Bwindi Women's Community Center

Evelyn, Denis' wife, runs the Bwindi Women's Community Center, having returned to the Buhoma area after getting a degree in tourism wanting to give something back to women.  She remembers her own mother, who was known in the community for having only one dress, and no shoes.  This in a community where women wear only dresses. Evelyn wants a better life for women.  There are 300 women enrolled in the programs at the Women's Center, and she tries to target the poorest (like her mother), and those in the local area.  The center teaches women skills that can empower them to change their lives.  Buying materials and making a product to sell is powerful.  It sounds lofty and it is, but their needs are modest.

When there are no funds, they don't operate, because they need to pay the women to come and feed them while they're working.  The women produce things for sale that are made on treadle sewing machines.  I remember my grandmother having one.  You rock a "treadle" back and forth with your feet creating the power and guiding the speed.  There were three women sewing, two cutting and two hand sewing when I was there.  One was feeding her baby.  They produce patchwork placemats, aprons, napkins, and cosmetic and shopping bags, all from African cloth.  I bought as much as I could.  Evelyn pays the women 5,000UGX (about $2USD) per day and feeds them lunch when they come to make it easier on their families for them to be away for the day, and to reward them for work outside the home.  Evelyn runs it as a business so she can show the women a different life than having babies, and the backbreaking work of survival that is all most of them know.

I asked her what she needed.  She needs a pit latrine so that the women don't have to relieve themselves in the bushes and woods surrounding the site.  She also wants to try some electric machines to encourage more creativity and products.

Sponsored by a Canadian group of women, another project underway is bike repair.  The women get road bikes to ride and maintain, and come once a week to learn bike repair.  They were learning to change spokes this week.  The plan is that they will rent and repair tourist's bikes.  Denis explained that they try to repair things by trial and error first, and then they look in the manual.  I couldn't help myself saying that it was a typical male approach, but Denis said the women learned well that way too...maybe...

A new electric sewing machine costs $150, and the pit latrine will be $2500.  They've saved $200 towards it.  Let me know if you'd like to help.  I'll be happy to collect your donations and get them to Evelyn.  It's money well spent for women. 

The Sounds of Bwindi

In this remote corner of Africa, bounded by the DRC, Tanzania, and Uganda, it is a rural, agrarian society.  Although electricity is available, not everyone has it and it has been out for twenty-four hours now, but not here where we are blessed by the hospital's generator.  We had a downpour last evening, and as a precaution against damage to the turbine that creates the electricity from the dammed water flowing past its fans, the water in the channel to the dam was diverted back into the river.  As we walked past it today (I was with two men), the power plant was silent, the spillway empty.  There is universal cell coverage, provided by satellites, I think, so many people have cell phones, but not all.

The Hydro-electric Pland

My room is in the back of the Guest House, and I like my windows open (the low this morning was 69F, and the high this afternoon 73).  The humidity is always high, and the only wind comes with the almost daily thunderstorms.  It has not been a destructive wind, nor has the lightening struck close by.  The valley is very deep, and people don't seem to fear it.  Life goes on the midst of crackling thunder and torrential rainfall.  And the sounds of life are everywhere around, as is life itself.  Many nights there have been drums continuously until 3 or 4 in the morning, endlessly repeating the same rhythm.  I dared to complain at dinner one evening, and Leonard (one of the Ugandan physicians who comes frequently) mentioned that it might be part of a ceremony honoring a death..."when they are very old, many days are needed."  The sound was suddenly not so irritating.  There are of course, birds calling at daybreak, and all day long.  At night, when the drums are silent, it's very quiet, since there are so few vehicles.  And with no lights, people sleep at night, especially when they've worked physically all day long, to wash clothes by hand in tubs of water, to cook every single mouthful from its raw ingredients, to walk everywhere they want to go, and to milk cows, collect eggs, tend gardens, and mind children.  Although I will say that children are left pretty much to roam free after a certain age.

But in the morning, as people awaken after the twelve hours of darkness, there is a continuous hum of human murmuring, surrounding everything.  The vegetation is so dense, and the area so remote, one might think they were in a wilderness.  It is so not so, except for the Bwindi Impenetrable Forest, which is a park.  Outside that set aside area, there are people, animals, homes and children everywhere, except on the steepest hillsides.  No roads, but trails.  Acres of tea plantations, but homes everywhere.  Because the weather is so mild constantly, kitchens are outside, and lives are lived outside.  Flip-flops are the most common footwear I've seen.  Goats blatting, cows lowing, children laughing and playing all create a low murmur all day long, every day.  No yelling, no screaming, very little crying of babies or children.  Just the sounds of humanity and all that goes with it. 

There's also always the sound of running water, in all the valleys, running down the hillsides and into the river at the bottom.  This is the rainy season, and daily thundershowers and storms are the rule, rather than the exception.  The sound of rushing water waxes and wanes depending on the volume, but it's always there. 

A waterfall along the river

Melissa, a Nursing Student in Uganda

I've introduced Melissa before, and no, Sarah, Kieran, and I did not go to the church ceremony.  Originally, the village ceremony had been planned for Friday and the church for Saturday.  Something happened with the schedule (the priest, the church, the groom's family?) and so we weren't able to stay.  During the 4 1/2 hour drive from Mukono to Tororo, however, I got to know Melissa, one of Jane's honor maids, along with Sarah.. 

Melissa (on right) and Sarah

Melissa is a graduating senior nursing student at Johns Hopkins University, doing a clinical rotation in nursing at a teaching hospital in Kampala.  She has been on the Pediatrics unit for her most recent rotation.  Her lack of experience in the profession showed in her conversation, mostly with Kieran and Sarah in the front seat during our drive to Tororo.  But her humanity and compassion and caring could not be doubted.  They are impressed with her ability to function in the chaotic environment of the Kampala hospital, which is known for its disorganization.  I am quiet, listening and wondering how someone from the Western medical model can provide compassionate care in a country where life is so fleeting. 

She describes being on the peds unit (sometimes two to a bed, with parents sleeping on the floor beside or under) where medication is simply not available, and the most aggressive respiratory treatment is high flow oxygen, with one concentrator shared between many patients, so no one knows exactly what is delivered.  There are shortages of IV fluids, and even IV cannulas.  Melissa bagged a baby with sepsis whose heart was strong, but just couldn't breathe on its own until she had to stop...there is no ventilator in Uganda--for anyone.  She said they'd had a run on sepsis, and it seemed as if she'd watched a lot of babies die.  She's concerned because frequently, there is a critical need for blood (Hgb of 2.0) and the lab is backlogged, and doesn't have the staff to do a type and cross, so she has been taught to do it by the physicians.  So she does, with full knowledge of her responsibility for getting it right, because there is no one else to save a life--maybe. I admire her sturdiness, and ability to deal with the tragedies of being a nurse and still function and do what's right, even though it's not anywhere close to ideal.  She sees clearly.

Melissa was a Peace Corps volunteer, living with a family for over a year, planting rice in the fields and helping them harvest it.  She had a cell phone that worked if she hiked to a hilltop and was to be used in an emergency.  She charged it weekly in town, and didn't use it during the week so that the charge would last.  She had been taught the language and had all of her immunizations courtesy of the Peace Corps and had to be evacuated after the year due to a coup in the country...don't ask me which one...it doesn't matter, maybe Madagascar???

She has a Biology degree, and ran a camp in the Uganda mountains for gorilla watchers for a year after leaving the Peace Corps, which is how she met Jane.  I didn't question her about her motivation for becoming a nurse.  I did ask her if she wanted to practice in Uganda, but she said no...she needed to work in the US for awhile to pay her student loans, which were huge.  She was a very pleasant intelligent woman, whose father lived in Nevada for awhile and whose family owned property in New Jersey, clearly a student of the world, and aware of her place in it.  She described learning to drive in Uganda, while also learning how to drive on the left, and said her greatest challenge was the rotary where she needed to go left around, and all of her instincts screamed to go right. 

On Sunday, when we were on our way home she texted Sarah that at noon the church wedding service, scheduled to start at 1000 had not yet started, and that it was to be another long day because they had then to drive to Kampala for a celebration dinner hosted by the Groom's family.  Oh my.  I'm sorry I missed the church service, but I'll enjoy the pictures.  

The Wedding

They had been up until after 0200 planning the village ceremony, which was to start at noon.  It actually started with the arrival of the groom's family at 1430.  However, prior to that there was much decorating, with three tents erected (who knew there were wedding planners in Eastern Uganda?).  Flowers, a cake, children everywhere, decorated chairs, and the women in the back cooking.  We were fed lunch (I asked for one small "Irish" please and got three, but it was an improvement) in the back, which was good because food would be a long time coming. 

At least eight chickens were slaughtered (for 100 people--meat is scarce in Uganda), the cow had been slaughtered the night before (happily I missed that).  The chicken slaughtering was carried out by 8 year old boys with machetes, very serious indeed.  Then the feathers were singed over the fire, and the boys also plucked them, while the women removed the pin feathers and butchered them.  These are very thin tough chickens, cage free their entire lives, living on greens and few grains. 

Chicken carving

At 1300 all work stopped because word was received that the groom's village procession was arriving.  The women hurried to change, and the food left to itself.  In their finery, they arranged themselves in front of the gate to welcome the arriving village--and waited another 1 1/2 hours.  Finally, we in the audience, and those waiting greeted the entourage, about 20 people.  Their credentials had to be verified prior to entering.  Imagine how this ceremony must have evolved.  Tribes would make arrangements to meet for a "greeting ceremony", but they didn't really know each other well, and so imposters and enemies had to be avoided.  Statements of peace for the duration of the ceremony were made by both sides.

Groom's family arriving

 And then lengthy greetings of  parents, children, sisters, brothers, aunts, uncles, and village officials from both sides began and the giving of gifts to the bride's relatives by the groom's representative .  All to music from a DJ with speakers as large as a bunk bed.  Dancers from Ngongdera, Jane's village danced. Joking back and forth was common.  The women in Eastern Uganda have a unique way of greeting each other and important strangers.  They simple fold to their knees and hold out their hand courteously.  It is done with dignity and beauty.

The Aunties and sisters

 Finally the bride was invited to come out of the house (after 3 1/2 hours!).  She arrived with her sisters and bridesmaids to meet the groom's sisters and representatives.  The Greeting Ceremony was over, and the party began.  The church service was scheduled for the next day. 

The bride

Back Home in Bwindi-via Kampala and the Jinja Highway

We arrived at Nagongera, Jane's village, which is north of Tororo, late Thursday evening, and departed late Saturday evening, traveling both ways via the Kampala-Jinja Road (A 109) that runs between Uganda's border with Kenya and Kampala.  I'll blog about the wedding later, but first--the trip there and back.

Thursday morning, Jane and I went to the fruit market in Kampala, and then she ran errands prior to heading out to meet Sarah and Kieran in Mukono, picking up Melissa, a friend of hers along the way.  Those words don't describe the lateness, the waiting, and the unfolding drama of Sarah and Kieran waiting and the taxi driver waiting, and the cell phone calls back and forth, and the getting later and later.  Melissa is studying nursing at John's Hopkins and completing an extra clinical rotation in Uganda.  (More about her later).  She would be a bridesmaid along with Sarah.  We were 2 hours late meeting them, operating on African time.  As many brides do, Jane had committed to too much in too little time.  We left Mukono at 3 in the afternoon, on a 2 lane sometimes 3 lane, sometimes one lane road that was sometimes under construction, sometimes had an accident, and sometimes ran through a village.  Instead of stop lights, there are speed bumps, which may or may not be signed and painted with white stripes.  Quite a shock at any speed. 

The fruit market

We arrived at Tororo at dark, in a downpour that caused local flooding, obscured potholes large enough to hide a truck tire and caused a power outage.  When we turned off the highway, we were still 20km from Jane's house, but diverted to Mororo village, an aunt's house where dinner waited.  We chatted with relatives by candle and flashlights while they finished preparing our meal--another hour--noodles, rice, chicken, port, beer (for myself and Kieran-hooray!), all very good.  BUT, it became known that there was more food  waiting, so tried to eat lightly, and moved on to Jane's village at Nagongera.  It turned out that Sarah and Kieran had reserved a hotel in Tororo Village, and I prevailed upon them to check if there was a room for me.  I just had a bad feeling...a wedding, many relatives, a remote village, small houses, bathroom facilities for many people, etc. etc.  I was right and lucky to be able to connect with a hotel and have transport back and forth. 

The back of the Toyota was absolutely full, luggage, fruit, various wedding supplies, etc., so we headed  down the dirt road, dark now, but at least not raining to the village.  No lights anywhere, and in the town of Tororo, people everywhere, trucks, cars parked on the street (I use the term  street loosely), with dogs, chickens, and cows running free.  Many motorbikes, with 2 or 3 people on each.  It was a warm night, as always in Africa, and eerie, so many people appearing and disappearing, and no lights.  There was just occasional candlelight in a house or shop. 

Sarah and Kieran and I unloaded the van with help, declined to stay for dinner but met everyone, including Jane's mom, and departed to the hotel (20 km back the way we'd come).  We returned Friday at 1000 to help with preparations.  I watched the cooking and they served me lunch after bringing me handwahsing water and soap, whens it was done.  I would have stopped them and gotten it myself if I'd known what was coming.  Ugandans are big eaters because they work so hard at everything, and they serve everyone that way.  I ate maybe 1/3 of what I got...posho (a soft pan bread sort of pudding made of boiling water, millet, and sorghum), chicken, rice, Irish (white potatoes as opposed to sweet), and a cabbage salad (like our cole slaw) all seriously mounded on two very full plates.  I had brought her mother a gift of scarves, and so I was hopeful that would absolve me of my offense of not eating....they just didn't understand how I could stop before the plates were empty.  I managed to get it consolidated to one plate so it didn't look so bad.

Cooking Posho

I love the company of women working, and they talked among themselves, while also making sure I was okay, and taking the food into the house for the others.  There were outside fires, built for the multiple I had a stool to sit on and just watched.  Sarah, Melissa, and I also made time to make the ribbon flower corsages/boutonnieres for the groom's family, and did quite a good job, if I do say so myself, with just scissors and creativity.  Sarah painted all the toes and fingers she could find.  Jane and Julius disappeared to go find a music system and DJ.  We left at 2100, not having seen them.

The Cooks

We returned at 1000 for the big day.  I'll blog about that later, but suffice it to say that the wedding started about 1430, which was 2 1/2 hours late, and the ceremony concluded at 1900, which was just past sunset.  Kieran and Sarah are physicians at Bwindi Community Hospital and had committed to be at work Monday morning.  Everyone knew we'd have to leave as soon as the ceremony was over, and we'd expected to hit the road at 1630 at the latest.  So we sneaked to the car (much pressure and angst would be caused by our departure if they knew) and hit the road.  Darkness was setting in as we turned onto A109 for the return to Kampala where we would spend the night.

We all agree that none of us have ever spent a more terrified 4 1/2 hours, 217 km.  First, it was dark, no street lights, no moon, no starlight, no house lights, and very little reflective signs, if any.  The road is the main route between Kampala and Kenya, so is a constant stream of trucks, buses, cars, motorbikes, pedestrians, bicycles, and some animals (usually dead).  When I say it was dark, it was very, very dark.  Weak headlights, non-existent tail lights, no lights.  Oncoming vehicles either had no lights or high beams that blinded.  Sarah and Kieran took turns driving, I held on.  Passing a 5mph truck on a hill was an exercise in supreme concentration, taking into account oncoming traffic, side traffic, and passing traffic, who gave one small beep of warning.  The universal sign for "move over, coming through" was a truck half in your lane, with his left blinker on...it meant that he couldn't yet move back into his own lane and for whatever reason needed half of ours.  Usually it was on a downhill stretch for him.  There were bicyclists on the breakdown strip--no lights or reflectors.  There were also motorbikes over there, too slow for the traffic, but weaving in and out of the pedestrians and bikes.  There of course, were very faint lane markings.

As we traveled through a village, the only sign were the speed bumps and trucks parked on both sides of the road.  Again, people, people everywhere, faint light from some charcoal braziers from the street vendors and shops, loud music.  Otherwise dark, dark, dark.

We arrived in Kampala safely, to all of our surprise, and spent the night at St. Augustine's retreat center, where a room cost 26,000 UGX ($10.00), was clean, comfortable, austere, but quiet.  It took 12 hours of hard driving to reach Bwindi late Sunday evening over bedrock roads that shook the vehicle and us to our limits of tolerance.  Tomorrow the wedding.

Crossing the equator along the way

 

More on Kampala

My hotel room overlooks a large outdoor tiled area, two floors below me.  The windows in my room open and they are screened, so unless it's too noisy, I open them, and use the fan for a breeze.  For the past two days, a man has been working to clean the tiles (they look much like Mexican saltillo tiles, but are Ugandan clay tiles), with a broad blade scraper by hand--why I don't know.  I don't see any mortar on them, or dirt, and what he's done doesn't show much, but he might have 1/6 of them done after the two days.

Jane and I went to Mukono to see the lawyer at Uganda Christian University about the Memorandum of Understanding to allow diplomas to be granted at Uganda Nursing School, Bwindi.  We were moderately successful and will have the MOU completed within a week or so.  The traffic out of Kampala was very bad, but not as bad as the traffic coming in.  Drivers are civilized, but very aggressive, and the motorbikes downright suicidal.  The picture below was taken yesterday, and is of the parliament building--it doesn't do the traffic justice.  There's also the exhaust to breathe in, and the heat and himidity

Kasule, the taxi driver, is a hip-hop artist who wants to go to New York, that being the source of music (according to him), but in the meantime, he plays at local clubs.  He has become an expert on Idi Amin, due to driving tourists around who are fascinated by the dictator and want to see some of the history.  He was full of information, some I already knew, and lots I didn't.  I find all Ugandans remarkably aware of their history, of the politics of their own country, Africa and the world, including the US.

Today's hire car driver, who took me to Mukono to meet Jane, told a horrific story of having a pain in his side and going to a hospital in Kampala where he was told he needed to have his kidney removed (we started by discussing flying in a small plane and he was telling me of his first and only plane ride). He got a referral to Nairobi for a second opinion from a local doctor, and consequently went on his first plane trip.  He was looking for an alternative to surgery because he couldn't afford it, even though it was a modest price of 1.5M UGX.  ($600).  After spending a week and a half in Nairobi, he was told that his kidney was fine, and he was, in fact, better.  No treatment was done except some pain pills.  And his pain was gone.  He's firmly convinced that his kidney would have been sold to someone needing a transplant.  My only advice was to hold on to all of his body parts, and to go to Bwindi Community Hospital if he needed care. Or maybe he just had a kidney stone and passed it by himself.

We went to see a furniture procurer in a town close to Kampala, and he agreed to provide a quote.  It took a couple of hours because he had to write every single thing down, and draw detailed pictures.  I thought of my remodeled kitchen, and how I had a computerized print out within 24 hours, showing detailed pictures with various views.  Maybe our furniture woes will be over.  Jane and I have struggled to find sources for classroom, dormitory, staff housing, kitchen, and lab supplies and furniture, that will include transportation to the remote location where it's needed.  I can only hope.

Jane is getting ready for her wedding and like any nurse, is doing most of it herself.  We came back to the city center where I have my hotel, and she, coincidentally, was going to have her hair done.  We had a late lunch, with time she could ill afford, she's scheduled to meet relatives to help them purchase genuine African clothes for her wedding, a brother of her fiance's (new brother in law) to go over last minute details of the ceremony, a visiting nurse from Johns Hopkins who will be traveling with us to Jane's village for the wedding, and friends who want to see her while she's in Kampala.  I offered her to stay with me tonight so she doesn't have to travel back to her sister's, by bus outside Kampala.  She agreed, since I have two beds in my room, and she's totally exhausted and frazzled (not that it shows).  So I'll have company, and will have her helped in some small way.

The power just went off, but the hotel has a generator, which fired up almost instantly.  Amazing Uganda. The housekeeping supervisor comes around daily to make sure that everything has been done in the room to my satisfaction--the housekeeper today was about to give birth (8 1/2 months) and looked absolutely miserable--her first.  Little does she know that her misery has not yet begun.  She really didn't want to make the bed, but I knew I'd have to give the supervisor a report, so I had her do it, but not change the sheets.  No one knows but us.

I've decided that I don't need to see the source of the Nile, or the gorillas or the Queen Elizabeth Park, unless an opportunity arises that I can't turn down, or I am in the neighborhood.  The stories from the people and the kindness of humans living their lives here is enough to experience.  I'll tell you one more.  The taxi driver yesterday had to drop me off to get money from the ATM because I had spent all of mine at the African arts mall, and there was no parking anywhere.  I was a little nervous getting out of the car in the middle of traffic.  There's no going around the block here because it could be two miles and an hour to get back.  So we agreed to meet back at the hotel, which I could see from the bank.  He got so nervous at leaving me that he came to the hotel and then left again to go back to the bank to pick me up.  Of course, I had gotten my money and came down to the hotel by the time he got back to the bank.  He left his cab and talked to the security guard, who told him I'd left.  It took him a half hour to get back to the hotel, where I was waiting in the lobby.  That's Uganda, too.

I don't have a picture of a gorilla,

but I do have one of a red-tailed monkey...taken from the Guest House backyard.  I leave tomorrow for points east for the wedding in Jane's village.  More later.

Kampala

I came to Kampala yesterday on the same Cessna that took me to Bwindi.  We left Buhma at 0830 for a 1055 flight.  I had to borrow a couple thousand shillings from Patrick because I had too generously tipped the Batwas people and the guide, and didn't have quite enough for the driver.  As interest, I gave him some of my hoarded jerky.  He was smiling as I left.  Down we went, back down the red roads, muddy from the rain, gullies from washouts--people, motorbikes, other vehicles all using the 1 1/2 lanes that are graded.  About halfway there, the driver (they all tell me their names, and if they'd spell them, I could maybe understand, but even though I repeat it twice, I just can't remember) stopped for petrol.  The man at the pump said "no power".  The driver looked at the gauge and said: "We'll make it", but I knew he wouldn't have stopped if he thought so, because I hadn't paid him yet.  I heard his woeful story about needing a sponsor to help him set up his mechanics business.  He needed "spanners" of many sizes of course, which he hadn't got.

So we drove on, rain showers, sun showers, green all around, people in their Easter clothes headed for church all around, and stopped again in another village--no explanation.  I think he was trying to find some gas in containers, but didn't have any luck.  I asked him to stop at the bank in Kihihi, where the airport is, so I could get some cash, and it looked like there might be power there.  So I sent him off for gas (gave him the money I owed him and said, "Don't you leave me here!", he replying, "Madam, I could not!") and the bank was out of power as well.  The man waiting (and the security guard holding a rifle, but smiling) said that they had gone to start the generator and it would be just a few minutes, he thought.  So I waited, and when the driver came back and there was still no power, I gave up and we left.

The plane was waiting for me, on the dirt runway, already loaded with people from the tourist camps who had seen the gorillas.  No formalities like ticket checking or baggage screening.  Up went my luggage, and up I went on the other side into the seat, and off we took.

The taxi driver bringing me into Kampala told me that the hotel I had reserved was not good, so he brought me here to the Holiday Express Hotel (I don't think there's any relation).  Andrew, at the front desk (see?--he has a non-African name) became my new best friend.  All is bedlam in the streets, they are under construction, there are no signs, traffic (on Easter Sunday, no less) is horrific, and I was terrified to go out of the hotel, not only for the chaos, I was afraid I'd get lost if I turned a corner, mugged, and/or run over.  So he took me to get a Uganda phone (across the street), so that I can call Jane and the driver I'll need to get me to the meeting we have scheduled at Uganda Christian University, and then back to Kampala for a meeting, and then on to her village, if we don't get a ride from others attending.  The phone man had a display that included Nokia and other brand names, and I told Andrew, that I just wanted the cheapest..Of course he said, "Don't worry; they're all made in China".  So I picked the cheapest, then bought a SIM card, which was installed for me.  They we went out to the street, and a man with a stack of cards sold me 10,000 Ush (Uganda shillings) worth of time.  Andrew loaded it up, and I have a phone, and it works.  (Of course I called home first.)  The phone and minutes cost 70,000 Ush--maybe $25-$30 total.  (Oh, I forgot to say that I got money in the airport...only one of 3 ATMs was working).

The hotel room is like a room from a harem, all gold and red, with mosquito nets hanging from the ceiling draped artistically.  The windows open (screened, no less) and there's also A/C in the room as well as a fan.  There is a restaurant here and I had a beer and a hamburger for a late lunch yesterday, a pretty good breakfast, and a very good chicken salad (no mayonnaise, trying not to have any--I've seen how it's stored) sandwich with avocado and fresh tomato on a french roll today for lunch.  But I scandalized the wait staff when I asked to buy two soft drinks to bring up to my room.  I had to promise to call down for them next time, and a waitress had to carry them up for me.

I asked the hotel to arrange a taxi and went out to do some shopping--not much open on Mondays, it turns out, but I did buy some small gifts, tried on some shoes (my feet are way bigger than African women), and made a date for tomorrow with the driver to do some serious shopping, AND go to a Chinese restaurant for lunch.  I have to buy a wedding dress, and a wedding gift, after all.

It's true, Ugandans are very nice people.  Although I did accidentally have some cash in my hand that I hadn't put away, and felt these eyes on me that weren't at all friendly, and the taxi driver made me put my pack on the floor instead of on my lap...sorry, wasn't thinking briefly.

No pictures today, I promise some tomorrow.  The city is very dirty and chaotic, but works, (there's a sewer system and a subway system) and the people are very professional and helpful, those that I've met.  The person at the shoe store was genuinely sorry that she didn't have my size and the woman at the African arts shop discussed the dress I was considering buying for my granddaughter in detail with me, when I was wondering whether it would fit.

Day 8 Bwindi

Sweat is a normal human response to heat.  It moisturizes the skin so that any breeze can cool the skin, using the principle of both conduction and convection.  The smell of sweat can be offensive, hence the market in antiperspirants and deodorants.  In Africa, you just can't worry about it.  Most people, including whites and blacks, bathe frequently and are clean, but there is no escaping the humid heat that causes people to perspire.  Generally, deodorants and antiperspirant aren't used nor should they be, because blocking this natural normal process that occurs twenty-four hours a day is not healthy, and the products are expensive.  So, I've smelled sweat on everyone I've come in contact with here at some time or another, women and/or men, myself included.  It is a normal smell and like everything else about Africa, part of the undercurrent running through the continent.

Today I went on a walking tour of the area with a guide, it was raining most of the time, but I stayed humidly dry under my rain gear.  We went to see a village, Mokono, just a short walk up the hillside.  No surprise, there was a bar and a small store.  We went on to a banana plantation where I got to taste banana juice (sweet, fermented flavor), banana wine (no sweetness at all, clear and a dry finish), and banana gin (70% alcohol--a lot like good tequila, goes down pretty easy), and a drink called Matwa, which is the banana gin plus banana juice.  Tasty, but I'd watch out.  I was offered a pint of the banana gin for $10 US and did not dare to buy it.  I'm all alone here with no one to say "are you sure"?  So, no.

Night, banana plantation worker

Then we went on to see a Herbalist, a healer or "witch doctor" who uses herbs to cure.  This was all on trails through the jungle, mud and cow dung everywhere.  The herbalist showed me a lot of different herbs that he uses--one to cure "tiredness with breathing problems" (probably CHF, maybe he was showing me digitalis...I didn't recognize it).  Also one he dripped into baby's mouths with a funnel for problems with feeding.  Also a gourd with measurements on the side that he would prescribe amounts of depending on age for those who needed a concoction of multiple herbs.  He explained how he examined the person afflicted (looked in eyes, ears, mouth, etc.), and put together the mixture based on their complaint.  It was horrifying, not because of the herbs--there are many that are effective against various medical conditions--it was the showmanship of it, and the appeal to mysticism that was appalling, especially if, as has been reported, the people spend their money on the witch doctors before seeking medical care.

Herbalist, Witch Doctor

Last we visited a faux Batwa village, the huts where they prepared food (or ones just like them) four generations ago before they left the jungle, the family eating structure, and the ladders into the trees where the women and children would hide while the men went hunting.  They danced and sang for me (I'm not sure they did that in their previous culture), and showed me baskets and beads that they made (I know they didn't do that in their previous culture).  The Batwa were forest people, who hunted for their food, had no permanent villages, and gathered as small family units for protection.  They were removed from the park when it was created, provided housing and land, and encouraged to develop some crafts to sell to instead of begging from tourists who patronized the national park.  Of course I bought a basket and tipped them for the dance....too much it turned out--to see the expression on the "chief's" face.

Batwa villagers dance

Day 7, One Week at Bwindi

Day 7
It is thundering outside, has been for a couple of hours.  I expect wind, pouring rain, and cracks of lightening, but so far not.  Down in the valley between rows of mountains, we are sheltered from most of the storms, but in the wet season, as it is now, the rains are inevitable.  We've had two days now with no rain, and Denis, the Guest House Manager, says that just means that more is in store for us.  The air is still, as it generally is before a storm, and I can hear all the sounds of rural Africa.  The river down in the valley echos as a backdrop, but the rooster also crows and the cows moo, louder as it gets closer to milking time.  There are pygmy goats as well, who wander about eating, but they generally are very quiet.  There is also the sound of drums, and the sound of people.

The Guest House sits above the hospital, and there area always people there, talking, laughing.  But there is a whole village around the hospital as well, and here, where the equator is a mere 1.05 degrees latitude north of us, people's lives are lived outside, except at night.  So babies are crying, although not as much as you'd think.  Many babies are carried on their mother's backs in a sort of sling, and are content there.  People are talking, singing, washing clothes, and generally carrying on their daily living tasks, all outdoors.  I've only seen one dog, loose of course, and he didn't look like anyone's pet.  Of course there are birds singing, some loud squawks, and some parrot like bird that I haven't been able to see yet.  I did see a Grey Crowned Crane, which is the bird in the middle (facing the staff) of the Ugandan flag.  The bird was chosen because it was on the crest of the Uganda soldiers when they were a British colony, and also for its gentle nature.

I don't know what I expected as a back drop to the scenery and weather, but it wasn't the sound of people and farm animals here in the African jungle.  There are also a lot less bugs than I expected.  I've seen the dreaded malaria carrying mosquitoes  and I've had a pet gecko in my room for a couple of days (he's now gone), and the wood ants are nothing to fool with (so I've heard, and you don't need to tell me twice).  I heard about a big snake, but no-one came to get me to take a picture, so haven't seen it myself.  I've also seen and tried to photograph the red-tailed monkeys who are all around, but the monkey moved, and the camera moved, and it's all a blur.  I have not seen any gorillas, nor lions, hippos, or other large animals.

Reverend Bernard gave the Good Friday prayer this morning and drew an analogy of how Jesus must have felt as he gave up his life on the cross, as the Reverend remembered the day in 1979 when soldiers from Tanzania (to Uganda's south) crossed the border and stormed Kampala to oust the dictator.  He said that when the people heard that Idi Amin had fled and abdicated, they relaxed and let go of their terror.  It was what he was thinking, and I would never question a Ugandan's interpretation of religion or oppression.

Here are the classrooms of the Uganda Nursing School, Bwindi.

The Bench

On a bench outside the Operating Theatre sit a group of young men in their late teens or early twenties.  They come every day sometimes 10 or more, never less than one, to get circumcised.  There is a profound look of concern and anxiety on each face  as he clutches a prepared booklet of handwritten instructions that tell him  what's to come, theoretically reducing his panic.  It's a big business here in Buhoma at Bwindi Community Hospital, and I was curious why young men at the beginning of their sexual experience would wait hours for a circumcision.

The bench

USAID, sponsored by the US Government, pays the hospital to do circumcisions, having done the research to show that circumcised men don't spread the HIV virus nearly as much as those who aren't.  In fact, the rate of HIV infection in Uganda is now 6.7%, down from I don't know what.  Here's what Jane described.

At the height of the epidemic, whole families would be affected.  It was not unusual for a 14 year old girl to be left an orphan, having the care of 6 or 7 younger children, all affected, as was she.  Spreading the disease even more were those who were infected and choosing to partner with those who were negative, as if somehow they would be made well again. There were so many dead that there was no one to bury them.  As a result, the villages created groups of men and women who were willing to be a sort of burial squad...the Bataka, or "people of the land".  They buried those who died in shallow graves in the fields, no formal graveyards and no formal services, there were too many and there was no time.

The Bataka are used now in community outreach to contact the young men, telling them the stories, which they well know, of the AIDS virus and what it does.  So their serious expressions tell not only their immediate concern, but also about their sense of responsibility, not only for their own lives, but for those who they love and will love in the future.  This is a serious business.

The irony is that yesterday, together with all of those on their tea break (every day at 11:15 and it's HOT tea) I watched CNN and the US Supreme Court debate over same sex marriages.  Everyone in the room looked puzzled and eyeballed me as if I could explain this craziness.  They told me that in Uganda the only reason to get married was when you wanted children, so they didn't understand at all why there was a fuss...people of the same sex can't have biological children, so why worry about marriage at all?  I responded that I thought it was a waste of resources to have the debate, that people should be able to do what they wanted, and they thought that was pretty funny too.

Today's picture is of my bed here at the Monkey Guest House

Bwindi Day 5

Providing electricity for the school involves bringing it from the hospital via two additional poles and a drop.  The local hydroelectric power company is getting us a cost for that.  However, that's only the beginning of the story.  The power generation is excellent in the wet season, and sometimes has enough surplus to last the dry season as well.  When it doesn't, power cycling begins among all of the customers on a rotating basis.  This means that the school will need a generator for those times, such as the hospital has.  Happily there is a generator supplier in Kampala, in fact two. We also will need a converter.  We priced the generator, but have not yet priced delivery, which will be significant.

We also priced 3-1000 liter holding tanks for rain water.  We now need to understand how to outfit a commercial kitchen and handle furniture procurement for the dorms, staff accommodations, classrooms, and offices.  We thought we had done well to outfit the lab!  Jane has done a remarkable job of getting the information gathered, but there is so much more to do that we're a bit overwhelmed.

It turns out that she needs to go to Kampala next week to see the attorney at Uganda Christian University (UCU) to finalize the Memorandum of Understanding that must be signed with UCU in order for Uganda Nursing School, Bwindi to provide a diploma.  We've discussed my traveling with her because we can see the commercial kitchen at UCU and perhaps see, measure and get estimates for  furniture if there's a vendor there.  So then she tells me that she's getting married next weekend as well, AND I'm invited to the wedding that will be held at her village--she'll be traveling there from Kampala.  The logistics and arrangements are daunting.  I asked her how she normally traveled to Kampala, and she takes the bus--12 hours, then stays the night and takes a taxi to do her errands, and comes back the third day.  Alternatively, she takes a night bus, sleeps a little on the bus, does her errands during the day, and comes back the next night.  Neither of those would be appropriate for me, for many, many reasons, so we are investigating a hired car, or renting the hospital vehicle.  Happily, there is almost a week to plan.

Today's story is about the oats.  As I've told you, there are Danes staying here, medical students, who've been here seven weeks.  Evidently, they were served oatmeal (the oats) when they first arrived pretty regularly, and they even asked for them as opposed to the unrelenting eggs, toast, and occasional sausage.  The oats consequently ran out three weeks ago, and there were none to be found in the village here or Kihihi.  Yesterday, a Scots couple, both of them physicians volunteering for a year at Bwindi Community Hospital and returning from Kampala, brought three containers with them to much celebration.  Oatmeal was served this morning to great acclaim--I had eggs, toast and sausage.  I like oats, but I hadn't the heart to take away from the stash.  The Danes are here for another six weeks.

Emile and Anna

Meet Robert, the Head Nurse for Nursing and Midwifery at Bwindi Community Hospital.  He will be one of the adjunct faculty at the nursing school as well and is struggling to implement the nursing process and nursing care planning at the hospital.  I told him that the school would take care of that, and that he could assume that our graduates would be doing care planning every day for every patient.  

Robert, Head Nurse, Bwindi Community Hospital

By the way, if you'd like to know more about the hospital, see their website.  http://www.bwindihospital.com/

Day 4: Bwindi
The day started as usual with prayer and announcements, briefer than yesterday.  Jane and I are making steady, but sure progress, and you should meet her.

Jane Anyago

We took a trip over to the school to see the progress and plan the furnishings, and worked more on the budget for opening this school in November.

The maternity department at Bwindi supports women's health in many ways, but one of the most profound visions of that is shown by the area surrounding the maternity unit.  There is a women's hostel where those who have high risk pregnancies or live too far away to be certain of reaching the hospital come at week 36 or 38 to stay until deliver.  They bring their other children with them and also their bedding and food for cooking.  They pay a minimal amount to stay, but are in the company of other women to learn, be supported during labor, and have ready child care when they deliver.  They also sit in the sun on the grass or in the shade and teach each other about living, motherhood, men, and various other things that women need to know to survive in this harsh area.  The image of the colorful laundry hanging in the open area expresses all of that.

And then there is Nurse Ruth, who works in Pediatrics.  The nurses here in Uganda have the core responsibilities of nurses everywhere, but do a variety of things and see many visions that we in the US might never experience.  When was the last time you gave an anti-helminthic?  More about that later. 

Nurse Ruth at morning meeting

We are having company for dinner, a visiting physician from England and his wife.  They'll be with us until Saturday.  Two Peace Corps workers will join us, who are staying at the other guest house.  They will be housed locally, and work on projects here in Buhoma, the village where the hospital is located.  Jane showed me a large plot of land that has been bought by an Englishman and planted for crops for the local villagers.  His plan is to teach them how to grow and incorporate vegetables in their diet.  I've been discussing this abundance of help with Denis, the guest house manager, who believes that the closeness of this area to the Bwindi Impenetrable Forest, and other beautiful spots in Uganda as well as the Mountain Gorillas, makes it very visible to an affluent group who can also see the great need.  In this remote area of Uganda, which is off the grid and 12 hours from the nearest large city, poverty and need are overwhelming.  Help is also given by those who can.

Day 3 Bwindi

Day #3 Monday

My first day of work was today.  Each day at Bwindi Community Hospital starts at 0800 in the area outside the outpatient department with a prayer and meeting of all staff who can attend.  Reverend Bernard read scripture about Jesus and the Last Supper, and then chastised those who had found other things to do than attend the services Sunday afternoon, telling them that as part oft the community, it was their obligation.  There of course was singing and clapping. I felt righteous, having done my part.

The Hospital Administrator, Charles, introduced himself and again welcomed me.  He and a group from the hospital were spending the day going out to one of the nearby communities--"visiting their stakeholders".  During these visits, they discuss the upcoming nursing program and also recruit participants to the health plan that the hospital has.  Patients pay monthly for the ability to use the hospital services when they need them--sounds kind of like insurance.

Jane and I attended a "Learning", held each Monday and Wednesday in the Dining Hall--all interested staff may attend.  The presentation today was provided by the HIV Outreach Team who travels to surrounding communities to educate and provide testing services for HIV.  The raw data was presented by a volunteer from the community who is part of the team and HIV positive.  She said: "I'm the advertisement for the reason to get tested, I live a full rich life with HIV."  The numbers tested had declined slightly over the previous year and the team felt it was due to a lack of funds.  They have not been able to visit the villages the day before to promote the next day's testing, relying on radio advertising instead.  There was a lively debate which it was a pleasure to watch.  Gently, and without blame, the group questioned the conclusions and discussed other ways to recruit, as well as point out different ways to determine success.  The dentist told a story about traveling to a village to provide dental care and, finding no one waiting, going to the school and asking the teacher to send all of the students home for a visit to remind their parents.  He got 10 patients.  Another asked whether they were looking at the right data...he wanted to know why they were not tracking those who tested positive to ensure that they had received follow up care, asking "Isn't that why we want to test?--in order to treat?"  There was no defensiveness, and no animosity among the group, only love and support.  They elevated their practice, and provided ongoing quality improvement by their actions.

Jane and I have been charged with developing the budget for supplies, equipment and other costs associated with the school and we are already late.  We organized the data and were pleasantly surprised to find much of the work already done, just needing to be combined into a presentable form.  We worked on that today, tomorrow will take the plans and go over to the school, taking pictures of progress, and placing furniture where it will be needed.  If we get that job done, we'll travel to one of the local schools to get an understanding of what it takes to outfit a kitchen for 3 meals a day....that's what the schools provide.

Jane and Charles (the administrator) have gotten a quote for a BioGas generator in order to fuel cooking. The BioGas generator will produce methane from the septic system.  There has been some discussion about whether the location of the septic was close enough to the kitchen to be economical to transport the gas, but evidently so.  We'll include that quote in the proposal for funding to Rotary International.   The electricity to the school may be able to be provided by the process which the hospital uses, a small hydroelectric company that is locally run.  Rain water caught in barrels will provide drinking water.

I had a surprise when I visited the restroom, for which I wasn't prepared.  The toilet was the eastern variety--within the floor.  I've used them before, but it takes thinking and practice, as well as strong leg muscles and a sense of balance.  I'm not always good at all of those things at once, so also need a potential hand hold.  I was only moderately successful.  Happily there are hand-washing stations everywhere.

Breakfast:  Scrambled eggs, toast, water, fruit, Nescafe.
Lunch: Beans, rice, plantains
Dinner:  Fried fish (probably perch), rice, mashed potatoes.  Oh what I'd give for a salad...

Monkey Guest House

I sleep at night in the back bedroom, which has two bunks.  Happily, I'm the only one in there.  I have a mosquito that wraps around the bed, and there's an open window with bars and hard screening attached.  There is a communal bathroom, but it has a real toilet, and a shower with a trickle of hot water.  Meals are served at the big dining room table in a great room.  My home for the next month.

Bwindi Day #2

Church of Uganda at Bwindi Community Hospital

Bwindi Day #2

NOTE:  In order to post a response you will need to have a google account.  They are easy enough to set up, just be aware.

Still recovering from jet lag, I was awake at 0100 for good.  I rested after breakfast, and spent the morning visioning my camera returning to me, having found Houssein and asked him to look in the pick-up truck and under the seat for my very small, but very precious camera. 

At 1500 the guests were all invited to attend Easter thanksgiving services for the United Church of Uganda-Anglican, held at the hospital in the administrative wing.  To follow was a good bye ceremony for 2 of the staff who were leaving the hospital.  Just before they started, Aida, the Communications Officer returned my camera to me--Hussein had found it!  So I have pictures to add to the blog. 

Other guests at the Guest House are a videographer doing a documentary on the Batwa pygmies, and two medical students from Denmark doing a rotation at the hospital.  Last night we were joined by four people from the other guest house who are part of a sonography company interested in and training sonography techs.  They are providing ultrasound machines used during pregnancy and the training to go with it.  I was excited to discuss the possibilities with them for including this training in the second half of the program during the midwifery component.  We exchanged cards.  Then the videographer, who is a Rotarian from Nevada City told me about an email he had received from the West Sacramento Rotary club seeking input on whether to support the Rotary International grant that is being submitted by Sacramento.  Since he is now very familiar with the project, thanks to dinner table conversations, he was happy to do so.  That must be what Scott and Carol Kellerman had in mind when they developed the Guest Houses and organized them along the hostel model. 

The Ugandans take church and all ceremonies very seriously, although not time as a specific thing to keep track of.  After starting ½ late, we were there 2 ½ hours, and the choir sang 14 songs, every stanza of each.  And then the good-bye ceremony started.  There was more entertainment, and I’ll say that the singers were excellent, heart-felt, and fervent in their religious expression, while all the time having a good time.  I was introduced, and received well wishes from all present.  There were many babies, and the Ugandan women were stunningly dressed with head scarves, dresses, good shoes.  They were beautiful.  All this in the midst of babies needing feeding and rocking, and a pouring rain storm.  Swallows flew in and out of the service, stopping to perch on the rail around the second floor balcony, and I swear they were joining in.  Dr. Burundi played the electric piano, which also had percussion, so it was quality entertainment.  Then it was time for dinner, for which I didn’t stay.  I’m still full from lunch.  I heard that it was utensil-less and pork, all parts.

For breakfast, we got one piece of toast, eggs (omelet or scrambled) and fruit, which was a banana and some very ripe watermelon.  Nescafe, tea and water are on offer all day and night, but there’s no ice (no refrigeration) and nothing else.  I’m already a bit sick of warm water, and you haven’t really experienced the need for coffee until you’ve settled for Nescafe with powdered cream…..it’s hard to find the resemblance to coffee in that mixture.  For lunch, it was spaghetti, Uganda style.  Some meat, sauce of tomato origin, over spaghetti, surprisingly good, but I’m still full.  And I’d probably pay $100 USD for a cold beer (or two).  It’s early days, but the Danes are game for finding some next weekend, but it won’t be in this area, perhaps Kihihi (40 km away).  

Eggs are served with most meals, and I love eggs, but the yolks are very, very pale.  The chickens are all free range and plentiful.  It seems that since they eat lots of grass, they don’t get anything to make the yolks yellow, they are pale—I think I’ve also heard that it’s a sign of iron deficiency in the chickens, now why would they be any different?  Overall, we probably eat better than 90% of Ugandans, and certainly higher than those in this area.  I'm not complaining,just discussing what there is to discuss.  Food is always important.  

I've made a list to begin discussing with Jane.  I wish I had a large chart pad to use as a brain storming device, but we'll make due.  I'm excited to get started.

Day 1: Travel to Bwindi from Entebbe

Day 1: March 22

I arrived about 1100 at the Monkey Guest House here at Bwindi, having flown from Entebbe on a 13 passenger propeller plane through rain to the mountains.  I was driven through the red mud, gully crossed roads by Hussein, who aired up his tires for my comfort.  I told him I'd been on roads like this in Nevada.  

Mist covers the valleys and mountain tops, but all is green except for the houses and the road.  People walk in the road to and from their business of the day.  There were at least 10 men at the Petrol station to help air up the tires, 5 men in Entebbe to help lift my suitcases up the stairs at the airport, 3 men and the woman pilot to help unload them at Kihihi Airport, 40 km from Buhoma, the village where Bwindi is located.  All labor appears to be manual…no electricity here except in the hospital and guest house and supposedly it’s solar, although I haven’t seen the panels.  There were many women with head burdens and I saw one with three small girls all walking with their head packages, it looked as if she were teaching them.  Pedestrians take to the ditches for vehicles, even small children.  All are curious about white faces. also very reserved--no smiles.  

Hussein explained that there are three roots of the many dialects spoken in Uganda.  Each dialect with one of the roots can usually be understood by those within the root one.  In Entebbe, they spoke Lugandan, here in the southeast, it's Rukiga.

Hussein showed me the Congolese border in the distant peaks, which is closed.  Along the way we had given a ride (back of the pickup) to a couple of soldiers, one with a gun…who was several miles from his destination.  We picked up a second in uniform, but without a gun.  We let them both out at the tea factory.  The soldiers patrol the border to prevent raiders from coming across.  There is a barracks not far from the village, Buhoma, where the hospital is.  He assured me that their president had promised there would be no more raids after the last one in 1999.  Fourteen years is a good long time to feel safe.  But Denis, the Guest House Manager also introduced me to Joshua, who is the nighttime guard.  The hotel in Entebbe had a fenced compound, with a gate and guard.

The hillsides and valleys are covered with tea plants, with some being hand-harvested.  One hilltop had women plugging rice plants—I guess at the start of the wet season it grows without irrigation.  The hills are softly molded, bespeaking the age of the countryside, with streams and rivers in the valleys, running brownish red with the rain.  Everywhere people are walking in the road, both directions.  

I had lunch here, some potatoes with mayonnaise, a small sausage, and a delicious cabbage salad.  There is tea 24 hours a day, and Nescafe with powdered cream.

 

I met Jane, the Director of the nursing school about 1430 and we had a tour of the hospital, without invading privacy.  I had been walked over to the hospital by Dr. Bugana, who was at lunch and is the Executive Director, turns out.  He showed me wood ants on the trail (very poisonous).  They were swarming across the trail as ants do.  There was talk of a snake, unseen, but I did see a small monkey in a tree briefly.  When I ran into the doctor a short while later, I mistook him for the hospital administrator, Charles and was embarrassed when he reminded me he’d had lunch with me.  He was sympathetic and said that when he’d met five new people at the Guest House, they all began to look alike to him.  Joke on me, although it wasn’t a joke. 

Jane and I walked around the hospital, a small boy was at the exit from the Pediatric unit, holding the large iron door.  I looked around for his mother.  I didn’t see anyone watching or concerned, but he also didn’t go out, probably already knew enough to stay put.  It was hard to tell if he was a patient or not, since the whole family comes when one is sick.  I didn't notice many men around, except one waiting for a circumcision…the doctor said they do several each day--but there were some in the maternity wing.  We walked over to the school, still visibly under construction.  It will be beautiful, but is very rough at this time.  There is a great room and administration building, with offices already designed.  I told Jane she needed the corner one with two windows.  There is a computer lab and a faculty office area.  The central area is for student work and study.  The dorms outline the perimeter, the kitchen area is open, with some sewer connections.  The dining hall and storage area on the other side….no connection between the two sides, which I’ll ask about, but it does bring up a clear almost class line between the professionals and workers, which I’ll ponder later.  I’m uncomfortable having people cook and serve me continuously, do my laundry, and watch me for what I might need.  They don’t do it out of concern, but because it’s their job, but they do it politely and with integrity.  Moses got as irritated as he probably gets (which is not much) when one of the dinner guests from the other Guest House was fooling around with a broken guitar when dinner was about to be served.  The rule is you sit down-at your own specified time-and they bring your plate.  This 20 something from Vermont, was just a kid on a trek who was exploring his surroundings, and hadn’t a clue until his (female) partner said, “I think he wants you to sit down for dinner”. 

Jane wants to start work Monday morning.  I’ll go to the meeting at 0800 where the staff plan and discuss the day in the Outpatient Clinic, then we’ll get started. Everyone has consistently said how much they’ve been waiting for me to get here, and are happy that I am here.

One example of their challenges is childhood malnutrition.  When a child is malnourished, both Jane and the pediatrician, Leonard explained over dinner, one of their goals is parent education.  They have a garden where they show the parents what foods to grow for the children and they do lots of other education as well.  Leonard said that the children's diet is high in carbohydrates and very deficient in protein.  Also, once they’re weaned the parents tend to feed them an adult diet, which does not meet their needs.  He says bananas are bad for children, especially since the ways in which they are prepared removes all nutrition.  However, just as in the US, malnutrition always has a social component, such as a mother ill or dead, or money being diverted for alcohol.  Also, the ground to cultivate for even a small plot is of poor quality because the tea plants take the very best soil, which led to a question about who owns the land, and he said ownership pre-dates colonialism, which I found fascinating, but in this corner of Uganda, evidently it’s been handed down from ages ago through the former tribe structure and is now divided up many times.  He says, it’s just “known” whose land is owned by whom.  Huh. 

So we certainly have to include much about nutrition in the curriculum.  I did tell Jane that I thought the basic curriculum to create a diploma nurse was adequate and doable--we didn’t pursue the topic.  

I'm in the backyard at the Guest House having morning Nescafe.  There are a mother and child red tailed monkey in the trees above me.  Pictures later.