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

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When Sunny Gets Blue: Sex on the Beach, Mosquitoes and Karen Silkwood

There are lots of songs about being blue, in fact of course a whole genre of music is called The Blues.  “I Guess That’s Why They Call It the Blues,” “Blue Moon,” “Blue Christmas,” “Blue Velvet,” “Blue Hotel,” “Don’t It Make My Brown Eyes Blue,” “Love Is Blue,” “Tangled Up In Blue,” and “Mood Indigo.”  Blue in a song usually connotes sadness, but of course “When Sunny Gets Blue” took on a whole other connotation after Klaus von Bulow allegedly poisoned his wife Sunny putting her into an irreversible coma.   Sometimes being blue is literal and dangerous.  But enough about me; I can write about that in a future blog post sometime.

Blue has lately been making quite a fashion statement in nail polish colors:  Blue Blowout, Navy Narcissist, Blue Freeze, Poolside Passion, Blue Rhapsody, Beach Bum Blue, and Sex on the Beach (honestly, I don’t think Sex on the Beach is blue, but I did think it would get your attention.)  Sometimes at the nail salon I simply marvel at the names of nail polish colors and wonder who gets paid to make them up.  What an amazing job that must be.  I usually go with something like Gucci Mucci Pucci, Tennis Corset,  Angel Food or Negligee, but I am pretty conservative about my nail polish colors, only an occasional foray into something like Fishnet Stockings, Berry Naughty, Affair in Red Square, Skimpy Bikini or Clutch Me If You Can.

I love getting my nails done: the soaking, the filing, the hand massage and the little back rub as my nails dry.  Oh my God! And then there are pedicures…..And you know what?  I love the women who do my nails at the little shop I have gone to for years in Closter, New Jersey called Lux Nails.  As they file and massage and polish we have gotten to know each other.  We talk about our relationships.  The holidays.  Vacations.  We talk about our kids.  I have met their daughters and they have met mine.  I have had my nails done for celebrations, professional events and sometimes when I have been sad and blue, because the women bonding in the salon is very comforting.

So in no way is the following information meant to discourage anyone from enjoying their mani/pedis or abandoning their favorite salon friends.  I do think we all need to get some information about the products that are used in our nail salons.  I got some at a very interesting information at a forum I attended sponsored by NYCOSH (New York Committee for Occupational Safety and Health) called Beauty at What Cost?  Hazards Associated with Exposure to Beauty Care Products on June 20, 2012.

Here is the issue in brief: there are some really hazardous chemicals in those lovely nail polish colors and the other products used in nail salons.  In addition to various other chemicals, there is what is referred to as the toxic trio:  toluene, formaldehyde and dibutyl phthalate which are all quite prominent in nail polish,polish removers and artificial nail products.  They cause breathing difficulty with asthma-like symptoms, headaches, dizziness and have been associated with cancer and kidney disease.  All of these of course should be totally avoided during pregnancy.

For those of us who go to have our nails done once a week, every two weeks, whenever we want to feel good, the effects are most likely a non-factor in our health (but ask your obstetrician if you are pregnant.)   For the women who work in salons, our dear friends with whom we chat and sometimes share our deepest secrets, the health effects can be dangerous, deadly.

There are safety precautions that can be taken:  ventilation is really important.  Your salon should have good exhaust fans, windows, vents to remove the chemicals from the air.   Chemicals should be labeled.  And long sleeves can keep chemicals from getting into exposed skin.  With harsh chemicals gloves should be worn.  Here’s what it says in a Health Hazards brochure from OSHA:  Most work in nail salons will not require respiratory protection:  good ventilation and good work practices should keep exposure to gases, vapors, and particulates to a minimum.

So next time you have your nails done, you might just want to look around the salon.  You don’t have to be the Salon Police and you certainly don’t want to hassle the workers.  You might just want to make some suggestions or ask a few questions.  You can get the Safety and Health Topics at http://www.osha.gov/SLTC/nailsalons/chemicalhazards.html

Don’t we just love the women who so caringly do our nails, massage our hands and talk to us even when we are blue?

As women we all deserve to be beautiful and healthy.  All of us should be able to enjoy Safe Sex On the Beach.

 

Mood Indigo:  Duke Ellington   http://www.youtube.com/watch?v=GohBkHaHap8

 

Or you might like the Harlem Ramblers http://www.youtube.com/watch?v=Akd7F_w0als&feature=related

 

And here are the lyrics by Ella Fitzgerald:

You ain’t been blue, no, no, no

You ain’t been blue till you’ve had that mood indigo

That feelin’ goes stealin’ down to my shoes

While I sit and sigh, “Go ‘long blues”

Always get that mood indigo

Since my baby said goodbye

In the evenin’ when lights are low

I’m so lonesome I could cry

‘Cause there’s nobody who cares about me

I’m just a soul who’s bluer than blue can be

When I get that mood indigo

I could lay me down and die

You ain’t been blue, no, no, no, no, no

You ain’t been blue till you’ve had that mood indigo

That feelin’ goes stealin’ down to my shoes

While I sit and sigh, “Go ‘long blues”

 

Mosquitoes and Karen Silkwood coming soon to a computer near you in my future blog posts. 

Stay Tuned!