̽��ֱ�� of Cambridge - Makerere ̽��ֱ��

Phone-based HIV support system repurposed for COVID-19 monitoring in Uganda

lw355 — Wed, 22 Jul 2020 07:50:39 +0000

People entering Uganda have been required to quarantine for 14 days as part of the country’s lockdown measures, during which time they are monitored by the Ugandan Ministry of Health for development of COVID-19 symptoms.

Cambridge researcher Dr Rosalind Parkes-Ratanshi and her team have been helping the Ministry monitor and support quarantined individuals using a voice and SMS messaging system, Call for Life Uganda (C4LU). ̽��ֱ��tool was rapidly adapted for COVID-19 by Parkes-Ratanshi, who is based jointly at Cambridge’s Institute of Public Health and leads the Academy for Health Innovation at Infectious Diseases Institute, Makerere ̽��ֱ��, Uganda.

̽��ֱ��C4LU system regularly phones quarantined individuals to request they report any symptoms. ̽��ֱ��automated system then generates symptom reports and anything of potential concern is flagged to healthcare professionals for triaging. This eases the burden on healthcare workers of widespread check-ups in person or by phone.

Parkes-Ratanshi and colleagues at the Infectious Diseases Institute have been using the tool for the past four years to monitor HIV patients, in collaboration with Janssen: Pharmaceutical companies of Johnson & Johnson. When the coronavirus pandemic reached Uganda, the team rapidly repurposed the system they had developed, re-scripting for COVID-19 and recording the messages in 11 of the languages spoken in Uganda.

“ ̽��ֱ��total number of COVID-19 cases in Uganda has been low so far, with just over 1,000 cases across the whole country,” says Parkes-Ratanshi, who is currently based in Uganda. “Almost all cases seem to be linked to returning travellers and so the quarantine system and lockdown have been vital to slow the spread of the pandemic.”

Currently, the team are monitoring around 250 people using C4LU, with a total of 599 having participated so far. “Only a very small number of people have then needed to be tested for COVID-19, which shows the benefits of having a tool that can take pressure off the health system by reducing unnecessary visits,” she says.

Although Uganda has been fortunate in not suffering the scale of cases seen in some countries, Parkes-Ratanshi is mindful that there could be a future surge in infection. “We could see a time when regular monitoring on a wider scale would be beneficial. A system like this could reduce the number of individual calls coming in to the Ministry of Health – it could take some of the burden.”

So far, the team has focused on implementation – getting the system up and running, and triaging for possible COVID-19 cases that require confirmatory tests. They are now adding a research component, so that they can learn more about the impact of the technology, with funding from Cambridge ̽��ֱ��’s Global Challenges Research Fund QR.

̽��ֱ��team has been asked by the Ugandan Ministry of Health to add a layer of mental health support to the tool, adds Parkes-Ratanshi. “Once you’ve gone through your symptom reporting, you might then be asked a couple of screening questions about anxiety or mental health issues. Depending on the answer, we could then offer mental health support for those people who may not need active care or active testing, but have got anxiety or mental health issues related to COVID. We think that this will also be exceedingly important to help in a situation where the health care system is very stretched.”

Crucially, the technology is appropriate to the context, says Parkes-Ratanshi: “Around 75% of people have phones in Uganda, so phone-based technology seems to be a very good way of doing this kind of public health monitoring. But it would be no good taking say a smartphone app developed in the UK and thinking it would work for Africa. Even those people who’ve got smartphones may not have access to the internet on the day they need it. So our technology is developed to work on low-cost mobile and analogue phones.”

C4LU itself is based on an open source digital system developed originally for tuberculosis patients by Janssen. “Time and resources are limited in sub-Saharan Africa. We don’t really want to be experimenting with new stuff in a pandemic, which is why we’re glad to apply our experience using this tool for HIV to COVID-19.”

Rosalind Parkes-Ratanshi is supported by several of Cambridge’s interdisciplinary networks and initiatives – Public Health, Cambridge-Africa, Infectious Diseases and Global Challenges.

How you can support Cambridge’s COVID-19 research

A cost-effective phone-based system developed by a Cambridge researcher and her Ugandan colleagues to support HIV patients has been rapidly adapted by the team to help the Ugandan Ministry of Health monitor those in quarantine during the coronavirus pandemic.

We could see a time when regular monitoring on a wider scale would be beneficial. A system like this could reduce the number of individual calls coming in to the Ministry of Health – it could take some of the burden

Rosalind Parkes-Ratanshi

Infectious Diseases Institute

Call For Life

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

Yes

African academics collaborate on Cambridge Research Office programme

plc32 — Fri, 21 Jun 2019 15:25:04 +0000

̽��ֱ�� administrators from Uganda, Namibia, Ghana, Botswana and Sierre Leone took part in collaborative workshops, heard from speakers such as ̽��ֱ�� of Cambridge Pro-Vice-Chancellor Eilis Ferran on the importance of administration to researchers and pored over the best practices for contracts, due diligence, audits, impact statements and applications.

̽��ֱ��GCRF Africa Initiative’s Capacity Building 2019 programme provided a forum for African university research office administrators to share their experiences, hear from the experiences of the Cambridge Research Office and develop their own unique solutions to the challenges of building capacity in the administration of grants and research in Africa.

“ ̽��ֱ��purpose of the programme is to help universities in the development of their research management support structures in the grants life-cycle,” said programme coordinator Debbie West-Lewis from the Cambridge Research Office.

Participants said the programme was as valuable for its insights into best practice at a global university as it was for discovering the shared problems and solutions at institutions across the African continent.

“It’s given us an opportunity to bounce ideas off each other and share ideas that will be quite useful for us as an institution to better serve our academics,” said Mercy Mwaura, Director of the Office of International Relations and Projects at the ̽��ֱ�� of Makeni in Sierra Leone.

Botswana Institute for Technology Research and Innovation Knowledge Commons and Research Manager Kgomotso Radijeng said it was refreshing to hear that even ancient universities with global reputations such as Cambridge also have their challenges.

“They’ve been able to share with us how they resolve their challenges,” she said. “So we shouldn’t despair.”

William Alpha from ̽��ֱ�� of Makeni in Sierre Leone said that the programme deepened his belief in capacity building as a key cornerstone to driving better research and helping Africa’s universities make a real difference at home.

“That’s the core value for universities: do research that will impact our people and our communities,” he said.

One of the key takeaways all of the group agreed on was the newly formed network of support they’ve created for themselves with colleagues from the programme.

They have all joined up in a new WhatsApp group.

“Now we have a network and you know when you have a problem you can call up and say I’m struggling with this,” Radijeng said.

Academics from across sub-Saharan Africa gathered in Cambridge this week to share knowledge and attend talks on how to build greater capacity in their research support offices.

That’s the core value for universities: do research that will impact our people and our communities

William Alpha, ̽��ֱ�� of Makeni, Sierra Leone

Debbie West-Lewis

African Academics on Cambridge Research Office Capacity Building Programme

Yes

Innovative and internationally competitive African research celebrated as part of the 10th anniversary of the Cambridge-Africa Programme

pbh25 — Tue, 01 May 2018 12:41:58 +0000

̽��ֱ�� ̽��ֱ�� of Cambridge celebrated the tenth anniversary of its flagship Cambridge-Africa Programme at an event held at the Fisher Building in St John’s College.

Recognising the need to support world-class research in Africa to identify African solutions to the continent’s challenges, the Programme provides fellowships to PhD or postdoctoral researchers, and matches them with Cambridge research leaders for mentorship and collaborative support.

In one of the day’s first presentations, Professor Gordon Awandare spoke of how the Programme played a crucial role in the establishment of the West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), which has evolved into a centre of excellence and major hub for biomedical research and training in West Africa.

He told the audience that the importance of a centre which could attract African talent back to Africa could not be overstated: “We are engaging African scientists in the diaspora – we want to address the brain-drain and make this about brain-circulation.”

He spoke of how investment from collaborators and from the World Bank meant the centre, based at the ̽��ֱ�� of Ghana, was an attractive place to work. African scientists could be confident that their facilities were as good as those in other institutions around the world, and that they could conduct the kind of globally excellent research they wanted to.

Further presentations throughout the day addressed a wide variety of research, including a study on gender-based violence in Uganda and research into the solar energy applications of graphene.

Professor Eilís Ferran, Pro-Vice-Chancellor for International and Institutional Affairs, said: “We know we cannot simply parachute in with fixed solutions to what we see as uniquely African problems. Nor can we be complicit in a model of education and learning that takes some of the brightest minds away from their home countries.

“This is why the Cambridge-Africa Programme is so valuable – and why it has thrived over the past ten years: Because it relies on real partnership; because it addresses, and helps to reverse, the continent’s brain drain. Indeed it is about brain mobility.”

Professor David Dunne, Professor of Parasitology at the Department of Pathology at Cambridge and the Director of the Cambridge-Africa Programme, welcomed all those present:

“Today we will hear from young academics who will share with us their research and their vision for the future,” he told the audience.

He added that the Cambridge-Africa programme was initiated 10 years ago to help bridge the mentorship gap in Africa, which meant that new research leaders struggled to find the mentors they needed to develop in their home countries.

“Building these relationships with Africa over the last 10 years has very significantly enriched Cambridge’s own academic environment, benefiting both our students and academic researchers. It is our hope that mutually beneficial engagement between African and Cambridge researchers will further deepen and flourish over the next 10 years, with African universities taking their place among the leading academic research institutions in the world.”

̽��ֱ�� ̽��ֱ�� of Cambridge programme supports research in Africa with 50 partner institutions across 18 countries.

It is our hope that mutually beneficial engagement between African and Cambridge researchers will further deepen and flourish over the next 10 years, with African universities taking their place among the leading academic research institutions in the world.

Professor David Dunne, Director of Cambridge Africa

By OER Africa

Balme Library, ̽��ֱ�� of Ghana, Legon

Current Cambridge-Africa Initiatives & Partnerships

Cambridge-Africa Scholarship Scheme: 25 Cambridge Africa PhD Scholarships, funded by the ̽��ֱ�� of Cambridge and the Cambridge Trust; 2015-20 (five students a year, for five years).
Makerere-UVRI Infection & Immunity Training Programme (MUII); Wellcome Trust and DELTAS Africa funding to Uganda; 2008-20. Building a Centre of Excellence for infection and immunity research and training in Uganda. Five PhD and four postdoctoral fellows are being mentored.
Training Health Researchers into Vocational Excellence (THRiVE); Wellcome Trust and DELTAS Africa funding to East Africa; 2009-21. THRiVE is establishing a Network of Excellence for supporting health research in a broad sense, in Kenya, Uganda and Tanzania. Fourteen PhD and eight postdoctoral fellows have/are being mentored by Cambridge academics.
Cambridge-Africa Partnership for Research Excellence (CAPREx), funded by the Carnegie Corporation of New York and the Isaac Newton Trust; 2012-18. Focuses on strengthening capacity for sustainable excellence in research in the humanities, social and physical sciences, as well as technology subject areas. CAPREx is also supporting knowledge exchange partnerships and training in research management and administration in specific universities in Ghana and Uganda. Sixty-two postdoctoral researchers have been matched to Cambridge colleagues for on-going collaborations.
Cambridge-Africa ALBORADA Research Fund, sponsored by ̽��ֱ��ALBORADA Trust; 2012-26. ̽��ֱ��Fund enables researchers from Cambridge and sub-Saharan Africa, across all disciplines, to apply jointly for grants to initiate collaborations. Funds are awarded for research reagents, fieldwork, travel between Cambridge and Africa, and the purchase of equipment. As at 2017, >150 awards have been made to joint applicants from Cambridge and their colleagues, in 18 African countries.
Wellcome Trust-Cambridge Centre for Global Health Research (WT-CCGHR), funded by Wellcome Trust; 2013-18. WT-CCGHR is helping to combat African and global health challenges. It capitalises on the extensive biomedical and health-related research capacity across many departments and research institutes at the ̽��ֱ�� of Cambridge, as well as the Wellcome Trust Sanger Institute.

Other Key Activities/Achievements of the Cambridge-Africa Programme Include:

Enabling the development of Africa-related initiatives and cross-School funding applications.
Supporting Cambridge researchers to teach and organise relevant courses and workshops in Africa.
Providing video-linked, live, interactive lectures by Cambridge academics to students in Africa.
Creating a platform for networking and debate between African and non-African students and staff in Cambridge, and mentoring African applicants who aim to study at the ̽��ֱ�� of Cambridge.

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

Yes

Under pressure: the battle to have a baby in Africa

lw355 — Thu, 16 Feb 2017 09:40:43 +0000

As a young doctor in Uganda a few years ago, Dr Annettee Nakimuli was told that nothing could be done about a complication of pregnancy that was putting thousands of pregnant women a year at risk of death.

She remembers the frustration: “I felt like we were accomplices in this war of sorts. People say we do not remember the words of our enemies but the silence of our friends. I did not want to accept that it was beyond hope.”

̽��ֱ��disease is pre-eclampsia, a condition that is thought to be caused by the placenta developing abnormally. Women with pre-eclampsia often experience very high blood pressure, which can be fatal without medical intervention. Although the condition affects women worldwide, in African women it is more common and particularly severe. It also occurs earlier in pregnancy and can recur in subsequent pregnancies.

“What makes pre-eclampsia such a challenge is it has been impossible to predict or prevent,” explains Professor Ashley Moffett, from Cambridge’s Department of Pathology and Centre for Trophoblast Research, who is an expert on the disease.

“It’s been called the ‘silent killer’ because many women cannot feel the danger sign that their blood pressure is rising until it’s too late. Even when it is detected the only course of action is constant monitoring, and ultimately the only cure is delivery – sometimes at too early a stage for the baby to survive,” adds Moffett.

̽��ֱ��silent killer

Nakimuli knows only too well the difficulties that African women face. Today she’s an obstetrician in Mulago Hospital, Kampala, where 33,000 babies are born each year. It has the highest number of live births of any hospital in the world (around 100 per day), and 15% of pregnancies develop life-threatening complications such as pre-eclampsia, haemorrhage, obstructed labour and sepsis. She describes herself and her colleagues as being “on the front line” in the battle against death in pregnancy and childbirth.

“I would often see women who had had four or more Caesarean sections with no living child – they continued exposing themselves to the danger until they had a baby,” says Nakimuli, who is also a lecturer at Makerere ̽��ֱ��. “I felt like not sitting back and just saying this is a disease with theories.”

Seven years ago, she began work with Moffett through the Cambridge-Africa Programme, first as a MUII PhD fellow registered at Makerere ̽��ֱ��, then as a MUII postdoctoral fellow and now as a research collaborator. Based in Kampala throughout, she would periodically travel to Cambridge to learn new techniques, analyse samples and spend time with Moffett trying to unravel why a complex disease is so much worse in Africa.

A few years earlier, Moffett had discovered that, when the placenta is formed, a remarkable ‘boundary-setting’ process occurs between the mother and the fetus deep within the lining of the womb.

“ ̽��ֱ��placenta must invade the mother enough to access nourishment for the growing baby, yet not so much as to penetrate through the uterus,” she explains. “Placentation is a setting up of the territorial boundary between two genetically different individuals – the mother and her baby, who carries genes from the father. It needs to be in exactly the right place for both to survive and thrive.”

Moffett found that maternal immune cells called uterine natural killer cells mediate the compromise between mother and baby. These cells have unique proteins on their surface called killer-cell immunoglobulin receptors (KIRs), which recognise proteins called MHC on the invading fetal cells. Certain combinations of maternal KIR genes and fetal MHC genes are associated with pre-eclampsia, whereas other KIR genes appear to protect against the disease.

But why would women of African descent suffer so much more from pre-eclampsia than other women? “There was an assumption in Africa that there was a socioeconomic reason, like poverty,” says Nakimuli. “I was convinced that there was something biological.”

Nakimuli set about recruiting 750 mothers at Mulago Hospital to what is the largest genetic study of pre-eclampsia conducted in Africa. She collected blood and umbilical cord samples and, in Cambridge, ‘typed’ the DNA to look at all the genetic variation. “It was kind of a high-risk project, but my determination kept my hope alive. I wanted to find big things.”

Her hunch proved right. She found that the KIR genes that protect African women against pre-eclampsia are different from those that protect European women. Moreover, the risky combination of maternal KIR and fetal MHC proteins occurs at a much higher frequency in sub-Saharan Africa than anywhere else in the world.

We think that women of African ancestry may have these risk genes because of certain beneficial selective pressures, otherwise why would genes that kill mothers and babies be so common in the population?
Ashley Moffett

̽��ֱ��findings immediately opened up new avenues of research into the biology of pre-eclampsia. ̽��ֱ��study also has implications for understanding infectious diseases, as Moffett explains: “We think that women of African ancestry may have these risk genes because of certain beneficial selective pressures, otherwise why would genes that kill mothers and babies be so common in the population? People with the gene that causes sickle-cell anaemia are able to fend off malaria – perhaps something similar is happening for KIR genes? And so now we are starting work to see whether the genes are protecting against infections such as measles, HIV and malaria.”

Africa's Voices

While Nakimuli and Moffett continue pinpointing the genetic basis of pre-eclampsia, and hope to bring out the first comprehensive textbook on African obstetrics, they are aware that one of the key issues surrounding pregnancy is that too many African women go to hospital too late, leaving it until their complications are advanced and dangerous.

“There’s a general lack of awareness and understanding,” explains Nakimuli. “There isn’t even an Ugandan word for pre-eclampsia. ̽��ֱ��closest people get to describing the condition is ‘having hypertension which is different from the other hypertension when you’re not pregnant’. It becomes a mouthful.”

Last year she took part in a series of radio programmes in Uganda as ‘Doctor Annettee’, the on-air doctor ready to answer questions from the audience. ̽��ֱ��programmes were part of an innovative Cambridge-led research project, ‘Africa’s Voices’, which uses interactive radio and mobile communications to gather and analyse the views of ordinary citizens.

“Because of the high rates of maternal mortality, a coping mechanism among Ugandan women is to consider pregnancy as being about bravery and fortitude,” says Nakimuli. “This way of coping might however lead to late self-diagnosis of the warning signs.”

“Sociocultural beliefs like coping mechanisms will determine how people behave,” says Dr Sharath Srinivasan, who is Head of Cambridge’s Centre of Governance and Human Rights and leads Africa’s Voices, “and so it’s important to understand a person’s thinking to support better maternal and neonatal health policies.”

However, the challenge has always been how to collect and assess all of the different ‘voices’ from hard-to-reach African communities. Srinivasan and colleagues realised that Africa’s digital revolution – particularly the widespread use of mobile phones and SMS messaging – could provide the answer when combined with the huge popularity of local radio stations and the team’s technical know-how.

̽��ֱ��team developed a format in which a radio presenter would play a real-life testimonial – such as a woman relaying the complications of her pregnancy – and then invite listeners to reply to a related question by sending a text to a toll-free number. Each respondent would subsequently receive an SMS sociodemographic survey to complete.

“What makes this set-up so rich is the fact that ordinary citizens are encouraged to voice their views. They aren’t restricted by a poll-style yes/no answer,” says Srinivasan. “We’ve developed a methodology that can take this data, which is often complex, unstructured and in more than one local language, and analyse it with qualitative social science and computational techniques to draw out key themes and insights.”

During Africa’s Voices pilot phase, the team used this format in eight sub-Saharan countries, working with nine radio stations, and choosing radio presenters who have a good relationship with their audience. In these ‘social spaces’, they probed beliefs on HIV/AIDS, vaccination, women’s issues, agriculture and governance processes.

Now spun-out of the ̽��ֱ�� as a non-profit organisation, Africa’s Voices works in East Africa with NGOs, health agencies and media organisations, and maintains strong links with researchers such as Nakimuli and Moffett.

An interactive radio project to shed light on pregnancy complications like pre-eclampsia was recently completed with three local language radio stations in Kampala, Uganda, and rich insights emerged into the perceived causes of complications in pregnancy. One finding is the difference in beliefs between men and women.

“Men, more than women, tend to think that the causes of complications are related to enduring traits of the mothers – their biology or their personality – but that the risk of complications is more likely to happen to other women, not their own partner,” explains Srinivasan.

“Women on the other hand are more likely to believe that complications arise because of factors that they can control – such as their lifestyle. Both women and men agree that insufficient health provision is the major reason women delay seeking healthcare.”

Srinivasan suggests from his experience that governments and service deliverers are keen to listen intelligently to what people are saying and to organise their work more attentively to the world views and collective beliefs of the populations they serve. “Sociocultural beliefs that limit the seeking of healthcare are addressable,” he says. “Interventions that engage women and communities in conversations can help change beliefs, opinions and norms, and thus behaviour patterns.”

"We needed to study the disease in Africa"

When Nakimuli is asked what her own research findings on the genetics of pre-eclampsia will mean for the mothers she sees every day on the wards at Mulago hospital, she is pragmatic.

“Can it help medically? We are still far from that,” she says. “Yes, theoretically we can predict risk by genotyping pregnant mothers, but we are in a low-resource setting – everything needs to be cost-effective. Really we need to develop a bedside test that doesn’t require costly and time-consuming laboratory analysis. Then we could know which women need to be monitored carefully.”

Sociocultural beliefs that limit the seeking of healthcare are addressable. Interventions that engage women and communities in conversations can help change beliefs, opinions and norms, and thus behaviour patterns

Sharath Srinivasan

In the seven years since Nakimuli first embarked on her studies to understand why so many women die in pregnancy, Cambridge-Africa research partnerships with Mulago Hospital have widened considerably. They now include pharmacist Dr Ronald Kiguba and Professor Sheila Bird OBE (Medical Research Council Biostatistics Unit, Cambridge) investigating how to report medication errors and adverse drug reactions; microbiologist Dr David Kateete and Professor Stephen Bentley (Wellcome Trust Sanger Institute) tracking how infections like MRSA spread through hospitals; and a group of obstetricians and midwives from Cambridge ̽��ֱ�� Hospitals NHS Foundation Trust looking at best practice with their contemporaries in Kampala.

Meanwhile, a typical day at Mulago Hospital will bring around five pre-eclamptic pregnancies and several cases of obstructed labour, preterm birth and stillbirths; and a team of five doctors will be supervising 80–100 deliveries.

Funds are being sought by Cambridge-Africa to help set up an African Centre of Excellence in Pregnancy and Childbirth at Mulago Hospital, in partnership with Makerere ̽��ֱ��’s College of Health Sciences. “We would like to train more specialised staff who in turn will train the next generation, and we want to turn new understanding of pregnancy complications into clinical interventions,” explains Nakimuli.

Looking back to when she decided not to accept that nothing could be done about pre-eclampsia, Nakimuli says: “I was convinced that the reason we didn’t know much about the disease was because we’d been looking in the wrong place. We needed to study the disease in Africa. After all, if you want to study a disease properly, then you should look at the population most affected by it.”

Dr Annettee Nakimuli was funded by the Makerere ̽��ֱ��-Uganda Virus Research Institute Infection and Immunity Research Training Programme (MUII).

Inset images: Top: Dr Annettee Nakimuli; Bottom: radio interview with 'Dr Annettee' at Akaboozi FM in Kampala, Uganda, as part of the Africa's Voices study (credit: Rainbow Wilcox, Africa's Voices).

To keep up to date with the latest stories about Cambridge’s engagement with Africa, follow #CamAfrica on Twitter.

A complication of pregnancy that causes the mother’s blood pressure to rise – often fatally – is more common in women of African descent than any other. Research in Uganda by African and Cambridge researchers is helping to uncover why.

I felt like we were accomplices in this war of sorts. People say we do not remember the words of our enemies but the silence of our friends. I did not want to accept that it was beyond hope

Annettee Nakimuli

DFID

Suffering from pre-eclampsia, this young mother had to undergo a Caesarean to deliver her twin boys, seen here in the arms of her mother (Malawi)

Graduate, get a job … make a difference #6

Cambridge graduates enter a wide range of careers but making a difference tops their career wish lists. Read about Kathryn Savage who now works in Uganda to improve health service delivery and increase utilisation by strengthening the leadership skills of health workers and district health teams. 'Graduate, get a job … make a difference' is a series in which inspiring graduates from the last three years describe Cambridge, their current work and their determination to give back.

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

Yes

Licence type:

Attribution-ShareAlike

̽��ֱ��Bible as a weapon of war

sjr81 — Wed, 08 Feb 2017 12:13:21 +0000

In 2012, one of the world’s most wanted war criminals, Joseph Kony, became one of the most repeated names on the planet thanks to a YouTube documentary (Kony 2012) and a call to action that sought to expose the terror and slaughter he inflicted on thousands of men, women and children in Central Africa.

Indicted by the International Criminal Court for crimes against humanity, Kony is now believed to be in hiding with his followers. He remains the genocidal leader of the murderous Lord’s Resistance Army (LRA) who claimed to have been sent by God to liberate the people of Northern Uganda from the rival National Resistance Army (NRA). From the start of their insurgency in 1987, Kony’s LRA claimed as their major objective the establishment of a government based on the Ten Commandments.

In the decades since, his army – often made up of thousands of forcibly conscripted child soldiers – have wounded, widowed and orphaned indiscriminately as they prosecuted a campaign of violence with a vigour befitting Kony’s vengeful readings of the Old Testament.

In the process, the LRA are thought to have displaced as many as two million Ugandans, the vast majority from Uganda’s Acholiland, where Kony originally hails from.

Today, Acholiland is a haunted place; haunted by the ghosts and memories of a recent past that has been written in blood rather than ink during nearly two decades of conflict.

But what happens when former LRA soldiers, those who have used the Bible as a weapon of war, return home from the front lines? How do former soldiers – male and female, adults and children – learn to reread and reinterpret scriptures that once spoke to them of fire and brimstone?

Kony says it is God who sent him to kill people so nobody should stop him. You know this thing is very difficult to understand as Kony refers us to the Bible... In Kony’s time, God has sent the Holy Spirit, and it is the one which is doing the work through Kony.
Zacchaeus, a former LRA commander

This is the puzzle facing Dr Helen Nambalirwa Nkabala from Makerere ̽��ֱ�� in Uganda. As a CAPREx fellow, she spent time in Cambridge working with Dr Emma Wild-Wood, from the Faculty of Divinity and the Cambridge Centre for Christianity Worldwide.

Nambalirwa Nkabala interviewed returning LRA soldiers in Uganda in order to examine how a positive engagement with biblical texts – especially those that seem to support violence – can help to promote peace instead.

She says: “My project identifies difficult texts in the Old Testament and seeks to identify the means by which they can be used in a constructive and meaningful way – with the central focus being on whether a particular interpretation promotes human dignity or not.

“ ̽��ֱ��way the LRA used the Bible, in a literal sense, to justify their violent actions has caused a complete overturn of the social and generational structures of the Acholi people.

“ ̽��ֱ��former LRA members I interviewed claim that all their actions are in accordance with Bible teachings; obedience to the law meant that anyone considered to have broken the Ten Commandments had to be destroyed.”

Kelly, a former child soldier, told Nambalirwa Nkabala that the Bible teaches that ‘somebody who does not obey must be killed’. This is the level of indoctrination that Cambridge researchers are trying to untangle as they work alongside Acholi leaders of varying denominations to promote peace and reconciliation using texts that were once wielded to justify murder on an industrial scale.

However, their work is complicated by the fact that Acholi cultural beliefs – as well as some readings of the Old Testament – also permit killing in exceptional circumstances, meaning that the LRA may have appropriated elements of Acholi culture to justify their own murderous ideology. For instance, the Achioli Chief and elders can pass ngolo kop me too – or ‘judgement of death’ – where killing is permitted, Likewise, Kony, a former altar boy in the Catholic Church, was brought up by a catechist father whom Nambalirwa Nkabala believes exposed him to Old Testament passages of death and punishment from an early age.

“Former LRA soldiers must be ready to reread the texts they were exposed to in a different way,” adds Nambalirwa Nkabala. “Texts with a violent message should be read with an ethical and nonviolent stance. Rather than passively accept what the text says, we must engage in dialogue with it. It is every Christian’s duty to expose and challenge any textual message which permits violence.

“ ̽��ֱ��Bible must be read contextually. By asking about the role of the text to a particular context, interpreters will automatically be pushed into the habit of checking what implications a particular reading/interpretation could have on a particular community.”

Wild-Wood met with Christian and Muslim leaders of the Acholi Religious Leaders Peace Initiative (ARLPI) during her trip to Uganda in 2015 as she sought to understand how the Bible is now being used to rebuild society. She was struck by the commitment to peace across differing faiths and denominations.

“A great deal of thought has gone into how former combatants can be rehabilitated,” says Wild-Wood. “From my focus groups, the religious leaders were optimistic about the future, but the challenges are many. They are dealing with people who are very traumatised. Some see the LRA soldiers as perpetrators, some see them as victims. But there is a recognition that people have dealt with awful situations – and may fall apart afterwards.”

When you look at what happened in the north and you go to the Bible and you read from the beginning to the last part you may find that 90 per cent of what happened here is in the Bible. Whatever has happened is exactly how God designed it.
Steve, a former LRA commander

Wild-Wood says that the ARLPI’s initial desire to publicise the atrocities being carried out by the LRA – and to protect civilians where possible – has now refocused to aid the process of reintegrating former combatants, and is working alongside international charities like World Vision to facilitate the transfer of former LRA soldiers from reception centres back to their communities.

“Projects of post-war reconciliation often engage with traditional beliefs and customs in order to effect lasting peace,” adds Wild-Wood. “Acholiland is no exception, and Acholi practices have been ultilised in restoring human relations. However, in the LRA and the wider population there are many Christians and a significant number of Muslims. It is important to engage the beliefs of those religious traditions when working towards long-term solutions to the destruction of society.”

While there may be a distance yet to travel, Nambalirwa Nkabala remains optimistic about Uganda’s future as it seeks to heal the deep scars caused by Kony and the decades of division and war he brought to his country.

“ ̽��ֱ��advantage in all this is that the Acholi have a deep sense of community and solidarity,” she says. “This is exemplified in the various means they use to reincorporate wrongdoers back into their community. If the Acholi communities can be encouraged to maintain their cultural values of healing and reconciliation – even while reading texts that may have a violent message – then they can in the future avoid situations that can lead to the destruction and erosion of these most important of values.”

Dr Helen Nambalirwa Nkabala was funded by the Cambridge-Africa Partnership for Research Excellence (CAPREx) and ̽��ֱ��ALBORADA Trust, through the Cambridge-Africa Programme.

To keep up to date with the latest stories about Cambridge’s engagement with Africa, follow #CamAfrica on Twitter.

How do former Lord’s Resistance Army soldiers – men, women and children who have used the Bible as a weapon of war – learn to reread the scriptures once they return home? This is the puzzle facing researchers from Uganda and Cambridge.

̽��ֱ��way the LRA used the Bible, in a literal sense, to justify their violent actions has caused a complete overturn of the social and generational structures of the Acholi people."

Helen Nambalirwa Nkabala

Charles Roffey

Kony 2012

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

Yes

Cambridge has waived application fees for graduate students from most African countries

ag236 — Wed, 26 Oct 2016 09:54:52 +0000

Applause greeted the statement by Professor David Dunne, Director of the Cambridge-Africa Programme, as he confirmed that Cambridge has waived the usual application fee for nationals of many of the world’s least developed countries.

Welcoming participants to the third edition of the Cambridge-Africa Day, he expressed his aspiration that this policy will allow Cambridge to attract increasing numbers of talented graduate students to the various scholarship schemes available for Sub-Saharan students.

“ ̽��ֱ��purpose of the Cambridge-Africa Programme is to make Cambridge’s support available to African researchers working on African problems, allowing them to build capacity in their home universities.” ̽��ֱ��fee waiver, he added, is a “major contribution” to that effort.

In his opening remarks, Professor Sir Leszek Borysiewicz, Vice-Chancellor of the ̽��ֱ�� of Cambridge, asked: “Why should academic institutions get involved in tackling some of the world’s most insoluble problems?”

“Because we have to decide what our values are, and how they allow us to succeed in our mission. Cambridge’s mission is to contribute to society through education, learning and research. ̽��ֱ��definition of society has changed over the past 800 years –but today that society is global.”

He added: “Being high on league tables does not make a university global. ̽��ֱ��real challenge is: what are you giving up? How are you sharing your influence to support other institutions? It’s not about aggrandising oneself, but about aggrandising others.”

̽��ֱ��Vice-Chancellor described the capacity building Cambridge-Africa Programme, set up in 2008, as an ambitious, long-term project with sustainability at its heart. “Cambridge-Africa is about planting seeds that allow partner institutions to thrive.”

Addressing a packed auditorium in Emmanuel College’s Queen’s Building, the Vice-Chancellor mentioned the Programme’s partnerships with over 50 African institutions across 23 countries, including its two regional hubs at the ̽��ֱ�� of Ghana, Legon, and at Makerere ̽��ֱ��, in Uganda.

̽��ֱ��Programme has enlisted the expertise and mentorship of a network of over 200 Cambridge collaborators, and to date has supported 70 African post-doctoral researchers and 35 African PhD students.

“ ̽��ֱ�� ̽��ֱ�� of Cambridge has invested £4 million pounds in the Cambridge-Africa Programme, and has leveraged that to attract £6.9 million to the ̽��ֱ�� for its mentorship and collaboration initiatives”, he said. “Crucially, this has led to almost £21.9 million in external funding being allocated to our African partners”.

In the day’s first keynote address, Kenyan palaeontologist Professor Richard Leakey said that internationally renowned universities like Cambridge should do more to educate civil servants and policymakers in Africa about the importance of research and education:

“A ̽��ֱ�� like Cambridge can play a much bigger role in Africa by interacting with African government at the highest level.”

He assured the audience of students, academics, administrators, NGO representatives and philanthropists that the ̽��ֱ�� of Cambridge is likely to be identified with the next major breakthrough in our understanding of African history.

“ ̽��ֱ��story of Africa is important for Africa, and Africans. There is a gap of self awareness in terms of who we are. We have an opportunity to see some real cooperation between Cambridge and Kenya.”

̽��ֱ��afternoon’s keynote speaker, Her Excellency Mrs Toyin Saraki, made an eloquent plea for closer collaboration between universities and Africa’s maternal and neo-natal health specialists.

Mrs Saraki, founder of the Wellbeing Foundation Africa, a non-profit organisation working with governments and NGOs across Africa to ensure better maternal, new-born and child health, remarked on the difficulties faced by women in her own country, Nigeria –where 14% of women are likely to die from maternal mortality complications.

“I started the Wellbeing Foundation out of personal suffering. We’ve moved beyond the suffering to providing the solutions.”

She challenged the audience to consider how academic research can cascade down to impact individuals at a community level: “What we need from our partnership with universities is the evidence that will allow us to advocate for the necessary support to improve maternal health and those providing it.”

̽��ֱ��day’s final keynote speaker, Professor Ebenezer Owusu, Vice-Chancellor of the ̽��ֱ�� of Ghana, recalled the collaborative links between his institution and the ̽��ֱ�� of Cambridge going back to 1948, when Cambridge academics helped to found what was then called the ̽��ֱ�� of the Gold Coast.

“Cambridge has long offered opportunities to train Ghana’s human capital and help meet Ghana’s developmental needs,” he said, reflecting on how the Cambridge-Africa Partnership for Research Excellence (CAPREx) has helped build capacity in research management at the ̽��ֱ�� of Ghana.

“There is a shift in the place of Africa in the world today,” he said. “It is amplified by the ‘Africa Rising’ narrative, and by the resoluteness of African growth in the face of an economic downturn. Yet the continent’s higher education institutions have not changed. There is a need for more inclusive partnerships with universities like Cambridge.”

He added: “Africa must lead research initiatives in solving African problems.There is a need for a new type of partnership: equal partnership in the generation of knowledge and creative solutions, not just for Africa abut for the world.”

At the end of a day that included discussions on collaborations in African archaeology, conservation, maternal health, plant science, pharmacology, social enterprise and student-led Africa-focussed initiatives, Professor Eilís Ferran, Pro-Vice-Chancellor for International Affairs summed up the key ideas:

“We’ve learned about the need to study a problem in the population most affected by it. We’ve heard about the multiplying effect of training the key people in any discipline. We’ve considered the challenges of mentoring, and raised the question of whether we are doing enough to equip people to operate in challenging environments. And we are clear about the challenges of new partnerships, and the role of African universities in leading those partnerships.”

Regarding the sustainability of the ̽��ֱ�� of Cambridge’s engagement with Africa, she concluded: “Frankly, it’s here to stay”.

Details of the ̽��ֱ�� of Cambridge's Graduate Admissions policy for applicants from Least Developed and Low-Income Countries can be found here.

̽��ֱ�� ̽��ֱ��’s policy on graduate admissions was reiterated at the opening of the third Cambridge-Africa Day

̽��ֱ��Cambridge-Africa Programme is about planting seeds that allow partner institutions to thrive.

Professor Sir Leszek Borysewicz

Nic Marchant

Prof Sir Leszek Borysiewicz

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

Yes

" ̽��ֱ��Professor is World Cup": understanding ‘secret’ urban languages

pbh25 — Wed, 22 Apr 2015 12:56:30 +0000

Uganda has one of the world’s largest percentages of people under 30 – more than 78% of its 37 million citizens, according to a report by the United Nations Population Fund. Many do not use the commonly spoken languages of Uganda (Kiswahili, English and Luganda) in everyday speech but instead express themselves in an ever-evolving street language called Luyaaye.

Originally a ‘secret language’ spoken by criminals, Luyaaye has grown in popularity because it’s seen as more playful and less traditional by many of its speakers, with its “joyful” use of English, Luganda and other languages.

Many of those who use Luyaaye are concentrated within Kampala, the capital city of a country that faces many challenges, including serious health problems. To combat these threats to health – and to get other social messages across – the government must communicate with its population effectively. This means using Luyaaye alongside the official languages, argue researchers from Africa and Cambridge who are working collaboratively as part of the Cambridge-Africa Partnership for Research Excellence (CAPREx).

Dr Saudah Namyalo from Makerere ̽��ֱ�� and Dr Jenneke van der Wal from Cambridge’s Department of Theoretical and Applied Linguistics have joined forces to understand how this increasingly popular, yet currently undocumented, urban language is built. ̽��ֱ��need is increasing, said Namyalo, as more people come to use forms of Luyaaye to communicate. “It is currently classified as an Urban Youth Language but it is becoming more widespread and used by some older people.”

Such languages are not unique to Uganda – elsewhere, forms of multicultural British English, the Dutch street language ‘straattaal’ and the ‘Camfranglais’ of the Cameroon are all examples of languages that have evolved out of, and usurped, the country’s mother tongue in certain communities, explained Namyalo.

These languages are fast-moving in their appropriation of new words, often borrowing them from TV, films and music. “I love the speed at which Luyaaye changes,” she said. “For instance, the World Cup was seen as a very positive thing. So world cup quickly became a shorthand for ‘a good thing’ or ‘excellent’.

“For a lot of people, Luyaaye is for fun – it is just for laughs! It often uses metonymy [calling something not by its own name but by a name linked to it] with surprising and comic results. So a Professor is someone with ‘street smarts’ who has learned to beat the authorities, to get away with anything.”

However, the language also has its darker side. ̽��ֱ��growth of Luyaaye began in the 1970s during the Idi Amin reign. “Illegal trade grew and it is thought that the language provided a code to serve those people who were involved in trade between Nairobi and Kampala. It was mostly spoken by the illiterate, young business community,” Namyalo explained.

Even today its past continues to influence its development as Luyaaye helps criminals conduct business and exclude the uninitiated from their ranks, said Namyalo. “Kampala is divided into five divisions and they are Luyaaye territories. If you are a criminal you are not supposed to cross into another territory – or you risk being burnt alive. ̽��ֱ��Luyaaye you use can show which division you are from or it can be used to uncover if you do not belong.”

Namyalo points to these past links with criminality as a factor in the reticence of the establishment in accepting Luyaaye: “Higher society does not take the language, or those who use it, seriously. When you use Luyaaye you are thought of as uncultured, and yet it is the more meaningful language for the youth than Luganda or other formal languages used in Uganda.”

She has begun the process of documenting this little-studied and evolving language, and would like to produce a dictionary. From her research, she now thinks of the language in terms of ‘layers’, each layer representing a slightly different set of vocabulary. ̽��ֱ��secret language used by criminals is what she calls ‘core’ Luyaaye, while the second layer is spoken by the youth, and the outer layer is the ‘ordinary’ Luyaaye, easiest to understand and popular with the general public.

Her work has so far concentrated on the lexical (word meaning) aspects of the language, but her collaboration with Van der Wal will allow them to examine the syntax (how sentences are constructed) of Luyaaye as compared with Luganda.

An expert in Bantu languages like Luganda, Van der Wal is also a member of a large-scale project to investigate the basic building blocks that underpin how languages of the world are structured – the Rethinking Comparative Syntax (ReCoS) project funded by the European Research Council and led by Professor Ian Roberts, also in the Department of Theoretical and Applied Linguistics.

“ ̽��ֱ��ability to speak a language is something very special – it is unique and part of what makes us human beings,” explained Van der Wal. “I want to find out what allows us to make grammatical sentences and how this varies between languages. For instance, unlike in some neighbouring languages, in Luganda you can say a word in two different ways: you can talk about eating rice (omuceere), but leave off the first vowel (mucheere) and it suggests you are only eating rice – it gives an exclusive focus on the rice.”

Namyalo’s visit to Cambridge and Van der Wal’s recent visit to Uganda were funded by CAPREx and the Alborada Research Fund, both of which are initiatives within the umbrella Cambridge-Africa Programme at the ̽��ֱ�� of Cambridge. ̽��ֱ��Programme aims to strengthen Africa’s capacity for research by equipping African researchers with skills and resources, and to promote mutually beneficial, long-term collaborations with African researchers across a wide range of disciplines.

For Van der Wal, research in Africa with African academics has been vital for enabling her to carry out meaningful research: “I loved working with Saudah in Uganda and listening to the languages as spoken. It was great to do field work together and get my hands dirty – well, get my ears dirty – and learn about yet another Bantu language.”

Namyalo sees the project as vital for helping her country combat some of its most challenging difficulties. “Programmes have been carried out to spread information about AIDS but even with increased dissemination there was a decrease in the take-up of that information. When asked what would help, people said ‘speak our language’.”

CAPREx is funded by the Carnegie Corporation of New York, the Alborada Trust and the Isaac Newton Trust

Inset image: Dr Jenneke van der Wal and Dr Saudah Namyalo

Research into a ‘playful’ and increasingly popular urban language that grew out of the necessity for criminals to hide their true intent could help organisations in Uganda communicate better with the country’s huge young population.

When you use Luyaaye you are thought of as uncultured, and yet it is the more meaningful language for the youth than Luganda or other formal languages used in Uganda

Saudah Namyalo

Understanding ‘secret’ urban language

Rod Waddington

Strolling, Uganda

Luyaaye

While the basic syntactic framework for Luyaaye is Luganda, it borrows words from English, with dashes of Sheng, Kiswahili and Sudanese.

As well as borrowing whole words it also borrows suffixes and affixes such as the English –ing which becomes –inga in Luyaaye.

Quite often when speakers use English words they do not alter the spelling, so that front page is used to mean 'forehead' and blood used to mean 'brother' or 'sister'.

̽��ֱ��language also uses metaphor, thus okusunagitta literally means 'to play a guitar' but actually means 'to scratch', and I would like to kill a chimpanzee means 'I would like to go to the toilet'.

It also uses tricks like antonym – making the meaning the opposite of what is said, so okwesalaobuwero means 'dressed in old cloth' but actually means to be smartly dressed.

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

Yes

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