This book explores the effects of war and displacement on the South Sudanese Zande, a people frozen in time by the classical anthropology of Edgar Evans-Pritchard. The research started in Western... Show moreThis book explores the effects of war and displacement on the South Sudanese Zande, a people frozen in time by the classical anthropology of Edgar Evans-Pritchard. The research started in Western Equatoria State, South Sudan, at a time of hopeful reconstruction (2014-2015). Yet after war resumed in 2015, nearly a million South Sudanese refugees fled to neighbouring Uganda – and so the study continues with South Sudanese Zande refugees there (2015-2019). Based on hundreds of inter views with refugees and stayees, chiefs and elder s, government officials and former combatants, and ordinary people, this book places conflict, confusion, and the search for continuity at the heart of the historical ethnography of the South Sudanese Zande. The book focuses on the ties between people, between people and land, and the competing efforts to control those ties. These three foci relate to proto-legal questions that underpin human society: Who are we? To whom and where do we belong? And whose authority do we accept? This study shows that these foundational questions gain new salience in times of crisis, as people turn to nostalgia and utopia to escape present despair. Show less
Chronic respiratory disease (CRD) is a silent, ongoing pandemic. It disproportionally affects low-resource settings. Tobacco smoke and kitchen smoke (caused by the use of solid fuels and... Show moreChronic respiratory disease (CRD) is a silent, ongoing pandemic. It disproportionally affects low-resource settings. Tobacco smoke and kitchen smoke (caused by the use of solid fuels and inefficient stoves) are major risk factors. Evidence-based solutions to CRD often fail to be effective, as they misalign with local needs and then fail to be implemented. This thesis focused on how lung health solutions can be implemented successfully by capitalising on the local needs.Within the Horizon2020 FRESH AIR implementation research project, we first studied local settings in Kyrgyzstan, Uganda, Greece, and Vietnam. For example, we found that COPD in the highlands of Kyrgyzstan occurred three times more frequently than in the lowlands, partly due to higher levels of kitchen smoke. We discovered the high indirect burden of asthma and COPD, by their impact on work- and daily activities. We also found that many communities and their health workers mistook CRD for infectious disease like tuberculosis. Based on these findings and on implementation literature, we then designed several practical tools addressing critical factors for implementation success of lung health interventions. These evidence-based tools can facilitate implementation success, thereby optimising the use of already scarce resources and benefitting health outcomes. Show less
In Luganda, the widest spoken minority language in Uganda, the word for photographs is 'ebifananyi'. However, 'ebifananyi' does not, contrary to the etymology of the word photographs, relate to... Show moreIn Luganda, the widest spoken minority language in Uganda, the word for photographs is 'ebifananyi'. However, 'ebifananyi' does not, contrary to the etymology of the word photographs, relate to light writings. 'Ebifananyi' instead means things that look like something else. 'Ebifananyi' are likenesses. My research project explores the historical context of this particular conceptualisation of photographs and its consequences for present day visual culture in Uganda. It also discusses my artistic practice as research method, which led to the digitisation of numerous historical collections of photographs. This resulted in eight books and in exhibitions that took place in Uganda and in Europe. The research was conducted in collaboration with both human and non-human actors. These actors included photographs, their owners, Ugandan picture makers and visitors to the exhibitions that were organised in Uganda and Western Europe. This methodology led to insights into differences in the production and uses of, and into meanings given to, photographs in both Ugandan and Dutch contexts. Understanding differences between ebifananyi and photographs shapes the communication about photographs between Luganda and English speakers. Reflection on the conceptualisations languages offer for objects and for sensible aspects of the surrounding world helps prevent misunderstandings in communication in general. Show less
Over the last two decades, there has been substantial progress in the area of blood safety in Uganda. In contrast, little attention has been paid to transfusion safety in Uganda and there are gaps... Show moreOver the last two decades, there has been substantial progress in the area of blood safety in Uganda. In contrast, little attention has been paid to transfusion safety in Uganda and there are gaps in laboratory and clinical transfusion practices within hospitals. Assessment of the current practice at Mulago and Mbarara Referral Hospitals showed inadequate documentation of the transfusion process, and poor monitoring of blood recipients. Our findings also indicated that one in every 16 transfused Ugandans and a similar number of RhD negative pregnant women possessed clinically significant red blood cell (RBC) alloantibodies in their plasma. However, RBC alloantibody screening is not performed during pre-transfusion and antenatal testing in the country. Thus, alloimmunized recipients and babies of RhD negative mothers are at high risk of morbidity and mortality due to haemolytic transfusion reactions (HTRs) and haemolytic disease of the fetus and the newborn (HDFN). Furthermore, data on the occurrence of acute and delayed HTRs and HDFN in Uganda are lacking. A cost-effectiveness analysis showed that introduction of RBC alloantibody screening would be cost-effective and improve blood transfusion safety. Therefore, there is need to improve immunohaematological testing in Uganda so that RBC alloimmunization and the consequences thereof may be prevented. Show less
This ethnographic study investigated what wartime children identified as common illnesses which affected them and how they restored normality. The research findings were aimed at providing baseline... Show moreThis ethnographic study investigated what wartime children identified as common illnesses which affected them and how they restored normality. The research findings were aimed at providing baseline information for policies and healthcare interventions consistent with children__s own needs and priorities. Qualitative ethnographic methods suitable for children aged 9-16 years were employed over a one year period in 2004-2005 and through visits to Gulu district in 2006 and 2007. A survey was conducted with 165 children (N=165), in addition to an extensive follow-up of 24 children. Data show that there was a high burden of illnesses among the children. Illnesses were mainly infectious diseases and complaints symptomatic of emotional distress. For infectious illnesses, children used herbal medicines and pharmaceuticals including prescription-only medicines like antibiotics and antimalarials. Coping mechanisms for emotional distress included discouraging open expression of suffering, using tranquilisers, atika plant (Labiate species), and engaging in income generating activities. Findings further highlight epistemological, methodological, theoretical, and policy issues regarding wartime children__s illness experiences and quests for wellbeing. Children readily discussed experiences with infectious illnesses because of their acute onset, primacy, and a priority. Infectious diseases are an immediate need and disorganize a relatively stable condition of emotional distress. Whereas some forms of emotional distress are severe and require immediate redress, there are no simple ways of dealing with them. Although this study underscores the importance of addressing wider socio-economic factors as effective preventive approaches in dealing with infectious diseases and emotional distress, I propose that it is fitting for children to engage in short term curative approaches in illness management, in the context of medical pluralism given the dire context in which they lived. Show less
