Reflections

Female Ward:

This week I spent 3 days on the female ward, 1 day in bed hoping I wasn’t getting sick, and 2 days doing Village Health Worker Training. I am beginning to find a rhythm on the female ward. I could have never imagined that I would be able to know the status of 24 patients in 1 shift. That is not without the help of the other nurse on the ward. It is working out well that I am acting as the lead nurse, assessing the Patients, documenting, and when possible making sure all of the doctor’s orders are getting done. The other nurse distributes medications, places IV cannulas, and wanders off from time to time.

All of the nurses have been great. There was one exception when one day the nurse assigned to the ward showed up for only about 20 minutes during the morning, and when it came time to give medications, she told me she was leaving. This was after I told her I did not feel comfortable passing the medications alone. I tried not to panic or be too upset at how seemingly uncaring this nurse was. There were 24 Patients, 7 that needed to be discharged, 2 new admissions, a demanding family, and an unstable elderly woman. I needed to keep it together. Fortunately, my interpreter Penninah helped me fill out the discharge paperwork, and the nurse from another ward assisted with the medications. The day ended on a sad note as an elderly women with malaria, who seemed to be improving passed away.

Village Health Worker Training:

The Village Health Worker training was a lot of fun. The topic I taught was on Diabetes. I am finding that I love preparing lesson plans. When I am in front of a group instructing, I really enjoy trying to get everyone engaged in learning. Diabetes is not an easy illness to understand, but I think that the Village Health Workers walked away with an understanding of what diabetes is.

I used a display of local foods to demonstrate the foods that a diabetic should and shouldn’t eat. The Village Health Workers loved it when I attempted to get an idea of how much beans they eat in one meal. I started by setting a small handful of beans on the table. They kept saying, “More, more, more,” giggling the whole time. It took awhile but I think they were finally able to grasp how their favorite food, the Irish potato, can raise a diabetic’s blood sugar.

The seriousness of diabetes was really driven home, when I asked leading questions that led them to figure out how a diabetic may require an amputation that begins from a small wound on the foot. I have a feeling that from now on the Village Health Workers will be checking the diabetic villager’s feet, and encouraging them to wear shoes. I also took these classes as an opportunity to promote and encourage them to send diabetics to the Chronic Care Clinic that the Doctors for Global Health residents set up a year ago. This clinic has been very successful, and diabetics could really benefit from the monitoring that the clinic provides. After the lesson I feel confident that most of them now know how to detect the signs and symptoms of diabetes, (including high and low blood sugar) and what they can do to help a diabetic who is unstable.

Lake Motunda:

I took a walk to Lake Motunda with Babak last Sunday. It is about a 90 minute walk, in the direction of the Democratic Republic of Congo, whose border is about 8km from where I am living. On the way to the lake we walked at a leisurely pace taking in all of the sights and sounds of nature. I finally got some good photographs of the large and lovely trumpet flowers. The bird watching was awesome and really slowed me down. Stopping to pull out my binoculars and identify the elegant Sacred Ibis is when I first noticed Livingston.

Livingston is a 13 year old boy, and a fellow wildlife enthusiast. Together we walked along and used my bird book and binocs to discover the names of the birds we saw. Impressively, Livingston already knew many names of the birds and I was also able to teach him some bird names he didn’t know. We really got into it together as he told me stories about animals, of his daily life, and his dreams for the future. His understanding of my English was by far the best of any African I have met so far. I learned that Livingston wants to study wildlife, and his favorite types of animals are “flesh eaters.” He seemed to know more names of “birds of prey” than any other. He told me this detailed story about how eagles take tortoises from the lake and fly them up to the hilltops and drop them on the rocks to break their shell. When he finished the story he paused and softly said, “It is not very sensitive of the eagle.” My heart melted.

Arriving to the lake was beautiful but anticlimactic after all of the birds we saw on the way there. My favorite on this trip was the curious-looking Great Spotted Cuckoo. They have long tails, and hang off branches side-ways. Livingston and friends accompanied us much of the way back. This is when I learned that Livingston goes to school in Kampala and he was waiting for his Dad to send him a ride to return to school. His Dad is late though, because all Ugandan schools have resumed session from the holiday. When I inquired further, I realized that his Dad may not be able to afford his school fees. This is not an uncommon thing to hear about in Africa.

This last week I have not been able to forget about Livingston. He was so intelligent and one of the few Africans I had met so far who was able to look far ahead into the future and have a dream, not just for livelihood, but for personal fulfillment. It was apparent that Livingston realized the importance of education, yet his future was hanging in the balance. I hear that foreigners often sponsor education for people they meet in Africa. I hope I can find Livingston again and see what I can do to help him fulfill his dreams; otherwise it will haunt me forever.

Bugs:

Bugs are fine, but I prefer bugs outside rather than inside. Babak and I can’t figure out how the bugs find their way into our cement house. Okay there are screens above each window, (the windows also have bars across them, and are covered with cheap shower curtains) but the only break in the screen we already covered with duct tape. Thank goodness Babak thought to bring duct tape. These one bugs, I call them the “Fighter Pilots.” They are like GIANT maggots with wings. They graze our faces at lighting speed, with an amplified BUUUUZZZZ……..BUUUUUZZZZ, but much more aggressive than the buzz of a bee. In fact right now I can hear them banging on my bedroom window trying to get in. When you see one you know that there will be more coming as long as you keep the light on. They like to chase us out of the common area. In the evening we are often forced to lock ourselves in our rooms.

Funny, I saw a medium sized cockroach running across the kitchen counter this morning and it didn’t even phase me. The troupe of roaches that found their way into my bag of honey really grossed me out though. Philip made me feel guilty when I told him I threw the honey away. He said, “You should give the honey to someone who wouldn’t mind the roaches.” That thought never even crossed my mind.

I cannot get used to the spiders. There are at least 20 different kinds of spiders that I have seen so far. For some reason it’s okay if they have long legs, but god-forbid their bodies are big and hairy. I lose all sense of reason. Hiring a spider killer seems like a good idea, although I really shouldn’t be killing the spiders. The reason is that one morning in the shower I found a “Fighter Pilot” hanging limp in a spider web. I was very proud of that spider and his dainty web.

Babak casually asked me this morning if I had been getting bitten by many bed bugs. Panic seized my body. If he is getting them, won’t they be coming after me soon? He nonchalantly said, “I thought everyone here had bed bugs.” That was news to me. I’ve only had one bug bite so far, and I suspect it was a spider. My only relief in my current life with bugs was when I learned that the fat jumping spiders that visited me in the shower every night were actually crickets. I can handle crickets.


Walking:

There is one main road to town, which is about a 15-20 minute walk from where I live. It is a rocky 2 lane road that is part dirt, and part paved. This TWO lane road needs to accommodate 2 lanes for pedestrians, 2 lanes for bicyclists, and 2 lanes for buses, cars, and trucks. Walking this road feels like Russian roulette. The giant buses cannot be bothered with pedestrians as the drivers lean on their horns, going 50 miles per hour, warning the mothers, children, and people on bicycles to move out of the way…...or else. I usually find myself forced to walk in the muddy, cow pie filled ditch.

As I walk, I pass by many people on the road and rarely do I see a fellow Mazungu, (white person), but everyone always says, “Hi, how are you?” or “Omezute?” I am always amazed at how many people have hoes slung over their shoulder, off to go digging somewhere. Yesterday I didn’t feel like walking to town because it was too hot. I asked one of the leering boda bodas if he would give me a ride on his motorcycle. “1000 shillings!” he barked at me. Now I know that it is only 50 cents, but that is the Mazungu price, and normally it costs only 25 cents for the 3 minute ride. He wouldn’t give me a ride, and I wouldn’t budge on the price. As I continued walking I wondered if arguing over 25 cents is really worth it.

The reliable fresh food source any day of the week is from the ladies and children selling avocados and yellow bananas from their hand woven baskets on the side of the road. The school children are always happy when someone is selling the 7 foot tall stalks of sugar cane. It’s cute to watch them skip along in their red and white checkered uniforms sucking on the juicy sweet stalks. Not so cute when they look at me and demand that I give them money. This doesn’t happen all of the time though. I can’t fathom how the men balance a stack of sugar cane lengthwise on the back of their bicycles on the bumpy road.

Other merchants on the side of the road sell used clothes. I’ve learned that these clothes are considered good quality because they are clothes donated from the US or UK. These clothes are apparently of higher quality than the new “made in China” clothes that are sold in the local stores. When I explained that most of our clothes are made in China too, I was told that the cheapest “made in China” clothes get sent to Africa. I guess Chinese clothes sent to Africa fall apart after one washing rather than after three washings in the US. I am curious. How do the DONATED used clothes from the US and UK become goods for sale though?

I love the sign that I always pass while walking. It is a picture of a gorilla that says, “I want to be your new best friend.” It reminds me that somewhere only ½ hour drive away there are fuzzy gorillas chomping on bamboo. Sometimes I meet Morgen at her favorite tea shop for African tea. For 15 cents a piece we sit on a rickety bench and enjoy a steaming mug of sweetened black tea spiced with ginger and cardamom.

One of the first stores I pass when I get to town is the Indian Supermarket. Not really a supermarket as much as a dark and dusty store where I can get my fix of processed foods. The local crackers are usually mushy and stale, but fortunately, or maybe unfortunately they have Pringles. The Indian community in Kisoro is small and they stay to themselves. In Africa, Indians are known as the shrewd and wealthy business people. They have always been very kind and helpful to me. I’d like to think it’s not just because they know I can afford to buy Pringles.

My new shopping addiction is down a muddy side street in town. Rose’s shop sells cheap vinyl handbags, hair products, other random toiletries, and what are considered the highest quality textiles in town. It is a cramped non-descript shop that has colorful fabric stacked high. Rose has a good connection for these sought after wares from the Democratic Republic of Congo. You may wonder what I do with all this fabric. Well you can’t walk far without seeing someone sitting in front of an old fashioned sewing machine, mending clothes or making elaborate African outfits. Laurence, my new tailor is making me a dress for only $10.00. I hope that when I pick up the dress it isn’t in the popular African style, which is floor length with giant puffed sleeves, and a matching head scarf. I don’t think I can pull off that look.

Further down the way is the market which is on Mondays and Thursdays. I love market day. Everyone is dressed up in their finest clothes on a mission to sell and socialize. At the market there is a passion fruit section, a pineapple section, a bean section, a dried fish section, and so on and so forth. I already have my favorite woman that I buy carrots and green peppers from. She always helps scatter the young boys who try and sell me plastic grocery bags for 10 cents. Apparently only city folk and Mazungus eat peppers and carrots. Villagers prefer Irish potatoes, cabbage, and tomatoes. All of the ladies that sell vegetables are super sweet. I can only imagine how far from their village they had to walk, carrying the heavy produce stacked high on their head.

At dusk families begin to gather. The Reggae-like African music gets turned up louder, and the smell of stewed beans, fried matoke, and fresh chapatti wafts about. It never fails that I get caught walking home in the dark. When I say dark I mean you cannot see your hand in front of your face, yet every star in the sky is visible. Reaching my “home away from home,” I rinse my dusty feet and feel content that after only one month I already feel a sense of community here in Kisoro.