"It's a wrap"

Michael Scharff, IRC Princeton in Africa Fellow, is helping to produce an educational video about hepatitis E in the Kitgum district of northern Uganda. Below Michael shares some of his experiences as he travels through Kitgum: “Not to toot our own horn, but the death rate would be much higher without the kind of response IRC and other members of the district hepatitis E task force have been providing,” says Samuel Malinga, IRC public health officer in Kitgum. Samuel is part of the IRC’s health team that travels on a weekly basis to nine IRC-supported health centers in Kitgum district to distribute drugs and assist the government health staff to treat patients. Asked whether hepatitis E can be eradicated from the north, he offers up a guardedly optimistic outlook for the future. “What we should bear in mind is that this is going to take time to kick. It’s really difficult to have good sanitation when people are still in camps,” Sam says. “But with a comprehensive response, and as people continue to move, and apply the good hygiene practice they’ve learnt, hepatitis E might be a thing of the past.” The educational film on hepatitis E that I’ve been helping to produce is just one of a variety of ways the IRC’s health and environmental health teams are directly addressing the outbreak of hepatitis E. The IRC is providing emergency interventions with the aim of reducing the number of cases and the likelihood that infection will result in death. The IRC is also looking towards the future and teaching the community about the need to change their attitudes and behaviors with regard to maintaining good hygiene and sanitary spaces. This is extremely difficult for the tens of thousands still living in crowded internally displaced persons (IDP) camps in northern Uganda. The situation is not much better for those who have returned home. People are without latrines or proper hand washing facilities, and easy access to medical care is almost nonexistent.  To help, the IRC is distributing bars of soap and tippy-taps, which are plastic containers that are filled with water and hung next to latrines. A small hole is punctured in a tippy-tap’s side, and typically plugged by a nail or small stick. The taps are designed to take the place of communal hand washing done in large buckets, which is one of the main conduits of hepatitis E. We’re also building latrines in camps and sites where people are returning home. Moreover, we’re constructing wells and providing routine chlorination to ensure a constant supply of clean drinking water. The film is a wrap. The sunset is magnificent: orange hues mixed with deep lavender reflect off the scattered cumulous clouds; the inside of the Land Rover is literally glowing orange. The driver pops in a cassette tape of traditional Acholi music. I turn to my right, roll down the window, and take a few quick photos in the fleeting daylight. Roughly 16 kilometers behind me, the mountains, which serve as the line of demarcation between Uganda and Southern Sudan, have already succumbed to the darkness of the night. We’re on our way back from Paloga camp, in the far reaches of northern Uganda, where we’ve spent the past two days filming scenes for an educational film the IRC is producing on hepatitis E. We’ve finished filming and soon we hope to have the film ready to share with local communities.