A Student's view of Lake Victoria

by Bill Matthieson

“I am not here for the sightseeing”, I reminded myself as I stood in Lake Victoria. The water was gently lapping around the top of my waders as that very special African light illuminated the glorious yellow colours of the male Weaver birds. The colony was frantically busy, intertwining blades of grass to produce a plethora of nests that hung from the branches of a tree on the nearby bank. I was snail-hunting on Sagitu Island, a small dot on the map, about 15km offshore in Lake Victoria, in southeast Uganda (at least it would have been a small dot if it had been marked at all – which, as was the case with most of the small neighbouring islands, it wasn’t). There was not a soul in sight and nor was there evidence of habitation - it was as if this landscape had yet to be inhabited by man. As I desperately tried to be as industrious as the weaver birds, and scoop as many schistosome-infected snails as I could from the weed around my feet I heard a sound behind me. I turned, half expecting to see one of the crocodiles I had been told inhabited the lake, but instead I saw an old lady. She was standing on the bank, waving an umbrella at me. After glancing at the cloudless, blue sky I waded ashore, to find that this lady was as curious about me as I was about her. She offered me her umbrella, and explained in a mixture of English and hand gestures that she had brought it from her village half a mile away, because she thought I might benefit from the shade it offered.

This, for me, is one of the most evocative memories that I have of the five-week period I spent in Uganda, because it typifies the thoughtfulness and generosity of the local people, who live a very hard and frugal life without the creature comforts that we take for granted. Yet despite this, they somehow retain the humanity that is often lacking in our culture.

I had been lucky enough to be seconded to the SCI to carry out a project that formed a part of the MSc course I had enrolled on at the London School of Hygiene and Tropical Medicine – to test new rapid diagnostic techniques and evaluate the role they may have in the establishment of disease prevalence. While I was there I was also to carry out a follow-up survey in those communities where mass treatment was already underway and see whether there were any teething problems.

Fortunately, I was not on my own. I was with a team of skilled scientists from the Vector Control Division of the Ugandan Ministry of Health. It was their powerful four-wheel drive car that made light work of the rutted and muddy roads that connected the plethora of villages to each other and the shores of Lake Victoria. We bumped and lurched our way from school to school, seeking out those areas where schistosomiasis was causing a problem (so that control measures can be put in place). Where the control programme was already underway, we sought out those teachers who had been entrusted with the job of administering the drugs - praziquantel (for schistosomiasis) and albendazole (for intestinal worms). I was unsure as to what to expect. Would our surveillance role be viewed with resentment? Would the children be prepared to let us have faecal samples? I needn’t have worried. Without exception we were welcomed wherever we went. We soon realized that our jeep was well known in the district – a mobile reminder of the ongoing commitment to control schistosomiasis and intestinal worms in their area.

The teachers were dedicated people, and those that had been recruited into the drug distribution process were proud of their dual role as health educator and drug distributor. Clearly, they felt that the anthelmintics entrusted to them had a great value.

Image: Bukizibu Primary School, typical of the schools in Mayuge district, Uganda.