements for celebrating Christmas at home joined by my young sister, Gladys who arrived from London on Christmas eve.

 Feelings of uncertainty, anxiety, fear, disbelief and confusion have weighed on all of us since 11 th March 2020 when the World Health Organisation declared COVID-19 Respiratory disease a global pandemic. This new virus has since proved to be the biggest threat to our lives and has changed all the rules about everything- how we do things, how we move, how we socialize.

It is more scary now that like most countries in the world, Uganda is experiencing the second wave of the spread of the virus in its communities. The disease that sounded so far away in Wuhan , China , in December 2019, is right here in our midst.

In the last two weeks, I have lost some relatives, friends, colleagues and the numbers continue to increase. Many others are fighting it in self- isolation at home . Kampala and its suburbs are the epicenter of the disease. Under such a situation the best thing to do is to stay at home while practicing the standard health guidelines to the letter and taking efforts to boost your body’s immunity.

 No wonder the Christmas carols sound that distant!

But then life never stops so we just have to find a way of moving forward with the new virus in our midst. Probably the launching of the mass vaccine campaigns in some countries like  Britain, USA, Canada and Russia may give us some sense of renewed hope but then I happen to live in one of the least developed countries of the world and may have to wait patiently for some months to receive the vaccine doses.

From March 21 st to date, our movements have been restricted in our attempt to slow down the spread of the disease in our communities. Failing to do this, our health care workers will be overstretched and our weak health care institutions will be overwhelmed. As the disease progresses in all countries of the world, a healthy crisis has turned into an economic one. No country was prepared for these crises.

Life is essentially about learning and each experience I encounter has a lesson in it which I have to pick and learn from it , grow and become a better human being.

Most psychologists agree on the five basic approaches to handling a crisis in one’s life.

  1. Live One day at a Time- when you feel uncertain about your future, the best way to remain functional and keep going forward is to take one step focusing on the next one.
  2. Reduce the stress to make you feel in control- You do this by dealing with what is most important in your life at that moment in time. Our major priority now is to stay safe and healthy.
  3. Communicate your needs to loved ones and friends- talk, share and be open about your concerns.
  4. Reach out and Ask for Help- no one has ever handled a crisis successfully alone. Two heads are better than one. You can get help from family and friends but if you feel overwhelmed, do not hesitate to ask for professional help.
  5. Get Proper sleep- the future looks uncertain, you have suffered losses- loss of loved ones or even lost a job. You need to rest a minimum of 7-8 hours of sleep regularly at night to restore your physical, mental and emotional well- being. It is the only way you can  make decisions, to take good care of yourself and loved ones and to adapt to new changes- becoming more creative and innovative.

One of my favourite quotes says: “It is not the most intellectual of the species that survives; but the species that survives is the one that that is able best to adapt and adjust to the changing environment in which it finds itself.” – Charles Darwin.

In life, no experience is ever wasted. The COVID-19 pandemic and its restrictions on my life has had unintended good consequence on me.

Having too much time to myself has allowed me to reflect on my whole life and forced me to make some adjustments. I have had to develop:

An attitude of Gratitude- I have stopped takings things for granted. I recognise that the most important gift to me is waking up strong and mobile.

 Real Connectedness – Despite the changes and losses, I am grateful that I am in constant communication with my children, my sibling and friends and I am having some quality time with my mother. I am grateful that I have been able to maintain and gain new friendships in the pandemic.

I have regularly been sharing what I know including scientifically proven information about COVID-19 disease to help people understand the disease and persuade them to become part of the SOLUTION other than the confusion.

Creating an adventure in my home- The kid inside me has been woken up- to be spontaneously  creative and innovative.

Combining the innocence and spontaneity of childhood with the maturity, skill and wisdom of my age, I have been able to write several short stories that have been published Online platforms like: Stories to Connect us on commonwealthwriters.org, Yours 2Read based in London and Kalahari Review Literary Magazine.

In October, I attended the Femrite’s  week of Literary activities on Zoom and several medical virtual meetings. I have also participated in Bloggers challenges in Uganda and USA. It has kept me fully alive, useful and relevant in this COVID crisis. I have learned the technique of living and working with style and grace, making me contribute to the greater good in an effective way.

I have also been able to polish up two manuscripts that I wrote some years back.

My passion for gardening and reading has been at its best. Doing what I love and enjoy keeps me fully engaged with life.

Taking good care of myself and others- the majority of adults have to fulfill this responsibility. I have to be strong physically, mentally, emotionally and spiritually to take care of others in a weaker state.

 As 2020 draws to its end, I am grateful that I still have the great desire to stay engaged in life- to stay active and grow mentally and spiritually. I have the opportunity to plan for 2021 and set out a few clear and inspiring goals to light my way. I have to create possibilities for 2021 and beyond.

After a tough 2020, which left the majority of us tired, feeling wrung out, stressed and unsure about what the future might bring, the greatest virtue that I now need is hope in capital letters.

The online Oxford dictionary defines hope as: a feeling of expectation and desire for a particular thing to happen.

I need a deep well of hope to expect something good with confidence in 2021 and beyond.

As a devout Christian, I trust God the Father and the Restorer , will in his own way gradually restore all of us.

Why I feel that I badly need hope:

  • Without hope, I cannot think of a future beyond where I am.
  • Hope is critical if I am to reclaim my enthusiasm for life- armed with hope, I can anticipate the outcome with excitement. It stirs me up to open my mind and heart for new possibilities. Once again I will trust myself and others to learn from them.
  • If I keep losing hope in the future, I shall sink in despair and a final state of powerlessness and become dysfunctional.
  • With hope I can lift my eyes to the horizon and truly believe that nothing lasts forever. Change always occurs. Some patience, discipline and responsibility to myself will keep me functioning.
  • I can easily accept 2020 as an incredibly challenging year and understand that it is only one year in my long life- not to allow it to define me. Once I understand this with absolute clarity, then I can find the wings to fly high in 2021 and beyond.

Alexandre Dumas said:  “All human wisdom is summed up in two words; wait and hope.”

The most uplifting words that I have heard during this pandemic so far were from the close to 91 years of age Margaret Keenan of UK who was the first person in the world to receive the approved Pfizer/BioNTech COVID-19 vaccine on the 8th December 2020.

“It’s the best birthday present I could wish for because it means that I can fully look forward to spending time with my family and friends in the new year after being on my own for most of the year.”

Herein lies our hope for the future; protecting the people against the disease, reopening economies and gradually returning to a New Normal.

My best present for this year will be making it to the end of the year and being given the opportunity to display a great generosity of mind and soul in 2021 and beyond.

QUESTION:

 Among your traditional rituals for the festive season, which one will you be missing most  this year? Why?

Thank you all readers and followers for walking with me through this unprecedented year.

Wishing you a Merry Christmas and New Year filled with new possibilities.

 Please take the personal choice to stay safe and healthy.

I WILL GLADLY QUEUE UP FOR THE NEW COVID-19 VACCINE

Immunisation is a priority in the control of Vaccine- preventable diseases.

For my fourteen years of formal education, I attended one school and left it to join the only university in my country at that time. By sheer coincidence, Gayaza High School, the oldest  girls boarding school in Uganda, founded by the Church Missionary Society of Britain in 1905, happened to be located within the “defined area” of the Makerere University , Kasangati Public health centre. This centre served as a clinical base where medicals students and post graduates were educated and trained in preventive medicine. At the same time it offered improved quality care to the community. It offered free prompt treatment of diseases, illnesses and injury, rehabilitation, prevention of diseases, improved community’s health and involved the community in the management of its health.

At the beginning of each term and at the end, all students were weighed, their heights recorded, had medical examinations, were dewormed and immunized against the immunisable diseases of that time like tuberculosis, tetanus, polio, measles, small pox, following the international schedules. Low weight students were put on a special diet and followed up.

I for one loathed the injection- prick pain but I had no way out. I was always among the last ones to get it.

When later in the fourth year in medical school, I spent three months training at this centre, I greatly appreciated its role in keeping us healthy during our childhood and I accepted whole heartedly that Immunisation was part of Primary prevention of disease in healthy people.

Fast Forward to 2020: the new coronavirus, COVID-19, continues to dominate all areas of our lives and stands as the greatest threat to global public health of the century. We are now into the second wave of the COVID-19 pandemic as it spreads into our communities

 From the Johns Hopkins University COVID-19 Resource Centre, as of the 9th December 2020,Uganda had reported a total of 25,059 and 219 deaths. Due to our limited resources, Mass testing is not yet available. USA had recorded the highest total : 15,392,196 and 289,450 confirmed deaths!

Like the second wave of the Spanish flue pandemic of 1918-1919 which killed 50 million people in total worldwide, the second wave of COVID-19 disease pandemic is killing more people than the first one.

We have the advantage of advanced science knowledge and technology to add another vital tool to the Public health measures of:

1. Washing your hands with soap and water regularly and properly.

2. Wearing a face mask properly in all public places or around people who do not live in your household.

3. Physical distancing – at least two metres between yourself and other people.

4. Being well informed about the disease.

In our fierce fight against this life threatening enemy which has no specific cure, some remarkable achievements have been made. By the 9th November 2020, collaborative studies and research by scientists and Pharmaceutical companies had born fruits

Currently, about 200 potential vaccines are in various stages of development. Public health specialist have assured us that it requires at least 60% of the world’s population of 7.8 billion people to have to have been vaccinated with a safe and effective vaccine to stem the tide of the pandemic.

The more  safe and effective vaccines developed and approved, the easier the production and distribution globally.

Talking to the people around me, their major concern is the safety of the vaccines since they have been developed rather fast- March 2020 to November 2020. Traditionally development of such a vaccine would tale 5-10 years.

They also want to know how long the protection of the 2-dose vaccine lasts and whether the vaccine directly affects the transmission of the virus from one individual to another. For the last two question to be answered it requires the follow up of those who received it, for a long period.

As for the safety and effectiveness of the vaccine, all scientists and researchers wherever they are have a role to play in reassuring the public so that they can accept the vaccine when it becomes available to them.

The day I graduated, all medical graduands had to swear to the Hippocratic oath-one of the oldest binding document traced back to  Hippocrates, the so-called father of Medicine who lived in the 5th century BC.  We swore to uphold the principles enshrined it. They included saving of lives and to share the scientific gains of those physicians in whose steps I walk and the knowledge that I would acquire acquire in the practice of Medicine.

I have always honoured these principles but as of now, I feel I have to do it with a lot of vigour and responsibility. I have read a lot about the COVID-19 respiratory disease and continue to do so to get a better understanding of the disease and help people to gain a solid understanding of the underlying science and how the disease affects our daily lives.

In this Digital era of free available information that can be shared instantly,  one has to be helped on how to filter it and get the right message – to make the right informed medical decisions and apply them to improve the quality of one’s life. Our beliefs and values play an important role in the decisions we make every day and we tend to pick what affirms our beliefs.

But having the right science knowledge about current health matters like COVID-19 respiratory disease, helps us to recognise our role in the prevention and control of the pandemic and to engage deeply in the ongoing conversations in our communities and nationally.

As of now, the COVID-19 pandemic is the most important science –based issue of our day and as a health worker I have to acquaint myself with the available knowledge about the pandemic and help the ordinary people understand it. We all know that when we get the necessary knowledge we understand the problem or issue at hand and willingly become part of the solution other than create more uncertainty.

Simplified scientific knowledge given to the public enables them to have a legitimate voice in the conversation about the matter. In the midst of fake news and the spread of misinformation, we have to remember that science is reproducible , evidence-based information that is factual not opinion intended to help the public know and understand scientific concepts and processes.

Drugs and vaccines have benefits and risks to the user but doctors generally use them when the benefits outweigh the risks .

I have summarized a few facts for you to help you understand why you and I need the COVID-19 vaccine.

  1. The COVID-19 vaccine has been developed rather fast: March 2020 to November 2020.

    Yes, this is true  and is record time in the history of the development of vaccines. It has been made possible by the available advanced science and technology.

In 2003, there was an epidemic of  Severe Acute Respiratory Syndrome-SARS. It was caused by a coronavirus SARS-CoV but researchers , doctors, funders and pharmaceutical companies got to work to develop a vaccine against this virus.

The current COVID-19 virus is a new strain of the family of the Coronaviruses to which SARS belongs. Since they are related, the previous work done in the development of the 2003 SARS-CoV vaccine facilitated the work on COVID-19 coronavirus potential vaccine. They did not have to start from scratch once they had identified COVID-19 as a new strain of an already existing family of viruses.

2 .The results of the studies have had to be scrutinised by the experts in Vaccine development to ensure that the highest standards of research were followed. They assessed the quality, validity and originality of the research work carried out. They have to determine the contribution of the research studies to the advancement in the field of vaccine development. Errors and mistakes must have been pointed out to the researchers for redress.

3. Developing a safe, effective vaccine against COVID-19 coronavirus has been the most pressing challenge of our time but the researchers , doctors and pharmaceutical companies have reassured us that they have not cut corners or made short cuts.

4. None of these new vaccines use real viral material therefore they are not likely to cause any significant side effects. All those involved are aware of what any compromise on the safety and effectiveness of the vaccine can cause to the population and the backlash on their companies or universities. Trust takes years to develop but can be lost in the blink of an eye.

5. As the vaccines are being launched and rolled out, all those receiving them are being followed up for any development of side effects like allergic reactions. Mass testing continues as well as the monitoring of the use of vaccines for at least a year.

6. At the onset , none of us had any immunity to this new virus- enabling it to spread rapidly in all our communities. For the pandemic to be controlled, 70 to 90 % of any given population in any country has to develop Herd Immunity– through having suffered from the infectious disease or having developed the immunity by being vaccinated against COVID-19 disease. To allow the biggest number of the population to suffer from the disease will overwhelm the health workers and the health care systems and cause many deaths especially in the high-risk part of the population.

The best way for the biggest part of the population to acquire immunity to the infection is to simultaneously reduce the spread of the infection in the population by using the Public health measures drawn up by the Ministry of health while rolling out wide vaccination of the frontline health workers and the population at the highest risk of developing the severe form of the infection. This was the same approach used to control Vaccine- preventable Childhood diseases  like Tuberculosis, tetanus , the highly contagious measles, rubella, chickenpox and polio in our populations. The quick development of a safe and effective COVID-19 vaccine and its wide use globally, will make this possible.

7. We in the developing world, have a big concern about the distribution and actual access to this new vaccine. Traditionally, those who could pay got the vaccines first. However, it is comforting to know that organizations like COVAX are covering our backs. COVAX aims at ensuring fair equitable access to an effective vaccine for all countries- a global collaboration to accelerate the development, production and equitable access to COVID-19 tests, treatment and vaccines. World health Organisation is part of this group.

8. Pandemics- in the past a pandemic like the Spanish flue were a once- in- a century event but in this 21st century, pandemics are becoming more frequent and more challenging to manage.

Viruses like HIV, Ebola, SARS-CoV and COVID-19 live in wild animals like monkeys and bats as their natural hosts but as huge forests are being cleared for timber, farming and new settlements, the animals’ natural habitat is being reduced. Wild animals have been forced to move and live close to human beings. This makes it easy for the viruses to move from these animals and jump into human beings thus causing diseases like Ebola, SARS and Covid-19.

EXCITING NEW DEVELOPMENTS.

  On the 5th December 2020, Russia launched its  COVID-19 vaccine programme in Moscow, the epicenter of the pandemic in Russia.  Over 5000 people in the high risk groups were vaccinated in 70 clinics within Moscow. The Russian coronavirus vaccine, Sputnik V was registered in August, is claimed to be 95% effective.

Russia had reported  2,541,199  confirmed cases and 44,718 deaths by 9th December 2020.

  The video clip of 90 years-old Margaret Keenan receiving the first injection of the Pfizer Covid-19 vaccine on the 8th December 6:31 am at Coventery as the  National Health System launched its mass vaccination programme, the largest in the NHS’ 73 –year history gave us renewed hope. The programme is being rolled out at 70 hospitals around UK.

UK has so far reported 1,771,552 confirmed cases and 62,663 deaths.

Uganda has applied to have the approved COVID-19 vaccine available in the country by January 2021 mainly for the Frontline health workers and highest –at –risk part of the population

I will be among the first ones in the queue and will mobilize many to join as a way of thanking all those researchers, doctors, funders and pharmaceutical companies that have worked together to get us this far in such a short time. Gradually, we can end the pandemic and then rebuild our lives and economies.

As a health worker in a developing country who has been involved in the struggles to control Tuberculosis, Neonatal Tetanus, Measles and polio, I consider this a remarkable achievement.

 However, I am still waiting for a safe and effective vaccine for Malaria which remains the number one killer disease in children under five in my country.

QUESTION:

Has this post helped you to understand why we need the COVID-19 Vaccine?

Will you willingly take it if you happen to be among the high-risk group of the population?

.

RAINBOWS OF HOPE

Photo by Jared Erondu :Unsplash.com

COVID-19 acute respiratory disease has been with us since December 2019 and has caused many deaths and morbidity all over the world. It started off as a health crisis that turned into an economic crisis as well as governments tried through Lockdowns to control the spread of the disease and save lives. It has evaded all aspects of our lives: how we do things, how we connect with one another, how we work and travel. We have been forced to create a new Normal as the virus overwhelms us.

As of the 24 th November 2020, according to the Johns Hopkins University Corona Virus Resource Centre , the global confirmed cases were 59,814,726 and the deaths were 1,410,190

USA is the most affected country in the world. It has:

   12,597,330 Confirmed cases  and 259, 962 Deaths.

Followed by India with : 9,222,216 Confirmed cases and 134, 689 Deaths.

 My country, Uganda, has reported : 18,406 Confirmed cases and 186 Deaths.

My second country,Botswana, has reported 9,992 Confirmed cases  and 31 Deaths.

 Since late October, Europe has been going through a second wave of the pandemic that forced countries like Britain, France and Portugal to shut down – a second Lockdown till early December.

Currently, we are focusing on the tried and tested public health procedures to control the spread of the disease.

1. Washing your hands with soap and water regularly and properly

2. Wearing a face mask properly in all public places or around people who do not live in your household.

3. Physical distancing – at least two metres between yourself and other people.

4. Being well informed about the disease.

Returning close to Nomalcy requires us to combine these four with the availability and access to a safe, effective and affordable vaccine against the COVID-19 coronavirus.

While the virus is raging havoc, researchers, funders and volunteers are getting together to develop a safe and effective and affordable vaccine. It is a race against time that started in March 2020.

Much as a vaccine is required urgently, it has to be developed following the rigorous Scientific testing of its potency, safety and purity because a vaccine is given to healthy people to prevent them from getting sick.

Safety is the priority. This is how it has been since the world’s first vaccine was developed by Edward Jenner, the English physician and scientist, in 1796. He used a relatively mild cowpox virus to immunize people against the deadly smallpox virus. Almost 200 years later, smallpox disease became the first disease to be eradicated from the world solely through vaccination in May 1980!

The standard model/process for developing a safe effective vaccine goes through 5 rigorous stages and requires huge investment from both the public and private sectors.

From the Wellcom.org website the process is made up of these stages:

  1. Discovery research- it is done in the laboratory to find ways of inducing an immune response at a molecular level. This stage normally takes 2-5 years.
  2. The Pre-clinical stage- the product is tested in animals to assess its safety and suitability as a potential vaccine for humans. It takes 2 years.
  3. Clinical development- the potential vaccine has to be tested in humans in three phases.

Phase 1– for any vaccine in development, its safety for use in humans is the priority. The potential vaccine is tested on small numbers of volunteers. It takes 2 years and requires 10-50 people.

Phase 2– this stage focuses on understanding the immune response induced by the vaccine in humans. It requires hundreds of healthy volunteers of the same age, gender and other laid down criteria to match the population segment for which the potential vaccine is being developed for. It takes 2-3 years.

Phase 3- To asses if the potential vaccine protects against that particular disease. Does it prevent the disease or does it prevent the development of the full-blown infection? How many doses are necessary to induce the appropriate Immune response?  How long does the induced immunity last?

This phase takes 5-10 years and requires thousands of eligible healthy volunteers to take part in the trial.

4.Regulatory review and approval- the researchers have to submit the data and information gathered through the trials to the regulators to gain approval for the potential vaccine. This stage can take 2 years. Once the potential vaccine passes this stage it is considered as a vaccine candidate now ready for licensing with drug and vaccine authority like the Food and Drug Administration of USA or the National Drug Authority of Uganda.

5. Manufacturing and delivery- the developed vaccine is manufactured at selected specialist facilities which are highly regulated and monitored.

Following this model for development of a traditional vaccine could take more than ten years and costs huge amounts of money.

As the COVID-19 virus continues to cause havoc worldwide , there is an urgent need to develop a safe, effective and affordable vaccine to prevent its quick spread and reduce the severity of the disease so that health care systems and the frontline workers do not get overwhelmed by it. The earlier we return to normalcy , the quicker our economies would recover from the  dire economic hardships induced by COVID-19 virus.

Thanks to the new technology innovations like Genome Sequencing- determining the complete arrangement/pattern of the germs’ genetic material- DNA at a single time.

These innovations can be safely used to develop the safe effective vaccine quickly: cutting the ten years to less than a year without compromising the safety, purity and potency of the new vaccine.

When the whole world seemed to be losing control over COVID-19 disease, the collaborative efforts of researchers, funders and volunteers started bearing some fruits.

Rainbows have started appearing in the sky giving us renewed hope.

They say ,“ Life is like a rainbow. You need both the sun and the rain to make its colours appear.”

The unprecedented COVID-19 crisis has demanded that scientists, medical doctors, funders and ordinary people form collective and collaborative partnerships to fight the pandemic.

9th November 2020- the New York –based drug company Pfizer and Biontech released the interim results of their phase 3 clinical trial. Their 2-dose vaccine was tested in over 43,000 enrolled volunteers. It was well tolerated and its efficacy was 92%. It is likely to cost 30-50 USD per dose and requires cold shipment and storage at minus 70 degrees Celsius.

11th November- Russia announced the completion of the phase 3 trials of its vaccine candidate Sputnik V, named after the world’s first satellite launched by the Soviet Union in 1957. It was tested in 40,000 volunteers and proved to be 92.5% effective. The data and the information are yet to be shared worldwide.

16 th November- Moderna Inc and NIH announced the completion of the phase 3 trials for its Covid-19 vaccine candidate conducted in 30,000 volunteers in USA. It was found to be 94.5 % effective but has to be kept at extremely cold temperatures of minus 20 degrees Celsius.

23rd November- Oxford University in partnership with the drug company AstraZeneca plc announced the interim data from its phase 3 trials for their vaccine candidate. A 2- dose vaccine whose efficacy ranged from 90- 62% tested in volunteers in UK, Brazil and South Africa. Its main advantage is that it is cheaper to manufacture and can easily be transported at temperatures of an ordinary refridgerator(2-8 degrees C) It is likely to be sold between 3-5 USD per dose. The two partners did not develop the vaccine for profit but as a contribution towards stemming the Coronavirus crisis.

The period from March to early November 2020 is too short to give us most of the answers we need to know about the new virus and these vaccine candidates. We do not know how long the vaccine-induced immunity lasts. The studies will have to be conducted in other countries too.

It is claimed that these vaccine candidates prevented the infection and those who went on to develop the infection did not develop the severe type thus cutting down on the need for hospital admission.

This is a remarkable achievement in our time and we thank and celebrate all the teams involved.

Many doses  of the vaccines are required for the most vulnerable and the frontline health workers among the 7 billion people in the world. The more vaccines developed, the cheaper they become and the easier the distribution worldwide. According to the World Health Organisation, there are about 200 potential vaccines in development and at least 24 of them are in the human clinical trials phase. China, Russia , Germany, Israel are in this race too.

Challenges

Developing the vaccine is half the job done ; manufacturing and delivering the vaccine to those who need it most  in the developed and poor countries like mine, could be equally challenging. The vaccines have to be bought , transported to different countries and be administered to the most vulnerable and the frontline health workers including those in war zones or conflict areas. It has to reach those who need it most without losing its effectiveness from exposure to extreme heat or cold weather conditions.

This explains why the Oxford Univesrity- AstraZeneca vaccine which can be transported at temperatures of a domestic refridgerator holds more promise for those of us living in the least developed countries . Even at that level governments and health workers will have the challenge to educate their communities about the benefits and risks of the vaccine to boost its uptake.

We have come far since the Chinese scientists identified the COVID-19 virus and completed its genome sequencing from a patient with severe pneumonia previously working in the seafood market on the 7th January 2020. Never before has a vaccine been developed in such a short time!

 As we are living in the age of pandemics, the knowledge and skills that we acquire and the partnerships we create as we try to control the COVID-19 pandemic prepares us to manage future pandemics better. Viruses like HIV, Ebola, SARS and COVID live in wild animals like monkeys and bats as their natural hosts but as huge forests are being cleared for timber, farming and new settlements, the animals’ natural habitat is being reduced. Wild animals have been forced to move and live close to human beings. This makes it easy for the viruses to move from these animals and jump into human beings thus causing diseases like Ebola and Covid-19.

If you want to go fast, go alone. If you want to go far, go together. African Proverb.

As we celebrate the best news about COVID-19 disease this year, each one of us has to remember the following:

Your health is you responsibility. You also have a role to play in stemming this pandemic.

Follow the public health safety and health guidelines.

Volunteer for the clinical trials when an opportunity presents itself.

Encourage  members of your community to use the new vaccine when it becomes available in your country.

QUESTION:

Have you identified your vital role in the control of the COVID-19 pandemic?

 Are you just a passive bystander?

We are all in this together.