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UGANDA MADI Short Term Mission Training

Manual

We are providing the following research and information for

your study. We recommend that you bring this document with you so that you may study it on the trip over.

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TABLE OF CONTENTS

STATE DEPARTMENT TRAVEL INFORMATION ............................................................................... 1  

SPIRITUAL PREPARATION ................................................................................................................ 4  COMMITMENT .................................................................................................................................................. 4  WARNING .......................................................................................................................................................... 4  CONTRITION .................................................................................................................................................... 4  PRACTICE HIS PRESENCE .......................................................................................................................... 4  DAILY DISCIPLINE .......................................................................................................................................... 5  CONVICTION .................................................................................................................................................... 5  CONFESSION ................................................................................................................................................... 5  YIELD TO HIM .................................................................................................................................................. 5  WITNESS ........................................................................................................................................................... 5  PRAYER PARTNER ........................................................................................................................................ 6  

PRECAUTIONS & HEALTH INFORMATION ....................................................................................... 7  MALARIA ............................................................................................................................................................ 7  DIARRHEA ........................................................................................................................................................ 7  OTHER DRUGS/SUPPLIES ........................................................................................................................... 7  AIDS .................................................................................................................................................................... 7  FOOD PRECAUTIONS AND HEALTH HINTS ............................................................................................ 7  MAKING YOUR TRAVEL TIME EASY .......................................................................................................... 8  

MEDICATIONS & IMMUNIZATIONS INFORMATION ......................................................................... 9  INSECT-BORNE FEVERS .............................................................................................................................. 9  SUMMARY OF RECOMMENDATIONS ....................................................................................................... 9  PROPER MEDICATION ................................................................................................................................ 10  IMMUNIZATION ALERT INTERNATIONAL HEALTH DATABASE TRAVELERS IMMUNIZATION INFORMATION ............................................................................................................................................... 11  ANTI-MALARIAL MEDICATIONS ................................................................................................................ 12  WARNINGS WHEN USING LARIAM .......................................................................................................... 12  SIDE-EFFECTS AND SPECIAL PRECAUTIONS ..................................................................................... 13  IMMUNIZATIONS ........................................................................................................................................... 14  REQUIRED INOCULATION .......................................................................................................................... 14  SHILOH’S RECOMMENDED INOCULATIONS ........................................................................................ 15  

MISSION TRIP PACKING LIST .......................................................................................................... 16  CAMERA, VIDEO & ELECTRONIC EQUIPMENT .................................................................................... 17  

MISSION TRIP DO’S AND DON’TS ................................................................................................... 18  PHOTOGRAPHY DO’S AND DON’TS ........................................................................................................ 19  

HOW TO HANDLE CULTURE SHOCK ............................................................................................. 20  

USING AN INTERPRETER ................................................................................................................ 21  

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GENERAL PROTOCOL ..................................................................................................................... 22  GIFTS ............................................................................................................................................................... 22  GIFTS COMING FROM YOUR CHURCH .................................................................................................. 23  PROMISES/GIVING CHANNELS ................................................................................................................ 23  LOCAL POLITICS ........................................................................................................................................... 23  PERSONAL SECURITY ................................................................................................................................ 24  

AFTER YOU RETURN ........................................................................................................................ 25  DEBRIEFING ................................................................................................................................................... 25  USING YOUR NEW SKILLS AT HOME ..................................................................................................... 25  KEEPING THE MEMORIES ALIVE ............................................................................................................. 25  

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STATE DEPARTMENT TRAVEL INFORMATION

Country Description: Uganda is a developing east African country. Tourist facilities are widely available in Uganda, on the coast, in the game parks and reserves. Entry Requirements: A passport and visa are required. Detailed entry information (and departure tax information) may be obtained from the Embassy of Uganda, 2249 R Street, N.W., Washington, D.C. 20008, telephone (202) 387-6101, or the Ugandan Consulates General in Los Angeles and New York City. Areas of Instability: Uganda is in a political transition period, from a single-party democracy to a multi-party democracy. From time to time, political or ethnic tensions associated with this transition increase – resulting in localized areas of civil disorder. Although the December 1997 elections were generally peaceful, political meetings, demonstrations, and strikes, which can sometimes be violent, are likely to continue. There was also an outbreak of ethnic violence in early 1998 in parts of the Rift Valley Districts of Laikipia and Nakuru. For these reasons, Americans who plan to visit Uganda are urged to take basic security precautions to maximize their safety. Travelers should follow the print and electronic media to keep abreast of where and when any political rallies and demonstrations are likely to occur, and of the potential for confrontation. Rally and demonstration sites should be avoided. Uganda has not traditionally been a target for international terrorists. On August 7, 1998, however, terrorists bombed the U.S. Embassy in Uganda, killing some 250 people and injuring many more in and around the Embassy. The U.S. Embassy has relocated after the blast to a different, temporary location. Although it has yet to resume all the functions the Embassy performed prior to the terrorist attack, it continues to provide emergency consular assistance to U.S. citizens. Medical Facilities: Adequate medical services are available in Uganda. Doctors and hospitals often expect immediate cash payment for health care services. U.S. medical insurance is not always valid outside the U.S. The Medicare/Medicaid program does not provide for the payment of medical services outside the U.S. Supplemental insurance with specific overseas coverage, including provisions for air evacuation has proven useful. Outbreaks of Rift Valley Fever, cholera, and malaria have occurred in Uganda. Information on these and other health-related matters can be obtained from the Centers for Disease Control and Prevention’s international travelers hotline at 1-888-232-3228, the CDC autofax at 1-888-232-3299, or via the Internet at http://www.cdc.gov. Information on Crime: There is a high rate of street crime against tourists in downtown Uganda, Mombasa and at coastal beach resorts. During periods when police are occupied with civil unrest related to political tensions, there may be an increase in street crime and banditry. Reports of attacks against tourists by groups of two or more armed assailants continue; pickpockets and thieves also carry out “snatch and run” crimes near crowds. Visitors have found it safer not to carry valuables, but rather to store them in hotel safety deposit boxes or safe rooms.

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There have been reports of thieves snatching jewelry and other objects from open vehicle windows while motorists are either stopped at traffic lights or in heavy traffic. Armed carjackings are common in Uganda, with some ten vehicles stolen by armed robbers each day. There is also a high incidence of residential break-ins. Thieves and con artists have been known to impersonate hotel employees, police officers or government officials. Tourists who accept candy, biscuits, or juice from new acquaintances on intercity buses have been robbed after being drugged by ingesting these foods which have been laced with sedatives. Highway banditry is common in much of North Eastern Province, significant portions of Eastern Province, and the northern part of Rift Valley Province—areas that are remote and largely unpopulated. Such incidents also occur occasionally on the Uganda-Mombasa Road, particularly after dark. Air travel is the safest means of transportation when visiting any of the coastal resorts north of Malindi. Walking alone or at night in public parks, along footpaths or beaches and in poorly lit areas can be dangerous. The Ugandan mail system can be unreliable, and monetary instruments (credit cards, checks, etc.) are frequently stolen. International couriers such as Federal Express or DHL have proven to be the safest means of shipping envelopes and packages. The loss or theft abroad of a U.S. passport should be reported immediately to local police and to the nearest U.S. embassy or consulate. The pamphlets “A Safe Trip Abroad” and “Tips for Travelers to Sub-Saharan Africa” provide useful information on protecting personal security while traveling abroad and on travel in the region in general. Both are available at the Bureau of Consular Affairs home page, http://travel.state.gov, and from the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402. Road Safety: Excessive speed, unpredictable local driving habits, and the lack of basic safety equipment on many vehicles are daily hazards on Ugandan roads. In addition, vehicle travel outside major cities at night should be avoided due to the poor condition of the roads and the threat of banditry. Severe storms and heavy rains have led to extensive flooding and critical damage to roads and bridges, making travel and communications difficult in many parts of the country. Some roads are impassable. Travelers are urged to consult with the U.S. Embassy in Uganda and local officials regarding road conditions. Service of Regional Airlines: Due to general safety concerns regarding African Airlines, a private airline company flying between Uganda and destinations in Africa and the Middle East, the U.S. Embassy in Uganda recommends that its personnel not use this carrier. Aviation Safety Oversight: As there is no direct commercial air service at present, or economic authority to operate such service, between the U.S. and Uganda, the U.S. Federal Aviation Administration (FAA) has not assessed Uganda’s civil aviation authority for compliance with international aviation safety standards for oversight of Ugandan air carrier operations. For further information, travelers may contact the Department of Transportation within the U.S. at 1-800-322-7873, or visit the FAA Internet home page at http://www.faa.gov/avr/iasa.htm. The U.S. Department of Defense (DOD) separately assesses some foreign air carriers for suitability as official providers of air services. For information regarding the DOD policy on specific carriers, travelers may contact the Pentagon at (703) 697-7288. Currency Regulations: Up to 100,000 Ugandan shillings may be taken out of the country. Destruction of Ugandan currency, even in small amounts, is illegal, and almost always results in arrest and a fine.

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Game Park Security: In response to increased banditry and incidents of robbery in or near many of Uganda’s national parks and game reserves, the Uganda Wildlife Service and police have taken some steps to strengthen security in the affected areas. Banditry does still occur in and around the parks. Travelers who do not use the services of reputable travel firms or knowledgeable guides or drivers are especially at risk. Safaris are best undertaken with a minimum of two vehicles so that there is a backup in case of mechanical failure or other emergency. Solo camping is always risky. Drug Penalties: U.S. citizens are subject to the laws of the country in which they are traveling. Penalties for possession, use or trafficking in illegal drugs are strictly enforced. The penalty for possession of illegal drugs, including marijuana, is 10 years imprisonment, with no option of fine. The penalty for purchasing or selling illegal drugs, including marijuana, is 20 years imprisonment, with no option of fine. Other Information: Local tap water is not potable. Sealed bottled water is safe to drink and can be purchased in local hotels, restaurants, and grocery stores. Travel via passenger train in Uganda is unsafe, particularly during the rainy seasons. The trains and tracks lack routine maintenance and safety checks. Uganda telephone and telegraph has discontinued its collect call facility. 1-800 numbers cannot be accessed from Uganda. Use of international long-distance calling cards is very limited in Uganda. International long-distance costs from Uganda are higher than corresponding long-distance rates in the United States. Several local companies offer computer Internet access, including on an hourly rate basis. Many hotels have facsimile machines but often limit their access to guests; some facsimile services are also available at office supply shops. Travelers are urged to consider their method of maintaining contact with family and friends when making their pre-travel preparations. Registration/Embassy Location: The Embassy is located at the USAID Building, The Crescent, Uganda, Uganda. The telephone number is (254-2) 751-613. Consular services are available at a separate site located at Peponi and Spring Valley Roads in Uganda. The telephone number is (254-2) 580-742. U.S. citizens visiting or resident in Uganda are encouraged to register with the Embassy and may fax biographic information, passport data, and itinerary to (254-2) 743-204, 749-590, or 749-892. Only emergency consular services are available at this time. The Embassy is currently attempting to determine when routine services can be resumed. In the event of an after-hours emergency, the Embassy duty officer may be contacted at (254-2) 751-871. The Embassy’s international mailing address is P.O. Box 30137 Uganda, Uganda. Mail using U.S. domestic postage may be addressed to Box 21A, Unit 64100, APO AE 09831. No. 98-132

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SPIRITUAL PREPARATION

You are about to embark on one of the most challenging spiritual experiences of your life. You really are not ready to go until you have grown a little. God will work uniquely in each life to present the opportunities for growth, but you must respond with a willingness to grow to complete the process. Perhaps it will be at the point of your faith to believe that God can provide the finances or overcome some major obstacle in your life. Maybe there are specific needs or arrangements at home or work to be accomplished before you can go. Maybe there is a habit that limits your effectiveness in witness that must be laid aside. As a volunteer, you have a tremendous privilege for personal growth and a God-given responsibility for fullest response to it. How, then, can you reach the highest levels of personal growth? Here are some suggestions:

COMMITMENT We make no spiritual advance without a commitment to it. Make a definite choice now to commit yourself to Christ for the personal spiritual growth He has for you as a volunteer in foreign missions. Just as you have committed yourself to go, commit yourself to growth. Exodus 20:1`1-17 Matthew 7:1-5 Matthew 5:27-28 Matthew 6:33 Matthew 23:23-28 Mark 7:20-23

John 2:15-17 Galatians 5:19-21 II Timothy 3:2-5 Titus 3:1-3 Ephesians 5:3-7 James 3:6-10

WARNING The temptation of the “spiritual professional” will be to skip this process. Don’t short-change yourself!

CONTRITION Let the Holy Spirit break and melt your heart before the cross. Let the impact of Christ’s sacrificial death once again overwhelm you as you read again: Psalm 51:10,17 Isaiah 66:1-2 Isaiah 57:15

Luke 23:32-49 Isaiah 53:1-12

PRACTICE HIS PRESENCE Begin or deepen your awareness of being in the presence of and having oneness with the Father at all times. Read John 17 at least every other day while in the volunteer processes.

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DAILY DISCIPLINE If you have not already done so, begin to set aside a portion of every day for daily prayer and Bible reading.

CONVICTION Allow the Holy Spirit to convict you of sin. With pen and paper in hand, read these Scriptures slowly, and when the Holy Spirit convicts you of some of those sins, write them down. There will be other sins that will come to your mind. Write them down.

CONFESSION In quietness, read the following Scriptures: Psalm 66:18 Proverbs 28:13 Isaiah 59:1-2 Isaiah 1:16-20 Psalm 51:1-17

Matthew 5:23-24 Mark 11:25-26 James 5:16 I John 1:7,9

After reading, take the paper on which you have listed your specific sins, confess them each to the Father. In faith fully accept God’s forgiveness.

YIELD TO HIM After confessing, and by faith claiming forgiveness, you are ready to present the cleansed channel to the Lord for His use and glory. Prayerfully read the following Scriptures: Psalm 37:4-5 Colossians 3:12-17 Philippians 4:8-9 Romans 6:6,7,11,14,22 Proverbs 3:5-6

Mark 12:30-31 I Corinthians 10:11 Colossians 3:1-4 Romans 12:1-2

WITNESS Begin to take every opportunity that God presents to share your testimony. Ask God to make you alert to opportunity, sensitive to spiritual need around you and spiritually bold in your witness.

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PRAYER PARTNER Enlist a person to covenant with you to pray. The Bible says, “That if two of you shall agree on earth as touching anything..., it shall be done for them of my Father which is in heaven” (Matthew 18:19). Make a joint list of concerns and persons for which you will pray daily. Perhaps you will be able to “meet” on the telephone to pray or take a break at work to pray with a coworker. God will impress upon you the way to do it, but pray, pray, PRAY!

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PRECAUTIONS & HEALTH INFORMATION

MALARIA Most areas of Uganda are subject to problems with malaria. The traditional remedy is a chloroquine based drug. It is available as a non-prescription drug in East Africa and is considerably less expensive than in the USA. However, there is chloroquine resistant malaria in Uganda and some people have trouble taking chloroquine. The drug most recommended in this case is Paludrin. It is taken once per day (2 tablets) after arriving in the infected locale. Paludrin is not available in the USA but can be bought without a prescription in East Africa. Be aware that you could possibly develop malaria even months after leaving Africa. The anti-malarial precaution should be continued for 6 weeks after you leave Africa. In case you develop an illness with fever, aching, etc., tell your doctor where you have traveled so that he/she can consider malaria as a possibility. We recommend that you check with your local health department for the latest recommendations from the C.R.C. for drugs available in the USA and their dosages.

DIARRHEA Travelers are highly susceptible to this problem. It is quite commonplace and you should not be embarrassed because you develop it. Imodium is a good drug to bring along to use to control the problem. Use of Imodium or Lomotil can be dangerous with some intestinal infections, so care must be taken. You will want to guard against dehydration, particularly in a high temperature area. One suggestion is to bring along Powdered Gatorade to combat dehydration. If the problem persists beyond 3-4 days, you should ask to consult a physician.

OTHER DRUGS/SUPPLIES You should bring an adequate supply of the drugs which you regularly take. We also recommend that you bring some band-aids, peroxide, and anti-bacterial creams. Individually wrapped hand cleaners (Antibacterial Wet Wipes) are nice to have.

AIDS There has been a lot of publicity concerning AIDS in Africa. By taking a few precautions, there is no significant risk to you. About the only possible contact is with an injured person who is bleeding. Missionaries carry surgical gloves in their vehicles in case they come upon an accident so that they can prevent contact with blood. You might want to carry a pair with you. Wearing seat belts is a good precaution against AIDS; it may keep you from needing a blood transfusion if you have an accident.

FOOD PRECAUTIONS AND HEALTH HINTS The item which requires the most care is water. Tourist hotels normally have safe water in a carafe in the rooms and in the restaurants. Missionaries will try to supply safe water in jugs to be carried. Sodas are available, even in remote areas, but will rarely be refrigerated. Diet drinks are not available in

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hotels, coffee and hot tea are served after the meal as a separate course. Be prepared to drink mugs of “chai” in the homes of Ugandans. Chai is made by boiling water, loose tea leaves, sugar and milk (when available). It has a unique flavor and can be enjoyed even if you ordinarily would not choose tea, especially with milk. Tea and coffee are safe because the water is boiled. Avoid drinking cold water or juice served in the villages or in homes of Nationals unless you know it has been boiled. In hotel restaurants all types of food are available and generally safe to eat unless you have a queasy stomach. It is often advised that all raw vegetables in hotels be avoided. Fruits which can be peeled are safe. If not peeling the fresh fruit, it needs to be carefully washed soaked in a weak of potassium permanganate or chlorine bleach or iodine. Anything cooked will generally not cause problems. Your Ugandan hosts will serve you in their homes or churches. A hand washing experience will accompany any meal and is necessary because you will probably eat with your hands. (It is possible for you to carry your own knife, spoon, and fork with you and this is not seen as offensive). A pitcher of water, a basin, and sometimes soap are brought. You wash your hands over the basin while water is being poured over them. A towel is seldom available and “drip dry” is probably best. This is done before and after the meal. The meal will vary greatly from one area or home to another but will consist of a starch (cooking banana called “matooke” (MA-TOE-HAY), corn meal, rice, millet, sweet potato or cassava) accompanied by boiled meat (beef, chicken, goat or fish) and maybe beans, greens or ground nut (peanut) sauce. All of this is well cooked, safe to eat and is usually quite tasty. Food is not served according to American meal times and the time period between meals may be long. You may want to bring along snack foods such as crackers, granola bars or jerky to hold you over until meal time. Being in good physical condition always helps make a rigorous schedule easier to live with. If you are not already working on that, two or three months before departure you might want to begin a walking program. You may be doing a lot of walking while in Uganda. Remember to use sun screen and hats when out in the sun. Drinking plenty of fluids is important. If you are outside, apply insect repellent about 6:00pm. Usually malaria carrying mosquitoes bite in the hours. Also remember to take your malaria precaution. The concern about AIDS has already been mentioned. Remember that mosquitoes do not transmit the HIV virus. If you should get sick, the Ugandans and missionaries working with you will know how to get medical treatment and will be able to advise you about what is safe. Do not hesitate to make your problem known before it becomes serious.

MAKING YOUR TRAVEL TIME EASY There are several things which you can do to make your travel time easier on your body and help you arrive in Uganda feeling better. Try to get as much rest as possible during the last days before you travel. During your flight, try to elevate your feet as often as possible to prevent swelling. Taking your shoes off on long flights can add to comfort, but be prepared for difficulty getting back into shoes if your feet swell. Get up and walk around the plane several times during the flight. Drink a lot of liquids during the flight. Sleep as much as possible on the overnight flights. A shower after an overnight flight does wonders toward taking away fatigue. Most airports have a place to at least freshen up and many have showers. During layovers in Europe, You may like to get a room and sleep while others prefer exercise and sight-seeing. Your personal body reactions need to be considered.

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MEDICATIONS & IMMUNIZATIONS INFORMATION Diarrhea Transmission Symptoms Expect some diarrhea during your stay due to contamination of food and water. Most will be self resolving and not require treatment. Illness starts in hours to days.

Water/food Stools may range from: loose to watery to bloody, green with bad smell, gas, bowel pain, vomiting, nausea

Chlorea Transmission Symptoms Contaminated food or water Frequent, watery stools Hepatitis A & Hepatitis E Transmission Symptoms Sewage, raw water, uncooked

foods Fever, lethargy, nausea

Treatment: Rapid replacement of lost fluids and antibiotic therapy. Vaccine not very effective. Thyphoid Transmission Symptoms Elevated risk in populated areas with poor sanitation

Sewage, contaminated water, uncooked foods

Headache, chills, loss of appetite, fever

Treatment: Antibiotics and replacement of fluids. Meningococcal Meningitis Transmission Symptoms Risk elevated under crowded living conditions and travelers having close contact with local nationals.

Direct contact, including discharge from noses and throats of infected persons

Range from mild upper respiratory illness to sudden fever, chills, headache, stiff neck, nausea, vomiting

Treatment: Immediate dose of proper antibiotic. Vaccine available.

INSECT-BORNE FEVERS Personal insect protection recommended for ALL vector-borne diseases Malaria Transmission Symptoms Mosquito bites Fever and flu-like illness, shaking

chills, headache, muscle aches and tiredness. Nausea, vomiting and diarrhea may also occur. May cause anemia and jaundice because of loss of red blood cells.

Yellow Fever Transmission Symptoms Mosquito bites Sudden fever, rapid pulse,

jaundice, headache and pain in lower back, legs, joints, behind eyes

Protection: Insect repellant, protective clothing and mosquito netting.

SUMMARY OF RECOMMENDATIONS

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YELLOW FEVER vaccine may be needed. Consider CHOLERA vaccine active infection present. You may be exposed to MALARIA. No clear consensus exists as to the optimal medication for malaria prevention. Malaria may develop even if all medication is properly taken. Consult a physician at once to evaluate any symptoms (fever, cough, muscle aches, diarrhea) which might indicate malaria infection. Refer to each country report for specific information about malaria prevention medication. In addition, be sure to avoid mosquito bites by using bed netting, repellent (DEET), and keeping arms and legs covered, especially from dusk to dawn. PRIMAQUINE treatment may be appropriate on return home. When traveling under poor sanitary conditions consider immunization against POLIO (IPV or OPV), TYPHOID and HEPATITIS (Hepatitis A vaccine - Havrix or gamma globulin). If you will be working in a rural area and occupationally exposed to animals, consider vaccination with RABIES or PLAGUE vaccine. Consider MENINGOCOCCAL vaccine. Meningococcal disease is active in one of the countries you will visit. Avoid wading or swimming in fresh water to protect against SCHISTOSOMIASIS. All individuals should have a DIPHTHERIA-TETANUS booster every 10 years. MEASLES immunization (or proof of immunity) is advised for international travelers born after 01 JAN 1957.

PROPER MEDICATION The following health problems may be prevented with proper medication:

• Motion Sickness: Can be prevented by using scopolamine (Transderm-Scop CIBA). For best results apply before symptoms develop. Each patch will last for up to three days. For short-term relief OTC antihistamines may be helpful, but watch for drowsiness.

• Traveler’s Diarrhea: Is best prevented by eating well-cooked food and drinking bottled,

carbonated or boiled beverages. Mild symptoms are effectively treated with loperamide (Imodium, Janssen). This advice follows the format of the U.S. Department of Health and Human Services, Centers for Disease Control as published in Health Information for International Travel. These recommendations are current as of the Weekly Summary of 06 MAR 1997.

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IMMUNIZATION ALERT INTERNATIONAL HEALTH DATABASE TRAVELERS IMMUNIZATION INFORMATION

• Havrix—Immunization for Hepatitis A, formerly called “infectious” hepatitis. Given to frequent travelers. Takes 14 days for immunity to develop. Need a booster dose in 6-12 months after the 1st dose for lasting immunity up to 5 years.

• Immune Globulin—Immunization for Hepatitis A. Given to short term travelers and people

in need of immediate immunity. If traveling longer than 6 months, you need to be revaccinated with Immune Globulin in the 6th month.

• Menomune Vaccine—Immunization for meningitis. Takes 10-l4 days for immunity to be

developed. Immunity up to 2-3 years. Need a booster dose if traveling to a high risk area.

• HDCV Rabbis Vaccine—Pre-Exposure Vaccine for Rabbies. A series of 3 injections given on day l, day 7, and day 28. Need a booster dose every 2 years if in a high risk exposure area. The vaccine does not eliminate the need for medical treatment and follow-up after a bite.

• MMR Vaccine—Immunization for Measles, mumps and Rubella. People born after 1957

should have at least 2 doses of MMR Vaccine in a lifetime. Gives immunity within a few days. Should not get pregnant for 3 months after immunization.

• TD Vaccine—Immunization for Tetanus & Diphtheria. Gives immediate immunity. Need a

booster dose every 10 years.

• HB Vaccine—Immunization for Hepatitis B, formerly called “serum” hepatitis. Given in 3 doses. Gives long lasting immunity. May need a blood test to determine level of antibodies after 5 years.

• IPV—Inactivated Polio Virus Vaccine- Immunization for Poliomyelitis Virus. A booster dose

given to adults age 18 or older who have an increased risk of exposure. Gives immunity for a lifetime.

• Yellow Fever Vaccine—Immunization for Yellow Fever. Vaccine given at Public Health

Department in your residential area. Immunity for 10 years. International Certificate of Vaccination needs documentation of receiving immunization at least 10 days before arrival to country.

• JEV—Japanese Encephalitis Vaccine. Immunization for Japanese -Encephalitis. Given in 3

doses, day 0, day 7, and day 30. Immunity can be expected in 10 days following last dose. Immunity lasts 3-4 years.

• Typhim Vaccine—Injectable Typhoid Vaccine. Takes 14 days to achieve immunity. Need

a booster every 2 years.

• Vivotif—Oral Typhoid Vaccine. It is essential that all 4 doses be taken on alternate days to obtain maximal protective immune response. Need to take 1st capsule on day 1, 2nd capsule on day 3, 3rd capsule on day 5 and 4th capsule on day 7. Take 1 capsule, 1 hour before a meal with a cold or lukewarm drink. Capsules need to be stored in refrigerator at all times, therefore you should complete all 4 doses before traveling. Do not chew capsule-- swallow

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immediately after placing in mouth. Not all recipients of typhoid vaccine will be fully protected against typhoid fever. Travelers should take all necessary precautions to avoid intake or ingestion of contaminated food and water. Provides immunity for 5 years. Should not take with oral antibiotic. The antibiotic should be stopped or completed 2-3 days before starting Vivotif and resumed 5 days after completing Vivotif.

ANTI-MALARIAL MEDICATIONS

• Lariam—Generic name is Mefloquine. Provides Malarial Prophylaxis. Take l tablet a week. Begin taking 1 week before departure to malarious area. Subsequent weekly doses should be taken on the same day each week. To reduce the risk of malaria after leaving the malarious area, continue to take for 4 additional weeks. Take tablets with food and at least 8 oz. of water. Lariam can be taken if pregnant.

• Aralen—Generic name is Chloroquine. Provides Malaria Prophylaxis. Take l tablet a week.

Begin taking 1 week before departure to malarious area. Subsequent weekly doses should be taken on the same day each week. To reduce the risk of malaria after leaving malarious area, continue to take for 4 additional weeks. Take tablets with food.

• Vibramycin—Generic name is Doxycycline. Provides Malaria Prophylaxis. Take 1 capsule

daily for 2 days before departure to malarious area, take l capsule daily while in malarious area and continue for 4 weeks after leaving malarious area. Do not take with iron, dairy or antacid products (wait 2 hours before taking these products). Sensitivity to the sun may occur while taking Doxycycline, therefore, use a sunscreen with a minimum SPF of 15 when you are exposed to the sun. Although you have received the recommended immunizations, there is not a vaccine guaranteed to provide 100% immunity and there are many other diseases and viruses we do not have immunizations against, therefore travelers should always be water wise and food wise and follow insect protection measures when traveling to high risk areas.

WARNINGS WHEN USING LARIAM

• If taking oral Typhoid and Lariam during the same week, you need to wait 24 hours between taking the 2 medications. DO NOT take them on the same day.

• Lariam should be used with caution in patients suffering from cardiac conduction diseases as

asymptomatic sinus bradycardia and other abnormalities have been reported.

• Caution should be exercised with regard to driving, piloting aircraft and operating machines as dizziness, disturbed sense of balance or neuropsychiatric reactions have been reported during and up to three weeks after use of Lariam.

• During prophylactic use, if signs of unexplained anxiety, depression, restlessness or

confusion are noticed, the drug must be stopped as these may be considered prodromal to a more serious neuropsychiatric event.

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• As preventive medication with antimalarials, including Lariam is not 100% effective, the following measures to prevent mosquito bites should be taken to reduce the risk of contracting malaria:

1. Visiting endemic areas during the dry season or in years when the rainfall is low.

2. High risk persons should avoid malaria areas altogether. High risk persons should

include: babies and young children less than 5 years of age; pregnancy; immunocompromised individuals such as those on long term steroids, cancer patients, chemotherapy, AIDS patients and those who have had their spleen removed.

3. Not going outside between dusk and dawn, when mosquitoes are most active.

4. Applying insect repellant to exposed skin and cloth.

5. Wearing long sleeves and long trousers at night.

6. Using mosquito nets, screens, coils and pads.

Resistance to Lariam has been documented in some areas. When flu-like symptoms develop patients should inform their doctors that they have been to a malarial area.

SIDE-EFFECTS AND SPECIAL PRECAUTIONS

The following side-effects have been observed: dizziness or disturbed sense of balance, nausea, vomiting, loose stools or diarrhea, abdominal pain and loss of appetite. Other less frequent reactions that have been reported include: headache, myalgia, feeling of weakness, visual disturbances, palpitations, bradycardia, irregular pulse and extrasystoles, AV-block, hair loss, rash or pruritis, urticaria, convulsions, psychological changes (e.g. depressive mood, confusion, anxiety, hallucinations, paranoid reactions), transient elevation of transaminases, leukopenia or leukocytosis and decrease of platelets. If signs of unexplained anxiety, depression, restlessness or confusion are noticed, these may be considered prodromal to a more serious event, and the drug must be stopped. The adverse effects mentioned above may be observed several weeks after the last dose. Interactions Lariam should not be administered concurrently with quinine, or related compounds (quinidine, chloroquine, quinolones) since these could increase the risk of convulsions. When Lariam is taken at the same time or shortly before oral typhoid vaccines, attenuation of the immunization induced by such vaccines cannot be excluded. Therefore, vaccinations of this type should be terminated at least three days before the first intake of Lariam, keeping in mind that Lariam prophylaxis should be started one week before arrival in a malarious area. Known Symptoms of Overdosage and Particulars of its Treatment

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In the case of overdose with Lariam, the symptoms mentioned under “Side Effects and Special Precautions” may be more pronounced. The following procedure is recommended in case of overdose:

• Induce vomiting or perform gastric lavage

• Monitor cardiac function (if possible with ECG) and neuropsychiatric status for at least 24 hours.

• Provide symptomatic and intensive supportive treatment as required, particularly for

cardiovascular disturbances. Identification White to off-white cylindrical biplanar, cross-scored tablets. Presentation Lariam 250 mg tablets:8

IMMUNIZATIONS We recommend that you have an inoculation for Hepatitis A. This is a new vaccine since June of 1995. We recommend that you have a tetanus inoculation within the past three years. Polio, typhoid, rabies, gamma globulin, cholera, and Hepatitis B are optional and you will need to do what you feel is right. Check with your local Health Department for any required inoculations since they change periodically. Carry with you the “yellow book” in which immunizations are recorded by the Health Department.

REQUIRED INOCULATION Yellow Fever: Given on a walk-in basis and cost is approximately $30.00. Anyone under 18 must be accompanied by a parent. Protection effective for ten years. Preferable: After yellow fever shot, wait three weeks, then cholera (2 shots 4 weeks apart). Malaria: Must have a prescription from own physician, and take to the Health Department. (Lariam)

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SHILOH’S RECOMMENDED INOCULATIONS Cholera: Two shots, 4 weeks apart and are effective for 6 months. Cost $60.00 Tetanus: One shot is effective for 10 years. Cost $6.00 Typhoid: Two shots, 4 weeks apart and is effectively for three years. Cost $60.00 Hepatitis A: Call the Health Department to schedule ahead of time. Cost is approximately $52.00 and is highly recommended.

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MISSION TRIP PACKING LIST This is a list of suggestions. You may choose to take part or all of the items and there may be other items which you will want to include after reading all the suggestions in this manual. The purpose of this list is to help you in your packing.

Important Papers Clothes Medication q Passport q Tickets q Itinerary q Mileage Plus Card q Drivers License q Credit Cards q Travelers Checks & Cash

(large bills for greater exchange rate ie. $50 & $100)

q Important Phone Numbers q Telephone Calling Card q Immunization Record

q Slacks/Skirts/Jumpers q Sport Coat q 4 Neckties q 5 Regular Shirts/Blouses q Socks q T-Shirts q Underwear q Shower Shoes q Walking Shoes/Dress Shoes q Pajamas q Lightweight Jacket q Plastic Rain Jacket q Baseball Cap or Similar q Swimwear q Handkerchiefs

q Gamma Gloublin q Malaria Tablets q Diarrhea Medicine q Antibiotics q Neosporin q Allergy Medicine q Throat Lozenges q Vitamins: C,E, Bee q Pollen q Aspirin q Tylenol q Antacid q Rx Drugs

Miscellaneous Toilet Articles

q Extra Pair Eyeglasses/Contact Lenses q Eyeglass Cleaner/Saline Solution q Zip Lock Bags q Lysol q Money Belt q Water Purification Tablets q Small Canteen q Mosquito Repellent 100% Deet q Towel q Sheet/Pillow Case q Inflatable Pillow q Flashlight & Extra Batteries q Camera q Film q Small Tape Recorder q Umbrella q Suitcase Lock q Address Tag on Suitcase q Travel Diary q Granola Bars & Crackers

q Toilet Paper (2 rolls) q Kleenex q (Antibacterial) Wet Towelettes q (Antibacterial) Soap q (Antibacterial) Deodorant q Toothbrush q Toothpaste q Dental Floss q Mouthwash q Lotion/Sunscreen (unscented) q Chap Stick q Shampoo/Conditioner q Body Power q Foot Powder q Q-tips q Mirror q Shaving Cream Razors q Comb/Brush q Sanitary Napkins/Tampons

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CAMERA, VIDEO & ELECTRONIC EQUIPMENT At least one member of each team will want to have a good quality camera and lots of film. You will want to preserve some of the glorious memories. You may bring a video camera. Be sure to bring extra battery packs for recharge since you may go several days without electricity. A small portable audio tape recorder could be appreciated to capture some unique sounds. Be sure to bring a flashlight since many areas do not have electricity and even in the city there are frequent power failures. Remember that Uganda power is 240v, 50 cycles. Missionaries have transformers you can use when in their homes, if the power is on, but otherwise US equipment will not work. The small travel transformers available from laces like Radio Shack will work for razors, hair dryers, and some tape recorders, but they can also be disappointingly inefficient and can even cause damage to equipment since voltage fluctuates greatly and often. Small transformers offer no real protection against voltage fluctuations. This can be especially dangerous to recharge for video equipment.

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MISSION TRIP DO’S AND DON’TS

• Do not bring expensive jewelry. There are many thieves, especially in the city, and jewelry snatching can happen. Jewelry is not needed, since Ugandan women do not generally wear it.

• A fanny pack is a welcome accessory to carry tracts, small Bibles, cameras, etc. We

recommend that you “wear it” in front of your body to protect the contents.

• Money belts are used with comfort by some.

• A hat and/or folding umbrella are usually necessary protection against the equatorial sun and rain. Bring sunglasses since the sun is extra bright.

• Do not over pack. Pack only what is necessary for your needs because you will be carrying

your own luggage.

• Make sure you have checked with your local health department that you have the necessary inoculations. These immunizations are necessary in order for you to enter the country. Also take your international health record showing shots you have received.

• Make sure you have your malaria drugs one week before leaving and continue for six

weeks after you return.

• It would be wise to take along something for diarrhea and other intestinal disorders that might arise.

• Take along some type of insect repellent (Deet). You will need to spray around your bed at

night and also something to rub on your skin.

• Take a canteen for water that can be clipped to a belt (water pouch).

• You need to have a healthy respect for the tropical sun. The use of a sunscreen is strongly advised.

• Dress comfortably. Wear loose-fitting clothes and comfortable shoes. Remember that weather

conditions will be different so plan accordingly. (Ladies, be careful about heavy makeup, jewelry, etc. Slacks are not acceptable while in country).

• Do not drink water, milk or any type of beverage offered to you unless the missionary is with

you and says it is all right to drink it. Usually, the carbonated drinks are safe in countries around the world. All water must be boiled before drinking.

• Do not eat any raw vegetables. They must be well cooked.

• Do not eat any fresh fruits unless you have peeled first.

• Make sure hands are clean before eating (use towelettes).

• When eating, be considerate of other’s having to eat. (Do Not Be a Pig.)

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• You must drink plenty of water that you bring with you. You can dehydrate because of the

hot climate.

• Be careful about displaying money. Volunteers should keep your money out of sight. Avoid giving the impression that you are a rich American.

• Keep your passport, traveler’s checks and airline tickets with you or close to you in a secure

place at all times. Before you leave home, copy your visa stamp and passport. Leave one copy at home and take one copy with you. Do not let anyone hold these documents unless you know them as well as you know Jesus.

• Go to serve as a volunteer and to help share the gospel of Jesus Christ. This is not a time for

you to spend a lot of time talking about politics.

• Go to serve and not as the expert.

• Size of your luggage should be carry on size.

• Brush teeth using bottled water.

• Handiwipes are good for wash cloths (throw away).

• Large zip lock bags can be used at night.

• If you feel yourself getting sick, let someone know right away.

Go With The Flow!

PHOTOGRAPHY DO’S AND DON’TS Photography can be an exciting experience. Be sure to bring lots of film and replacement batteries with you. They are available in Kampala, but not necessarily where you will be, and are very expensive. To get good pictures of African people requires more light. Consider using a flash with an automatic camera, or decrease your stop setting at least one stop. If your subject faces the sun, facial features will show up much better. When you take photos of children, squat or kneel to be on the same level. EXCEPT IN CHURCH SETTINGS, DO NOT TAKE PICTURES OF PEOPLE WITHOUT THEIR PERMISSION. It is still against the law to take pictures of government buildings, government officials, at the airport, or any military facility. Before taking any pictures it is best to ask the missionary or Ugandan with you if it will be permissible. Ugandans will want copies of pictures taken of them. Don’t promise to send copies unless you really intend to follow-up. Unfulfilled promises create bad feelings and can demean the good things you do.

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HOW TO HANDLE CULTURE SHOCK Culture shock is when all the cultural maps we learned as children do not apply. The experience of culture shock can be very devastating. However, there is value recognizing the symptoms and making preparations to minimize the experience. You can have hope; not everyone experiences culture shock during relatively short stays. Culture shock is an emotional or physical experience created by circumstances which are significantly different from one’s usual environment, such as different languages or lifestyles. You can minimize your reaction to language differences by recognizing that you will not be able to communicate with many people except through signs or an interpreter. If you have visited ethnic communities in the U.S. or a foreign country where language is spoken, you should not have a problem with culture shock because of language differences. One very likely aspect of culture shock is our reaction to the poverty or lifestyles which you confront in Africa. Most Americans have never seen people living under conditions like you may observe. The emotional impact of seeing people living in mud huts or urban slums can be traumatic. Seeing the conditions in which the food you are eating is prepared may be more unsettling. Sometime during your stay in Uganda, you will very likely experience “negative emotions” or discomfort with circumstances or conditions to which missionaries or Ugandans seem oblivious. Understand that these things are “normal” in Ugandan as missionary hosts. They will usually be eager to explain their point of view and help you to adapt to the way things are. The best preparation to guard against culture shock is spiritual preparation. Recognize that you are on this trip because you want to share the love of Jesus Christ. Pray that God will protect you in every circumstance and expect the prayer to be answered. Many missionaries will tell you that God has given them a “special stomach.” Go to Uganda expecting God to protect you from harm, including culture shock. Most villages have Catholic and Anglican churches and about 80% of the people have nominal affiliations to one of these. A great difference is recognized between being a Christian (church membership, Christian name given at infant baptism) and being saved. Pentecostals and other groups have a strong impact in some areas. Some areas of Uganda have a very strong Muslim influence. People in most areas now are very open and responsive. In our preparations, a study of basic beliefs and customs of Catholic Anglicans and Muslims could be helpful.

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USING AN INTERPRETER

Although English is widely known, the probability is that you will converse, teach, or preach using an interpreter while you are in Uganda. Some churches in Uganda translate into two and three languages even when there are no visitors. There are some “tricks of the trade” which you can use to make your translation more easily understood. Regardless of the skills a translator possesses, his translation quality is controlled by the person who is the primary speaker. You can make your speaking more effective by following these principles when you speak:

1. Speak short phrases or simple sentences to permit a rhythm of translation. Try to complete a thought or phrase and then pause to allow your translator to understand the meaning of that phrase. In many cases, translated ideas require a different word order in the vernacular language.

2. Stick to simple English and avoid the use of complex or difficult English words. African

English is different.

3. Do not use poems or colloquial sayings and avoid American slang, jokes, and idioms. Most of the time, they don’t translate well.

4. Review your outline and Scripture with the interpreter before the service.

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GENERAL PROTOCOL

One major communication problem is the use of illustrations which are American in context and content Ugandans are very loving and forgiving of such but there may be embarrassment. You should always shake hands with both men and women. Always shake with your right hand (as well as giving and receiving with your right hand). Handshaking is a practice which has real meaning to the Ugandan people. You will very quickly learn that Christian brothers have a unique handshake they will teach you. Ugandan’s generally do not hug or embrace one another, especially not the sex. You should not initiate a hug but respond if you are hugged. Some Ugandans started hugging people from America because they know it is our custom. Men often hold hands while standing together or walking together. It is a sign of friendship, has no sexual implications, and need not be an embarrassment to you. Husbands and wives and especially engaged couples are not demonstrative of their affection in public and are sometimes embarrassed by Americans who are. If you smoke or drink, you must abstain from these practices while you are in Uganda. Ugandan Christians consider these actions as major sins. Your witness will be destroyed with these actions since Ugandans think that a person who smokes or drinks is not a Christian. Furthermore, you will damage the integrity of the missionaries who have invited you to work with them. Being a guest in a home anywhere in the world is a trait which is appreciated and which builds a good relationship. If you are the polite, caring persons every Christian should be, any problems from a cultural faux pas will be forgotten. Let the Ugandans advise you rather than having all the answers. Let them buy the soda when they offer. Paying for everything can be a “put down”. Just relax, listen, and learn and everybody will be happy.

GIFTS Remember that you cannot give a gift to everybody, even though in your heart you will want to share your riches. There will be mobs of people if you start giving out candy or pencils. Monetary gifts to individuals can often do more harm than good. Please check with your host before giving gifts or anything to Ugandan’s ball point pens, baseball caps, key chains or other souvenir type items from the USA or your state would be fitting gifts for a pastor you work with most, your interpreter, or possibly one or two other special people. It is not a “given” that gifts must be taken to the host. However, it is a nice gesture to the host if you take some American “goodies” which are not available in Uganda. Items which are always appreciated are magazines, DVDs of recent TV shows or movies, new grocery items, candy bars, peanut butter, snack crackers, ready-to-eat cereals, powdered drink mixes such as Kool Aid, and dry mixes such as salad dressings, meat marinades or sauces.

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GIFTS COMING FROM YOUR CHURCH History has taught us that one of the easiest ways to kill a host church is to flood it with foreign money. Missionaries have testified that the heart and faith of these churches may be devastated by outside income. There are countless illustrations of members within a host church choosing not to tithe in exchange for their reliance on others to fund the work of their local church. This is a faith killer and the creation of what we call “a welfare state.” DON’T FALL INTO THE TRAP! There are horrible stories of how Americans have squandered God’s resources by haphazardly giving money without the council of those most familiar with the interworkings of a host country. Always coordinate your financial intentions with a MADI staff person to ensure that your best intentions are not the death blow to a host church or community. Additionally, we will be capable of providing you with the accountability tools that will ensure good stewardship of the resources. Our commitment is to encourage the joyful giving of tithes and offerings to fund the outreach efforts of the local church. With that in mind, we strongly urge all short-term missionaries traveling with MADI to exercise restraint and good judgment in the area of financial contributions. Finally, in an effort to build strong, vibrant churches in these countries, we must allow them to strive towards unifying their efforts in reaching their own stated goals. Let us not undermine the vision of the pastor and stunt the growth of the church.

PROMISES/GIVING CHANNELS Unkept promises made by volunteers create many problems, particularly for the missionaries. Africans have a memory like an “elephant” and remember every promise or what they interpret as a promise. Please clearly communicate when you are asked to provide an item by saying “I cannot do that” instead of saying “I’ll see”. Your heart will be touched by need. Recognize that you cannot meet every need. Please consult with the host before making any promise or giving any gift. Avoid giving money to individuals. This creates serious relationship problems. Gifts to a group church, school, or community can be acceptable, but we stress the importance of using the regular channels for financial gifts.

LOCAL POLITICS Missionaries have learned that it is wise to avoid taking a position concerning local politics. Even though the Ugandans may want to invoke a “foreigner” in political discussions, it is smart to refuse to listen or discuss these issues. This is particularly true for the Christian witness. Few issues raise the emotions as much as political discussions while you are visiting Uganda.

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PERSONAL SECURITY Personal security is related to wisdom of actions. Just as you would not walk the downtown streets of any major American city at night, it is wise to follow the same practices while you are overseas. Neither should you wear expensive watches or jewelry. Safety is not an issue of major concern when you exercise good judgment, but follow the advice of Nationals and missionaries about what you should do and where you should go. Your Ugandan brothers will often be more cautious about your safety than the missionaries.

Congratulations! You, too, have reached far!

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AFTER YOU RETURN

DEBRIEFING Before your departure from the field, a time will be arranged with field coordinators where you will have an opportunity to share your experiences and make suggestions which could help future groups. Please be ready to objectively evaluate your experiences. After your arrival back home, a time will be arranged for you to meet to review your project. You will be notified of the date and location for this opportunity.

USING YOUR NEW SKILLS AT HOME One of the most positive things about partnerships is the spiritual renewal which many volunteers experience. Many report a fresh commitment to personal witnessing in their home communities. Others have discovered a spiritual gift during their volunteer project. Most have opportunities to share mission stories seen with their own eyes and heard with their own ears. Your personal experience cannot be predicted. The important thing is to keep the experience fresh and to use your skills in your daily life. Our Biblical imperative Found in Matthew 28:19-20 says, “As you are going, make disciples, baptize them, and teach them.” May God use you and bless you as you are going back home and wherever God leads you.

KEEPING THE MEMORIES ALIVE There are many ways by which you will be able to retain your memories of your trip to Uganda. Your pictures, slides, or video will provide an opportunity to relive the experiences. One of the best ways to help you remember is to keep a daily journal of events and people whom you meet. This journal will be very important to you as you prepare to share with your church after you return home. The journal will also be useful to you as you remember to pray for new friends by name and perhaps carry on correspondence.