T.I.A.

With just a little over 30 days before we’ll be returning to the states for a visit, we’re taking a few minutes to look back over the last eight months of living in Uganda. It’s been quite an adventure…a real melding of cultures; there’s been exasperation, excitement, curiosity, frustration, joy, confusion, moments that have taken our breath away, some moments when we wish we weren’t ‘breathing it all in…” We can’t even imagine not having had the opportunities we’ve had so far; the blessing to meet the people we’ve met; the heartbreaks, the happy moments. It’s been delightful, brilliant, satisfying.

And on the lighter side, here’s what it means to live in Uganda;

A need to travel in convoys through many places

Passing truckloads of soldiers with rocket launchers and AK-47’s; they’re always going the other way…is that good or bad?

Learning to distinguish the difference in your mosquito net, between lizard poop, rat poop, roach poop, bat poop and scorpion poop.

The big three—cockroaches, sweet ants, and big black grease ants. They seem to have an agreement over whose turn it is to own your home. I just spray Doom and watch them fall to a heap. Here that is called "punishing" them with "medicine."

Figuring out why people "smoke their latrines”. They set methane gas beneath the concrete slab (the one with the hole in it you straddle) on fire. They tell us this makes it smell better.

When you shop at any of the Chinese herbal shops, they will sell you one particular medicine that is good for; “relief for cardiac and abdominal pains, rheumatic pains, aching back, quadriplegia, sprains, and bruises, injuries from falls, contusions, strains, cuts, burns, bleeding, stings, bites, and deep-rooted ulcers.” You should know that two of the ingredients are turpentine and kerosene.

You must learn to figure this out: In 2004 a generator cost $600, or 1,065,000 UGX at an exchange rate of 1,775. So if it's $300 at today’s rate of 2,300 shillings, is that a good deal?

Signs here are interesting...and different.

Termite mounds are taller than Mike. Anything wood that comes up missing has probably been consumed by the termites for their mounds.

Don’t get excited if you hear a gun blast in the middle of the night. All guards carry guns and forget they’re loaded.

Most all of the delays here can be explained with one sentence, "The man with the key has gone." We have seen schools, churches, businesses closed for weeks because the key is with “the man “and they cannot locate him. Every door in Africa has a key. Our apartment has 6 different keys.

It’s hard to kill these cockroaches with flip flops no matter how hard you smack them.

You see everything in traffic here: Boda-Boda passengers holding huge sheets of plate glass; lorries with 60 armed guards jammed in the back; lost cows, taxies with dead fish on the bumper or squawking chickens hanging out the windows, bicycles with 5-foot high stacks of raw eggs or 14-foot lengths of lumber, vendors selling fried grasshoppers or goat on a stick, adolescents on skateboards, beggars, soldiers with AK47s…

Vanilla, Dove soap, and roach motels disappeared from stores 3 months ago. Pudding, ‘Minced’ Helper (like our Hamburger Helper?) and Listerine mouth wash made a debut.

Reasons you won’t get any sleep:

• The neighbors are swarming all over the white ants that are swarming all over the property all around us. Yes, you pull the ‘feathers’ (wings) off and fry them…or not. Good either way.
  
• The buzz of a mosquito…is it inside the net or outside?


• The endless noise of obnoxious music blaring from bars all around
  
• Horns ‘hooting’…relentlessly


• Roosters that cannot tell time, so they just tell you each time the hour changes.

Taking a shower in Kitgum— mix water from the borehole with hot water from the coffee pot. (if someone will put the generator on…because there is no power.) Dump over your head.

Using the toilet in the village: find someone with the key; step over roosters, past cows, goats and pigs…push cement block off hole, ignore the enormous lizard watching you from overhead, pick up travel toilet paper roll from the ground that you always drop, blow the dirt and giant spider off. Think of the squat as part of your work out to build muscles you didn’t know you were suppose to have

If you try to watch a program with anyone here, half-way through, your companions will begin to share some bizarre story…then go back to the show as though they hadn’t just completely interrupted the show. It doesn’t really matter though…either the place you’re staying will change the channel before the show is over anyway, or the power will go off.

At any given time, the electric will be off, the propane empty and “finished” throughout all of Kampala…and you will have no water, but the internet will be up. You can never have it all at the same time. Deal with it. T.I.A.

You have to appreciate the language here; "Had a close call today. The car almost got knocked up by a boda-boda carrying a long, steel pipe." At hotels, the answer to everything you ask for is “sorry, it is just finished.” Driving directions are always hysterical…there is no left or right, there is up, down, or continue while people are making directional hand gestures from the back seat. The answer to your every request, “it is coming.” It is coming can mean anything from 2 hours to 2 weeks. Seriously.

The church collection basket will look something like: a cabbage, a bag of beans, 2 avocados, carrots, 2 onions, 3 eggs and a live chicken…on a good day.

When the internet guy finally shows up to fix your internet, the power will go out.

The insurance company seriously informs you that they will not replace a car windshield more than two times a year.

ALL glass on a car needs to be etched with the license plate number of the car or it will be stolen and resold to you later at the repair shop. Count on it happening at least once.

Tubs and showers here have no shower curtains. We have stopped trying to keep the water from drenching everything in the bathroom. Someone comes in and mops up afterwards. A curtain would be so easy.

It’s a big deal if you get served the gizzard of a chicken. It means they killed the bird for you.

What’s wrong with this picture? The meat markets are little places in the market where the vendor sits INSIDE while the meat hangs OUTSIDE…in the heat. hmmm

A knife sharpener is someone showing up with a bike and pedaling madly while holding your knife in a contraption on top

Deworming is a fact of life here. And we thought it was just for our pets back home.

Do not try to return soda bottles without buying new sodas. A refund is inconceivable and perplexing.

You really miss home at Christmas when the Christmas decorating involves the Energizer Bunny being pulled by reindeer.

Count on fun “extras” in everything you purchase from the market; baby roaches in the egg cartons; roaches imbedded in the toilet paper; feathers and chicken poop still on the eggs. No, you don’t pay extra. And then there’s the game our good friends who know we love word games gave us for Christmas…”SCRAMBLE, the WORLD game” uh huh.

And my favorite…If clothes are hung outside, and they always are, it is very possible for a female fly to lay eggs on them. The clothes are then worn and the eggs penetrate the skin and within three days, painful, boil-like lesions occur. Pus emerges from each sore as it gets ripe. Once the sore is expressed a worm comes out of it. Ick. We'll try to leave these behind when we visit.

A Bug is Still a Bug

Yes, this is a grasshopper. Nsenene is what they are called here. You know me...it’s bad enough that this thing is jumping around just acting like a bug. But here they are also a delicacy. Uh huh. Food. Snack. Something you would send your husband out for in the middle of the night when you’re pregnant and having cravings.
But a bug is still a bug. Right? It’s grasshopper season right now in Uganda. There are guys carrying large containers of these things everywhere you look selling them. Typically they just walk right on by the mzungu car. They’ve learned. We’re just not cool enough to want to eat grasshoppers.

Mike and I made a pact a while back, before we knew better; before we knew grasshoppers were a delicacy; we would ‘try’ anything any local person gave us to eat.

How bad could it be? We weren’t very ‘africanized’ then.

They catch them like this: They put traps up at night after it gets totally dark out. They use 14 foot long aluminum sheeting and have lights set up shining on the sheeting. The light attracts the bug...they fly into the metal sheets, knock themselves silly and fall into big barrels at the bottom of the sheets which are filled with water.

Then they are deep fried and you just can’t get enough of them. Uh huh.

Recently we were in the home of some very sweet people here. And after being in Uganda nearly eight months, we were finally eyeball to eyeball with a plate of fried grasshoppers. Our hosts offered them up quite freely; and Mike and I stood there staring, with our mouths hanging open.

I poked them. I smelled them. I looked at one of the kids who had just finished an entire bowl of them...much like we would eat potato chips. He looked ok. Everyone was watching us, and my husband, who really will eat just about anything...except strange food in Uganda, was not even encouraging me to go for it. “But we said we’d try it, dear; everyone is watching,” I whispered.

Our cute little hostess suggested trying a small, brown one...”they will be the crunchiest” she said. As opposed to, what? A mushy bug? Oh this was not going to be easy.

We fished around for the smallest, brownest, crunchiest one. I picked it up and looked at it...it was looking back. I tried hiding the little face by putting my finger over it...but I still knew the little face was there.

The tiniest member of the family kept saying, “just eat it. They are quite good.”
Okay Deb. Stop over thinking it. Just put it in your mouth, I was saying to myself. Alasdair says, “I will count to ten. 1, 2, 3, 4, 5, 6, 7, 8;” ”wait a minute; start over please.” Alasdair; sigh; "1, 2, 3, 4,...”

Everyone else had become bored staring at us. It’s just a bug after all. Now is my chance to just put it in my mouth. Here goes. Crunch. Crunch. Oh, I’m eating a buuug. Hmmm. Tastes very fishy. I looked at Mike. He was trying to swallow his bug.

Feeling quite proud of myself for eating a bug and not offending our hosts, I held the plate out to them, relieved I hadn’t passed out or puked, and said, “Not terrible. Here you go.” Hosts: “Oh, no, we don’t eat those. They’re bugs. Just our oldest son enjoys them." T.I.A.

An Ounce of Prevention

As parents, it is our instinct to help those we see in harm's way, isn’t it? The fallen child or the little one running towards traffic. But it is hard to assist those that we do not see, people who struggle every minute of every day, just to survive.

I have to admit, in the days I used to tuck my little babies into bed, I took their good health for granted. Being in Uganda for nearly eight months, we have been hit with the unfathomable number of people, babies and children that die here daily. 200,000 children under the age of five die annually. Of these, more than half die during their first year and 45,000 within the first month of birth. Nearly all of these 45,000 babies, and most of the 200,000, die from completely preventable causes and diseases. Now please reread those numbers. Staggering, yes?

Every woman deserves the security of knowing that her child will live another day.

If those sad statistics are not bad enough, one in seven African moms can expect to die as a result of pregnancy. The Commissioner of Social Affairs for the African Union says, “In Africa getting pregnant is a gamble between life and death.” A woman giving birth in sub-Saharan Africa is 100 times more likely to die in labor than a woman in a wealthy nation. These deaths occur in the early neonatal period and often result from obstructed labor or hemorrhage, which are linked to the delay or non-existent pre-natal care. No wonder expectant mothers here look at me with horrified expressions when I ask about their pregnancy or due date.

Most at risk babies are born in rural village areas where health care is unaffordable or unavailable. Many of the deaths that occur in the baby’s first month are a result of poverty and lack of knowledge. The three major causes of newborn deaths are asphyxia, infections, and complications of premature birth.

It should be noted here that all deaths from birth asphyxia can be prevented by use of proper equipment such as resuscitation kits. Yet, basic equipment and essential drugs for new-born care are lacking in most hospitals, and certainly unavailable in the villages.

Infection at birth is the number one robber of a newborn baby’s life. Sepsis, pneumonia, meningitis, tetanus and diarrhea are the single highest killers of newborns. Infections can be prevented through two simple doses of the tetanus vaccine during prenatal care, hygiene practices during childbirth and clean cord care after birth.

There are also many cultural practices that are recipes for infections and postnatal death; the application of ash by traditional birth attendants, or the shaking of a baby to start its breathing right after birth.

Premature birth is responsible for 25% of newborn deaths. More than half of the babies are born at home and mothers do not take their babies to be weighed. Even babies born in health facilities may not be weighed due to lack of equipment, broken equipment, or just the fact that some health workers do not have the skill or knowledge for weighing newborns.

Globally, Sub-Saharan Africa has the highest fertility rate. Uganda has the fourth highest fertility rate in all of Africa at an average of 7.6 births per woman. This results in shorter birth intervals, greater risk of newborn death, and malnutrition, as the mom’s breastfeeding capabilities diminish when there are two or more babies needing breast milk.

Basically, poverty and poor access to healthcare are the fundamental causes of all the newborn deaths in Uganda. Many of the deaths that occur in the first month are a direct result of poverty. Most of the at risk babies are born to young moms, in rural villages, in the bush, and slum areas who cannot afford healthcare. Even if the birth takes place in a hospital, there is no strategy to support newborns in their first week.

We have witnessed firsthand the frustrations of delivering effective healthcare to a population with no electricity, no running water, and very little knowledge of or access to proper nutrition or health management. We are just doing a tiny part but have been so encouraged by the results from our Healthy Village and Family Workshops. The testimonies have fortified our belief that preventable diseases and illnesses can be fought by arming people with knowledge.

With the support of the local pastors and one local nurse, we began our Healthy Village workshops at the grassroots level in several remote villages that had little or no Western style healthcare. We implemented a village-driven training program based on the training Mike did in the states through CERF, the concepts presented in the reference book, Where There is No Doctor; A Village Health Care Handbook, and The Health Education Program for Developing Countries. The two initial and lengthy trainings we taught brought to the top the most dedicated trainers to continue the training throughout the villages. Forty-two driven grads are now out spreading the word in their villages.

In our first training we conducted a simple health survey asking participants to identify the biggest problem they faced in the past year. Sadly, poverty proved to be a major issue and huge barrier to healthcare. Villagers could not afford to eat properly or buy nutritional supplements or appropriate medications. They did not have access to safe water for drinking or bathing. They did not know proper ways to handle excrement. They did not have fuel in which to cook by, or boil water. They typically could not afford to travel to reach a clinic or hospital, and due to fear of medical costs, they would often remain in the village and die.

Other challenges were inadequate or nonexistent diagnosis before treatment; ineffective treatment; and the pervasiveness of superstition, ignorance, and influence from witchdoctors.

The responses to our initial classes helped us shape our current program. We center our Healthy Village and Family training around the most significant health challenges, like Malaria, AIDS, STD’s, tuberculosis, pneumonia, diarrhea, goiter, anemia, malnutrition, worms and other parasites, lack of prenatal care, limited access to immunizations, and lack of clean water and sanitation.

We have been blessed with some donations of medical supplies from friends in the states. And because of the generosity of others who share our passion to eliminate the suffering of the Ugandan people we have been able to add bandages, some medications, beds, mattresses, bedding and mosquito nets to the clinic. There is a lot more training that needs to be done, to share knowledge and prevent preventable deaths and suffering. Medications are difficult for the locals to procure for the clinic. But with funding we’re able to buy medications for them. The general lack of donations forces us to be resourceful and creative…to improvise; banana leaves for bandages, ways to recognize and diagnose anemia, malnutrition, worms and dehydration without equipment or tests; methods in which to treat water without cooking fuel or power; ways to cook without charcoal or firewood.

Why is it okay for a woman giving birth in Uganda to be 100 times more likely to die in labor than a woman in a wealthy nation? Why is it okay for 200,000 babies to die every year? Why is it okay for 320 people to die DAILY in Uganda alone from Malaria…mostly children and pregnant women? Why does life or death depend on where one is born?

There are many challenges that face the people of Uganda that need to be addressed. Want to roll up your shirt sleeves and work beside us? Find out ways you can help change the lives of people in Africa. Check out our website; www.onecityministries.org