Sunday, October 26, 2024

It’s a cool, slightly overcast morning here, a nice change from the increasing heat during the day. It’s wild to think that my trip here is almost finished! I will have three more days of scanning, Thursday will be hands-on evaluation day, then Friday I will take a small plane from Gulu to Entebbe. I will spend the night in Entebbe and fly to Dubai on Saturday afternoon.

Rachel will be leaving tomorrow, for a conference in Kampala, then another conference in Kenya. It’s been great having her here and we have had continuous conversations about past, current, and future trainings. We spend a lot of time talking about how to optimize the training, problem solving, and how to best support the midwife community in Northern Uganda. It’s great to work with someone who is so supportive and appreciative, and flexible. It’s counterproductive to be too rigid here, which is why I am continuously working on my curriculum materials and adding necessary lectures.

Sister Georgina spent a week with us, leaving on Friday afternoon. She is an amazing human being, steadfast in her belief that she should speak up for the disadvantaged and always personally striving for more knowledge. She is also just a straight up joy to be around and so committed to being the best midwife and caregiver that she can be. I believe I mentioned that she was transferred to the refugee camp almost immediately upon completion of her ultrasound training (Group 1) without any warning. The nuns also delayed in sending her ultrasound machine, and the move prevented her from getting to work with a local sonographer that we had set up for mentoring. She proceeded to continue scanning, referencing ultrasound books and her notes from training, and managed to keep her skills up surprisingly well. She can also be quite funny, telling us about a pregnant refugee who came to her at 2am for an ultrasound, just because she wanted to know how big her baby was. Georgina told her the machine works on solar and won’t work at night! 😆Brilliant.

Susan and Dinnah have also been spending a lot of time in the classroom with the new group, acting as teaching assistants and getting some extra training as well. Having them explain my instructions in Acholi (the local language) has been so helpful. I have also been having them do the final ultrasound exam on the mothers, which not only shows me how they are progressing, but also allows me to give them further training. I am so amazed and proud of how hard they have been working since I have been gone and how much they have progressed in such a short time.

I have also found out that much of their progression has been in spite of the Sonographer mentor Rachel hired, not because of. Considering my first encounter with him, Rachel and I weren’t surprised, but he was our only option at the time. I discovered that he often would not arrive at the scheduled time, if at all, promised to send resources that never arrived, and was not responding to messages. He was supposed to go through the training course this time, managed to show up last week for a total of 30 minutes, took a set of my lecture notes, and left. Needless to say, Rachel will be looking for a new Sonographer Mentor, and we are hoping she can get enough funding to hire them full time. Their job will be to travel to all of the clinical sites where trainees are located, helping the midwives improve their skills. The plan is that whoever she finds for the position will go through my training program and I will be able to work with them to ensure that their have the necessary skills and personality to work with the midwives. Unfortunately, many of the Ugandan trained Sonographers that I have met have egos that far exceed their ultrasound knowledge, with a healthy dose of misogyny for good measure. Rachel and I have had a lot of discussion about this and have both agreed that this will be a challenge. Flexibility and problem solving! That’s my mantra!

Rachel will be meeting with her top donors in November, to share the details and outcomes of the two ultrasound training groups, and to propose additional funding to continuing training more midwives. This would be incredible on so many levels, both for the community and for my fundraising efforts. My transportation, room and board, and much of my supplies would be covered, allowing me to raise funds for more solar lamps, rain ponchos and extras to make life easier for the midwives. With or without the funding, I plan to come back and continuing this incredible work. Rachel and I agree that we will figure out a way to continue.

In the past few weeks that I have returned, we have had a significant number of patients who have received improved care, thanks to ultrasound. We have had many mothers who we were able to treat successfully here at the birth center, eliminating unnecessary referral to the hospital in Gulu (where they are unfortunately not guaranteed of receiving the care they may need), and unnecessary expense and travel. We’ve also had a few patients who did need to go to the hospital, and we were able to get them transferred quicker with clear recommendations. These patients are proof that our training is working and so necessary!

I took a short break from writing, because chicken mama and her brood were hanging out on my stoop, asking for a snack. Of course I had to comply! The compound women are highly entertained by my love for this chicken and her babies, and one of the aunties told the others that she heard be talking to them and telling them to “have a good day” when I left for the classroom. They also have been waiting by my hut when I return in the afternoon and even came running when I was leaving the shower one evening. They know that they are safe with me, as I am allergic to meat and eggs! 😁

Earlier this week, one of the local Acholi passed away. It is part of the village culture to “celebrate” after the funeral, playing extremely loud music, dancing and drinking non-stop, sometimes for days. Luckily, the celebration only lasted for two days, with one loud, long night, disrupting everyone’s sleep. My hut is one of the farthest from the party and I could hear it over my fan. We were all a bit groggy and cranky the next day.

I’m running on my last bit of data, so if you don’t hear from me this week, I will check in from Entebbe when I have Wi-Fi at the hotel. Today, I plan to finish a few changes in the lectures, knit another baby hat (keep knitting, ladies! We’ve had over 20 babies born just this week) and relax a bit before the week. I also have a mother that needs a rescan, recovering from a post-birth infection. Yesterday, I was called to the birth center to scan the mother, then I pre-packed some of my things, worked on lectures for most of the day, knitted a hat and watched a movie in the evening.

These are used to take mothers back home after delivery and to take
midwives on local visits to the nearby villages.

Zilla, our amazing cook and her kitchen.

I’m wishing you all a relaxing and restful weekend.

I am also sending love to two of my friends who have lost their husbands recently. My heart hurts for you both and I am so sorry that I am not there to offer my love and support in person.

Much love, Jo/MB