Advertising posters can catch one’s eye while sitting in a Kampala traffic jam staring into space. “Big bums quick” certainly did the job for me – complete with a phone number for getting the appropriate food supplement to allow the desired rapid expansion of such regions. What struck me most however was the juxtaposition of the poster 2 feet further along the same wall for “weight loss while you eat” with the same phone number. Rather than phoning the advertising standards agency I was struck afresh by the heterogeneity of culture in Uganda.

Many people talk about cultural sensitivity in mission and development work, and rightly so, but it is important to remember that culture is alive and organic. In some traditional areas, particularly with some of the tribes originating in the West of the country who keep cattle, ladies with large stores of fat around their middle and behind are considered particularly attractive. Yet in Kampala, the more ‘Western’ concept of skinny ladies with heels and tight trousers is viewed as the goal.

I was also struck by how Uganda is changing – or to be more precise, how some of Uganda is changing. Kampala is developing – and slowly resembling the traffic jams and multicultural milieu that is seen in so many cities across the globe today. Meanwhile in the rural areas there are large areas with very little development and very little change demonstrable for many years. Whether one’s goal is large padding to sit on, or suitability for tight leggings is not particularly critical. However the development of Kampala in a manner out of kilter with the rest of the country certainly does produce difficulties. With some people in Kampala driving large shiny German automobiles and sporting Italian suits, it is understandable that some from the rural areas move to town to make their fortune – and often end up much worse off than if they had stayed subsisting on their farm surrounded by friends and family.

The sirens from the city are also an ever present lure to the unwary health professional tempted by large income and less work. The value of working up country is indisputable to all, but the personal lifestyle and family opportunity costs are very real, and are too much for some. Thus 80% of the countries health professionals continue to reside in cities where 20% of the population live.

Do I have a solution if our presidents in waiting Obama or McCain are reading….well no. But sadly a lot of the ‘development’ in Kampala is driven by aid dollars (indeed often AIDS dollars.) Clearly I think that mission/development/aid are good things – when well done. Sadly when not well done they can be deeply unhelpful.

So what is well done mission development? For that you’ll need to take me out for a drink when you next see me and we can talk about it properly.

Cheers for now

Rory