Friday, December 19, 2008

Day 3

12/19/08

We left the clinic yesterday at around 4:15pm. 14 people packed into the van and we dropped people off at different points in town (either one of the banks or the post office), and then came back to Anne’s house. Several people came over because Anne, who is the director of the center, has not been feeling well, and everyone wanted to offer any comfort they could. I sat with everyone here for a while. There was some chatting, several people asked about Maital and Adam, but there was plenty of what Americans would call “awkward silences” which didn’t seem awkward at all. I eventually passed out on my bed until dinner, which I ate with Anna the Swede, Rasmus the Danish/German, and his German friend Yen who is doing his civil service duty instead of going to the army by teaching computer classes to kids pulled off the streets in Uganda and put into a program. For dinner we had white rice and some sort of pea/cabbage/onion dish which we, of course, mixed together. I’m really starting to like the simple, to-the-point foods they have here that provide energy without providing obesity. It’s very refreshing actually. After dinner, at around 9pm, Rasmus, Yen and I walked to the Mount Elgon Hotel nextdoor which usually offers internet service and has a few bars. The internet was down (I swear, that was my true purpose in the trip) so we sat at the bar and watched British MTV, which is brutal. I order a “Club” beer and the Germans ordered 4 each. Rasmus and I finished the night with a shot of Bailey’s and then the Germans smoked the obligatory European cigarette before we left. We got back to Anne’s around 12:20am and I went straight to bed. It was strange to me not to shower but that is just the way it is here.
I woke up at 6:30am today and washed up (still no shower! The water is just too cold in the early morning). I then had a banana and tea for breakfast and decided that I was not going to go to the clinic today, but rather take a boda into town and find my way around, buy some bottled water, get to an internet cafĂ© and post this, and then prepare to go to the Abuyadayya Jewish community for Shabbat. So that is my plan for the day. I think Anna and I are going to plan a trip for sometime next week to go to Sipi Falls which is supposed to be the most beautiful waterfall in the country. The scenery just around town is incredible. It is like we are in this massive valley plain with mountains around us. And because of the dust and hot weather, the mountains are always covered in a fog of some sort, adding to their mystique. It is really quite breathtaking.Anyway, I wish everyone a great weekend, I’m sorry internet has been such a disaster here, and I hope to hear from you soon!

Day 2

12/18/08

I didn’t really sleep last night, a mix of the time difference and the animals making noise outside, as well as everyone in the house being awake at 5am to start their chores. I decided at 6:15am to organize my stuff, packing 1 suitcase with all the medical supplies and the other with my clothes, since I split them to begin with in case anything got lost. We lost power in the process but I used my flashlight and whatever sunlight there was. I left my room at 7:15am, said good morning to everyone, and washed up using bottled water for teeth-brushing. I dressed and sat down to breakfast, which was porridge, tea, bananas and eggs. There was bread available with some buttery spread and a fruit jam (both imported from Kenya), but I couldn’t have any because of my wheat allergy. I had plenty of porridge though, with lots of sugar.
At around 8:30 I went back to my room to take a nap before the driver picked me up at 10am to take me to the clinic. This is when I realized why everyone awoke so early. It was too hot to sleep at 8:30am. So I read a bit, wrote a bit, prepared for my day. I met another houseguest named Rasmus who is from Denmark/Germany. The driver came at 9:45am and I loaded my suitcase with the medical supplies and took my backpack with my laptop, notebook, and insect repellant. I put so much of that stuff on but I’m still itching everywhere that is exposed. The clinic was about 5 miles away; we went through town so it took about 15 minutes. The driver, John, was extraordinarily nice. He showed me the post office, the banks, and other destinations in town…well it’s mostly just the post office and banks. The drive from town to the clinic was gorgeous. The scenery is incredible, with mountains and trees of all different kinds. People were everywhere, walking, riding bicycles, driving boda-bodas. It’s hot but still comfortable because it’s so dry.
The clinic is more in need than even I expected. It is difficult to describe the situation without seeing it for oneself. They have “wards” which consist of 3 beds cramped into a room smaller than my own at school. There is a men’s ward, a women’s ward with 6 beds, a pediatric ward and an isolation ward with 2 beds. The maternity ward is in a separate structure (no, not a building, but a structure) and has a single delivery bed, a resting bed and room for the mother and child directly after birth, and then a ward of 3 beds for the next few days. There is a lab, which consists of a microscope and centrifuge. The autoclave is a tiny metal box which looks out of place but it seems to be able to do the job. The only things autoclaved are the single set of tools for deliveries and clothing (lab coats). There is a fridge, about 5 cubic feet, and a freezer, about 3 cubic feet. That is where vaccines and certain drugs are kept and they are administered on Tuesdays in the adjacent room. There is a single reception/examination room, a dispensary for drugs, and a drug stockroom. None of these rooms are larger than 100 square feet. There is a treatment room with 2 beds, where nurses administer drugs. Nurses aides are the gofers, bringing the doctors and nurses all the necessary equipment (or whatever they have that day) from the stockroom and monitoring patients.
I started my day, after a cursory tour, with the CO (clinical officer – the acting doctors in the clinic) Juliet seeing patients in the reception/examination room. Doctor Levert Wafula (also known as Dokta, Levy, or “Levaat”), the doctor with whom Maital and I coordinated this trip is home in Kenya until Saturday (and he took with him the internet…not sure what that means but I’m guessing its some sort of portable modem). So unfortunately I won’t meet him until Sunday and won’t have internet, in the clinic at least, until then. Anyway, there were 6 patients waiting for Juliet. The first patient had a brother who had ringworm; she was given a prescription for the first two weeks of a month-long drug to bring to him. The next patient spoke Lugandan so I didn’t understand anything but I think she had a cold. Oh, it is 12:35pm and the power just came back for the clinic. Next patient was pregnant and is considering an abortion. From what I understood, Juliet talked her out of the abortion and gave her directions to the main hospital’s maternity ward. The next patient was circumcised yesterday. He is 14 years old. The ritual circumcision here takes place on one month every two years, and all boys between the ages of 13-15 are circumcised in front of the community. If they flinch, they are not manly. This patient didn’t flinch. But from the looks of it, he should have. I won’t get graphic but it didn’t look good. The CO, Juliet, re-wrapped the penis in gauze and sent the boy on his way. They cannot dispense antibiotic cream as a preventative measure, not until there in an infection because of the scarcity of the medication. The next patient was a 1-month old baby with pneumonia and malaria. Enough said. The last patient we saw this morning was just a follow-up for a young child. Not sure what went on there. Ugandans speak very softly and it is hard to make out the words, even when in English, because of the accent and soft tone. After seeing the patients, Juliet and I went to the drug room to hang out and we watched WALL-E on my computer (thanks Yoni!) Every so often she is called out of the room and that is when I write this. So that’s where we are now. Today turns out to be a fast day so no lunch was made. So the driver came and offered to pick me up and take me home to eat and rest but I feel like there is more for me to do here today so I am going to stay until 4:30pm. Screw lunch. I’ll have a peanut butter nip instead (thank you Danielle). I will write again soon!

The first day

12/17/08

This is the longest blog; I promise they will get shorter but this is about my trip here so it has a lot of details. It is all exciting so take a few minutes and read it! (Judah, if you need to, read a little bit everyday instead of all of it at once. I understand.)
I have now been in Uganda for one day and it has already been a crazy adventure. I flew from New York to Amsterdam on KLM on Monday evening. The flight was delayed an hour and a half because of engine trouble and then being 21st in line for takeoff on the runway. I was seated next to a Dutch-speaking couple who slept the entire trip which was nice except that I was pumped for an adventure already, seeking friends about whom I could write and tell you stories. Luckily, after a 4 hour layover in Amsterdam (another delay due to fog), I was seated on the plane next to a Ugandan Reverend who was pursuing a PhD in theology at the Dallas Theological Seminary and acting as a missionary in Texas as well. He was one of the friendliest people I have ever met, and we spoke about Ugandan culture, the commonalities and differences in our upbringings, and, of course, about G-d. I slept a couple of hours on the flight to Entebbe, but also managed to watch one full movie and then most of another one until they decided to land the plane with about 5 minutes left of it. It must not have been so good though because I honestly, right now I could not tell you what movie it was.
The moment we landed in Entebbe, the most incredible gorgeous song erupted from somewhere behind me on the plane, 30 or so young, vibrant voices singing an African tune. The only words I could make out were “Welcome,” “Uganda,” and “Jesus.” Everyone clapped, smiled, laughed. The excitement of the Ugandans to reach home was contagious. We deboarded the plane by stairs onto the tarmac, and then walked into the airport customs area. I waited on line, bought a visa (US $50), and once again was treated to the most beautiful tunes sung by these 30 young children, now accompanied by dancing. I then picked up my luggage, which all luckily arrived, and made my way outside. I was approached by maybe 8 taxi drivers, selected one, and borrowed his phone to call the friend in Muyenga (I think that’s how its spelled) at who’s house I would be spending the night. She gave him directions and we were on our way to Kampala.
Now driving in Uganda is an adventure unto itself. The wheel is on the right, we drive on the left. The rules seem to be as follows. If you have no headlights, use your brights. If you only have one working bright, use it except when passing anyone else, because they’re working headlights will probably shine enough light for everyone. Also, drive as fast as possible, honk before you pass someone (on the right by swerving into oncoming traffic), and if someone is passing you, slow down so they can swerve back into your lane before being hit by a car driving in the opposite direction. It seems to work.
I arrived at Jen’s in Muyenga at about 11:30pm, and was treated to some wonderful South African mango juice and some water, as well as a steaming hot shower (couldn’t get the cold water to work) and wonderful company until around 2am. I was given my own room with a big bed wrapped in a mosquito net. I slept until midday (that’s what they call noon…thanks Jen!) and then went for a drive with Jen into town where I exchanged my money for Ugandan Schilling. With an exchange rate of 1960 USh to 1 USD, I quickly became a millionaire. With a large wad of cash, I returned to our driver, feeling like I was smuggling something, not letting my bag out of my hands.
We then drove to the main bus park which is a chaotic market of a place. I bought a ticket to Mbale (15,000 USh = ~$7.65) on a bus I thought I wanted, since they told me it was the Mount Elgon Flyer (it wasn’t), and gave someone 20,000 USh to buy me phone airtime. We loaded my bags onto the bus, and I got on at 2pm. Over the next hour, 30 or so people came onto the bus selling water, corn, chicken, chips, sneakers, scarves, shirts, soccer balls, and children’s toys. They would come to me and say “Muzunge, you want wada?” (white man, you want water). I bought 2 600mL bottle of water for 1000USh (= ~$0.51). I was squeezed between two Ugandan men, both very nice and talkative and they offered to help me determine where to get off. On the way out of the bus park, we hit 2 cars, and just kept on driving. We drove through Kampala a bit and then stopped for gas. We then drove a bit more and stopped for food. More people got on the bus and this time sold oven-roasted chicken and meat on a stick (similar to a kabob but everything looked more like the animal than like the meat). We took off again, this time pulling onto the right side of the road in order to avoid the traffic in the left lane. This led to our holding up of all traffic flowing in the opposite direction and we had to pull off onto the right side of the road and drive on the dirt for a mile or two. We finally were let back into the left lane and sat in traffic for about another hour. At some point we started driving fast again and for about 2 hours we drove uninterrupted.
We then were stopped at a police checkpoint. An officer came on, looked at every face in the crowd and then yelled at the bus driver in Lugandan. He pointed to the aisle which was piled high with random goods, and I think he was upset about that. As we pulled away from the checkpoint, we hit a car. Hard hit, nice whiplash, big loud BOOM. The cops looked our way, and then we just kept driving. We passed the Lugazi sugar cane farm, some livestock farms, and gorgeous landscapes of green hills and trees and mountains. It is the pearl of Africa after all.
I got off the bus in Mbale at around 8pm, but at a different place than where I had told my host I would be since I was on the wrong bus. So I called her when I got off and she sent someone to meet me where I was waiting. A muzunge with two big suitcases is an opportunity, and I was constantly approached by young boy after young boy asking me if they could help get me a special hire (taxi) or a boda-boda (motorcycle, comes from border-to-border, a route often taken by motorcycle back in the day). I kept responding “no, no, someone is meeting me.” They respectfully backed off and I finally met up with Joseph 20 minutes later at the clocktower in town. He gave me a big hug and with the biggest smile said “you are welcome.” I replied “thank you.” We hired two boda-boda’s, strapped my two suitcases to one (I wish I had been lucid enough to take a picture), and climbed onto the other. We followed to one with my luggage in order that we could tell him if the luggage was off-balance. After 3 days of travel with very little sleep, I was holding on for dear life. But we made it to Anne’s house (after some stops to rebalance the luggage and some off-roading where necessary), and the guards opened the gates and let us in. Everyone in the home (I don’t yet know who is family and who is not) came out to welcome me, with a double hug from Anne, hugs from the boys and handshakes from the girls. They all kept saying “you are welcome, you are welcome.” I kept responding “thank you, thank you.” I’m pretty sure they meant “Welcome, Welcome” but luckily “thank you” fits the bill as a response either way. There are 2 young girls named Fazira (Faz) and Mary, and there is Joseph who picked me up and Matthew. They also have a woman from Sweden named Anna who is doing her doctorate attachment (thesis) in econometrics (Dan, you’ve got a future here), focusing on developing economies. Anne, Anna and I sat down for dinner and I accidently took a drink too quickly. As soon as I put it down, and took off my hat to reveal my kippah, Anne said to me in a slow, precise English “I know Maital and Adam said grace differently than we do. How would you like to bless the food?” I apologized for drinking too quickly, embarrassingly mumbling that I had whispered a blessing of my own before downing the juice. I answered that I would love to see how they do it, and I would do my own way after. So Anne and Anna bowed their heads and opened their palms. Anne said a beautiful prayer thanking G-d for my safe arrival and for bringing her enough food to feed her guests who bring her such delight. We all answered amen and then helped ourselves to boiled potatoes, beans and onions of some sort, matoke which is steamed plantains (it is bland itself with the texture of slightly undercooked butternut squash but it is eaten mixed with some green and salt, making it substantial and absolutely delicious). The food was wonderful but I was afraid to eat too much after not having really eaten in 2 days. I took a shower after dinner (no hot water this time) and came to the conclusion that this just won’t be the cleanest 3 weeks of my life, a fact about which I am perfectly happy. As I learned on the bus, cleanliness and smell is not of utmost priority here, and it’s nice to change values for a small time. I was given a room with two beds, a mosquito net, and 1 outlet. I called my parents to tell them I was alive and lay in my bed, tucking the mosquito net under the mattress. I woke up at around 3:30am, wide awake and unable to sleep, so I read a bit and now I am writing to you. I hear the chickens and dogs outside welcoming in the morning (I can almost hear the chickens saying “you are welcome, you are welcome”). I hope I can sleep a bit more (it’s now 5:15am) before my day gets going, but I am excited to see the clinic and deliver all the supplies you have all sent with me. I will hopefully have internet soon in order to post this and I look forward to hearing back from you! Email me at jrothwax@gmail.com!!

Wednesday, November 19, 2008

The Beginning of an Adventure Lay in Its Preparation

Today is Thursday, November 20, 2008. I have received a total of six vaccination injections in the past week, consisting of influenza, hepatitis A, hepatitis B, polio, tetanus, and Japanese yellow fever. I have also begun the typhoid vaccine which involves remembering to take a pill every other day for a week (not the easiest thing for a 20-yr old male). I had a bit of a cold for a day after the flu shot, but it was nothing compared to what I experienced last night. I believe that the culprit is the weakened-yet-still-live yellow fever virus injected into my left bicep. Immediately after receiving the shot, a cracked knuckle felt like a guillotined finger lit on fire. That sensation has persisted to a degree but has fortunately improved since the really indescribable feeling I experienced immediately after receiving the shot. Again I was impressed by the power of the "weakened" virus when I awoke at 5:56 am to the feeling that every joint that was slightly achy the day before felt like an independent entity yearning to separate itself from the rest of my body. I popped two extra-strength (vanilla-coated) Tylenol and urged my brain back into a peaceful dream. The rest of the day only brought on sneezing and headaches.

But it is all worth it. The excitement has been the strongest analgesic and the trip is coming together with hints of unexpected opportunities that may present while I am there. I can't end this first post without mentioning Maital and her husband Adam who have likely done more work to make this happen than I have, and my parents for letting me talk them into allowing me to do this. Much thanks to you all. I leave December 15th and I will update the blog when the next opportunity arises. The next post will tell you a bit about the travel plans and what I plan to do while I am there, and the next after that will hopefully be written from Mbale, Uganda!!!

-jtr