Rain just one of the blessings as return visit sees Katine forging ahead

http://www.theguardian.com/global-development/2015/dec/31/rain-katine-uganda-return-visit-guardian-readers-health-boreholes

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The most obvious difference that leapt out at me as I arrived in Katine this month was the weather. In December 2007, Katine was scorching hot and the vegetation was a lifeless brown, which, as a first-time visitor, made me wonder how livestock survived. Eight years later, Katine is in the middle of heavy rains that have rendered many roads impassable to two-wheel-drive vehicles.

These changing weather patterns have left farmers at a crossroads, trusting neither traditional knowledge nor modern meteorologists for the best time to plant their crops. It is not unusual to find neighbouring gardens with crops at different stages of growth: one with sorghum ready for harvest, the other with the crop just flowering.

Related: 'The future should be bright': Katine's farmers ready to fend for themselves | Richard M Kavuma

But rain is generally seen as a blessing, even in this flood-prone Teso region of north-eastern Uganda. And the current rains coincide with a sense of optimism about Katine.

Back in 2007, Katine, a sub-county of 25,000-30,000 people, was recovering from waves of insecurity, including attacks by Joseph Kony’s Lord’s Resistance Army. Its socio-economic indicators were among Uganda’s worst.

But a six-year project funded by Guardian readers and Barclays, with Amref Health Africa as the principal organisation working in the community, sought to improve health services, education, livelihoods, water and sanitation, and community empowerment.

Amref formally left Katine in 2013, but the livelihoods component morphed into the Katine Joint Farmers Association Co-operative (Kajofaco). With financial backing from Guardian readers, the NGO Farm Africa, which was also involved in the original project, has been providing technical support to Kajofaco, whose 1,000-tonne produce store is easily the largest building in Katine. In February, Farm Africa will leave, hoping that Kajofaco will stand on the shoulders of its 792 members.

Eight years on, I have returned to the villages I reported on between 2007 and 2010 to see what else has changed. Ojom health centre, my first stop, appears to be doing well, judging by the nearly 50 people waiting for immunisations and treatment. It is heartening that the local government has given the facility more support. The vaccine fridge donated through the Katine project broke down, and the Soroti district authorities provided another one. Its batteries are weak, and sometimes vaccines are ruined, but otherwise it works.

Under the second northern Uganda social action fund, the government gave Ojom a second staff block that can house two employees. Ojom now has three permanent staff: the clinical officer in charge of the facility, a lab technician and a nursing assistant.

“Sometimes we have a really good turn-up – about 60 or 70 patients a day – especially when we have drugs in stock,” says nursing assistant Betty Aguyo. “Even now we still have drugs for malaria, diarrhoea, and antibiotics. The delivery from the national medical stores has improved. Even when they delay, it can be for a week at most.”

The laboratory, built by the Katine project, is still functional, and one of its three rooms now serves as the drugs store for the entire facility.

The health centre’s fortunes have changed with improved staffing and delivery of drugs. Each of Katine’s five parishes – with at least 7,000 people in each – is meant to have a health centre; but Aguyo says Ojom serves three parishes. Perhaps, she says, it should be upgraded to the next level of health centre, which would allow it to have more staff and admit some patients.

On the way from Ojom, I run into Charles Eyagu, who has tried his hand at large-scale citrus fruit growing. He is distraught, although he smiles warmly on seeing me. The truck carrying oranges, including those from his garden, has got stuck on a rain-soaked road. About a dozen villagers have tried and failed to push it out of the mud.

Eyagu chairs the management committee for Ominit borehole, built by Amref in 2008. That, he reports, remains functional, because each household still pays 1,000 shillings (about 20p) a month.

“We have repaired our borehole so many times,” says Eyagu. “People even came from Gulu [a district in northern Uganda] in a bus to study how we are managing our borehole. We recently had 1m shillings [in household payments], and we are now loaning it out to village members.”

The water facilities set up by Amref have been maintained by the communities. “The system is working well so far, because we have kept sensitising people about the importance of paying the monthly fee,” says Moses Elebu, chairman of the Katine Water and Sanitation Association. “All the water sources built by the Katine project are still functional.”

Also still functional is the piped water line to Tiriri health centre, the largest mini-hospital in Katine. But the surgical theatre that was renovated and equipped by the project in 2011 is still not operational. As Dr Jackline Angwec, the first female doctor to take charge of Tiriri, tells me, without mains electricity and without an anaesthetist they can only do minor surgery. Among the intended main purposes for the theatre is emergency obstetric surgery – key to cutting maternal deaths.

With general elections due in February, there is hope the government may connect power – although similar hopes were raised before the 2011 elections.

“Those electric poles were planted in the ground and left there more than a year ago,” says Angwec. “But two days [ago] I saw Umeme [the power distribution firm] people here and they have been told that power must be connected by January.”

Echoing Aguyo’s comments, Angwec is happy with the regular drug supplies from national medical stores. The challenge is that essential medicines often run out long before the next supply is due. On those occasions, patients must buy their prescriptions from pharmacies.

Leaving Tiriri health centre, I am in no doubt that Katine is forging ahead. Cattle are slowly coming back to Katine. According to Farm Africa officer David Ogwang, this is partly due to the village savings and loan associations, most of them started under the Katine project.

I am disappointed to learn that the Katine resource centre no longer exists. The old project office, which housed the facility, was taken over by the sub-county. Administration officials now enjoy the computers, tables and swivel chairs.

I run into Simon Edangat, one of the brains behind Kajofaco. Edangat is team leader at Katine Integrated Farmers Development Association (Kifda). He tells me Kifda recently received a loan from Kajofaco to mill locally grown cassava into flour, which is sold as far away as South Sudan. “The business is good, but it could be even better for the members if the lending rate [2% per month] could be lowered,” Edangat says.

As I turned to leave, Edangat says he has forgotten one thing: “I can’t end without thanking the people of [the] Guardian for supporting the Katine community.”