Thursday, September 17, 2009
Wednesday, January 28, 2009
An Adventure That Never Ends...
01/27/09
Three Weeks Later
I struggled for a bit, deciding whether to write this last post as soon as I got back in an attempt to preserve the Ugandan “purity” of the blog or to wait. I decided to wait for one selfish reason. I felt that if I closed the book the moment I returned, then I would mentally view the trip forever as an isolated adventure that I was privileged to experience at one point in my life. I wanted to make sure it meshed with my life in the “real world,” which, even after a trip like this, I need to continually remind and convince myself lends millions of real people only mud huts and underfunded clinics. I needed to ensure that the “hungry kids in Africa” remained real in my mind, with voices and laughs and cries that I heard not in a video but while holding their hands and speaking, laughing, and crying with them. So I apologize for the delay and I hope I didn’t lose anyone, but that is why I waited.
As promised, I’ll tell you about how this whole adventure came to be. This past summer, my roommate and I decided we should go to Africa and see some true, simple, non-“computerized” medicine. We are both EMT’s and figured that we could probably even do a lot more there than would be allowed here. Make your own ethical judgments but, in all honesty, that is how it began. We had a small tie to Rwanda and looked into that for a bit, making some contacts and slowly planning the trip. It was not materializing quickly enough, however, and it was discouraging when we realized that we would most likely have to cover all the costs ourselves. We gave up completely around Rosh Hashana, mid-October, and I was pretty frustrated. I was in Teaneck for the weekend and went to visit some friends at Rutgers on Saturday night. (I’m telling you the details because it is unbelievable how it all came to be.) I had planned to just go to NYC on Sunday morning from Rutgers but I forgot something in Teaneck so I went back to an empty house on Saturday night. I woke up early, called a cab, but when I was told it would cost $15 to go to the bus station to catch a $3.40 bus, I decided I would walk. So, carrying my stuff, I began the two-mile walk. As luck would have it, it began to rain…hard. I got soaked but made it to the bus station. Unfortunately, every other bus turns down the street right before the bus station at which I waited and I watched the bus I wanted to board turn and drive away. Soaking wet, I waited for the next bus which came 25 minutes later. When I got on, I paid with my wet money and started walking toward the back of the bus when an older woman dropped her coat into the aisle in front of me. I bent down to pick it up and as I handed it to her, she slapped me across the face for touching her coat. Great. I said “you’re welcome” and continued toward the back of the bus. We obviously hit a lot of traffic on the way in and then I boarded a subway…in the wrong direction. I switched trains and finally got off at 116th St. I was hoping to get to friends at Columbia on 121st but, of course, I walked south until I saw the street sign at 111th St. I turned around and started walking the half-mile (it had stopped raining by now) to 121st. That is when I ran into Maital, who was on her phone accomplishing something (on a Sunday morning) which I have come to believe is normal for her. I waited until she finished her conversation and, having not seen one another in about 5 years, we quickly caught up. She had just returned from…Uganda! The whole trip sort of bloomed from there. She helped set everything up over the next couple of weeks and it all worked out! Weeks later, about a month before the trip, thinking of how that day played out is what convinced me to buy that ticket on KLM. It was hard to argue anything other than that I was “supposed” to go on this trip.
People have asked me how the trip was. The answer is…fantastic. Scary. Real. Absolutely eye-opening. I can’t yet say I learned too much because I think it was more like being accepted to some sort of educational program; the trip was just the tour and I decided I’d like to attend. Now I can begin to learn from it. One thing I about which I might have gained some knowledge, however, is meaning. I’m no expert, but from what I’ve experienced, I am pretty confident about this. I think that there are two ways for pieces of one’s life to acquire meaning. One way is to remove oneself from whatever it is that has meaning. The lack of electricity, toilets, food on-demand, family, friends, adequate medical care – these things all gained so much more significance when I didn’t have them. But that was the obvious and easy way to assign meaning to parts of my life. The more difficult but, by far, the more rewarding and “meaningful” way of infusing meaning into an aspect of one’s life is to throw oneself entirely into a challenge. I’ve heard versions of that advice before but until I was in the dry sun, riding the back of a bicycle from village to village, and then thinking about it all to a degree which made me unable to sleep at night and consequently staying up until 4am working on a grant, I had no idea what it meant. To envelop yourself completely with a goal, and even better, a goal that is beneficial for you and others, is absolutely the most rewarding, uplifting, and energetic feeling one can attain. The more drained I became each night there, the more energy I began with the next day. I definitely look forward to finding another experience into which I can bury myself and gain so much more (Rwanda anyone?) That’s the only advice I feel comfortable giving over to the public.
To wrap it all up, I want to say thank you. Writing this blog allowed me to experience this whole trip twice over, once in doing and once in telling. To those of you who read it, thank you. Your comments, questions and related (and unrelated) anecdotes have made this experience that much more special. But please, if you feel at all inspired, don’t just look for another experience to read about. Please, please…make your own. Throw yourself into it entirely and, I promise, you will never regret it.
-jtr
Feel free to email me at jrothwax@gmail.com. And lastly, to my parents, thank you.
Three Weeks Later
I struggled for a bit, deciding whether to write this last post as soon as I got back in an attempt to preserve the Ugandan “purity” of the blog or to wait. I decided to wait for one selfish reason. I felt that if I closed the book the moment I returned, then I would mentally view the trip forever as an isolated adventure that I was privileged to experience at one point in my life. I wanted to make sure it meshed with my life in the “real world,” which, even after a trip like this, I need to continually remind and convince myself lends millions of real people only mud huts and underfunded clinics. I needed to ensure that the “hungry kids in Africa” remained real in my mind, with voices and laughs and cries that I heard not in a video but while holding their hands and speaking, laughing, and crying with them. So I apologize for the delay and I hope I didn’t lose anyone, but that is why I waited.
As promised, I’ll tell you about how this whole adventure came to be. This past summer, my roommate and I decided we should go to Africa and see some true, simple, non-“computerized” medicine. We are both EMT’s and figured that we could probably even do a lot more there than would be allowed here. Make your own ethical judgments but, in all honesty, that is how it began. We had a small tie to Rwanda and looked into that for a bit, making some contacts and slowly planning the trip. It was not materializing quickly enough, however, and it was discouraging when we realized that we would most likely have to cover all the costs ourselves. We gave up completely around Rosh Hashana, mid-October, and I was pretty frustrated. I was in Teaneck for the weekend and went to visit some friends at Rutgers on Saturday night. (I’m telling you the details because it is unbelievable how it all came to be.) I had planned to just go to NYC on Sunday morning from Rutgers but I forgot something in Teaneck so I went back to an empty house on Saturday night. I woke up early, called a cab, but when I was told it would cost $15 to go to the bus station to catch a $3.40 bus, I decided I would walk. So, carrying my stuff, I began the two-mile walk. As luck would have it, it began to rain…hard. I got soaked but made it to the bus station. Unfortunately, every other bus turns down the street right before the bus station at which I waited and I watched the bus I wanted to board turn and drive away. Soaking wet, I waited for the next bus which came 25 minutes later. When I got on, I paid with my wet money and started walking toward the back of the bus when an older woman dropped her coat into the aisle in front of me. I bent down to pick it up and as I handed it to her, she slapped me across the face for touching her coat. Great. I said “you’re welcome” and continued toward the back of the bus. We obviously hit a lot of traffic on the way in and then I boarded a subway…in the wrong direction. I switched trains and finally got off at 116th St. I was hoping to get to friends at Columbia on 121st but, of course, I walked south until I saw the street sign at 111th St. I turned around and started walking the half-mile (it had stopped raining by now) to 121st. That is when I ran into Maital, who was on her phone accomplishing something (on a Sunday morning) which I have come to believe is normal for her. I waited until she finished her conversation and, having not seen one another in about 5 years, we quickly caught up. She had just returned from…Uganda! The whole trip sort of bloomed from there. She helped set everything up over the next couple of weeks and it all worked out! Weeks later, about a month before the trip, thinking of how that day played out is what convinced me to buy that ticket on KLM. It was hard to argue anything other than that I was “supposed” to go on this trip.
People have asked me how the trip was. The answer is…fantastic. Scary. Real. Absolutely eye-opening. I can’t yet say I learned too much because I think it was more like being accepted to some sort of educational program; the trip was just the tour and I decided I’d like to attend. Now I can begin to learn from it. One thing I about which I might have gained some knowledge, however, is meaning. I’m no expert, but from what I’ve experienced, I am pretty confident about this. I think that there are two ways for pieces of one’s life to acquire meaning. One way is to remove oneself from whatever it is that has meaning. The lack of electricity, toilets, food on-demand, family, friends, adequate medical care – these things all gained so much more significance when I didn’t have them. But that was the obvious and easy way to assign meaning to parts of my life. The more difficult but, by far, the more rewarding and “meaningful” way of infusing meaning into an aspect of one’s life is to throw oneself entirely into a challenge. I’ve heard versions of that advice before but until I was in the dry sun, riding the back of a bicycle from village to village, and then thinking about it all to a degree which made me unable to sleep at night and consequently staying up until 4am working on a grant, I had no idea what it meant. To envelop yourself completely with a goal, and even better, a goal that is beneficial for you and others, is absolutely the most rewarding, uplifting, and energetic feeling one can attain. The more drained I became each night there, the more energy I began with the next day. I definitely look forward to finding another experience into which I can bury myself and gain so much more (Rwanda anyone?) That’s the only advice I feel comfortable giving over to the public.
To wrap it all up, I want to say thank you. Writing this blog allowed me to experience this whole trip twice over, once in doing and once in telling. To those of you who read it, thank you. Your comments, questions and related (and unrelated) anecdotes have made this experience that much more special. But please, if you feel at all inspired, don’t just look for another experience to read about. Please, please…make your own. Throw yourself into it entirely and, I promise, you will never regret it.
-jtr
Feel free to email me at jrothwax@gmail.com. And lastly, to my parents, thank you.
Thursday, January 8, 2009
Tuesday, January 6, 2009
Day 20 - Beginning of the End...For Now
01/05/09
I got up at 6:45am this morning without an alarm. I hope my jetlag destroys that habit and I can sleep until noon again when I get back. I packed a bit more and had a banana and tea for breakfast. I then went to BCC with the most of the family in the van. On the way, we picked up a lot of the staff, a routine I missed over the holiday season, and dropped Grace and Matthew off at the bus station to catch a ride to Kampala. When we got to BCC, I went on rounds and then internet-ed for a bit. At around 11:30am, I was summoned to the heads-of-department meeting where each head said a personal thank you and Mama Anne gave a long speech about my working habits and being-a-guest habits. After they were all done, I asked if I could say a few words. I told them that as much as they might think they gained from me, they could ask anyone who has read my blog about how much I’ve gained from them. I promised them that my association with BCC was not over, that this was only the end of my introduction. After the meeting, I packed up, said goodbye to the staff, gave hugs and Ugandan handshakes (they’re cool, ask me to show you) and headed home with Mama Anne and Mary. Fazi had made me lunch – potatoes, peas, and avocados – and I ate and then finished packing. I fell asleep for a bit and then Mama Anne woke me at 2:55 when she came back home with the van. We loaded my things, I said goodbye to David, and we headed to the bus station. It’s a good thing we went early. The 5pm buss was nearly full at 3:05pm and I got one of the last seats. And it must have been a miracle that I made it to Mbale in the first place because now I was actually on the Elgon Flyer, the premium bus service, and I needed Mama Anne to save me a seat while Mary and John helped me load my luggage and I stood there helpless. After saying goodbye to everyone I took my seat and waited until the bus left at around 3:45pm, still way before the scheduled time. The ride was still chaotic but much more professional than the bus service to Mbale 3 weeks ago. We drove for 4 hours, crossing over the Nile at one point, passing the Lugazi sugarcane fields, passing through Jinja, all places I have become familiar with during my time here. We made the traditional stop in the middle of some field for people to get off and find a place to relieve themselves and get back on again. I was tempted to pass around my bottle of Purell but I no longer wanted to be the silly muzungu. Street merchants sold matoke and kabobs and chicken at every stop, bombarding the sides of the bus and sticking their merchandise through the half-open windows. But this time I smiled at all of these Ugandan quirks. I’m not yet one of them, nowhere near it, but I appreciate the practicality of their ways. The sun set as I was on the bus, and I watched the sky turn multiple bright colors as the sun seemed to drown in the Nile. I arrived in Kampala at 7:45pm, carried my luggage across the bus park to meet Jen, and came to her house. We dropped off my stuff at, now that it was 8:40pm, decided we were starving and needed dinner. We walked to an Indian restaurant down the street and ordered two vegan dishes, one spinach and corn bases, the other tomato based, as well as tomato chutney rice. One thing I’ve learned in Uganda is that you can mix anything into rice as long as it can be mushed and it will taste good. So we mixed the two dishes into the rice and enjoyed. I was lucky enough to bite into the hottest pepper imaginable and I cried for a couple of minutes. That’s what I get for ending my Ugandan trip with another type of food instead of a simple dish of matoke. We ordered a few beers, stayed a bit, and then came back to her place and now I’m writing this before I go to sleep for the last time in Uganda…for now. I will spend tomorrow roaming around Kampala with Joseph, Jen’s driver, then dinner and a ride to the airport. I will hopefully get a chance to make a detour to the old Entebbe airport to see the hijacked plane and one of the rescue planes that I’ve heard remain there on display. This will probably be the last post in Uganda but remember to check in for another week or so. See you soon!
I got up at 6:45am this morning without an alarm. I hope my jetlag destroys that habit and I can sleep until noon again when I get back. I packed a bit more and had a banana and tea for breakfast. I then went to BCC with the most of the family in the van. On the way, we picked up a lot of the staff, a routine I missed over the holiday season, and dropped Grace and Matthew off at the bus station to catch a ride to Kampala. When we got to BCC, I went on rounds and then internet-ed for a bit. At around 11:30am, I was summoned to the heads-of-department meeting where each head said a personal thank you and Mama Anne gave a long speech about my working habits and being-a-guest habits. After they were all done, I asked if I could say a few words. I told them that as much as they might think they gained from me, they could ask anyone who has read my blog about how much I’ve gained from them. I promised them that my association with BCC was not over, that this was only the end of my introduction. After the meeting, I packed up, said goodbye to the staff, gave hugs and Ugandan handshakes (they’re cool, ask me to show you) and headed home with Mama Anne and Mary. Fazi had made me lunch – potatoes, peas, and avocados – and I ate and then finished packing. I fell asleep for a bit and then Mama Anne woke me at 2:55 when she came back home with the van. We loaded my things, I said goodbye to David, and we headed to the bus station. It’s a good thing we went early. The 5pm buss was nearly full at 3:05pm and I got one of the last seats. And it must have been a miracle that I made it to Mbale in the first place because now I was actually on the Elgon Flyer, the premium bus service, and I needed Mama Anne to save me a seat while Mary and John helped me load my luggage and I stood there helpless. After saying goodbye to everyone I took my seat and waited until the bus left at around 3:45pm, still way before the scheduled time. The ride was still chaotic but much more professional than the bus service to Mbale 3 weeks ago. We drove for 4 hours, crossing over the Nile at one point, passing the Lugazi sugarcane fields, passing through Jinja, all places I have become familiar with during my time here. We made the traditional stop in the middle of some field for people to get off and find a place to relieve themselves and get back on again. I was tempted to pass around my bottle of Purell but I no longer wanted to be the silly muzungu. Street merchants sold matoke and kabobs and chicken at every stop, bombarding the sides of the bus and sticking their merchandise through the half-open windows. But this time I smiled at all of these Ugandan quirks. I’m not yet one of them, nowhere near it, but I appreciate the practicality of their ways. The sun set as I was on the bus, and I watched the sky turn multiple bright colors as the sun seemed to drown in the Nile. I arrived in Kampala at 7:45pm, carried my luggage across the bus park to meet Jen, and came to her house. We dropped off my stuff at, now that it was 8:40pm, decided we were starving and needed dinner. We walked to an Indian restaurant down the street and ordered two vegan dishes, one spinach and corn bases, the other tomato based, as well as tomato chutney rice. One thing I’ve learned in Uganda is that you can mix anything into rice as long as it can be mushed and it will taste good. So we mixed the two dishes into the rice and enjoyed. I was lucky enough to bite into the hottest pepper imaginable and I cried for a couple of minutes. That’s what I get for ending my Ugandan trip with another type of food instead of a simple dish of matoke. We ordered a few beers, stayed a bit, and then came back to her place and now I’m writing this before I go to sleep for the last time in Uganda…for now. I will spend tomorrow roaming around Kampala with Joseph, Jen’s driver, then dinner and a ride to the airport. I will hopefully get a chance to make a detour to the old Entebbe airport to see the hijacked plane and one of the rescue planes that I’ve heard remain there on display. This will probably be the last post in Uganda but remember to check in for another week or so. See you soon!
Day 19 - Last Full Day In Mbale
01/04/09
This morning brought a late start; I was up until 2am working on a grant. I got up around 7:45am, decided I had somehow become cleaner while I slept and no longer needed a shower, and had a slow breakfast – hot water with jinga and sugar as well as a banana. I walked over to the artist next door and spent an hour creating a website business plan for him and taking pictures of his work. This guy is beyond talented and dreams big which I like. I then took a boda bicycle into town, during which the driver thought it appropriate to serenade me with some beautiful African song. That was weird but nice and when I got into town I gave him an extra 200 UGX. I met up with a kid I met this weekend, a Jew who converted from Islam (like Norah, the rest of his family did not convert), in order to copy a music video he created onto my computer to send to some guy in the States that is going to help him publicize it. We sat on the side of the street, on the steps leading up to one of the banks, with my laptop on my lap and a bunch of people gathered behind us to watch. That took about 20 minutes and then I grabbed a boda motorcycle to BCC. It was 11:15am and everyone was still in church so I didn’t have too much work to do. Even when they got back, people didn’t want to give me a project to start since I’m leaving tomorrow so I left early and headed back to the house for lunch at around 2:15pm. I ate quickly – rice, cowpeas, and avocado – and then took a boda bicycle to Mbale Main Hospital to meet Julliet for a tour.
We started out in the casualty ward, or trauma ward, which smelled like urine and was constructed of chipping, drab concrete walls. I felt like I was standing in the tunnels under the tracks of the Metro-North Railroad, the ones with walls painted two colors, divided halfway down, in order to give the place some aura of maintenance. Patients were splayed onto the metal framed-worn mattress beds, some frames half broken and looking as if they would collapse any minute. Blood transfusions were being administered everywhere and there was not much else to see so we walked outside and headed to the surgical ward. Here, patients were kept before and after surgeries for monitoring. Male and female patients were kept on opposite sides of the ward, separated by 3 or 4 private rooms which can be attained for a high fee. Many of the beds had metal frames that extended a few feet above the bed surface, allowing for a rope to be tied from the top to a patient’s fractured limb. And I don’t mean a nice, machine-wound, nylon flat strap like you would see in the States. I mean a rope, handmade, worn and tearing. Patients of all ages lay on the beds which were placed less than a foot from one another. Their families stood crowded around them, mixing with the families of the patient next to them. There was really no semblance of privacy, as we would walk up to any patient and take their medical record from the edge of their bed (there was no plastic holder for it there, it just lay on the bed). There were fractures and tumors and deformities. One patient on the female side was an eight year-old girl with burns on about 40% of her body. A pot of boiling oil fell on her. The next few sentences are graphic so skip them if you’d like. The entire right side of her body, her arm, chest and abdomen were no longer covered in black skin. There were not even blisters. It almost appeared as if she had just been skinned and was left with a useless transparent membrane over her veins and organs. Her mother held her right hand high above the rest of her body in an attempt to keep the burned regions from irritating one another. The girl was shivering, as hot as the day was, because of the heat loss from her no-longer-capable-of-insulating skin. We then moved on to the HIV ward, in which 90% of the patients were HIV+ and the other 10% had some other autoimmune diseases. Again, patients ranged from very young to very old and many had some other infection as is common with HIV. 30% of the patients in this ward had tuberculosis (TB), which is also common among HIV patients in this area of the world. As we walked through this ward, a man and woman were preaching the Bible in English and one of the Ugandan dialects. The patients and their families were joining in, mumbling prayer and crying.
Then we moved onto the pediatric ward; even though the other wards have patients of all ages, the pediatric ward housed only children. There were two sides to the ward, A and B. Children were arranged in beds close together, some touching with the mothers lying across the crack. Ailments ranged from heart conditions to severe malaria, dehydration, malnutrition, and pneumonia. Most of the patients were referred to the hospital by a clinic that was no equipped to handle the case. From the pediatric ward we went to the maternity ward which was spacious and open. One building housed mothers pre- and post-pregnancy while another building was used for the actual deliveries. The delivery unit had approx. 12 beds separated by frosted-plastic curtains, the kind you see in the back of a butcher’s shop (not to say this was a butcher’s shop). The curtains were practical but morbid and I was uneasy my whole time in the unit. We spoke for a few minutes with the Ob-Gyn there and she told me about the 7 types of high-risk delivery which the unit was going to start handling next week – diabetic bothers, breech, premature deliveries, etc. From the maternity ward we went to the malnutrition ward, a place kept dark and quiet due to the heightened level of sensitivity of malnourished children. There were three buildings - one for the doctors and nurses, another for mild malnutrition, and the last for severe malnutrition. There was a fourth building which was used in extreme cases and as an overflow ward. Thank G-d, only two patients were in the malnutrition ward today. But even two was too many. The children were at least 1.5 yrs old and could not lift their heads on their own, they could not speak, had tubes and IV’s dripping into what seemed like every vessel in the body. I couldn’t help but notice that their teeth were the foremost part of their bodies, extending beyond any body part that should have been further forward. It was as if they didn’t even have enough flesh or fat to lower their lips over their teeth. Their eyes bulged and stayed focused on one point in space, as if they did not have the will to even move their eyes. Once again it was hard to walk away but we left the hospital from there and went to town. I got a ride back to the house, showered, and started packing. Dr. Wafula and his brother came for dinner and they, Anne, and I sat at the table while the rest of the family sat around the couch. Fazira made me rice pasta with sauce and everyone else had chicken. We had rice, peas, pumpkin soup (which was delicious), and passion fruit juice. After dinner, everyone stood around the couches and Dr. Wafula led a 15-minute long prayer thanking G-d for my visit and for the family and BCC’s good fortune in having volunteers who work so hard and wishing me a safe journey back home. They said the nicest things and I once again knew I had family in Uganda to whom I can return at any time. After the prayer and a song, I continued to pack, did some work, and went to sleep.
This morning brought a late start; I was up until 2am working on a grant. I got up around 7:45am, decided I had somehow become cleaner while I slept and no longer needed a shower, and had a slow breakfast – hot water with jinga and sugar as well as a banana. I walked over to the artist next door and spent an hour creating a website business plan for him and taking pictures of his work. This guy is beyond talented and dreams big which I like. I then took a boda bicycle into town, during which the driver thought it appropriate to serenade me with some beautiful African song. That was weird but nice and when I got into town I gave him an extra 200 UGX. I met up with a kid I met this weekend, a Jew who converted from Islam (like Norah, the rest of his family did not convert), in order to copy a music video he created onto my computer to send to some guy in the States that is going to help him publicize it. We sat on the side of the street, on the steps leading up to one of the banks, with my laptop on my lap and a bunch of people gathered behind us to watch. That took about 20 minutes and then I grabbed a boda motorcycle to BCC. It was 11:15am and everyone was still in church so I didn’t have too much work to do. Even when they got back, people didn’t want to give me a project to start since I’m leaving tomorrow so I left early and headed back to the house for lunch at around 2:15pm. I ate quickly – rice, cowpeas, and avocado – and then took a boda bicycle to Mbale Main Hospital to meet Julliet for a tour.
We started out in the casualty ward, or trauma ward, which smelled like urine and was constructed of chipping, drab concrete walls. I felt like I was standing in the tunnels under the tracks of the Metro-North Railroad, the ones with walls painted two colors, divided halfway down, in order to give the place some aura of maintenance. Patients were splayed onto the metal framed-worn mattress beds, some frames half broken and looking as if they would collapse any minute. Blood transfusions were being administered everywhere and there was not much else to see so we walked outside and headed to the surgical ward. Here, patients were kept before and after surgeries for monitoring. Male and female patients were kept on opposite sides of the ward, separated by 3 or 4 private rooms which can be attained for a high fee. Many of the beds had metal frames that extended a few feet above the bed surface, allowing for a rope to be tied from the top to a patient’s fractured limb. And I don’t mean a nice, machine-wound, nylon flat strap like you would see in the States. I mean a rope, handmade, worn and tearing. Patients of all ages lay on the beds which were placed less than a foot from one another. Their families stood crowded around them, mixing with the families of the patient next to them. There was really no semblance of privacy, as we would walk up to any patient and take their medical record from the edge of their bed (there was no plastic holder for it there, it just lay on the bed). There were fractures and tumors and deformities. One patient on the female side was an eight year-old girl with burns on about 40% of her body. A pot of boiling oil fell on her. The next few sentences are graphic so skip them if you’d like. The entire right side of her body, her arm, chest and abdomen were no longer covered in black skin. There were not even blisters. It almost appeared as if she had just been skinned and was left with a useless transparent membrane over her veins and organs. Her mother held her right hand high above the rest of her body in an attempt to keep the burned regions from irritating one another. The girl was shivering, as hot as the day was, because of the heat loss from her no-longer-capable-of-insulating skin. We then moved on to the HIV ward, in which 90% of the patients were HIV+ and the other 10% had some other autoimmune diseases. Again, patients ranged from very young to very old and many had some other infection as is common with HIV. 30% of the patients in this ward had tuberculosis (TB), which is also common among HIV patients in this area of the world. As we walked through this ward, a man and woman were preaching the Bible in English and one of the Ugandan dialects. The patients and their families were joining in, mumbling prayer and crying.
Then we moved onto the pediatric ward; even though the other wards have patients of all ages, the pediatric ward housed only children. There were two sides to the ward, A and B. Children were arranged in beds close together, some touching with the mothers lying across the crack. Ailments ranged from heart conditions to severe malaria, dehydration, malnutrition, and pneumonia. Most of the patients were referred to the hospital by a clinic that was no equipped to handle the case. From the pediatric ward we went to the maternity ward which was spacious and open. One building housed mothers pre- and post-pregnancy while another building was used for the actual deliveries. The delivery unit had approx. 12 beds separated by frosted-plastic curtains, the kind you see in the back of a butcher’s shop (not to say this was a butcher’s shop). The curtains were practical but morbid and I was uneasy my whole time in the unit. We spoke for a few minutes with the Ob-Gyn there and she told me about the 7 types of high-risk delivery which the unit was going to start handling next week – diabetic bothers, breech, premature deliveries, etc. From the maternity ward we went to the malnutrition ward, a place kept dark and quiet due to the heightened level of sensitivity of malnourished children. There were three buildings - one for the doctors and nurses, another for mild malnutrition, and the last for severe malnutrition. There was a fourth building which was used in extreme cases and as an overflow ward. Thank G-d, only two patients were in the malnutrition ward today. But even two was too many. The children were at least 1.5 yrs old and could not lift their heads on their own, they could not speak, had tubes and IV’s dripping into what seemed like every vessel in the body. I couldn’t help but notice that their teeth were the foremost part of their bodies, extending beyond any body part that should have been further forward. It was as if they didn’t even have enough flesh or fat to lower their lips over their teeth. Their eyes bulged and stayed focused on one point in space, as if they did not have the will to even move their eyes. Once again it was hard to walk away but we left the hospital from there and went to town. I got a ride back to the house, showered, and started packing. Dr. Wafula and his brother came for dinner and they, Anne, and I sat at the table while the rest of the family sat around the couch. Fazira made me rice pasta with sauce and everyone else had chicken. We had rice, peas, pumpkin soup (which was delicious), and passion fruit juice. After dinner, everyone stood around the couches and Dr. Wafula led a 15-minute long prayer thanking G-d for my visit and for the family and BCC’s good fortune in having volunteers who work so hard and wishing me a safe journey back home. They said the nicest things and I once again knew I had family in Uganda to whom I can return at any time. After the prayer and a song, I continued to pack, did some work, and went to sleep.
Saturday, January 3, 2009
Day 18
01/03/09
Sorry it has taken me a while to post. No internet available for a bit so there are three new posts today beginning with "Day 16" below.
Today was…different. I woke up at 7:30am, when the heat became too unbearable to sleep in, and read for a bit. Then I got dressed, had an egg and some fruit for breakfast and headed to the synagogue. The service was the usual but hot. I was given the first aliyah, being the only Levi for…hundreds of miles most likely. After the service, we returned to the guesthouse for lunch. Two American-Israelis from Tel Aviv joined us. The man, whose name I never got, was a doctor who taught at University of Michigan and University of Wisconsin after fighting in WWII. He has published over 65 papers in nuclear medicine and invented the test for Cushing’s disease twenty-something years ago. After lunch, we sat in on the Torah discussion for a bit and then the day started becoming different like I mentioned above. I took a walk with some friends to Semei Kakungulu’s grave. On the way, I realized how much of Nabugoya I had not yet seen. There was a huge leveled soccer field in the middle of the mountain slope, the Semei Kakungulu high school which consisted of multiple buildings (including, to my initial surprise and eventual disappointment, an ill-equipped science lab), and a dorm building for girls who would otherwise have to travel too far to school everyday. The grave of Kakungulu turned out to be more of a tomb than a grave. Kakungulu was the governor who rejected the New Testament and declared himself a Jew, and is considered by the Abayudaya to be their founder and first rabbi. His descendents live in the (relatively) massive home next to the tomb. In front of the tomb, which is marked by a huge stone extending the entire length of the body, are his three spears – one wooden with a single metal tip, one wooden with a double-headed tip, and a third which was all metal with just a cone-shaped head. The man was a warrior and spiritual leader, his family made up of Christians and self-declared Jews. Behind his tomb lay more graves, family members of both religious faiths. We walked back from the grave and the girl who guided us, Norah, told me a bit about her life. She is 17 and converted to Judaism when she was 12, because most of her friends were Jews and she wanted to share in their faith which she felt penetrated much more of their lives than Christianity did hers. Her father, a brick-layer, and her mother, a farmer, were still both Christian and, along with her siblings, did not plan on converting. I felt sorry for the girl but was extremely impressed by her courage and certainty at such a young age. Her intellect was mature way beyond her physical years which was apparent even with the language barrier between us which often makes it difficult to tell if someone is not so bright or just lacks any advanced English skills. As we neared the heart of the Jewish village, we bumped into basically the rest of the Jewish village who were walking down the mountain to a funeral. The nurse of the Jewish clinic is a Catholic (they also have a Muslim and Protestant on the Board), and her father was a well-respected community healthcare worker. He passed away yesterday morning and hundreds of people headed to the family’s property to attend the burial. We asked if it was okay to tag along, me thinking that, while this may not be the most usual Shabbat activity, I would likely never get another chance to attend a Catholic funeral, in African, with members of all religious faiths. So I went. The sun was brutal and I was sweating and dehydrated about halfway to the home. When we arrived, we found hundreds of people in bright colors, some women with their heads covered, men with kippot and the traditional Muslim head-covering. People wore suits and dresses, others wore rags. The body arrived from the cemetery in an ornate coffin lying in the back of a pickup truck. The immediate family sat around the coffin in the back of the truck. As they pulled up to the house, the family jumped out and men lifted the coffin from the truck, carrying it to the other side of the property as the crowd followed. As the coffin passed the children who were sitting outside the house, they began to wail, screaming in Lugisu. I let most of the crowd pass by me, and everyone began singing this somber tune in Lugisu. Again, though it was a sad and slow song with words I did not understand, the melody was moving and unnaturally perfect, with harmonies emitted from the natives that complemented each other with ease. A few more somber songs were sung and then a man, whom I’m guessing was the priest, spoke for a bit. At various times throughout the ceremony, old women wailed from behind me and family members in the front of the crowd broke into these horrid screams of agony and were lead away back into the house, fighting their guides and crying out. Suddenly the ceremony ended and everyone turned around, leaving me in the front of the crowd. I let a few people pass and then followed them off the property again before heading back to the Jewish village. The climb back up the mountain was once again brutal and I downed two Fantas when we got back. Then I napped for a few hours. When I woke up, I hung out with Isaac the manager for a few minutes and then went to the synagogue for the afternoon service. I was given the first aliyah again, same reason as last time. After the service, I spoke with the rabbi for a few minutes outside, possibly convincing him to visit Brandeis when he is in the States in April/May. After three stars were visible, we said maariv, the evening service, and then havdallah, the blessing signifying the separation between the Shabbat and the rest of the week. Another muzungu around had glowsticks for all the children and they had a good time with those. I returned to the guesthouse, said goodbye to everyone there, went to the rabbi’s house and watched some Israel news before saying goodbye to him and his family, and then took a boda motorcycle back to Anne’s house. I had not seen Anne since Monday when she left for Kampala and it was good to see her back home. Tomorrow I am meeting with the artist next door to take pictures of some of his work in order to possibly set up a website for him (which, if successful, I may partner in), and then meeting someone I met today who wants me to get some music of his to someone in Chicago, so I’ll copy his cd onto my computer and then email it from a US internet connection to whomever, and then head to BCC to work. It’s funny…I think I mentioned earlier that people here work to finish a certain amount of goals each day, rather than work a certain amount of time each day. Several people have asked me why I haven’t taken a day off besides for the trip to Sipi. I can’t understand why they are so surprised. I am here for 3 weeks and there is so damn much to be done, I spend some nights writing a grant until 4am. How can I stop working for a day? I don’t think I could ever forgive myself for not achieving the most I could during my short time here. But I’ve almost been…reprimanded for working too hard. In my mind, I’ve been pretty laid back work-wise here. Yet Anne told me, very kindly, that all the people at BCC have been telling her was how focused I was and how determined I am to get a job done. I know I take my work seriously and work hard but I recognized that this was my vacation and while I was exhausted most of the time, I don’t think it has been due to overworking. I’ve been enjoying myself immensely and everything I’ve seen has been fascinating and I feel rested and happy. Why should I take a day off? I guess the only answer is, once again…Welcome to Uganda. Shavua tov everyone, have a good week. I will be home soon! And if you’ve been following along, don’t stop for another week. After I get home, I plan to post one last blog – summing up the trip, the culture shock of returning to my world, and telling you about how this whole thing came together in the first place. Stay tuned for tomorrow!
Sorry it has taken me a while to post. No internet available for a bit so there are three new posts today beginning with "Day 16" below.
Today was…different. I woke up at 7:30am, when the heat became too unbearable to sleep in, and read for a bit. Then I got dressed, had an egg and some fruit for breakfast and headed to the synagogue. The service was the usual but hot. I was given the first aliyah, being the only Levi for…hundreds of miles most likely. After the service, we returned to the guesthouse for lunch. Two American-Israelis from Tel Aviv joined us. The man, whose name I never got, was a doctor who taught at University of Michigan and University of Wisconsin after fighting in WWII. He has published over 65 papers in nuclear medicine and invented the test for Cushing’s disease twenty-something years ago. After lunch, we sat in on the Torah discussion for a bit and then the day started becoming different like I mentioned above. I took a walk with some friends to Semei Kakungulu’s grave. On the way, I realized how much of Nabugoya I had not yet seen. There was a huge leveled soccer field in the middle of the mountain slope, the Semei Kakungulu high school which consisted of multiple buildings (including, to my initial surprise and eventual disappointment, an ill-equipped science lab), and a dorm building for girls who would otherwise have to travel too far to school everyday. The grave of Kakungulu turned out to be more of a tomb than a grave. Kakungulu was the governor who rejected the New Testament and declared himself a Jew, and is considered by the Abayudaya to be their founder and first rabbi. His descendents live in the (relatively) massive home next to the tomb. In front of the tomb, which is marked by a huge stone extending the entire length of the body, are his three spears – one wooden with a single metal tip, one wooden with a double-headed tip, and a third which was all metal with just a cone-shaped head. The man was a warrior and spiritual leader, his family made up of Christians and self-declared Jews. Behind his tomb lay more graves, family members of both religious faiths. We walked back from the grave and the girl who guided us, Norah, told me a bit about her life. She is 17 and converted to Judaism when she was 12, because most of her friends were Jews and she wanted to share in their faith which she felt penetrated much more of their lives than Christianity did hers. Her father, a brick-layer, and her mother, a farmer, were still both Christian and, along with her siblings, did not plan on converting. I felt sorry for the girl but was extremely impressed by her courage and certainty at such a young age. Her intellect was mature way beyond her physical years which was apparent even with the language barrier between us which often makes it difficult to tell if someone is not so bright or just lacks any advanced English skills. As we neared the heart of the Jewish village, we bumped into basically the rest of the Jewish village who were walking down the mountain to a funeral. The nurse of the Jewish clinic is a Catholic (they also have a Muslim and Protestant on the Board), and her father was a well-respected community healthcare worker. He passed away yesterday morning and hundreds of people headed to the family’s property to attend the burial. We asked if it was okay to tag along, me thinking that, while this may not be the most usual Shabbat activity, I would likely never get another chance to attend a Catholic funeral, in African, with members of all religious faiths. So I went. The sun was brutal and I was sweating and dehydrated about halfway to the home. When we arrived, we found hundreds of people in bright colors, some women with their heads covered, men with kippot and the traditional Muslim head-covering. People wore suits and dresses, others wore rags. The body arrived from the cemetery in an ornate coffin lying in the back of a pickup truck. The immediate family sat around the coffin in the back of the truck. As they pulled up to the house, the family jumped out and men lifted the coffin from the truck, carrying it to the other side of the property as the crowd followed. As the coffin passed the children who were sitting outside the house, they began to wail, screaming in Lugisu. I let most of the crowd pass by me, and everyone began singing this somber tune in Lugisu. Again, though it was a sad and slow song with words I did not understand, the melody was moving and unnaturally perfect, with harmonies emitted from the natives that complemented each other with ease. A few more somber songs were sung and then a man, whom I’m guessing was the priest, spoke for a bit. At various times throughout the ceremony, old women wailed from behind me and family members in the front of the crowd broke into these horrid screams of agony and were lead away back into the house, fighting their guides and crying out. Suddenly the ceremony ended and everyone turned around, leaving me in the front of the crowd. I let a few people pass and then followed them off the property again before heading back to the Jewish village. The climb back up the mountain was once again brutal and I downed two Fantas when we got back. Then I napped for a few hours. When I woke up, I hung out with Isaac the manager for a few minutes and then went to the synagogue for the afternoon service. I was given the first aliyah again, same reason as last time. After the service, I spoke with the rabbi for a few minutes outside, possibly convincing him to visit Brandeis when he is in the States in April/May. After three stars were visible, we said maariv, the evening service, and then havdallah, the blessing signifying the separation between the Shabbat and the rest of the week. Another muzungu around had glowsticks for all the children and they had a good time with those. I returned to the guesthouse, said goodbye to everyone there, went to the rabbi’s house and watched some Israel news before saying goodbye to him and his family, and then took a boda motorcycle back to Anne’s house. I had not seen Anne since Monday when she left for Kampala and it was good to see her back home. Tomorrow I am meeting with the artist next door to take pictures of some of his work in order to possibly set up a website for him (which, if successful, I may partner in), and then meeting someone I met today who wants me to get some music of his to someone in Chicago, so I’ll copy his cd onto my computer and then email it from a US internet connection to whomever, and then head to BCC to work. It’s funny…I think I mentioned earlier that people here work to finish a certain amount of goals each day, rather than work a certain amount of time each day. Several people have asked me why I haven’t taken a day off besides for the trip to Sipi. I can’t understand why they are so surprised. I am here for 3 weeks and there is so damn much to be done, I spend some nights writing a grant until 4am. How can I stop working for a day? I don’t think I could ever forgive myself for not achieving the most I could during my short time here. But I’ve almost been…reprimanded for working too hard. In my mind, I’ve been pretty laid back work-wise here. Yet Anne told me, very kindly, that all the people at BCC have been telling her was how focused I was and how determined I am to get a job done. I know I take my work seriously and work hard but I recognized that this was my vacation and while I was exhausted most of the time, I don’t think it has been due to overworking. I’ve been enjoying myself immensely and everything I’ve seen has been fascinating and I feel rested and happy. Why should I take a day off? I guess the only answer is, once again…Welcome to Uganda. Shavua tov everyone, have a good week. I will be home soon! And if you’ve been following along, don’t stop for another week. After I get home, I plan to post one last blog – summing up the trip, the culture shock of returning to my world, and telling you about how this whole thing came together in the first place. Stay tuned for tomorrow!
Day 17
01/02/09
This morning I didn’t have to do laundry. Thank G-d. I came to BCC early, wanting to make the most of my last few days. We went on rounds, saw the same types of cases, which I wish I wasn’t getting used to, and then went to the maternity ward where we found a woman who had miscarried. The doctors did some tests and determined that the miscarriage was incomplete so they gave her some drugs to finish it. I know the woman was sad but the emotions were very different here from what I would expect in the States. Maybe it was because it was more common here, or because they have more children, although I don’t think the latter would make it any easier. After feeling pretty crappy about that, I took inventory of the storage room with a clinic administrator named Judy. We went through everything in stock, from tablet-form drugs to injectables to creams to lab supplies. We recorded everything on the computer and at 1pm, we grabbed a quick lunch of…rice. Then, at around 2pm, I set off, with my heavy backpack again, to the village of Napulu with a woman who administers vaccinations at the clinic. Every Friday, another village is visited and mothers bring their children to get vaccinated. I carried the vaccines themselves in an insulated case on the back of a boda bicycle, and the nurse carried the syringes and alcohol. We came to Napulu and were brought two handmade wooden stools and a small wooden table. Little kids gathered to see the muzungu and I handed out an entire bag of orange sucking candies to the kids. When they finished the sucking candies, which often found their way out of their mouths, onto the dirt, and back into their mouths again, the children filled the wrappers with small stones and put them back in their mouths, pretending to have another sucking candy. It was sad and adorable and I wished I had brought more things for them. Then I took out my camera and took pictures of them which once again fascinated them. I don’t think that most of the children had ever seen what they look like before, not having mirrors or cameras at their disposal. So it was pretty amazing for them to see their images on a small screen, see what their smiles looked like for the first time. They were giggling for hours and, as much as I had to leave early to get to the Abayudaya, I couldn’t walk away. I sat there, recording each injection in a big register book, greeting each newcomer with Mulembe, cama ahoowa, grasila. They loved that I spoke their language and pushed me with more responses until I reached the limits of my Lugisu knowledge. We left Napulu at around 4:30pm, walking back to the road and raching it at about 5pm. I took a boda motorcycle to the house, ran inside and packed, ran back out to catch another boda motorcycle to Nabugoya. There were none near the house at that hour so I took a boda bicycle into town and caught a motorcycle from there. I got to Kakungulu hill around 6pm and took a shower and got ready for Shabbat. My friend Isaac, the manager, welcomed me with a big hello and there were 3 guests from Kampala – one Wisconsin girl volunteering in some small-business-building initiative, her sister, who is educating about AIDS in the Peace Corps. and stationed in Zambia, and an older woman from Riverdale who is volunteering for a few months with the American Jewish World Service (AJWS). We went to the synagogue together, and the Friday night service was as exciting as always. I wasn’t introduced to the community as a guest again and I felt like part of the family. I told the rabbi so after the service. Dinner was potatoes, rice, greens, veggies, and japati, the pita-like homemade bread. We talked and then got tired and I went to bed relatively early.
This morning I didn’t have to do laundry. Thank G-d. I came to BCC early, wanting to make the most of my last few days. We went on rounds, saw the same types of cases, which I wish I wasn’t getting used to, and then went to the maternity ward where we found a woman who had miscarried. The doctors did some tests and determined that the miscarriage was incomplete so they gave her some drugs to finish it. I know the woman was sad but the emotions were very different here from what I would expect in the States. Maybe it was because it was more common here, or because they have more children, although I don’t think the latter would make it any easier. After feeling pretty crappy about that, I took inventory of the storage room with a clinic administrator named Judy. We went through everything in stock, from tablet-form drugs to injectables to creams to lab supplies. We recorded everything on the computer and at 1pm, we grabbed a quick lunch of…rice. Then, at around 2pm, I set off, with my heavy backpack again, to the village of Napulu with a woman who administers vaccinations at the clinic. Every Friday, another village is visited and mothers bring their children to get vaccinated. I carried the vaccines themselves in an insulated case on the back of a boda bicycle, and the nurse carried the syringes and alcohol. We came to Napulu and were brought two handmade wooden stools and a small wooden table. Little kids gathered to see the muzungu and I handed out an entire bag of orange sucking candies to the kids. When they finished the sucking candies, which often found their way out of their mouths, onto the dirt, and back into their mouths again, the children filled the wrappers with small stones and put them back in their mouths, pretending to have another sucking candy. It was sad and adorable and I wished I had brought more things for them. Then I took out my camera and took pictures of them which once again fascinated them. I don’t think that most of the children had ever seen what they look like before, not having mirrors or cameras at their disposal. So it was pretty amazing for them to see their images on a small screen, see what their smiles looked like for the first time. They were giggling for hours and, as much as I had to leave early to get to the Abayudaya, I couldn’t walk away. I sat there, recording each injection in a big register book, greeting each newcomer with Mulembe, cama ahoowa, grasila. They loved that I spoke their language and pushed me with more responses until I reached the limits of my Lugisu knowledge. We left Napulu at around 4:30pm, walking back to the road and raching it at about 5pm. I took a boda motorcycle to the house, ran inside and packed, ran back out to catch another boda motorcycle to Nabugoya. There were none near the house at that hour so I took a boda bicycle into town and caught a motorcycle from there. I got to Kakungulu hill around 6pm and took a shower and got ready for Shabbat. My friend Isaac, the manager, welcomed me with a big hello and there were 3 guests from Kampala – one Wisconsin girl volunteering in some small-business-building initiative, her sister, who is educating about AIDS in the Peace Corps. and stationed in Zambia, and an older woman from Riverdale who is volunteering for a few months with the American Jewish World Service (AJWS). We went to the synagogue together, and the Friday night service was as exciting as always. I wasn’t introduced to the community as a guest again and I felt like part of the family. I told the rabbi so after the service. Dinner was potatoes, rice, greens, veggies, and japati, the pita-like homemade bread. We talked and then got tired and I went to bed relatively early.
Day 16 - The New Year
01/01/09
Today was fun. I got up early, did my last load of laundry, and then headed to town. Only one supermarket was open, and I bought a kilo of sugar and a kilo of flour. Then I headed to BCC, paying a good price because at this point, I think I give off the impression of a muzungo who knows his way. When I got to BCC, I discovered that most people had taken “leave” for the day but there were some nurses, nurse’s aides, and Dr. Wafula. We went on rounds, saw the usual innumerable cases of malaria, pneumonia, malnutrition, etc. At 1pm, Paul Toboti, Maital’s and Adam’s friend, picked me up from BCC to go to his house for a New Years meal. We walked to his village which must have been a mile+ away, in the beating sun, as I carried my multi-pound backpack thinking we were taking a boda. We arrived at his house which is a small mud/cement hut with a tin roof. I met his family, which included children of various ages ranging from mid-twenties to an infant. Paul told me that his parents died of AIDS so he and his siblings went to live with their uncle, who then died of AIDS, then to the next uncle, who died of AIDS. So the children were split to different homes but were still underfed and felt they belonged together. Paul lived with his grandmother who also died. When he was old enough and after many of the children were sponsored by generous donors, they arranged to build this small house so all the children, cousins, etc could live together. I’m not sure of the total number but in a 4 room hut, I met at least 7 people. This hut was in a village and the children came from old-school village culture, so the girls kneeled on the floor when they greeted me and ate on the floor in a different room. They served rice, matoke, and fish. I may have told a white lie to dismiss myself from eating the fish, something regarding a bad stomach and I felt terrible about it but I just couldn’t bring myself to eat the fish. And it was so much worse because they had meat for themselves for the celebratory meal but made fish for me because they knew I could not eat their meat. I felt so terrible every second but I felt it was the only way and better than gagging on the fish when force-feeding it to myself. Before we dug in, I was asked to say thanks to G-d. I’ve been asked before and politely declined but I already felt too guilty to say no. So now I had to figure out how to pull this off. As everyone closed their eyes and lowered their heads, the world seemed to go completely silent; there was not even a sound made by the goat or chickens outside. I hesitated for a few seconds and then said “Blessed are you , our G-d, King of the universe, who creates species of nourishment,” the exact translation of the hebrew blessing before eating grains like rice. Then, in keeping with the tradition of not making any interruption between blessing food and eating it, I made a perfunctory glance around the room, saw all eyes closed and heads down, and snuck a bite of rice into my mouth. I swallowed quickly and then continued with something they were more used to, something along the lines of “and thank you for providing us with this food and bringing us together on the beginning of this new year and bless these people who have taken me in and treated me like family, etc.” I don’t think anyone got wind of my Jew-move and I was pretty proud of pulling it off. They told me afterward that the blessing was beautiful.
I was given a fork to eat with but everyone else ate old-school style, removing food from the big plate with their right hands and delivering it straight into their mouths. I was honored as the American guest to have utensils but honestly, I wanted to be absorbed in the culture so I put down my fork and joined them, which they thought was pretty funny. Paul showed me pictures of his Ugandan family and his American family (Maital’s family, who came to visit when she and Adam were here). I had a great time and when I left, everyone over 17 y/o walked me to the road. Then Paul walked me down the road a bit until a boda motorcycle drove by, which I boarded (with a word from Paul to the driver about driving slowly and safely), and took to town. I went to the market which I had heard so much about and was slightly disappointed. The only other market I have seen has been the shuk in Israel, which is 100x better than this market. Now I understand that this is a town in a third-world country as opposed to a major city in a first-world country, but still I wanted a market. This was a number of old ladies sitting under umbrellas in the sun selling matoke, bananas, rice, etc. There were men calling to me “muzungu, muzungu! 500 Schilling!” I don’t even know what they were selling but I guarantee, if they said muzungu before it, than it was sold to Ugandans for a tenth of the price they were calling out to me. After the market I came home and passed out until dinnertime. I can’t remember what we ate, probably some variety of rice and beans and cabbage and greens. Now it is bedtime. Not sure when I will have internet next; the people I am with, who share the account with BCC, haven’t paid January internet yet so maybe I’ll get to the internet café sometime this weekend but I don’t want to waste any time with only a few days left! Goodnight!
Today was fun. I got up early, did my last load of laundry, and then headed to town. Only one supermarket was open, and I bought a kilo of sugar and a kilo of flour. Then I headed to BCC, paying a good price because at this point, I think I give off the impression of a muzungo who knows his way. When I got to BCC, I discovered that most people had taken “leave” for the day but there were some nurses, nurse’s aides, and Dr. Wafula. We went on rounds, saw the usual innumerable cases of malaria, pneumonia, malnutrition, etc. At 1pm, Paul Toboti, Maital’s and Adam’s friend, picked me up from BCC to go to his house for a New Years meal. We walked to his village which must have been a mile+ away, in the beating sun, as I carried my multi-pound backpack thinking we were taking a boda. We arrived at his house which is a small mud/cement hut with a tin roof. I met his family, which included children of various ages ranging from mid-twenties to an infant. Paul told me that his parents died of AIDS so he and his siblings went to live with their uncle, who then died of AIDS, then to the next uncle, who died of AIDS. So the children were split to different homes but were still underfed and felt they belonged together. Paul lived with his grandmother who also died. When he was old enough and after many of the children were sponsored by generous donors, they arranged to build this small house so all the children, cousins, etc could live together. I’m not sure of the total number but in a 4 room hut, I met at least 7 people. This hut was in a village and the children came from old-school village culture, so the girls kneeled on the floor when they greeted me and ate on the floor in a different room. They served rice, matoke, and fish. I may have told a white lie to dismiss myself from eating the fish, something regarding a bad stomach and I felt terrible about it but I just couldn’t bring myself to eat the fish. And it was so much worse because they had meat for themselves for the celebratory meal but made fish for me because they knew I could not eat their meat. I felt so terrible every second but I felt it was the only way and better than gagging on the fish when force-feeding it to myself. Before we dug in, I was asked to say thanks to G-d. I’ve been asked before and politely declined but I already felt too guilty to say no. So now I had to figure out how to pull this off. As everyone closed their eyes and lowered their heads, the world seemed to go completely silent; there was not even a sound made by the goat or chickens outside. I hesitated for a few seconds and then said “Blessed are you , our G-d, King of the universe, who creates species of nourishment,” the exact translation of the hebrew blessing before eating grains like rice. Then, in keeping with the tradition of not making any interruption between blessing food and eating it, I made a perfunctory glance around the room, saw all eyes closed and heads down, and snuck a bite of rice into my mouth. I swallowed quickly and then continued with something they were more used to, something along the lines of “and thank you for providing us with this food and bringing us together on the beginning of this new year and bless these people who have taken me in and treated me like family, etc.” I don’t think anyone got wind of my Jew-move and I was pretty proud of pulling it off. They told me afterward that the blessing was beautiful.
I was given a fork to eat with but everyone else ate old-school style, removing food from the big plate with their right hands and delivering it straight into their mouths. I was honored as the American guest to have utensils but honestly, I wanted to be absorbed in the culture so I put down my fork and joined them, which they thought was pretty funny. Paul showed me pictures of his Ugandan family and his American family (Maital’s family, who came to visit when she and Adam were here). I had a great time and when I left, everyone over 17 y/o walked me to the road. Then Paul walked me down the road a bit until a boda motorcycle drove by, which I boarded (with a word from Paul to the driver about driving slowly and safely), and took to town. I went to the market which I had heard so much about and was slightly disappointed. The only other market I have seen has been the shuk in Israel, which is 100x better than this market. Now I understand that this is a town in a third-world country as opposed to a major city in a first-world country, but still I wanted a market. This was a number of old ladies sitting under umbrellas in the sun selling matoke, bananas, rice, etc. There were men calling to me “muzungu, muzungu! 500 Schilling!” I don’t even know what they were selling but I guarantee, if they said muzungu before it, than it was sold to Ugandans for a tenth of the price they were calling out to me. After the market I came home and passed out until dinnertime. I can’t remember what we ate, probably some variety of rice and beans and cabbage and greens. Now it is bedtime. Not sure when I will have internet next; the people I am with, who share the account with BCC, haven’t paid January internet yet so maybe I’ll get to the internet café sometime this weekend but I don’t want to waste any time with only a few days left! Goodnight!
Wednesday, December 31, 2008
Day 15
12/31/08
I did laundry again this morning! I find that I do a better job if I do small amounts at a time so I think tomorrow morning’s washing should allow me to reach the end of my trip with “clean” clothing. I came to BCC at 8:30am, took a boda motorcycle from Anne’s house for only 3000 UGX. Usually I take a bicycle into town first for 300 UGX, then a motorcycle for 2500 UGX from town to BCC. I figured the extra 200 UGX was a worthwhile investment, and the driver was safe and talkative. Mom and dad, I know this won’t make you happy, but at some point in my life I will likely own a motorcycle. There is just this un-matched art involved with finding the perfect spot for your two aligned wheels, avoiding potholes and feeling fast a powerful when you ride a motorcycle that I think I will be too tempted to avoid for my whole life. We went on rounds when I got here and saw nothing which seemed too unusual to me at this point. Ah, just lost power. Computer is dying. I’ll finish later.
Sorry about that. Welcome to Uganda. So the ward was packed today, with three of the beds housing two people each. The extremely malnourished child is as sick today as he was yesterday but is being transferred (that means carried by his mother on the back of a motorcycle) to Mbale Main Hospital. Hopefully they can save his life there. It looks like he has a long road ahead of him in order to regain a healthy life. There were the numerous more patients with malaria, babies, adolescents, and adults. The woman with the jiggers seems a bit better but, now that she has more energy, she walking around outside naked scratching her body. The isolation ward, which was just being used as an overflow area today, smelled like urine, due to the lack of ventilation and the overcrowding of infant patients inside. After rounds, I went to the lab and observed a MPS malaria blood test. Thomas, the lab technician, has a manual centrifuge (I have a picture), a microscope, a few reagents, a sink, and a makeshift drying rack, constructed of two wooden planks on top of which lies a metal box with a light bulb inside. Place the slide under the light bulb, allow the air inside the box to heat up, and wait for the blood to dry. Desperate, ridiculous, but efficient. He showed me a positive and negative TB test; I saw the red-dyed bacilli sitting there in the patient’s blue-dyed sputum. This TB patient has + + + TB, with between 400-4,000 bacilli in at least 50 microscopic regions of sputum. The only worse condition is + + + +, which is much more difficult to treat, the victim having 4,000-40,000 bacilli in at least 20 microscopic regions of sputum. He showed me an HIV quick-test, a pregnancy test (not the disposable at-home ones here), and the rest of the 12 lab tests that they have the most primitive equipment to conduct here (urine pH, stool). Fascinating but frustrating at the same time. Then I did some work on the Assurance Scheme and grants, went on rounds again when Dr. Wafula arrived (stayed out of the isolation ward this time), and finally met Paul Tiboti, a good friend of Maital, who invited me to his home tomorrow afternoon for a new year’s celebration. I ate lunch with Julliet, something called posho, a mash of maize and water. Tasteless but the topping was meat and I just ate the dry grain plain. I confirmed my flight for next week and then left early because we lost power again and hadn’t gained it back, meaning all the work I was doing on the desktop computer at the clinic had to wait. So I took a boda home, Americanized (changed into shorts and a t-shirt), and took my computer to the resort hotel to work here. On my way (I walked!), I met an officer of the UWA, the Ugandan Wildlife Agency, who patrols the Mount Elgon National Park, the home of that gorgeous mountain I see everyday. He was excited to meet an American and we spoke for a while, somehow reaching the topic of circumcision. I got to whip out the word Yudaya to tell him I was Jewish which was on the exciting side. The internet was down at the resort so I sat by the pool for an hour, met some Swiss people, then walked back home. I took a nap (accidentally), had dinner which was rice, cabbage, beans, and homemade fries, and then watched a movie. New Year’s is more of a religious event than a party scene here so everyone goes to church. There are apparently candleworks (fireworks) over Mt. Elgon that are best seen from the back of the hotel next door so I might head over there around midnight with Matthew. Tomorrow morning I will probably head to the market to buy some food-gift for Paul and his family. Then work hard, as my time here is almost up! HAPPY NEW YEAR EVERYONE! Wish I could be home to celebrate!
I did laundry again this morning! I find that I do a better job if I do small amounts at a time so I think tomorrow morning’s washing should allow me to reach the end of my trip with “clean” clothing. I came to BCC at 8:30am, took a boda motorcycle from Anne’s house for only 3000 UGX. Usually I take a bicycle into town first for 300 UGX, then a motorcycle for 2500 UGX from town to BCC. I figured the extra 200 UGX was a worthwhile investment, and the driver was safe and talkative. Mom and dad, I know this won’t make you happy, but at some point in my life I will likely own a motorcycle. There is just this un-matched art involved with finding the perfect spot for your two aligned wheels, avoiding potholes and feeling fast a powerful when you ride a motorcycle that I think I will be too tempted to avoid for my whole life. We went on rounds when I got here and saw nothing which seemed too unusual to me at this point. Ah, just lost power. Computer is dying. I’ll finish later.
Sorry about that. Welcome to Uganda. So the ward was packed today, with three of the beds housing two people each. The extremely malnourished child is as sick today as he was yesterday but is being transferred (that means carried by his mother on the back of a motorcycle) to Mbale Main Hospital. Hopefully they can save his life there. It looks like he has a long road ahead of him in order to regain a healthy life. There were the numerous more patients with malaria, babies, adolescents, and adults. The woman with the jiggers seems a bit better but, now that she has more energy, she walking around outside naked scratching her body. The isolation ward, which was just being used as an overflow area today, smelled like urine, due to the lack of ventilation and the overcrowding of infant patients inside. After rounds, I went to the lab and observed a MPS malaria blood test. Thomas, the lab technician, has a manual centrifuge (I have a picture), a microscope, a few reagents, a sink, and a makeshift drying rack, constructed of two wooden planks on top of which lies a metal box with a light bulb inside. Place the slide under the light bulb, allow the air inside the box to heat up, and wait for the blood to dry. Desperate, ridiculous, but efficient. He showed me a positive and negative TB test; I saw the red-dyed bacilli sitting there in the patient’s blue-dyed sputum. This TB patient has + + + TB, with between 400-4,000 bacilli in at least 50 microscopic regions of sputum. The only worse condition is + + + +, which is much more difficult to treat, the victim having 4,000-40,000 bacilli in at least 20 microscopic regions of sputum. He showed me an HIV quick-test, a pregnancy test (not the disposable at-home ones here), and the rest of the 12 lab tests that they have the most primitive equipment to conduct here (urine pH, stool). Fascinating but frustrating at the same time. Then I did some work on the Assurance Scheme and grants, went on rounds again when Dr. Wafula arrived (stayed out of the isolation ward this time), and finally met Paul Tiboti, a good friend of Maital, who invited me to his home tomorrow afternoon for a new year’s celebration. I ate lunch with Julliet, something called posho, a mash of maize and water. Tasteless but the topping was meat and I just ate the dry grain plain. I confirmed my flight for next week and then left early because we lost power again and hadn’t gained it back, meaning all the work I was doing on the desktop computer at the clinic had to wait. So I took a boda home, Americanized (changed into shorts and a t-shirt), and took my computer to the resort hotel to work here. On my way (I walked!), I met an officer of the UWA, the Ugandan Wildlife Agency, who patrols the Mount Elgon National Park, the home of that gorgeous mountain I see everyday. He was excited to meet an American and we spoke for a while, somehow reaching the topic of circumcision. I got to whip out the word Yudaya to tell him I was Jewish which was on the exciting side. The internet was down at the resort so I sat by the pool for an hour, met some Swiss people, then walked back home. I took a nap (accidentally), had dinner which was rice, cabbage, beans, and homemade fries, and then watched a movie. New Year’s is more of a religious event than a party scene here so everyone goes to church. There are apparently candleworks (fireworks) over Mt. Elgon that are best seen from the back of the hotel next door so I might head over there around midnight with Matthew. Tomorrow morning I will probably head to the market to buy some food-gift for Paul and his family. Then work hard, as my time here is almost up! HAPPY NEW YEAR EVERYONE! Wish I could be home to celebrate!
Tuesday, December 30, 2008
Day 14
12/30/08
I was very productive today! I woke up at 6am and did my laundry. It was still a disaster but I think there is less soap left in my clothes than there was last time. I then shaved (first time in Africa! I was getting a beard tan-line) and showered and took my time with breakfast. I said goodbye to Anne who is heading to Kampala until Thursday. Then I took a bicycle boda into town and was passed by two vans of the muzungus from this weekend who were heading into town as well. They waved hi and I finally felt like a native, riding on the back of a bicycle while a van of privately-chauffeured muzungus passed by. I exchanged some money at the bank (rate was down to 1830 UGX per dollar) and then bought two DVDs to back up my photos. Then I turned down 3 boda motorcycles who wanted too much money (I told you I’m a native!) and finally agreed to 2500 UGX with one to take me to Bushikori. I got here at 9:30am and we went on rounds. The wards were packed, since people didn’t want to come in over Christmas and, as sick as they or their child were, waited until yesterday to seek help. Rounds were tough today. I saw at least 5 children under 2 years old who were severely malnourished (the best case being just half of the “safe” weight at that age) and this time I took pictures because it is something that will effect even the medically-unstimulated (that’s my term) at home. The children were born to mothers married to men with no jobs and several wives, and these women laughed at the mention of family-planning. They can’t afford to feed themselves, let alone 7 children. We moved from bed to bed, reviewing each patient and each of their situations seemed to be more desperate than the last. I was tempted to use the rest of the charity-money I brought to buy plumpy-nut, a mix of peanut butter, milk, butter, and sugar and what the WHO distributed to refugee camps around the world. But I realized that that just wouldn’t help these people. I would feed the child today and what about tomorrow. The helplessness I felt, standing there looking at a 14 mo/old baby with skin that looked like it belonged to a 70 y/o, was one I don’t really wish to ever experience again. The only way I was able to turn my back literally was to do it figuratively – to just accept that I can’t do anything and to approach the problems we could solve instead. Ladies and gentlemen, I introduce to you my most recent source of motivation to become a doc. I could go on for pages about how I wish I could do something about it, today. I’ve seen pictures before but the child was never sitting there in front of me, too weak to open his eyes and withering away by the minute. I became incredibly nauseous, not because of the medical aspects, but because of the socio-economic and cultural ones. These mothers couldn’t feed they’re babies. And that was just that for them. I felt angry and sorry at the same time.
There was one woman who was eaten by what they call “jiggers” here, scientifically known as Tungiasis penetrans. I took pictures of this too. Her skin was just eaten away in places, leaving pink patches all over her arms. The bottoms of her feet looked like slabs of wood with empty nail holes in them. The woman lives with her brother, a consequence of her children abandoning her because she drinks too much and becomes “slutty.” The rest of the patients had the “usual” illnesses – malaria, pneumonia, titis externia.
After rounds I went to watch the immunization program. Women brought their babies to one of the buildings here and one by one, the children were given an array of polio vaccine, DPT, BCG. The sat on the ground outside, babies naked and wrapped in a towel, in the same fashion with which they brought them on the back of a boda motorcycle. The women nursed the children to keep them calm as the nurses here filled out their vaccination forms and administered the immunizations. Babies were weighed by being hung in a sac from a grocery scale, the kind you see in the produce section in supermarkets in the States, which was hung from a wooden beam outside the vaccination building. One baby had albinism and at the young age just looked white, not yet expressing the red blotches and white hair. After watching this for a bit, I had lunch with Levert, rice and cabbage which was delicious, and then came back to the office and worked on the Assurance Scheme and grant a bit more. Jen came by to say hi on her way back from the Abayudaya, then went to hang out with Levert in town. At 4:45pm, I took a boda motorcycle to town with Linus, one of the administrators at Bushikori. On the way to town on Mbale-Tororo Rd., we had to pass through a big crowd of people spanning the road from end to end and extending about half of a mile ahead. It was some dancing, chanting crowd traditionally celebrating the end of the year. People were dancing, screaming. They seemed drunk but who knows. As we literally split the crowd open with our motorcycle, I heard the word muzungu more times than ever before. This time I really felt like a zoo animal as people reached out their hands to touch me. When I finally got to town, I grabbed a bar of Ugandan chocolate and bought some art. Then I took a boda motorcycle home. As we left town it started to rain, and I finally got to experience what it felt like to ride into falling water at 40mph or so. That ride was a bit scary, with the wheels of the motorcycle skidding in the wet sand, but I got home and had some dinner with Matthew – rice, peas, homemade salsa and mango. Now I’m finishing this up as we watch some cheesy English-dubbed Spanish soap opera. One week from now I’ll be sitting at the Entebbe airport waiting for my plane. Time flies. Stay tuned!
I was very productive today! I woke up at 6am and did my laundry. It was still a disaster but I think there is less soap left in my clothes than there was last time. I then shaved (first time in Africa! I was getting a beard tan-line) and showered and took my time with breakfast. I said goodbye to Anne who is heading to Kampala until Thursday. Then I took a bicycle boda into town and was passed by two vans of the muzungus from this weekend who were heading into town as well. They waved hi and I finally felt like a native, riding on the back of a bicycle while a van of privately-chauffeured muzungus passed by. I exchanged some money at the bank (rate was down to 1830 UGX per dollar) and then bought two DVDs to back up my photos. Then I turned down 3 boda motorcycles who wanted too much money (I told you I’m a native!) and finally agreed to 2500 UGX with one to take me to Bushikori. I got here at 9:30am and we went on rounds. The wards were packed, since people didn’t want to come in over Christmas and, as sick as they or their child were, waited until yesterday to seek help. Rounds were tough today. I saw at least 5 children under 2 years old who were severely malnourished (the best case being just half of the “safe” weight at that age) and this time I took pictures because it is something that will effect even the medically-unstimulated (that’s my term) at home. The children were born to mothers married to men with no jobs and several wives, and these women laughed at the mention of family-planning. They can’t afford to feed themselves, let alone 7 children. We moved from bed to bed, reviewing each patient and each of their situations seemed to be more desperate than the last. I was tempted to use the rest of the charity-money I brought to buy plumpy-nut, a mix of peanut butter, milk, butter, and sugar and what the WHO distributed to refugee camps around the world. But I realized that that just wouldn’t help these people. I would feed the child today and what about tomorrow. The helplessness I felt, standing there looking at a 14 mo/old baby with skin that looked like it belonged to a 70 y/o, was one I don’t really wish to ever experience again. The only way I was able to turn my back literally was to do it figuratively – to just accept that I can’t do anything and to approach the problems we could solve instead. Ladies and gentlemen, I introduce to you my most recent source of motivation to become a doc. I could go on for pages about how I wish I could do something about it, today. I’ve seen pictures before but the child was never sitting there in front of me, too weak to open his eyes and withering away by the minute. I became incredibly nauseous, not because of the medical aspects, but because of the socio-economic and cultural ones. These mothers couldn’t feed they’re babies. And that was just that for them. I felt angry and sorry at the same time.
There was one woman who was eaten by what they call “jiggers” here, scientifically known as Tungiasis penetrans. I took pictures of this too. Her skin was just eaten away in places, leaving pink patches all over her arms. The bottoms of her feet looked like slabs of wood with empty nail holes in them. The woman lives with her brother, a consequence of her children abandoning her because she drinks too much and becomes “slutty.” The rest of the patients had the “usual” illnesses – malaria, pneumonia, titis externia.
After rounds I went to watch the immunization program. Women brought their babies to one of the buildings here and one by one, the children were given an array of polio vaccine, DPT, BCG. The sat on the ground outside, babies naked and wrapped in a towel, in the same fashion with which they brought them on the back of a boda motorcycle. The women nursed the children to keep them calm as the nurses here filled out their vaccination forms and administered the immunizations. Babies were weighed by being hung in a sac from a grocery scale, the kind you see in the produce section in supermarkets in the States, which was hung from a wooden beam outside the vaccination building. One baby had albinism and at the young age just looked white, not yet expressing the red blotches and white hair. After watching this for a bit, I had lunch with Levert, rice and cabbage which was delicious, and then came back to the office and worked on the Assurance Scheme and grant a bit more. Jen came by to say hi on her way back from the Abayudaya, then went to hang out with Levert in town. At 4:45pm, I took a boda motorcycle to town with Linus, one of the administrators at Bushikori. On the way to town on Mbale-Tororo Rd., we had to pass through a big crowd of people spanning the road from end to end and extending about half of a mile ahead. It was some dancing, chanting crowd traditionally celebrating the end of the year. People were dancing, screaming. They seemed drunk but who knows. As we literally split the crowd open with our motorcycle, I heard the word muzungu more times than ever before. This time I really felt like a zoo animal as people reached out their hands to touch me. When I finally got to town, I grabbed a bar of Ugandan chocolate and bought some art. Then I took a boda motorcycle home. As we left town it started to rain, and I finally got to experience what it felt like to ride into falling water at 40mph or so. That ride was a bit scary, with the wheels of the motorcycle skidding in the wet sand, but I got home and had some dinner with Matthew – rice, peas, homemade salsa and mango. Now I’m finishing this up as we watch some cheesy English-dubbed Spanish soap opera. One week from now I’ll be sitting at the Entebbe airport waiting for my plane. Time flies. Stay tuned!
Monday, December 29, 2008
Day 13
12/29/08
Today was relatively uneventful. I came to the clinic at around 8:30am, and worked the whole day through. When Maital was here, she and the Dokta set up an Assurance Scheme, accounts in which patients could deposit money each month in order to ensure that they could pay for services when needed. In order to promote the program, I set up a bonus campaign with most of the money collected from the nicest people at Brandeis (and my parents, my favorite ones, of course). First of all, thank you to everyone who contributed; your money, which I promised would go directly toward saving lives, is doing just that, while at the same time teaching people money and family-health management. Job well done to you all. We offered a bonus of 3500 UGX to everyone enrolled in the program and actively contributing to their account, which seems like nothing (it is about $1.80), but when the monthly deposit requirement to remain active is 1000 UGX, or $0.50, this contribution is pretty damn significant. I think it will do a lot to make people more comfortable coming for care even if they fear they cannot afford it and encourage people to continue to participate in the program. We also set aside a certain amount to match the first monthly deposit of the next 100+ patients to enroll in the program. I drafted a letter that is being given to every participant, informing them of the good fortune you all brought upon them and encouraging them to urge their friends and family to enroll in the program. So once again, thank you all. I then took a ride back to town on the back of the Dokta’s motorcycle and now I’m at the internet café to post this. Unfortunately, for the last time, Happy Chanukah, and if the internet doesn’t work, Happy New Year. Keep emailing and commenting! Miss everyone and I will be on my journey back to the airport this time next week, with a day to kill in Kampala with Jen in between. Can't wait to come home; don't want to leave here. Sounds like life.
Today was relatively uneventful. I came to the clinic at around 8:30am, and worked the whole day through. When Maital was here, she and the Dokta set up an Assurance Scheme, accounts in which patients could deposit money each month in order to ensure that they could pay for services when needed. In order to promote the program, I set up a bonus campaign with most of the money collected from the nicest people at Brandeis (and my parents, my favorite ones, of course). First of all, thank you to everyone who contributed; your money, which I promised would go directly toward saving lives, is doing just that, while at the same time teaching people money and family-health management. Job well done to you all. We offered a bonus of 3500 UGX to everyone enrolled in the program and actively contributing to their account, which seems like nothing (it is about $1.80), but when the monthly deposit requirement to remain active is 1000 UGX, or $0.50, this contribution is pretty damn significant. I think it will do a lot to make people more comfortable coming for care even if they fear they cannot afford it and encourage people to continue to participate in the program. We also set aside a certain amount to match the first monthly deposit of the next 100+ patients to enroll in the program. I drafted a letter that is being given to every participant, informing them of the good fortune you all brought upon them and encouraging them to urge their friends and family to enroll in the program. So once again, thank you all. I then took a ride back to town on the back of the Dokta’s motorcycle and now I’m at the internet café to post this. Unfortunately, for the last time, Happy Chanukah, and if the internet doesn’t work, Happy New Year. Keep emailing and commenting! Miss everyone and I will be on my journey back to the airport this time next week, with a day to kill in Kampala with Jen in between. Can't wait to come home; don't want to leave here. Sounds like life.
Day 12
12/28/08
It is now noon on Monday. Yesterday was unreal. I woke up at around 7:30am, had a small breakfast consisting of a banana and tea. Then I caught a ride into town in the van with Anne and her family on their way to church. It was already 8:45am and the weddings were supposed to begin at 9am, so I quickly found a boda motorcycle and took a bumpy ride to Nabugoya Hill and the Abayudaya.
I arrived a couple of minutes after 9am and walked down to the guesthouse. I sat for a few minutes with the muzungus and then we all made our way to the grassy area right outside the synagogue. None of the brides nor any grooms had found their way to the place yet so, working on African/Jewish time again, we waited. Men who were related to the wedding parties were dressed in an array of occasion-clothing, from suits to sportcoats to business-casual wear. Guests wore regular every-day clothing. Women dressed in colorful dresses with pinched shoulders, apparently a “peacock-style” dress that is customarily worn as such joyous occasions. The women entered the synagogue making these sounds that I can only describe as…African. It is a high-pitched version of the sounds one makes when patting the opening of the mouth while screaming a solid note. But their hands were nowhere near their mouths; they were up in the air leading the way for the women’s spins and hops as they made their way toward the front of the synagogue. African and Abayudaya music was played on speakers and the scene that was forming as we took our seats in the synagogue at around 9:30am was an informal one, and I became excited for a loud, fun, African wedding.
At around 12:00pm the first couple made their appearance. Rabbi Gershom announced that they had arrived, which was unnecessary because it was obvious due to the sounds made by the women outside the synagogue who were awaiting their arrival. The man entered the synagogue first, surrounded by an entourage of people to the point where it was difficult to pick out the groom. Nobody wore matching colors or suits and everybody just stormed the scene to the point at which it was completely impossible for me to have any clue as to what was going on until one man was left standing under the chuppah…I tagged him as the groom. Then the woman entered in a black and white dress, her hair stylishly arranged. Several older women and even more younger ones danced her down the aisle, making those high-pitched la-la-la sounds the whole way down. They reached the chuppah and the entourage crowded the couple’s space right outside the chuppah. The couple faced the crowd, staring straight ahead without making eye contact with anyone and never revealing a smile. The rabbi said a blessing on a cup of wine and the groom drank a bit before bringing the cup to his bride’s mouth. The rabbi then handed the groom a ring and recited the words “Harei At Mekudeshet Li, B’Taba’at Zu, K’Hilchot Moshe V’Yisrael,” “Behold you become sanctified to me, by way of this ring, according to the laws of Moses and Israel.” The groom repeated the statement to his bride, and then the rabbi handed the her a ring and she performed the same ritual, changing the words that relate to a female to those which relate to a male. The women made their sounds once again and jumped up and down in excitement. Rabbi Gershom and the two visiting rabbis then recited the first six of the seven blessings made over another cup of wine. Before the last blessing, the bride and groom were wrapped in a tallit, a prayer shawl. At this point they faced eachother and looked into each other’s eyes until the end of the ceremony. The rabbi recited the final blessing and the crowd went wild. The music blasted through the synagogue and the bride and groom were danced out of the building and down to the guesthouse.
The rabbi then suggested that, in order to fit everyone and in hopes of a cooler setting, we move to the front of the guesthouse where three tents had been erected. The crowd made their way down, each person carrying their chair from the synagogue with them. Younger people carried two chairs, the elders carried none. When everyone had settled in under the tents, the next bride and groom were driven down the rocky path in a jeep. Another entourage (I can’t swear it was made up of different people…too many colors) came rushing down the hill surrounding the jeep, singing, dancing, and making that noise. This time, there was an equal amount of men as there were women. The bride a groom made their way to the chuppah, this couple smiling the entire way, and the rest of the wedding proceeded similarly to the first. The final wedding, not to take away from its significance, was a repeat, although it seemed to be the youngest couple with the most enthusiastic friends, unless it was just the point where everyone accepted how sweaty we were and didn’t care about soaking their clothes anymore. This time one of the visiting rabbis read the Ketubah, the marriage contract, to the crowd. Everyone – Jews, Muslims, and Christians present – went wild at the end. After the weddings, I went with Jen to Rabbi Gershom’s house and was fed a good big lunch (and then some) of rice and peas by Jen’s friend Rachel who I think was Rabbi Gershom’s niece although I may have gotten the relationship wrong. I hadn’t eaten since breakfast much earlier in the morning, and then spent the day in the some trying to sing with the crowd, and I was hungry. The doctor from Chicago, Dr. Feldman I believe, joined us. We ate and then I returned to the guesthouse and spoke with the Israeli’s for a bit.
Then the music festival began. The videos only attempt to do it justice and my words can’t even make a dent. Imagine a National Geographic special on African dancing, but with more clothing. The women stole the show, with groups from each Jewish village sharing two or three songs, the only instruments being their vocal chords, bodies, and two bongos. The performers ranged from single-digit ages to some women who must have been in their 50’s, and it seemed as if not a single limb of any individual was attached to any other limb of that individual. The videos are worth asking me for. To top it off, the last dance of the last group was crashed by three muzungus who will remain un-named until I get permission (some might say they made fools of themselves, which they did, but the crowd loved it!).
After the music festival, we attended the afternoon service, lit the candles for the last night of Chanukah, and sang some songs in the synagogue. This was mostly just muzungus and the rabbi’s family, and it was a nice way to say goodbye to the holiday. The Israeli’s, a dancing muzungu and I then caught a ride to town with a friend, and after stopping at their hotel to drop off their things, we went out for a few beers. I took a boda motorcycle home at around 11pm. A long but absolutely incredible day.
It is now noon on Monday. Yesterday was unreal. I woke up at around 7:30am, had a small breakfast consisting of a banana and tea. Then I caught a ride into town in the van with Anne and her family on their way to church. It was already 8:45am and the weddings were supposed to begin at 9am, so I quickly found a boda motorcycle and took a bumpy ride to Nabugoya Hill and the Abayudaya.
I arrived a couple of minutes after 9am and walked down to the guesthouse. I sat for a few minutes with the muzungus and then we all made our way to the grassy area right outside the synagogue. None of the brides nor any grooms had found their way to the place yet so, working on African/Jewish time again, we waited. Men who were related to the wedding parties were dressed in an array of occasion-clothing, from suits to sportcoats to business-casual wear. Guests wore regular every-day clothing. Women dressed in colorful dresses with pinched shoulders, apparently a “peacock-style” dress that is customarily worn as such joyous occasions. The women entered the synagogue making these sounds that I can only describe as…African. It is a high-pitched version of the sounds one makes when patting the opening of the mouth while screaming a solid note. But their hands were nowhere near their mouths; they were up in the air leading the way for the women’s spins and hops as they made their way toward the front of the synagogue. African and Abayudaya music was played on speakers and the scene that was forming as we took our seats in the synagogue at around 9:30am was an informal one, and I became excited for a loud, fun, African wedding.
At around 12:00pm the first couple made their appearance. Rabbi Gershom announced that they had arrived, which was unnecessary because it was obvious due to the sounds made by the women outside the synagogue who were awaiting their arrival. The man entered the synagogue first, surrounded by an entourage of people to the point where it was difficult to pick out the groom. Nobody wore matching colors or suits and everybody just stormed the scene to the point at which it was completely impossible for me to have any clue as to what was going on until one man was left standing under the chuppah…I tagged him as the groom. Then the woman entered in a black and white dress, her hair stylishly arranged. Several older women and even more younger ones danced her down the aisle, making those high-pitched la-la-la sounds the whole way down. They reached the chuppah and the entourage crowded the couple’s space right outside the chuppah. The couple faced the crowd, staring straight ahead without making eye contact with anyone and never revealing a smile. The rabbi said a blessing on a cup of wine and the groom drank a bit before bringing the cup to his bride’s mouth. The rabbi then handed the groom a ring and recited the words “Harei At Mekudeshet Li, B’Taba’at Zu, K’Hilchot Moshe V’Yisrael,” “Behold you become sanctified to me, by way of this ring, according to the laws of Moses and Israel.” The groom repeated the statement to his bride, and then the rabbi handed the her a ring and she performed the same ritual, changing the words that relate to a female to those which relate to a male. The women made their sounds once again and jumped up and down in excitement. Rabbi Gershom and the two visiting rabbis then recited the first six of the seven blessings made over another cup of wine. Before the last blessing, the bride and groom were wrapped in a tallit, a prayer shawl. At this point they faced eachother and looked into each other’s eyes until the end of the ceremony. The rabbi recited the final blessing and the crowd went wild. The music blasted through the synagogue and the bride and groom were danced out of the building and down to the guesthouse.
The rabbi then suggested that, in order to fit everyone and in hopes of a cooler setting, we move to the front of the guesthouse where three tents had been erected. The crowd made their way down, each person carrying their chair from the synagogue with them. Younger people carried two chairs, the elders carried none. When everyone had settled in under the tents, the next bride and groom were driven down the rocky path in a jeep. Another entourage (I can’t swear it was made up of different people…too many colors) came rushing down the hill surrounding the jeep, singing, dancing, and making that noise. This time, there was an equal amount of men as there were women. The bride a groom made their way to the chuppah, this couple smiling the entire way, and the rest of the wedding proceeded similarly to the first. The final wedding, not to take away from its significance, was a repeat, although it seemed to be the youngest couple with the most enthusiastic friends, unless it was just the point where everyone accepted how sweaty we were and didn’t care about soaking their clothes anymore. This time one of the visiting rabbis read the Ketubah, the marriage contract, to the crowd. Everyone – Jews, Muslims, and Christians present – went wild at the end. After the weddings, I went with Jen to Rabbi Gershom’s house and was fed a good big lunch (and then some) of rice and peas by Jen’s friend Rachel who I think was Rabbi Gershom’s niece although I may have gotten the relationship wrong. I hadn’t eaten since breakfast much earlier in the morning, and then spent the day in the some trying to sing with the crowd, and I was hungry. The doctor from Chicago, Dr. Feldman I believe, joined us. We ate and then I returned to the guesthouse and spoke with the Israeli’s for a bit.
Then the music festival began. The videos only attempt to do it justice and my words can’t even make a dent. Imagine a National Geographic special on African dancing, but with more clothing. The women stole the show, with groups from each Jewish village sharing two or three songs, the only instruments being their vocal chords, bodies, and two bongos. The performers ranged from single-digit ages to some women who must have been in their 50’s, and it seemed as if not a single limb of any individual was attached to any other limb of that individual. The videos are worth asking me for. To top it off, the last dance of the last group was crashed by three muzungus who will remain un-named until I get permission (some might say they made fools of themselves, which they did, but the crowd loved it!).
After the music festival, we attended the afternoon service, lit the candles for the last night of Chanukah, and sang some songs in the synagogue. This was mostly just muzungus and the rabbi’s family, and it was a nice way to say goodbye to the holiday. The Israeli’s, a dancing muzungu and I then caught a ride to town with a friend, and after stopping at their hotel to drop off their things, we went out for a few beers. I took a boda motorcycle home at around 11pm. A long but absolutely incredible day.
Sunday, December 28, 2008
Day 11
12/27/08
Shavua tov! It is now Saturday night and I am back at Anne’s. Anna is gone and it is a bit lonely being the only muzungu and Westerner. Shabbat was great in Nabugoya. Last night, I lit Chanukah candles with the Israelis in the guesthouse. We then walked to the synagogue where there were so many visitors that, for the first time ever, there were more muzungus in Nabugoya than Ugandans. The services were full of African/Jewish songs once again and all the first-time muzungus seemed to really enjoy it. There were two families from the West Coast there. One was backpacking with their children, all under the age of 13, for one year around the world. The other was doing a chesed project in Uganda and brought gifts for the Abayudaya. There were visitors form Kampala and Chicago as well and someone brought bottles of wine so we were able to make a proper Kiddush this time. After the service Friday night, we went back to the guesthouse and ate with all the muzungus. We had matoke, potatoes, greens, fish, and vegetables. The families sat together at the big table and the Israelis and I sat at a smaller table. I got some good Hebrew practice again and numerous visitors form the other table came to meet us throughout the meal. I thought my trip was pretty interesting but I always felt pretty lame when these guys told about their year-long backpacking adventures.
The other muzungus included a doctor from Chicago who is here for three weeks to help out in the Abayudaya clinic, an attorney from New York researching the international criminal courts, and a woman working with the coffee co-op here that is shared between the local Jews, Muslims, and Christians. Everyone had a different story about how they ended up here and it was exciting to hear others’ and share my own. After dinner I spoke for a few hours with the visiting rabbi who runs a nondenominational school in Phoenix. We shared some views and others differed but I really enjoyed the dialogue and his perspective on Jewish history. I went to sleep around 12:30am and slept well until 7:30am. I woke up, ate some fruit for breakfast with everyone else, and then headed to the synagogue for services at 9am. As I walked, I bumped into Jen, the woman at whose house I spent the night I landed in Uganda. She was visiting her Ugandan “family”, Rabbi Gershom’s family, whom she befriended in the States and whose impact on her life resulted in her relocation to Kampala, Uganda. The services were similar to last week’s, enjoyable and unique. The Torah was read by several different people and Rabbi Kleinberg led the Mussaf service. After the service, the community gathered for Kiddush outside the synagogue and I spoke more with Jen and was introduced to the doctor of the Abayudaya clinic, Dr. Samson. I then went to the guesthouse for lunch which I ate with Yisrael, Rabbi Kleinberg and Marc, who happens to be a professor of Jewish history in a university in CA. I mostly listened to Rabbi Kleinberg and Marc discuss the present situation of Jews in the world and was fascinated by how much I don’t know. I threw in a line here and there when I thought I had something valuable to add but I easily recognized that I was the least knowledgeable individual regarding the topic and I had much more to learn by listening than I had to add. After lunch I slept for a couple of hours, then returned to the lobby area to find the Israelis making guacamole. I shared some of that with them and we then began to sing zmirot, songs that are traditionally sung on Shabbat. We sang for about an hour, with various others joining us at times for one song, two songs, or more. The father of the backpacking family, Tzvi, joined us for a bit and it turns out his brother is some famous TV-personality in Israel. After singing, we returned to the synagogue for the evening service and havdallah, the blessing symbolizing the distinction between Shabbat and the rest of the week. The whole community gathered outside the synagogue and the blessing was recited, then Chanukah candles were lit. Chanukah songs of Abayudaya, Israeli, and American tradition were sung as everyone stood in a circle holding hands. I then returned to the guesthouse, lit candles for Chanukah with the Israelis, then said goodbye. I went to Rabbi Gershom’s house, spoke with Jen for a bit, loaded my pictures from the Torah dedication ceremony onto Rabbi Gershom’s computer, and took a boda home with a guy named Noah who is working for an NGO in Sudan. Tomorrow I will hopefully post this in town and then head to the Abayudaya again for three weddings and a music festival. Then I think the Israelis will come back to Mbale with me and I will spend tomorrow night with them before they leave the area on Monday. I hope everyone at home had a great weekend and happy Chanukah (only one day left!) Shavua tov!
Shavua tov! It is now Saturday night and I am back at Anne’s. Anna is gone and it is a bit lonely being the only muzungu and Westerner. Shabbat was great in Nabugoya. Last night, I lit Chanukah candles with the Israelis in the guesthouse. We then walked to the synagogue where there were so many visitors that, for the first time ever, there were more muzungus in Nabugoya than Ugandans. The services were full of African/Jewish songs once again and all the first-time muzungus seemed to really enjoy it. There were two families from the West Coast there. One was backpacking with their children, all under the age of 13, for one year around the world. The other was doing a chesed project in Uganda and brought gifts for the Abayudaya. There were visitors form Kampala and Chicago as well and someone brought bottles of wine so we were able to make a proper Kiddush this time. After the service Friday night, we went back to the guesthouse and ate with all the muzungus. We had matoke, potatoes, greens, fish, and vegetables. The families sat together at the big table and the Israelis and I sat at a smaller table. I got some good Hebrew practice again and numerous visitors form the other table came to meet us throughout the meal. I thought my trip was pretty interesting but I always felt pretty lame when these guys told about their year-long backpacking adventures.
The other muzungus included a doctor from Chicago who is here for three weeks to help out in the Abayudaya clinic, an attorney from New York researching the international criminal courts, and a woman working with the coffee co-op here that is shared between the local Jews, Muslims, and Christians. Everyone had a different story about how they ended up here and it was exciting to hear others’ and share my own. After dinner I spoke for a few hours with the visiting rabbi who runs a nondenominational school in Phoenix. We shared some views and others differed but I really enjoyed the dialogue and his perspective on Jewish history. I went to sleep around 12:30am and slept well until 7:30am. I woke up, ate some fruit for breakfast with everyone else, and then headed to the synagogue for services at 9am. As I walked, I bumped into Jen, the woman at whose house I spent the night I landed in Uganda. She was visiting her Ugandan “family”, Rabbi Gershom’s family, whom she befriended in the States and whose impact on her life resulted in her relocation to Kampala, Uganda. The services were similar to last week’s, enjoyable and unique. The Torah was read by several different people and Rabbi Kleinberg led the Mussaf service. After the service, the community gathered for Kiddush outside the synagogue and I spoke more with Jen and was introduced to the doctor of the Abayudaya clinic, Dr. Samson. I then went to the guesthouse for lunch which I ate with Yisrael, Rabbi Kleinberg and Marc, who happens to be a professor of Jewish history in a university in CA. I mostly listened to Rabbi Kleinberg and Marc discuss the present situation of Jews in the world and was fascinated by how much I don’t know. I threw in a line here and there when I thought I had something valuable to add but I easily recognized that I was the least knowledgeable individual regarding the topic and I had much more to learn by listening than I had to add. After lunch I slept for a couple of hours, then returned to the lobby area to find the Israelis making guacamole. I shared some of that with them and we then began to sing zmirot, songs that are traditionally sung on Shabbat. We sang for about an hour, with various others joining us at times for one song, two songs, or more. The father of the backpacking family, Tzvi, joined us for a bit and it turns out his brother is some famous TV-personality in Israel. After singing, we returned to the synagogue for the evening service and havdallah, the blessing symbolizing the distinction between Shabbat and the rest of the week. The whole community gathered outside the synagogue and the blessing was recited, then Chanukah candles were lit. Chanukah songs of Abayudaya, Israeli, and American tradition were sung as everyone stood in a circle holding hands. I then returned to the guesthouse, lit candles for Chanukah with the Israelis, then said goodbye. I went to Rabbi Gershom’s house, spoke with Jen for a bit, loaded my pictures from the Torah dedication ceremony onto Rabbi Gershom’s computer, and took a boda home with a guy named Noah who is working for an NGO in Sudan. Tomorrow I will hopefully post this in town and then head to the Abayudaya again for three weddings and a music festival. Then I think the Israelis will come back to Mbale with me and I will spend tomorrow night with them before they leave the area on Monday. I hope everyone at home had a great weekend and happy Chanukah (only one day left!) Shavua tov!
Day 10
12/26/08
This morning Anna and I went to the Abayudaya at around 8:45am. We shared a boda motorcycle and got there around 9:10. These Ugandans are unquestionably Jewish because the ceremony, which was scheduled to begin at 9am, didn’t start until 10:30am. But Anna got to meet a bunch of Jews and we spoke with Rabbi Darren Kleinberg, the rabbi from Phoenix who brought the Torah (or “Mateka” in Lugandan), for quite a bit before people began to gather. We also met two families from the west coast of the US. One is just doing some Africa traveling/safari, and another is backpacking for a year with their four children. I didn’t get to speak to them enough, but a room opened in the guesthouse so I will be returning this afternoon to spend Shabbat with them.
The ceremony was amazing. It began with Rabbi Gershom, his brothers and their sons, and Rabbi Kleinberg standing in a circle with some musical instruments, guitars, bongos, cymbals. The African/Jewish music erupted full-throttle from the start, and the obvious excitement and joy at receiving a new Torah was contagious. Sometime in the middle of the first song, I realized what was occurring in front of my eyes. I just took a mental step back and immediately got the chills. A village of African Jews, recently exposed to the Jewish world and more eager as a community than anything imaginable to embrace all aspects of Judaism, was taking on the responsibility of caring for and internalizing every word of this scroll. And I was a muzungu, with my camera out and unable to decide how to balance battery life, video, and stills. Scratch that; I was just another Jew, proud as hell to be here to experience this. After some songs outside, everyone moved inside the synagogue. Rabbi Gershom welcomed everyone and gave a brief overview of the ceremony’s proceedings. The new Torah was brought by Rabbi Kleinberg and one of the men who is here with his family, Marc, to the newly-built Beit Midrash, the building in which Judaic studies are taught and learned. I was given the honor of holding one of the four posts upon which was tied the chuppah, the canopy under which people are married and a Torah is traditionally received. The four Torahs that the community already had were carried out of the synagogue and met with the new Torah under the chuppah. Each Torah was touched to the new one, and the whole community along with plenty of muzungus sang and danced around it for a bit. The Torahs were then brought into the synagogue and several verses were read from the new one by Rabbi Gershom. I got a good amount of pictures and videos of the fascinating event. After the ceremony, Anna and I took a boda motorcycle back down the rocky mountain to town. We picked up some things at the supermarket and grabbed lunch at the Mount Elgon Hotel nextdoor to Anne’s house. We then came home and I decided I wanted to go back to the Abayudaya for Shabbat so I packed up, said goodbye to Anna who is leaving tomorrow for Dar-el-Salaam in Zanzibar, Tanzania for a holiday, and went to the clinic to work for a couple of hours. At 5pm, Dr. Wafula gave me a ride on his motorcycle to town where I got a boda motorcycle ride back to the Abayudaya at Semei Kakungulu. Luckily a room had opened up which I shared with an Israeli backpacker named Noa. Yisrael and Ohad, the Israelis who I met last weekend were also back and I felt quite at home.
This morning Anna and I went to the Abayudaya at around 8:45am. We shared a boda motorcycle and got there around 9:10. These Ugandans are unquestionably Jewish because the ceremony, which was scheduled to begin at 9am, didn’t start until 10:30am. But Anna got to meet a bunch of Jews and we spoke with Rabbi Darren Kleinberg, the rabbi from Phoenix who brought the Torah (or “Mateka” in Lugandan), for quite a bit before people began to gather. We also met two families from the west coast of the US. One is just doing some Africa traveling/safari, and another is backpacking for a year with their four children. I didn’t get to speak to them enough, but a room opened in the guesthouse so I will be returning this afternoon to spend Shabbat with them.
The ceremony was amazing. It began with Rabbi Gershom, his brothers and their sons, and Rabbi Kleinberg standing in a circle with some musical instruments, guitars, bongos, cymbals. The African/Jewish music erupted full-throttle from the start, and the obvious excitement and joy at receiving a new Torah was contagious. Sometime in the middle of the first song, I realized what was occurring in front of my eyes. I just took a mental step back and immediately got the chills. A village of African Jews, recently exposed to the Jewish world and more eager as a community than anything imaginable to embrace all aspects of Judaism, was taking on the responsibility of caring for and internalizing every word of this scroll. And I was a muzungu, with my camera out and unable to decide how to balance battery life, video, and stills. Scratch that; I was just another Jew, proud as hell to be here to experience this. After some songs outside, everyone moved inside the synagogue. Rabbi Gershom welcomed everyone and gave a brief overview of the ceremony’s proceedings. The new Torah was brought by Rabbi Kleinberg and one of the men who is here with his family, Marc, to the newly-built Beit Midrash, the building in which Judaic studies are taught and learned. I was given the honor of holding one of the four posts upon which was tied the chuppah, the canopy under which people are married and a Torah is traditionally received. The four Torahs that the community already had were carried out of the synagogue and met with the new Torah under the chuppah. Each Torah was touched to the new one, and the whole community along with plenty of muzungus sang and danced around it for a bit. The Torahs were then brought into the synagogue and several verses were read from the new one by Rabbi Gershom. I got a good amount of pictures and videos of the fascinating event. After the ceremony, Anna and I took a boda motorcycle back down the rocky mountain to town. We picked up some things at the supermarket and grabbed lunch at the Mount Elgon Hotel nextdoor to Anne’s house. We then came home and I decided I wanted to go back to the Abayudaya for Shabbat so I packed up, said goodbye to Anna who is leaving tomorrow for Dar-el-Salaam in Zanzibar, Tanzania for a holiday, and went to the clinic to work for a couple of hours. At 5pm, Dr. Wafula gave me a ride on his motorcycle to town where I got a boda motorcycle ride back to the Abayudaya at Semei Kakungulu. Luckily a room had opened up which I shared with an Israeli backpacker named Noa. Yisrael and Ohad, the Israelis who I met last weekend were also back and I felt quite at home.
Friday, December 26, 2008
Day 9
12/25/08
Today was Christmas here, and everyone slept a bit late and ate a big breakfast together. We had hard-boiled eggs, bananas, and hot water with jinga. Then we were driven to Bushikori; I went to the clinic and Anne and Anna went to church across the street. When I got to the clinic around 9am, they had already dealt with one boda motorcycle accident in which a boda carrying three people hit a pedestrian. The pedestrian died on the spot, the driver fled, and the two passengers were taken into our clinic. One received stitches for his wounds, the other had only superficial bruises. 15 minutes after I arrived, another boda accident victim came in. He was around 25 y/o, and fell while riding himself. He had a concussion and did not remember any of the accident. He had a dislocated hip and several abrasions along the right side of his body, on which he presumably skidded. He also needed a stitch to a laceration on this head. Yesterday while I was away, Bushikori had a patient with meningitis. They referred him to the hospital but he died last night. The lady with shingles came back even sicker than last time. It turns out she has had HIV for 3 years, took anti-retroviral medications for 1 year and 3 months (I’m pretty sure they need to be taken indefinitely) and then stopped because she was preached to and told that G-d will save her and she didn’t need any extra help. She then developed TB around 6 months ago and once again, started the meds and then stopped them prematurely. Now she is so sick that she will most likely die from infections of any open blisters from the shingles.
Another recurring theme here is the failure of patients to take prescribed medications as indicated by their doctor. Rather, they stop when they feel better and consequently, their disease builds a resistance toward the treatment and it becomes ineffective both to them and anyone they infect. I think the problem is most likely due to the inability of doctors to remain in contact with patients who often live in isolated villages without electricity, and to initial miscommunication between doctor and patient because of the numerous dialects here of which everyone assumes everyone understands perfectly.
The weather today was very strange. It heavily rained for about 45 minutes, not a hint of blue in the sky. And then suddenly it stopped and you couldn’t find a single cloud. The sun didn’t feel as strong and it was much cooler the rest of the day which was very, very welcome.
I began writing a grant proposal for Bushikori today in order to build a new building for the clinic. A British/American team of engineers and engineering students came a few months ago and drew up plans for the expansion. Now the funds are the only thing holding them back. The new clinic will have wards with higher capacities, a surgery theatre, two more laboratories, and sleeping areas for the staff who remain overnight with the patients. It should be really helpful both for Bushikori and for the people they help. I hope I can turn out a good proposal.
After church ended, I came home with Anne and Anna to a big lunch cooked by the girls of the house, Grace, Mary, and Fazi. We had matoke, peas, potatoes, rice pasta for me, avocados (they are amazing here), and freshly-squeezed mango/passion fruit juice. I’m really growing fond of the types of foods served at meals here and I hope I can bring some of the style back to the States.
After lunch Grace, Matthew and I watched WALL-E on my computer…they had never seen a fully animated movie before and I think they really liked it. I then napped for a bit, had tea with Anne (now becoming “Mama Anne”) and then dinner with Matthew, just leftovers from lunch. Then Matthew and I went to the hotel nearby to play some minigolf. It’s now 10:00pm and I am more than ready for bed. Tomorrow morning Anna and I are going to the Jewish village as they receive a new Torah. Another fun boda ride through the hills. Then off to the clinic until Shabbat which I will spend at Anne’s since the guest-house at the Abayudaya is full with visitors! That’s all for tonight. Thanks to everyone who has written comments and emails. I’m sorry if I don’t get back to you right away or even after a few but I promise I read them all! Internet is just slow and timed so it’s difficult to respond. So please keep writing…it’s always nice to hear from home. Miss everyone and I will be home in less than 2 weeks! Goodnight and Chanukah Sameach!
Today was Christmas here, and everyone slept a bit late and ate a big breakfast together. We had hard-boiled eggs, bananas, and hot water with jinga. Then we were driven to Bushikori; I went to the clinic and Anne and Anna went to church across the street. When I got to the clinic around 9am, they had already dealt with one boda motorcycle accident in which a boda carrying three people hit a pedestrian. The pedestrian died on the spot, the driver fled, and the two passengers were taken into our clinic. One received stitches for his wounds, the other had only superficial bruises. 15 minutes after I arrived, another boda accident victim came in. He was around 25 y/o, and fell while riding himself. He had a concussion and did not remember any of the accident. He had a dislocated hip and several abrasions along the right side of his body, on which he presumably skidded. He also needed a stitch to a laceration on this head. Yesterday while I was away, Bushikori had a patient with meningitis. They referred him to the hospital but he died last night. The lady with shingles came back even sicker than last time. It turns out she has had HIV for 3 years, took anti-retroviral medications for 1 year and 3 months (I’m pretty sure they need to be taken indefinitely) and then stopped because she was preached to and told that G-d will save her and she didn’t need any extra help. She then developed TB around 6 months ago and once again, started the meds and then stopped them prematurely. Now she is so sick that she will most likely die from infections of any open blisters from the shingles.
Another recurring theme here is the failure of patients to take prescribed medications as indicated by their doctor. Rather, they stop when they feel better and consequently, their disease builds a resistance toward the treatment and it becomes ineffective both to them and anyone they infect. I think the problem is most likely due to the inability of doctors to remain in contact with patients who often live in isolated villages without electricity, and to initial miscommunication between doctor and patient because of the numerous dialects here of which everyone assumes everyone understands perfectly.
The weather today was very strange. It heavily rained for about 45 minutes, not a hint of blue in the sky. And then suddenly it stopped and you couldn’t find a single cloud. The sun didn’t feel as strong and it was much cooler the rest of the day which was very, very welcome.
I began writing a grant proposal for Bushikori today in order to build a new building for the clinic. A British/American team of engineers and engineering students came a few months ago and drew up plans for the expansion. Now the funds are the only thing holding them back. The new clinic will have wards with higher capacities, a surgery theatre, two more laboratories, and sleeping areas for the staff who remain overnight with the patients. It should be really helpful both for Bushikori and for the people they help. I hope I can turn out a good proposal.
After church ended, I came home with Anne and Anna to a big lunch cooked by the girls of the house, Grace, Mary, and Fazi. We had matoke, peas, potatoes, rice pasta for me, avocados (they are amazing here), and freshly-squeezed mango/passion fruit juice. I’m really growing fond of the types of foods served at meals here and I hope I can bring some of the style back to the States.
After lunch Grace, Matthew and I watched WALL-E on my computer…they had never seen a fully animated movie before and I think they really liked it. I then napped for a bit, had tea with Anne (now becoming “Mama Anne”) and then dinner with Matthew, just leftovers from lunch. Then Matthew and I went to the hotel nearby to play some minigolf. It’s now 10:00pm and I am more than ready for bed. Tomorrow morning Anna and I are going to the Jewish village as they receive a new Torah. Another fun boda ride through the hills. Then off to the clinic until Shabbat which I will spend at Anne’s since the guest-house at the Abayudaya is full with visitors! That’s all for tonight. Thanks to everyone who has written comments and emails. I’m sorry if I don’t get back to you right away or even after a few but I promise I read them all! Internet is just slow and timed so it’s difficult to respond. So please keep writing…it’s always nice to hear from home. Miss everyone and I will be home in less than 2 weeks! Goodnight and Chanukah Sameach!
Wednesday, December 24, 2008
Day 8 - Vacation
12/24/08
Today was my vacation. So I woke up half an hour late, at 7, and re-hung all of my clothing outside. Then I prepared for a hike, packing 3 liters of water, a camera, and suntan lotion. We got a ride into town from the BCC driver to pick up some last-minute things. Then we walked around town until someone driving a van yelled to us “Sipi Falls.” That is how it works here. If you are muzungu in Mbale and you look lost, you’re probably looking for a ride to Sipi. We got on the van, the first two in which is both good and bad – good because you get to choose your seats and bad because they don’t leave until the van is full…and then some. In the 8-seater, we left and hour later when we had 15 people inside. The drive to Sipi was a bit less than an hour but we were dropped off 2 km from where we wanted since we didn’t know any better. Sipi is in the mountains so the 2km walk was up- and downhill. We arrived at Sipi River Lodge at around 11am, an hour and a half later than Anna told the guide yesterday. No problem here, everyone is too laid back to care really. So we ordered banana-pineapple-mango smoothies and then headed out with our Ugandan guide, Tony. We went to 3 waterfalls, a full hike of about 3.5 hours. The first one was difficult for the American (me) but everyone else did it easily. I stepped in a massive mudpit and my left foot was covered the rest of the hike. It was beautiful and it was a nice day but I need to say, the hikes in Israel are far better in my opinion. We grabbed lunch back at the lodge when we returned around 2:30, then set out to find a taxi ride back to Mbale. Some van full of phone salespeople picked us up (it was a bit like hitchhiking but they asked for money at the end), and took us and 18 other people back to Mbale in the 14-seater. Being the only two muzungus in the van with many other much-too-friendly Ugandans, Anna decided to tell them we were married. She claims that 4 people asked for her number so her “only way out” was to tell them that I was her husband. I think a simple “no” would have sufficed but…We were dropped off in town in Mbale and then took a boda motorcycle back home. A shower, dinner, and then massages at the resort. A good vacation and back to the clinic tomorrow. Happy Chanukah!
Today was my vacation. So I woke up half an hour late, at 7, and re-hung all of my clothing outside. Then I prepared for a hike, packing 3 liters of water, a camera, and suntan lotion. We got a ride into town from the BCC driver to pick up some last-minute things. Then we walked around town until someone driving a van yelled to us “Sipi Falls.” That is how it works here. If you are muzungu in Mbale and you look lost, you’re probably looking for a ride to Sipi. We got on the van, the first two in which is both good and bad – good because you get to choose your seats and bad because they don’t leave until the van is full…and then some. In the 8-seater, we left and hour later when we had 15 people inside. The drive to Sipi was a bit less than an hour but we were dropped off 2 km from where we wanted since we didn’t know any better. Sipi is in the mountains so the 2km walk was up- and downhill. We arrived at Sipi River Lodge at around 11am, an hour and a half later than Anna told the guide yesterday. No problem here, everyone is too laid back to care really. So we ordered banana-pineapple-mango smoothies and then headed out with our Ugandan guide, Tony. We went to 3 waterfalls, a full hike of about 3.5 hours. The first one was difficult for the American (me) but everyone else did it easily. I stepped in a massive mudpit and my left foot was covered the rest of the hike. It was beautiful and it was a nice day but I need to say, the hikes in Israel are far better in my opinion. We grabbed lunch back at the lodge when we returned around 2:30, then set out to find a taxi ride back to Mbale. Some van full of phone salespeople picked us up (it was a bit like hitchhiking but they asked for money at the end), and took us and 18 other people back to Mbale in the 14-seater. Being the only two muzungus in the van with many other much-too-friendly Ugandans, Anna decided to tell them we were married. She claims that 4 people asked for her number so her “only way out” was to tell them that I was her husband. I think a simple “no” would have sufficed but…We were dropped off in town in Mbale and then took a boda motorcycle back home. A shower, dinner, and then massages at the resort. A good vacation and back to the clinic tomorrow. Happy Chanukah!
Day 7 - The Villages
12/23/08
It is now 10:30pm on Tuesday night; last night we watched a movie and went to sleep early. Today, I had to take a boda motorcycle to the clinic because the driver was off. But let me tell you – there is nothing like a fast motorcycle drive in the early morning to wake you up. I got to the clinic around 8:15am and finally met Doctor Wafula, or Levert (pronounced “Levat”), gave him his gifts from Maital and family as well as some Hershey’s chocolate that I brought him. He thanked me again and again for the medical supplies we provided, and described to me the disorganization that surrounds the proper supply of protective-wear for doctors in clinics here. I went on rounds with the doctors and saw some patients that were still there form yesterday, and some new ones, but no crazy cases. Just a few more malaria patients. In the middle of rounds I left with the head midwife at the clinic and we walked a short distance (maybe a mile) to a village. We met with the midwife there, and I realized how apparent a distinction there is between the class that I often encounter in town and the people living less than a mile away. The culture seemed older, in that the women came to greet me and sat on the floor to shake my hand. They always remained lower than the man, like in The King and I. The midwife spoke no English but Zawija, the midwife from the clinic, was constantly translating for me. It is difficult to describe the situation without picture, but women deliver in a mud-hut just a mile from the main hospital. They lay on a papyrus mat which is cleaned with just water between births. The midwives lack gloves and are supposed to charge 5,000Ugh (= ~$2.50) per birth, but are usually only paid 200Ugh, which doesn’t even buy enough soap to wash their hands afterward, let alone gloves. Since these midwives report to the clinic and are given further training and refresher courses there, they are aware of the threat of AIDS and HIV due to unprotected deliveries. But it is their livelihood and they choose to do it anyway. The clinic secured money to buy tin roofs for the mud-hut delivery rooms in the villages. This way, the mud-hut doesn’t collapse onto the mother or baby during the rainy season.
We took bicycle bodas the rest of the day to villages throughout the valleys. We traveled as far as 45 minutes on bicycle, through trees and high grass. I took videos and pictures because it was such a strange experience for me. Off-road bicycling with nothing to hold onto and no way to see what’s coming ahead because your driver is sitting directly in front of you. And it was 90-something degrees out, without a single cloud. Brutal, long, but incredible day. We went to a total of 5 villages, all in these valleys and plains and forests. Whenever I saw a group of children, they would scream “muzungu” and chase after me waving and giggling. In some ways I felt like a zoo animal but it was adorable anyway to I waved back and smiled. When there were children in places we stopped, they would ask me to take a picture of them. When I then showed them the picture on the back of the digital camera, they got so excited they would jump around and dance and laugh. It was very cute and I wish I could have gotten video footage of it but it took them looking at the back of the camera in order to trigger the reaction. I saw some malnourished children with these large, swollen bellies. I wish I had brought plumpy-nut with me which happens to be available in town.
The situation was sad and these people were poorer than poor. One man was bathing in a roofless hut made of dried leaves when we came and just spoke to us over the top. One midwife asked me to take a picture of her and her husband and send it to them so she can hang it in the delivery mud-hut. There were flies buzzing around the mud-huts and the dirt floors are cleaned with…dirt. It is a very bad situation and again, difficult to describe without pictures. It is similar to what one would see on the Discover Channel or in National Geographic magazine. I actually pictured English subtitles in front of me whenever the women spoke. Nudity doesn’t seem to be a thing of concern and the people are happy. I want to say they don’t know any better but who knows, maybe they’re way of life is better. I think the best thing to say is I don’t think they know any differently.
The bumpy bicycle-riding did a number on my back, so when I got back to the clinic, I gathered my things and caught a ride to town with the Doctor who was bringing a computer to be fixed there. It was already around 3:30pm so no new patients were really coming. I bought some things in town, including 2 big bottles of water for a 4-hour hike tomorrow as
When I got back from town, I decided it was time to do my laundry. That means scrubbing, kneading, and wringing my clothing in these big plastic bins filled with soapy water. It took me 2 hours just to wash my clothes and rinse out the soap (mostly). Then I hung them all on two clothes lines outside. But the sun was setting and we were leaving for dinner and the night watchman had not yet arrived. So 20 minutes after I hung the clothes, I took them down and threw them over the chair in my room, soaking wet.
Anna and I then treated the whole family and Levert to dinner at the resort for Christmas. Anna, David, Matthew (Anne’s sons) and I sat in the back of the pickup truck that took us there, because we wanted to be those people. I think everyone had a really great time and they enjoyed not cooking dinner. When I got home I lit candles and now I think it is time for bed. Goodnight all and Happy Chanukah!
Monday, December 22, 2008
Day 6
12/22/08
I slept so well last night! I think the sunburn knocked me out. I woke up at 6:30am, dressed, ate an egg and banana for breakfast along with some hot water and jinga (maybe she was saying ginger?). I reapplied the pregnancy cream (which is working great, lesson learned for future sunburns) and the van came at 7:30am to take me to the clinic. I went on rounds with Juliet and the nurses aides. We saw seven patients. The first was a 16 y/o male who had been in a motorcycle accident last night. He had a large laceration on his right knee and his teeth had punctured his upper lip. The lip was stitched last night but the injury to the knee cannot be stitched and was therefore cleaned with hydrogen peroxide and covered in gauze. The second patient was a 20-something y/o male with malaria and ringworm throughout his body. The first line treatment of malaria had not worked for him last week, so he has begun the second-line treatment of quinine injections and will be sent home today but must return for three more injections. We then proceeded to the women’s and children’s ward. The first patient was a baby with pneumonia, titis externia (not sure I spelled it correctly but it is an infection of the outer ear with discharge), and malaria. This child is obviously very sick and will remain in the clinic under observation for a few days.
The next patient was a baby with an upper respiratory infection and malaria. He is being treated with intramuscular injections of quinine. The next patient was the healthiest of all, a baby with only malaria. We then moved to the isolation ward where we saw a mid-40 y/o woman with Shingles. The last patient was also in the isolation ward, a baby with tetanus that he acquired after receiving his circumcision two weeks ago at home. The baby exhibited tremors and spasms of all four extremities and had difficulty focusing his gaze.
That was pretty rough to see so I went outside for some fresh air and then sat in the office for a few minutes to gather my thoughts and to recognize that 90% of those cases would never occur in the US. We then went to the examination room to receive new patients. The first patient was a baby with malaria who had received intramuscular quinine injection on Friday and was supposed to receive three more over the weekend but the mother did not bring the baby back to the clinic because she didn’t have the money for the last few treatments. The baby’s condition worsened and she came back today with money to start the treatment over. The next patient was a middle-aged man who came two weeks ago with symptoms of tuberculosis. His sputum test was negative but he was told to go for an X-ray at Mbale main hospital. He did not go due to lack of money. He came back today to the clinic with a worsened condition.
The next patient was a baby who had been diagnosed with malaria last week, received a full first-line treatment, but was up vomiting all of last night. An IV treatment will be started today. The next patient was a baby with symptoms of the flu, has a fever and cough, but her chest is clear. Upper respiratory tract infection and malaria tests will be done in the lab.
Juliet and I then spoke about TB here, how doctors in clinics, who likely see the highest percentage of TB cases, lack masks and gloves for protection. Most people here are exposed to TB at an early age and if they have a healthy immune system, build an immunity toward it. However, the discussion revealed the lack of attention on the protection of doctors in underdeveloped regions, something I think I’d like to research further. If the problem is as vast as it seems, maybe there is a need for an organization that serves to provide the necessary information and equipment to ensure the safety and protection of health workers in these places.
A 37 y/o female patient then came in with lower abdominal pain and some other symptoms that indicated a menstrual problem. It turns out that she had a miscarriage 3 days ago due to untreated malaria. She has had 4 children before, one of which died at 9 months old. She had never used any form of birth control. The treatment for the patient is a pill that induces the delivery of the undeveloped fetus. The clinic does not have any of the medication in stock, so we had to send someone to the only pharmacy in town which sells the drug for 5,000Ugh. The entire procedure will cost the patient roughly $2.50. I think every co-pay in the States for anything is more than that.
Juliet and I then talked about the seasons in the States. She was surprised to learn that we also have trees and that we have houses made of wood. She also told me that operations at the main hospital are free, but patients are required to supply all of the equipment. They are basically given a shopping list and told to go get the things in town, soap, scissors, etc, and then return for with the materials for the operation. Circumcisions are done at the clinic for 5,000 Ugh (= ~$2.50).
Another patient, a teenage boy from the “projects” (they have them here too, and after describing to you the conditions of those not living in them, you can imagine what they are like). He complained of a cough that is productive (mucus is expelled) that he has had for 4 days. He has no history of the diseases common here of which this type of cough is a symptom. Something I notice is that patients without an educated background find it difficult to describe their symptoms, due to a small vocabulary. This patient’s eyes are bloodshot and yellow, painful and itching so he is given drops for allergic conjunctivitis. He was then asked if he has a girlfriend and if so, when he last slept with her. He says he does and it was two days ago. Juliet asks if he has been tested for HIV before he had sex with her. He answers no and she offers to give him a test but he refuses, saying he doesn’t want to know whether he is infected or not.
The next patient was a toddler carried in by her mother. The mother laid the child down on the examination table and told us that she had been fine until about 2 weeks ago when she looked weak and fell while walking on the side of the road. Since then, she has not spoken or been able to stand on her feet. The child lay quiet, not reacting to forceful movement of her legs. She has some control over her arm movement but doesn’t seem to have enough energy to initiate any movement. She suddenly moans in pain and then quiets down again. The mother says that the onset was sudden, but Juliet felt that she was not being 100% honest since she told the nurses that she had not gotten all of the immunizations for her child but had then told Juliet that she had. The case was a classic of what I knew about polio and I asked Juliet if that is what is was. She agreed with my diagnosis and we referred the child to an NGO on the other side of town that provides physical therapy for polio victims. As the mother lifted her daughter she was teary-eyed, and the girl, sprawled out over her mothers shoulder began to throw her head from side to side. The behavior suggested a sort of mental deficit – I assume another effect of advanced polio.
I have not yet managed the courage to ask if it is okay to take pictures of patients, but after seeing a case of polio, I asked Juliet if it would be okay if I asked her each time, and she’d tell whether or not it would be a problem. She agreed.
We broke for lunch – rice, potatoes and cabbage. The rest of the day was pretty quiet. I still haven’t met Dr. Wafula, the man with whom I organized my trip, but he is returning from Kampala today and I should meet him tomorrow. I am going to the villages tomorrow to meet with the traditional birth midwives so that should be interesting (gloves and goggles?). I will probably leave here around 5pm and head into town to post this. Then a quiet night I think is in order with the family. Maybe we’ll watch a movie on my laptop (thanks againYoni). Goodnight everyone, and Happy Chanukah!
I slept so well last night! I think the sunburn knocked me out. I woke up at 6:30am, dressed, ate an egg and banana for breakfast along with some hot water and jinga (maybe she was saying ginger?). I reapplied the pregnancy cream (which is working great, lesson learned for future sunburns) and the van came at 7:30am to take me to the clinic. I went on rounds with Juliet and the nurses aides. We saw seven patients. The first was a 16 y/o male who had been in a motorcycle accident last night. He had a large laceration on his right knee and his teeth had punctured his upper lip. The lip was stitched last night but the injury to the knee cannot be stitched and was therefore cleaned with hydrogen peroxide and covered in gauze. The second patient was a 20-something y/o male with malaria and ringworm throughout his body. The first line treatment of malaria had not worked for him last week, so he has begun the second-line treatment of quinine injections and will be sent home today but must return for three more injections. We then proceeded to the women’s and children’s ward. The first patient was a baby with pneumonia, titis externia (not sure I spelled it correctly but it is an infection of the outer ear with discharge), and malaria. This child is obviously very sick and will remain in the clinic under observation for a few days.
The next patient was a baby with an upper respiratory infection and malaria. He is being treated with intramuscular injections of quinine. The next patient was the healthiest of all, a baby with only malaria. We then moved to the isolation ward where we saw a mid-40 y/o woman with Shingles. The last patient was also in the isolation ward, a baby with tetanus that he acquired after receiving his circumcision two weeks ago at home. The baby exhibited tremors and spasms of all four extremities and had difficulty focusing his gaze.
That was pretty rough to see so I went outside for some fresh air and then sat in the office for a few minutes to gather my thoughts and to recognize that 90% of those cases would never occur in the US. We then went to the examination room to receive new patients. The first patient was a baby with malaria who had received intramuscular quinine injection on Friday and was supposed to receive three more over the weekend but the mother did not bring the baby back to the clinic because she didn’t have the money for the last few treatments. The baby’s condition worsened and she came back today with money to start the treatment over. The next patient was a middle-aged man who came two weeks ago with symptoms of tuberculosis. His sputum test was negative but he was told to go for an X-ray at Mbale main hospital. He did not go due to lack of money. He came back today to the clinic with a worsened condition.
The next patient was a baby who had been diagnosed with malaria last week, received a full first-line treatment, but was up vomiting all of last night. An IV treatment will be started today. The next patient was a baby with symptoms of the flu, has a fever and cough, but her chest is clear. Upper respiratory tract infection and malaria tests will be done in the lab.
Juliet and I then spoke about TB here, how doctors in clinics, who likely see the highest percentage of TB cases, lack masks and gloves for protection. Most people here are exposed to TB at an early age and if they have a healthy immune system, build an immunity toward it. However, the discussion revealed the lack of attention on the protection of doctors in underdeveloped regions, something I think I’d like to research further. If the problem is as vast as it seems, maybe there is a need for an organization that serves to provide the necessary information and equipment to ensure the safety and protection of health workers in these places.
A 37 y/o female patient then came in with lower abdominal pain and some other symptoms that indicated a menstrual problem. It turns out that she had a miscarriage 3 days ago due to untreated malaria. She has had 4 children before, one of which died at 9 months old. She had never used any form of birth control. The treatment for the patient is a pill that induces the delivery of the undeveloped fetus. The clinic does not have any of the medication in stock, so we had to send someone to the only pharmacy in town which sells the drug for 5,000Ugh. The entire procedure will cost the patient roughly $2.50. I think every co-pay in the States for anything is more than that.
Juliet and I then talked about the seasons in the States. She was surprised to learn that we also have trees and that we have houses made of wood. She also told me that operations at the main hospital are free, but patients are required to supply all of the equipment. They are basically given a shopping list and told to go get the things in town, soap, scissors, etc, and then return for with the materials for the operation. Circumcisions are done at the clinic for 5,000 Ugh (= ~$2.50).
Another patient, a teenage boy from the “projects” (they have them here too, and after describing to you the conditions of those not living in them, you can imagine what they are like). He complained of a cough that is productive (mucus is expelled) that he has had for 4 days. He has no history of the diseases common here of which this type of cough is a symptom. Something I notice is that patients without an educated background find it difficult to describe their symptoms, due to a small vocabulary. This patient’s eyes are bloodshot and yellow, painful and itching so he is given drops for allergic conjunctivitis. He was then asked if he has a girlfriend and if so, when he last slept with her. He says he does and it was two days ago. Juliet asks if he has been tested for HIV before he had sex with her. He answers no and she offers to give him a test but he refuses, saying he doesn’t want to know whether he is infected or not.
The next patient was a toddler carried in by her mother. The mother laid the child down on the examination table and told us that she had been fine until about 2 weeks ago when she looked weak and fell while walking on the side of the road. Since then, she has not spoken or been able to stand on her feet. The child lay quiet, not reacting to forceful movement of her legs. She has some control over her arm movement but doesn’t seem to have enough energy to initiate any movement. She suddenly moans in pain and then quiets down again. The mother says that the onset was sudden, but Juliet felt that she was not being 100% honest since she told the nurses that she had not gotten all of the immunizations for her child but had then told Juliet that she had. The case was a classic of what I knew about polio and I asked Juliet if that is what is was. She agreed with my diagnosis and we referred the child to an NGO on the other side of town that provides physical therapy for polio victims. As the mother lifted her daughter she was teary-eyed, and the girl, sprawled out over her mothers shoulder began to throw her head from side to side. The behavior suggested a sort of mental deficit – I assume another effect of advanced polio.
I have not yet managed the courage to ask if it is okay to take pictures of patients, but after seeing a case of polio, I asked Juliet if it would be okay if I asked her each time, and she’d tell whether or not it would be a problem. She agreed.
We broke for lunch – rice, potatoes and cabbage. The rest of the day was pretty quiet. I still haven’t met Dr. Wafula, the man with whom I organized my trip, but he is returning from Kampala today and I should meet him tomorrow. I am going to the villages tomorrow to meet with the traditional birth midwives so that should be interesting (gloves and goggles?). I will probably leave here around 5pm and head into town to post this. Then a quiet night I think is in order with the family. Maybe we’ll watch a movie on my laptop (thanks againYoni). Goodnight everyone, and Happy Chanukah!
Sunday, December 21, 2008
Days 4/5 - A Jew and a Muzunge
512/20/08
Mulembe! Como ahoora? Grazil. It is now Saturday night, 9pm. I have just arrived back at Anne’s house from the Abayudaya community. On Friday, I went into town with Rasmus (we took bicycle bodas, 200 USh = ~ $0.10) and got on the internet, as you might have guessed from the blog being posted. The internet is slow but inexpensive, about $0.75/hour. We then went to a crafts shop because Rasmus is leaving on Monday and wanted to buy gifts. The things at this little hut are amazing, all one-of-a-kind pieces. Gorgeous crafts of every sort made of ebony grown under the Nile. I left the craftshop to find a boda to take to BCC (the Bushikori Christian Center, the compound on which the clinic is located) and a car honked behind me on the street. I looked inside a there was a black family, all of the boys wearing kippot. The driver introduced himself as Rabbi Gerhsom Sizomu, the rabbi of the Abayudaya, and told me he always became very excited when he sees a man wearing a kippah in Mbale. He offered me a ride to the village but I was not ready so I said goodbye and then took a motorcycle boda from town to BCC. That cost 3000USh = ~$1.50, for a 10 minute ride, and apparently I was ripped off. BCC was closing all of the services except for the clinic for the holiday season, and they had a goodbye lunch. I arrived about an hour before the lunch and saw two patients, simple cases of a cough and malaria. Lunch was interesting. It began with washing hands and getting food; they served rice, crushed-nut sauce, matoke, and a green of some sort. Everyone sat in a classroom of the primary school and then the MC began to speak. He spoke about closing and Christman and family and poverty. Then they broke out into gorgeous African gospel music. They sang for about 10 minutes, and then I had to leave to return to Anne’s in order to make it to the Abayudaya in time for Shabbat. Jon, the BCC driver took me home, I packed, and then took a boda motorcycle to “Semei Kakungulu,” the name of the hill on which the Jews live, named after the founder of the community. The trip began on paves roads, but about 2 minutes into the ride, the road tuned to dirt and rocks. The Abayudaya live in the mountains, and the ride was basically off-roading through hilly mountain roads on the back of a motorcycle for roughly 15 minutes. My driver went too fast so I told him I wouldn’t pay unless he slowed down. That worked. We arrived an hour before Shabbat, my hands numb from holding on to the motorcycle. I was shown to the guesthouse and given my room. The guest house was beautiful (great job Adam) and I finally took a (cold) shower before Shabbat. Staying at the guesthouse as well were two Israeli backpackers, Ohad and Yisrael, and Isaac the manager showed us to the synagogue at around 6:30pm. The synagogue is made of brick and cement. It has a tin roof and on the front is painted something along the lines of “Abayudaya Community, Moses Synagogue, Nabagoya, Uganda.” It is adorned with menorah decorations on the windows, and a beautiful bimah covering. As pre-modern as the synagogue seemed to me, it stood in stark contrast to the majority of homes in the community, most of which are made of sun-dried mud. Women sat on the left of the synagogue, perhaps 12 rows of 3 seats. Men sat in the same style on the right. Shelves on both sides held prayer books and the chumash, the 5 books of the Torah. The men wore a range of clothing, from jeans and torn shirts to suits, and of course knitted kippot of red, black, white and blue. The menorah seemed to be the decoration of choice.
Kabbalat Shabbat, the prayer welcoming in the Sabbath, was sung by Rabbi Gershom and his brother J.J., a musician. Several members of the community played guitars, a cymbal, and a bongo. Once again, the music was unreal. The Hebrew words were sung to African melodies, with natural harmonies from what seemed like specifically selected members of the community, although it was obvious that it was truly just natural. Some psalms were sung in Lugandan, the only word of which I understood was the name of G-d. Bob Dylan, Bob Marley, Jimi Hendrix, The Beatles, Rabbi Carlebach – these people were extraordinarily talented musicians. But I’m almost positive that they all had to try. The Africans just sing and enhance each other’s voices with such ease and simplicity and beauty. And to then add to that effect the Lugandan-accented Hebrew, the language of Jews – it was an experience that I know I will not forget. The evening service began with a short discussion led by the rabbi about dreams, and several people offered their dreams for an interpretation by anyone in the community. I found it funny that one boy told of a nightmare he had in which he had a bad voice. I think most people I know at home would dream the opposite. Another man told of a dream in which he went down to the watering hole and the water was very deep. A whirlpool began, driving the water lower and lower into its center, and then suddenly water shot up from the center higher than it began. I decided to throw my neck out there and offered an explanation. I told him that water represents life, and sometimes, in order to bring life to its highest levels, one needs to fall a bit, to recognize the heights that are truly attainable. The rabbi liked that, applying the idea to the poverty of the Abayudaya and life in Africa, but to the height of being members of the Jewish community. I felt good after that. The evening service was then recited and when it ended, the Israelis and I went to the rabbi’s house for Kiddush and Hamotzi, the blessings before the Friday night meal that are customarily made on wine and bread. We sat in his common room and spoke a bit about ourselves. He asked if any of us could read the Torah, and I told him it was the portion that I read for my bar mitzvah, so I could do some. I agreed to read the first three aliyot.
No grapes grow here, and imported wine is unavailable, so the Kiddush is made on the challah, the bread. The young children walked around holding a large bowl and a cup filled with water. Each person washed their hands, as is the custom before eating bread. The rabbi then made Kiddush on the bread and everyone ate some. The Israelis and I said goodnight and returned to the guesthouse where we had rice, greens, cowpeas, potatoes, and some vegetables for dinner (or what is called ”suppa” here). After dinner, we sang a Jewish song, said the blessing after the meal and retreated to our rooms.
I was up a lot of the night because of the heat but managed to stay awake most of the day. We had some fruit and tea for breakfast at 8:30am, then walked up the hill to the synagogue at 9am. More people were at the services than the night before because it is safer to walk during the day. The service was a chanted in a mixture of Hebrew and Lugandan, and African and Western tunes. The rabbi spoke again about dreams before the Torah reading, this time with a Lugandan interpreter repeating everything he said. I read the first three aliyot and when I finished, everyone stood up and sang Mazel Tov U’Siman Tov in celebration of my bar mitzvah anniversary. I was then given the fifth aliyah as well. Ohad, one of the Israelis read the fourth aliyah and Rabbi Gershom read the last few.
I have learned a lot in the past about why certain prayers are said aloud or repeated, the reason usually lying in the fact that not everyone knew the prayers by heart and prior to the widespread availability of prayer books, one individual who knew the prayer or used the only prayer book available would recite the prayer aloud on behalf of the community. Here I was able to see this idea in action, as Rabbi Gershom and a few others led the rest of the community, most of whom were not completely literate in Hebrew. After the Torah was read, the Musaf prayer was recited by everyone silently and then Rabbi Gershom aloud. After the service, everyone took the chairs outside and sat in a large circle on the grass. Lunch was served, potatoes and beans, and the whole community ate together as Rabbi Gershom lead a discussion about the Torah, current politics, and other topics. Some was in Lugandan, some in English. The Israelis and I returned to the guesthouse and slept until the afternoon. There was no minyan for the afternoon service so I prayed in the guesthouse. We sang some Jewish songs with some of the children until the Shabbat ended. We walked to the rabbi’s home where he made havdalah, the blessing separating the Sabbath form the regular week, on beer, again since no wine was available. Ginger was used as the customary smelling spice during the blessing. We spoke to the rabbi for a few minutes about the upcoming holiday of Chanukah, the music festival they will be having with all 8 of the Ugandan Jewish communities next Sunday and then returned to the guesthouse. I took a shower because the water would be only cool instead of freezing, after having been in the sun all day, and then Isaac the manager called a boda motorcycle (that he trusted to drive safely along the mountain roads at night). The ride back was pretty uneventful besides for riding about 40mph on the back of a motorcycle on a dirt mountain road with no light anywhere except our headlight. But I’m getting used to that (no hands this time!). I arrived at Anne’s ate a quick suppa, and schmoozed with the family for a bit. Then I sat to write this. I hope to get to town tomorrow to post this and send some emails for Anne. Sorry for the long post again! Have a good week everyone and I will write again soon!
12/21/08
I slept until 9am this morning! I think I am finally getting used to the sounds of the animals in the mornings. Although I wasn't able to fall asleep until 4am so... Everyone was in church when i woke up so Anna and I came to the Mbale resort for a swim, hot shower, beer and internet. I am here now, sat in the sun a bit, swam a little, and very much looking forward to the hot shower. Very much. I will return to the clinic tomorrow and get back to work. Anna and I are planning a trip to Sipi Falls on Wednesday, so that should be fun! Have a great week everyone and Happy Chanukah!
Mulembe! Como ahoora? Grazil. It is now Saturday night, 9pm. I have just arrived back at Anne’s house from the Abayudaya community. On Friday, I went into town with Rasmus (we took bicycle bodas, 200 USh = ~ $0.10) and got on the internet, as you might have guessed from the blog being posted. The internet is slow but inexpensive, about $0.75/hour. We then went to a crafts shop because Rasmus is leaving on Monday and wanted to buy gifts. The things at this little hut are amazing, all one-of-a-kind pieces. Gorgeous crafts of every sort made of ebony grown under the Nile. I left the craftshop to find a boda to take to BCC (the Bushikori Christian Center, the compound on which the clinic is located) and a car honked behind me on the street. I looked inside a there was a black family, all of the boys wearing kippot. The driver introduced himself as Rabbi Gerhsom Sizomu, the rabbi of the Abayudaya, and told me he always became very excited when he sees a man wearing a kippah in Mbale. He offered me a ride to the village but I was not ready so I said goodbye and then took a motorcycle boda from town to BCC. That cost 3000USh = ~$1.50, for a 10 minute ride, and apparently I was ripped off. BCC was closing all of the services except for the clinic for the holiday season, and they had a goodbye lunch. I arrived about an hour before the lunch and saw two patients, simple cases of a cough and malaria. Lunch was interesting. It began with washing hands and getting food; they served rice, crushed-nut sauce, matoke, and a green of some sort. Everyone sat in a classroom of the primary school and then the MC began to speak. He spoke about closing and Christman and family and poverty. Then they broke out into gorgeous African gospel music. They sang for about 10 minutes, and then I had to leave to return to Anne’s in order to make it to the Abayudaya in time for Shabbat. Jon, the BCC driver took me home, I packed, and then took a boda motorcycle to “Semei Kakungulu,” the name of the hill on which the Jews live, named after the founder of the community. The trip began on paves roads, but about 2 minutes into the ride, the road tuned to dirt and rocks. The Abayudaya live in the mountains, and the ride was basically off-roading through hilly mountain roads on the back of a motorcycle for roughly 15 minutes. My driver went too fast so I told him I wouldn’t pay unless he slowed down. That worked. We arrived an hour before Shabbat, my hands numb from holding on to the motorcycle. I was shown to the guesthouse and given my room. The guest house was beautiful (great job Adam) and I finally took a (cold) shower before Shabbat. Staying at the guesthouse as well were two Israeli backpackers, Ohad and Yisrael, and Isaac the manager showed us to the synagogue at around 6:30pm. The synagogue is made of brick and cement. It has a tin roof and on the front is painted something along the lines of “Abayudaya Community, Moses Synagogue, Nabagoya, Uganda.” It is adorned with menorah decorations on the windows, and a beautiful bimah covering. As pre-modern as the synagogue seemed to me, it stood in stark contrast to the majority of homes in the community, most of which are made of sun-dried mud. Women sat on the left of the synagogue, perhaps 12 rows of 3 seats. Men sat in the same style on the right. Shelves on both sides held prayer books and the chumash, the 5 books of the Torah. The men wore a range of clothing, from jeans and torn shirts to suits, and of course knitted kippot of red, black, white and blue. The menorah seemed to be the decoration of choice.
Kabbalat Shabbat, the prayer welcoming in the Sabbath, was sung by Rabbi Gershom and his brother J.J., a musician. Several members of the community played guitars, a cymbal, and a bongo. Once again, the music was unreal. The Hebrew words were sung to African melodies, with natural harmonies from what seemed like specifically selected members of the community, although it was obvious that it was truly just natural. Some psalms were sung in Lugandan, the only word of which I understood was the name of G-d. Bob Dylan, Bob Marley, Jimi Hendrix, The Beatles, Rabbi Carlebach – these people were extraordinarily talented musicians. But I’m almost positive that they all had to try. The Africans just sing and enhance each other’s voices with such ease and simplicity and beauty. And to then add to that effect the Lugandan-accented Hebrew, the language of Jews – it was an experience that I know I will not forget. The evening service began with a short discussion led by the rabbi about dreams, and several people offered their dreams for an interpretation by anyone in the community. I found it funny that one boy told of a nightmare he had in which he had a bad voice. I think most people I know at home would dream the opposite. Another man told of a dream in which he went down to the watering hole and the water was very deep. A whirlpool began, driving the water lower and lower into its center, and then suddenly water shot up from the center higher than it began. I decided to throw my neck out there and offered an explanation. I told him that water represents life, and sometimes, in order to bring life to its highest levels, one needs to fall a bit, to recognize the heights that are truly attainable. The rabbi liked that, applying the idea to the poverty of the Abayudaya and life in Africa, but to the height of being members of the Jewish community. I felt good after that. The evening service was then recited and when it ended, the Israelis and I went to the rabbi’s house for Kiddush and Hamotzi, the blessings before the Friday night meal that are customarily made on wine and bread. We sat in his common room and spoke a bit about ourselves. He asked if any of us could read the Torah, and I told him it was the portion that I read for my bar mitzvah, so I could do some. I agreed to read the first three aliyot.
No grapes grow here, and imported wine is unavailable, so the Kiddush is made on the challah, the bread. The young children walked around holding a large bowl and a cup filled with water. Each person washed their hands, as is the custom before eating bread. The rabbi then made Kiddush on the bread and everyone ate some. The Israelis and I said goodnight and returned to the guesthouse where we had rice, greens, cowpeas, potatoes, and some vegetables for dinner (or what is called ”suppa” here). After dinner, we sang a Jewish song, said the blessing after the meal and retreated to our rooms.
I was up a lot of the night because of the heat but managed to stay awake most of the day. We had some fruit and tea for breakfast at 8:30am, then walked up the hill to the synagogue at 9am. More people were at the services than the night before because it is safer to walk during the day. The service was a chanted in a mixture of Hebrew and Lugandan, and African and Western tunes. The rabbi spoke again about dreams before the Torah reading, this time with a Lugandan interpreter repeating everything he said. I read the first three aliyot and when I finished, everyone stood up and sang Mazel Tov U’Siman Tov in celebration of my bar mitzvah anniversary. I was then given the fifth aliyah as well. Ohad, one of the Israelis read the fourth aliyah and Rabbi Gershom read the last few.
I have learned a lot in the past about why certain prayers are said aloud or repeated, the reason usually lying in the fact that not everyone knew the prayers by heart and prior to the widespread availability of prayer books, one individual who knew the prayer or used the only prayer book available would recite the prayer aloud on behalf of the community. Here I was able to see this idea in action, as Rabbi Gershom and a few others led the rest of the community, most of whom were not completely literate in Hebrew. After the Torah was read, the Musaf prayer was recited by everyone silently and then Rabbi Gershom aloud. After the service, everyone took the chairs outside and sat in a large circle on the grass. Lunch was served, potatoes and beans, and the whole community ate together as Rabbi Gershom lead a discussion about the Torah, current politics, and other topics. Some was in Lugandan, some in English. The Israelis and I returned to the guesthouse and slept until the afternoon. There was no minyan for the afternoon service so I prayed in the guesthouse. We sang some Jewish songs with some of the children until the Shabbat ended. We walked to the rabbi’s home where he made havdalah, the blessing separating the Sabbath form the regular week, on beer, again since no wine was available. Ginger was used as the customary smelling spice during the blessing. We spoke to the rabbi for a few minutes about the upcoming holiday of Chanukah, the music festival they will be having with all 8 of the Ugandan Jewish communities next Sunday and then returned to the guesthouse. I took a shower because the water would be only cool instead of freezing, after having been in the sun all day, and then Isaac the manager called a boda motorcycle (that he trusted to drive safely along the mountain roads at night). The ride back was pretty uneventful besides for riding about 40mph on the back of a motorcycle on a dirt mountain road with no light anywhere except our headlight. But I’m getting used to that (no hands this time!). I arrived at Anne’s ate a quick suppa, and schmoozed with the family for a bit. Then I sat to write this. I hope to get to town tomorrow to post this and send some emails for Anne. Sorry for the long post again! Have a good week everyone and I will write again soon!
12/21/08
I slept until 9am this morning! I think I am finally getting used to the sounds of the animals in the mornings. Although I wasn't able to fall asleep until 4am so... Everyone was in church when i woke up so Anna and I came to the Mbale resort for a swim, hot shower, beer and internet. I am here now, sat in the sun a bit, swam a little, and very much looking forward to the hot shower. Very much. I will return to the clinic tomorrow and get back to work. Anna and I are planning a trip to Sipi Falls on Wednesday, so that should be fun! Have a great week everyone and Happy Chanukah!
Subscribe to:
Posts (Atom)