Tag Archives: uganda

This Lopsided Earth

Ugandan baby

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

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.

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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!

Carols

Michael and I were reminiscing, a few weeks before Christmas, about Carols by Candlelight in Australia. When we are here, we always miss this quintessential Australian Christmas experience in Uganda:

Warm summer nights where the sun insists on staying up late

People from all walks of life flocking to reserve their place at the park

Picnic rugs covering the grass, eskys packed full of treats and drinks

B-grade celebrities on stage, bantering

Parents anxiously watching their young children’s budding pyromania as they play with candles

Australian out-of-tune accents belting out well-known Christmas songs

At first we assumed that the concept of singing carols, outside, by candlelight, was some kind of universal phenomena.

In hindsight – since the entire northern hemisphere is in the middle of winter at Christmas time – this could not be the case. It turns out it is a uniquely Australian tradition, that started in the 1920s.

So this year, we decided to put on such an event at our home.

We invited a combination of Ugandan friends, expat friends from all over the world, and some MH staff. We provided food (and others brought food as well!), I made Christmas biscuits, we had a big camp fire, and there were candles for everyone. Instead of BYO picnic rugs, people were asked to bring the Ugandan equivalent, woven mats. About 30 people turned up.

Michael, together with our talented friend (and MH staff member) William, played guitar and sang.

And it was lovely.

There is something about singing carols under the stars with a group of people that makes me feel soft inside. Emotional. Dreamy.

This feeling of course, was slightly impeded by the act of chasing the twins around near an open fire…until they went to bed.

Towards the end of the night, Michael sang and played ‘Aussie jingle bells’. It’s corny, and ‘over-the-top’ Australian, and not normally my thing.

I loved it.

It was simultaneously the cause of, and a salve for, my homesickness.

Being so far from home at this time of a year is hard. I miss our wider family. And as much as Australian Christmas tradition has become tangled up with consumerism and expensive presents and stress and all that other stuff….

Having a little bit of Australian tradition in Africa this time of year was exactly what I needed.

The Chaos

“But…our life is not conducive to twins! You need to find just one baby”

“I can’t un-find a baby Kim. There is definitely two in there.”

“Are you sure?”

“yep…I know what I’m doing!”

“holy crap”

“Yep…”

This conversation (with some more colourful wording  from both of us edited out for your sensitive ears) took place at the Maranatha Health hospital in Kabarole District, Uganda, in my husbands’ consulting room, as we used the ultrasound to check on my not-yet-showing belly.

It was the first of many terrified, frantic, awe-struck discussions around why God and the universe would see fit to give us the ‘blessing’ of twins.

My extended absence from this blog has been for this very reason; a reason I could never ever in a million years have forseen. But, twins we had.

It has been a long journey, this shedding of our previous ordinary identities, and our tumultuous-yet-triumphant transformation into Naalongo and Ssalongo [Rutooro words for mother-of-twins and father-of twins].

Somehow, someway, Michael and I survived 2016. The year of upheaval. Of reluctantly moving our family back to Australia due to the high risk nature of my pregnancy, for close monitoring. Selling our house in Oz, buying another, and moving in before the twins were born. Of finding work for Michael in Australia. Of overseeing the MH project from afar. Of coping with the sheer discomfort of the last few weeks of my pregnancy, carrying around 5 and a half kilos of baby inside me. Of expanding our hearts and lives as we met our new little people, William and Thomas. And then, the all-consuming sleepless, relentless reality of two newborns to care for. Newborns that didn’t particularly like the outside world very much (or sleep) and decided to express their discomfort very often and loudly (if only we had known it was due to allergy!). Newborns who decided the only solution to said discomfort was to breast feed All The Time.

It was a tough first 6 months. The hardest of my life. The combination of sleep deprivation and exhaustion has rendered the memories of those early days with the twins into the hazy, murky back-waters of my mind. I remember specific moments: Michael and I staring at each other over the table one night, glancing at (but not able to eat) our defrosted donated dinner, our toddler having a meltdown because he wanted our attention and we simply couldn’t give it to him, while each of us juggled a crying screaming baby, knowing there was at least a few hours left of wailing before sleep would eventually come. I remember the look of panic in his eyes that mirrored my own – “How do we ACTUALLY survive this!?!?!”

It wasn’t pretty, but we did survive.

And then sometimes, all the sleep deprivation and baby cries and breastfeeding exhaustion and baby eczema/allergy flare ups and toddler tantrums and my own intense feelings of inadequacy pulled me completely under in their swell and the only thing that saved me was my village grabbing me by the cuff of my shirt and pulling me out spluttering and gasping for breath – primarily my husband, my own mum, my mother in law, and then a multitude of different friends at different times taking a baby to hold, giving me a shoulder to cry on, cooking me a meal, playing with my first born little boy and reminding me that THIS IS A SEASON.

Sure there were lovely bits too. Snuggly new born cuddles. Watching Dave’s language explode with humour and insight. The twins holding hands while I tandem fed (they more often poke each others’ faces now!). Fun time with family and friends on the not-so-hard-days. My incredible support system showing me love. Sunny autumn days gathering walnuts from our tree. Imaginary fun with Dave. A thousand ways Michael has supported me as we walked in the thick of it together. Dessert nights with close girl friends to remind me of me. First smiles and then giggles. Pool play. Learning how to love another 2 humans. Warm, easy conversations with my own mum about motherhood…

And then, somewhere in the midst of it all, we decided that we would move back to Uganda. Uganda – and Maranatha, the organisation we founded – is home in so many ways, after all.  We have been living there on-and-off since 2011. So the decision felt inevitable, and right. The reality of course – uprooting our family, leaving our incredible Adelaide-based support network, heck, even getting on an international flight – was largely terrifying. But nevertheless, in April we packed up our house and our life and moved countries once again (dragging some grandparents along to help us on the long-haul flights), hoping we would find a house to live in soon after arrival!

With approximately 20 hours of flying behind us, we shuffled out of the familiar mugginess of the Entebbe airport – a faster speed was impossible – with my parents, 11 month old twins, a very overwhelmed and tired three year old, a double pram (not that we have used it since), 2 porta cots, 2 car seats, 8 bags of luggage, and eagerly looked for the person who was meeting us. After a couple of minutes of frantic searching with lots of stares and offers of taxis, Michael and I faced each other with dismay and realised that the person sent to pick us from the BnB was  either a)very late or b)not coming, two extremely likely scenarios in Uganda! In true Findlay laisse-faire style, Michael and I realised we had no cash on us at all, no working phones with Ugandan SIMS within easy reach, nor an address for the guesthouse we were going to.

We marched over to where the taxi stand was and after discovering my father had brought a small amount of Ugandan shillings from a previous trip, set about finding a taxi to bargain hard with. This was an interesting process, given I had no clear idea where in Entebbe we were heading to! Eventually we all piled into an SUV (with all our luggage there was actually only 3 seats available!) and drove in the general direction of the guesthouse based on my husbands’ super amazing memory. Along the way, we stopped maybe 6 or 7 times, showing motorbike taxi drivers the one photograph we had of the house, in the hope someone would know the place. Our twins and toddler loved the excitement, with David yelling at the top of his voice “ Look mummy another goat!” every time we drove past the multitudes of goats on roads.

On our first day back in Uganda (after finding our accommodation), we took a walk through a quiet neighbourhood. Walking along a dirt road, with only a sprinkling of houses right by Lake Victoria, there was a group of people lazily chatting in the shade of a big tree – some boda (motorbike taxi) drivers and several women. They turned to look at us, and then with mouths wide open their conversation ceased. After a respectable recovery time, the women started laughing and broke out in applause, which led to some dancing, until I felt like I was the star of some bizarre African musical featuring a set of miracle twins. It became apparent to me at that point that anglo-saxon identical twins are not a common occurrence here.

I won’t bore you with the gritty details of the first few months – finding a house to move into and making it suitable for us, getting over jetlag and reteaching our twins to sleep, adjusting to life without grandparent help and consistent power, finding the right people to help us out with child care at home, walking alongside of our 3 year old as he experienced intense culture shock and homesickness, re-entering MH and (for me) adjusting to being back at work after a long absence….

We are rebuilding our community here, slowly. Our staff, as expected, welcomed us and our kids back with open arms. And despite agonising almost every day if we made the ‘right’ decision for us and more significantly our children, I’ve come to the conclusion there probably isn’t one. Sometimes, I’m realising, the story isn’t supposed to be just about ‘us’ as individuals. Mark Sayers, a Christian pastor/sociologist, introduced me recently to the idea of people having 3 ‘stories’ – my story, a community story, and then a universal story. In the west, he argues that almost all of our life and decisions are made based on our individual story – what is best and meaningful and important to me. More than any other time in my life, Michael and I are trying to move away from this. Our decision to move back to Uganda, regardless of some of the challenges this brings personally, is born out of the inextricable weaving together of our personal story with the story and community of Maranatha Health, and our universal story of hope for a more just world. So that is why we are back here.

We try to take all 3 kids with us to work once a week. On those days, David hangs out with a crew of staff children who sometimes hang out at MH in the afternoon (or at the moment during school holidays, all day) with Ellen, the staff children’s carer on staff. Despite his limited Rutooro -he is learning slowly- he often leads the pack, with a group of them running around MH giggling and playing like they own the place. The crèche, a tiny room which is a third of an old shipping container, is now referred to by Dave as ‘my office’. William and Thomas, while mostly looked after when at the clinic by our very energetic young nanny Violet, wander happily around until they see Michael or myself and are reminded of their separation anxiety that seems to plague them still. The other week I spotted them both wondering into one of the wards, and then guiltily tottering out with mouths stuffed full of sweet potato that one of the mums on the ward feeding her own child had given to them. They certainly draw a crowd, and I often walk out to the MH playground to find a crowd of 3 or 4 people just staring wide-eyed, gaping at the site of 3 mzungu children, 1 who is about as gregarious as is possible to be, the other 2 identical in looks (though polar opposites in personality!).

Michael and I divide our time fairly equally now, between the clinic and home. We often swap over around midday, where one of us rushes home on a boda and the motorbike driver waits out the front for the other while we give a quick handover: ‘this email needs to be sent, this management issue came up, someone needs to talk to this staff member….” and “this child’s been tired, this was what was eaten for lunch, this load of cloth nappies is washed…”. I feel utterly grateful to have a husband who sees child-rearing as just as important a task and wants to share equally in that responsibility.

So this is life now. It’s messy, chaotic, busy, mostly unplanned, and so much less productive than it ever was a few years ago. I spend so much of my time feeling like I am on the brink of catastrophe, wondering if there is a better way to do ‘life’ here (or anywhere), but I think the answer is that in this season in life, just being a part of MH Uganda and raising our 3 children is enough.

I’m enough.

At least, I’m learning to be.

It takes a village

Ugandans love children. As a culture they celebrate them fiercely. Everyone seems willing to smile and get down on their knees to say hello to a child. Babies are cooed at and admired. For women, bearing children is a sign of prestige and of strength.  I have earned a respect through motherhood that I tried futilely to gain for the duration of the time I lived in Kamwenge.

When I speak of African children, the oft quoted proverb ‘It takes a village to raise a child’ comes to mind. In my imagination, this phrase conjures up exotic images of intricate networks of beaded half-naked villagers working together for the good of the communities’ children. Our over-use of this saying in the West highlights the exoticism and idealism with which we frame our discussions of child rearing in Africa. I’ve heard it said that in the developing world, child–rearing is somehow a more ‘natural’ process, beyond reproach.

To confess, I have many times scoffed at this idea.

While I believe wholeheartedly that a village – a community if I may use a less exotic term – is essential for raising children (given how exhausting and monumental such a task is!) it is also true that if everyone is responsible, than in a sense no ONE person is responsible.  My time in Kamwenge exposed me to some of this –children neglected and uncared for, malnourished and left to be looked after by young siblings or distant relatives. I think I saw the worst of this, working at the referral health centre in Kamwenge.

There are many great and (in my opinion) not-so-great things about parenting ‘Ugandan style’, as there are in any culture. I don’t need to thrash them out here.

But one of my greatest reservations about moving back to Uganda as a family were some of those ‘not so great’ bits to Ugandan child-raising, especially when I plan to be a working mother here and have other women look after my son for chunks of time. I would think of all the opportunities that I perceived our son would be missing out on, not living in Australia; that I, as his mother, would be denying him, by making the choice to live here, away from his culture and community.

Before we arrived here, when I was super-stressed or having a moment of doubt, all the marvellous moments of my own childhood unravelled before me, as a taunting list full of red crosses, marking the experiences my own son would not have.  The freedom of playing in parks and exploring creeks, running through sprinklers in bathers on lazy summer days in our backyard, the safety of playing with neighbourhood kids, the amazing quality of suburban kindergartens and playgroups, and most significantly, a community of friends and family that were invested and involved in my upbringing. I feared that we wouldn’t find a community for him to belong to here.

However.

Slowly and surreptitiously

Without any intention or expectation

And in the midst of my concern that this could not happen…

A community has begun to form, winding its way around my son and through his little life.

After all, community is something that Ugandans know how to do.

I see it when I take Dave to our clinic, and he immediately squirms out of my arms into the arms of one of our staff.

I see it when he waltzes into the reception area at Maranatha, climbs onto the receptionist’s lap and begins to play with her phone.

I see it when he hears a cow moo, then searches for and is picked up by our security guard at the clinic, in a successful attempt to be taken to see the cows grazing nearby.

I see it when our landlady at the apartment where we stay buys him bunches of bananas so she can watch the ecstatic little dance he does every time he is given a banana!

I see it when Dave shrieks with excitement and then runs outside to play every day when his 6 year old neighbour (adopted by our American friends that live upstairs) arrives home from school

I see it when we take him to the shop where I buy most of our consumables, and the staff greet him with a big smile and call his name ‘Mandela!’ and produce a ball for him to play with while I shop.

I see it when we attend church on Sunday, and his Sunday school ‘teacher’ cuddles him and jokes that he is now her child, while I hold her little girl of the same age.

I see it when the cleaners or groundskeepers in the apartment block where I stay rush to help Dave down the steps on the compound where he continues to attempt death-defying acts.

I see it when we sit down for lunch and after polishing off his own g-nut stew and rice, he looks to see which woman on our staff will feed him some of theirs.

All these moments are small, but they remind me to take a breath and be thankful for the village here that is helping me to raise our son.

And perhaps

scoff at the proverb a little less.

Cuts and bruises

If you had asked me a few years ago what was the most rewarding part of Maranatha Health in Kamwenge, I would have said without a doubt, the staff community.

If you had asked me what was the most gut-wrenching thing about closing the clinic and leaving Kamwenge, my answer would have been the same.

In Australia, I really missed being a part of the Maranatha Health Uganda team, especially when coupled with the grief that it may not ever exist again.

But when I reflected on our Kamwenge team, wearing the rose-coloured glasses of distance and with the nostalgia of time passed,  I often wondered if the memories I had floating around in my head were deceiving me in the way memories often do.

Memories of hard long hours but with people that really cared about outcomes for those we were serving. Memories of staff giving of themselves to others. Memories of making a difference in peoples lives, together. Memories of laughing and frustrations and chaos and fun. Memories of real community. Certainly not perfect. There were also lots and lots of hard bits.

Sound cheesy?

So we are back.

And do you know what the absolute coolest thing is?

Most of the staff DO want to come back and work for Maranatha Health again, just like me!

Since we have arrived back in the country, most of our old staff – be they nurses or cleaners or receptionists or security guards – have contacted us asking for their jobs back. They have called us from new work places, from training schools they are attending, from their gardens in Kamwenge, and from various places around western Uganda. But the message is almost always the same – when can we start?!

And then when staff come to talk with us about their position, there are reunions as those that are already here greet those returning. There are hugs, questions about families and marriages, stories of new babies (at last count there are 5!) and lots of excitement in finding out about who is returning.

Some of the staff are taking pay cuts to come back and work for us. Some are relocating families.

The whole experience of gathering our team back has been extremely counter cultural – for Australia also but definitely for Uganda. Generally, money and conditions are the determining factor in jobs here. Ugandans aren’t generally very sentimental people.

But again and again, staff are saying that they miss the team, they want to work with us to make an actual difference to patients, and they want the experience, skills and training that comes along with being a part of MH in Uganda.

Which is good news, considering our new project is very much focused on sharing all of those aspects of MH with other clinics!

The other day, Michael met with a key former staff member – someone we were hoping would come back to join us for MH#2.

That staff member agreed to join us, a decision we are incredibly thankful for. But in discussion with Michael (which he relayed to me later), this staff member thanked us for returning to this place and for trying again, and acknowledged that almost nobody would have come back to this country, after what happened last time (read here).

That is the first time someone here has openly acknowledged us for this.

And do you know what? Despite knowing I should be here, and despite enjoying the first few months, moving back to Uganda has been tough.

And so here it is. The acknowledgement I needed to give myself:  It should be tough!

My trust was broken. Last time I was in this country, my idealistic, hopeful self – the self that wants to see the best in people and tries to downplay the corrupted agendas of others – took a good ol’ beating.

The staff returning, however, has helped to heal some of the cuts and bruises I collected from the last time I was here.

Motorbike meditations

I have always loved riding on boda-bodas – the humble motorbike that serves as the main form of taxi transport for short distances in Uganda.

There is of course a lot of negatives about this form of transport, top on the list being the amount of accidents that happen every day, due to terrible driving, hazardous roads and conditions, lack of helmets and protective gear, and also the decision making (whether effected by some form of drug or not) of your chosen chauffeur. I don’t take bodas (unless there is no other choice) in Kampala, but up-country, where the roads are quieter and you can befriend and loyally use the same boda’s daily – it is my main form of transport (except when I am with my son – no bodas for him!).

The freedom that comes from sitting (side-saddle for me) on the back of a bike with the breeze in your hair is unparalleled in my humble opinion. It was one of my favourite things about working in communities in Kamwenge: at the end of a long day in the village, riding on the back of a friend’s boda-boda  along a dirt track, the sky hazy with the sun’s disappearing rays and the smoke from the evening cooking fires in the village, the hum of the boda not quite drowning out the birds evening calls.

I have tried being in the driver’s seat of the motorbike – a colleague in Kamwenge was giving me lessons for a while, and I managed a few rides around the place. But I didn’t enjoy all the concentration required to ride the bike myself.

So now, enter the new me, in Fort Portal. I am tired. We are starting up MH again. Motherhood is relentless (and rewarding and amazing and all of the good stuff that gets written about… ) There is rarely time to myself. There is a lot to process and much change happening in my life. And there are no grandparents here to look after my child for the day if I need a break.  I have always had a tough time knowing how to switch off my brain and adding motherhood to this mix has made for an interesting journey over the past year in Australia. Even more interesting now I am here.

But lately, it has become almost a daily ritual to go to town in the late afternoon, to buy food we need for dinner from the market while Michael stays at home with David. I normally catch a boda. And for the five minutes to and from the market that I am on that boda, there is nothing else to do. No child to be responsible for. No list to write or action. No need to concentrate on anything in particular.

So I look. I breathe. I listen. To what’s around me – trees and birds and people and the sun setting over the Rwenzori mountains. And to whats within me – my fears and prayers and reflections on what’s good.

And with that comes some clarity and a little pause from the pandemonium of life.

False quotes and failing health…

In light of all that has happened over the past few months, including the closure of the Maranatha Health clinic due to a factory being illegally put up next to our land, I have been following the Ugandan media with interest this week. Mostly, to track the articles that are being written about Maranatha. (By the way, I wrote this blog over 6 weeks ago but have only got around to posting it now!)

When I first moved to Uganda, I took an overly-keen interest in the newspapers, delving very deeply into the politics of this country.  Like many Ugandans, I became quite wrapped up in the politics of Uganda, the key players, the scandals, the economy, the issues. The average educated Ugandan’s interest in politics is a fascinating phenomenon that I’m still getting used to. After 25 years of my life lived in Australia, where most  young people who have finished high school can barely offer up the names of the PM and deputy, it is still bizarre to me that so many Ugandans know all the key ministers, their families, their business dealings, and scandals. In essence they are the Ugandan version of celebrities.

However, about 1 year in, and after reading about the millionth corruption investigation story, my interest in the media waned, especially since 99.9% of the time nothing was achieved by reporting the story. It made me a little too cynical, reading again and again of men being found ‘not guilty’ for crimes that have appeared to cost the country millions of dollars in tax payer funds. Although I would’ve loved to, I also didn’t feel (and still don’t) that I should share my thoughts publically about such issues considering the sensitive nature of my employment and status in this country. Furthermore, although the media is open, free and can report essentially whatever they want, I feel almost every story is fanatically event-based, rather than drawing Ugandans into a bigger-picture conversation on long term solutions to the issues facing the country.

Last week reminded me again of why I have tried to avoid getting too heavily invested in Ugandan politics and media. Keeping track of the headlines, two things have been highlighted to me:

Much journalism in this country (in my opinion) is amateur and opportunistic*. I was completely ignorant until a few weeks ago that when one needs to have a story written in this country (unless it is a national issue) one must PAY journalists to write it. Yep, you heard me correct. Over and above the wages that journalists receive from the newspaper, to have an investigation and story written about the issue in Kamwenge (or any issue for that matter, so I’ve been informed from Ugandan friends), we were expected to fork out money (per media outlet/journalist) for the mere privilege of their interest. Now let me get this straight. We do not pay them for a one sided account. After you fork out such ridiculous sums of money for mediocre reporting, they write what is purported to be a ‘balanced story’ (while others take your money and write nothing!). So far however, the quality of articles has been at best slightly inaccurate, at worst totally missing the point of the issue. Every single article written so far has described us as being from Austria (it really isn’t that hard to get the donor country correct, these journalists are degree holders for goodness sakes!); has dramatically misquoted or just plain made up ‘quotes’ we are purported to have said; and the one published the other day quoted a man in Kamwenge town – a maize dealer who is OF COURSE going to benefit and side with the factory – claiming that the residents don’t need or want the health centre, and can easily go to Fort Portal (70kms away) for treatment. Might a journalist point out or question the agenda behind his one sided view? Not in Uganda it seems! Moreover, most neglect to highlight or only vaguely mention, (1) the level of corruption and negligence of district officials which surely must have been present to put up a factory next to a health centre, and (2) the extremely poor quality of health services currently being offered in Kamwenge, that has been redeemed dramatically by the services at Maranatha, and do not currently exist elsewhere in the district.

The second thing that was sadly highlighted to me this week as I poured through the newspapers is, in a demonstration of ironic timing, a collection of articles lamenting the state of health and health services in this country. Of particular interest in the past week, I have read that new figures have shown the HIV rate is rising from 7.5 To 7.9% (the figure I suspect is much higher in Kamwenge); Family Planning levels in rural areas are decreasing; that child malnutrition rates are on the rise and now stand nationally at 35% (in Kamwenge they sit at around 60%); and maternal mortality is again on the rise, with the national figure now at 438/100,000 live births. Michael and I observe the practical realities of these stats everyday and they simply confirm what we are seeing in our own district. However, most alarming is the last statistic about maternal mortality rising. See, from my Masters, I have learnt a bit about health systems – their elements, different ways to strengthen them, schools of thought around this and also how to measure their capacity and effectiveness. One of the key ways to assess the efficiency and effectiveness of a health system is through maternal mortality statistics. Why?  Because maternal services rely on so many different aspects of the health system – things like the presence of primary health care services (ANC and delivery), staffing levels, transport mechanisms, referrals, emergency response, availability of drugs and equipment, and availability of tertiary/specialist care. All these services combine to ensure women do not die in pregnancy or labour (and so poetically, in countries like Australia, that maternal mortality barely exists). Basically what I am saying is that health services in Uganda, generally, are decreasing in quality, in turn producing these unfortunate statistical realities.

Which begs the question – why allow a health centre doing such a fantastic job fighting against these statistics, to be forced to shut by putting a factory next door? Why aren’t the district leadership – among others – viewing this as an issue of urgent and significant importance?

And, why oh why, didn’t the journalists of Uganda identify – and point out the link – between the broader problems of health in Uganda they were writing about this week, and the articles written about Maranatha Health, a much needed service subsidizing a broken health system.

Thus endeth my rant.

*As a disclaimer, I’m sure there are many fantastic journalists in Uganda – I may have lucked out! Also, there are many things that combine to make this a problem – including lack of support and good educational opportunities, corruption, and small salaries.

Is that a weevil in my bean, or am I just unhappy to eat this?!

I am a fairly resilient person. I am flexible. I can handle most things that come my way. But I really need good food.  It sounds lame and a little pretentious, but nothing is better therapy for me than a delicious meal, or a block of creamy chocolate. It was the thing I was most worried by, about coming to live in rural Uganda. Don’t get me wrong. There is wonderful, tropical fresh fruit and vegetables here. There are some pretty yummy snack type foods. There are PLENTY of carb options…but after a while the food can get a bit….well…same-ish.

Michael and I recently had the immense privilege of travelling to Italy for 10 days, to meet my parents for a holiday.

This was my first trip to Europe, and I absolutely, whole heartedly loved every bit of the experience. More than anything I loved the food. Well, maybe love is not the right word.

I devoured the food.

After so little access to food from my own culture and food with FLAVOUR, it was an incredible feast.

I ate my way across Rome.

A gelato every single day; the most light, soft gnocchi I had ever tasted; delicious local meats, cheeses, breads and pesto; luxurious panacotta’s; hearty homemade tomato sauces; scrumptious bakery food (for breakfast!!); and freshly brewed coffee whenever I felt so inclined…

All enjoyed in one of the most ambient, beautiful, historically rich cities on this earth. Sigh

I got fat.

And it was totally worth every last calorie. I thought it was an impressive effort, to put on the weight I did in the short 10 days I was there.

So did my staff. A few of them commented to both Michael and myself that we really ‘got fat’ while away, with the MH receptionist stating proudly (and loudly) that particularly my bum and hips had become much larger. There was lots of enthusiastic hand gestures to explain this. Meanwhile, I beamed with pride.

You know you have lived in Africa for too long when you don’t react with even the slightest indignation to such an observation, but receive and enjoy it for what it is – a grand compliment.

But the first day home in Kamwenge eating staff lunch was tough. Really tough.

Here’s some pictures to show you the difference between what I ate in Italy:

and what I eat for lunch at work:

Ugandan food: Matooke, Posho and Beans

As you can see, it’s really different.

For those of you who don’t know, matooke is basically THE food of Uganda – plantain banana steamed in banana leaves on a charcoal stove, then mashed and served with either red beans (Monday, Wednesday, Friday lunch) or g-nut sauce (Tuesday and Thursday lunch) or meat stew (once a month ‘cos meat is expensive!)

We always offer another staple with the matooke. Occasionally it is rice (yum!) but almost always it is posho – which is maize meal cooked with only water until it turns thick and hard, kind of a playdough-y texture. (I know you think I’m under-selling it but that is honestly what it is!)

The first day back home in Kamwenge – back to matooke and beans for staff lunch – was a little bit of a shock to the system. And my tastebuds.

Not only was it a shock, but it reminded me of why I had been so excited to NOT eat staff lunch for a few weeks. We had  purchased a 50kg bag of dry red beans from a farmer, about a month ago, who it turns out had sold us dud beans – full of weevils. They were everywhere, buried into the beans. We tried lots of local methods to get rid of them, and although these methods may have killed the majority, there was still one tiny but important issue remaining.

They were still in the beans.

Only now they were dead.

So we still have another few weeks at least to go of these weevil infested beans, which none of us at Maranatha are that happy about. And on my first day back home, I didn’t really feel like crunching down on little black dead insects in my food. Do I sound like a food snob?

I am.

So to keep us sane, Michael and I started a conversation about all the delicious food we could imagine eating, instead of the beans. We got into quite a lively debate about the best possible food dishes, so we decided that we were allowed to choose one dish from each country…

As this was unfolding, some other staff were listening curiously to our odd conversation (“laksa or rotti chanai?” “creamy gnocchi or a good Italian pizza?” “pho or cold rolls?” etc). It is times like this that I realise how much of my identity and world view has been influenced by the intense multiculturalism of urban Australia – especially when Uganda (although full of different tribes) is mostly Bantu in origin.

I turned to one staff member and invited her into the conversation by asking what her favourite food was. She looked confused. I explained, if she could have any food in the world, what would she choose as her favourite.

She thought for a moment and then enthusiastically replied:

“Posho and beans! I love posho and beans too much! I wish I could have them every day. Really, I don’t like Tuesdays and Thursdays, because I have to eat posho with gnut sauce.”