When I hear of local activities commemorating volunteer contributions in honour of the International Year of the Volunteer, I can’t help but bow my head and silently celebrate the 500 family planning volunteers going door to door with information and contraceptives in the villages of Kabarole, western Uganda. This was the scene for my thesis field research on a communitybased family planning program and the backdrop for lessons in generosity and commitment to the health of women, children and families.
In Kabarole, where family planning clinics are either too far away or not available at all, trained community volunteers spend eight to 10 hours a week promoting the benefits of family planning to their neighbours. Not an easy or enviable task given that the setting is still rife with religious and male opposition to family planning. The need is clear: Uganda’s fertility rate is seven children per woman. Eight per cent of women use modern contraceptives and 50 per cent of women become mothers before reaching the age of 18.
Like the clients they serve, most volunteers live in poverty, are overburdened by the daily struggle for survival, and are often unable to meet the basic needs of their own families. I asked them what the program could do to help them in their work. Expecting screams for salaries, I heard humble requests for food. “We should just be able to earn enough to get some salt, some soap,” said one volunteer shyly. “We really are not asking for so much money but just the ability to get some of the little things we need.”
Despite the challenges, volunteers are committed to improving the health of families in their villages. “We know women’s problems”, another volunteer said, “you produce lots of children and then you do not even have the money to send them to school. We really love to help women, we have that commitment, the problem is that the work is frustrating.” Besides providing a convenient supply of contraceptives, the volunteers help to reduce the abundance of fears and misconceptions about family planning and encourage partners to communicate about the need to limit or space the birth of their children. In a country ravaged by AIDS, the promotion of safer sexual behaviour and education about HIV are added to the list of volunteer responsibilities.
Despite Uganda’s success in reducing HIV prevalence, HIV/AIDS continues to have a devastating impact on every facet of Ugandan life. More than 800,000 Ugandan adults and children—the population of Greater Edmonton—were HIV infected at the end of 1999. The magnitude and injustice of the situation was brought home to me one rainy afternoon when 100 enthusiastic adolescents and I crammed into a remote, one-roomed school to talk about responsible reproductive behaviour. I asked them to stand if they had a relative or friend sick or dead because of AIDS. Not one student remained seated. One boy, struggling to find his pubescent voice, respectfully asked, “Madame, we hear that in your country you have few people with HIV and they have drugs to help them. In my country, we have many people with HIV but they do not have any drugs. Madame, please tell me, why is this so?” I provided a lame and all-too-diplomatic response about the greed of pharmaceutical companies. They retaliated by generously offering me a live, squawking chicken in appreciation for my visit to their school.
Perhaps it was the sense of helplessness generated there that led me to seek refuge at the local baby orphanage. Many of the children are AIDS orphans—close to one million Ugandan children under the age of 15 have lost a mother or both parents to AIDS. My arrival always sent the 31 orphans on a squealing and hugging frenzy. Due to budget cuts and the recent death of the orphanage’s milking cow, the children were losing weight and seemed less energetic with every visit. Unable to finance even the tail of a good milking cow, I e-mailed the idea of buying a cow to my family and friends in Canada. Generous donations, often made in lieu of family Christmas gifts, poured in. Alice, a pregnant Friesian, was presented to the orphanage on my last day in Kabarole. The orphans have the taste of milk on their lips again and I maintain a healthy diet of international co-operation and compassion.
(Annette Flaherty’s field research in Uganda, under the supervision of Dr. Walter Kipp, was made possible by a grant from the University of Alberta’s Fund in Support of International Development Activities.)