Saturday, November 16, 2013

Reflections a year later

This morning I found myself back on this blog, hungrily reading every word I'm so grateful I captured while I was at Shanti. I may even have blog posts left to post, I'll have to check. Just days after I landed back on American soil from this life-changing, paradigm-shifting, eye-opening adventure, my mother suddenly died. I can't deny that it sucked away all my attention and any stamina I had left for self reflection was poured into surviving her death.

Now, a year later, I find I have changed in so many ways. 2012 brought me thyroid cancer, intensive fundraising while healing, a trip to the Redwoods to repair my heart, then Uganda where I left tiny bits of myself and took so much away, and then my mother's death. I can't say I am the same person that I was before that all began, or even the person I was before I left on this great trek across the world. My reflections now are stacked on the subsequent experiences I've had, the people I've met and the passions enflamed in me as a result of everything I went through.

So this morning I woke and for some reason, wandered to my Shanti blog. I was surprised to see how much I'd forgotten as I scanned through my photos, the tiny details that are tattooed on my heart, even if my memory isn't up to the task.

I think back to standing in the airport, looking for women I barely knew, if it all, trusting that we were going to cross the globe together and navigate whatever obstacles came before us. Waiting in line for the staff to take our bags, my vision went dark and I thought for sure I was going to literally faint, I was so terrified of all of the unknowns. I almost backed out, but remembering all the generosity that people in my life showed so that I could have the privilege of even standing at that gate, I put one foot in front of the other, leaned into my husband and breathed, and left them behind at security. It was terrifying and liberating in a way I can't find words to describe.

Landing home, ready to be back into the nest of my family so that I could absorb everything I'd done, seen, and been a part of. Having shared those moments with the women who stood with me, I was ready to be away from them, so I could find myself again, try to see where I fit in my life now that I knew what I knew about the world, as small as that was. At the same time I knew we might never be all together again and I couldn't bear that thought. How could we not ever see each other again, reminisce, process our experience, reveal our new selves? It (still) seemed wrong and sad, but a sacrifice worth making in order to find respite in my own bed.

Now I am learning a new language as I talk about our differences, and our similarities. I see the unfortunate ways that we deal with each other and I am relieved that Americans are not the only ones who experience privilege and thus perpetuate (unknowingly, oftentimes) discrimination, elitism, and so much more. I learn that our hearts do not want separation, we want to understand each other even if what we've learned all of our lives is the opposite. We are inherently curious and on some level we butt up against the way we've been taught to deal with each other, alongside our deep, innocent curiosity. Often they can't match up, and curiosity takes courage.

I could talk about the birth center we are opening, but more important to me is the clinic we are opening to provide access to any women in our county to quality, safe prenatal care. This feels so incredibly enormous a task, absolutely doable, and at the same time, a drop in the enormous pool of inequalities in care.

I speak a new language now, one I am not at all fluent in but can choke out a few phrases and be understood- one of our sameness. One of our differences, one of our privilege, and of our inequalities, and how desperately simple the cure for these things can be when people come to the table ready to act.

I crave to talk to birth professionals about how we interact with our clients, how we recognize need, how we see ourselves reflected in the eyes of a diverse population. I crave to be fluent in these languages so that I can address my own prejudices (that are always revealing themselves, no one is immune!) I want to talk about solutions with all parties at the table, representing their need, their point of view- and open to learning about every other perspective, so that solutions can be created that are sustainable and lasting.

Things were so stripped down in Uganda, I wrote about the simplicity of food, of the daily life. You don't worry about deodorant because everyone is covered in a sheen of sweat, and everyone smells, and it is amazingly wonderful to be so close to another human being in just this simple way. You don't worry about whether you will have hot water because the very fact you can stand under a shower is a huge privilege and blessing, and if you must squat over a hole to poop, at least sometimes they are holes that actually flush, so that giant swaths of flies don't shoot up between your legs.

I am grateful to have had the words to be there, and to hold it and speak it, and I am sad about the total apathy in our country for the dire needs of those in other countries. We worry so much about ourselves, we are afraid to extend a hand to someone else, lest we don't have enough for ourselves. It's truly by sharing what we have that we ensure we will have enough, but that takes a kind of courage we do not currently know.

I take all that I've learned and I carry it with me where I go. Constantly questioning myself, asking questions, identifying my own privilege. A friend said she hoped that dental insurance would be come universal as she really needs to go. I have dental insurance, I had never considered what it might be like for families who just literally don't have the option to take care of themselves in this way. I listen to white people tell black people how they should interpret their own experiences, and it is innocent but not harmless. I am raising sons and a daughter and see the differences in how they are treated just because of their genders, and on nothing more than that. We want people to hear our experiences, but we do not want to openly and courageously hear theirs. We defend and explain, rather than listen and take responsibility.

This was so much more than just a great adventure, it shifted my lens and broadened my capacity to love others, to see us in our brokenness and wholeness, our desire to be more deeply connected and our lack of language to create that. There is no Tower of Babel to help us understand each other, we just muck along and try to tend ourselves as best we can. We are creating the new language out of the need for one, the lack of one, for us to understand each other, we are innovating, something that big brain and those amazing thumbs certainly allow us to do!

There were things that weren't perfect about the trip, things I won't write about just yet but probably will eventually. We have to continue to dialogue about our role in birth in other countries, and whether it is appropriate to hope that women from other countries would welcome us at their births. I watched women come and go in our brief time there, and the power dynamics were so askew, I could never have confidently walked into the birth space of one of those women confident that I was truly needed and wanted there. This is one of the many small things that occurs all over the world, which thankfully is changing - but that we need to keep discussing. What are the rights of students to learn, and why must it always be between the legs of those who have the least power?

I would go back to Shanti in a minute, I would teach doula trainings to local women (or to tourists with some restrictions on our interactions on site)  there every year if I could. The magic they have created there is unmatched in my life experience, the beauty of the relationships, of the grounds, the joy of the people who work there, and their profound understanding of how revolutionary their work is in Uganda.

I can't think about my trip without remembering all the work that went into me getting there - what an emotional rollercoaster to decide to go, find out I have cancer, have to juggle surgery and healing with fundraising a large sum in a small amount of time- my people truly showed up for me. I thought every day of the generosity of every person who encouraged me to go, down to donating large sums of money, or donating commitments to provide services that I could auction, or talking about what I was doing so that other people would buy in. Every step I took on that red earth was in absolute humble gratitude that I couldn't be there without all of you, and that I hoped I soaked up every ounce of what was offered to me, tread lightly and left a small mark on the earth, and brought home something of value to our community to enrich us all, too. I couldn't have done all of that without you, and again, I think you from the deepest wells of gratitude in my heart.

Going forward I am focusing on bringing more discussions to the local community about how we support each other not from a distance, but from the ground. How we get involved in the local micro-communities so that they can claim their need, rather than gathering a think-tank who objectively decides the needs of these communities. I talk about race and diversity and bring compassion and openness to that discussion so that we can be heard, and hear each other. These are things that will follow me my whole life, and hopefully ripple out in an impactful way.

Monday, November 5, 2012

Dancing Muzungus (10/1)


After waking up yesterday at 5:30 and not going to bed until 1, I slept hard last night and really didn't want to hear my alarm go off at 7. Here I am, I'm up, with my warm cup of instant coffee and the quiet of the morning.
I just need more words- I need a broader vocabulary, perhaps to learn to speak in other languages. This experience defies definition and continues to expand in my consciousness.

Yesterday, our much anticipated day at Shanti, we enjoyed a lecture from Florence Nagawa and shared lunch with her as well. We'd all been looking so forward to getting to have time with Florence outside of Shanti, to hear her experiences and share with her. 

Traditional birth attendants are essentially the African version of the 'granny midwife' of America. Women who grew up watching their mothers or grandmothers attend women in labor, who knew local herbal lore and generally cared for the community, would grow up and step into that role herself. There was no formal schooling as we like so much in the West (and for good reason, mind you!) The neat thing is that learning in this model tends to be less formulaic and requires a more intimate, hands on (literally) approach than the distance we often feel in the West between ourselves and our providers. I digress.

Florence and me :) 
Florence was born in 1964 watching her grandmother attend the women of her community.  As a girl, she always knew that she wanted to grow up to be a midwife, and sought every opportunity that came available to learn. When she learned of a training that came available in the next village, she walked six miles each way every day to attend it.  In 2001, Florence herself became certified as a Traditional Birth Attendant and was able to formally assist families. Who knows how many families she helped in between and after that time? Her job as a Health Officer brought her to the homes of the people of her village so she developed strong relationships and as a result is known to everyone, and highly respected.

I want to describe the scene but I also don't know if it will translate well. It has taken me to come all the way to Africa to let go of some of my assumptions, my prejudices, my ethnocentricity- and I don't want to put this incredible experience out into the world and know that it will be heard in a way that is anything but of deep, mutually shared respect. I also do not fully understand the dynamics at play so maybe I will leave some of the details out and say instead that Florence taught us about herbs, and shared her home with us. Her children were beautiful and healthy, and Florence feels strongly that we need to use local medicines (food, herbs, clean water, hygiene) to care for ourselves. She is paid by Shanti Uganda to do several jobs and everyone in our party fell in love with her and felt so honored to be with her that day.

She told us about becoming a birth attendant and then about some of the local herbs she grows and uses for different things. I think she's able to integrate some of her knowledge into Shanti (I'm not sure about that) which if true, would be a good use of her experience! She was much relaxed at home, her voice at Shanti is quiet and she seems to lack confidence in her English speaking skills. In her home, she is bright and colorful and energetic with a quiet strength and deep love for her family, and for Shanti Uganda.

High fashion, my friends. High fashion.
We enjoyed lunch of a soup made of pumpkin, g-nut sauce, matoke chunks over rice, which was so generous, and then the fun began. Florence pulled Ildiko out of the room and when she returned, she was bedecked in a bright orange gomes - the high shouldered formal wear of the Ugandan women. It's many layers of sari material so not at all practical for Uganda. Sadie tells me that someone came to Uganda and felt their traditional dress was too revealing so introduced the gomes, which is more of an East Indian style dress. I am doubtful this style has evolved in the last 60 years, and I see women wearing them everywhere. One by one, Florence grabbed us back and each of us got squeezed (in my case, anyway) into a brightly fashioned gomes. Then we went outside for photos and Florence began to sing and dance for us. 

As we all started to clap and dance together, we moved toward the tree in her yard and her grand children appeared to drum for us. We all danced for several songs and then finally were able to sit down, sweaty and laughing. As the crazy muzungus wearing African dresses danced in Florence's front yard, a crowd began to grow -and quickly. They laughed with us and were so excited to see us, and thought we were so funny! Someone brought a chair, another was carrying a keyboard- we really had an audience of about 20 people in a very short amount of time, all of them tickled pink.

"Kristina you are most welcome! Kristina you are most welcome. Let us kneel and pray to the Lord! Shanti Uganda is going to shine again!" 

Florence and I dance. :) Mwebele Nyo, nyo!!
I'm not sure any experience here can compare to that one. 

A little break and now we try to resume

It's been a bit of a stressful month, but I think I am finally in a place I can write again. I'm eager to keep talking about Uganda and sharing the stories - I think I'll post a video today rather than photos since it's just less work and probably more interesting anyway!

I want to keep telling you about Africa, about my trip, and I don't think I can until I write this post, transitioning who I was before my mother died, and now, afterwards, who I am discovering myself to be.  The night I posted the last entry here, I found out that my mom passed away. She wasn't terminally ill so it was a huge surprise to my brother and I. As anyone can imagine it swept away the luxuriously slow integration that I was making between Uganda and home, and forced me to -be here now- in a way that I didn't like at all. I feel a bit cheated of my experience while also grateful that I was home when she passed, and not in another country, so far away.

It took some time to feel like I could write about anything except her passing so here I am, almost a month later, and I'd like to continue sharing with you if you're still out there, listening.


video
Lisa Saper-Bloom talks about the reaction she had to her 
malaria meds, and I breathe hard for some reason. LOL


It's fascinating to me that as I weave my way through the maze of mourning my mother, that even at this time I pull the lens of Uganda in front of me and see it all through that. I guess I'm marveling a bit that I can't go backward, I can't be who I was before I left, forget what I learned, unravel the threads that my trip wove through me. I think about the many women I met there, who are raising grandchildren because their daughters died of AIDS. The sorrowful, rich, heart of Death that is in all things. We were gathered at Shanti when we heard some children had found a black mamba in the bush, its dead body had now become a plaything in the street. Death truly is in every corner and touches us all, and it's something that as human beings, every single one of us, no exceptions, have in common.

We all have to grieve our dead. We all have to wonder, what will the future be, without this person we love? Each culture has its rituals around death. When we sat at the bonfire on the last night at Shanti, Stella, one of the midwives, told me that they don't usually have a bonfire unless someone dies, and that now people would wonder if someone died. We both had a good laugh as we danced around the big fire.

I have to wonder, what would happen if I grieved in Uganda, in Kasana? How would I be held there? What would be expected of me, of my family - how would the community feel the loss? I won't know these things, but that's okay. It feels good to wonder, to have access to Shanti in a new way.

The next thing I'll post is one of my entries from while I was gone. I still welcome questions, is there any specific thing you want to know about? Hit me with your ideas and inquiries!

Saturday, October 13, 2012

Dancing in the dark (9/30)

Things to remember: 


- dancing in the dark
- matoke
-Luwero market
Luwero
talking to my family
Acclimation
Bugs
Power/water outages
laundry
Yvonne Christine

Best chapatis in the whole entire universe.
Yesterday we started the day with breakfast of chapati and pineapple. So far I've had pineapple with every meal and I can't say that I'm sad about that. Luwero's pineapple is the softest, juiciest, ripest pineapple I've ever had and I will be sorely, sorely sad to leave it. Pineapple in the states is very firm, rather tart at times, and the center stalk is often quite woody or hard, and difficult to eat. Here, with a sharp knife, Joann (our care taker) holds the golden yellow pineapple by the leaves and shaves off the peel, and then cuts the pineapple into chunks (still holding the leaves!), no cutting around the center stalk, no cutting board needed. Can you imagine??

One thing that's funny (well, one of many) - coffee grows *everywhere* here. But there is no one here who can roast it or process it, so the Ugandans sell it around the world as their major export. Consequently, there is no ground coffee to be had, and we are all drinking instant coffee. Not too proud to say that Nescafe is my friend. I'm not drinking nearly the amount of coffee here that I would at home, and not becuase it tastes bad (because honestly, it's fine), but just because I have one cup and I'm set. It's nice to have that small comfort of home. I don't even miss triple-grande-white-chocolate-mochas yet.

It's so interesting to me how much I am not missing- television, internet access, electricity, cool weather - not to say that i don't love all of those things, but I'm not miserable here without them. Yesterday I was in the shower and the power went out. Naked, soaking wet and in the pitch black I had to find my way to where my head lamp is hanging so that I could continue my shower- and it didn't even phase me at all. Of course i got back into the bathroom and the power came back on!  This morning I went to the bathroom and then flushed- and nothing happened. Water is off. No big deal. It'll come back on some time and I can flush it then. (I'd rather have a toilet that could only be flushed every few days than have to poop over a latrine hole!!!) Thankfully the blackouts of power and water are temporary for the most part. At the volunteer house they have been without water for 5 days. It makes life a little more challenging because you have to go to the pumping station to get water for cooking/whatever, but it's not a huge deal and is very common here.

Part of my ease in acclimation is that I don't live here, and I don't have to deal with the consequences of these things on my own. I'm sure I'd do just fine doing that, but coming from the luxury of living where I do, it would take some time to adjust and surrender to it. Here, Joann turns on our generator. Here, we do have a flushing toilet and hot water for our showers, breakfast is prepared for us, lunch and dinner is arranged- we aren't cooking dinner over a cooking fire at the hottest part of the day so that it will be ready three hours later, like the women who have hosted us in their homes have done for us. I have a mosquito net and a door that locks, and clothes that I bought brand new. Here, the dress code is amorphous, the children running around are not easily identifiable as boys or girls because the clothing is interchangeable when they are little. As they get older that is less true but the youngest children are all beautiful and unisex until you find out their names.

Yesterday we piled into two cars and Ben and Sadie drove us  on an impromptu visit to the Luwero Safari. 'Safari' is a stretch- there is a beautifully enclosed and well cared for (by one person, it seems!) area tucked well off the road, surrounded by wild growth. A statue of two zebras snuggling each other  greets you as you pull in, and there is a large gazebo, and then a few smaller buildings.

He's playing a traditional instrument.
By 'traditional' I mean, I don't know what it's called.
When we pulled in, some children and a small monkey came out from the gazebo and Muhammad came out to greet us- the owner, our tour guide. Very, very soft spoken, it was often hard to hear him but he took us on a leisurely tour (in the amazing heat- it was so hot yesterday!) of his enterprise. He showed us the traditional buildings he'd constructed, small granaries that families would use, and then some rather random historical items including a gramaphone, a blood letting knife, some kind of neat boxy guitar - it was all laid out on mats on the floor and he would just pick it up at random and tell us about it.

Then we went to the Luwero market- a very serious, intense place with many people. The producers looked very suspiciously at us and I did not feel welcome there at all, so when Sadie suggested that we leave, we hurried to do that. There was dried tilapia (covered in flies), slabs of goat and other meat hanging (covered in flies), many, many tomatoes, cabbages, ginger, potatoes- all quite beautiful but not something I would have felt comfortable purchasing, much less eating. We left and picked up the woman taking care of lunch along with the food, and headed to Shanti to eat and start our workshop.

With Viola still in labor, Melinda and Jane were busy with support so I was able to take on the bulk of the training day- which was totally awesome. We had an energetic day full of practicing laboring positions, pain coping techniques, and laughing a whole lot. I was able to demonstrate to the Ugandan midwives why different positions were helpful to the mother and baby using my cloth pelvis and knitted uterus model, which I am leaving behind for them to use for education.

Last night we had dinner at Yvonne's house. Yvonne is the leader of the beading group and the best at English (I'd say, fluent, almost) and the best beader. She hosted us in her home for supper and put out a wealth of food for us. We arrived in two cars but only a few of us stayed at first, the rest needed to go back to the guest house to freshen up before we sat down to eat. Walking into Yvonne's home, it was a very small room that was curtained off by half or so. The sitting area that we were in was probably at the very most, 12' by 15', by my terrible estimation. A sofa, a larger table and a smaller table was in the room, and in any spare space between them was stuffed a plastic outdoor chair so that we could all fit. We were knees to knees in some cases and there was no walking around. The only place to go would have been back outside. (My camera was dead, I wish I had photos!)

Jane, Kelli, and Madelyn, one of the volunteers, sat outside on the long cement porch. The children saw us inside Yvonne's house and began to gather and make silly faces, and would laugh hysterically if I waved or made faces back at them. When we went outside, the children started to multiply and there were probably 20 kids of young ages (the oldest was probably 9 or 10) all dancing to make us laugh and clap. They danced and danced and Madelyn, who is a trained dancer, went out with them and got them to copy some silly dances she made up. We laughed and marveled at each other for a good 20 minutes. People walking by would stop and watch, or stare, or smile. Everyone seemed very curious about the muzungus on Yvonne's porch!

Then the rest of the group arrived and we filed in to the small space and Yvonne set out matoke, g-nut (ground nut, like peanuts) sauce, greens (these three things have made up most of our meals here - I love the greens but I'm going to admit that I won't miss matoke and g-nut sauce!)

The children started to file in and touch us by shaking hands and then holding our hands while staring at us with huge smiles. We met Yvonne's grandchildren who were just incredibly sweet and beautiful. One of her granddaughters came to greet me and I asked her name, and she said, "Christine." I said, "My name is Kristina!" and her face lit right up and she was so excited! We had almost the same name! She attached herself to me and later she and her friend walked us back to our guest house.

We got back to our guest house and the first thing I did was shower- it was the hottest day we've had so far (no clue on temp) and I was literally wet with sweat, down to my underwear. I peeled everything off and stood in the nice cold shower and hoping that someone else was using up the hot water that I didn't need. The lights went out, and then came back on, I finished my shower and visited in the common area for a while.

The nights are interesting here. We rush back to our rooms and we take time to breathe for a few minutes before we continually find ways to get back together. We play games or sit around the table and drink water and laugh and review the day, or we share the one phone we have between us. Then it's time to go back to our rooms and I continue to be grateful that I spoke up when we arrived and asked for a private room. I'm getting so much out of being able to reflect and write, confront my anxieties about being so far away from my family, and to do what I need to do to sleep, or get up early (lately it's 5:30am. Ugh!) and not worry that I'm bothering someone else.

This group is really fantastic and given that we largely didn't know each other before we came here, it's a really great thing. Ildiko is from Toronto and has traveled internationally. She is soaking up every bit from our training which is very exciting and fun to see. Bobbi is a yoga instructor/childbirth educator from Newfoundland and has an amazingly calm, gentle presence and a quick sense of humor. Melinda is the introvert- the other person with her own room and who is enjoying the trip very much and yet, missing the comforts of home a lot. Jane has been here before a year ago and this is home to her, and she is a very fast thinker, fast talker, and fast to believe that ideas that we generate will happen. Kelli is a doula from Seattle and she reminds me of a friend back home that I care about a lot. She's very funny and warm and saucy - I love saucy!

I got to talk to my whole family last night, the first time since I left. It's interesting to not talk to my family daily- we're so busy that it would be hard to make it happen even if I had the ability to do so. Down here, you buy an unlocked phone for $30 or so, and then you buy cards with minutes. Jane bought a large number of minutes for us all to share so we're doing our best to talk briefly but as often as needed. My family knew I wouldn't be able to call much and I'm trying to call when I can - there just hasn't been a lot of time. I have texted my husband a few times, and at $0.50 per text (send/receive), it will add up quickly so I'm trying not to do that too much.

It was sweet to talk to my kids and I wish that I had some kind of awesome gift for them. Interestingly I think the neatest thing I could bring home for Niall would be some of the very quartzy rocks. He could take them to school and show them off if he wanted and rocks are very much his thing. I bought a bracelet for Eidie that I keep wearing- so I'm thinking I need to find her something else. I have no clue what to get my husband and I don't think an embroidered, brightly colored African shirt would be his style. Just a hunch. And for Dryden - he's so much his own guy, I also do not know what I could possibly get him. There aren't touristy shops in Kasana, not truly, so you won't find posters of Kasana, or spoons or shot glasses or postcards. I could bring back some African soda for everyone which I probably will do (glad I remembered to do that!) and hope that it doesn't explode in my bags on the way.  I miss my family, and when I talked to them they sounded so glad to hear from me, and my husband sounds so proud - I'll take it!

Bless you, Ildiko!!!
This morning I woke up again at 5:30 and I took that time to separate out the laundry that I will need to hand wash tonight, to clean up my desk, to put away the things that I brought 'just in case' but have not needed - wow, I brought a lot of stuff I didn't need, and I know that's just what happens when you go somewhere new, but it's still funny to me. I think if the apocalypse happened while I was here, I'd be prepared for it!

Drying laundry. Stay away, mango flies!!
Today we're going to Florence's house to hear about traditional midwifery/birth attendants in Uganda (which are now illegal) and her 30 years of supporting Kasana families. She is very well respected here, as a health officer she would visit families and gather information about census, illness, births, deaths- etc. and so interacted with the families here intimately. Shanti is so lucky to have someone with her knowledge and community connections! She's rather soft spoken when she is speaking English so I'm hopeful that the exchange is one that feels complete to her, and is something we can take away good information and ideas, and understanding. I'm not sure yet what the rest of the day holds but I believe it includes a little internet! I hope so!  

9/29 - Hospital

Shanti's bookshelf. There is another small shelf
with a lending library for the mothers.
Things to remember

Tetanus
Hospital
Sister Mary's talk
Drum
Walked to lunch at the diocese
Shanti - educating clients, politics, power dynamics
VIola
Cristina's (chicken and chips)
Beer!



Yesterday was a busy, intense day. I find they all are. I'm still going deep down the rabbit hole of what and who I am in Africa - is it a good thing for me, is it a good thing for this community that I am here. I suppose without interviewing all of the Ugandans I won't possibly know what they truly feel. We've seen thousands of people and the Ugandans wear a rather closed off look on their faces that seems unapproachable, and then they approach and the widest, most beautiful smile breaks over their faces. And then there are the occasional people who make a good effort to let you know you are unwanted, not liked- whatever it is they're trying to impart, I am picking up the vibe I shouldn't approach you.

It is scary at times, not knowing what people are thinking. The children here are so incredibly excited when they see muzungus drive by, their faces light up like they've just seen a pile of Christmas presents and they yell, 'Hi Muzungu, hi!!!" and they wave, and wave and wave until we're out of sight. Not all of the children, but if you're driving down the road and slow down whatsoever, you'll be met with children very excited to see you, waving their little hearts out.

Yesterday we were given a tour of the local hospital, it is a level four facility which means it has more capability to help the local people than a lower level clinic. Shanti is a level two. The hospital (I'll have to find out the name) was quite the experience. I feel reluctant to write about it- to have the people I saw there reduced to, "Oh, that's too bad." Or worse, "That's just what happens in Africa."  I'll write about it because the story should be told, because I do want to share it, and because I hope I can do it justice.

Dr. Agaba and Henry gave us a tour of the hospital.  I'm not sure I have this correctly and I'll try to fact check this before I leave, but Dr. Agaba is in charge of the hospital, and Henry is sort of his right hand man, I think. Dr. Agaba is not a tall man but his spirit is bright and his strength resolute. He smiles easy and laughs hard, and has deep understanding of the plight of the people in his community, and the context of what that means in the world, what challenges the Ugandans face in health care and what those factors are - and he cares very, very much about what he does and the people he's responsible for.

When we arrived we were told we could not take photos. I'm glad they had this rule in place, some things are not for tourists, and today, we were all midwives. As we were entering the building Henry approached Dr. Agaba and whispered in his ear. Dr. Agaba alerted us that they had a case of tetanus in the hospital, which was very rare. They had limited capacity to help the sick person - they lack the serum here (which isn't terribly uncommon anywhere in the world, I imagine). The hospital is a compound of several buildings in various stages of being built, and disrepair. The first building we went into was the children's ward. One room with several beds, naked of bedding. Most of the beds filled with mothers holding their unconscious or very sick children in their arms, or touching the child laying on the bed. Everywhere we go, the people here stare at us. The hospital was no different. The mothers all watched as a group of muzungus led by Dr. Agaba filed in among the beds.

I didn't want to look at the children because there was no privacy, just beds together in the room. It felt so rude to me to be looking at someone's most terrible situation, to be worrying about the health of your child, but I also know that it is my own cultural bias that tells me this. I actually don't know what is appropriate in this situation so I hope my heart leads the way that I do not want to invade or pry, only to learn, and that I understand that this could feel like an invasion to some, and maybe not others - I try to keep my energy in integrity as I stand among these mothers, fighting for the lives of their children. With no coaching, it's difficult to know how to be in this room.

Dr. Agaba walked us over to a bed with a child whose mother stood next to him with giant eyes. Her little boy, age maybe 5 or 6, lay on the bed under a sheet. He was very still, receiving an IV drip. Dr. Agaba told us that this boy had tetanus, and as we listened to him explaining it to us, the boy's back arched and his head went back. The mother reached down and tried to pull his head back forward and Sister Mary (the head Midwife at Shanti who had accompanied us) told her not to do that, she could hurt his neck muscles, to let him go. The boys arms were pulled up and rigid and his back taut. Dr. Agaba explained that if we were to see the boy's face, it is pulled back into a tight grin because all of those muscles are seizing too. I dared not look. 

I ached to hug this mom, I wondered what she was thinking. My heart hurt in a way I have never experienced, because I have never been in a room without hope before. 

There is no hope for the boy, and within a few days, if that, he will die. I can explain it all to you, but the short version is that this hospital does not have any serum, and the family can have him transported to a higher level hospital but if they do not carry the serum they'll have to buy it themselves- and there is none anywhere nearby, and they couldn't afford it anyway. 

This could be any parent, anywhere, whose kid, playing outside, stepped on a nail and got sick with tetanus - and I don't expect that my local hospital carries the medicine for tetanus but we'd be able to get it and my kid would have a pretty good chance at surviving. It brought home to me the luxury we have in America to 'discuss' vaccination. I did not become a vaccine flag waver in Africa but it definitely exposed me to the fact that we relish in the knowledge that we will have clean water, we will have safe food, we will have access to medical care one way or another (even if it bankrupts us) to care for our illnesses. It's lofty to be able to discuss vaccination as an option, and how fortunate we are to be so very, very blessed with the abundance we have here. Our children die of preventable diseases too, things happen- but I don't think vaccination is even ever considered to be something a parent wouldn't do in Uganda, Africa? If you want your child to have a shot at surviving, you give them the shot.

Standing in the presence of this mother who already knows what is about to happen to her son, and seeing the terrible situation that the hospital is in to provide help and wondering how I will survive it when my heart breaks into a million pieces. I started to cry, I had to walk away because it felt so desperately inappropriate for me to grieve for her and her family, and her child, to see myself in them- I had to collect myself. I walked away and put my head against Jane and allowed myself to sob for a moment, just one moment, because I was helpless and I hated it, and the hospital was helpless, and I hated that, and worst of all, this mother had to stand by her seizing child, helpless, staring at us, and we could do nothing but look at her. (Writing about this, days later, I am still crying.) We walked away.

We went on to see the terrible conditions and amazing work they're doing at the clinic. They're trying to be recognized as a hospital instead of a clinic so that the government will need to give them more money, which would allow them to provide better care. In one of the rooms we went into, the ceiling is falling in and leaks. Hospital beds are bare of linens for infection control and also because to have enough linens to use and keep safely would be a ridiculously inappropriate luxury when there aren't enough drugs, and there aren't enough of a lot of things to make this hospital function- and yet they are making it work.

We went to the maternity ward and there were several beds, many of which had mothers with their babies. He said that sometimes the ward is so full, there are women on the floors. Shanti Uganda has on average, in the last couple of months, about 12 births per month. The hospital has about 180 births a month. We met Sister Margaret (Sister is a designation for the head midwife/head nurse) the midwife for the hospital. She said that they had someone in labor now and we went in to see the room where the women delivered. There was a woman there in labor, undressed to the waist. She was having intense contractions that made her stretch her back and make pained faces, and sat alone, unattended, on the stripped mattress. 

My heart, my heart, it's breaking, I can't take this- I'm a doula, I'm a human being, I am a woman who has given birth, and I'm on a tour of the hospital and this woman is alone, what do I do? What is appropriate? Would she want me near her, or would it be something she'd have to suffer as she tried to get through her labor alone, on that bed? I looked at Jane and she looked at me and she walked over to the woman and started reassuring her. I am glad she did that, later Jane shared with me that she told the woman she was doing such a good job, and the woman said, "I don't feel like I'm doing a good job." Jane reassured her and we looked at each other and I know that she would have stayed by her side if she could have, as would I, as would any of us, and we couldn't. We had to keep moving. We walked away.

I think that we have this 'noble savage' concept of Africa - that women just set down their headbaskets of wood, squat in the bushes and push out a baby, tie it to her back, picks up her wood and keeps walking.  Also, that the women are so stoic that they don't doubt their strength, they don't doubt their ability to give birth, and they don't really need assistance, or reassurance. It's a problem. I hear this concept in childbirth circles all the time, "Your body was made to give birth!" And yes- this is so, so, deeply true. In addition to that, time and evolution has required us to be attended in labor, to be seen through safely. We require that. Yes, babies will come out without it, but for our optimal birthing situation, we are in attendance. 

That noble savage concept - none of that is true. Anything that you felt when giving birth, women all over the world are feeling. While there are many cultural mores around birth,  the transition into parenthood is something universal- to let go of who we are and become who we need to be- and that will be fraught with worries and preparation and all kinds of traditions.

(10/12 inserting my thought here...) I recently saw a picture posted on Facebook of a few African children standing before a panoramic view, and they're discussing how American children have to sit behind desks, inside for schooling, and how terrible that is, and one of the other children says, "We should take up a collection for them!" I'm paraphrasing but I have to react here, rather than Facebook (and with no bad feelings to people who posted/shared it, whatsoever!) - this very idea that being in a tribal setting, in the bush, is some sort of 'authentic' way to live, is damaging and frankly, a brand of racism. Rather than diminishing the way another race lives, exists, we overly celebrate it and put it on a pedestal. Make no mistake- this is still very much racism. 

When I saw this posted all I could think about are the girls all over the world, even in these 'ideal' tribes, who will never be allowed an education, because they are raised to make babies as soon as they are fertile, and be good wives, and therefore have no need of an education. The Ugandan children who are home all day because their parents can't afford to send them to school, and will grow up with very limited options, and are at risk for dying, at risk for harm, risk for disease, and worse, risk of perpetuating the cycle onto the following generation. The girls who will have sex at a young age to a man too old for her and get pregnant, assuring she will not be able to continue her education, if she even gets to start it. My eyes have been opened and I'm sharing this thought with you- now you must decide what to do with it. Let's drop the "noble savage" concept, okay?

When a woman goes to a health clinic to have her baby and needs a cesarean or life saving treatment that the clinic doesn't have, she has to pay the fuel to be taken to another clinic that can help her. She may be forced to pay for medications if the clinic doesn't stock it. If that family is too poor to pay for the gas, she or her baby (or both?) dies.

Very simple. No gas money? You don't get treatment. You die.

I took this in, I cried again, and felt helpless and overwhelmed again. I will write a check right now so that this never happens again!! And yet, that is not enough, nor is it even adequate. It's just what I know how to do.

We were all quite shaken by what we'd seen. The result of being so shaken is not only to just be upset, but to want to do something. But what? What can we do? How can we possibly assist in such a complex and in many ways corrupt system? I'm white, I'm American, and privileged. Do I share what I have? I don't know the answer, I don't know how to make it better. I don't know where to go, and that feels right to me- because it will come. 

Midwives working on the exercise.
For now, I feel that I am doing a small part to heal the situation with this training. We have met the most amazing, funny, creative, visionary midwives at Shanti. Despite the language barrier that exists between us and a couple of the midwives and staff, we are making it happen. Jane, Melinda and I are continually crafting this workshop to be more culturally relevant, to appeal to the knowledge base of our attendees, to give them the basic skills that any doula training would provide alongside the really awesome differences in opinion that the three of us share on many topics, but in a highly constructive way.

What this means is that the midwives here at Shanti who are already very compassionate and quite skilled, are adding tremendously valuable tools to their toolboxes- things like fetal positioning and how to encourage changes, how to recognize in a labor pattern that a baby might be malpositioned rather than asking a mother to have a vaginal exam, different positions for laboring and how they affect a pregnant woman's anatomy - information that they can give the mothers so that the mothers can make choices in their labors on how they want to help their babies be born.

That my friends- that is a direct impact. Maybe there's a step between me and that laboring mother but it's a critical one and not one I'd ever want to skip.

We have a mama laboring the last few days at Shanti, Viola. She looks like she's 16 and we found out today she's actually 25 and laboring heavily with her 6th pregnancy, 3rd baby. A couple of days ago Lisa showed us massage techniques and some acupressure points on Viola but her she is, two days later- still laboring. It was sweet to meet her and I know that Jane, Melinda and I were both envisioning how delicious it would be to be present at her birth.

Viola's Swing!
Finally today she was almost fully dilated and Melinda and Jane were able to do some midwifing/doulaing with Viola while I taught. Unfortunately she hadn't given birth when we left although she doubtlessly has by now, and hopefully tomorrow we can give her some love before she goes back home. As we discussed positions for birthing, knowing that Viola's baby was asynclitic, we discussed different ways of coping with that and as I started talking about how dangling a mother (having her hold on to something with her arms and let her pelvis completely go, Melinda walked in having thought of the same thing. She managed to wrangle a rope from town and it was installed before we left- and promptly turned into a swing. ;) 

After the day was done we met with Sadie and Sarah from Shanti and had dinner outside, below the almost-full moon, and even provided dinner to some mosquitoes. (I haven't been bit yet, yeah!!) We drank beer together and got to know each other a bit- It was a treat to find out that Melinda has been making beer for 20 years and has even won awards for her brew, and did some matchmaking for Sadie. Every day I feel more and more at ease here. It will be so, so hard to leave.
We went back to the guest house and a couple of our troop went out to a local dance club with some of the volunteers and the rest of us stayed here and drank beer and laughed and chatted until 1:30am. It was solidly good fun and I am so glad we had that downtime together.

Ahhh the latrine hole. At least I
didn't pee on my feet... oh wait...




Thursday, October 11, 2012

Random thoughts

I wrote all these random word lists in my journal so that I wouldn't forget things. I'll write about some of them in this post, just for something different.

Asanti-sana! Whenever someone does something wonderful or generous, or people are generally grateful, they sing, "Asanti-sana!" and clap in a rhythm, then open their hands toward the person. The person who is receiving that love crosses her arms over her chest indicating her reception of that love and appreciation.

Mosquito bites - I left Uganda with 7 mosquito bites. I am tossing around the idea of getting tested for malaria just in case, but I actually feel intuitively like I'm probably fine.

Ugandan pizza - One night we went over to the volunteer house to eat dinner with Jamilah, Sara, Hazuki and Madeline. They asked us what we wanted and we said, "Please, no more matoke!" and negotiated to get a sort of pizza made. Jamilah is amazing! We had a doughy crust and Hazuki made short work of many types of veggies and put them together in this spicy, tomato-y sauce which we poured over the bread, and then had pineapple to top it off. No cheese, it wasn't baked, but it was absolutely wonderful nonetheless!

Giant Flying Bugs - There are these giant (I mean, 2-3" long) flying bugs. They look like crazy wasps from space. They're black and they sort of bungle along and smack into windows and thankfully, don't come too near us. I watched the Ugandans to see how they reacted, I figured I'd trust them. They weren't phased by them which... yeah. I was phased. But only on the inside. On the outside, I pretended they didn't exist. I'm sure if they'd noticed me, I'd have lost an eyeball to their giant stingers or whatever pointy thing was at their back end.

Craving American Food - I don't think I craved American food until it was time to leave. I really, really let go and surrendered to the flow of things, food included. I ate whatever was presented to me, with a full heart- even though we'd paid for the food and the delivery of it, it never occurred to me that it was anything but a heart gift from the Ugandan folk who were receiving us and caring for us. As we started to wind toward our flight, I realized I really, really wanted a hamburger. REALLY. We got to the airport at Entebbe and even though I was still quite sick, I was feeling well enough that I scoped out the cafeteria and saw they had "Beef patties" or some other obscure thing and I got really excited. Kelli saw me drooling and shook me hard, saying, "PLEASE don't eat the beef, Kristina, PLEASE!"

Well, if you insist.

Boda bodas and babies - And the mothers ride the what? The motorcycle. Mothers heading into town or home from work or where ever mamas go, who choose to ride the boda boda, sit side saddle with their babies in their laps. Little babies bundled in blankets are also held in arms inside cars racing down the street among bicycles carrying jerry cans or many people, boda-bodas and the many, many pedestrians.

Shops - Many shops are the size equivalent of a garden shed. At night, you'll see the doors thrown wide open and a single candle lit within while packets of things are draped on string back and forth across the width of the structure. So fascinating.

Black mambas - I didn't know there were black mambas in Uganda until some kids found one in the bush. I assume that it was dead when they found it, otherwise, they killed it. A black mamba. For realz.

Lions and Tigers and Bears, Oh My! - Soooo yeah. We stayed at the Entebbe WIldlife Preserve and we sort of hung out in the restaurant a lot. Our waiter, this incredibly gorgeous man named Abel took excellent care of our troupe that two days. We ate lots of food and drink many beers- especially that first night. I'm not sure how much I drank. I remember feeling like I was being too loud and self-imposing 10 minutes of silence upon myself which helped me to slow down my thinking and to let other people talk once in a while. When we decided we were done with the restaurant we had to walk back to our bandas through the preserve. The animals are largely caged but there is no lighting on the road, you're just walking and hoping for the best. Especially when you're six large beers deep. My good friends Bobby and Ildiko each let me take an arm and we skipped down the road chanting, "Lions and Tigers and Bears, oh my!" much to my endless delight! I was very tickled to be able to do this at full volume - that was until we ran into the French tourist who was also walking back to his banda. Doh!

Wednesday, October 10, 2012

Thou shalt not covet thy neighbor

Have you ever been in a long term relationship that seemed perfectly fine, and then found yourself unwittingly, unexpectedly, in love with something/someone else? That is me. I am breaking that commandment that says, "Thou shalt not covet thy neighbor." My neighbor is misty, and smells of many people. My neighbor is made up of the darkest skin and the widest smiles, and huge leaves from banana trees, and smells of sweat and cooking fires and red dust. My neighbor, she tastes of pineapples and papaya, and cold Nile beer. In my deepest heart, I am aching for Uganda, aching and sad and grieving that I had to leave, reaching my heart across the American earth where we are free in so many ways that the Ugandan people are not, and conversely, bound and limited, too. I wake up and for a fraction of a second I feel relieved that I am home, in Uganda, that I will be sweaty and dirty at the end of the day, that a mosquito net hangs above my bed, that the sounds of the cows with giant horns will mark the morning alongside the roosters, alongside the giant loud monkey-birds, alongside the cooking fires, alongside the children moving in colorful groups toward the school buildings.

For a fraction of a second I know that my day will be spent with Sisters who understand the significance of touching a woman in labor, of having the right energy when we approach her. They'll know it without the trappings of all of the birth politics, it will just be daily life. I won't be barraged with marketing from the nearest fast-food joint, I won't have a million options to choose from in the grocery store. Life is stripped down to bare essentials and my heart blooms fully into my work, into my interactions with every person I come across. It's no longer a novel treat that I had a conversation with someone, it is built into the bricks that lay the path of my day. There is no step forward without touching each other, sharing each other, and caring for each other.

And then the fraction of a second is over and I feel a crushing grief and a huge sense of relief. I reach over and touch the warm skin under many blankets, rub my foot against my husband who has my heart and my soul. I get out of my soft, clean bed that is not draped with mosquito netting. I walk on the ground and see that there are no trails of ants to surprise me this morning. There is just dust from the day. I step into a warm shower and put on clean clothes that a machine washed and dried. I walk outside to my paved driveway and get into my new car and drive in an orderly fashion to where ever the day takes me.

I feel tremendous gratitude to have all of these things, and a deep confusion at the same time. I expect the ants to carve a trail across the floor and when they are not there, I am sad. Then I remember that here, that would be unwelcome, and unwanted, and we would poison them to make them go away. Which is not to say that wouldn't happen in Uganda too but when I was there, the ant trails were little visitors that reminded me that I was in Africa, and I let them be.

Even if I were to go back tomorrow it would not be the same, and I have to remember that. Because of the arrangement we had with Shanti, the money we spent covered our expenses for food, for a driver, for visits to restaurants (that were planned), and for our housing. I didn't have to think about anything, or worry about anything. I just had to figure out how to relax in a new environment, how to adjust to a shower that shocked me when I used it, to the music of Lugandan being spoken all around me at all hours, to the blanket of heat that greeted us every day. I adjusted so fast, that I actually miss every one of those things. The volunteers I fell in madly love with will be gone, new faces will replace them before long. My travel companions, save Jane, would be different.

I live in two places now, this is the new normal- and who am I now? I don't know. I don't know. It's going to arrive as it will.  I'm sitting in the place in-between-the-worlds of Africa and my home, and working on letting myself just be here, until I can just be there again, and being there, until I can just be here. No wonder I feel sad, and uncomfortable, and unsettled. I'm neither here, nor there.

When I arrived in Kasana I literally had to cut an energetic cord to home in order to let go, and fully be there. I can't bring myself to do that on this side.