Thursday, November 13, 2008

Oriti Uganda

Long day yesterday – driving back to Kampala. Snuck another picture of the Nile River. Shame on me. Benjamin is going rafting tomorrow on the Nile as he has an extra day here. I am so envious – I love white water rafting – can’t imagine it on the Nile River!

Slept in Kampala at a Catholic Guesthouse. Nice place - although it felt like a convent. A convent with a watch dog, gates, and an armed guard. I'm growing fond of these guards!

Today, our driver and friend, Anthony, took Elizabeth and me to a market in Kampala to shop for souvenirs. I’m going to become an importer – the African handcrafts are very high quality and beautiful. And, Uganda must be one of the last places on Earth with a great exchange rate. Elizabeth bought Anthony a shirt and I bought a skirt for his wife who has been taking care of their eight year old, infected with malaria, while Anthony patiently drives us all around the country and watches out for our safety. Did I mention that he has a degree in Forestry? It came in very handy as we were always asking him the name of various trees, flowers, etc.

After the market, we met Felix, Dave and Joe, along with a man from D.R. Congo named Pastor Njoli (sp?) for lunch. Elizabeth and I think he’s L.L. Cool J in disguise. We kept waiting for him to bust out a rhyme. The pastor helped get a quick Visa for David from the Congolese Embassy as they’re leaving Thursday for two weeks to meet some MTI volunteers and assess the disaster there. Another small world thing – this Congolese pastor went to college in Portland and has an affiliated church in Seattle – I believe it’s called: International Full Gospel Church.

Later in the day, we met with the Lira District’s member of the Ugandan Parliament – the Hon. Charles Angiro Gutomoi. He’s a walking miracle – he was abducted by the LRA, tied with his arms behind his back (along with his brother and friend), and then shot three times in the head and once in the arm. He lived to tell about it – but his brother and friend were killed.

Charles was discussing the discrimination against the Luo tribe in Uganda and Kenya. As I mentioned, President-elect Obama’s father was a member of the Luo tribe, as are most people from Northern Uganda. The Luo have historically not supported the Ugandan government. Charles said that when Obama was running for president, the Ugandan government tried to enact a measure of non-support for his candidacy because of his tribe-affiliation. That surprised me as it seems that Africa as a whole is thrilled about his election. Charles is very amused that Obama is now President-elect of the most powerful nation on Earth – he claims that he’d never get elected in Uganda or Kenya.

We’re leaving tonight – driving to Entebbe for an 11 p.m. flight to Amsterdam. We’ll spend the day hanging out in Amsterdam, and then fly 10 ½ hours to Seattle. I have such mixed feelings about leaving. I care deeply for the friends I’ve made, my heart is heavy over the suffering of the Ugandan people, I wish I could bring some of the babies home, and I love the gorgeous country. I’m also sad that Joe will not be returning with us – but such is the life of someone whose job is to respond to natural and man-made disasters. On the other hand, I do look forward to seeing my family, to sleeping in my bed, to not worrying about mosquitoes, to being clean, and going to Starbucks. I realize now how spoiled I really am – however, I hope that I will have the opportunity to return soon to Africa, and hope that in my own way, I can continue to serve and help these beautiful people.

An Education

I’ve missed some time blogging as I’ve been busy and tired. I’ll try to catch up a bit.

First of all, some corrections:
David’s last name is “Alula

The exchange rate is not 7,000 Shillings to $1 USD, it’s 1,780 Shillings to $1 – big difference but I knew there was a “7” in there somewhere.

I wrote that when MTI came to Uganda in 2006, 15-20 people were dying a day. That is still true, but that was per camp. MTI worked in 14 camps in 2006, where almost 280 people died a day. David tells us that people would die in line waiting for treatment. Now, the rate is 2/month.

A white person is: “Munu Munu.” I’ve honestly tried to pick up some Luo (not Lewell). But it’s been difficult for me. I know about 5 words but I usually mess them up somehow and end up saying something ridiculous like: “You have a pretty potato.”

So, I’ll try to catch you up on some activities as well as some things we’ve learned:

Visited Apala where the Gates Foundation funded a community health project MTI initiated. This involved building an outpatient center and maternity center – just like what Elizabeth did in Ogur. We learned about pit latrines (we’ve installed over 6,000 in this area), the culture of using them, and an ingenious hand washing system that we’ve put into the local areas (where, the people live in huts without any running water, electricity, etc.). It may not sound exciting, but it is very interesting and is making great strides in improving community health. In case you don’t know, a pit latrine is basically a big hole in the ground that people squat over. Sometimes there’s a concrete slab surrounding the pit, and usually there minimal privacy surrounding the hole. And yes, Elizabeth and I have both used pit latrines. Believe me, we understand why people would rather use the “bush” then one of these latrines. However, the problem is, using the bush means run off into the streams that people then draw water from, bathe in, etc. This leads to cholera. Up until recently, the rate of cholera in the camps was 70%. This is a major health education issue that MTI is trying to address.

This year, cholera has been replaced by a Hepatitis E outbreak. People get this from the streams they bathe in, drink from, and play in. You see children everywhere playing in the streams. Malaria, Hepatitis E, Cholera and a host of other NASTY parasites all originate in the streams.

HIV/AIDS in Africa: I already told you about the IDP camp where 80% of the people have HIV/AIDS. MTI has employed counselors who are trying to measure the rate of the disease in the community, and educate people about abstinence and condom use. It’s going to be a steep learning-curve for people – hopefully the newest generation growing up can learn early on and avoid transmission of the disease. Also, if a pregnant woman who is positive is given treatment in the last trimester of her pregnancy, she has a 90% chance of avoiding transmission to the baby. AMAZING! Across from the MTI headquarters in Lira, there is a field where every Monday, USAID gives food (maize, flour, sugar, etc.) to people with the disease. We saw them lined up today for the food distribution – so many people! How many are hiding the fact that they are HIV + or have not been tested?

I don’t like goat. Not only that, in the open market in Lira, we wandered through the butchers’ area. This was NOT MY CHOICE – Benjamin forced us. I won’t write about it but if you’re dying to know, you can ask me later and I’ll describe it to you. Suffice it to say that I’m thinking of going back to vegetarianism. Sorry Pete.

We went to Felix’s church on Sunday. Let’s call it cardio-church because there was a lot of dancing and singing! It was the best church experience that I have ever had. And even though it was the longest church service I’ve been to, it was terrific. The preaching was exuberant, we all got introduced and were asked to speak to the congregation, the music was fun as was the dancing, and of course, little Ugandan girls sat on our laps the whole time. Elizabeth was a good sport when her little girl peed on her lap! We got to meet Felix’s wife, Esther, and his son, Daniel, who is 12 and his 19 month old daughter, Favor.

Please note: the food items I’m craving are a skinny triple grande latte and a big, chewy chocolate chip cookie.

When you see African children with reddish hair, it’s a sign of malnutrition. I have a picture of a little African boy (4 yrs?) and his sister (6 yrs?) who is carrying a red-headed, one year old baby (a very common sight here). David told me today that the mother must either be pregnant of just had a baby. Once that happens, the daughter becomes responsible for the next youngest one. She’ll probably be responsible for that child long enough that she’ll miss the opportunity to go to primary school, and therefore, will never get educated.

Cutting: When babies and children get sick, traditional Ugandan medicine is to either poke holes in the child’s gums with a spoke from a bike wheel, or make deep cuts around the chest and back. Which method they do depends on the symptoms. As you can imagine, many of these children become septic and can die. Or, perhaps they get AIDS. David was cut as a child – not only that but when he did recover from his ailments, the woman (witch doctor??) would make a 1” slash in his face to indicate recovery. David still has scars on his face from these slashes. A few months ago, his baby was sick. His wife called him at work to tell him that old ladies in their neighborhood wanted to cut the baby. You can imagine how David, an incredibly well educated man in modern medicine and community health, felt about that. David can go into an IDP camp with our volunteers and pick out the children who have been cut as they are paler then the other children. The MTI volunteers must not only treat the symptoms of the children they see, but also try to dig deeper with their questions to uncover any cutting so that they can educate the mother.

I asked Felix what percent of the children in the camps will grow up and not suffer from severe health issues. He estimated 10%. Ten percent.

Sunday, November 9, 2008

Padar

Saturday

Woke up at 3 am to two cats either fighting or loving – not sure what but it was quite a racket. We have an armed guard at our hotel all night – I fantasized about him shooting those kitties. One more thing before I talk about yesterday, I want you all to remember to never sleep with chickens under your bed. Enough said.

Yesterday we travelled 6+ hours total on the muddiest, bumpiest, pot hole strewn (the word “pot hole” doesn’t begin to describe the gigantic holes) one-way, red dirt road. We went to visit an IDP Camp north of Padar, in far northern Uganda. The area around Padar was the home of the LRA and the people there suffered tremendously at the ruthless hands of this brutal gorilla group.

As you travel to Padar, you see IDP camps all over the place. Some of them are empty – the people have been relocated to their own land. Problem with that is that their villages/homes were destroyed as well as the entire infrastructure. So, they leave the camp, but they come home to absolutely nothing – water, sanitation, etc. Other camps are empty during the day while people work the fields, and then they return to the camps at night because they feel safer there. And then, there are many, many camps that are still fully occupied. We passed one that is next door to military housing (actually they’re really huts). In this particular IDP camp, 80% of the residents are infected with AIDS/HIV as the women have either been raped, or the husbands come home after serving in the military and then transfer HIV/AIDS to them. A very sad place.

MTI staff and volunteers worked in many of these camps - 14 to be exact. In the four year time period that we've worked here, we have changed the death rates in the camp from 15-20 people a day to 2 a month. Our Ugandan staff and the medical volunteers who devote a month of their time here have done incredible work in not only helping people through this man-made disaster, but also creating healthier communities.

The camp we travelled to is just north of Padar (which isn’t really much of a village – it’s an old IDP camp where families live in huts and pretty much the only buildings are occupied by NGOs). Padar honestly feels like the end of the Earth - a forgotten, awful place. I saw UNICEF, the UN's World Food Program, Medecins Sans Frontieres, and of course Medical Teams International. Met MTI’s 20 Padar staff there, and then travelled up to the camp itself.

I’m not sure where to begin with the Padar camp. These residents are truly the poorest of the world’s poor. They live in these tiny small huts with thatched roofs. In one hut that I went in, the lady said through our translator that 9 people sleep there at night. They cook in these huts with a fire with little ventilation, so smoke just fills up the hut, while children are sleeping on the floor. I was in one for probably only 2 minutes and I couldn't wait to get outside for fresh air. They don’t cook outside because of the rain. It was very tragic to see.

The people are, for the most part, illiterate. The children were all over us as usual, especially when they realized we had candy for them. It actually was a bit too crazy as they slap you to get your attention. They are so desperate! It was muddy there, mud all over my legs and shoes. But, I couldn’t complain because I had shoes unlike the residents. One 8 month old baby let me hold him. He was so sweet and was loving my hair (as most people there keep their heads shaved). I’m sure he was also intrigued by my skin and eyes. Can you imagine Ms. Blondie Elizabeth and me there? We make quiet an entrance – two strange looking ghosts in their midst.

However, we were not the only white people there, we also had two Medical Teams volunteers working and set up under MTI tents. Dr. Mike is a P.A. and Dr. Cosimo is an internist. They are there for over a month, treating people as they patiently wait for their turn to get much needed medical care. Most people can be treated with the drugs MTI brings, however a few need to be admitted to a hospital which is about 30 miles away. Ugandans must pay for the hospital before they’re admitted and of course, they don’t have that kind of money. So, MTI pays for hospital care. Yet another thing about MTI that makes me proud!

One girl was receiving an IV in one of our tents. She had suddenly become unconscious from malaria. However, her parents thought she was possessed and were going to take her to a witch doctor. Fortunately, our volunteers learned of this girl and convinced the parents to let them do a quick test for Malaria and they consented. Now, a couple days later, she is in much better shape – no need for a witch doctor.

These people are illiterate, malnourished, barely clothed, eating millet only, dirty and hopeless, yet, they are so grateful for the help and hope that Medical Teams brings to them. Dr. Cosimo told me that now and then, he gets a case that he thinks is just post traumatic stress disorder from the atrocities committed during the war. These people have haunted eyes, but they are as gracious as they can be, and will reward you with a beautiful smile if you bestow the simplest kindness toward them. I can’t imagine being in a more destitute, impoverished place on the planet. And, I realize that it may even be worse right now in Darfur where we have volunteers (Joe calls Darfur “Hell on Earth”), or Congo, where Joe will be travelling at the end of our trip with Felix Omodi and David Alulu (?sp), to assess the situation and make plans for MTI to help the over 1 million people there who have been displaced.

This has been a difficult day to write about. I’ll try to post some pictures later (if I can ever hook-up to the Internet again) so that maybe, you can get a small idea of what it’s like. We are the most fortunate people in the world – in fact – on his last trip to the U.S., Felix said that Heaven won’t be a big deal for us because we already live in Heaven. He said that when Africans go to Heaven, it will look just like America. I now see what he means.

Thursday, November 6, 2008

Cats, Crowing and Calls to Prayer

Friday morning, 5:15 am

A cat outside my window woke me up at 4:45. It better be quiet or someone will eat it and I will help them catch it! Then a rooster started crowing at 4:56 – his clock must have been 4 minutes fast. Now I hear this interesting pounding sound, a bell, and someone in the distance singing a haunting chant in what sounds like Arabic – I’m guessing it’s the Islamic call to prayer. I’m thinking about Parker and Charlie, Pete and my parents, many others of you, and thought about how very far away you are – 11 hours to be exact. This is an amazing place – it takes some getting used to but I can understand how one’s heart can remain here. Will be getting up soon to check if there’s power and start today – going to the IDP (Internally Displaced People) Camp in Padar.

MTI, Elizabeth and a Crowd of Over 1,000

Thursday Night

Today was the Ogur Health Center IV commissioning ceremony. For those of you who don’t know, my friend and generous Medical Teams International (MTI) donor, Elizabeth, gave a gift that enabled a maternity center and outpatient clinic to be built here in Ogur. This is what today is about – in three parts.

Elizabeth
Elizabeth is a woman who is blessed in many ways. We met almost a year ago after our mutual friend, Marilyn, made the connection. Elizabeth felt compelled to do something in her life that was impactful; she knew God was calling her. After much thought and prayer, she decided to help the people of Uganda. The MTI project she brought to fruition was the rebuilding of the outpatient clinic and maternity center that was destroyed during the violent rebellion led by Joseph Kony (please Google it if you’re not familiar with what happened). In this area alone, 300 people were slaughtered, people were boiled for soup, children were forced to murder their parents. What was left of the original centers had bullet holes, no running water, filthy mattresses (but not every patient got one), no electricity, etc. Can you imagine delivering a baby here? It was also difficult to find medical staff as no one wanted to travel to this rural area and these truly horrific facilities. Elizabeth, in her amazing generosity, changed all that.

The Ogur Health Center IV and the maternity center that Elizabeth funded are truly the most beautiful buildings I have seen on our visit. The Islamic contractor who built them in four months (a miracle in Africa) with the help of prisoners did an amazing job – they’re not just buildings as the attention to detail is beautiful with even mosaic-like patterns in the ceiling. There are rooms for counseling, exam rooms, waiting rooms, doctors’ offices, a pharmacy, birthing rooms and even an operating theater. What really hit home is that this money Elizabeth donated could have been lost in the bucket in Seattle. Not to diminish the size of her gift, which was OVER THE TOP amazing, but I couldn’t help thinking that this money made a huge and very visual impact here in Africa. In fact, this center is supposed to serve up to 200,000 patients a year that otherwise would get minimal or no care.

Medical Teams International (MTI)
I am humbled to work for this organization. MTI has 60 Ugandan staff and they all are devoted to their fellow Ugandans through improving their immediate health care needs along with building community health and awareness. In fact, the Minster of Health today said that 80% of the diseases that afflict Ugandans are preventable such as malaria, cholera and HIV/AIDS. This statistic is what drives the work of MTI’s staff and volunteers’ in Uganda.

Today, their focus was on this celebration. They all worked incredibly hard to pull off this amazing event. Not only did they get UNICEF tents erected to protect us from the African sun, but they fed over 1,000 people who came from who knows how far for the ceremony. One MTI employee MC’d the event, translating between Lewell and English when necessary. They brought in African dancers and singers, dignitaries, and it all seemed to come off without a hitch. It was as professional of an event as I’ve been to anywhere.

The Crowd
Ok, I thought sitting for over 6 hours was difficult. Talk about guilt – we were front row in the VIP tent next to a member of Parliament, the Ugandan Minister of Health, the Anglican Church Bishop, etc. etc., sitting on couches, drinking the water we were handed whenever we needed it, and here these people from the countryside were calmly sitting in the sweltering heat on the ground with nothing to drink and no shade. Perhaps even more amazing is that the children there (and there were soooooo many children) sat obediently the entire time with no squirming, no screaming, nothing but a calm serenity and curiosity at the five Bunu Bunus in their midst.

If you look closely, you can see people who I’m sure are victims of the war. Men with burned faces, people whose legs were chopped off. In fact, one of the performances today featured people who were raped, tortured and otherwise brutalized by the LRA. The ones (all women) infected with HIV/AIDS because of these events raised their hands and identified themselves to us – probably 7 people out of the group of 20 singers. That was a brave thing for them to do as many people infected are shunned and ostracized.

The colors the people wear are beautiful – they may only have one piece of clothing, but you can tell that they try to be clean and the ladies look pretty. I hope to attach a picture of the most beautiful baby – the mom thought I was smiling at her because I’m nice, but really I was planning on kidnapping this child. The men are serious, will smile if you smile first, and frankly treat their women pretty poorly. It’s a hard place to be female. But the children, I can’t even explain how I feel about them. The braver ones swarmed our SUV as soon as we pulled up. They’re so excited and shy. They love to have their picture taken and then seeing their picture after the shot. One little boy named Stephen (probably the same age as Charlie) followed us wherever we went – he tried to sit in the VIP tent next to us but some guards shooed him away. He had a ripped blue shirt, dirty shorts, bare feet, and a constant entourage of flies. He was sweet and shy – I will always remember his little face.

Perhaps the people sat through the six hours of speeches, prayer and performances because they knew they’d be fed at the end. That’s ok – I’m so glad they were all fed. Felix said that a bull was slaughtered for the event – a BIG DEAL! Most Ugandans eat meat one time a year – at Christmas. I doubt there was enough meat for everyone there, but I was quite relieved that they were all fed, and didn’t sit watching us eat. (Did I mention that we had to eat with our hands? It’s a great new diet strategy – there’s only so much millet, rice and beans you feel like putting into your mouth with your own hand.)

Lack of utensils and toilets aside, it was one of the most amazing days of my life and I feel privileged to have experienced Africa in such a meaningful way. Thank you!

Deet is Neat

Wednesday Night, 9:45 PM

Wow – what an interesting, culture-rich day. Uganda is everything I thought it would be and more. I don’t know where to start so I’m going to bullet my thoughts and memories as they come to me.

BUT FIRST – NOTE TO SELF: Dear Self, If you again try to spray your 50% DEET directly on to the mosquitoes flying around your bathroom, you’re just going to slip on the DEET soaked floor again and then those same mosquitoes will dive bomb you as you’re lying there in the oily DEET pool. Next time, settle for the three coats of DEET you already applied (nevermind that the instructions say one light coat is sufficient), get under your cute little mosquito net that took four people to install for you, and cuddle up with your anti-malarial drugs. Also, just add a sleep aid and you’ll sleep like a baby. Love, Marnie


Ok, here we go:

Kampala

  • Beautiful setting for a very interesting city. A large white mosque sits on a hill across from my hotel balcony.
  • Checked out and drove to a bank in a mall to exchange currency (something like 7,000 shillings for $1 USD). On the way, drove by huge homes protected by 10’ walls with barbed wire on top, big beautiful gates and guards. Anthony says mainly government officials live there.
  • The mall – not quite Bell Square. You enter and feel so safe as there are guards with machine guns wherever you look. REALLY I toyed with the idea of asking them if I could take their picture but they didn’t really look like they had a sense of humor.
  • Went to a market inside the mall – mainly to get water and clothes for Benjamin as his suitcases were maybe in South Africa? Quite a well-stocked market. I needed a bottle opener for the Coke Light Elizabeth and I splurged on. The men were too masculine and insisted that they wanted the “real thing”. The bottle opener worked on that too.
  • Driving through Kampala was sensory overload. For the ears – sirens, shouts, goats bleating, longhorn cows mooing, motorcycles roaring by, all while trying to maintain a sense of equilibrium. The eyes - shack upon shack upon shack all up and down the hills. Little tiendas (shacks too) selling everything from recliners that are lined up along side the road, to carpets to tomatoes and bananas. People everywhere. A boy around 8 selling sugarcane stacked high on his bike – huge machete in hand.

    The six hour drive to Ogur
  • The scenery changed dramatically along this trip –many varieties of tropical plants, far more lush than Hawaii. Everything has thick, large leaves and it’s very dense. As we got further north, the plants thinned out some, the land was flatter, and the landscape was closer to a green savanna. I’ve never seen such a big, expansive sky.
  • Roads were good about ½ the time. After that, I felt like a pinball. SO many potholes, on a single lane road that you share with oncoming cars, buses, bicyclists, and pedestrians. We didn’t just drive slowly through the potholes, we dodged as many as possible while going probably 45 MPH. Anthony is a very good driver, but it was, ummmm, exciting.
  • You drive through such rural areas, but everywhere there are people walking. I remembered something I read that said one reason Africans can’t pull themselves out of poverty is that they have to spend so much time taking care of life’s basics such as walking miles to retrieve water, and then food, and then firewood. By the time you’ve done all this, it’s time to start cooking dinner. There’s no time to consider plans or potential opportunities. Also, there are the most beautiful and very young kids walking too – often alone or in small groups. Many wear matching uniforms from their primary schools – bright green, or a pink/blue combo, or yellow. All so pretty!
  • Four people on one scooter, or a man riding a bike with the mom sitting side-saddle behind him with a baby strapped to her back. This is the second most common way to get around, after walking.
  • Crossed the Nile River. Beautiful – with roaring falls and very blue water. However, only got one not-so-good picture as your camera will be taken by the armed guards on the bridge if you take a picture. Something to do with heading north into the territory once occupied by the LRA.
  • Monkeys (goats, cows, chickens, etc.) and baboons alongside the road. I tossed a banana to a mom baboon with a baby on her back. She caught it with a clap and shoved the entire thing in her mouth. Fed two more baboons – they will come right up to the car and beg. Yes, Charlie, I did get the picture you requested.

    Ogur
  • Arrived and went straight to the Medical Teams International Uganda headquarters. Met Joanna, Dick and the other Felix (can’t remember his last name). Received a tour (nice building) and then went to our hotel to prepare for dinner.
  • · Ate at the MTI volunteer house. Our wonderful chef, Okio I think, prepared dinner for Joe, Elizabeth, Ben, and me and Ugandan staff: Kristen, Dick, and David. Dinner was ok – we all tried to follow the “don’t ask don’t tell” policy with the food. (I do think we had some goat – it wasn’t that bad.) However, I later found out that in her enthusiastic hunger, Elizabeth didn’t look closely at what she put on her plate. Fortunately, she realized as she was eating that she was about to bite into a pig’s snout. No, really it was too large for that – maybe a boar? Anyway, she told me about it on the drive back and we were delirious in our laughter – especially because we didn’t want anyone to know what we were laughing about. Sorry Elizabeth, but since you didn’t eat the snout, you will be voted off the island tonight!

Big day tomorrow in Ogur for the commissioning ceremony. We were advised to eat a large breakfast because it will be a long day. We are very honored to be a part of this important event for the District and the sweet, beautiful people of Uganda!

Tuesday, November 4, 2008

Waiting on Benjamin Lie to join us - he's coming by bus from Kenya with no luggage (lost somewhere in South Africa). Linda - LOVE THE IZZIES!!!! Felix had me bring some extras with me to feed to baboons along the way to Lira but I may have to eat them myself. Sorry baboons. Forgot to brush my teeth with bottled water, ugh!

OBAMA OBAMA OBAMA - so interesting to experience his victory in Uganda. People here are so excited - televisions are on everywhere and I can't understand what everyone is saying but I keep hearing "Obama" mentioned in their discussions. A Ugandan newscaster was complimenting how gracious John McCain was - she said Africans could learn a lot from him and also how smoothly the transition from George W. to Obama will be. They are very impressed with our political system.

Today's agenda - drive 5+ hours to Lira. Felix switched our hotel as there are apparently American soldiers staying in our original Lira hotel and he didn't think we should stay there. Probably a good call. We'll be crossing the Nile today. I'm pinching myself! Wish you all could be here to share in this amazing experience with me. Elizabeth says: "We're having the best time and look forward to even more excitement in Ogur."