Big shoes…

Quietly

I notice

One of the verbs of me

 

The becoming,

The familiarity

of embedded patterns,

hiding themselves in plain sight and

forgotten; woven between the subconscious and the links of dusty DNA –

Brushed off and ready for another round

of motherhood.

 

And gradually

my own mothering memories cocooned in nostalgia

These soft-edged replays

Of careful kindnesses and strained patience

Of steadfast believing-in-me with secret sacrifices

Of space-less snuggles and laugh-out-loud adventures

Now star myself

 

The actors morph

And now it is my own voice; but is it?

My own flaws; but are they?

My own laughter; but is it?

My own human attempt at love; but is it?

And I am suddenly grateful

 

That in my own rocky road to mastering motherhood

Where days stretch and failures amass

I can step, unashamedly

into the patterns of my own mother’s making

The good, the bad; but mostly the warm

And surprisingly the shoes fit

Almost perfectly

Just a few sizes too big

The ways my kids are being shaped by the chaos of 2020

I wouldn’t be a middle-class, over-educated, 21^st century mother if I hadn’t unnecessarily analysed how the Covid-19 pandemic was affecting my children. I wonder about their fears, I wonder how this is forming their idea of sickness and germs, I wonder about  the importance placed on ‘social distance’ and not physically being with others.

But so far, all my meandering musings have led me to this one simple thought: my kids are fine. Children are pretty resilient – and elastic – in general, and this has been no exception. Of course, we are living in a place where the pandemic has not really ‘arrived’ in any significant way. We are in a moderate lockdown, yes. But there is no mass community spread. Very very few deaths. And while many have lost jobs, the governments’ impressive economic stimulus package will help. Of course, there are pockets of society (the poor, refugees, the homeless, victims of DV, the arts community) who are suffering  through this time.

In other parts of the world dealing with lockdown, I am acutely aware that the  experience is dramatically different. I am grateful that in Australia:

• Fresh water and soap is readily available
• Housing is mostly large, and outside leisure space is abundant
• Food security and supply is not an issue for most
• Police are not using excessive force to impose the lockdown
• Health services are easily accessible and supportive

I try to discuss with my children the challenges of lockdown measures for children in other parts of the world. We’ve also spent a lot of time talking about how important it is for humans (when we are not in a pandemic) to be connected with others – in our homes and lives.

But I thought, just for fun, I would start to compile a list of the little quirks that I’m noticing in my children and their lives:

My 3 year old twins William and Thomas, without a second thought, reflexively sneeze and cough into their elbows rather than their hands (the way we’ve all been mistakenly doing up till now)!

The modern miracle that my consistently unhygienic 6 year old now remembers to wash his hands after going to the toilet without my nagging. I did threaten that he could be arrested the other day, when in public after a bike ride, he wiped his runny nose with the back of his sleeve!

In the familiar evening argument about teeth brushing, I asked my children why we need to brush our teeth. Instead of the more orthodox (and correct) answer relating to the amount of chocolate consumption over Easter, Thomas answered suspiciously ‘because we will get corona virus if we don’t?’

My children’s adoption of the Ugandan public health song that they sing at full volume at any opportunity ‘Corona virus is sweeping over mankind; everyone must be alert…’ It works well. Everytime lockdown measures mean we can’t do something, I playfully ask ‘and why is that?’ to which they reply by breaking out in this song.

My kids make-believe play outside (which occupies a lot of time) was today them first running around tagging each other, then yelling ‘I have corona virus!’ and being taken to the doctor for treatment.

David’s glass-half-full gratitude moment of the month after being conditioned earlier at school he can only touch his family: “I am SO lucky to have 4 other people in my family! That means I can have cuddles with 4 different people! That is so many!”

The excitement of social isolation when I first arrived home, and their desire to share this information with every.single.person. walking past our house while in our front yard (Tommy to our postman: Guess what? We are in isolation! We are isolating! Mummy was on a plane and now we have to isolate!!).

School being reduced to PE, Kitchen lessons, and as my husband officially calls playing with the chickens in our yard, ‘animal husbandry’.

That our chaotic evening prayers at the dinner table now includes William requesting that all the people in all the countries in the world get well. A big ask (it used to be mostly Uganda, and limited to kids at the MH hospital there…).

Their intimate knowledge of every single climbing tree within a 1km radius of our house. Seriously. Now we take what David has labelled his ‘climbing rope’ with us when we go for a walk.

And from the mouths of (very opinionated) children, here’s what they think about corona virus:

William: Our bodies need to call out to us, to tell us we have corona virus. Otherwise we don’t know! So everyone needs to stay away from each other.

Thomas: My lungs tell me that I don’t have corona virus. I know I don’t have it because I eat vegetables. But it can make people very sick.

David: I’m sad that I cant see my friends. I think they should send more people to the doctor through the window [for testing], because it doesn’t do anything to you but you still have it.

And my favourite: Even though nanna and pop are old, they aren’t dying right now. (Sorry mum and dad, I know you aren’t that old!)

A shout-out to all the parents around the world, trying to balance the oxymoron of ‘working from home’ with parenting and their kids learning. From one parent rocking in the corner to another, we will get through this!

The collective sigh

The housebound inhabitants

from all cultures, creeds and colours

on this fatigued and fractured earth

heave a collective sigh

 

It whispers down the silent streets

past the well-worn and once-busy

finding this pad-locked planet

altered and estranged

 

The people ponder this world

and its assumed truths; unraveling

from their sacred, secret position

into the realms of history texts

 

Abrupt reversals of connectivity;

this physically distanced world

quieted under plane-less skies

breathes a newly tasted connection

 

Of separateness

Of shared sadness

Of waiting

Of the un-knowing,

of what is to come.

The ethics of scarce health resources did not begin with Covid 19

A lot can change in a week.

This little person with big cheeks was not very happy to be admitted to hospital today!

When I boarded my flight in Adelaide on Thursday, travelling to Uganda where the not-fot-profit Hospital my husband and I established 10 years ago is located, I wasn’t overly concerned about Coronavirus. I wasn’t too anxious about what the current state of affairs may mean for my time in Uganda or to be honest, the world at large. The talk amongst my circles was primarily that the media had been ‘sensationalising’ coverage for weeks, leading to a moral panic and in some cases racism. Cases in Australia were low, and my region had (to my knowledge) no community transmission.

By the time I arrived in Dubai, new measures were being put in place. It seemed overnight not just Italy but now the whole of Europe was erupting with cases. On the departure board when I stepped off the plane, people gathered around to see the flights canceled. Going through security, regular announcements were made by staff, alerting travelers who were transiting through Europe to the US to rebook via different routes. The day I arrived in Uganda, the Australian PM introduced self quarantine measures for all people entering Australia.

A few days earlier Uganda issued quarantine measures for people travelling from 17 different countries, leading to a situation where I was 1 of only 3 Anglo-saxons on the very empty flight to Entebbe. Arriving in Entebbe, many Ugandans were surprised to see me. The customary handshakes that last the whole conversation which I have grown to love, were absent. I felt under-suspicion, a potential carrier of this much-feared pathogen.

My choice to use social distancing while here, just in case, has been appreciated by Ugandans but it has also been met with amusement. For this glorious time, the disease has not risen out of deepest darkest Africa. Africa is largely safe, while the rest of the world is plagued (literally) by this virus.

Now, DFAT are recommending Australians abroad to return home, immediately.

Honestly? I have found it difficult to arrive at the decision that I need to come home early. There is valuable work to be done while I am here, and I wanted to use this trip to have as many useful conversations as possible. My heart (as always) is torn between the needs of Maranatha Health, and my own need to be with my kids as the world rapidly changes. I am unsure if flights will be canceled, if airports will be shut. I am hoping that I don’t pick up a simple cold virus while here (which is a distinct possibility considering it is the wet season and I am working in a kids hospital!) because I worry I won’t be allowed on the plane. The idea of further separation – beyond 2 weeks – from my still-young children is like a hovering dark cloud over my time here, yet it feels like an extremely superficial concern considering the state of our world right now.

These are all my own small personal anxieties, none of which effect quality of life to any significant degree for me.

The desire to curb the spread, to ensure our health system won’t be overwhelmed, is a noble one. But listening to discussion happening in Europe (and now Australia) regarding the ethics of treatment when there may not be enough ICU beds – has again exposed the deep chasm in our world, between those who have money and access to health care, and those who do not.

Health economics, and the perplexity of treating patients when there are scarce resources, is not a discussion topic I am new to. In fact, working for MH for the better part of a decade, it has been our lived reality. Uganda has around 0.09 doctors for every 1000 people – compare this to Australia, whose ratio is 3.59 doctors per 1,000 people.  Currently Uganda has 55 ICU beds, mostly reserved for the very wealthy. Whilst for most in the West these conversations about overloaded health systems remind us of surreal, post apocalyptic scenarios we may have watched in B-grade movies, for me they conjure up our dining table in remote Kamwenge, Uganda, my feet tapping with frustration on the cold concrete floor.

The stale air of a warm rainy-season night

The smell of cooking fires from across the valley

The crunch of grass underneath feet as our security guards diligently watch over the hospital premises.

And Michael and I, in our late 20s, in passionate debate over the ethics that confront us in our management of the rapidly growing demand at our hospital: patient protocols and reasonable resources and especially-needed equipment and an overcrowded ward with far more patients than beds.

Should we stand by the ethics of the greatest good for the greatest number, or the dignity of every life, or first in first served, or prioritize the poorest, or the youngest, or the ones with the greatest chance of survival? What is the right thing to do?

These considerations did not begin with Covid 19. And they are not conversations that only happened hundreds of years ago before the introduction of modern medicine. These are the lived realities everyday for the heroic health workers in the majority of the world.

These are conversations that happen in this era, in this world, in this time.

Even today at the hospital, we were discussing some challenges with the MH solar system with an electrical engineer. When mains power goes out (which it does regularly) we have been overloading our solar system, causing some batteries to swell. We need to replace these batteries, and add more, but the costs are prohibitive to us right now. Alternatively, the expense of running our big noisy generator through long breaks in power is also incredibly high. The other option is to cut down on some key equipment when power is off. The options when the power goes out are to cut back on: essential lab machines that help us with accurate diagnosis; a refrigerator that keeps much needed blood required for transfusions cold; or the life-giving oxygen concentrators that are drawing a LOT of power. If we only used one concentrator at a time (we have five) the system wouldn’t overload. But during busy periods, or after surgeries, we might have 4-5 kids who need oxygen.

This conversation lasted 15 minutes, without reaching a solution. A conversation for tomorrow.

The ICU discussions in the media take me back to one of our first group of neonates in Kamwenge. We had received one donated humidicrib from Australia, and had (at the time) only 1 oxygen pump that could connect to two patients. We had 3 neonates, all who were born very early – a set of twins and another little baby. We encouraged kangaroo care with the mothers (a good practice anywhere in the world!) and then offered them each a certain allotment of hours in the crib each day, hooked up to oxygen. If one of the neonates breathing became laboured, we would switch before the allotted time.

Only 1 of the babies survived.

It was tough. Mostly for the mothers, but also for our staff and for me. I was new to this reality of little babies in little cardboard box coffins being carried back down the winding dusty path away from our clinic, balanced on top their mother’s head. It was my first jarring and bitter taste of injustice, swallowed while the world nonchalantly continued spinning around me.

Ugandans are strong. They are resilient. Despite all the trauma of day-to-day life, they seem to be able to rise up, out of the ashes, time and time again – and keep living. I think the living Ugandans do, despite the uncertainly and all-of-life toughness, is extraordinary. Like someone at work said to me today of Coronavirus and everyone’s fears: “these things come and go…but we push on”.

So,

just for a minute

lets press pause.

Think about some of the uncertainty we have faced in the last week. The unknowing. The fear. The confusion around jobs and salaries and school closures and what might happen to the economy. The distrust that the government has our back, that there will be enough food and toilet paper and resources to go around. That our health system (for once in our entire life time) may not be able to cope if Covid 19 swallowed Australia as it has done to parts of China and now Europe.

And imagine, for a minute, that life was always like that.

This fear and risk we are swimming in is a glimmer of what the world’s poor are accustomed to every day. And when Coronavirus hits Africa – there won’t be many ICU beds and I doubt there will be flattened curves to ensure health systems can manage. There will be lots of people with underlying health issues such as HIV and malnutrition, and, well, poverty. But alongside all of this there will be the indestructible human spirit that Ugandans seem to possess in droves.

But may I ask something of you? Instead of fearing for ourselves and running to the shops to stock up – lets use this temporary suspension of the norm to put ourselves in the shoes of those whose lives are always uncertain – and remind ourselves of what we normally take for granted.

And despite the mounting economic pressures and the looming recession, let’s be generous. This world needs generosity now more than ever. Extend generosity to those around you, to those vulnerable in our own communities, to those who find themselves unemployed currently – yes.

But also to the multitudes of not-for-profits around the world (Maranatha Health included!) who are on the front lines fighting for a more certain world for those who have never tasted it.

 

Otherworld

Small people climbing beneath crumpled sheets;

Connect.

Weetbix laden accounts; wriggly bottoms on seats;

Connect.

Squinting through golden rays, hanging washed clothes;

Connect.

Coffee meetings, meaningful ideas to propose;

Connect.

The rushed overdue email, work to oversee;

Connect.

A kiss required for a barely scraped knee;

Connect.

Sandpits squeals and castles created;

Connect.

Kitchen madness as dinner’s anticipated;

Connect.

Bath bubbles, minty breath, stories by shadowy light;

Connect.

Warm chats with friends, a summer night;

Connect.

 

And still…

It corners me, demands me, tempts my doubting

Unchecked;

Awake or asleep, it stays close; shouting

“Connect!”

 

This noisy otherworld:

despite my efforts to turn away

Follows me, instep, along my way;

Or instead: (with a sad sigh of dismay)

Is it I who follows day-to-day?

 

This noise reaches the depths of longing

With the addiction of false belonging

Not with pain, or force, or attraction

But with this powerful Drug of Distraction.

 

This new currency that

Lulls

Us

To

Sleep

With the full force of a half-lived half-numbed, ‘connected’ life.

 

This otherworld:

Of instagrammable beauty, impatient emails and Must Watch series

Of trending tweets, social echo chambers, unlimited knowledge and theories;

And then,

ever so silently

earth and heavens’ take-your-breath-away moments on offer

Are replaced with a neatly packaged dopamine hit…

From your phone.

 

 

*A little bit of background:

I have been reflecting lately on my own addiction to technology, and have been listening to some powerful podcasts on the effects of this constant distraction to the human spirit. I remember a time where I could happily ponder or write or read for hours without a thought to technology. But gradually, it feels as if my very ability to be present to myself and whatever is happening around me – to enjoy a moment in time, a lazy read, a slice of solitude, a magnificent sunset, a connection with another – is slowly eroding.  I feel a twinge often, to record and share, rather than savour, and it makes me tired. In his book Digital Minimalism, Cal Newport writes that ‘Simply put, humans are not wired to be constantly wired’, and I find myself nodding aggressively in agreeance with this. Watching my children, who are growing up in an era where digital connection distraction is the norm,  is driving me to learn to model a life that is cautiously balanced, full of tangible face-to-face connection, and brimming with the gift of presence to each other and the world around us. I wrote this poem as a reminder; a warning to myself when I feel the temptation to ‘check out’ of the beautiful ordinariness of real life to “connect” with this noisy but often pointless other world.

This Lopsided Earth

Scan after scan after just-to-be-safe scan

The Risk of just-born jeopardy,

Entirely absent from my pregnancy plan,

Concealed by the masters of modern medicine.

Launching oft-futile guerrilla assaults;

Striking in response to the misstep of man

Rebellion against the promised assurances

of midwives and monitors and surgeries and scans;

But rarely a success in battle.  If it occurs:

there is shock, and shame, and blame, and a cry

That ‘no child should die’!

No baby should lie

Without a life to satisfy

 

But in the occupied territory, where risk reigns in little lives:

Over the great chasm of access and supply

Faintly, if you have ears eager to listen to the cry

And block out the lapping of luxury at your heels

And make room for what this dystopia reveals

And pierce through the privilege that cocoons your truths…

 

With each live birth, each safe passage to our world;

Comes the quiet grief of a mother’s tears

Sidelined by other-ness and foreign fears

Whispering of sweet promises unkept

Until, with un-lived memories; she wept

Wept for the babe, their newness now gone

Wept for a health system she cannot depend on

Wept for the vacuum of drugs, staff and cars

Wept for tiny hands, now safe in the stars.

 

Geography seals fates for these babes, and thus;

They’re torn from women who, despite the distance, are like us…

But with sad acceptance of their world;

Where children do die

Where babies do lie

Without a life, to satisfy…

In a world where risk is always nigh

 

No just-to-be-safe scans, no monitors, no available staff

The certainty of risk beyond our comfortable grasp

A gamble for mothers, who bet on their own hearts;

A gamble unseen, unheard by us; their counterparts

A gamble, in Uganda, which mothers’ lose,

If only there were other choices to choose….

On this lop-sidedly serviced earth,

For every 19 Ugandan babes?  1 ill-fated birth*

 

A little story behind the poem:

I started writing this poem a few years ago, when a staff member at MH lost his newborn baby. It was him and his wife’s first baby, and the grief seemed to swallow up our team for a few days. I remember the jarring nature of the baby’s death, some 12 hours after birth, when staff were still celebrating the original message that he and his wife had welcomed new life into the world.

It was tragic, and mainly left unexplained. There was deep sadness. One of the things I love and find frustrating about Ugandan culture – in equal measure – is the passive acceptance of, and embracing of the world as it is with all its suffering. It seems to allow Ugandans the ability to grieve well, and then rise up out of the ashes, resilient as ever. In the same breath, this acceptance often prevents a critique of the source of the suffering; so often relinquishing the possibility for questioning and change.

This particular little baby died in a big hospital; all seemed fine until it wasn’t. MH doesn’t offer maternity – we don’t have space or resources to do so – though we hope to in the future. But the lack of quality maternity services in our region, juxtaposed against the incredible obstetric/neonatal care available in Australia that I have been lucky enough to access with my own births, will always stay with me, and drives much of our passion in the journey of MH.

*based on 2017 infant mortality rate of 54.6/1000 live births

Little Lives

I’ve been writing a little bit of poetry lately. My brain feels very full of Maranatha Health and theory and programs and I find it difficult to sit down and write anything apart from work. But poetry seems to be the exception to this. I’ve never shared my poetry before – a little scary, so thanks for reading 🙂

Little Lives

Another day

Dances in front of me, fast and frenzied, and departs the stage

Again the curtains fall and before the lights are dimmed ready for the next act

I feel the hurried lurching of little lives

Passing by,

the uncovering of fate and fears and freedom.

A birthday, and new skills, and fresh individuality

Swirling into the shadows of shared history

And then, occasionally the moment freezes.

A gift.

And in that moment I breathe in the sweetness of my children’s cheeky joy; I linger in my magic power to kiss away pain; I melt into the circling chubby arms declaring their love; I laugh at familiar punchlines that signal home; I stand in wonder as little hearts make room for grown-up failures in our shared life

But so often

the frame stubbornly refuses to freeze.

And life escapes and I run and we survive and days dissolve and the mess of life seems to pass by without any of us stopping to smell roses or daisies or sunflowers:

or the intoxicating scent of freshly washed toddler skin;

or the sniff of sweaty after-naps snuggles;

or the fragrance of trampoline-jumping joy and pool-splashing fun

or the post childcare aroma of summer days and sand pits and playing hard wrapped in the wiff of I’m-home-and-can-let-it-all-out explosions.

I will miss it, I say…

All the whilst wishing giant chunks of the not-so-good-days away, where illness and chaos and sleep deprivation and brotherly rivalries and too-much-yelling take hold and the exhaustion blocks out the smells of a life brimming with beautiful ordinary things

But when the pauses declare themselves

Aren’t they marvellous?

Aren’t these things we’ve created so marvellous?

And then the relentless weight of motherhood feels so…

light.

Cultural transition: lessons from my little people

*This blog was written a few months ago, but I’ve only got around to posting it now. We are (thank goodness) past this initial stage of disorientation, feeling quite settled now, and are enjoying much of what Australia has to offer… although still missing Uganda!

My crazy boys!

Many would agree that shifting countries and cultures can be tough. Each time, the transition leaves me with the same sense of disorientation one experiences from being woken abruptly mid-dream; somewhere deep in your conscious you know you are awake, but emerge from sleep floundering between the two worlds, until that point you grab hold of reality once more.

And this time, moving back to Australia, has been no exception.*

Other times when we have moved ‘home’ to Australia, it has been on a temporary basis, and normally full of chaos and the unplanned scramble for accommodation, health checks, finding work quickly and setting up somewhat of a life before baby/babies come.

But this time has been much calmer. And more permanent.

It’s been chosen and planned and executed by us. We booked our tickets from Uganda more than a few weeks in advance, for the first time, ever. We are not in crisis mode.

We actually are now faced with the challenge of making a life for ourselves here.

And that pesky but familiar friend of mine that follows me like a shadow through my transitions has unsurprisingly surfaced: Grief. But this time, I was prepared.

Since becoming a mother, I have found it difficult to give myself the time and space to process big emotions like grief. This time it has been a full-time job for Michael and myself to help our kids through the transition, and be available as they grapple with the changes in their lives. Luckily we have fantastic family support, which has offered me the luxury of a few hours off here and there to think and pray and meditate and accept and write.

I am still very much in the midst of my cultural re-entry, where I feel awkward and emotional and a little disconnected from life in Australia. Trying to connect and find my feet often feels clunky, and because I look and sound the same as everyone else, it always gives me a strange feeling of being an imposter, attempting to fool everyone that I’m an expert in Australian culture. It’s a weird feeling.

Thankfully, children are amazingly resilient creatures, and I have much to learn from my own!  I have been watching them closely over the last few weeks, and these are some of the helpful things they do to make it through the first messy 6 weeks of transition:

Do things you love:

Since being back, all my children have been a little bit in a funk. Their little lives were uprooted and they have been placed somewhere new, all outside of their control. This is most clearly the case with my eldest, who is 4. However, they are well practiced in the art of living in the moment, as most children are. Since being home we have borrowed some ride on bikes for all 3 (thanks to grandparents!), and they have gleefully wizzed up and down our driveway, happily unconcerned in those moments by the stresses of the transition. It is a reminder that doing things you love is so important to give yourself a break from the hard stuff, no matter what country you are playing in!

Notice the differences with wide-eyes:

David’s observations remind me how different life is, which has helped adjust my own expectations of myself as I settle back in.

‘Wow mum, they have a LOT of electricity in Australia!’

‘They have a lot of footpaths and playgrounds!’.

‘The houses are very different…’

‘There are no boda’s here! And not as many people!’

It reminds me that once again, we are adjusting to a new normal. Every observation he makes, every discussion with David around the differences, gives me permission to take my own time to adjust. I’m allowed to go to the supermarket, look with wide eyes, and come home flustered mid shop. I’m allowed to feel overwhelmed by what we see as different. Seeing David remark on all the changes with wide eyes, sometimes with uncertainty creeping into his voice, has reminded me to look at my own experience with self-compassion.

Find a balance of what you will hold onto from Uganda:

I often find when I am home, I swing wildly from denying my ‘African’ self and choosing not to talk about life there, to not embracing anything about Australia and complaining about my own culture.  My kids, in their own little ways, are learning what they want to incorporate into their lives here, from Uganda. Normally any accents are the first thing to go, which is true this time round as well. Language provides a profound little insight into their process of transition though. Thomas and William were in the car with me the other day, and saw a motorbike. As they would in Uganda, they immediately pointed to it and exclaimed ‘mummy, boda’! I explained to them that it wasn’t carrying passengers, so it was just a motorbike. William disagreed strongly, shaking his head wildly and proclaiming ‘boda!’. Thomas looked at William with those cute little profound eyes that he has, and raised a finger. ‘no William, boda-bike’, to which William nodded and agreed. The tribe has spoken.

David in the meantime insists on using (arguably) the most useful term in the Rutooro language, ‘kabalega’. The term is used to describe, among other things, when children put their shoes on the opposite (wrong) feet. There is no word like it in English. Every day, whether he is talking to us, his grandparents or others, Dave puts his shoes on and asks ‘is this kabalega?’.  He has decided that this Rutooro word will stay as a part of our household, and the twins when I put their shoes on now also say ‘lega? Lega?’ as well, which is not only useful, but super cute!

I need to enjoy some of the luxury here:

In Africa, I am constantly drumming into my kids not to drink water unless they know that it has been boiled. They get told off regularly for trying to drink tap water, bath water, etc. The other day, we were having a conversation with Dave about being able to drink tap water here and how lucky we are to now live in a place where water is safe to drink from taps, where in Uganda so many kids get sick from drinking unsafe water. He was sitting in the bath at the time, and looked at me in disbelief. ‘Really?, I can drink ANY water from ANY tap?’, he asked in surprise. I nodded, smiling. He laughed, and looking doubtful, asked ‘what about the bath tap?’. I nodded my permission and he turned the water on and drank from the tap in our bath, all the while laughing in delight as if he was doing something utterly outrageous and thrilling. It’s the small things.  The lesson? I don’t have to feel awkward and reminded of the vast inequality of our globe, every time I drink fresh clean water out of my tap. Sometimes I can just enjoy the convenience!

Re-learning doesn’t take too long:

Taking David on a kindy visit gave me an awareness that once again – although socialising in this context feels ‘familiar’, its often clunky after being away. David is used to different social rules and a different culture. He was super overwhelmed at his kindy visit. When the other kids asked him his name, he responded (as he always does) with his full name, said in one long burst of syllables ‘DavidMandelaFindlay’ as every child in Uganda does. Everyone, including the teachers, struggled to understand (despite his clear articulation). He looked at me in bewilderment, and I introduced him as just David. He has followed suit since then, and has switched easily. I’ve already had my own clunky experiences, and watching him have them too is a reminder that we have become used to social interaction in another context. But seeing him adapt so quickly reminds me that humans are hardwired for connection.

I am learning once again that feeling at home in a place takes time.

When we were here in Australia last time to have the twins, we bought a house. This international move (the sixth one in eight years!) has been the first time that we have ever – on either side of the world – moved back into the same house, or even known where we would be living before we arrived. In many ways, this has been lifesaving! Naively though, I assumed that this would mean I would immediately feel settled.  Not so.

In every new place we went after leaving our home in Fort Portal, William would look at me with his big curious puppy-dog eyes, and raising his voice in a question ask; ‘mummy, home?’ First in Kampala at our friends place, then in Entebbe, then when we reached Dubai airport, then in Adelaide at  my parents place, and finally when moving into our house. I can now answer in the affirmative! But still at least once a day, even now, he looks at me and says ‘mummy, home?’ Sometimes it’s in the context of pretending he is on a plane, and he will also say ‘Violet?’ or some other favourite person of his in Uganda. It pulls at my own fresh farewell grief immensely, and reminds me that home is not an instant reality. It is people and community and familiarity and history, things that are built over time.  What my own children are teaching me, is that I need to carve out a big chunk of time for Australia to feel like home again, and that’s ok.

So that’s my lessons on moving countries and cultures, from my little people!

 

Building consensus and community

Over the past 7 years, since we first started MH in Kamwenge, Michael and I have learnt much about management, particularly in a Ugandan context.

Most of this learning has been through the school of hard knocks. Which is often painful. And extremely humbling.

It also can be a very effective way to learn.

It’s not quite like learning things at university. I don’t seem to forget the mistakes as much as I would if they were simply questions I marked wrong on an exam.

For the first year or so of our management experience here, I spent a lot of my time trying to prove myself.

Trying to give myself permission to lead.

Trying to remind others that I had authority

Trying to show our staff and the community that I did have the capacity to run this organisation.

There was a lot of flailing arms and big emotions and alienation from our staff and then questioning my decisions retrospectively.

I don’t mean to say I was hopeless, back then. In the interests of practicing some self-compassion, I still bought a lot of skills to the table, we set up a fantastic workplace and worked round the clock to do this – we did a pretty good job considering the circumstances, all round.

But I have realised that my management style these days looks remarkably different. And because of this, our organisation looks very different as well.

This slow-moving shift is due to two revolutionary factors.

The first thing is me. I am different. I believe in me and my gifts. I have experience. I have proved to myself that I am (mostly) resilient to setbacks in a professional capacity, and I have realised somewhere along the way that I can actually do this work – though insecurity still plagues me at times.

The second is that I have learnt, ironically, that management is not about me.

It is about everyone else. It is about building a community of equals that are authentic, free to question and critique, free to own failure and learn from it, and most importantly, sold out to the vision and values of an organisation.

The natural progression of these values is that everyone has a voice – from the cleaners and security guards, all the way up to top management. Our hope always is to foster an environment where building consensus is a priority; where everyone has space to talk, and will be listened to when they do. This is obviously counter cultural around the world, but in Africa, where the ‘big man’ syndrome is endemic, this is powerful. It stands out from a mile away.

Lately we have been reviewing our organisational policy and procedures. It’s a big job. Everything from employees coming to work on time and how much maternity leave we should offer, to big decisions on what constitutes gross misconduct and what corruption looks like at Maranatha. Even thinking about these topics can give me a headache. It would be much easier for me to sit at my desk and review the policy myself, or better yet, to bring in an outsider.

But instead, we are slogging through the 70 page policy handbook in the morning meetings, which is when all our staff on duty for that day meet for half an hour to raise concerns, discuss issues, encourage each other, tell stories… and invite God to help us in our work for the day. Some of this policy discussion has been really painful, as you can imagine. Opening up to humans the ability to make decisions about their own work benefits creates the kinds of demands that would be expected – we have had many slow discussions (where I would consider giving my first born child away to avoid facilitating) regarding why we can’t have more annual leave or longer time away from work for a burial or why sick certificates are important. But with those issues, it has been important for the staff to learn the limitations of a tight budget and choices between benefits. I have also learnt and then revised my own position many times, based on Ugandan cultural norms and our staffs’ passionate discourse.

Other meetings, we have entirely thrown out my own freshly drafted policies that departments originally identified a need for, because the staff felt it was unnecessary or problematic. That was hard. But it was the best decision for the organisation, in hindsight.

This last week, as part of this process, we have had a discussion on what constitutes corruption at MH. Uganda now rates top on the list of East African countries in corruption indices. Corruption is everywhere and health care is no exception.  The patients we serve expect a broken system, where tips and bribes to health care workers replace the right to universal health care, and attention for ailments is purchased by greasing palms. Simultaneously, turning down appreciation tips for services however –especially to someone older than yourself – is culturally equivalent almost to spitting in someone’s face!

So as you can imagine, this was a controversial issue fraught with potholes and layered with thick cultural expectations. It was an amazing discussion to facilitate though – to see the passion of the staff around this issue, and their desire to protect MH from this seductive sin. It took place over 4 morning meetings– with much honesty and laughter and debating with raised voices – before we came to an acceptable standard for the practicalities of dealing with this in the workplace. I’m not 100% sure that the policy we developed will work, but we will find out along the way. Much of the point is the discussion itself and the investment in the outcome that our staff now have.  As part of this policy, the staff agreed that they needed to revisit this discussion every 3 months in the meeting. To keep conversation open to ensure they were keeping each other accountable to the standards we have set.

After one such meeting, I was sitting in Maureen’s office voicing the difficulties of facilitating such discussion. I was complaining that the next section in the handbook is going to be tough to talk through. I was wondering if we should skip it.

Maureen smiled and shook her head and reminded me in words something like: ‘But now Kim, do you see how they are satisfied once they have had the opportunity to discuss and decide? They will hold each other to this. If me and you were to sit down and agree and then order them to do something, even if we knew it was the right thing, do you think they would listen? The minute our backs are turned, they will ignore the order. This way is slower, but it’s the right way.”

Such pearls of wisdom from the woman that has taught me so much about managing staff!

Maranatha and Me

So, Michael and I have decided that we are moving our family back to Australia, permanently.

Even writing those words is tough.

I write those words with a heavy heart, taking a deep breath, and acknowledging that it is probably one of the most difficult decisions we have ever had to make. Maranatha Health has been the core of our life for a long time now.  Leaving will bring more change. And, I can only assume, quite an uncomfortable period of readjustment.

Michael and I went on our first date in November 2007. It was a blind date organised through conspiratorial match-making friends who knew we both had an interest in Africa.

Like I wrote in another blog previously: “It seems like an eternity since Michael and I were sitting opposite each other…sharing with each other our passion for Africa and our desire to move there and try to DO something one day. It was then that Michael mentioned his idea – then in the very initial stages – of ‘Kamwenge Maranatha’. I remember sitting there excitedly listening and sharing, ideas already swimming around in my head about the possibilities, about the logistics, about how to transform this vision into reality. And then, embarrassed, I sheepishly tried to bring myself back to reality. This was our first date – I didn’t even know Michael, let alone whether I could be a part of such a vision…”

From sometime in the months following, until my children came along, I had only two great loves: my husband and Maranatha Health. I have now added my 3 children David, William and Thomas to that already-bursting-at-the-seams mix. I often feel in awe of what God has given me.

Michael and I have often joked about MH being our first child. On reflection, to date it has given me much more heartache and sleepless nights than the other 3 (which is quite a statement!). In Maranatha’s defence though, it has been around a lot longer than the other 3!

I have wept tears of frustration, tears of joy, tears of grief, and tears of pride over this project over many years.

Idealistic and in love, Michael and I married in 2009, asking for donations to MH in lieu of wedding gifts from our guests. Then we got to work with the MH Australia team. We fundraised. Solidified the MH board in Australia. Were incredibly lucky to have some AMAZING people join the initial team in Oz. Begged for money anywhere and everywhere. And planned and read and studied and dreamed for 2 years.

When we finally moved to Uganda in 2011, we were young and naïve. We had in a combined effort, just short of 2 years of experience living in East Africa. Neither of us had worked as managers before, let alone managers in another cultural context. All we had, really, was a nervous willingness to be obedient to whatever our Creator asked of us.

We estimated it would take us between 5-10 years for the organisation to be fully in Ugandan hands, and this is the timeframe we committed to. At the time (I was 25) it seemed like a very long road stretching ahead of us. In our generation full of instant gratification and commitment-phobia, where it is unfashionable to commit for the long haul, even the 5-10 year timeframe seemed extremely daunting.

There have been many times over the years when I have been tempted to walk away from Maranatha Health and our calling for both personal and professional reasons. Times when funding has been cut indefinitely for complex reasons; when friends and foes have stolen funds and cement and fridges and everything in between; when one too many children have died in a month at the clinic and I’m angry that the world just keeps nonchalantly spinning, when the weight of managing so many staff has become too heavy; when the grand injustice of having an illegal factory built next to our land in Kamwenge gave me a brief insight into the overwhelming powerlessness of poverty; when programs have flopped and I’ve felt completely inadequate to run the organisation; when feeling flawed by the ferocity of grief after a miscarriage; when we faced land grabs and power grabs and big egos that wouldn’t give up without a fight; when we lost our beloved Mzee, and wondered how we would ever run the project without his guidance; when we found out we were having twins and wondered if that could possibly ‘work’ anywhere, let alone in Africa….

And so many more times, when being a part of this project has stretched me far beyond what I thought my limits were.

But in all of this, God kept showing up. In beautiful, miraculous, ordinary ways.

Being a part of Maranatha Health has built my character and moulded me into the person I am. I barely recognise the girl that rocked up in the backwaters of Kamwenge, in 2011.

It has offered me an opportunity to discover and develop my gifts, a community to embrace and be embraced by, and a grand over-arching mission to pour myself into, shoulder to shoulder with my husband.

And it has offered me a front row seat to watching the poor accessing quality health care, sometimes for the first time.

God – the creator of all good things – has allowed this organisation to flourish in spite of all the challenges, in spite of our own brokenness. This I now know for sure: She is definitely on the side of the poor accessing health care.

And we are so grateful. The good has been really good. And Oh, how we will miss it. I cannot even imagine never again being a part of the MH Uganda staff team, day-to-day. Outside of my family, it has been THE most rewarding, life-giving, eye-opening, challenging-but-deeply-worthwhile experience of my life.

But now

…we are tired.

Down-to-our-bones tired.

We miss home. We miss the ease of raising children in our own culture. We want an Australian education for our kids. We’ve moved countries 4 times in 5 years, first not knowing if we would go back after the clinic closure in Kamwenge, then because of the twin pregnancy. But for the first time since MH Uganda began, we feel like it is actually time to leave this place.

And do you know what?

We can leave. There is this incredible organisation that will carry on the work without us. In fact, I think at this point, it is actually time to let the staff manage this place without us peering over their shoulder.

No-one wants us to be the over-bearing parents.

Of course we will never really leave Maranatha. She is our first born. We will always be there to support. We will fight for her, when we need to. We will protect her as much as we can, from afar. We will visit as much as possible.

What does this look like practically? Over the next few years, we will remain as the Ugandan Directors, volunteering a few days a week from Australia. We will do much skyping and emailing.  We will provide support to our management team, continue developing resources and policies when we need to, continue to steer strategies and programs, write reports, participate in research and encourage our staff. Most of the same stuff we do here, but just condensed. We will hopefully visit twice a year.

And while we are reducing MH to this smaller, bite-sized part of our lives, Michael and I – like all parents must do when their child leaves the nest – need to figure out what else we want to do with our lives. What else we could possibly do that will give us purpose and meaning and allow us to contribute to a more just world, both professionally and personally.

If you have an idea for the rest of our lives, let me know!