Monday, October 20, 2025

Hello Friends!

We have had continuous challenges with the power and WiFi network, so I will write away and we shall see when I am able to post!

We have completed the first two weeks of training, as well as the lecture portion of the course, and today we will begin the scanning only portion of the course. We begin at 9am and review saved images from the previous scanning session, then start scanning patients as they arrive. We will take a lunch break at midday, then resume scanning until the last patient has gone. I have just found out that Max has been delayed by the heavy rain, so today I will manage the students on my own. We have three beds/scanning stations in the classroom, so I will float between the stations for instruction, and also scan every patient to make sure no pathology has been missed.

Last Thursday evening, Rachel arrived in the new (to us) Toyota truck ambulance! She drove in with the ambulance lights flashing and all of the midwives came out to dance, sing, and give blessings for the much-needed ambulance truck. It was very exciting and fun to watch. The group of visitors arrived the night before, so the greetings and hugs went on for at least 30 minutes. 

Last Friday, the midwives had their written exam and all of them did incredibly well, the lowest score being 87%. There is no “final grade” for the course, if you are here all four weeks, and put in the effort, you pass the course. The students still cling to the importance of a numerical grade, but I am only concerned with their comprehension. I am happy to say that the student who needed a talking-to has gotten her act together and has really been doing well. I made a point to pull her aside after class and let her know that I have noticed her improvement and that I am very happy to have her in the course.

Friday evening, there were 11 mothers in active labor in the birth center. The working midwives had to place the women who were closest to delivering in the birth rooms, the rest were in the open waiting area of the birth center, resting on mats or walking around the compound. If a waiting mother progressed quicker than expected, she was swapped out with a mother in one of the birth rooms who wasn’t progressing as fast as expected. Once the mothers delivered, that had a shorter than usual respite, then moved to the postnatal building.

I was called on to scan some patients, one of whom was a first time, 17-year-old mother to be, who was having sciatic pain. I confirmed baby position, quickly ruled out any possible placental abnormalities, and made sure she didn’t have Hydronephrosis. Hydro is when the kidneys fill up with urine, because something (a stone or a baby) is blocking the ureter, and it can be extremely painful. I’m happy to say that although her labor was long, she had a smooth delivery.

Saturday morning, I gave a couple of ultrasound lectures to the visiting group of black women who are here from the US, Mexico and Jamaica, which led to some fascinating conversations. The visiting group is made up of doulas, a midwife student, a traditional midwife and a woman and her friend who are here to film and create a short documentary, to bring attention (and hopefully financial support) to the birth center.  Rachel and her friend Nikiya (a doula who is now in midwifery school, are working with some of these women to start a fellowship specifically focused on bringing black midwives to Uganda. Black midwives are severely underrepresented in the US and black mothers are 2.5 to 3.5 more likely to die in childbirth. Black midwife students also face a high incidence of racism with preceptors, limiting their opportunities to get adequate work experience before they graduate. It’s been incredible listening to their experiences.

Saturday afternoon, I brought some knitting to the birth center, and within 20 minutes a group had formed for more lessons. We moved to a shady spot outside, as the birth center filled up with more mothers in labor. I am definitely going to have to collect more yarn and knitting supplies for the next trip, I’ve been wiped out!

There were four more babies born overnight and another still in labor by Sunday morning.  Rachel and Nikiya and I piled into the fancy new ambulance and headed to Gulu for the day. Nikiya had a red eye flight in Kampala, so we headed to the market and nearby shops for her to pick up some gifts for home, ate lunch at our favorite Ethiopian restaurant, and then transferred her to a car for the drive back to Kampala. Rachel and I went to a nearby coffee shop to meet the visitors, who had taken taxis to Gulu. We gave them a quick tour of the market, then set them loose before Rachel went to the produce section for food supplies. After packing the truck full, we ran a few more errands, picked up another visiting midwife and her 2 young daughters, then headed back to Atiak. We pulled in just as it was getting dark and during a light, but solid rain.

local honey and honeycomb

dried smoked fish

popcorn

beautiful fabric

calabash bowls

After helping unload the truck, I returned to my hut and found a visitor…

Yikes! There are a myriad of insects and creepy crawlies here, but scorpions creep me out (even more than spiders!). I scooped it into a small bucket with a lid, contemplated burning my hut to the ground, gave myself some CPR (because I’m pretty sure I had a small heart attack), and called on the traditional midwives to take it off my hands (RIP). During the dry season, they are very abundant here, so I did not expect to see one in rainy season.

I was up early this morning, we have power but no WiFi, swept out my hut and made myself some breakfast and tea. I’m going to set up the classroom and wander up to the dining area to say good morning to everyone. Hopefully, Lyca will resolve their issue, and we will have internet by the afternoon.

My router and data were sorted, so I'm sending this out Monday evening. At the end of class, I gifted my students some of the scarves I had brought along, and it was a big hit!

Whew, I think I've gotten you all caught up on the fun stuff. I'm going to add a few more food photos for you...

green cooked with tomatoes and onions, and beans
over posho (maize flower cooked into a firm paste).

Beans, Casava and rice, with Malakang. malakang is made using the leaves of the 
Malakang plant, and odi, a paste made from peanuts and sesame seeds.

Mandazi, fried doughnut style bread.

 I hope you enjoy the photos! Thanks for joining me and for the continued emotional and monetary support.

Much love, Jo/MB