Numbers surround us every day, from the code used to communicate between mobile phones to the number of plates needed for lunch. It is easy to forget exactly how important these numbers really can be, especially when removed from the actual people or functions they represent. This year, I have been working as a Monitoring and Evaluation Officer for the Uganda Village Project, a NGO based out of the rural district of Iganga, Uganda. Throughout my year, I have seen numbers: HIV testing numbers, malaria bed net distribution numbers, family planning outreach numbers, obstetric fistula repair surgery numbers, among thousands more. In the daily deluge of information, I must constantly remind myself that these numbers, though aggregated for analysis, represent actual people and lifesaving situations. The 15 participants who received the Depo shot at the last outreach in Namunkesu represent 15 women who are planning their families for a brighter future for themselves and their own. The 150 participants who received HIV test results mean that there are 150 villagers in Bukaigo that can receive ART treatment if necessary, and sleep easier that night knowing their status. The people of these villages are the true representation of the numbers, but unfortunately the human story is too often divorced from them after collection in order to do mega-analyses and aggregation.
This past month I had the incredible opportunity to help lead an impact evaluation research project of the villages where UVP does their work. Currently they have worked in 24 villages out of a list of 70. Julius (my co-fellow) and I were tasked to collect data from 15 households in each village to see if the intervention villages differ from the non-intervention villages. It was a busy six weeks; we both were responsible for supervising a team of enumerators and worked Monday through Saturday 10 hours a day. All of the data collection happened in dry season, meaning better roads but also constant 95-degree temperatures (35 degrees Celsius). Despite the challenges, the collection went well and gave both Julius and I a chance to interact with the "numbers" we had been working with all year. Reading on a computer screen that a family has four children and the mother is using family planning is no substitute to seeing the pride and joy shining from her face when talking about her family's health and wellbeing. During our 36 days of data collection, I was able to see the numbers come alive, and it left me with a profound gratitude for the life-changing work my organization is doing. Not all numbers tell a happy story, sadly, and directly viewing the challenges also has left a deep impact on me, and an insatiable desire to do more.
The Iganga District is very rural and one of the poorest for the amount of access to health the populous should have; the main artery road from Nairobi to Kampala almost bisects the district. This has traditionally resulted in greater government investment, but also in a host of problems brought in by transportation workers and other migrants. With a large government hospital already in place in Iganga, and a private one being built, there is no reason that any women should give birth without an attendant, or for any life-threatening health situation to go untreated. We found lack of access to be the case time after time and were able to see firsthand the pain of sick family members or lost loved ones. This is unacceptable to me, and shows just how far we still have to go for health equity in rural locations around the world. Health should not be something that can only be accessed by those who have the means to pay for treatment, but should rather be shared by everyone, especially those in fragile economic situations.
How de we solve these issues? I am not sure if I have the answer for that, but I am confident that programs such as Global Health Corps, Uganda Village Project and their host of other partner organizations are working towards a viable solution. The Iganga District is changing: Overall health is increasing and people are generally more knowledgeable about healthy behaviors than they were 10 or 15 years ago. This change has come slowly though, and many thousands of lives have been negatively affected in the meanwhile. I may not have the solution, but I do have my experiences and skills that I continue to use to promote health equity and justice. The journey for a healthy world is far from over, and I am ecstatic that I am able to do my part to support that important voyage.
Numbers still surround me on a daily basis, but I can take satisfaction in knowing that they are no longer only numbers. I have seen the source of these numbers, and their stories and faces will continue to be present in my daily data use for as long as I work in this field.