Saturday, October 6, 2012

Return to Atiak


October 4, 2012
What a journey back from Nairobi.  After a long tiring morning, but with delightful company at the airport and on the plane I arrived in Entebbe. My driver Ali was there to pick me up and we began the long journey to Atiak.  We made a few stops along the way which put us smack in the middle of a riot in Kampala.  The president of Uganda who is not popular and considered corrupt by most of the people had arrested the main speaker for a strike/ rally that was to occur.  The strike continued and the people spoke out.  The police however, were there to stop it.

There we were, in the middle of the city center, in stop dead traffic with shouts and people in the streets, police were everywhere.  All of a sudden not too far in front of us we could hear tear gas canisters being thrown then screaming and crying and within seconds countless people running through the street crying and gasping and fleeing.  It was obviously very close to us and I was so worried that if it got closer to us I wouldn’t be able to breathe.  Ali, my driver, tried to turn around and was making headway going over the curb but everyone else was doing the same thing.  We were stuck.  Then, very very close – gunshots.  They kept going off and more screaming.  Somehow while we were all ducking Ali got us onto another street but it seemed the gunshots kept following us.  He called a friend and got us good directions out of there but it was 10-15 minutes of terror. I called John a couple times during the event, and while I didn’t want to worry him I didn’t want to be alone. I was actually more afraid of the tear gas than the bullets – whether that was reasonable or not. I do not know, but it was how it was.

On the way to Atiak we saw truckload after truckload full of police being sent down to Kampala. It was very sad.  So marks another eventful arrival to Uganda.

I met Paul in Gulu for the rest of the ride home. It was so good to get back and see everyone who I connected with in such a short time. There is a family from Kenya here having their baby here who are delightful.  After meeting them I walked into the clinic to see how everything was going and literally within 3 minutes caught a lovely baby girl.  Then off to bed for much needed sleep.


October 5, 2012
It was a very hot day. So hot I was dizzy every time I had to go into the sun, and the birthing center was stifling with lack of air movement.  We had a lovely baby boy this afternoon to a mother who didn't even speak Acholi which made it more complicated for everyone, not just myself.

I was speaking to Katherine, one of the TBAs and she was telling me of her children – 2 boys and 1 girl.  Then she mentioned she had 2 other sons, one who died very young and one who was taken from their village nearby by the LRA and killed in that terrible massacre.  I cried when she told me.  The history of this place is so easy to forget and yet it is so close it is palpable…


October 6, 2012
I rode out to the village today to pick up a woman in labor.  She met us on the side of the road with her family. I so wanted a photo but did not want to insult anyone – here I am the white girl gawking.  They probably would have been fine with it.  This family was literally in rags.  Herself, her 3 other children, her husband – and covered in dirt.  They seemed concerned and quiet and a bit taken aback by seeing me in the ambulance.  She also did not speak Acholi and there was no communication.  She gave birth within an hour of arriving - a beautiful little girl.  

I used to think women had a way of speaking to each other that transcends language, and that birth especially is universal. Not here.  At least not the way I am used to.   The women don’t make eye contact and seem so beaten down that they would never consider a bit of comfort. You have to be tough to survive here and maybe any comfort is a luxury that would cost more than it is worth. Yet I can still empathize and understand and try to send them my encouragement and reassurance even without language.  Sometimes I feel there is a connection and understanding, mostly I don’t.  At least not until the birth is over.

Let me share a bit about how birth is done here.  Women are often left alone.  I do not know if that is what they want or not, but their lack of eye contact makes me uncomfortable in stepping in and supporting.  Only once has a woman leaned on me and held me and had me rub her back, and I was told that was very unusual.  Not only am I not with them, but no one else either – not their attendant, not the TBAs. They are brought tea and food, but that is all.  They sometimes go and hang out with the other women in the center.  They are encouraged to move around and be in different positions which I suspect is quite unique to this center and is not done in the villages or anywhere else.  For the birth, however, they are expected to lie down.

In many ways it is disheartening to see these women give birth flat on their backs, naked, on a plastic sheet.  Just seeing them so hot and sweaty and lying on that plastic is difficult for me.  No cotton or polyester sheets as the birth center does not have enough and apparently cannot afford to dirty them.  They used to, but not any more. It would be so much more comfortable for them and make clean up that much easier.  Yet that is the culture here and I have decided that my role is to support these women as much as I can and offer the respect they deserve, regardless of how this seems to me. And really, this isn't about the women or culture but about the center itself and how it is run and what the needs are. I do believe that women are treated better here than in the villages and certainly in the hospitals. And they are treated well.   I actually love how the women are birthing and the attendants and midwives are chatting (not me, I just listen and feel very out of place).  It is clear birth is important, but just another part of daily life.  It is not sacred in the way I am used to, but it is not bad either. I often reflect on how we treat birth back in the states and am even more disheartened. At least here, plastic and all, women are endowed with a strength of knowledge that is not education but at the core of their being that is so lacking with the birthing culture in the US today.

After the birth we clean the woman up with whatever material is handy, usually a piece of cloth or clothing.  We wipe her and the plastic down as well as we can but birth is messy and it is not ever enough. Women are not cleaned with water.  Then she lies back on the plastic that is usually still damp and a piece of some sort of material is put next to her to lay the baby on. Sometimes it is large enough to put her body on as well; sometimes not.   The attendant washes all the laundry and makes her food.  She is left alone again for most of her stay, unless her attendant keeps her company.  Most women are staying overnight and leave as soon as they can in the morning after breakfast.  Their attendants sleep on a straw mat in the middle of the big room.  I was told that one night they had so many babies they had the women move to the mats and then had to have women and babies share mats.  Later the women washes from a basin and will bathe their babies as well.  When they leave they are given 2 outfits and a blanket and we ask them to come back for postpartum care.  Most women do not return - the journey is often too long and difficult.


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