The Ants Go Marching On…..

For some reason, the past few weeks I have had some unpleasant encounters with ants. Maybe that is why Friday afternoon, I began to think about all the people I passed in Mulago in terms of ants. 

First of all, let me tell you about ants in my pants…..literally. When I was in the rural hospital in Buluba, two of us often sat under a tree while we waited for the rest of the students to arrive for our Ugandan lunch. Most days I wore a skirt and as I saw little red ants crawling on my feet and legs, I quickly brushed them away. Then one day I wore scrub pants and didn't notice the ants crawling. Halfway through lunch, I started to feel extremely painful pinches in different place on my legs. I didn't realize it right away, but there were dozens of ants crawling up my legs and attaching their super sharp pinchers into my skin. I tried to inconspicuously reach into my pants to find them and brush them off but it was no use. I had to run to the bathroom and take off my pants so I could remove them all. I learned my lesson about sitting under trees. I had a similar experience during our hike in Sipi. I stopped to take a picture of some beautiful flowers and shortly after, realized I had stepped near a tree with lots of ants and they were crawling up my legs. Luckily, I was able to get them all out without having to find a place to take off my pants. However, later that night, I took off my pants and found 4 or 5 dead ants that were still attached with their pinchers to the seams of my pants. Writing about it now sort of makes me hurt just remembering those experiences! 

Such a pretty flower - worth ants the ants!

My most recent experience with ants was not so negative. Last Sunday after church, my friend Patt and his father took us to Entebbe for fresh tilapia straight from the Nile. (this was my first experience with eating a fish cooked whole, which is an entirely different story that I should probably tell later). After we finished, I became fascinated with the ants crawling all over the table. There were some fairly large pieces of fish and fries remaining on the table and slowly, the ants gathered to collect them. When I watch ants, I find that I end up seeing one big black blob of crawling things just moving aimlessly and crawling all over each other to do whatever it is that ants do. Then, if I take the time to look closely, I try to watch one ant and see what it does and I realize that all the aimless movement actually has a purpose. I watched one of the ants for a few minutes as he seemed to chip away at a piece of fry until he was able to break it off and carry it back towards where I assume his home was. He had a goal and was working hard at it. Sometimes other ants were joining near him - maybe helping him or maybe trying to interfere - I don't know that much about ants. Eventually he made it and appeared to finish his task as he disappeared into a crack in the picnic table's wood.

So fresh!

So that was a lot about ants - the more important thing I was thinking about is people. This country has around 36 million people and the area of the whole country is about 4,000 square miles bigger than Minnesota (with a population just over 5 million). That's a lot of people in a small amount of land! At Mulago hospital, and especially in the Labor and Delivery floor, you really feel the sense of a dense population. When you look through the rubber ducky curtains, it is easy to just see a bunch of "ants" as they are all going through the process of delivering a baby. If you walk over to postpartum areas in the afternoon, there are women in every bed and the floors are covered wall to wall with people who have just had babies. You have to push your way through most times to make it from one end to the other because other people are either trying to go the opposite direction or have stopped to accomplish some task in the middle of the walkway.

On Friday, Pamela and I had to bring a newborn baby with respiratory distress from one end of the ward to the other to deliver it to the special care unit, which meant passing through the pre-natal, postnatal, and special care units along the way. As we brushed past so many people and navigated our way around messes on the floor, I suddenly had a flashback to the ants this weekend. It felt like so many people were just wandering from place to place, brushing past each other in their movements. If I look at it from a birds-eye view, all I see is mass movements of people going from place to place without a real purpose. It is easy to see the people simply as obstacles as we moved through with our important delivery to special care. If I would have stopped to look instead at an individual person, I would have realized that everybody is trying to do something. Maybe it is a husband going to fetch porridge for his wife and new baby. Maybe it is a new mom trying to find a place to rest. Maybe it is a new grandmother looking for medicine for her daughter. Maybe it is a woman trying to find out where she can go to deliver her baby. Maybe it is a women who lost her baby who is just trying to grieve. You just don't know until you take a look at the individual. I wish that I had the time and energy to look at every individual as we interact with them. It's so hard to be able to do when you are overwhelmed by the masses! It makes me so sad sometimes that I have been forced to move so quickly from patient to patient and not really get a chance to always have those individual interactions. 

My biggest reminder was when we finally arrived at special care. Pamela proceeded to bring the baby inside while I stopped at the front desk to fill out the paperwork. As I stood there, a man with another man who appeared to be his father stopped to talk to me. They started by thanking me for my work. He then proceeded to sadly tell "our baby died" and that he was trying to find the papers to bring the body home. What do I say to a stranger is this situation. I just stopped my work, put a hand on his shoulder, and said "I am sorry for your loss". He and the other man thanked me again and I said something probably useless about hoping they found the information they needed soon. I still don't have a good answer when confronted with these sorts of situations. Yes, I am going to be a doctor (IN JUST OVER THREE WEEKS!?) but that doesn't mean I have lots of things figured out. At least at home, I generally have a structured environment and usually have answers for the people who come to me with questions - or know where to find answers. I have a long way to go in making sure that I always find a way to be compassionate and find a way to really show that I care, even if it is just a few minutes in passing, those little interactions may have a lasting impact. It is easy to forget and just ignore the little things along the way. I am glad I had at least a little bit of a reminder on Friday. 

So maybe it does seem a little bit like the ants are always marching on and on at Mulago but that doesn't mean that every "ant" isn't a special person with a story and a purpose. I need to keep reminding myself to look at both the big picture and the individual no matter what I am doing and hope that I can find  way to make a difference for individuals as well as a group of people whenever I can.

I was so fascinated by these little ants that I snapped a picture