"Never buy shoes in Uganda after dark" Robert, GHSP Nurse Educator

Robert was born in Uganda but raised in the US and allowed me to share his quote. I am hopeful that it doesn't extend to cars as well!

And this friends is what happiness feels like. I got my car. This was the one that I found on Sunday (dream car pictured previously). I have been wading through parking lots, met at least twenty sincere owners and sellers of cars, walked through mud and dust, discussed tax ID numbers, log books, insurance and heard hilarious stories about how Ugandan’s “don’t use AC because it is too hot, radio’s in cars are not safe, etc.” It was in the end a great cultural experience as people selling cars are pretty much the same everywhere. I know having just sold one. As it was I ended up with all of those unnecessary things.  Bargaining on a very short budget helps. I had nowhere to go but down. The fact that this car was on a website advertising cars in Uganda gave me a baseline to bargain from. 

For now, I love my car, which has been affectionately named: Lefty 2. In America, Brian and I named the car Lefty 7 which was on my vanity plates, me for political reasons and 7 is his favorite number and I thought this new one should also be a Lefty. This car is sweet, or as sweet as a 1999 car that started out in Japan and ended up on a lot in Uganda can be. The fact that changing the oil filter and making all other repairs is on me is okay and standard practice.

The chance that I could have purchased and can have this car brought back to drive without Adam is zero.  I most certainly won’t drive to Lira on these roads.  They aren’t as bad as Viet Nam or India but I’m not driving there either. Adam the driver accompanied me through three car sale adventures yesterday, all done in the parking lot mainly with three or four people crowded in the vehicle while I sat there saying, “Sir I really don’t want this car at any price.”  When we went to Western Union to pick up my funds that Sue sent Adam, who isn’t exactly a small dude, and three other guys running from large to larger, accompanied me. The man at WU asked me if I wanted an escort to the car with my three thousand bucks I shrugged and told him I was going in their car. He nodded with a bit of a perplexed look. Who goes inside WU with 4 people?

Shout out to my sister Sue for always, always being there for me though Viet Nam, India and now Kampala, she hopped on line and transferred the money so I could buy this baby in record time. Sue, I love you.

We went out to meet the regular volunteers yesterday; they are a great group and some of them referred to themselves as the “fossils.” They are above 50 and joining volunteers who are mostly in their 20’s. Met some great people who will join us for swearing in today.  I moved on to the important things and met a Bronco’s fan that is going to a site in Southern Uganda.  He is also from Colorado and found a café in his village where they live stream Bronco games. The owner has returned to Uganda to live and brought the spirit with her, he tells me that she shows every game and that she airs them at any time day or night, he is worried about his curfew as he is outside the city. My data plan is exploding so I need to try to change it before heading back to Lira tomorrow. Clark family members when in Viet Nam, Indonesia, Thailand, Mexico, India, the UK, the US, Costa Rica, Palestine or Israel don’t let other family members miss the game.

As for this “privilege” of buying a car in Uganda. So grateful that Lefty 2 and I are on this journey. The University is at least 10 kilometers from my house and despite my passion and my desire to make this work, I can't manage that. The idea that I have arrived, that I can do this, that I can make this happen is so real for me. The fact that one of the great enemies that I face is Malaria and HIV I am ready to get out there and make try to make a difference. I have already seen one kid too many die of something that should not even be on the radar. To ask me to come fight malaria was a great idea and I am so blessed to be here. Seeing several children arrive in wards when it is already too late is jut not acceptable These kids do not fir the profile of what you might imagine, they are well nourished children who arrived for care too late, most with something viral that should have been prevented.

I met young PC volunteers yesterday who will be far more vulnerable that I am who are going to be living way outside of Lira without a walled compound surrounding them, even though I feel that even with my limitations I could scale that wall. Easily. The PC volunteers are the people who are making an amazing contribution and will utilise public transport and live at a very local level as I worry about if the radio on the car is working. (It does).   I can make this journey happen in part because I have wheels. I am so fortunate that my time came just as SEED was developing this program. To quote Hesse in Siddhartha,  “there is no such thing as chance.”   

We took out oath this morning, it was touching and we will swear in after just a few more hours. I am excited, happy, expectant, ready and willing to move in to whatever position now awaits me.  We had a Skype call with Seed yesterday; I summed up how things are going.  It was great to hear the voices of those who have been following our journey. Much has happened since then, I have jumped into the owners seat while preparing to be the driver.

Our GHSP group swearing in at the US Ambassador's house. 

My brief introduction to Lira gave me the opportunity to meet some students and this is all incredibly important. Our visit to the hospital here in Kampala was informative and taught me a few things.  I can walk for four hours, climb steep slopes, and not lag behind or fall over in the Kampala sunshine.  We actually made several trips up and down the same flight of stairs and … I made it. My internal thermostat is no longer working at optimal condition, so it took me a bit of time to cool down after the time spent in the hospital but I wasn’t alone.  I am enjoying this journey so much and it has only just begun.

Buying a car in Uganda, 101

First of all, the fact that a Peace Corps volunteer can even thing of buying a car is a bit remote for most people to grasp. The GHSP volunteers have a bit of an advantage in that our host group. Seed has negotiated and worked hard so that we can buy a car. So from there......the fun starts. And no matter what I say this has been fun, and a great cultural experience. I might at the end have a car, and maybe not.

When we were in DC, Dr. Bonny the GHSP rep told me I could buy a car for around $1500. that seemed amazing, and doable. I know for me the fact that transportation is a major concern that actually having "permission" to purchase and drive a car was huge. Next things was to arrive here with destination Lira, check it out, and move forward. The options that the University have seemed sketchy at best. PC provided me with a local driver and car and everywhere we met, sometimes 10 to 12 km. outside of town ended up with me arriving and waiting for them to arrive in the hospital ambulance, which seems to function more as the hospital transportation vehicle. My goal was to become as independent as I can at my age, within my budge and with what might be available. As luck would have it I seemed to have stumbled upon a driver who was willing to work with me toward that goal. Cautious optimism, at best. Steven the PC guide and language instructor has also been helping as has Jesse one of the drivers for PC that I happened to meet who is also an Iraq survivor having worked for the UN.

And this 

Onward and upward. Anyone can go online and find cars for sale in Kampala, an abundance of them. Finding your car and finding one that will suit the roads of Lira even when it is flooding and finding one that suits your budget (extremely tight) begins the highlight of the search. We went out today with a driver who picked us up. I am leaving Lefty 7, my 2012 vehicle far behind and now looking at cars made in Japan circa 1999. I have tried to forget that the Japanese team obviously wasn't utilizing a female design team back then and have tried to forget that I really dislike that boxy look. I don't care about the style of the car much, what I care about is what is under the hood. We have found slipping fan belts, which I am told can be fixed and with one Honda I was told that Honda manufactures cars so that the door has a distinct clicking sound when you open it, two of them in fact but only on the left side. This I am told is a particular Honda design. To have perfected this on the left side but not on the right is a fete that I applaud Honda for. I have not seen a single Hyundai in all of the parking lots I have been through. The brokers are nice, but let's face it I am a foreigner looking for a cheap used car. Transferring the money to buy said used car from my almost non-existent savings is quite another fete that I am tackling. The rest of the group I am here with are off to a cultural show again tonight. They went last night but it was closed due to some wedding or something. I had a good day, Jesse the driver and I spent some time swapping war stories about Iraq, as a UN troop member he was on the side that was at the check points and hopefully not shooting at us civilians. I was once in a convoy, took out my camera to take a picture of an incredibly long line of tanks and saw the gun barrel moving toward me as the person in the carrier noticed a silver flash. Maybe Jessie? Wish me luck in this adventure. My goal, Wheels by Thursday. But, I am resigned to whatever happens, happens. If I can't accomplish this it isn't from lack of effort.

Spent the day at the hospitals, even though this was one of the best in Kampala many departments were lacking in significant interventions. We saw one little girl about five years old who had been brought into outpatient at the nutrition ward and moved to ICU, there was no truly no hope for her. Very very sad.

All that separates us is $$$$$

Sobering

Thursday Evening:

Met up with the Gulu group yesterday and made the trip back down here to Kampala. The less said about the ride the better. Hot, dusty and crowded sums it up. The only thing I wanted to do was to take a shower but ended up going outside to sit with Jennifer and heard about her trip to Embale (phonetic). Her experience was similar to mine except the hospital she is in seems to be a joint venture with Korea and has all kinds of equipment, which isn't used or useful, at this point it seems. She didn't exactly say that but it was my summary of events. We were joined by others who shared their experiences and in all we seemed to have a similar feeling of the scope of the challenge.  I left Lira happy and hopeful and after a few hours was beginning to feel as though nothing would ever change. I finally made it back to the room. Steven and helped me get some plugs so that my cords are a bit more organised and I can charge more than one thing at a time.......progress.

In all it was good to share my experiences and to hear from people that the poor kid I was worried about back in Lira probably just laid there and died which I suspected but didn't know all along. Transfer him to where? we were in the best place they had. No blood? no blood.

I woke up with one thought, that is to remain focused. I came her to train nurses and that is really all that I can do. I can work with a group of nurses and do my best to make sure that they know the best technique and that they can take care of patients with dignity. As Dan always tells me, "lead by example"......other than that I can't re-write this chapter of the Ugandan Health System. I can only do what I can do or would quickly run out of steam, sharing experiences is great but there experiences are what they are. I can't get into group think or begin to think of this as impossible. I just have to do what I can do.

Friday afternoon:

We actually had a very productive round table discussion today with Bonny and I felt some powerful issues were raised. I was also able to have a private chat with him this afternoon and to lay out more of my feelings I actually feel a bit more upbeat. David the GHSP volunteer is turing into a powerful ally for us and is able to assist us in being a bit more direct. You know how American's are, always evasive. Which is sarcasm, we keep hearing that Ugandan's do not like to be confrontational, neither do most Amreican's.

Success

Last week I was brought up to stay with my host family to experience life, food, and the culture here in Lira. It was a wonderful experience and the family who hosted me will always be part of me now that we have found each other in this great big wide world.

Steven and I started the day by going to meet with local authorities in three different departments. We were warmly received everywhere and did quite a bit of line jumping everywhere we went. The police had many people waiting to see them, but as usual the crowds parted as we walked in. Steven will have a hard time after he leaves me and the waves no longer part for him wherever he goes, the advantages of being an older person is not lost on me. 

They actually received a certificate for taking care of me with my picture on it. 

Steven is the man 

Host family, Elizabeth and Felicite

Ann from Peace Corps Uganda 

We met the top official in the area who is appointed by the President, his name is George and he is a very well spoken and interesting young man who studied in Switzerland and has worked for Oxfam in the Philipines and traveled about in India. This is a bright, rising star for Uganda. Very delightful to meet and talk with him.  The local police officer suggested that I might want to purchase land in Lira and build a retirement home, might be a good suggestion as this might be the only place I can ever afford one!

On to meet up with Ann of Peace Corps Uganda, what a lovely and delightful woman. She works very hard to make sure that all PC volunteers are happy in their families, that would be quite the task with over 150 volunteers in country.  Ann had an interesting thought to share with me, some African wisdom. She said that in Uganda they believe that if you always eat at home you will believe that your mother is the best cook in the world, it is only when you go outside that you might come to know something different. She wrote down my favourite saying of mine  about "ships in harbour are safe but that is not what ships are made for." 

I had a conversation with a nice gentleman this morning who gave me a call. He is an American who has resided here in Lira with his wife for many years. There was dead silence on the phone when I told him I would be living alone. He said they have an armed guard and have had their house broken in to twice in recent months. I started to ask if the guard was sleeping but did not. The house I am going to reside in appears to be quite safe with good locks and a wall around it that anyone who is of the least mind to do so can easily scale but hopefully things will stay locked up well enough that there won't be any reason to come inside the compound. The previous volunteers did not seem to feel that there was any danger. Other than his admonishment that he would not leave his wife alone here for one night we carried on discussing other such things, such as his recent case of malaria. He is very well informed and a nice guy and I hope to meet him and his wife in the days to come. They have a literacy project and teach inside the jails. In all it was a good chat and I am not going to dwell on what might happen.

I am at last adjusting to the anti Malarial medication but it still hits me right after I take it with nausea, no appetite and I can almost guarantee a bit of a headache. I know that it is the medicine as I have not had any symptoms until I take it and have taken it at various times of the day, if I take it at night I would be crawling the walls. I must continue though as yesterday we went to a level 4 hospital about 20 minutes outside the town and again the place was filled with Malaria patients. The sister on duty informed me that this in her mind is an "epidemic" and that on one 8 hour shift they had admitted 40 children. Keeping in mind that they only admit the sickest of children who go on IV medication this appeared to be a very serious problem. While we were there we met up with five of the nursing students and gave them an "examination" this consisted of observing them brining in pregnant women who have arrived for pre-natal care. The two nurses from the University, Nancy and Agnes and I watched the student and the patient as they went through the assessment with the mothers, to be honest at times it was very awkward. The room was tiny and the mothers were uncomfortable with the crowd and the students were almost unbearably nervous.  I don't think we saw their best effort and they were very comfortable with the women prior to our taking them out individually and I was brand new for them. For first year nursing students they did pretty well. One was lagging far behind and the scary part about that is she is a trained mid-wife. The others obviously were doing their very best and it made me more at ease about the relationship I will have with them as these will be the students in my classrooms and I will have a chance to work with them in the clinical setting.

There was the perfect picture moment as we were leaving of an outpatient clinic with mothers and children out under the trees that I was reluctant to snap. I don't want to be one of those American's that always has my phone out to take pictures. When I asked later they said that it would have been fine. Sounds like I will be visiting that hospital frequently with students so,  next time. Agnes and Nancy told me from the moment I put on that white coat I will be "doctor" and expect to be grabbed to assist with deliveries or whatever else emergency comes along.  Should be interesting times ahead.

The family came to the hotel and we had a farewell luncheon, before I returned to their home with them. They are lovely people and were even given a certificate from the Peace Corps thanking them for caring for me. I know that the most difficult part for them has been that I am a very picky vegetarian and I think for them that is just flat out insane.

Anyway, we made it. Back to Kampala tomorrow for more training. I cannot say that I am happy about it but as the days have passed here I have come to know how much I don’t know and look forward to a closer look at how the health care system works. I look forward to seeing the rest of my group and hearing how they have fared in their host families and with the University's where they will be working,

Wake up call

Today was a reality check on who I am, where I am, and what I am doing here. Steven, Adam and I met at 8 and then went to the hospital. I had a chance to spend hours on the pediatrics ward and to get to know some children, some families, and to review medical charts and observe procedures. It left me overwhelmed and when it comes to hospitals and medical wards that is something I didn't think I had left in me. I walked through this section of the hospital last week but only saw children lying in beds and spent less then a few minutes inside the ward. Today was entirely different. I had to re-evaluate just about everything I think I know and to be honest it has left me almost speechless, although thankfully not wordless as I need to at least sit down and write about my feelings. Such a great tragedy is taking place, some times right under our very own eyes and we can only see it when we slow down enough to actually observe, to see children, not numbers.  I feel almost "guilty" about my pleasant day off in the cool breeze on Saturday when right here, practically next door, when so many are waging a battle for life.

The interns were welcoming as was the sister and we arrived as their rounds were taking place. There are about 40 children under the age of 5 and more children are on general wards and several arrived while I was there. There is ONE nurse taking care of all of these children who are very ill, there were two students, one was looking through charts and the other was running errands. The interns were seeing an endless line up of children waiting in their mothers arms. Some things that surprised me was that no vital signs are taken and recorded and that the doctorgot up at one point and weighed a child. I suppose with only one nurse who was at that time drawing blood, that's the way it is. The first few children were very sick and I saw several with sickle cell, one who had been in the hospital a few weeks ago and was discharged but then ended up back having had no treatment at all since he was discharged. He is a beautiful little two year old and you could almost feel how painful it was when the physician moved his swollen limbs. What was a bit more painful is that he kept moving them to show me how painful it was for the child. Ouch! My goal is to study far more tonight about SC as I haven't exactly lived in places where we see an abundance of it and suddenly there were textbook examples right before my eyes. The next three children were suffering from malaria and so ill. Fevers, pain, anorexia, and so the list went. For the doctors it was an almost endless line and stretched across the ward as one tired mother after another carried her child up to them. I was looking at the mothers faces and thinking that I would have no idea at all how old they are. None. For the most part they looked too old to have a child to me. After some time a boy of about 7 was carried in by his mother and grandmother. He was limp and the intern who had spent the most time talking with me jumped up and ran to a cot to examine him before I realized what was actually happening. He was coming in from the out-patient department. He was unresponsive and three staff members tried to get blood from him until at last one was successful, I am sure that on top of all else he was dehydrated as they simply could not get the vein, one doctor ended up poking his own self and had to wash up and take anti-HIV medication while others continued to work on the boy, they finally got blood through the femoral artery as best I could tell and the child cried out in a very hoarse voice, to be honest I was happy to hear at least a sound from him. Although I would still classify him as "unresponsive" throughout the rest of the time I saw him. The mother and grandmother appeared to be almost numb and said that he had only been sick since last night which might not be possible.  I wonder what kind of obstacles this family faced trying to bring little Steven in, transportation, arrangements for children at home, and of course money even though the treatment at the hospital is free no doubt there are many expenses involved. The doctor did not even have a guess to what was going on but the blood work came back very fast and they was some rushing about and exclaiming over the results. I got a fast enough glance at the lab paper before it was whisked away to say that I  have never seen blood work that was this out of whack. WBC was three times above normal, his platelets were so low that a student nurse was rushed out to go get blood so they could start it immediately. Then the bad news, No blood at all in the blood bank. The boy was moved to a bed, the doctors went back to other patients, they had a few laughs and discussed some other items and the child and his family seemed to have been left behind in the thought process. The most that I could glean without being intrusive, as I was only there as an observer,  was that they were going to try to transfer him to another hospital, and whether or not he could even survive a transfer remained a question to me. And what hospital? We were at the Regional Referral.  In all it looked catastrophic and for an older child who appears to have been a healthy child with adequate nutrition prior to this event I think I could venture a guess what will happen but I might not be told immediately. I said good bye to the staff shortly thereafter and wrote down his name as I want to follow up on him when I return from Kampala. There are so many like him who I didn't truly see the other day and it all became more real for me as I saw him come in, for the rest they are just lying in their cots in the heat and with family members caring for them. It was all there, I just didn't really see it until I came to know the children's names and saw their mothers faces. That poor, poor, family. There are tough days ahead.  There is no chance that I can imagine that this child will survive the event and I feel frustrated, tired, and ready to get to work.

I had some mixed news from one of the nurses who I had met in the Neonatal until. The little 1 kg baby did not survive, I didn't honestly think he would but had hoped, he died not long after we left and the mother is doing a bit better and has been released and the malaria is stable. When the nurse came up to me she spoke in Lango and I answered and for some reason at least 5 words came rolling out of my mouth, which is sort of the beginning and end of my Lango so far but it was nice to at least be able to speak and to see that this helped bring at least a few smiles to some faces.

Only one nurse on duty in the children's ward seems so impossible because these children are all so very, very sick. Another nurse came in for a few minutes but was dispatched off to somewhere else and the two student nurses were busy with their own tasks, one is training in public health and recording something in a book which is no doubt important statistical data.  We are going out to another hospital tomorrow which I understand will be smaller and maybe with "less" resources.

Agnes and I had a long chat after we finished on the ward and I was able to get a better idea on what I will be doing, in addition to teaching I will also have about 5 students with me on this Pediatric ward at least one day a week. It would be helpful to have a few more hands around I am sure but I need to keep our nurses on track as to what they are there to learn and best practices in that environment. I came home eager to start doing more research on malaria in children. I knew that this is the way it would be on an intellectual level but most certainly was not prepared for the strong emotional reaction I saw these children, these aren't tiny babies, these are real kids who were learning their first words, toddling about and laughing and playing perhaps just a few days ago.  It would have been a stretch to imagine the hospital before I got here, no matter what I had heard. I can't even totally grasp what it is like to work with with no blood, and children lying about without intervention and with one nurse. I am sure that there is much more going on then what is visible with my limited knowledge of the language or the care which they are trying to provide but it isn't going to be easy.

 I had a very positive glimpse of what USAID is providing to the people here through the website "Sustain Uganda" when I got home as I wanted to read more about the hospital and ended up writing my therapeutic journal/blog. The boy in our home seems to have broken his thumb playing ball at school today. He is about 12 and they had no tylenol or aspirin for him and seemed to be upset about the fact he would have a hard time writing his exams, meanwhile the boy was tearing up and trying to be brave. I feel like I am at the bottom of a great big hill looking upward and wondering how on earth I can make a difference in the lives that touched me so profoundly today. I can't change anything today, or tomorrow but I most certainly am going to be doing my very best to help train some nurses to relieve Susan's duties as she had her hands full. Time to study Lango so I can actually develop more sentences. Feeling a bit deflated and overwhelmed but also feeling like I still have a great deal that I can contribute, and will.

In the meantime I found this article from a local newspaper on line which probably sums up much of what I am trying to say far better than I ever could. It is from 2012 and I hope that things have improved since that time, I haven't been in the hospital on a weekend so time will tell.

"Lira Regional Referral Hospital is facing a crisis as it has only nine doctors offering medical care to more than 500 patients per day. According to the principal administrator, Mr Henry Lwigale, the hospital requires 39 doctors. “It means that we cannot provide some specialised services because the clinicians are not there,” Mr Lwigale said on Wednesday.

Being one of the only two regional referral hospital in northern Uganda, many patients are stranded at the hospital. Some are forced to travel several kilometres to Gulu Referral Hospital for specialised treatment. “That situation has made service delivery a bit difficult because some health facilities are overworked while others are redundant,” he said. 

The District Health Committee chairperson, Mr Moses Ogwang Adonyo, said due to the shortage of health professionals, sometimes patients are not attended to on weekends.
“They (health workers) work only on week days; when a patient reaches the health facility you have to wait up to Monday but it is not even guaranteed that when it reopens on Monday, you will get help,” Mr Ogwang said.

“The few doctors cannot do much to help us in case of an emergency. I took my wife to the hospital in September last year but unfortunately she died before seeing a doctor since it was a weekend,” said Mr Denis Obang, a resident of Adyel Kisubi, Lira Municipality.

Lira Resident District Commissioner Susan Akany confirmed the challenges the hospital is grappling with.

Ms Akany said recently she got information that some babies died at the hospital shortly after they were borne. She blamed the incident on the crippled healthcare system. “Power went off all of a sudden and by the time they could start a generator, the babies were already dead,” the RDC said, without offering details of date of the incident and the exact figure of the victims."

Another Honeymoon

I should start this by saying……..another long hot day toiling in the African Sun bringing love and enlightenment. It was actually me who got the love and some language so scratch that. Truth is that today some of the words actually began to make a bit of sense……. Amaro Chai! I love Chai, for anyone who lived in India this is cheating but what the heck. 

Adam the driver and Steven my guide, guard, translator, teacher, etc. picked me up this morning after 8. Today was one of those magical, interesting, very fun days where you think you have really stepped into a place that you want to get to know better. We went to meet the local police and the guy is was so nice and friendly.  He even rushed off to pick a bag of oranges to give to me. He has been voted into his position since 2001 and was someone that I would definitely count on to keep things in order.  Our friendly conversation drifted into football (how is that possible?) and of course I have a way of leading any conversation into B R O N C O’s.  I actually think I could have a more interesting conversation if I go into Manchester WHO? United. They explained that in Uganda there are fights after the game, how well I understand, I won't even take a connecting flight through Seattle any longer unless the fare is very good. My personal goal is to find someone to watch SB 50 with me, when the Bronco’s kick butt. Just an overall great experience meeting the powers that be and walking about in a garden with some vegetables I had for lunch yesterday but it was delicious, something like rau mung and a cheap but delicious dark green veggie. Yeah!

We went to visit my humble abode where I will be spending the next year. It is embarrassing how nice it is. Very clean, large and safe, they were installing screens, a new lock, and I was imagining which of the four bedrooms to store my 3 suitcases full of “stuff.” One for the electronics’, one for skirts, one for this one for that. The house is lovely and the compound is large. The house was used in the past for 3 volunteers so I will have plenty of space for those of you planning a visit to Northern Uganda any time soon.  It has running water, a gas stove, and a lovely compound. That lovely compound also was pictured on a previous volunteers FB page with a Cobra or a Boa (she thought one, David our "guide" thought another) I’m not going to test the grass.  In all it looks quite comfortable and can be made a bit more homey. Previous volunteers left an abundance of kitchenware, including wine glasses. Got wine”

We headed out to the countryside. Steven is a man of short sentences but is delightfully friendly and full of surprises. He said that we were going to go to the country and I was of course prepared to experience a Saturday afternoon in a grass hut. Not so. We went to a place that had very fast Internet connection, and was clean, spacious, beautiful gardens,  cool breeze and has some rooms for rent that actually do have thatched roofs. Remind self: fresh air is just beyond the bend.  It turned out to be a very relaxing day at the Brownstone Country Home, about 7 miles from Lira.

We had lunch which appears that they ran into town to buy the ingredients for which has been my ongoing experience with meals that I have ordered. Sketchy refrigeration makes for fresh food if you find the right place. Very lovely. By chance? If anything is by chance in this place we ran into our country director for GHSP Bonny and said hello. 

Last night! Lest I forget. We had a remarkable dinner with University staff and I was able to have a great chat with the President of the University (could be the wrong title) who was a Fulbright scholar who lived in Chicago and Boston. We were having a wonderful conversation and enjoying our talk so much when at some point we were reminded that it was raining and it we should go inside. Speaking of Malaria……… which I am reluctant to do, I am sure that I was bitten about 20 times. Overall, a very good day. Bonny led some very good session earlier in the day with my Supervisor (the Dean) and Counter Part Agnes that I felt were some of my most productive in Uganda where he did his best to lay out his expectations for me as a GHSP volunteer and for the University as for the expectations for me.

The greatest stumbling block appears to be centered on when the University opens, when classes begin, and when the lectures and other staff members actually show up to start teaching. A perfectly illogical set of problems for some of us but very real here, My host family says that the time stretch between when the students arrive for classes and when the lectures actually are to be taught left me with the impression that there was a gap that was about ten days between what we hope for and what we get. We played a few interesting games which seemed a stretch culturealy but actually gave me some good insight into what they might be expecting from me.


I heard quite the music fest going on near my house and assumed it was a karaoke bar or some such thing, it actually is a "born again" church the family informs me. Sounds like they are having a very good time. 

There is no way on earth that I am going to be able to spell or grammar check, or at least not be able to keep up with my data use but this is the way it is August 1, 2015.  Bonny the country director assured me this is just the “honeymoon” period if so this is a marriage I can live with.  Amaro Lira 

The day.....where to begin?

University

Up and around by 6 and Steven was here at 8 to take me just as he stated. He was very happy today and seems to have found his energy. First we went to the University by car, this involved quite the trip to town, the university is about 10 km from here so took some doing to get to as there was a major and not usual flood in the area which had the entire road blocked off a bit. We arrived at the University, me ready to meet the staff and went to the room that I will call my office for this year. We did what? Oh we studied Lango of course. I would have had no way at all of knowing what we were going to do but as I learned back in Vinh with the Viet Nam vets, "All will reveal itself as it unfolds." Steven was fresh and ready to present me with some simple yet important words and phrases. This guy is a true professional. This is one of those "You Know Nothing Cherie Clark moments" as I was staring at his well made chart, his well planned out program as my mind calculated when I would be meeting the staff and what was going to happen the rest of the day. I realize I complain too much about language. My family is perfect, the town is perfect it is the Lango that exhausts me to think of, night or day I think this is because so many people speak English so well it makes it harder to want to kick in. Then I remind myself, this was my first full day in Lira.  Steven worked so hard and I can now remember how to say "thank you." Throughout the day today I frequently heard words being spoken and would brighten up whenever I recognized one. Big shout out to Steven for being so incredibly persistent and determined. I'm waiting for him to reach out and strangle me at some point.

Agnes, who will be my counterpart this year reached the University and gave me a wonderful tour of all of their planned project and the current class room. We then continued onward and met at least 20 of the nicest, kindest, funny, big hearted people you could encounter. Delightful people in all capacities. We toured the library, the proposed rooms of the hospital and the class rooms.  They are off to a wonderful start and it is exciting to be here in the 3rd year of operation of this University. I met so many people and from the first to the last they were so open I felt as though I had been here forever and I knew that I had come across an ocean and found people who I will remember all of the days of my life.

One of the gentleman told me of his experience in meeting with Vanessa Kerry and how overjoyed he was to meet the daughter of the Secretary of State, I assured him that I was impressed myself and had met her father back in 1992 or so in Viet Nam.

Lira

Agnes took me then way back to town and we had a tour of the hospital. I have very mixed emotions. It is poor but perhaps on the scale of what I saw when we returned to Viet Nam, not that poor, or what we saw in busy crowded Kolkata on a daily basis it looked relatively okay. But all is relative and there were young people who were very sick with Malaria and other preventable diseases that should not have taken hold to begin with. We had an interesting visit with many nurses. The previous nurses who have come before me certainly have found their way into the hearts and minds of these people as they spoke fondly of them and their contribution. In the neonatal unit we saw one baby who weighed 1kg. his mother had malaria and he was delivered prematurely as she is quite ill. His struggle looked incredibly familiar, another preemie was lying in his mothers arms as the only working incubator was already full. We walked past maternity as we were leaving and saw several women in active labor ......many with mothers and other people there to offer them support as they labored on the sidewalk outside of maternity ward in the hot sun.

Agnes asked me today if she can add Anatomy to the classes I will be teaching. Anatomy? I have a distant memory of some of it. I probably know enough to stay one day ahead of these bright young students but as for teaching it, we will be on an amazing journey. "Good Question!" I will frequently say, can anyone answer that?

It was quite the journey and as we were leaving we were able to meet with the head matron. I have no idea what all of the titles and names are but she obviously was "in charge" ...... when we reached the entire discussion with her and the pharmacy was over the fact that they had NO gloves ..... no gloves for tomorrow for all of the patients filling the wards! This seems like an incredibly large problem to tackle and she looks like a woman who can do it. How can that possibly be I wanted to ask. I have seen gloves hung up to be washed and dried years ago in Viet Nam and it effected me more than seeing the patients filled with the very sick people, the ones that are sick are very sick and many have exhausted all other methods before they arrived at the hospital for care.

One big boost for me is that Agnes was in Bangladesh in the past and lived there as a student for several years. That was so helpful as she had some baseline to judge my experiences in India. This poverty and this place is so very different and yet I find small similarities with the preventable diseases.

Steven then arranged that we go to the Palace which is the best Indian restaurant in town. He sat with the driver and they looked at the menu like. ... what is this stuff! I had a great conversation with the young woman who waited on me and had delicious Naan and Paneer. It was some of the best Indian food I have had in a very long time. She explained to Steven what dal is, brought the packet and of course he ran across and bought some. So for now I am set. I am content and overwhelmed at the same time. I wonder how this will all unfold and feel confident that I have something to offer while at the same time I met with numerous nurses and staff who looked as though they were managing things very well on their own. The NICU nurse was confident and knowledgable, she said her dream is to go back to school to earn her BSN.

What to say about the heat, it is here, all the time, surrounding me, sometimes feeling overwhelming (and it isn't the hot season). I wonder how I will manage it and at times I seem to be the only one who has noticed that it is overwhelmingly hot. Even sitting in the Dean's office, a delightful man named Tom's room I kept thinking.....has anyone noticed it is VERY hot in here but life just seems to go on without anyone taking too much notice of it. Hopefully I will adjust as the days go by. All and all, this was a what? A good day.

Young Idler, Old Begger