Health
In Kony’s Shadows: Faith Atai Emerges School of Public Health’s Best Student
By Davidson Ndyabahika & Brenda Namata
Despite her troubling background, Ms. Faith Atai, 33, has emerged as the overall best student for Makerere University School of Public Health’s Bachelors of Environmental Health Science.
Ms. Atai, will, during Makerere University‘s 71st graduation ceremony this year walk away with a First-Class Honors with a CGPA of 4.46. She becomes MakSPH best student, according to Ms. Gladys Khamili, the School of Public Health’s Registrar. This also makes her qualify for a Vice Chancellor’s list, of the best students in the University.
Born to Naume Ariimi and Ebwaat Jonathan, a firstborn and the only child from a father, she lost before birth.
Her mother, Ariimi, an enrolled nurse at Asamuk HCIII, in the Amuria district struggled to raise her single-handedly since her birth in November 1988.
“My mother being a single parent needed to fully work to provide for the family, I had to grow up with my grandmother Atai Faith Odongo, in Telamot village, Omugenya parish, Gweri Sub County in Soroti District,” she recounts.
Growing up in a rural setting, Atai engaged in several home chores but that did not disrupt her focus in School. She went to Jameler Primary School for her early education, until she sat her Primary Leaving Examination in 2001, at the age of 13. It was here that she became a Health Prefect.
“I would wake up as early as 4:00 AM to do home chores (wash utensils, sweep the compound and leave beans set on fire) and be at school 6:00 AM,” Atai recalls.
She would later, in 2002, join Ngora High School in Kumi district for Secondary education, some 50kilometers from her home district.
In 2003, the LRA rebels entered Teso, in eastern Uganda, Atai was in Senior three, and learning processes in all schools in the region were suspended for over a month. During this period, Atai recalls she stayed with her grandmother but under tense moments.
“Our movements were restricted. You would hear the open fire in the neighborhood and that whole time we were confined at home; you would pray to be alive the next day. I remember hiding under the bed always. Amidst fire exchanges, I was still optimistic about School,” she says.
Upon returning to School, Atai concentrated and completed O’ Level, scoring 23 aggregates in 2005. With this performance, her dream of becoming a lawyer was in sight. However, in 2006 when she joined Nabumali High School for her Advanced Level of education she was inspired to offer Science subjects. Here, she took Biology, Chemistry, Geography, and Agriculture but she says School fees was a major hurdle that kept her in and out of school.
“The environment was not friendly after I switched from my former school. I faced a lot of challenges in accessing school fees. This affected me both emotionally and academically. Catching up with the rest of the students. Sometimes I would take two weeks at home as my mother looked for fees and I would only return to school whenever money would be available,” Atai recounts.
Adding that; “My A level results were very disappointing. I got 5points in BCG/A. I was taken up by sports also. I thought of repeating the class. However, one of my maternal uncles who happened to have done Environmental Health Science for a career advised me to enroll at Mbale School of Hygiene for the same course.”
She enrolled for a certificate course in Environmental Health Science at Mbale School of Hygiene in 2008 and completed it in 2010.
Her desire and passion to challenge her background inspired her to enroll for a diploma. But her mother’s health had begun to deteriorate and this forced her to look for work.
At the time, Soroti Municipal Council had advertised for a health assistant job, which she applied for and got in 2013. But she wasn’t contented with a certificate alone.
“Conditions at work were not favorable. I asked if I could get a study leave as I continue to work. I had applied for a Diploma Course at Mbale School of Hygiene but I could not join because I was denied permission. But my immediate supervisor stepped in for me and would fill the gap when I enrolled the next year,” she says.
Despite the divided attention, Atai managed to enroll for her Diploma in 2014-2016 where she left a mark, as the best student.
Joining the School of Public Health at Makerere University
As she pursued her diploma program, Abel Walekhwa, then a student pursuing a Bachelor’s degree in Environmental Health Science at Makerere School of Public Health visited Mbale School of Hygiene where he extended a career talk to the students. It is here that Ms. Atai inspired, felt she was closer to fulfilling her dream.
“I got his contact and further engaged him. He told me that I would still join Makerere University after my Diploma. I goaled towards applying for the same program at MakSPH in 2017. Luckily, I was admitted on government sponsorship Diploma Entry,” says Atai.
According to Faith, having a social life does not deter a student from being an academic genius. In addition to reading books, Atai loved leadership and student politics as well as the church. She was a General Secretary to MUEHSA, an association that unites undergraduate students at the School of Public Health, Makerere University. She spearheaded discussion groups and indulged in all school projects. This was in addition to reading and holding discussions and consulting her lecturers.
Asked about what she felt when she was told she was the best student, Atai said it was an honorable thing to find she had topped the class.
“When I received a phone call about this, I cried with tears of joy, prayed, and thanked God for the journey this far. My mother was equally overwhelmed with joy,” Atai says.
COVID-19 and Studies
Since March 2020, schools and education institutions in Uganda were closed because of the COVID-19 pandemic. At the time of closure, Atai and her colleagues were anticipating completing their course on time.
One would have equally thought that this abrupt closure would affect her performance in the final semester examinations. “I didn’t abandon the need to keep in the books as I read, researched in hope of resumption soon,” she says.
The lockdown set in when she had conceived and her expected date of delivery was 15th October 2020, a time School was to resume for final students.
“It was hard for me as I had to do zoom lectures that were ineffective, approached exams and yet a first-time mother with a newly born baby. I had thoughts of a dead year however resolved to carry my 1week and 3days old baby to Kampala to finish my studies,” she recalls.
A first-class honors & What It takes
Faith says a first-class degree is attainable if, as a student, one knows what they want. She adds that it takes being committed, time management, and the right attitude.
“Good grades are attainable. As a student, there are a few values that you should work on; self-esteem, commitment, time management, and teamwork. I want to especially thank my classmates for their moral support, encouragement, and contribution to my success in this program,” Atai says.
Atai has also hailed the MakSPH administration for supporting her through her studies.
I thank the selfless and committed team at School. Thank you for putting everything in place for a convenient learning environment. The lecturers have been so supportive to me and my classmates. Am grateful for the mentorship I have received especially from the Department of Disease Control and Environmental Health,” she says.
The Lord’s Resistance Army’s (LRA) reigned in Uganda between 1987 and 2006, spreading terror through the country’s northern-most region.
The group, now believed to operate in the Central African Republic and the Democratic Republic of Congo, pursued its vision of a new state based on his interpretation of the Ten Commandments combined with local Acholi traditions.
Although it is not known how many people were mutilated by the guerrilla group, but at least 20,000 children were abducted and more than 1.9 million people forced to leave their homes. Atai could have fallen into the LRA trap at a tender age she recounts, but she survived.
Article originally published by MakSPH
Article courtesy Fogarty International Center
September/October 2024 | Volume 23 Number 5
Until recently in Uganda, most children with sickle cell disease (SCD) never celebrated their fifth birthday—only 30% lived past this milestone. This low survival rate was mainly due to inadequate health care interventions for these children, plus lack of widespread newborn screening, explains Dr. Sarah Kiguli , a professor at Makerere University College of Health Sciences. Things are different today. Over the past decade, the East African nation has instituted a policy of screening newborns while strengthening strategies to manage their health. This means more children with SCD are growing into adolescence and adulthood.
Challenges still exist, says Kiguli. For example, the community and district facilities where many Ugandan children are born cannot provide comprehensive services, including newborn screening. Another issue: the risk of SCD complications related to kidneys, lungs, heart—almost all organs—grows higher as patients grow older, yet scientific research in Uganda hasn’t caught up with the reality of these longer lives. As a result, teens and adults with SCD don’t get “the care they deserve,” says Kiguli.
“It’s very painful for us pediatricians to see our patients encounter challenges and problems when they transition to adult care.”
Renewed research focus
Despite years devoted to children’s health, Kiguli believes it’s time to prioritize studies exploring appropriate SCD management in teens and adults. “We need solutions that address all the patients’ needs, including reproductive health, as they transition out of childhood.” She’s spearheaded a multidisciplinary research training program for researchers focused on the needs of people with SCD at all ages: Enhancing Research capacity for Sickle Cell Disease and related NCDs across the Lifespan in Uganda (ENRICH).
“Among our PhDs, we don’t have anyone from pediatrics—and that’s fine,” says Kiguli. Importantly, the researchers are trained as a group to amplify the benefits of multidisciplinary collaboration. “We’ve been working in silos—pediatricians alone, physicians alone, social scientists alone—that won’t help us address the comprehensive needs of these patients.”
Methodology has also been given sufficient consideration. “We provide both individual and team mentorship from the beginning,” said Kiguli. Monthly meetings help trainees develop personal development goals and career path plans in the hope they will continue in the field. The program also provides research training to health professionals, such as medical doctors, laboratory personnel, and nurses, who are not necessarily doing degree programs, “so those who manage patients routinely might also benefit,” said Kiguli.
South-to-South unity
For the project, Makerere University has partnered with Busitema University, located in eastern Uganda, where “prevalence of the sickle cell trait is as high as 20%,” says Kiguli. (Sickle cell trait refers to when a person has inherited one mutated allele of the sickle cell gene, not two.) This local prevalence contrasts with about 13% prevalence elsewhere in the country. Studying the disease in a high burden locale is highly relevant, because results may influence policy and treatment guidelines.
Kiguli has other reasons for collaborating with Busitema University, which is less than 15 years old. “We want to build capacity at this young institution since our colleagues there have less chance of doing research than we at Makerere do.” Working and supervising trainees together will give Busitema’s faculty much-needed experience, while providing opportunities for faculty at both universities to learn from each other. Kiguli also hopes the new collaboration will advance progress made as result of the universities’ past partnerships. “Capacity must be built in a sustainable way,” says Kiguli.
“It’s important to work collaboratively and not competitively—this is just as important for Makerere University as it is for Busitema University.”
ENRICH trainees talk about their projects
Dr. Jackline Akello
Dr. Jackline Akello, PhD candidate
Dr. Jackline Akello, PhD candidate
My project is “Sickle cell disease in pregnancy: Experiences in provision and access to care and adverse pregnancy outcomes at Mbale and Kawempe Referral Hospitals.” As an obstetrician and gynecologist, I work as a lecturer at Makerere University and provide clinical care at the two national referral hospitals. I have encountered significant challenges in managing pregnant women with sickle cell disease (SCD) due to a number of healthcare navigation challenges. Additionally, the diverse cultural beliefs associated with SCD in Uganda affect access to care and ultimately outcome and quality of life for the patient.
By October, I will have started the enrolment of 161 pregnant women with confirmed SCD for my project. These participants will be followed throughout their pregnancies to track maternal and fetal complications, including stillbirths and low birth weight. Their experiences with the healthcare system will also be explored. As a Safe Motherhood champion, I have been focusing on hypertensive disorders in pregnancy, including pre-eclampsia, but this October at the Safe Motherhood Conference I will discuss the effects of SCD during pregnancy with the Ministry of Health. One of the endpoints of my study is to improve care for pregnant women who have SCD to enhance their pregnancy experience and outcomes.
Dr. George Paasi
Dr. George Paasi, PhD candidate
Dr. George Paasi, PhD candidate
My project is “The Clinical Epidemiology, Spatiotemporal Patterns and Disease Modifiers of Severe Malaria among Children with Sickle Cell Disease in Eastern Uganda.” Uganda ranks fourth among countries with high burden of SCD and is in the top 10 with respect to malaria burden. Eastern Uganda has the highest burden of both diseases. My project addresses this dual burden of SCD and malaria in eastern Uganda—I want to decipher the SCD-malaria syndemic in this region.
I’m a medical doctor, I have a master’s in public health, and I just finished a fellowship in infectious disease, epidemiology, and biostatistics. I’ve worked at Mbale Clinical Research Institute for the last 10 years. Previously, I worked on an NIH-funded trial in Africa called Realizing Effectiveness Across Continents with Hydroxyurea (REACH) as a medical officer, and now I’m embarking on this PhD training. My hope is that the findings from my study will improve the identification of patients with SCD at risk of adverse outcomes when they get malaria. I also want to identify, through spatial temporal analysis, hotspot locations that require priority interventions. I also want to gain skills as an independent researcher in SCD and make a meaningful contribution to this field.
Dr. Anita Arinda
Dr. Anita Arinda, PhD candidate
My project is “Prevalence, associated factors, course and impact of major depressive disorder in adolescents with SCD in Mulago National Referral Hospital.” We have limited data on mental health of adolescents with SCD, so that’s why my project mainly looks at depression in adolescents (ages 10 to 17).
In our setting, we are fortunate that children with SCD live past their fifth birthday thanks to improved health care, but this presents new challenges. During adolescence, patients enter a crucial stage where they’re trying to develop their identity, yet they’re also beginning to understand the implications of their condition—that having this serious health condition cuts their life short. I want to understand their experiences. How does depression in adolescents with SCD differ from depression in adolescents without SCD? We know that sickle cell disease causes inflammation, so does that contribute to their depression? How does depression affect clinical outcomes, if at all?
If we can understand the underlying mechanisms of depression in teens with SCD, then we might find new ways to manage their care (as opposed to conventional treatment with antidepressants). I’ll do my research at Mulago National Referral Hospital, which has a clinic dedicated to children and teens with sickle cell disease. The clinic provides many services, but unfortunately no specialized mental health services. One day I hope that changes, so that children with SCD and depression can get help early.
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