Just trying to blend in....

I feel like this picture sums up pretty well a bit of what these last weeks has felt like... 

Mostly I'm kidding. But I do feel a bit out of place. Another missionary wrote about it and I am going to be lazy, not write it myself and just use his words. Furlough...
"...It is hard emotionally. Why? Because we discover that we have changed and that you no longer really want to be around us. Let me summarize. A man from the land of Blue became a missionary to the people of Yellow.  He struggled because he was a Blue man among Yellow people.  However, after a while he began to truly understand their culture and become partly assimilated.  One day he looked in the mirror and saw that he was no longer Blue, he was now Green.  It made being in the land of Yellow easier.  Then, after many years, he returns to the land of Blue. To his dismay, no one there in his homeland of Blue wants to be with him because, well because he was a Green person in the land of Blue.

After being on the mission field you are a different person.  People perceive you differently.  Even people who were friends are no longer friends.  They have grown without you.  They have had different experiences without you.  You are no longer ‘one of them’.  When you return, people want to shake your hand and say that they missed you, but they don’t understand you. " (Joe Holman)

I don't get pop culture references, and worse, I don't want to. I can figure out how to make a hot caffeinated beverage here :

But here is a whole different story: 

I have no desire to be permanently attached to the internet and it baffles me that my five year old nephew has checked and discovered there are no apps on my phone. I've heard how many missionaries feel overwhelmed in the cereal aisle while trying to remember how to grocery shop. So I decided I don't really need cereal. But I did need toothpaste. Turns out it isn't just cereal decisions that can trigger overload in Meijer. 

I'm very happy to report that I have not tried a single time to drive on the left side of the road. However, I keep trying to shift with my left hand and keep checking on the left for the rear view mirror. And I'm pretty sure I'm the most aggressive driver on the northwest side of Grand Rapids.  But I'm working on it.

Mostly I'm just trying to give myself time to adjust and adapt. I feel a bit of guilt about all the things I could be doing but mostly I'm just enjoying time with family. 

I've discovered some of you are still receiving mail from International Teams implying that I still work for them and suggesting you donate. If you are one of these people will you please drop me and e-mail to let me know?  kragtjen@yahoo.com
Thanks!

International Travel

Yikes. So it was a really rough couple days of travel and now I seem to have come down with the flu. I'm sorry I've been antisocial for these first few days back.  I left Soroti on Monday morning on a little MAF flight, got a taxi from Kampala to Entebbe and spent a few hours waiting there, then was supposed to fly out of Uganda at 11:30pm. But there were more than 200 IOM refugees on that flight which between security, immigration and boarding caused us to be nearly 2 hours late.  The flight was terrible. The flight staff had no patience for these folks who spoke practically no English and I'm suspecting most of them had never been out of their villages or refugee camps before. I was seated next to two little boys who spoke a bit of Swahili and who thought their parents were on the plane but weren't sure. They were very overwhelmed. One wet themselves because they didn't know there was a toilet on the plane. They were normal kids and 9 hours of sitting in a seat is tough even when you have your parents around. Harder when you a left with strangers in a very strange place.
Because it was an overnight flight we should have been able to get a little sleep but meals took FOREVER to distribute and the overhead lights weren't turned off until nearly 3am and were turned back on a 5am for breakfast. The flight was very hot and very smelly.  I had a 5 hour layover in Amsterdam but they are doing major renovations on their international terminal so there is almost no seating. Hundreds of people were sitting on the floors between departure gates. The flight out of the Netherlands was a noon and we were supposed to land in Chicago at 4 pm but it was definitely not a four hour flight. (  I think it was a nine hour flight). We arrived in Chicago nearly an hour late and between that, hours of waiting in immigration, and missing luggage I missed my connecting flight to Grand Rapids.

After re-booking for a later flight I went back to the international terminal to file the report for the missing luggage. Well, turns out it wasn't actually lost, but broken. I waited nearly a hour but finally they brought it to me. The whole bottom of my case was broken out. Now I needed to figure out how to repack it in such a way that I could get it to the domestic terminal (requires a train ride in ORD) and there was no way they would let me check it the way it was. I also discovered at this time that my american cell phone's sim card was no longer working because it had been shut off for the past two years. And pay phones are rather hard to find these days. After less than two hours of sleep in the last 36 hours it felt like an insurmountable challenge to solve these problems. But a 9pm I finally arrived in Grand Rapids. My family was all there waiting to greet me.
I feel like I've done next to nothing these last few days but I'm starting to feel human again and hope to be connecting with all of you soon!

Wow! It is that time already! I'm tired of saying goodbye and packing. Tomorrow morning I fly out of Soroti. Tomorrow evening I fly out of Uganda and Tuesday evening I fly into Grand Rapids! It has been a crazy few days tying up loose ends, getting coverage for my patients, getting all the animals food or shipping them out (the dog, cat, eleven rabbits, eight chickens and two ducks) making sure everything I pay for has been paid for the next three months (like school fees and VHT wages) and getting the house closed up. I have a few more hours of work left but I am getting close. See most of you soon!!

Politics

So it is that time again. Election time in Uganda is coming….Actually elections aren’t until Feb 2016 but primaries are soon and papers are reporting that there are almost two dozen presidential candidates that have submitted nomination forms. This country tries to be a democracy but has a history that only includes one truly “free and fair” democratic election.  (This was in 1996. Museveni initially came into power in 1986 through armed conflict and stays in power by changing the constitution to suit.)   Mostly coups or rebellions have been the means to become a new president.

Today Mbabazi (the Prime Minister until 2014) tried campaigning here in Soroti. I don’t know if it was a planned thing or not (I hadn’t heard anything about it) but the police got all upset and forcibly removed him from the open park in the town center. Back in 2005 laws were put in place making it increasingly difficult for opposition to hold any rallies or anything that could be construed as political dissent of the current president. People got really angry and there was a good sized mob in town. I’m not exactly sure what happened as I cleared out as soon as the parade passed (I love that this city can close streets and have a parade anytime it wants, without any notice, on any day of the week ,at any time of the day, marching bands included.) but later in the afternoon as I skirted town to get to the hospital it was clear that things were escalating. Tear gas was being fired into the crowd that formed outside of the hotel that Mbabazi was in. Most of the protesters were unclear if his own security had locked him in to keep him safe or if the military had locked him in to keep him quiet.  But they felt the need to light piles of tires on fire to make a point. Though, when I asked, protesters weren’t exactly sure what their point was.  Around this time I was drawing far more attention than I wanted so decided that I really didn’t need to see my patients again this evening and decided not to push through the crowd.

photo credit: Red Pepper News

I really hope this isn’t a foretaste of the political situation of the coming months….

This makes Ugandan history as clear as anything else  if you are interested.

Steven update

Sarah and baby Steven are continuing to improve. She is still quite anemic and her incision is healing more slowly than I had expected but otherwise she is doing fine. He is taking about 20 ml of milk every two or three hours without too much challenge. We are still having to tube all of it but will try breast feeding again soon. He is still often too cold and O2 sats aren't always great but he is holding his own. We have planned a "meeting" friday to make a plan how to get them home. The medical staff are afraid she can't care for him well enough. I don't feel like we even have anything to discuss until he starts putting on weight so we'll see how things go. 

I promised more pictures...

This is Whinny's little baby boy. He still doesn't have a name but that is normal and he will probably get his name after he meets his grandparents and extended family. Both mother and baby are doing fine and I expect them to head home tomorrow.

(I love that he is bundled up like it is 50 degrees. I would like to point out that is is easily 90 degrees in the hospital when I took these pictures and warmer outside in the sun.)

Sarah and her baby boy (possibly to be named Steven, it is still under discussion) are struggling a bit more. Sarah is discovering how hard it is to take care of a baby with her handicaps (on top of the pain of c-section) and expressed a lot of frustration today. She is also trying to hand express her milk into a cup and that is not too easy to do. I'm trying to get her a breast pump but this is rural africa...

Her little baby is also still struggling. His breathing is much improved and he can maintain O2 sats above 88% on 2L which is much better than initially. His work of breathing is still significant though. He also has lost almost 200g of weight which isn't completely unexpected but is more than 10% of his initial weight in two days so we have to get that to turn around. He weights almost exactly 1kg right now. 

This is Dr. Elisabeth, a pediatrician and I'm extremely grateful that she works in Soroti now. We were having a discussion today about how many weeks we actually think this little guy is. I've been using the date that Sarah thinks she became pregnant but Elisabeth pointed out that people rarely know the actual date and to prove her point she asked Sarah what day today is and Sarah was pretty sure it was September but wasn't positive. Elisabeth thinks the baby is actually nearer to full term but is so small due to IUGR because of the mother's extreme handicaps. She pointed out that his lack of lanugo and descended testicles means he is full term. I tried to argue that his hypoglycemia, inability to maintain his body temp, abnormal breathing and decreased oxygen levels all indicated he was several weeks early She said these were related to his low birth weight, not his age. Anyone want to weigh in? 

baby boy

Update: So everyone made it through the night. Winny and her baby are doing fine. She is up and moving around. Baby is suckling and things look good. Sarah is still having a hard time shaking off anesthesia and is hypotensive this this morning. But wants to eat and is headed the right direction. Baby boy however is still struggling.  Now made worse by the fact that the hospital doesn't have power which means his incubator isn't keeping him warm and the oxygen condenser isn't giving him any O2.  (I was told someone went to get fuel for the generator so hopefully that will be remedied soon.) I seem to be the only one concerned that he is extremely tachy and hasn't yet urinated. I had to wake up the nurse when I arrived to point out to her that every alarm in his room was going off and I never did find the doctor. I know I just have to put this little guy in God's hands but I am trying not to get frustrated.  I want to be able to say at least we did all we could. Please keep praying.

I know this picture is pretty much useless but I was working by lantern light and I didn't want to open his incubator and let any of the remaining heat out. So all you get is his hat and one little arm. I will try again later.

Prayers please!

This is going to just be a quick post because I want to grab a few hours of sleep before heading back to the hospital but I want to ask you to be praying for some of my patients.
Ajiko Sarah (the physically handicapped pregnant girl) went into labor today. This is six weeks early and four weeks before we planned to c-section.  But now she has a baby boy. He weighs 1180 grams (2.6 pounds).  He needed some serious resuscitation in OR and still isn't doing great. At least they are in a hospital that has an incubator, oxygen and a doctor that will at least try. Sarah is having a rough time too. She lost a lot of blood and is not going to get any (that story is for a post when I have more time).  She also had general anesthesia because there was no way to give a spinal with all of her handicaps and she didn't tolerate that very well.  So at the moment I would say she is stable but far from out of the woods.
In a weird twist of fate one of my other high risk pregnancies decided to pick today to go into labor also. So we did the two sections back to back. Winny (I delivered her first baby- story here) wanted to be a v-bac but that clearly was not going to happen. She was having significant late decels. So while trying to prep Sarah for OR I was trying to do frequent FHTs on Winny. (They don't have any continuous monitoring. They just have this fetoscope. They were extremely impressed when I pulled out my doppler and recommended we use that.)

Anyway. Winny and second baby boy are stable. Her baby is full term and normal sized so I'm not too worried about them. It just made the evening quite a bit more complicated. Pictures, update and the details of the story tomorrow.  

Babies, babies, everywhere!

My camera is full of baby pictures! I love this newest aspect of my job!

Twins! 

My favorite TBA. The women seem to really like working with her too. 

More twins

One hour old! 

This poor kid spent a long time coming and ended up with a rather pointy head.   

First bath!

How excited is this father?!

Ready to take on the world.

More harvesting

It was a busy few days in Lormoruchbae. Harvesting maize, sorghum, green gram, and sunflower.  I've yet to find a specific job for women in Karamoja that I wouldn't describe as back-breaking labor. Even sunflowers. Though beautiful to look at, they are a lot of work for very little gain. After months of planting and weeding comes the hard work of keeping the birds from stealing all of your produce. We hike out to the field and try to find the flowers that are ready. There seems to be a very limited number of days between mature and too late. Mary told me it is because this year was so dry, the flowers are drying too fast. We cut down the stalk, most of which are over six feet tall, remove the heads and carry them back. Then they have to be laid out in the sun to dry. Then threshed, some of which you can do by hitting the heads with a stick but some of the seeds need to be removed by hand. Most of the seeds are just consumed at this stage. But who is satisfied after a meal of sunflower seeds with the shell still on?! So, then it has to be pounded to make paste and rinsed to remove as much of the hull as possible then that watery, oily, gritty paste is used as oil in foods. Yummy! 

Putting them out in the sun to dry

After threshing

Making a paste (hulls still on)

We also harvested green gram. Which left my hands bloody the plants are so spiky. They explained this was also because it was so dry this year.  Green gram is a little like lentils and a really good protein source in their diet. But also very hard to harvest. This plant has an interesting method of seed dispersal.  Though not nearly as interesting if you are trying to contain the seeds. The little seed pods are a bit twisted and as they dry they become practically spring loaded. So when you attempt to pluck them off the plant if you don't have your hand wrapped around them the tiny beans go flying off the plant and there is no getting them back. 

Also harvesting pumpkins and gourds. 

And sorghum. Because of the abundance of this grain is seems the whole village is permanently intoxicated right now. Sorghum is used primarily for making beer. And it is the thing they have all grown the most of. And the home brew they make is so thick they drink it like porridge. And, like porridge, they have it for breakfast .

Celebration with the TBAs

One of my goals with this new birth attendent's program is to value these ladies who have so much to contribute but yet are so under valued because they are women. I had to write a grant application and here is how I described it:

"One of the issues that prevents the gospel from taking root in the villages of Karamoja is that women are not empowered, in fact the opposite is true. They are demeaned and devalued. They disregard gospel presentations because they don't believe they have any decision making power.  Women overall have very little autonomy, however an access point is through women who are already birth attendants (TBAs) as these women do have some standing within the community. We aim to value these women who are serving as TBAs. Through group meetings and trainings their knowledge base can be expanded with the intention of the threefold benefit: 1.) Reduction of overall mortality and morbidity for pregnant and nursing mothers and neonates.  2.) Empowerment of the TBAs within the skills they can provide for their own communities so that others see their wisdom and value. 3.) Increase of trust and a foundation for the sharing of the gospel and discipleship so that the disciples can become those who disciple others. "

Putting them on immediately

So this week we had a little celebration of how many lives they've made a difference in. They got shirts which they really enjoyed.  They told me now they have a "uniform" so people will know they are really trained now. They also got soda and cookies. They were surprisingly excited about that too.

cookies

and soda

This is how they wanted their pictures taken. 

I told them they had to smile to show me they liked their shirts. 

Headed home

Translators

A quick shout out to all of my various translators today. Because without them I'm only talking to myself.

On the right, Mary. She lives in Lormoruchbae and often goes with me to Nakayot.

Kodet. Not actually a translator. He is CLIDE staff but he gets stuck translating for me more than anyone else. 

Judith (and son Ezra) who is also CLIDE staff. She has some medical training so is extremely helpful. 

Betty. She is a former Timothy Student so likes attending CLIDE programs. 

There are several others, Sokoku, Petua, Lomakol, Mary and David. Sadly, I just discovered I don't really have pictures of them. Please pray for them as they have to put up with me and my strange ways of doing things so often.

Harvest!!

Harvesting in Lormoruchbae. Long days of hard work but it means food in the granaries! 

Sorting the harvest

Cant stop working even to feed the baby...

Notice that nice group of men watching us work while sipping beer? They did practically nothing all day.  

The random pictures on my camera....

I ride my bike quite often. I wear long skirts quite often. It is actually quite surprising that these two things haven't meshed this poorly before now. My knee is pretty sore though the scrapes are pretty superficial  and the bruising on my right leg is pretty painful so standing for long periods is troublesome.

All seven baby rabbits are growing and if possible are getting more cute. They are almost completely weaned. I'm planning on giving mama rabbit and a male (not one of these) to Ken and Janet along with my rabbit house while I'm on furlough. They are going try rabbit breeding, which is a good income generating activity here as a rabbit for eating will sell for more than a kg of beef.

There are a strangely large number of baby things on my clothes lines lately. The birth kits program is really taking off and I had to go to the second hand market last week to get receiving blankets and newborn clothes. I'll be taking 50 kits up with me for our next training.

I've mentioned before that each month I place an order for more than 1 million shillings worth of meds so the pharmacy gives me "bonus" drugs. This month was enough ferro and folate (the two key ingredients in  prenatal vitamins) for 10 pregnant women for their whole pregnancy! And as no one here starts taking it as early as in in the states I expect this to treat more than twenty women. A really nice bonus!

Thus concludes today's unnecessary blog post. I'm headed to the village right now and will be there until the weekend. However, I've heard the roads are really bad so we'll see how far I make it. There maybe more relevant blog posts possibly next week (hopefully).