Just another big kid

I love the Wooly Kids! After knowing them since 2007, I feel like I have watched them grow up before my eyes and become vibrant young men and women who have such strong personalities. It's so much fun to spend time with them now that they are a little older and we can talk with them and tell stories. Kenneth, Trevor, Arthur, Kirabu, Martin, and John are now all ages 11 and up and they have started to take on bigger responsibilities at home. Arthur helps a lot with cooking. Kirabu has been helping with the media at church services. Martin is in senior high school and wants to be an engineer. I almost always lose sight of Kenneth and Trevor when we visit Watoto and usually find out that they were going to help with hauling food from trucks or cleaning the house. It's always really fun to see the older boys watching out for the younger kids, too. They make sure that all the little ones aren't left behind and they gently correct them when they are fighting or not following the rules. It's been very rare that I have seen them bullying the younger kids but occasionally I see them snatch a toy or a piece of candy from the little ones either to tease them or just plain be mean. I don't think it's much more than what Ross probably did to me as a kid and I would never say that he was a bully to his little sister.

Every year since the second year we were here, we have managed to take the kids to a fun place outside of the village. We have gone to the zoo, to the mall to eat chicken, and even to a big kids event at the rugby field. This year we went to a new kids park at a mall called Freedom City. When Joseph dropped us off and said there is a nice pool, I had a hard time envisioning where a pool would be in a mall. It turns out the entire top floor is a kids area complete with 3 pools, carnival style rides, trampolines, swings, and a big outdoor concert stage. Since Easter Monday was a holiday and Tuesday was not, the place had been packed full the previous day, but today was deserted, especially in the morning on Tuesday. We got the whole place basically to ourselves for the first couple of hours which meant we had the freedom to run around and not worry about losing any of them.

To make it a short post, I am just putting some of the pictures we posted to capture the day. The kids just make me happy and some of these totally capture their personality. We are off on a 3 day safari until Saturday! I'm hoping for not too much rain and safe driving all the way to Queen Elizabeth!

Trevor jumping on one of the seven trampolines

This and the next are my two favorites. Kenneth had just climbed all the way to the top and you can't see it, but one of the other boys is trying to pull him down.

Joy - she's mischievous and full of energy and will do whatever she wants if you don't watch her carefully. This face is pretty much how I can sum her up.

Irene - I picture her as the most calm of the kids. She is always even tempered and has a smile that lights up the room

Hanging out with Arthur, my sponsored kid. I looked at old photos of him from the first time I met him and he is SO grown up!

Their favorite past-time - eating chicken and chips. 

I think my mom was in her glory, getting to have Irene sit on her lap the whole mtatu ride home. There were 2 moms, 3 other adults, the driver, and 16 kids crammed into one.

The whole crew waiting to go inside. It is not easy to get them to stand still when they know we are about to start an adventurous day!

Arthur, Trevor, and Joshua - three of the boys with the biggest smiles

Swimming - Patricia was on tour with the choir and we met her in Canada. She had recognized us from visiting Bbira in the past and we were able to find her when we visited last week.

The beginning of boat races - I think these boats are pretty sweet, but much harder to crank those wheels than you would expect.

Sheer determination - this look was on his face the whole time he was paddling.

Pamela and I were tired so sleeping on the trampoline seemed like a good idea. Arthur, Kenneth and Patricia just wanted to join us.

Awesome little wading pool. Warning - if you try to stand with 16 kids in the pool, you will not stay dry, splashing is a favorite pastime.

I was ecstatic that they let me on the big slide. It is much harder to climb than I expected but so worth it!

Swings

The lady watching the trampolines insisted I take a turn.

Making some bracelets while we waited for chicken.

Peter made sure he had it in his favorite color!

A Bit of Buyer's Remorse

Happy Easter Monday Everybody! Today is a national holiday here in Uganda! In addition to Friday, Saturday, and Sunday, Easter Monday is officially a government holiday where people are not required to work and most people are still spending time in the village with family. The city has felt very quiet all weekend which I assume is because so many people have gone out to be with their families to celebrate in the village. Even church on Sunday did not seem as full as previous weeks! 

By the way, the messages have been really great at church, Worship Harvest. They seem to be relevant to everyday life and are delivered in a very energetic way. There might not be a choir of over 100 people like there is at Watoto, but the dozen or so musicians and singers really know how to sing and DANCE! If you know me well, I am not always the one to be first on the dance floor or move around. When it comes to worship, I love singing and maybe a little moving around but I just can't seem to move my body in a fluid and natural way to the beat of any song the way that pretty much every Ugandan I meet can. There is one Mzungu singer in the choir. (if you haven't learned before, this is the word meaning "white person" or "foreigner" and is how many people on the street call out to us non-Ugandans who are lacking a bit of skin pigmentation) She has a lovely voice but she always looks out of place when she is with the group. She moves around and dances a bit while she sings but her movements just don't appear natural. Whenever I see her, I am reminded of what I must look like and become a bit more self-conscious about how I am moving during the songs. Then I remind myself that it doesn't matter if I look like a fool or not. God just loves it when we have genuine and heartfelt worship, whether it is song, prayer, or crazy dancing. 

I just thought I should share one part of the message on Sunday that stuck out the most to me. Let's be honest, it's pretty amazing to celebrate the great sacrifice that was made so all of us could live so Easter Sunday is automatically expected to have a good message. The main reading was from John talking about finding Jesus' tomb empty. I don't ever remember this one detail about Peter and another disciple  both were running to the tomb and the other disciple arrived first. He stopped outside and stooped down to look inside to find the tomb empty but the linens remaining. Peter then arrived and went inside the tomb and examined the linens and wrappings. Later the other disciple entered in and examined for himself and then he believed. So many times God calls us to something and we stand on the outside peering in to see what we can see instead of entering in all the way to experience the thing that we were called to do. 

At this point in the sermon, I stopped to re-examine what in the world I am doing here. I think that nearly every trip I have taken I try to fully immerse myself in the people and places while I am here. This trip, though, I sometimes find myself stopping short and not fully engaging. I don't think it is on purpose, but rather that it hurts when I actually step all the way into things. Whether it is not wanting to fully focus on one patient because that makes the disease hit harder and feel more real to me, trying not to stop for every person that calls mzungu on the street to talk to me because that means I actually have to listen and learn about them and their story is likely hard to hear. It's easy to try and justify NOT fully stepping in because it is too hard, but that doesn't mean it's right. It's not that I am always this way, but sometimes I realize that I could have done more or done things differently and the outcome might have been a little different or at least I would have felt more strongly about what happens. I want to be sure that I am fully engaging, fully entering in, and fully experiencing what it is I am meant to do here. 

I think about something my mom did on Sunday. There was a woman walking behind us on our 1.5 mile walk to church. After a little while, she started talking to my mom and in her true character, my mom asked her all kinds of questions and learned a lot about her. She even invited her to come to church with us and the woman decided to come and sit with us, even though she had been planning to go to some other church. Who knows what the plan was with this woman, but she ended up being very thankful to come with us and it seemed like my mom had made a new friend. I used to be a lot more like that here and still do talk to a lot of strangers, but I am a lot more weary. After dozens of interactions that ended with "can I get your contact?"(and then they call multiple times daily until you leave the country) or "so I really need a sponsor for school fees, can you help me" or simply, "Mzungu you give me money", I just tend not to engage in as many of those random conversations anymore. I have to remember, though, that not every such random meeting on the street is random and there is often a purpose in meeting a stranger. 

Okay, that was a little off the topic of the title of today's post title, but maybe I went on the rant because I just feel a little bad that the only activity I really did today was shop. We decided to dedicate one day to shopping at the craft markets to get all the gifts and souvenirs we wanted so that we wouldn't have to go back and that we could then move on and focus on the projects the rest of the time here. The problem with this strategy is that I spent more money during today's excursion buying things I don't REALLY need, but liked a lot, than I usually spend every 3 weeks since I have been here. In reality, it isn't that much money, but it feels like a ton. For every 100,000 shillings, I am spending around $40 and the most expensive single I bought was a beautiful painting of an elephant for 80,000, so $32. 

I also spend a fairly large amount of shillings on fabric with the intention of making a quilt and some other projects at home. The first week I was here I went with a friend to pick some other things from downtown and we had looked briefly at the fabrics but I decided to wait for Pamela and my mom before I made a purchase. The problem is, it's not always easy to find the places again because downtown there are tightly packed streets with narrow walkways and they all start to look the same. This was the third attempt for me to find the street with all the fabric on it and I finally found it with a little help from our cab driver, Joseph. I knew that it was across from where the food market is and a short walk from the taxi park (a huge parking lot with hundreds of mtatus jammed in waiting to go all over the city and the country) and that there is one yellow arched sign. The details clearly are not that helpful, and the other times we went we were walking and it is harder to pay attention when you are just trying to put one foot in front of the other without knocking into people or things. Riding in the car, I was able to pick out the details of the street and found the right one on the first try! It's easy to know it is the right place because the same items tend to all be sold on the same road. If you are looking for a computer, you just need to find one shop and alongside it will be 20 others. If you see a sign for paint, the entire street will be shops selling it. It's easy when you find the right stuff, but if you are looking for fabric and all you find are floor tiles and building supplies, it can be frustrating.

This third attempt I was finally able to find the right street. I saw a guy using a sewing machine outside of building and then one shop selling textiles and I knew all the rest would be the same. We took one little detour, but after that I remembered the spot I was looking for and found the exact woman's shop that I wanted. I had purchased fabric for curtains a few years ago from the same lady and I knew she always has a good selection of the types I like and I remembered her prices were fair. After she spent over 30 minutes climbing over fabrics and pulling down dozens of different prints as my mom and I tried to put together complementary patterns, I was finally satisfied with my collection. I thought I was buying a lot of really expensive things because the amount of shillings I handed her seems outrageous. Then Pamela announced that she did the math and what we got was about $2.50 per yard, which is significantly less than most similar fabric you can buy at home. It was a success!

The rest of the day was spent walking around so many little shops that I couldn't even give you an accurate count. All of them sell similar, but slightly different things and, as with most markets, the prices are never the same and are always negotiable so if you have the time you can look around until you find exactly the thing you want at a price that is what you want to pay. It's a lot of asking, "how much is it" and then, "will you give it to me for, XX?" and then back and forth with questions of price. The whole process of bartering is tiresome, though, and at the end of a day like that I just want to go to a quiet place and not ask or answer a single question more, even if it is something as simple as, "what do you want to drink?". 

By the time you go through so many shops and see the same things over and over again, it all starts to look like the same old stuff. So I could go on and on about stories from the market and all the crap, I mean, craft market things that I bought and was pretty happy with, but I think I do feel a little bad about it, still. I mean, in total, I spend probably around $175, with the majority of that on fabric and my special elephant painting which is relatively not that much if I were shopping back home. However, when I am here and have been spending so little on things to take home and have been so focused on the people here, it feels like a spent a small fortune. Although I like the things I got - like some sweet sandals, an elephant with crazy eyes, and a pretty bag, plus lots of random gifts that I can't wait to give to the people I got them for, I don't really need any of them. I will say, that when I get home and wear them and use them, I am reminded of this country, of these people, and of the memories here. It's not like I need the things to remember because so many of the moments I remember are engrained in my mind, but sometimes I like that my living room makes me feel a little like I am in Uganda or that when I wear certain items, they become a conversation starter about this place that I love. 

For tonight, I will feel a little buyer's remorse for doing nothing but shopping, but will try to remember that it's not like this always. After today, there will be a lot more of visiting orphanages and giving them things they need and sharing life with them. Hopefully there will also be a lot more stepping into every interaction and not examining from outside.

Ground Breaking

This week as already gone by really quickly! I can't believe that it's Friday tomorrow or that it's Easter weekend already! My time in Uganda is winding down, but as expected the last three weeks are shaping up to be lots of work, but lots of fun, too! On Wednesday, we went to Kayunga to visit Pastor Kawooya and House of Peace to take a look at the start of latrine digging and to give my mom a real picture of what needs to be done in order to get the house back in shape.

I don't think I mentioned it before but on Saturday I had a meeting with Pastor K and two members of government offices responsible for overseeing children's homes in Uganda. I was really glad that we met with the official members of the office instead of just getting the information second hand from Pastor K. It's not that I don't trust what he has to say, but sometimes it gets a bit confusing when you are talking about renovations for things you have never heard of or seen before. I have also realized over the years that although sometimes it is really easy to just go in and help out or give some money to assist in doing things that people need, it isn't always the best way to go about things. A lot of times there are members of offices in charge of important regulations that are willing to help out if they know you are all working towards the same goal of giving the kids a safe place to live and grow. We got some good clarifications on requirements. For example, Paul and I initially thought that building a fence was a waste of resources because they live in a village and have 10 acres of land. It turns out that every home that has orphans in it needs to have an enclosed space around the home, but there isn't a specific requirement of how the fence should be built. It still isn't completely clear if the fence will keep anybody in or out, but we want to follow the regulations. In addition to the fence, there is a long list including fixing the foundation of the floor, putting in new windows, digging a garbage pit, possibly adding a flat ceiling, getting electricity, building a shelf in the kitchen,  putting beds in every room, painting the walls, and fixing the outside cement work. What started out as a request to help build a toilet to get the kids back in their home has turned into a bit of an extreme home makeover.

Sometimes I have my doubts about any project in Uganda - or any project in general. I have talked about this project in previous posts and I still have pretty much the same thoughts. However, my mom did give me some new perspective that I am a little ashamed to say I was pushing aside. In my mind I kept thinking that now that the kids are in Jinja, even though they are split up in many different homes, they may not have it so bad. I mean, the schools are a bit better, the walk to town and school is shorter, they are in smaller groups, and they seem to be doing just fine. When Pastor K talks about it, though, he reminded us of how he left the village after the majority of his family and many in the village died from HIV/AIDS in the early 90's. He didn't want to be a part of the village anymore. Later, God called him back and put it on his heart to help these children and he has been taking them in since around 2004. Since he started, this has become their home. The place they have been growing up and the place they love. It might be in a rural location, and it might seem like the village isn't the best place to be, but I think that is mostly because that isn't where I grew up and that isn't what is familiar to me. Thinking about it this way made us realize that being home is a big deal and it is important for us to help out in any way that we can. So to anybody who donated to Medicine for Sick Children or directly to my mom for this project, thanks a lot! This project is meaning a lot to Pastor Kawooya and the kids and the goal is to have them back at home before the next school semester starts in June.

During our actual visit, we watched as a tractor tilled some of the fields while a couple of guys were doing the same work by hand. A month ago I was discouraged when we visited because it looked like any attempt at having a legitimate garden or farm had completely failed. I think all it needed was a little bit of the rainy season! This time, there was so much green that I almost didn't recognize the place. It seems that planting and growing isn't going to be that difficult, after all! Also, in honor of the re-building and fixing of the house, Pastor K wanted to symbolically plant an orange tree. Here's to hoping it grows up big and strong!!

Orange tree in the middle of the maize - it grew that tall in just 4 weeks or so!

The orange tree

The man came to start digging the pit for the latrine style toilet. It needs to be something like 60 feet deep and he said it will take about 5 days. He managed to dig himself in about 6 feet by the time we left. His tools were a pick-axe, a shovel, and a hoe. I am a little unsure of how 60 feet is going to happen, but I have seen some pretty deep holes dug by hand here before, so I am sure it will eventually get done!

New Site for the Latrine. Here's to hoping for no rocks!

The old toilet - totally full and falling apart

We are planning on doing a lot more work over the next three weeks but our next visit won't be until about a week and a half from now. We are hoping that they will have been able to fix the walls inside and do enough that we can do some painting inside. Clearly, we don't have a lot of skills with building things, gardening, or doing other projects in this country, but I think painting is pretty universal. Hopefully our painting abilities will be useful more than they will hinder progress!

It's not all about work, though. On the drive home, we took a pretty nice stop at a waterfall along the way to Jinja. Just a 5 minute drive from the main road and about 5,000 shillings ($2.50) got us on a beautiful little hike to stretch our legs for about a half hour. It was much cheaper than our $65 hike in Mt. Elgon to see a little trickle after 5 hours of hiking! Sometimes you just don't have a clue what you are paying for but you have to take a chance on seeing something great! I think we won with this pit stop!

$2.50

$65

Mom is Coming = The Beginning of the End

Yesterday I went to bed thinking about the arrival of my mom, who is arriving in a couple of hours! I talked with her a few times throughout the day to be sure she didn't have any questions and that she made all of her connecting flights. The last time I was here she ventured on her first solo international flight ever and she was appropriately careful make a clear plan. Good thing she can wing it, even in Africa as we showed up at the airport and waited until 4 am only to find that her final flight was temporarly cancelled due to some fluid leaking and an unfixable plane. She ended up making friends with 3 people my age from Poland and Uganda and explored a really nice hotel in Kigali, Rwanda with them for a night. We have been praying for safe travels all the way and no broken planes, but I think making new friends again would be okay.

If you are reading this blog you have probably met my mom - since I expect that it is generally family and a few close friends that have been following along - then you know she is pretty awesome. If you haven't, you should know - she is a pretty awesome woman. I mean, she took her first trip to Uganda when she was 61 years old and has the energy and enthusiasm of somebody younger than me. She is always ready to do whatever it is we are doing, whether it is riding for hours on a bumpy road in a cramped car to spend just a few hours with some kids at an orphanage, wait on a hard wooden bench for 4 hours while we wait to bring a child to a doctor, or walk around a crowded flea market in the hottest part of the day collect huge bags full of shoes and clothes weighing 50 lbs. Oh yeah, and my personal favorites, horseback riding near the Nile and riding an unruly (and drooly) camel at the Giza Pyramids.

These are just a few ways that my mom has amazed me while she has traveled. Prior to that she had lived in Hawaii with my dad for a couple of years when she was in her early 20's but hadn't done any international travel in her life. That doesn't mean she isn't strong and capable. Let's be honest, she has overcome a lot of things in her life (those are her stories to tell, if you don't know, you can ask) and managed to raise at least one incredible doctor (that would be Ross - I'm not there yet) . She has done it all with a smile on her face, a positive attitude, and a constant willingness to keep going. She is a prayer warrior in everything I have ever done and she continues to be an inspiration. That's not to say we don't have our moments, as I think any mother and daughter do. I am thankful that she forgives my impatience and continues to support me even when I make mistakes. I consider it a true blessing that my mom and I have shared two previous adventures in Uganda and this is going to be the third. I can't wait to see what these three weeks bring!

This post started out thinking about the end of my trip, but quickly became all about my super special mom, but the important thing is that her arrival marks the last part of my trip. In my mind, these 3 months are split up into three parts. First - myself living with Angella and learning as a medical student - also exploring Uganda independently and learning to be very self-sufficient here. Second - Pamela coming to be with me at the hospital and have some fun while we work in Obstetrics and Gynecology. Finally - my mom arriving while we focus on visiting orphanages and working on projects for Medicine for Sick Children. The second and third are overlapping a bit, but that makes it even more fun!

As of this evening, my mom has already proven her incredible ability to make friends wherever she goes. She called me from the terminal in Minneapolis to inform me that she made a new friend who is Ugandan and traveling on all the same flights as her to Entebbe. So now she has a travel buddy that will help her through the short connection in Chicago and make sure that she could make it all the way to Entebbe even if there were delays. Then she called me from a random phone in Amsterdam - turns out a nice passenger who she also got to know in the airport offered to let her call me so she wouldn't have to email me a message. I sometimes can only laugh as I stand in awe of how God has answered her prayers for protection and guidance as she travels alone. She has a way of finding the divine appointments that have been set out for her and making these connections so easily. Sometimes I wish I could be as friendly and talkative with strangers as she is in stores, airports, restaurants, and basically every public place.

The next week and a half will be with my mom, Pamela, and I sharing an apartment and doing as much as we can to help the orphanages we have known for a while, visit old friends, and try to figure out what the most appropriate and God-led purpose is for the donations that my mom has collected. Since I arrived, I have been doing some of the legwork, but now is the time to really focus. Most trips have been between 3-6 weeks and focused mainly on projects so this last stint will feel more like that. The bonus is, I have been here for a long time and done a lot of other things already. As Pamela and I walked to work today, I said that "I ONLY have three weeks left" and she reminded me that a lot can happen in 3 weeks. It's totally true, in 3 weeks, a lot can get accomplished and we can go a lot of places. The important thing now is that we continue to pray and focus on why we are here so that we can finish the task!

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

"Our" kids are all grown up!

Today was a day that made me happy. There was no pressure to do any project or buy anything specific. It was just a day to hang out with children that I truly love. I call them "ours" because between my family and myself, we hold a special place for them in our hearts even though they have a mother that cares for them, other sponsors around the world, and a large church and village that take care of them on a daily basis. The first time I "met" these kids, they were living in a small home with a total of around 18 children called Need for All Children's Home. My brother, Ross, was doing his elective clinical rotation in Uganda and he wrote about meeting them in a blog and shared pictures and stories about them. Back then, the oldest was maybe 6 years old and the youngest was around a year old. That was April 2007.

Now, almost exactly 7 years later, the same kids are in such a different place. I am sure if you were bored and wanted to read more specifics, you could find that the majority of my other posts in previous years are about them. The short story is, the orphanage had some problems with finances and the person left in charge was not doing the right things, so in 2009, Watoto Church took in the remaining 8 kids and they have been happily living there ever since. A couple of years ago, four of the kids needed more sponsors so my parents, brother, and I added ourselves to their donor list. Now, every time we come back, we get to see the kids at least a couple of times and remind them that we love them and we still think about them and pray for them often. Last winter, my parents and I even got to visit a couple of them in Canada when they were on tour with the Watoto choir. While we may only see them once per year if we are lucky and exchange a few snail mail letters and a phone call on holidays, we still feel that they are an important part of our lives.

The house mother, Bridget, is the same age as me - she will be 30 in a couple of months. She takes care of 8 children. That means she cooks, cleans, works on homework, does laundry, administers medicines when kids are sick, travels when kids have appointments, and any other tasks that comes with managing a house. She has a group of 9 other mothers and they really raise the kids in a village setting, helping each other out as much as they can but they each manage a house as well. Overall, she is basically a single mother of 8. I am impressed. She does it with joy and excitement and she truly does love all of them as if they were all her own. Oh yeah,  I forgot to mention that she cooks in a fireplace with coal, laundry is done by hand, ironing is on a sheet on the floor, the power is off for large portions of the daylight hours, and she doesn't have a car to do any of her tasks. That makes me REALLY impressed. I can't imagine taking care of just one child by myself at this point in my life, let alone 8.

Pamela and I took some coloring sheets and colored pencils, my iPad with pictures and videos to look at, a soccer ball, balloons, bubbles, and some stickers. This kids were really quiet when we arrived because they had just finished breakfast, but they eventually got more energetic as we played games and laughed with them. We spent the entire day from 10 until 4 just having fun, taking out new toys and things as we thought of them. Although it's not the same hanging out with a bunch of little kids playing games and trying not to get pooped or peed on like when we first met, it is a different kind of fun. There is something really special about seeing them grown up and maturing. They are able to talk a lot more in English. They tell stories and ask if I remember things about the house where I first met them. They tell me what they want to do when they get older. They take responsibility for chores around the house and the older ones correct the younger ones when they don't listen.

When we were leaving, Bridget said how much the kids love us and look forward to every time that we come. She said they really understand that we care about them because over time we have invested so much in them. Even though Ross hasn't been back in Uganda for a few years, he always sends a video message. The kids still ask about him more than they usually care about talking to me some days. It's kind of crazy that we feel such a strong connection to them. While they are pretty well off financially because Watoto supports children so well, they still appreciate the fact that we love them more than they really care that we pay a monthly donation to help support them. That's what matters. I think that's what matters to most of us. I can only speak for myself, but I would much rather know that people care about me than have them pay for things for me.

One thing I loved about the day was when Kenneth was looking through my music and chose a song called, He Knows My Name and said he really likes it. I told him it is my favorite song and it reminds me of Uganda. He asked why and I explained that the first time I met him in Uganda I went to church shortly after and that was the first song playing at the service. The message always reminds me of how much God really knows and cares about us no matter who we are and where we came from. We have the same God whether we live in Uganda or America and we can trust that he cares about everything in our lives.

I am closing with a few before and after pictures. The first is Ross with Kenneth in 2007 and me with Kenneth today. He is one of the oldest and always had a special bond with Ross.

Next is Arthur when I first met him in 2008, which was when he moved to Need for All. Arthur is officially the child that I sponsor so I am able to write to him and I saw him in the choir in Canada. I have always felt a strong connection since the first time I met him and we spent some time doing simple math problems.

Finally, there is a group picture in 2007 and a group photo from today. There are some children that were adopted from Need for All in the first picture and there are other children from Watoto in the second, but see if you can spot the kids that are the same between the pictures. It's incredible to think how much they have grown!!

A Whole New Ward - L&D

I have to say, I wasn't sure how much I would like Labor and Delivery because it is one of the busiest floors in the hospital. It is possible to be really slow paced as only a few mothers are delivering, but in general, over a 24 hour period, the number of new babies is staggering. I asked somebody how many births there are annually, and the answer is around 35,000 each year. That means around 100 babies are born every single day! At first I thought that was outrageous, but as I have learned from the log books, the high risk ward where we have been placed gets about 30-40 normal deliveries and 20-30 C-sections. That is not even counting the handful of other wards in the hospital that take care of the "uncomplicated" deliveries. Can you imagine 50-60 new little babies and their mothers packed into one ward every day?! There is a post-natal room where the women go to recover. If they had a relatively uncomplicated delivery, they stay for 24 hours. In the morning, the room is nearly empty, but by 5:00 pm, it is overflowing and women are lying on colorful mats on the floor and are spilling out into every hallway on this level of the hospital.

The fact that the ward itself functions so well might surprise you if you were just looking at it from the outside. It is probably one of the most well organized places I have seen, but it appears to be mass chaos all the time. There is a main hallway where new patients come to be evaluated. Once they have checked in, they go to the triage room which is probably only 30 x 30 feet and crammed with at least a dozen beds. Oh yeah, I almost forgot my favorite part! Above the reception desk there is a giant lighted sign with red and green letters that run across, showing the names of the physicians and midwifes on duty and random information about what is going on during the day. It reminds me of a sign you would see flashing on Wallstreet or Times Square. It just stands out as a little odd when everything else on the ward is recorded on paper that is falling apart, basic medical supplies like gloves are constantly running out, and most communication is by directly speaking to the next person who will care for the patient.

If a women is determined to be in labor, she is brought to the labor and delivery room which is a giant room with around 30 beds. (Another fun change - ALL THE BEDS ARE NEW!!! At first I thought it was just this ward with new beds because I had left Infectious Disease with beds that were falling apart, half without mattresses, and some adult patients in pediatric sized beds. It turns out the hospital had a goal to get all new beds and they somehow managed to do it! So I checked the ID ward a couple of days ago, and sure enough, they have new beds, too! There are certain places - appropriately, one is next to the morgue, with hundreds of bed frames stacked as high as they can go. Hopefully they are getting rid of them and nobody will have to sleep on them again!) Back to the L&D beds - the 30 beds are almost always full. In fact, you know it is no longer a "slow" day when they women are on mats on the floor in addition to filling every bed.

Privacy is another resource in short supply. Above every bed there is a track where a curtain can hang, but most are rusted and bent so hanging a functional hospital curtain wouldn't work. However, somebody at some point donated whit shower curtains with yellow rubber duckies and blue bathtubs on them. When we are lucky, there is one hanging at the foot of every bed, but often there are some being washed and if you end up in that bed, you have even less privacy. It doesn't make a whole lot of difference though, because with the windows open all the time, the curtains are usually blowing all over the place and you have to hold them down so they aren't in your face during deliveries or while you go around as a team to assess the patients.

The privacy issue leads to another important point. NO VISITORS ALLOWED! That's right, none! Occasionally a female relative will be allowed to come in to look at a new baby if the mother has passed away or they really need a confirmation, but they are only allowed in for a few minutes. It makes sense that you can't have extra people around in a room without curtains and dozens of women in a lot of pain (also, no epidurals or even IV pain medications here! These women do it naturally and they are TOUGH). Without a relative to coach them through labor, a lot of women make it through the process just fine. Even in the few days I have been here, I am usually able to tell which women are having their first baby by how much they seem to be stressed (I mean, more than the normal stress of labor)

On the ward, there are usually only a couple of doctors and the rest of the work is done by nurses and midwifes. As long as a delivery is going smoothly, they handle the situation very well but the overall management and instructions are given by the doctor and his team. If a women is determined to need an "emergency" C-section, they are put on a list. There are two operating rooms and they are always full. One of the physicians told us that they have plenty of doctors - Mulago has over 45 people working at any given time who can do a C-section. The problem is space and tools. They have to wash everything. Often, they run out of tools before they run out of patients. As many of you may be able to attest with loved ones who have had emergency C-sections, there is usually very little time between the decision to use surgery and the arrival of the baby - on the order of minutes. Here, it might be hours depending on the number of other women in line and the determination of severity of the woman.

When a baby is born, they are assessed and then brought back to the mother. There is the equivalent of a neonatal ICU but it is packed full - there is barely room to set a baby down anywhere and there are just a few incubators and supplies to put in a breathing tube if necessary. So if a baby is doing well or having just a little bit of trouble, they get oxygen for a few minutes and maybe a little extra help breathing with a mask, but it doesn't last long because there are usually other babies that need it. (there is only one oxygen hook-up on the floor).

Surprisingly, there are lot of babies that do really well in this setting and most of them end up going home, relatively healthy, with their moms. There have already been some heartbreaking cases of women who had lost their babies or, rarely, women who have passed away in the process of delivery, but it is actually pretty rare for the complications to occur once they arrive in the hospital. The doctors and midwifes are really skilled at what they do and they are excellent managers of their patients and the ward.

I hope you got a bit of a picture of where I am. Obviously, I will NEVER bring a coverall near this ward, so maybe my words help a little. I will post again later about some really intense moments Pamela and I had without sharing too much of the patients' stories. For now, I will leave you with a picture from Sipi Falls. We went over the weekend for some great hiking and had a wonderful time meeting some other people from Minnesota. It was a welcome change from the busy-ness of the city!!