Good morning from Atiak!

 

Picho and I arrived at the Birth Center Wednesday evening, along with another passenger, Denis. Denis is a biomedical engineer and works on Ultrasound machines and Rachel asked us if we had room for him in the car, so he would not have to take a bus. It worked out well for all of us, because he is such an enjoyable young man and he and Picho share are sharing a hut. His company made the 6-hour drive very entertaining, like most Ugandans that I have met, he is friendly and funny and eager to have a meaningful conversation.

Allan had set up a portable router with local Wi-Fi for me, unfortunately it is not working this far north, so I am using my Google Fi network, which is spotty at best. Today, a group of us will drive to Gulu (about an hour south) and spend the day shopping for supplies and getting some work done. There are hotels in the area that offer day passes, where you can use their pool and restaurant, but most importantly, their internet.

Delicious Ethiopian food for lunch, after some power shopping.

We bought afternoon passes at the Bomah Hotel, where we can use slow Wi-Fi and the cool pool!

The past two days I have been getting familiar with the center, sitting in on a couple of midwife classes, getting comfortable with their machines, and I have scanned a couple of patients. The “students” that are here now are actually licensed midwives, completing master’s level courses. Rachel has chosen 6 midwives for me to teach in the next 4 weeks. Normally, we would be able to teach more students, but there would also be more than one trainer. The lectures will be fine, but the challenge will come when I am trying to teach six people how to scan at the same time. They are all so excited to have ultrasound training and I am excited for a continuing partnership with MHI.

I was able to give 10 rain ponchos to some of the midwives at MHI.
To say they were "Tickled Pink" is an understatement! 💗

Here is what I have learned about MHI…

MHI has a birth center that uses the midwifery model of care, employing traditional midwives, community health workers, and doctors who work collaboratively to treat women during their pregnancy and follow them through one year after they deliver.

“MHI staff are guided by principles of compassionate care that combine practical skills from the West and renewable traditional methods that are specific to the communities being served.”

The “Ot Nywal Me Kuc”(House of Birth and Peace) Birth center is a sustainable, solar powered birth center with 4 private delivery rooms, each with a birthing pool or shower, a supply room, vaccination room, midwife on-call sleep room, and a large community room with 4 hammocks for family members of pregnant mothers. There is a small family kitchen area just outside the birth center, where family members can cook for the mothers. MHI found that even though they were supplying the mothers with food, they preferred food from their family and village, so the family kitchen was built. 

The Birth Center

Donating 65 towels to MHI for ultrasound use.

The Antenatal building

Once of the private birthing rooms. Myel means dance, the other rooms are named Moon, Sun, Peace, Earth, and Water in the native language of Acoli, named by the midwives.

The birth center campus has a Postpartum building with 4 private rooms, an Inpatient building with 4 beds, used for antenatal care and pregnant mothers not in labor, but needing care for Malaria or other illnesses. There is also a building with a Lab and additional antenatal room.

There are several huts on the property, housing permanent employees, traveling employees, and guests. When large numbers of students come from the states or Makere, Sisters of the Sacred Heart have a large compound next door with extra housing that MHI can rent. There are outdoor showers and multiple restroom buildings, as well as a row of 3 composting toilets. There are 2 ambulances and 2 Tuk Tuks, used for transporting patients to and from the birth center, the tuk tuks take midwife teams to villages for antenatal care and community outreach.  

Composting toilets: the hole in the floor is for urine only, the seat is for...well, you know. 💩

Hand washing station near the dining area.

Outdoor shower, the tank above is hand filled. The water is almost hot from sitting in the sun all day.

The inside of the outdoor shower.

There are 60 midwives, many of whom live in approximately 15 neighboring villages, all affiliated with MHI. There are approximately 20 midwives that work out of the birth center. Midwife call is on a rotating schedule and there is a Labor Line (a specific cell phone) that is answered 24/7.

Yesterday, I was asked to scan a few patients. It was a great opportunity to get familiar with the machines they are currently using, allow some of the midwives to observe and also to allow then to see how beneficial ultrasound can be. As working midwives, they definitely know the benefits of ultrasound, but it will be so helpful when it comes to determining the need for transport to a hospital or the ability to treat mothers here.

Despite the oppressive heat during the midafternoon and middle of the night, I can honestly say this is one of the best places I have stayed in Uganda. They have created such a welcoming, nurturing environment here, it permeates everything they do. There is something so incredibly wonderful about being in a community of mostly women, whose sole purpose is to create a feeling of safety and comfort. It’s a rare thing for most women in the world and something to be cherished.

Yesterday I moved to a hut closer to the community area. One of the visitors left, Rachel and her daughter moved to a bigger hut with more space for 2 beds, and I was moved into a hut with more space as well. I was finally able to unpack my personal items, and especially all of the teaching material I brought. Four weeks is a long time to try to work out of a duffle bag and as much as I love adventure and a little bit of chaos, I do love having an organized space to return to at the end of the day. My hut is next to the community eating area, kitchen and wash area, so the kitchen staff is awake just before dawn. I am usually an early riser, so I don’t mind and it’s so beautiful here in the morning.

My new hut for the next 4 weeks.

The view from my hut.

There is food available from morning to late evening, allowing the midwives to eat whenever they need to. All MHI employees get meals as part of their contract, and the food is so delicious! Some of the offered foods have been Irish potatoes, sweet potatoes, plantains, cabbage, beans, posho, rice, gnut sauce, boiled eggs, a special treat of pancakes, and fresh fruit in the heat of the day. There is always coffee and tea available, and I brought along oats, which works out because I cannot eat the eggs that are usually offered for breakfast, and I am up hours before most of the team. This morning, I had a large mug of Ugandan tea and a bowl of oatmeal with cinnamon and local honey. There is a lovely light, cool breeze this morning, that I know will not last, so I am savoring every moment.

Posho, rice, beans and cabbage, with some Szechuan Chili Crisp Rachel brought from home.
This is a typical meal at the center, delicious and filling!

Our communal dining area, lit up with solar lights.

Monday I will start the training and it has been decided that we will have hands-on training in the morning, when most mothers arrive, take a break in the hottest part of the afternoon, and have lectures in the evening. Tomorrow I will organize the agenda and map out my training schedule for the next four weeks. Flexibility is key, not just because of the weather, but also because of life at a birth center!

It is 8:30am and the heat is already creeping in. I am hoping to buy a few dresses in Gulu that are better suited for the heat. I often travel with linen clothing and dresses, which would have been perfect, but I brought so many supplies this time that I was forced to leave behind a lot of my own clothes to make the luggage weight. Our plan is to be on the road by 9:30am, arriving in Gulu by 10:30am. Hopefully I will be able to load photos and post this! 

** Okay, folks, I'm attempting to send this from the hotel. I don't know if I will be able to resolve the Wi-Fi this weekend but know that all is well, and I am really enjoying my time at the birth center. 😍

Wishing you all well and sending love!

Jo/MB