Tag Archives: kamwenge

2011: The year of learning

I just said goodbye to the hardest year of my life so far…

*sigh*

I know that doesn’t mean much, considering I’m actually only 26 and have lived a pretty cruisy life by world standards.

But this year has been really tough. For a thousand different reasons. There are lots of other more positive adjectives though too, like rewarding, fulfilling, exciting, adventurous, unexpected, validating, and of course…learning. Learning, learning and more learning.

It’s a funny thing, how you learn a lot, develop your character and get over yourself a little bit when life is challenging and you get out of your comfort zone…

Even Paul from the early church agrees with me: ‘We continue to shout our praise even when we’re hemmed in with troubles, because we know how troubles can develop passionate patience in us, and how that patience in turn forges the tempered steel of virtue, keeping us alert for whatever God will do next. In alert expectancy such as this, we’re never left feeling short changed. Quite the contrary – we can’t round up enough containers to hold everything God generously pours into our lives through the Holy Spirit.’ (The message)

I have learnt so much this year. Sometimes I wish I could go back and visit myself, that naive girl at the start of the year, and tell her that it all works out ok. That things will be difficult but that through all the hard stuff, I ended up learning what I needed to learn, to be able to live in Kamwenge…

So how am I different from last year at New Years?

I’ve learnt about moving to another place. I’ve learnt…

How to say goodbye to some of my closest friends and still remain involved in their lives

How to live apart from my family

How to open my house for inspection and rent it out…

How to move my entire life to another part of the world

I’ve learnt about how to live in Kamwenge. I’ve learnt:

How to speak (a little bit) in another language

How to make friends in another culture so different from my own

How to cook using only food available in Kamwenge, including Uganda’s famous Matooke dish

How to use a cigiri (a traditional charcoal stove)

How to wash clothes by hand at a break neck pace

How to bargain so that I don’t get mzungu prices all the time

How to live without a fridge (something I’m still working on…)

How to light a Kerosene lamp

I’ve learnt a lot about running an organisation. I’ve learnt:

How to manoeuvre through a million bureaucratic-red-tape-scenarios

A LOT about construction, materials, and all sorts of building-related things.

How to manage staff with Michael (10 at last count…!)

How to work with the police to arrest someone who is stealing from you

How to conduct job interviews and board meetings

How to import a shipping container

How to use Quickbooks, manage finances, sort out legal issues, and put on a great event…

How to avoid paying bribes (although I certainly don’t have a 100% success rate with this one!)

I’ve learnt some extra bits and pieces that have made life easier. I’ve learnt:

How to grow cassava, matooke, zuchinni, garlic and a whole bunch of other food

How to drive a massive old hilux ute –reluctantly, even on Kampala’s chaotic streets.

How to pick milk from the dairy, boil it, and scrape the cream off the top for later

How to work 9-5 with my husband and still have a great marriage

How to (begin) writing a thesis – including all sorts of useful stuff about methodology, field research and ethics, things I use to have no idea about.

How to enjoy cold water showers!

How to LET GO of my drive for efficiency, timelines and plans and embrace ‘community’…

 

It’s been a big year. Here’s hoping next year is a little more chilled…

Photography clichés

One of the most amazing things about living in Kamwenge are the beautiful sunsets we get on many evenings. (I assume the sunrises are just as appealing but I wouldn’t normally choose to be up at that hour – my commitment to a good photo is fairly pathetic….)

I thought I would share some of them with you. I only wish the photographs could capture their magnificence. I do think that might have something to do with the amateur-ness of the photographer!

Sunset

Beautiful huh?

Then again the  night after. This time you could see the Rwenzori mountains so clearly…

Or something simple, like this one…

Then… one of the most magnificent sunsets I had ever seen. We both stood outside, mesmorised for half an hour by the colours and clouds.

The colours were so bright and stretched all the way across the sky….

…and it was raining too.
 What a beautiful part of the world this is!

Bring your blade, bedding and basin…

A good friend of mine who lives in Kamwenge town is pregnant with her second baby. During the birth of her first child, her labour became obstructed. Because there was no place in Kamwenge that could help her, she travelled 1.5 hours on a dirt road, in severe trauma, on public transport to reach the nearest clinic that could operate on her. Her and her beautiful boy survived, although she now has a great fear of childbirth. Every time I see her, she fervently asks for me to pray for the safe arrival of her baby due in August.

But she was fortunate enough to be able to afford the cost of transport to Fort Portal, and was able to get there in time.

In Kamwenge, where the population has reached at least 350,000, there is no district hospital. The two main clinics in the district do not offer Emergency Obstetric Care. There is no working theatre. No running water or electricity. Many of the health staff are hardworking, compassionate individuals who are tired of having so few drugs and equipment.

Being a woman in Africa is tough. And one of the toughest things of all is giving birth. I read lately, in a journal article written by an anthropologist (I can’t remember the name of the article!), that in an area of eastern Uganda, childbirth is sometimes referred to in vanacular as ‘the trap’ because of the risks involved.

The maternal mortality rate in Uganda is 506/100,000 live births. In Kamwenge it is unknown, but expected to be much higher. Every year, 1.5 million African children are left  without a mother because she dies trying to give birth to a brother or sister. The risks in child birth are a struggle faced almost exclusively by poor women, with 99% of maternal mortality in developing countries. It is astounding in this era of medical advancement, that so many women continue losing their lives giving birth, and it is for this reason that Maranatha Health have chosen to focus on improving maternal mortality in Kamwenge.

Despite what I know, every now and then I wonder if what we are doing is worth it – maybe the situation in Uganda’s health care system isn’t ALL that bad.

Then, I read an opinion piece by Frederick Golooba-Mutebi in this weeks East African:

Maternal deaths: Why Ugandans are victims of their own civic incompetence

Recent media reports detailing the tragic deaths of expectant women and their unborn or newly-born babies in referral hospitals and health centres across the country have laid bare the crisis in Uganda’s healthcare system and made a laughing stock of the NRM government and its extravagant but empty claims about being focused on service delivery.

The anger, despair and disgust the many preventable deaths have caused are captured in the decision, reported in this column last week, by activists to take the matter into their hands and drag the Museveni government to court.

Reports from the “grassroots” indicate that in some cases relatives of the victims take matters into their own hands and threaten health personnel with violence. Others, however, behave as if their experience were the natural order of things and simply return home to bury their dead.

Before the decision of activists to enlist the law, only in a few isolated cases had victims of Uganda’s shambolic maternal health services sought to enlist the help of the police or courts of law. Two cases stand out.

One involved the death in early May of one Joyce Nabatanzi at Nakaseke Hospital, allegedly because nurses had been negligent. I have no idea how or where the story ended. However, a senior officer who claimed his staff were hardworking attributed the incident to the hospital having run out of essential drugs and supplies without which lifesaving surgery could not take place. Several phone calls to the National Medical Stores had not led to the desired response. To make matters worse, the hospital did not have an ambulance to transfer the patient.

The other was of a couple who lost a baby at Jinja hospital, also because of alleged negligence by nurses. The bereaved woman spoke for herself: “These people should improve. I heard countless insults from the nurses using obscene language. They handled me like I was a thief, pulling me from all sides.”

Unwilling to accept what had happened, her husband filed a case with the police. Here, as in Nakaseke, the hospital lacked drugs and supplies, as the father pointed out: “I bought everything since the hospital did not have the needed items to facilitate delivery.”

To add insult to injury, he could not get a post-mortem without coughing up more money: “Now someone tells me if I want a post-mortem, I have to give the pathologist transport.” According to a police officer on the scene, this was not the first time incidents of this kind were happening at the hospital.”

With all this in mind, it is difficult not to equate going to give birth at a public health facility in Uganda to going to war. As with combatants in war, here too, there is no way to tell whether one will come out alive.

There is, however, a sense in which combatants going off to war are better-off: They do not buy their own uniforms, guns, bullets, bombs, boots, or even food.

Meanwhile, expectant mothers going into government facilities must carry their own food, gloves, razor blades, sugar, tealeaves, bedding, basins and even saucepans. You have to see it to believe it. You would be forgiven for thinking they are moving house.

It is all too easy to buy into stories of the by now legendary negligence of health workers in Uganda. That is until you learn a thing or two about the conditions many face at work. Consider these statistics, which appeared in a recent newspaper report: Hoima hospital has 97 staff out of the 197 required. It requires 56 nurses but has only 34. It is run by eight doctors out of the required 35.

A brave nurse summed up how things work over there: “There is no other option than doing what we can and leaving what we can’t. What do we do when things are beyond our reach?”