"Step-Up" stands for "Sustain, Train, Educate and Promote in Uganda". SUU is an ITD project which offers medical and psycho-social capacity building in Northern Uganda, an area which continues to suffer from the effects of a 20-year armed conflict. Volunteer U.S. health and social work professionals work in partnership with Ugandan colleagues at our sister NGO, also called SUU, to offer training and consultation to professionals and community members. The project is predicated on the belief that medical and psychosocial well-being are inextricably related to the process of peace and reconciliation.
Because of the destruction wrought by Joseph Kony's Lord's Resistance Army, Northern Uganda lacks adequate roads, water, electricity and economic resources. It has high rates of infant mortality, child health issues, malaria, war-related trauma, domestic violence, land disputes, and other serious medical and psychosocial conditions stemming from poverty, political isolation, and the armed conflict. The U.S. wing of SUU works with Ugandan SUU colleagues as well as Ugandan health providers year round, including during annual visits, using a training of trainers model. We work to build the capacity of a small group of leaders who in turn train others in their community. This approach involves working collaboratively rather than employing an “expert, top-down” model. We recognize that while our team holds medical and psychosocial expertise, our Ugandan colleagues are experts about their culture and community and have much wisdom, knowledge, and expertise to share.
In its first visit to Uganda in 2011 the U.S. team worked collaboratively with local Ugandan healthcare providers on malaria prevention, safe sex education, neonatal resuscitation, preventing child dehydration, and offering responses to a range of other medical challenges. The U.S. team returned to Uganda in 2013 and expanded its work to include a “Helping Babies Breathe” program. This involved training Acholi midwives, who in turn trained more midwives, in the essentials of improving infant survival rates at birth. American SUU staff also offered psychosocial training to taxi drivers, small business owners, women's leaders, religious elders, police officers and other community leaders about how to work with people who are suicidal, drinking excessively, and other behavioral manifestations of the toll of the 20-year armed conflict. And we worked alongside our Ugandan colleagues as they saw patients and clients in local health centers in what we call “Health Camps.”
In addition to the training and services the U.S. team delivers, it supports developing our Ugandan colleagues' organizational capacity and access to resources for improved response to the region's needs. SUU has also been working with Ugandan partners in the fields of democracy, good governance, conflict resolution, and women's civic involvement. In January 2014, the U.S. team will be sending two doctors and two social workers to build on last year's work. We are excited about continuing the “Helping Babies Breathe” program initiated last year. This will include follow-up training with the original group of six midwives trained last year and then observing them instruct twelve new trainees. We will also provide ambu bags and newborn masks to every health center in the sub-county.
The U.S. team will deliver medical training in substance abuse and alcohol withdrawal. This training will integrate psychosocial factors and interventions. We are excited to involve a new Ugandan organization into our project. PACTA is a local Acholi NGO that addresses chemical dependency prevention and treatment in the city of Gulu. Our Ugandan colleague and partner Dr. Auma Maria Alai will do a presentation to Acholi medical providers on early detection and management of diabetes. And we will do presentations on anorectal disease, pediatric HIV, preventing and treating ear infections (which contribute to high rates of hearing impairment), how to talk with teenagers about preventing sexually transmitted diseases, and suicide prevention. STEP-UP's American social workers will be working with community leaders to continue addressing the serious psychological scars from the war. They will be working in concert with PACTA and with Caritas, another local organization. They will also hold a one-day “Health Camp” as in previous years where US and Ugandan providers work side by side seeing patients, exchanging knowledge and practice wisdom, and assessing what future topics should be covered in training sessions. We are proud that the participants in our trainings consistently value our collaborative approach. As one of last year's participants said, “Lots of NGOs come in to train us but they tell us what to do – they don't ask questions or respect that we also know something and have something to teach you.”
In the words of a member of the Ugandan branch of SUU, "we envision a world in which individuals, families, and communities have the capacity and hope to build conditions that promote total health, education good governance and livelihood. The activities of SUU are therefore meant to address health needs, good living standards, timely delivery of services, promotion of democracy, good governance and open opportunities for the young to build a strong nurturing working society in the whole Acholi sub-region."
Please take a look at our video. Donations may be made at that site, or you may support our work by writing a check to ITD, with “STEP-UP” in the memo line. Mail to: Joshua Miller, Lilly Hall, Smith College, Northampton, MA 01063.
Jaimie COLICA, MSW, LCSW, is a licensed social worker that lives and works in Western Massachusetts. She is originally from New York. Jaimie holds her bachelor's degree in psychology from Tulane University in New Orleans and her master's degree in clinical social work from Smith College School for Social Work. She currently works as a crisis clinician for Behavioral Health Network in Springfield, Massachusetts. Jaimie worked on a psychosocial capacity building project in a small Haitian village.
Dr. Matt KANE is a medical internist who worked in primary care for 25 years. He is passionate international medicine since spending a semester abroad in Kenya as a college student where the beauty of the people and the country moved him greatly. His background includes living and working at a small rural hospital in Kenya for a year with his wife Ann Markes before having children. Since raising his kids, he has focused our efforts on developing the medical capacity in Haiti and Uganda.
Leah KRIEGER, MSW is a graduate of the Smith College School for Social Work program. Her professional background includes a decade of working in the fields of immigration, education, community building and clinical therapy with immigrants and refugees both domestically and internationally. She currently works at the Treehouse Community (http://refca.net/) in Easthampton, MA using a psychosocial capacity building approach to support children who have been affected by foster care. Additionally she teaches a class titled "Psychosocial capacity building in response to disasters" at the Smith College School for Social Work.
Dr. Ann MARKES trained at Baystate Medical Center in both internal medicine and pediatrics and practiced in the Pioneer Valley of Massacusetts for two decades at Worthington Health Center and Hadley Family Practice. However, her first experience of clinical medicine was in Kenya, while participating in a semester program abroad as an undergraduate. Since then, she has pursued her real professional interest, global health. She and her husband, Dr. Matt Kane, practiced in a rural hospital in Kenya from 1985-1986. After a long hiatus of local practice and three kids, global medicine has again surfaced to the forefront. This includes volunteer work in St. Lucia, Vietnam, and China, but over the past few years, she a commitment to focusing on the work of STEP-UP in Uganda, and a project in Haiti (Haiti Village Health).
Joshua MILLER, Ph.D., MSW is a professor and Associate Dean at Smith College School for Social Work. His major practice and scholarly interests are psychosocial capacity building and antiracism work. He has responded to many disasters, including 9/11, Hurricane Katrina, the Asian Tsunami, and earthquakes in China and Haiti. He also regularly teaches a course on responding to disasters at Beijing Normal University. He has written many articles and has published a book – Psychosocial capacity building in response to disasters (2012, Columbia University Press) that describes the model of collaboration, capacity building and training of trainers used by STEP-UP. He has worked with STEP-UP in Northern Uganda for 6 years and has prioritized medical and psychosocial capacity building in this area as his central professional, political and spiritual focus.