Day 3: Spencer's Shoelessness

Tuesday, August 10, 2021 - Kampala, Uganda and Soroti, Uganda

Well, it turns out that Dr. Acharya is into sprouts. He spreads them on a small plate and soaks them in water for a day prior to eating. B12, antioxidants, protein, and the yogic concept of Prana. He’s been very kind to share them with me! I think they are lentil and chickpea sprouts, and he’s right, there is something magic about them. At this point it seems like the jet lag should really be taking a toll, but I really haven’t felt anything! I blame the sprouts.

We’ve been thinking about how we can make this project truly sustainable and not just a feel-good flash-in-the-pan. Making the software open-source is one important step in that direction. Another would be manufacturing everything in-country. This will help create jobs as well as ensure that the program can be truly self-sufficient. Winnie, by some superhuman ability, managed to coordinate two meetings with manufacturing engineers within 24 hours of an offhand request from us. First, we met with her brother who has been working on a solar energy project with DFID. His company makes solar system (?) control units here in Kampala. They have pick-and-place and reflow machines, and they are working to start their own in-house injection molding. He is a great example of a grassroots entrepreneur pouring everything into a project – in less than 1.5 years they have gone from prototype to exporting their units to 5 surrounding countries. It was an honor to tour his facility and learn about the Ugandan manufacturing scene. Good news: we should be able to manufacture everything here!

Getting to/from meetings today I got to ride shotgun. Shotgun in Uganda is very exciting! A true front row seat to an actual life and death drama. I’m sure this is too American of me, but I am constantly amazed by the flow of traffic here. The motorcycles are referred to as boda bodas, and they are mostly used as an Uber-like form of transportation. There is an associated app and a ~15-minute ride costs about $1. They outnumber the cars 10+ to 1, and they act like fish. At least, that’s what I think of when I watch them move. A chaotic school of fish that seems to flow like a liquid to conform to the cars and trucks. They can slip through impossible spaces and are tapped into some sort of hive mind that allows each rider to know what every other driver will do next. Dr. Acharya tells me that traffic in India is much more intense, which I actually cannot imagine.

The second group we met with was part of the Makerere University engineering department. They have developed an air-quality monitor that they have been placing around Kampala to better understand the effect of pollution. They 3d-print their enclosures, and they allowed us to print an updated version of the prototype (designed by Summer, literally overnight) on their machines. They also graciously allowed us to use their hot glue gun, which was critical to finishing up the modifications we had made with the saw the previous night. These experiences with local engineers really helped clue us into the capabilities of local manufacturing. My takeaway - it’s very impressive.

And then, we met The Guy. The man in charge of Uganda’s National Malaria Control Program. We traveled to the Ministry of Health and waited for our only shot to make a good impression and get his buy-in. We waited in the hall outside of his office, and I had mostly one main concern on my mind: I had forgotten to wear shoes. Somehow in the excitement of the morning I had ended up at the most dressy and important meeting of our entire trip in my goofy sandals. We watched a group of men in dress jackets exit his office (his previous appointment, who had obviously gotten the dress code memo that I had missed) and then we were immediately ushered in. I did some rapid line-of-sight calculations and then quickly took the seat with the least foot exposure. Dr. Acharya presented our ideas to this man who carefully maintained an intimidating poker face behind his N-95. Finally, he spoke. He gave us some critiques about usability within the Ugandan system, specifically identification of mosquito abdomen status and integration with their Digital Health System. Then he proceeded to tell us how needed our technology was and how it would make the implementation of their malaria control program possible. He really got excited about it, in a formal sort of way. His feedback validated our work to this point! And perhaps more importantly, his buy in will, as Joselyn put it, “prevent closed doors.” This turned into a great meeting, in spite of my shoelessness. Spencer-luck strikes again!

We immediately packed up and hopped into our van to travel out to Soroti. I love road trips – they are a great way to take in a new landscape. In this case, that was especially true. The 6+ hour drive from Kampala allowed us to see many sides of Uganda, from the tea fields to urban markets to wild jungles. Most of the road was well maintained, but some of it was a bit of a rodeo! Again, I am always impressed with the drivers here – they are unparalleled in the US. We talked for a while, then I sunk into some good music and soaked in the view from my window. I especially enjoyed the slower driving through the smaller towns where I could catch glimpses of the faces of people living their normal lives. I saw so many new things, but many familiar things also - people sharing a meal or playing soccer or chatting with friends. I really enjoyed absorbing the roadside from my surprisingly comfortable seat.

Finally, at about 10 PM, we arrived at our lodging. We ate a tired dinner with our new friends, the Vector Control Officers. Tomorrow they will show us how mosquitos are captured, collected, and identified in the field.