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.

Tuesday, October 9, 2012

Still Adjusting 9/27

I'm still adjusting to the time zone, as much as I feel like I'm on top of it, nights are just difficult in some ways, and suprisingly easy in others. Last night I went to bed around 11 and fell right to sleep, but woke up many times. My guts are feeling a little loose and I feel totally fine, not ill at all, but it's a distraction that wakes me up. So it's almost 5:30am and here I am, listening to the music of the African morning. It's still dark and will be for another half an hour or so, the sun rises and sets here in a 12-hour time span because we are so close to the equator. When the sun wants to go down, He goes down quickly! The moon is becoming fuller each night and I feel the intensity of it. I can't wait to be under a full moon on African soil.

I was sleeping and sort of chewing on my post from last night while I slept- I'm dreaming a lot and easily but every dream so far has disappeared as soon as my consciousness rises. I think these reflections I have about my relationship with the people here, my role, my "self", what that is, what it means, how it's impactful, trying to be responsible, trying to be loving- how can I actually do or be any of those things if I'm constantly trying to be them? I have to let go of something big and fundamental and I am surrounded by teachers who have given me big clues.

Lisa Saper-Bloom & Moi
The volunteers who work at Shanti have this easy, honest, way of being with the Ugandan people- and I think on some level it's because they don't see them as Ugandan people, they are just people, exploring and experiencing a different way of being on the earth than they have. It helps that they have all traveled around the world and to different cultures and have a deep sensitivity that is not ego bound or a performance, or overly caretaking. Watching Lisa laugh with Rabina, cracking jokes and talking with her as if they have been friends forever, made me realize that I am tiptoeing around worrying that I will offend, or won't make a good impression, or that I will miss some important custom - basically worrying a lot about myself. Really, that's the situation, at the end of the day.

Me, Hazuki & Madeline
I think that is something that is rubbing against me in some way about my involvement here- and I do see it, this awkward intention to be loving and to be on common ground, but we stumble in with egos. I don't know how to not do that, and I know it's because choosing to let go of ego is really, really hard and scary. I give myself permission to not do that easily! But I also know that true compassion means seeing the thread that binds us, not the things that separate us from each other - and that is something I'm very good at. I know because I'm writing this that the moment will arrive where I will release this and I look forward to that moment, and hope it arrives before the day I have to leave.

Sara & Me
I truly feel that my heart can not take everything I am experiencing here, and this painful growth is growth indeed- my heart stretching wider, and deeper, so that Africa, Uganda, her people, her dusty red roads and her matoke, and morning calls to prayer, and wailing roosters, her mosquito nets and wild chickens and pineapples fresh off the bush, will all settle comfortably within me. Like a mother who is stretching and opening around the body of her baby as it emerges from her, who feels she can not possibly go for one more instant, she does it, and her baby comes out, and she's intact and knows something new about herself that no one can ever take from her. I feel this is happening to me, too. How can I take anymore? How can I absorb one more thing? And then I leave the sanctuary of my room and I see one more amazing, beautiful sight, or am touched by one more person, or hear something so funny and share unrestrained laughter with people who don't know me but who are so glad I'm here, and then I cry because I have never known gratitude in this way before.

Gratitude is something that is a very easy place for me to be, and there is something about being here that has cracked that box wide open. This place for me, it's all about being broken like an egg so all my gooey insides can come out, it seems! While it's become an easy place for me to be, I am truly, truly taken aback by the intensity of the gratitude I have just to have stepped foot here.

Me and Jane at the drum shop :)
I knew that Uganda was holding something for me, that there was something waiting here, that I would experiencing a great "Letting Go", and it is happening, and I cry a lot. Jane looks at me once in a while (I don't know if she does this to anyone else, she probably does, but it feels like a sweet secret between us) and says, "We're HERE!!!!" It makes me cry almost every time. I see how much this community means to Jane and how much she is a part of it, and how much love she pours out here, and I am profoundly humbled that she would find me worthy of sharing this with her. Like a master gardener, she warns us all to step gently, to watch the new ideas that have sprouted and to tend them with love, to have respect for the things that have grown deep roots and strong branches without us, before we can come in. We've been invited in to plant our own seeds, and to harvest some of the fruit of the experience, but we are to tread carefully because this is her Eden, in some ways. I love that.
I want to just pick something to write about to give a snapshot to what it is to be here, bear with me because wrapping words around Africa in an attempt to describe it is like trying to explain a Holy experience- in some ways, it is just impossible, and in some ways, it makes the experience a little mundane, and in some ways, we just don't have words.

Maybe my morning rituals, I'll start there. I wake up and instantly hope that it's late enough so that I can just get up. I sleep without blankets and while last night was nice and cool, it was still too warm for blankets. There isn't power at night, just the generator, so the fan doesn't work after about 10pm. Most people sleep with their windows closed to keep mosquitos out, I have slept with it open every night but last night because it's just too hot. When I wake up I come out from under my mosquito net and use the toilet. Having a toilet is a great thing and I'm grateful every time I sit on it that it's not an outhouse, or a whole to squat over, - all of which I would have been fine with, but this little comfort is so luxurious! 

The shower is a hose with the handheld attachment but my hose is broken right at the base of the attachment so water shoots out there, instead. Sometimes we have water, sometimes we do not. To shower I just hold the hose and wash that way, but there is some kind of electrical charge and so holding the hose is scary because it has this buzzy sensation that makes me fearful about standing in a pool of water! I shower quickly.

I don't have a towel and none are provided so I dry off with some of the dirty clothes and hang them to dry. I pray that I won't get mango flies in my room because I think I would die on the spot if I had to squeeze a larvae out of my body like a pimple. Die on the spot. I have no choice but to take the chance though- mango flies lay their eggs on wet clothing and when the clothing is worn, the eggs hatch on the skin and burrow underneath the skin to mature. Like bot flies, they have to have their air hole cut off with vaseline or nail polish to kill them, and then the body is squeezed out like a pimple. FUN! No, no, no, it's not fun.

I generally get dressed and grab my Nexus (thank you, Husband!!!) and will read or write for a while. Yesterday I was able to visit with Jane and Kelli a bit and that was sweet, to start the day with laughing and crying and more laughing. We get dressed and then I go into the grass to spray myself as lightly as possible with that awful DEET bug spray. I only do this once a day because I just can't stand it and the mornings/evenings are the most likely times to deal with mosquitoes. I go into the common room where breakfast is served- generally it is pineapple, watermelon (both native and AMAZING) and perhaps toast with peanut butter or eggs. Coffee grows here everywhere which is really neat but interestingly, Uganda exports their coffee so the only option to have coffee here is to have instant coffee. I appreciate so much to even have that option, and bought myself a little jar of Nescafe.

We eat breakfast and then the schedule for the day begins. Yesterday we were picked up at 9ish and went to Shanti, where we first had a wonderful hugging and reconnecting time with the midwives and volunteers. There were many women in labor (Shanti has usually about 10 babies born per month, the last two months they saw that number going up, so yesterday they had a surprising five women in labor at once!) which brought a sweet energy to our gathering.

Organizing the class folders.
First the group did yoga with some of the pregnant women, while Jane, Melinda and I went over our curriculum for the day. Then Lisa led a massage session for two of the mothers, one of which was in labor and the other was not. She taught techniques for helping to massage our clients safely and in the ways that would feel good to them, some very basic techniques that I think will be helpful. It made me miss learning new fun tools to help my clients when they are birthing- something I haven't done in a long time because I'm convinced I'm retiring (even though so far, I can't say no to the opportunity to attend births!)

After this time we broke for lunch. Lunch has been brought in by I think a local caterer, which basically means someone who has a restaurant locally prepares our food, and then Ben, Shanti's driver, goes and picks up the food and the person who will serve it. We eat on mismatched dishes under the shade of the trees, sitting on papyrus mats. Yesterday's lunch was probably my favorite meal so far- rice, beans, fresh pineapple and greens. We eat all vegetarian which is fine because there is a lot of protein in the foods we are eating. Ugandan food is very dense and heavily cooked- it has to be to be safe. There are no salads here. There's really no way to grow vegetables for a salad, or to pick an apple off of a tree and have it be safe to eat. Things must have a peel that can come off, or be really cooked in order to avoid parasites. Water must all be boiled for at least 10 minutes to kill anything in the tap water, and we drink and brush our teeth with bottled water.

We sat under the papyrus with the doula training people, the volunteers, and chatted and enjoyed each other. Bugs crawl all over the mat and I just watch them, and wonder about them, and hope they won't bite me. I did get bit by probably an ant yesterday which hurt for a few minutes and then went away. Once lunch was over we pulled over more mats and the midwives joined us to begin our session. We did most of it outside but it gets quite warm and sort of sneaks up on you, so we went inside the Shanti reception area where it is much cooler. As we were talking a storm blew through, blowing wind through the structure and cooling us all, which felt so good, and felt like a whisper of home with all of our rain and cooler temperatures.

Rabina's twins
We talked excitedly together until 6pm and then left to Mama Pico's (aka, Rabina, who is the leader of the textiles group) for dinner. We clustered around her living room with sofas and comfy chairs and she set out the food she'd prepared for us. I didn't know what to say- I don't think that the Ugandans want for food, it's growing everywhere here, but to be welcome in to her home with her husband and children (all of whom remained outside while we filled up her living room and ate together) was profound for me, and of course Jane picked that moment to pull, "Hey, look, we're HERE! Can you believe it?" - and I started to cry. Rabina is "Nalongo" (I hope I spell that correctly), which means "Mother of Twins". Her husband is known as "Salongo" and introduced himself to me this way. Twins here (depending on the tribe) are a huge blessing. Older children will get a new name after twins are born that means, "Before Twins", and children born after the twins will have "After Twins" attached to their names. All twins have the same name here, one means "Older twin", and the other means, "Younger twin" - I'll try to find out again what those names are, I'm not recalling it just now.

(People are starting to wake up and talk in the courtyard now, and I am continually surprised at how natural it is to hear people speaking around me in Lugandan, I don't feel out of place, or that I need to try to understand, it's just part of the dense immersion I'm experiencing. I love it!)

After dinner was completed with thanked Rabina, "Mwebele Nyo!", to which she replies, "Kale!" (KAH-ley!) which means, "Thank you for appreciating me." I will be bringing Kale back with me, because it is such an amazing sentiment! We piled into the van, too many of us, and Ben drove us down the bumpy roads weaving between pedestrians of all ages, people on bikes carrying drinking water, and many boda bodas to get the volunteers home. We dropped them and then came here, where Melinda and Jane and I debriefed and generated ideas for today's session.

At night I don't know what to do with myself, it's so quiet and there is nothing for distraction. I'm grateful I brought my Nexus because it means I can write easily and even listen to a little Zoe Keating when the night is too quiet. I usually write and write and write until I can't keep my eyes open because that makes it easier to fall asleep- I don't want to lay here in the dark waiting to fall asleep, and this is working well so far. I do have melatonin next to the bed just in case, but so far I think I'm so heavily stimulated from the day that my brain is so grateful for the quiet, and the darkness, and the colorful background noise of bugs and bats and people getting ready for bed. I turn off the lights and in pitch black, I fall immediately to sleep.

We have a busy day ahead of us- we'll be picked up at 9am and then will go on a tour of the local hospital and maternity wards. We had the luck and luxury to meet one of Shanti's partners, a local physician who supports Shanti's mission at one of the local hospitals. I'm not clear on their relationship but there was great affection between Sadie and the doctor - we joked about how many cows he would need to give in order for her to marry him. It was very funny and sweet. We also talked about how if Shanti is going to support a teen girls group, that teen boys must also be supported. He spoke about how when boys are not connected that they grow up to be angry and that it is not good for families. This touched me deeply, because it is my thought as well and something I'm very conscious of back home- too little support for young men to know what it means to be men, too little tribe.

I'm not sure if we'll see him again today but we'll visit the hospital and then have a chance to do a little shopping. Apparently there is a drum shop in Kasana and I have been looking for a drum of my own- I don't know for what, it's just something I want to have, and I hope that there is something I feel good about buying because it would be amazing to take a drum back home!

After lunch we will do our session for today and then I'm not exactly sure what we're doing for supper yet. We fly by the seat of our pants here a bit - we did get a wonderful schedule sent to us ahead of time of what our plans would be but I left it at home and don't feel at all like I need it. I like getting up and finding out what each day will be, and being in the easy flow of things.

So far I have not been terribly hungry, but I really, really miss ice cubes. I wish I could have a really cold water and I could if I bought one from the little market in town, probably, but it seems like such a wasteful thing to spend money on.

I suppose I could keep writing but I think instead I'll get my tired behind out of this bed (which is pretty comfy, I have to add!) and maybe shower, or see if there is water for coffee boiled yet. I hope the adventure of this trip is coming across and I hope it's enjoyable to read my long, rambling thoughts.

The floor at Shanti Uganda

Sunday, October 7, 2012

Things to remember (9/28)

Things to remember:

Dancing in the dark
Matoke
Mama Pico
Webele Nyo kale!
Gratitude
Drums
Training
Under the tree
Henna
Mazungu
Labor support
Viola
Calling home
Belly ache
Mentos
Coffee and chocolate/exports
snoring

I'm working through some things being here. My tears are coming so easily, I can hardly stop them once they start. I can't count the times already that a huge wave of gratitude has washed over me, that I get to have this experience. I get to be in Luwero, where everyone goes to get the best pineapples, and enjoy the most amazing pineapples at every meal. I get to hug, and dance, and kiss the women who have this intensity, and power, and quietness, and who seem so stoic to me, and be touched by their laughing and their appreciation and gratitude that we are here to be with them.

I don't know what is for the Ugandan women for us to be here, and the muzungu (white) people on the ground assure us frequently that that the people enjoy our presence very much, that they are grateful we would come here, and then we drive and I see faces that look so curious, and not always welcoming - and I realize I'm making a lot of assumptions based on driving past someone I'll never speak to, but it feels sometimes like I am just another white girl trying to 'make a difference' to those 'poor Africans', and I have to constantly challenge that cultural thought in my mind. 

This is an area that I am constantly turning over in my mind. For example, it's been explained that muzungus are viewed as privileged, and so it's considered to be a good thing when we are involved with the local people. I don't know if that explanation is accurate (and it feels so weird to me, weird, weird, weird, and uncomfortable) or not. What I experience is that taking my own perceptions of body language, that the women here who aren't already in relationship with us are quite deferential and permissive when we make requests. I am very serious and cautious about asking permission before I photograph someone, or their child. Without looking me in the eye, the eyes cast down and the head shakes back and forth like, "No", but what she is actually saying is, "No, I don't mind." So from my perspective, I'm seeing someone say, "I'd rather you didn't, but I don't want to offend you." From her perspective, she is saying, "Go for it." In between the lines of that, I'm experiencing the inner turmoil of wondering, is she TRULY okay with it, or is she saying yes because I am white? Is she saying yes because she wants to be easy going? 

And then I go further into the weeds of, how disempowering is it to not be taken at your word? If she says she doesn't mind, why can't I let it be true? So I snap the photo, still bewildered and concerned, and I walk away knowing that there is just no possible way for me to know the inner workings of a Ugandan woman after three rather isolated days within her own country, immersed and unversed in her customs and culture, wobbling around like a baby, bumping into things I don't understand and bonking my head on corners that I didn't realize where there, hoping that my ability to walk confidently here will just have to come with time. That is very difficult for me. I hear my Annie and my Louisa in my mind at all times, reminding me to make no assumptions, to never see myself as a rescuer, or as a person with the answers - which is not hard, because I don't tend to take those roles on - but like little saucy angels on my shoulder, they keep me conscious of my interactions as I am having them. And then I also worry that I'm thinking too much. It is hard to know where the line is drawn of what is overthinking, and what is maintaining integrity within myself- that I should be able to find a common ground if I make mistakes.

The power is currently going on and off, I go from sitting in total black darkness to lights but no fan, and then back to darkness. Fun! There was a little gecko or lizard on my door and Jane assured me it was a blessing because they eat the bugs that might be in my room (so far, I've only seen one dead bug in my room. Thank you, Gods of Africa, from sparing me that terror (so far!!)), and that I should name him. And that she named her gecko friend from her last trip here, "MC Hammer". I named my gecko Isaac but he chose not to come inside the room.

Let's talk about bugs - because while there are mosquitoes here and malaria is obviously an issue, it is not nearly the situation I thought I'd be walking into. From what I am told, the mosquitoes that can carry malaria are only out from about 11pm - 6pm and that a mosquito must bite someone with malaria pretty recently (like, within the hour, at most) and then bite someone without it in order for it to be transmitted. Considering that I'm tucked well under my mosquito net and that my whole room is doused in tea tree and citronella, I really haven't worried much about mosquito bites- and that's working out well because so far, no mosquito bites!

I made a list of things to remember from today - so much happens, these little moments that are so precious and exquisite and hard to believe they are happening to me, right now, ME, that I want to make sure I write them all down.

Yesterday we got to participate in the women's beading and textiles group- the local women come to Shanti and learn techniques for making jewelry and cloth bags and then sell them all over the world, via Shanti. It's a wonderful exchange and we were able to have the women come to Shanti where we saw their wares and were able to make purchases. The women were also able to practice their English with us which had us all laughing together. Mistakes are made and what I love about Uganda over Europe is that when attempts are made from the heart, they are seen as heart gifts, and not dismissed simply because I'm distastefully American. 

The Ugandans I've met know something important about graciousness, and warmth and tenderness, that I haven't experienced many other places, and certainly not in this way with perfect strangers. When we arrive, we are told that we are welcome here, that they are glad we are here, and their faces are lit up with real smiles and the hugs are genuine and warm.

Jane and Melinda and I are working very hard to make sure this workshop is valuable to the women who are attending it. We had a great outline thanks to Melinda on the topics we'd cover but we got barely any time ahead of our trip to actually flush out the activities- and then we all three have different teaching styles so working through that when we've never taught together is interesting. I feel like I am a balance of Melinda's methodical, analytical self, and Jane's free flowing, comme ci, comme ca perspective. There are definite things we each want everyone to get out of each activity and it's so beautiful and inspiring how we can dance around and through and under a topic together, finding our own tension points, honestly claiming them and moving forward in trust of each other, even if we don't see eye to eye. Each one of us is good at letting go when the time comes for us to do that. I enjoy these women very much and for different reasons, and I'm grateful that for the rest of our lives we will tell the story of our trip to Shanti, and be in each other's hearts. Kind of like attending a birth.

Last night, I was too tired to write about it but I wanted to make sure people knew about their donations. Everything that I received came with me, meaning I have only a few changes of clothes and a desperate, desperate hope that I won't have any issues with mango flies hatching their little eggs on my clothes if I end up needing to hand wash them (please, please don't make me have to do that!! Mango flies, eww!) We each brought a similar amount of stuff, most of which was baby clothes and took several suitcases full of things to the Volunteer House where we had spaghetti and pineapple with the Shanti volunteers who live down here for the term of their internship. They were shocked at the amount of things we were able to bring and it felt so amazing knowing that I was leaving things here that will literally save women's lives- directly, no bones about it. I am leaving things here that will help improve the health of pregnant women and their new babies- directly, no more direct way to wrap that. Literally making a difference, right here, on the ground. We all did that together, so if you're reading this far, I want you to know that the money that you gave so that I could come here, the purchase you made so that I could come, or that I could bring things with me, the donations you collected - you've touched the women and babies, and the staff as well, with your thoughtfulness and generosity. Nothing here is taken for granted, and nothing goes unappreciated. I want you to know that you were each in my heart as with teary eyes (that's happening to me a lot here!) I offered the donations of YOUR hearts - so thank you, from Shanti and the mothers, and from me. Thank you so much. You can't know how such a simple thing affects someone else's life until you actually do it!

Today we got up and only Jane, Kelli and I were away at an early hour, so I hid under Jane's mosquito net and in our pajamas we had ourselves a good old fashioned bull session. It was really awesome to have some time to get to know some of the team in a deeper way. Last night I was having dinner at the Volunteer house and I looked around the room at all of these incredible, daring women and I just felt so humbled to be counted among them all. The highest caliber of human beings- and I am here, with them. It's a precious experience for me to be with people who had principles, who took risks and made huge, enormous sacrifices because they believed in something so profound, so strongly, that they couldn't live without doing it. I know how that feels. I've been on the edges of that, and I was just so grateful that I could be in their presence. They laugh so easily with each other and it's clear that their affection for each other is deep, and they are wonderfully, amazingly brave in ways that I do not know myself to be- and that is perfectly okay because I think that's true in opposite as well. It's wonderful to be with strong women who are not in competition, and who seek only to make sure that each other's needs are met, that they are speaking the truth to each other, and that love is ever present in all interactions - and maybe they wouldn't say these things but it is apparent to me that these things are true.

I'm still writing, and getting tired- and I have barely scratched the dusty, red surface of what Uganda is, and what I am experiencing here. Goodnight for now.

Saturday, October 6, 2012

Safe-ening up birth in Uganda

I wanted to just write a bit about what we did in Kasana. I don't know that I did a very good job of explaining that before we went.

Shanti Uganda and Jane put together this awesome idea of having a doula training at Shanti. The midwives there have clinical skills but their training didn't expose them to things like dealing with traumatic birth, fetal positioning and how to influence it, VBAC, positions to ease pain, and all kinds of other things that doulas know like the backs of their hands.

They put together a training and invited Melinda and I to come along and co-teach it with Jane, so the three of us wrote a curriculum. Melinda did the structure and then we literally wrote it as we went each day, together. It was pretty fabulous.

(L-R) Jane, Bobby, Melinda (teaching), Sadie, Ildiko
Some of the volunteers that are on the ground at Shanti joined us as students for the workshop, and we brought some tagalongs from Canada and the US as well. All told, we had several countries represented which made the training an exercise in assumptions, absolutes, cultural sensitivity, mores, traditions, language - all kinds of things. We had the Ugandan midwives who come from different tribes, we had a Canadian student who was born and lived in Hungary, another Canadian student who works primarily with displaced women from all over the world including Sudan, the Democratic Republic of Congo. One of the three instructors was born and England, traveled the world and grew up in America and me, born here in America but raised in the Filipino culture. We had volunteers who have traveled and lived all over the world for lengths of time, a visitor from Zimbabwe who travels regularly to New Zealand and all over Africa, and we had a volunteer from Japan.

People ask me about diversity where I live. I'm not sure I realized what that even means until this trip!

Hazuki, Ritah & Sarah
The midwives in Uganda (as I understand it and I might not have this exactly correct) are nurses who have undergone their training, a part of which is rotation in different rotations of nursing. They do a three-month stint doing OB as a part of their training and if they enjoy it, can choose to become midwives. The Ugandan midwives are crying out for more training, they want to be able to get advanced degrees in midwifery and provide safer, better care for the women they serve, but for now, we have to fill in the blanks.

We brought 40+ hours of doula training to Shanti Uganda. There are no 'doulas' per se, in Uganda, but there are displaced Traditional Birth Attendants. TBAs are essentially the 'granny midwives' of Africa- most of the countries have them, I believe- women who were trained in the apprentice model to care for families and catch babies. The TBA who works at Shanti, Florence, is even certified as a TBA which is pretty neat that Uganda recognized their work in this way, until they were made illegal relatively recently.

Mama Viola and her son, Patrick, born into Jane's hands.
Viola asked Jane to name him, she chose to name him
after her husband, Pat.
We taught about the transition to parenthood, we talked pain coping techniques. We discussed positions for labor and demonstrated anatomically why they are important, and what they do for the mother and baby. We told many birth stories, we heard the midwives talk about how the Ugandan women come and deal with their labors, what they expect from their families for support, how involved fathers are. We visited the local hospital to see what the care is like there, and we saw a young boy who was very sick with tetanus and likely died within days of our visit. (That was very, very, very hard. Writing about this young boy and his mother does them NO service, does not do his story justice.)

They taught workshops for us on maternal health in Uganda, the goals they have of decreasing maternal and infant mortality, nutrition, local herbs and the importance of hygiene and diet. We learned about the herbs that are used on site, traditional medicines. We spent time with Florence and learned about how and why she became a TBA- turns out that the 'birth bug' bites women in any country, anywhere, the same way it bites us here.

All in all we taught a doula training, but the incredible thing is that we taught the midwives skills that will make birth gentler for the Ugandan women. They learned the reasons why women do some of the things they do in labor, which will make them more patient and understanding as care providers. We exchanged stories and they know that they have Sisters around the world who truly understand them, and what they are trying to do for Uganda, and her amazing women. We brought teaching supplies, medical supplies, basics like cloth menstrual pads and pens and paper, and baby clothes.

Melinda teaching while Madeline, Stella and Bobby take
it all in.
The trip wasn't small, of course. It cost a lot of money for me to go, and a lot of time to get the training together. It was an endeavor to get there (what with cancer, fundraising $6000, a trip to California, births), but in just 10 days, the very fact that we walked through the gate and sat down together, and shared our stories together, literally, makes birth safer, and better yet, happier there. Literally. Less women will transfer, less women will have cesareans, more women will go home feeling powerful, and recognized as strong, and beautiful, and accomplished. Less women will have to birth alone because now the midwives can come in and take a shift as a doula, and just be there for support.

And the most beautiful thing is that the Uganda midwives want to do it. They want to know more, and more, and more ways to help women in labor. They want more tools to be able to effectively teach, because they care about these women and their births. They want to be able to go back to school for higher degrees of learning. They want to pioneer and be on the leading edge of this dream of less death, and more satisfaction in birth.

This is absolute proof that little things do make an enormous difference. There was no hoop to jump through, we just dared to say YES. We just dared to push through our fears (oh boy, many changes to jump through that particular hoop!), and we changed the world, just a little bit.

Florence Nagawa, former TBA.
After finishing our course,she said, tearfully,
"I am no longer a TBA. Now, I am a doula!"
I remember my aunt used to talk about going to school. All my life I heard her dream about going to college and what she'd do, and who she'd be. One day I said to her, "Call and get a catalog. What can it hurt?" She was resistant- it was very emotional to just call and get the catalog! It is hard to make that first step. I said, "The hardest thing you'll ever do is make this first phone call. But think about it, it's just a phone call - no commitments, no money, just a phone call. So just do it." She did it, and on her own, ended up registering for school shortly thereafter.

So what are you waiting for? Dare to say yes- dare to try. Dare to be the change someone else needs in the world. It's hard, and it's sooo worth it.

Shanti Uganda, Boda-Bodas, Matoke - Day 2

Breakfast. Salt loaf is bread, salted chips, papaya, bananas and tea.
Too much has happened today. I'm not sure I can write it all. I had a hard time sleeping- I crashed for a few hours and then bolted awake in the middle of the night with crushing darkness all around me. I started to feel that "wishing I was home" sensation and started feeling panicky, like in the Redwoods. I realized that letting myself go down that line of thinking was surely going to put me into an unmanageable panic attack, and hell... why indulge it?? So I breathed and listened to the sounds of Africa.

Africa! There are bats outside that chirp like birds - not the sort of weak pinging of the bats where I live, but several kinds of bats that all sound different, making the night time sound as vibrant as the day.


Our courtyard. The doors are rooms.
 I got back to sleep for a few more hours and got up and over a fine breakfast of salt-loaf (bread), baby food (peanut butter), fresh pineapple and watermelon, worked with Jane and Melinda to get our handouts organized and try to polish off the plan for the day.

It's interesting trying with two people I don't know well- we each have our own styles, our own priorities, and different things to offer, and to top it off, a difference in our approaches. I think today was a good breakdown of testing the water and really getting to see where each of us fit.  Back to the day...

Cooking stove.

Sadie (Project Coordinator for Shanti) came by and alerted us that we'd be riding boda-boda to Shanti. Boda boda is a motorcycle and there are TONS of them. Everywhere. Tons! I was nervous but you know, it can't be scarier than it was to walk away from Randy and getting on that plane to Africa, I figure. We went outside when Sadie said the drivers had arrived and while we chatted one of the men said, "The big one, you ride with me." Well, ladies and gents, he was talking to me. I'm 'the big one'. I checked in with myself and thought, "Am I offended?" I wasn't, not at all. We all had a really good laugh and then we had a sweet ride over to Shanti. Turns out that a chubby white girl is what's on the menu in Uganda, after mentioning it to a few people- it's desirable because we're seen as prosperous. I still laugh when I think about that! Who knew I had to go all the way to Africa to have my womanly charms appreciated by the larger public? ;)

The ride from the airport to the guest house was in the dark so I couldn't see a whole lot, but from the guest house to Shanti, we got a little taste of what is around us. The ground is a rusty red color, and it's a hard pack of dirt. There are deep ridges and pot holes and the boda boda drivers navigate it pretty smoothly. The road is traveled by people walking- and walking- and walking. There are people everywhere, walking a slow, sure pace. As we drive by, every person stops and turns and watches us go past, many smile, and some wave and yell out, "hellooooo!!!" with big smiles.
Boda-bodas and drivers to take us to Shanti Uganda.

We've all seen photos of children walking together, little girls holding babies as they walked with dusty, bare feet without adults in sight. Well, this is accurate, except there are adults everywhere. I mean, everywhere! I was stunned by how many people are out at night, sitting around and eating and talking. I haven't seen more than a couple of people smoking, which is interesting.

Flanking the hard, deep roads is a lush, green cascade of plants and trees. Banana, mango, avocado, coffee, papaya, guava - these all grow wild all around. There are many types of banana and the locals can tell you which ones are edible, and which ones must be  cooked and mashed before you can eat them.

We made it! Shanti Uganda! Front gates.
Periodically and with no apparent rhythm, there are houses. Some houses are brick (the local red bricks that are handmade by the villagers here), they are all small. The yards often have chickens, goats, perhaps a cow, and sweet potato or some other kind of crop growing. They don't eat a lot of meat here, it's probably too expensive, so the meals are all vegetarian just because that's what they have.

If it's not a standalone structure, it looks like a long building with doors. It looks like there is a roll up door, like a garage door, but narrower, next to the door to the entrance, and there may be 3 or 4 entrances to a stretch of the building. A long cement slab makes up the 'porch' and you'll see women with bowls, wearing traditional clothing, or long skirts with shirts, or very fancy dresses with tall shoulders - cooking and tending the children, or sitting down and staring as we drive by. I've never seen anything like the structures here, how people run businesses and live in the building that are around.

They capture rainwater and store it here.
There are also the giant, empty buildings, nothing left but the bricks that still stand- all glass, all wood, all contents stripped away. I'd like to ask questions and know more but in Uganda,the people here do not want to revisit the past. It isn't that it's too painful to do (or maybe it is), but a sort of national 'Why would we talk about it, when it is over?" perspective. There isn't a huge drive to process the past, the Idi Amin time and all that came of it. So the empty buildings stand empty and quiet, and I just wonder what led them to be that way.

I have had to get over any bug issues I've had pretty quickly and I feel like I'm doing a good job on that front. I came here with a goal of not getting bitten by any mosquitos- and so far I haven't but I'm less concerned. I'm taking good precautions, I wear bug spray, and I spray my mosquito net with citronella and tea tree oil before I go to bed. I can only stand to be sprayed with the chemical bug spray once so I just keep freshening up with the spray I made instead.

Placenta pit.
My feet are still quite swollen from the flight and while right this minute, at 1:30am, I can actually see the veins and bones in my feet again, my ankles are still so swollen they pit deeply when I indent them with my finger. I'm sleeping with my feet raised up on the folded blanket (I love that I'm offered a blanket when it's a million degrees and practically dewy with humidity in here at night!) and I think it's helping.

Water - I'm drinking a lot of water. Lots of bottled water, and I still don't think it's enough. I'm a little constipated- we're not eating fresh greens and the food is heavy and dense. We are getting fresh fruit but there just isn't a lot of it, and matoke is made from mashed plantains or bananas, which is quite binding as well. Whatever anxieties I have in the middle of the night, waking up in a dark room alone, I'm sure glad I can sit on the toilet without worrying about someone needing to use it or all the little things we worry about when we need to poop with people around!

Proof I actually made it. ;)
One of the people that volunteers at Shanti is named Sarah, a beautiful dark haired fairy with this sword carrying ferocity about her. She came and did yoga with us in the morning which I had a few concerns about but it was a sweet session that actually allowed me to let go. In the morning I was feeling very resistant to the flow of things, and wishing more than anything that I was home, and realizing that it will be many days before that's going to feel close at hand. I was hanging on and thus, I was between the worlds. I couldn't be home, but I wasn't letting myself be in Africa either- I wasn't grounded.

The meditations we did allowed me to see this and I cut a cord that bound me to home. I need to let go deeply because otherwise I am suffering, and why would I allow myself to suffer? I can miss my family without pining for them, and I can learn to feel safe and comfortable in this new environment without feeling that the only safety is at home. This is a great experience and it makes me laugh, these realizations! We are such complicated, interesting beings!

I started this post at about 8pm and not long after, I had to stop and go to sleep. It's 1:30am now and I woke up to pee, and just because I needed to wake up- and alas, I'm tired again. I still have so much to say and document but it's time for sleep. More tomorrow.