On the Road in Uganda


on the road

I arrived at Entebbe Airport on Saturday night June 7, 2014 after about 26 hours of flights and stopovers. Was picked up by David and Joseph and immediately taken to a party at the home of Dr. Sarah Nkonge to celebrate the work we had been doing together, the Rotary of Makindye and me. Thus began my journey in Africa. The following is from a few days later when we traveled to the Lwengo District.

 

I didn’t sleep much last night and got through some of the toss and turn hours by reviewing my suitcase contents…why did I pack Catwalk Sleek hair spray?  Maybe for my visit to the King of Tororo…but more about that another time.  We left Kampala for a 3 hour drive out to Lwengo; of course it takes well over an hour just to get out of Kampala, the city of no public transportation or beltways so all roads lead to massive “jams.”  Our driver Joseph is amazing (the best, except maybe for Mahindra who drove me from Kathmandu to Hetauda for 8 hours over hairpin turns up very steep, narrow mountain roads with no guard rails.)  Sarah, David and a reporter from a local TV station and I all loaded in the four wheel drive Ford.  Sometimes beautiful landscape of rolling green mountains and then the villages of rusted tin sheeting and concrete blocks, the ubiquitous charcoal smell and piles of mostly plastic garbage, rotting foods and road kill.  A strange occasional battered phone booth, odd because almost everyone seems to have a flip phone and there are ads for “mobile money” everywhere. Always the sad lost discarded flip flops.  Traffic of cars, mini buses, bicycles, motorcycles piled with people, bananas, mountains of plastic containers; on one, a man and a women; on another, a man, a woman, a baby and a goat; on one several boxes of condoms that spilled out in a trail along the side of the road precipitating, among those in our car, several hilarious adaptations of and responses to, “why did the chicken cross the road?” which during all drives was prominent as many chickens actually crossed the road right in front of our wheels. Women walking with massive bundles of sticks, huge plastic jugs of water or gasoline, and bowls of cassavas on their heads, and babies scarfed onto their backs, the little baby feet peeking out on both sides of his or her mother’s breasts. Children playing in the gravel alongside the roadway and a few elderly people crawling.  All this takes place at dizzying speeds in a dangerous dance of near misses, and every moment that someone isn’t killed is a miracle, proving that Uganda is actually overflowing with miracles.

 

We arrived at a Girls School, a collection of large low buildings and toward the back of the “campus” was a large barn with a dirt floor and about 50 women and their children waiting for our presentation and distribution of the birthing kits.  The women are beautiful and the children adorable.  They were all obviously dressed in their best colorful clothes, some very worn but still bright and bespangled with sequins, decorated with embroidery.  The clinic director introduced me in Luganda, one of the several languages in Uganda that vary from district to district. She said I was bringing the kits from Australia, short cut for I am from the United States and I got the kits donated from the Birthing Kit Foundation in Australia.  I told them I was so pleased and honored to be there, that I had been all around the world but they were the most beautiful women and then I went through the contents of the kits.  The little piece of soap, a pair of latex gloves, black plastic sheet for the birth area, 4 cord ties, and the one clean wrapped razor blade  “Please don’t use this for anything but cutting the umbilical cord,” I pleaded, knowing that some research had indicated that the blades were sometimes used prior to the birth for any number of household tasks like cleaning fish.

womens group 2

I marveled that the babies and children actually looked quite well and healthy and were very playful and engaging.  When I commented to a few of the mothers later they told me that it is the healthiest babies that survive, the ones that are “right sized;” the others that are too small die at birth or shortly thereafter, the ones that are too big die with their mothers since they often can’t be delivered at a hospital that can perform C sections.  Other children that aren’t really strong die in the first year of malnutrition, malaria, dehydration or accidents…so it is the healthiest, most resilient that are with them.  Tragic Darwinism.

 

The women so were appreciative of the kits, but said they needed more than one pair of gloves, because they sometimes tear, and more pads for the bleeding after birth.  I said I would try.  Someone delivered bottles of soda. Fantas all around.

 

Then we went over to the Girls’ School to distribute sanitary pads and soap during the student lunch break, which I was told would be chips and soda.  There were about 50 girls in red uniforms.  This was outside on a hill and the breezy atmosphere was an opportunity to have a good time with them.  The girls all spoke English, so I could speak with them without a translator. I talked to them about staying in school, staying strong and being sisters.  Having babies when they were really ready and in a good relationship.  I found myself saying the same things I had said to kids in the Bronx:  Your body is your own. If someone hurts or touches you, tell an adult you trust.  I had an almost imperceptible heart pang thinking of my work at the Child Advocacy Center in the past.  They sang a song for me and we all danced and I taught them to kick like the Rockettes. Then we gave out the sanitary pads and soap which was like giving out party favors on someone’s birthday.

 girls kicking

The women had talked to me about how bad a local clinic was and that was why they would rather have their babies at home, so before we drove back to Kampala I asked to visit the clinic.  We drove to the clinic and on first sight I could see why.  It was literally a hole in the wall shack attached to other shacks.  The crumbling concrete steps alone spoke volumes about how difficult it would be to give birth there.  The clinic director showed me around and said she had been trying to get more support from the Ugandan government so she could improve the facility. She also has to charge 15,000 Ugandan Shillings for a delivery, the equivalent of about $6 US, and some women just can’t afford to pay. There was a small room of deteriorating concrete for the exams, the labor room with a damaged table and stirrups, and a room with 4 little beds side by side for recovery.  The women can stay for 6 hours after the birth to recover before they have to leave. I asked if (since there was a long drive back to Kampala) I could use the bathroom and was shown a rocky path to a shack beyond a stubbly field.  Let’s just say it was much more rocky than path.  The toilet inside the shack was a squat hole. Now I have used many squat toilets and they can be quite nice, tiled, clean and you get a good stretch workout in your quads while peeing. This one was covered with excrement and urine and dirt and full of insects.  Mosquitoes and flies and any number of unidentified winged things buzzed around my head. A caterpillar that could have morphed into an exotic butterfly or something that would rip my leg off humped past my foot as I stepped onto the two bricks on either side of the hole.  I did a quick flashback of all the meds I had taken: Hep A, Hep B, Polio booster, Yellow Fever, Typhoid capsules with live bacteria, Cipro in my bag and antibacterial wipes at the ready.  The women who gave birth there and the staff who delivered the babies did not quite have these advantages.

 

The four hour ride back to Kampala was quiet.  I perused a local newspaper:  Article “Uganda Fails to Achieve the Millennium Goals and Reduce Maternal Mortality.”  17 women and 106 babies die every day during childbirth.  That is a maternal mortality rate of 370 per 100,000. Most “economically developed” countries have a rate of between 5 and 10 per 100,000. The United States has a rate of 26 per 100,000 which has been increasing.

 

As the Ugandan landscape sped by my window, I needed a little “normal” and slipped in my earbuds, turned on my Ipod and slid the power bar.  It was on Shuffle, which i call Random.  Paul Simon’s most tender, sad, wrenching lyrics:  In a phone booth in some local bar and grill, rehearsing what I’ll say my coin returns.  How the heart approaches what it yearns.

 

 

 baby

Advertisements

You Gotta Learn How to Fall

 

Jeremy Abbott

The 2014 Winter Olympics ended two months ago, but this post was delayed by some circumstances beyond my control; let it suffice to say that I was temporarily “censored” on the subject of falling.  Now, however I think this post actually is even more meaningful for me, and I hope still relevant for you.  Thank you for joining in….please do skate along.  KA

 

Another Winter Olympics has come and gone with all of the

pyrotechnics, international attention (and international tension,)

competition, national pride and defeats, and personal achievements and

disappointments.  The performances were dazzling, daring and in some

cases downright dangerous.  Put a sharp blade or skinny ski on ice and

packed snow, or icy slush, at dizzying speeds and there is bound to be

calamity.  We witnessed the crashes of Andorra’s Joan Verdue Sanchez

in the Giant Slalom, Germany’s Johannes Rydzek in the Nordic Combined,

Chile’s Stephanie Joffrey and China’s Chao Wu in the Freestyle Ski

Event.  Our Americans Kelly Clark and Shawn White slammed into the

Half Pipe.  Germany’s Monique Angermueller skidded off the Speed

Skating track at 30 MPH. Each of these individuals landed and had to

pry themselves out of the snow or off the ice surface, possibly to try

again, possibly not, their dreams of Olympic metal dashed or at least delayed.

 

 

Then there were the Figure Skaters.  Our Jeremy Abbott who literally

hit the wall so hard it seemed he might have to be picked up and

carried off.  Japan’s Yusuru Hanaju, who did win the gold, hit the ice

hard in his short program. Beautiful intense young Russian Yulia

Lipniskaya fell in both of her programs slamming down from her

magnificent jumps.  Mao Asada of Japan, repeatedly fell; so sad to see

such a champion hit the ice again and again.  And our jewel box

princess perfect Gracie Gold, with a name destined for Olympic skill

and artistry, landed hard.

 

 

What is both amazing and baffling about the figure skaters unlike

their colleagues on the slopes and tracks is that they get right back

up, with grace, without missing a beat to the music, without a wince,

perhaps a nano second of disappointment flooding across their faces,

to be quickly transitioned to eyes focused with determination, perhaps

even a smile lifting their lips.  And they skate on, beautifully.

Only Jeremy Abbott crunched against the wall took a full 20 seconds to

return to his feet to glide and spin on.  Of them all only Eugeni

Plushenko, landing hard in the warm up, decided to call it quits, but

vowed that even if it took 10 more surgeries he would be back to skate

 

 

I wonder how these athletes, artists, competitors, champions, recover

so quickly.  How to rise from a clumsy and undoubtedly painful fall

onto that hard cold ice in their beautiful, somewhat skimpy, delicate

costumes.  It seems this would be difficult to bounce back from in the

privacy of one’s own home, alone on a private rink, but they have

fallen in front of literally millions of people.  Once, wearing a

dress, I slipped off an unbalanced chair at a Bat Mitzvah surrounded

by about 20 people. I was mortified.

 

 

So this makes me think about resilience.  What is it and where does it

come from?  Something fashioned into an individual’s DNA or is it

learned?  Is it practiced and practiced and practiced like a double

salchow into a triple toe loop?  Is resilience a learned confidence

that you can fall, and get back up?

 

 

I took ice skating lessons two years ago and the first thing I was

taught was how to fall.  My coach taught me a procedure similar to

this one I found on the internet:

 

 

Time Required: Practicing falling over and over again is the only way

 

 

to learn how to fall safely.

 

 

Here’s How:

 

 

Practice falling on the ice without skates on.

 

 

Next practice falling on the ice with skates on.

 

 

Practice falling on the ice from a standstill.

 

 

Practice falling on the ice while moving slowly.

 

 

Practice falling on the ice while moving a bit faster.

 

 

Practice falling on the ice over and over again.

 

 

Tips:

 

 

Wear gloves or wrist guards. Knee and elbow pads will also protect a

 

 

skater from getting hurt if a fall occurs.

 

 

Don’t allow your hands and arms to swing around or to get out of

 

 

control while you skate.

 

 

Put your hands on your waist or out a bit in front of you when you

 

 

ice skate, but don’t use your hands to help break a fall.

 

 

The only way to get over the fear of falling on the ice is to fall, so

 

 

practice falling on purpose over and over again.

 

 

If you anticipate that you are about to fall, bend your knees and

 

 

squat into a dip position.

 

 

What You Need

 

 

Gloves or wrist guards

 

 

Ice skates

 

 

Warm clothing

 

 

Knee pads and elbow pads are optional

 

 

I skated on a rink at a mall with a gazillion kids skating, falling,

sliding fearlessly around and around, zipping past my carefully

calculated glides and squats.

 

 

There is a massive amount of information about resilience in books,

journal articles, and on the internet.  There is a useful brochure

called The Road to Resilience from the American Psychological

Association http://www.apa.org/helpcenter/road-resilience.aspx   I

found an article about resilience by a clinician, Michael Ungar I

actually met at a conference in Belfast, Northern Ireland.   He is the co-director of the Resilience

Project http://www.resilienceproject.org/research-and-evaluation/biographies/90-michael-ungar

 

Michael Ungar relates the Olympic experience to the development of

resilience in children in his article Olympic Gold Medalists and

Raising Resilient Kids.

http://www.psychologytoday.com/blog/nurturing-resilience/201307/olympic-gold-medalists-and-raising-resilient-kids

In addition to getting control over one’s thoughts, having a positive

personality and having strong social supports, he cites the following

as a major contributor to resilience:

 

1) The advantages of setbacks. As odd as it sounds, most of the

study’s participants said that while serendipity (being in the right

place at the right time) sometimes helped them get a chance to show

what they could do, it was life’s challenges that provided them with

the motivation to push a little harder. Without some setback, most

would not have reached their full potential. The experience of failure

brings with it opportunity: the chance to say with certainty whether

one wants to give everything one has to achieving one’s goal.

Sometimes, those personal challenges were as simple as a bad

performance or being denied a spot at a qualifying competition.  But

personal milestones also played a factor. The loss of a parent, a

divorce, a personal injury all caused these athletes to pause and

reconsider their commitment to success.

 

What does this tell us about raising resilient kids? Don’t shelter

them from every challenge. Let them fail! (or fall!)

 

 

And the support network:  one of the major advertisers and supporters

of the Olympics, Proctor and Gamble sponsored the “Thank you, Moms”

spots and the Family Support Center in the Olympic Village.

www.google.com/search?q=proctor+and+Gamble+thank+you+Mom&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a&channel=sb

 

For teaching us that falling only makes us stronger. For giving us the

encouragement to try again. Thank you …

 

 

And what does this tell us adults who stumble, fall, sometimes totally

crash, whether in a relationship, our professions, our dreamed of

aspirations.  We can’t always foresee the event in advance enough to

squat and avoid falling.  We slip and slide and land sometimes with

painful results, damage, a massive set back.  It will certainly help

to have our loved ones and advocates on the sidelines cheering us on.

We may need to be physically or emotionally picked up.  But most

importantly we need to know that we can skate on, with confidence,

with good thoughts of ourselves and others, and then, we move on with grace.

 

 

You got to learn how to fall
Before you learn to fly
And mama, mama, it ain’t no lie
Before you learn to fly
Learn how to fall

You got to drift in the breeze
Before you set your sails
Oh, it’s an occupation where the wind prevails
Before you set your sails
Drift in the breeze

Oh, and it’s the same old story
Ever since the world began
Everybody got the runs for glory
Nobody stop and scrutinize the plan
Nobody stop and scrutinize the plan
Nobody stop and scrutinize the plan

You got to learn how to fall
Before you learn to fly
The tank towns, they tell no lies
Before you learn to fly
Learn how to fall