Downs and Ups

I have not felt like blogging this time around. As Aimee has written, this trip is very different from our first. We have come back into a network of relationships and responsibilities, both old and new. We’ve come back with the understanding that we very likely will not be back this way for quite some time, and we are trying to utilize each moment for the work we’ve come to do. One of the first things we discovered when we arrived in Gulu was that the two brothers who we’ve been sponsoring in school since February are in very different situations. Fred, the younger boy, is in his first year of secondary school in a private, Catholic school. His campus is secluded and very green. There are only 130 boys there and they have (old) computers, functional science labs and, most importantly, a feeling of normalcy. Stephen, his older brother, is twenty years old. He dropped out of secondary school seven years ago when his Aunt could no longer afford the school fees. When we met Stephen, he was driving a matatu and trying to support Fred and his Aunt. He had a terrible stutter and he seemed, in many ways, traumatized. I think that for Stephen, just the pride of being in school and wearing a uniform has contributed to a major shift in his personality. His stutter is considerably less pronounced, he is smiling a lot, and he talks positively about his future. Unfortunately, the school that Charity for Peace placed him in is in ruins. It honestly looks like a burned out squatter flat. The school consists of a single administration building pushed back from a dirt road atop a small hill on the outskirts of town. If no one were in front of the building, you would honestly think it was abandoned. There is graffiti all over the face of the building and the windows are almost completely broken out. Next to this building is the boys dorm. When we went in, the smell was enough to knock a person down. Trash and dirt is piled in every corner of the living quarters. When the power is on, there is a single lightbulb on the ceiling to illuminate the room. All of the boys sleep on thin, foam mattresses on the floor. It is quite a sight. Fifty or sixty boys to a room, crammed together like sardines. Stephen had few clothes and just a thin sheet to keep warm. Despite the fact that he had been in school for six months, they had failed to provide him with the uniform that was supposed to be included in his fees. The weather now ranges from very hot in the midday to quite cool in the evenings and throughout the night. Stephen was complaining that he was quite cold. He also told us that he had yet to be shown his report card so he had no idea how he was progressing in his studies. When I went to speak to the headmaster, a man who seemed to be in his late twenties or so, he didn’t have a very good explanation for the uniform or the report card, but both miraculously appeared within a day or two. On the day that I came by to pick up a copy of the report card, the headmaster asked if I worked for an NGO. When I said no, he said he was sorry to hear it because he was going to ask me if there were any job openings in my company. Text books are only for those who can afford the 20,000 shilling cost per book, so hardly anyone has books. That’s not just at Stephen’s school. I have only seen one or two children in any of the schools I’ve been to who have even a single book. Fred, even though he was in a “good” school, had no mosquito netting on his bed. He had only two shirts, a pair of pants, and a pair of shorts that substituted as underwear… So sponsoring a child, we’ve discovered, requires a lot more than just writing a check and sending it to some charity. There has to be some follow-up. Now we are in the process of getting Stephen into a better school where we can be somewhat sure that he is not freezing on a cement floor each night. If we hadn’t come back, Stephen may have finished his schooling in this place and he would never have mentioned anything to us because, to him, it was a better situation than he had been in…

On a completely unrelated note, I was feeling quite homesick this week. I had been getting quite a bit accomplished last week. I was plowing through a lot of reading for N.Y.U. that I had fallen behind on during the year. I was preparing some abstracts for papers and conference proposals. And I had started working with the prisoners and Gulu prison on a theater piece. Things were moving along wonderfully, but then I came down with some terrible infection. I don’t know if it was viral or bacterial or what. A lot of the locals are convinced that it was malaria. Whatever it was, it threw me for a loop! I was truly down and out for about five days. High fever, vomiting, night sweats, headache, intense joint pain, the whole nine yards. Aimee was amazing. Despite all the intense weight she was carrying on her shoulders from her days at the hospital, she really nursed me back to health. I was so out of it, I wasn’t really aware of what was going on for her. Nevertheless, she was transporting back and forth to Gulu Independent hospital to get checked, to get medication, and then sitting with me at home until she was sure I was comfortable. So after a tough, long weekend, I am feeling much, much better. But ever since I got sick, my spirits have been really low. Actually, I’m feeling a bit like myself today. We’ll see if I can maintain through the day because for the last few days, I’ve been pretty low. Dreaming of the Atlantic Ocean, Brooklyn pizza, and Brian Lehrer (my favorite NPR host in New York). Missing my niece and nephew and my brothers and my parents and my cat (!) and feeling sorry for myself about all of it…

But then I woke up this morning and the sunrise was absolutely stunning. The air was clean and fresh and I felt a bit lighter. As I walked down the red-clay roads, I tried to see the scene with fresh eyes again. I tried to remind myself that it was pretty incredible that I was strolling down this road in Central Africa. It is incredible. Aimee and I don’t know when we’ll be back here. It may be many, many years. It may be never. I know I’ll have pizza again. And I’ll swim in the ocean in a few short weeks. But when will I see this African sunrise? And when will I live with a group of singing, dancing, drumming nuns? When will I be offered a steaming bowl of white ants again as an after-dinner treat? When will I have the chance to enter a Ugandan prison and do a bilingual theater workshop with 100 inmates? It may be a while. So I’m telling myself to stop bitching and start rediscovering these landscapes. When we left in January, we said that it had been a once-in-a-lifetime trip. Well, now it’s been twice-in-a-lifetime and I don’t want to take it for granted. I still look forward to coming home in a few weeks. I really do miss everyone, and I can’t wait to get a slice and some chocolate ice cream. But it will keep. For now, we are here and I want to soak it in because I don’t know if I’ll pass this way again.

More to come…

The Privilege of Self-Reflection

6.26-We’re in the middle of our third week. I can’t believe it. My days are booked. Today Rachel and I are working the evening shift at the hospital so I have the morning to write and catch up on some things around St. Monica’s. After lunch, we’re teaching a workshop with the child mothers that live and go to school here. Sister Rosemary asked us to teach them a course about mothering, focusing on the basics of washing and caring for their baby etc. We’re hoping to have more of a conversation around the joys and challenges about being a young mother. We’ll see how it goes…

Well, I’m finally feeling like I’m gaining clarity on the purpose of this trip. Our meetings with the TBAs have pointed most directly to what’s most needed and what can be most easily sustained. My heart is with them. They are a vital part of the health care system in the North. They are not compensated for their work in any way. Yet, they identified so strongly with being a TBA as a profession. It is their profession. They are proud and passionate about their work. If they’re lucky they’ll receive some sugar or sim sim (peanut) paste as payment for a birth. Most of the time they are not paid. They have been forced to move into IDP camps because of the conflict, without any support from the government at all or any supplies to protect themselves. They attend births often unprotected without any gloves. They shared with us about their concern about contracting HIV and other diseases. Some have been living in the camps for a few years, some up to twenty years. Once again, women are carrying the heaviest load for their community without any recognition, training, funding, or outside support. This is what feels important to me. Each group that we’ve met with has a leader. It would be feasible to implement a program to support the TBAs through local leadership to get them supplies, funding, and training. I believe that with long-term governmental and NGO support these women could change the structure of healthcare for women living in IDP camps. They have sincerely asked us not to forget them.

The hospital is another story. The need for supplies and training is also very great. I filmed and witnessed a cesarean birth two days ago and was horrified at what I saw. It is not their fault. To begin with, the two surgeons performing the procedure were both junior doctors. They have been trained in an outdated technique. I watched in horror as this poor woman was butchered with a 10 inch midline incision. Blood was pouring off the table as she lay with her scarred uterus on her stomach and her placenta in between her ankles (they just left it there). To everyone’s surprise she gave birth to twin girls. I honestly wasn’t sure if she would make it out alive. Thank g-d she was in the cesarean ward the following day. She is in severe pain but she is alive. This was her second cesarean. Each day at the hospital is horrifying. I wish it wasn’t this way.

One thing that I have found here is the absence of critical thinking. As a culture, they have been taught not to question. The roots of this absence come from the conditioning of being colonized. There is a formula for everything they do. Thinking outside of the box is not even an option. There is no awareness that there is a box. There is a lack of self-reflection. I see how in our culture, self-reflection is a privilege. This is extremely disturbing when it comes to birth, an art that so heavily relies on intuition. From the time we are very young, our parents ask “How do you feel, honey? Did that make you feel sad? Did your feelings get hurt?” Your feelings are a privilege. I am constantly trying to find ways to reframe that question. It just doesn’t translate here. Kevin is finding the same thing with his work at the prison. The men there are most comfortable being a collective, but to ask someone to individualize a performance is foreign to them. It took him 45 minutes the other day to have them act out something from their own experience. The removal of one’s own personal experience from the culture plays into birth in a fascinating way. You might think that women would birth silently, shamefully, or introspectively due to a lack of individualism and self-reflection in the culture. But we’re finding the opposite. Birth gives these women permission to emote and be dramatic. It gives them permission to feel, shout, scream, rage, and cry. It’s an eruption of emotion! The midwives in response will laugh and call them “stubborn”. The performance of birth comes to a screeching halt after the baby is born. A woman that was tearing at my neck and kicking me one moment becomes immediately docile and expressionless after the birth. Or she goes from a raging fit to being so lovely and sweet.

Last week, a young midwife, Beatrice, fresh out of midwifery school joined us on the maternity ward at GRRH. She is obsessed with conducting every birth and in my opinion, a little “catch obsessed”. Each birth is approached the same way as if each mother’s needs are the same. I appreciate her passion for wanting to learn. I share that passion with her. But what I’m witnessing her practice is actually dangerous to the mother. She was taught to do thorough vaginal examines after a mother has delivered. As a student in this system (British) you are taught to learn through rote memorization. That is they way to succeed. Do as the book says. So even if we have controlled a mother’s bleeding with nursing or breast stimulation, she insists on vigorously inserting her hands inside a woman after each birth. One of the last mother’s that this happened to fainted in the hallway five minutes after being examined in this way. It’s disconcerting to say the least. We are always walking such a fine line. A dangerous line. An important line. There is a time and place to step in and protect mothers, to actively train the other birth attendants and midwives, and there is a time to respect their practices and watch. I do not blame the women that I’m working with for what I see as negligence. It would be naïve and arrogant to do so. The problem runs so deep, and is a direct consequence of the effects of colonization. But at what point, as a culture, do you evolve from that history? Where does critical thinking come from? As a culture, what is the catalyst for questioning? Rachel calls it “a shell of Western medicine”. It’s true. It reminds me of how women were treated in the nineteen fifties when the medicalization of women became the trend, and sadly, remains as the dominant paradigm. So here we are…and this is the “referral” hospital that the TBAs are being told to send their women. This the place for high-risk mothers. This week one of the mothers came in with a prolapsed uterus. Her uterus was still hanging out of her vagina two days after she first came in. She left and went home untreated.

We’re filming our days here with the hope of creating a documentary that will not only tell the story of the hospital, but help to raise funding and awareness for the TBAs. Soon, two more doulas will be joining us. That said, I question if an exchange program is what is most needed here. If my intention is to create a sustainable project for TBAs I have to be honest and say that it is not about bringing more of “us” here.

July 27th – I’m returning from a very upsetting day at the hospital. It is honestly just getting worse and worse. We came for the evening shift and found out that one of the mothers lost her baby in a cesarean section. It took a few minutes to find out that it was Harriet’s, a seventeen year old girl that I was with all yesterday. When I left her at 4pm she was 8cm dilated, the heart rate of her baby was strong, and she was in good spirits. We spent most of the day walking the halls and singing a song that we made up. “Today is the day of birthday. Today is the day for your baby to come...” then I would ask her, “When will your baby come?” “Today!” When will it happen?” “Now!” and she would point to her belly. Then she would tell me that she thought we should switch bellies. She wanted me to have the big one! I asked her when this should happen and she responded “Tonight!”. We laughed together and kept on walking. Out of all the teenagers that I’ve worked with I felt most connected to her. She was responsive in a way that I hadn’t experienced with other girls. She had a large group of mothers helping her, supporting, and loving her. It was shock to come back today to the news that her baby had died. What happened?! What went wrong?! I was not satisfied with the doctor’s explanation that her pelvis was compressed. He said that he got a call at 1:30am but he was not on-call that night. He tried three other doctors and not one of them answered the call. Apparently, one was officially on-call but his phone was off. So he waited until the his morning shift and gave her the cesarean at 9am. By that time the baby had already died. I went to see her in the cesarean ward. A ward filled with about ten beds full of recovering mothers, most with infected incisions. The room smells like shit and piss and is full of flies. I don’t think the mothers get cleaned up or cared for. Usually one of their relatives is responsible for washing them. She looked at me asked about her baby. I couldn’t believe it. I didn’t understand. No one had told her that baby died. It was explained to me later that the policy is to wait a few days until the mother has recovered. I spoke with the doctor again (the junior surgeon who performed the cesarean). I told him that she was awake and that she had been asking for her baby. We walked to the ward and I thought he was going to give her news. Instead, he lied to her and told her that the baby was not well but that we’re hoping he will be better by tomorrow. He was speaking in Luo so I thought the whole time that he was telling her truth. Instead, he lied to her face and to mine. There was nothing I could do except hold her hand and be with her. I left it up to her mother to tell her, but I don’t think she has. Her family had been informed and had taken the baby home after the cesarean. It wasn’t until a few hours later when Harriet was asleep that I got the real story. I took her mother outside in the hall along with a translator to find out what went wrong. The translator was this wonderful woman who has been working at GRRH in the dental ward for ten years. I was told that she was 9 cm at 9:30pm. She felt the urge to push but was told that she was going to get slapped if she cried or screamed. The midwives then went into the back room (the room were we change) and slept throughout the night. They told the mother and Harriet that they would only come out to clamp and cut the cord. They totally left her alone. They abandoned her. Her mother said that no one touched her, no one encouraged her, or helped her. About an hour later she was pushing on her own. The baby came down and was close to crowning because her mother said she could see head. Again, no one came to be her, check the fetal heart rate, or help her push her baby out. They left her in that state until morning. The baby was in distress with his head compressed in the birth canal for twelve hours. Of course, by the time they performed the cesarean in the morning he was dead. The mother said to me that she thought of us all night because she knew we would have helped her daughter. She said she knew we would have touched her. The woman translating, Janet, was extremely open and told me that this happened too often at this hospital. “The midwives hit and hurt the women. They should not treat mothers this way. They should be encouraging them, especially such a young girl.”
My blood rushed through my body. I was livid. An entire month of justifying, of playing mediator and peacemaker, came to an end. What is happening at this hospital is criminal. I’m sorry to say it. It needs to be reported to the administration. It needs to change. I apologized to Harriet’s mother. I told her this should not have happened to her daughter. I asked her if I could film her story with Janet translating and she agreed. I’m going to return to the hospital today to follow-up with that and a few other things. My heart is so heavy. There’s really no time to process here. I just seem to be moving on. There are so many issues colliding at once. I’m reflecting on my first time at GRRH. What was the difference? The majority of my time, I was working with two other midwives, Jackie and Jennifer. I haven’t worked a shift with either one of them this trip. Compared to the midwives of this trip, they both are kind, knowledgeable, and thorough in the care of mother and baby. They taught me a lot. In that time, I never witnessed a resuscitation. I never saw a baby die. I knew the conditions were atrocious but I felt that the mothers were being cared for.

This type of violence against women happens all over the world. It is another case of victim/victimizer. The truth is I have compassion for the midwives abusing these women. I see how little they have, how unsupported they are. But this can’t go on… Will my reporting them really do anything? I doubt it. But I feel like I can’t leave here without handing in a formal report on the conditions that we’ve witnessed. I do feel clearer about my own role at the hospital. I’m putting my energy into educating. I don’t want to reprimand or continue the violence I’ve witnessed by assaulting my midwife sisters. I want there to be real rehabilitation for the women and staff. I even thought about incorporating non-violent communication into the next trip (who knows when that will even be?).

Sorry for the extremely long blog. I’m really just journaling for my own sanity. It helps to write. The week in Rwanda is looking really good right now!

Love to you all. Thank you for your support and Love. I feel it. The work is hard but I love it, and it's what I came here to do.

Ps Update on Kevin:
Kevin told me that he plans to post a blog this week. He just hasn’t felt like writing. He’s working at the prison everyday from 9-12. He’s also advising the NYU students on the Teachers for Teachers program. It’s all going well. Unfortunately, he got sick last week but has made a full recovery! We have our “dates” throughout the day and week. But we’re really looking forward to an enjoyable last week together in Rwanda. And we can’t wait for gorilla tracking on our last day!

Love,
Aimee


Photo Kevin's first night out after a week of being sick!
Photo Sister Florence, our Ugandan mother who we love so much.
Photo Harriet in labor

Birth in Question

June 20th, 2007

The walls are covered in a streaked brown stain spanning seventy years worth of women laboring. They coat the corridors of Gulu Hospital and are a permanent fixture in the story of birth at the maternity ward. I feel caught in a conflict that has no resolution, only temporary ebb and flows—some positive, some negative. The more I work here, the more complex the issues become. Am I just here as a witness? Am I here to bring back the narratives of these women? Am I here to “help”? Does my very presence only solidify the constructs of Western power in a developing nation? I try to keep it simple. I take it ALL in. My heart is bursting, aching, crying in love. I don’t want to be preachy, but only G-d can hold this love and pain. I feel alive here for that reason. I am always brought closer to this presence. It is extremely humbling. The role of the midwife is just that—a role. I watch, listen, act, and care. I’m laughed at by the women that line the corridor whenever I give labor support to a birthing mother. It’s a cultural difference. Women don’t really touch the birthing mom. But the mothers in labor are very responsive to a loving touch and comfort. Many of the women don’t speak English but they respond to a kind touch. Who doesn’t?

I literally am walking in two worlds. Yesterday at the hospital, we resuscitated a baby back to life. We watched it go from blue to gray to pinkish brown. We watched its breathing go from shallow to steady. After many attempts of trying to explain that this baby needed oxygen immediately, we trained the grandmother to give mouth to mouth. She didn’t understand what that was so after several more minutes, Rachel got a glove, ripped a hole in it, placed it over the babies mouth and gave him mouth to mouth. It was the only way to save this baby. We’ve noticed that the midwives don’t assess the newborn after they are born. Have they become so apathetic to witnessing death? Has it become such a normal part of their daily experience that it no longer warrants emergency intervention? I watch this and wonder…aware of my own biases, aware of my own arrogance. But when you know you can save a life how can you just walk away and let that baby die? It is extreme. The mothers scream out. They grab you and pull on you with the force that is the tsunami of birth. My shoulders ache at the end of the day and yet I rush back to check on these mamas eager to see them holding their new baby the following day. I love these women. There is so much that I don’t understand. So much that I’m trying to put together.

I hop on a bodha and head back to St. Monica’s. Yesterday was the Feast of the Sacred Heart. It was a day of celebration for the nuns here. I go from being immersed in birth and the relationship between life and day into overflowing exuberance! Within a short time I was sweating and dancing my heart out to Ugandan music with the girls (and Kevin). They can get down! We sipped on homemade pineapple wine and resumed our dance party with the nuns after supper. Happiness, togetherness, and a sense of family envelops the convent. We spent the night rejoicing in this celebration of the sacred heart (I love that). The night ended with the earth quaking which for me was the perfect response to the type of day that I had.

The last few days were spent traveling and speaking with TBAs (Traditional Birth Attendants) in IDP camps. We heard the stories of over seventy women. These women are the villager midwives who have come into this calling through their mothers and grandmothers. One woman said she started as a midwife at the age of twelve. There is a very interesting dialogue going on between TBAs and nurse midwives in Uganda. It is now illegal to give birth in the villages and all TBAs are being trained to refer their women to the hospital. But we’ve found that the relationship between TBAs and the hospital midwives is very good. They respect each other and recognize the differences of their roles in the community. Many of the midwives are grateful for the TBAs because the truth is that they relieve a lot of pressure and work for them. The midwives are all understaffed and overworked. The TBAs are being trained through large NGO health programs. They are being trained in the Western way. We’re watching how this force comes in and undermines the ancient wisdom already present in the Acholi people. They learn their information through song, dance, and skits. They are a lively bunch! We have even exchanged cultural dances. They taught us some traditional Acholi dances and we busted out havah nagilah. We even got one of the elders bouncing up in the chair!

There is a lot more to write about our time with them but I’m at the internet café with little time…

I love you all and look forward to seeing you in a few weeks.
Afoyo!

thank you for all your comments!

xo-aimee

photos:
TBAs in Koro
TBAs in Bobbi demonstrating how when the refer a mother to the hospital

Seeing Gulu Through New Eyes

Before I start writing I’d like to dedicate this trip to our dear friend Komakach Kenny Odongpiny. His absence from our lives is deeply felt. His tragic death only underlines how severe the suffering is for the people of Northern Uganda…

Wow, we’re back!

Being here a second time feels very different. What I look at, smell, hear, taste, and touch is now familiar. What was all so new the first time has rushed back into my senses and landed in a previously recorded place in my memory. It didn’t take long to jump right back in. I’m focused on the work and on the relationships that I have here with my dear friends in Gulu. Once again my heart is touched beyond all measure by their kindness and generosity. It is quite amazing to be with people who witness the worst suffering and still emanate a joy that surpasses anything I have ever witnessed before in my life. I love it here.

Kevin and I are staying at “St. Monica’s Girls Tailoring School” with our friend, Rachel, a midwife from Brooklyn. The girls here are survivors. Many of them were abducted during the war. Just the other night about twenty child-mothers were dropped off with their babies. Many look despondent. It’s as if they are somewhere else… We eat all three meals at the convent with the nuns that run St. Monica’s. There are a lively bunch! Every meal is filled with a lot of laughter. We feel like we’re in the African “Sound of Music”! Each Sister has a very distinct personality. Sister Jane is a big woman who jokes all the time. Sister LaCosta is a beautiful Sudanese woman with a fiery spirit. She is combative in a way that makes everyone in the room laugh. Assunta is another Sudanese woman with deep, dark skin. She is quiet and thoughtful and has a very caring spirit. And then there is the Mother Superior, Sister Rosemary. She is a large woman who shakes all over when she laughs… and she laughs a lot. She loves music and will sometimes turn on the radio, bust out the house-made wine and donuts, and shake her booty around the kitchen during supper. It’s been a delight to be with them. The work they do in this community is amazing. Of any group we’ve seen in the community, they are efficient and organized. The school is dedicated to the practical training of the girls in an effort to make them self-sufficient and employable upon their graduation. They study tailoring, secretarial skill, cooking, and catering. To Americans, this might seem awfully backward, dated, or sexist, but in the context of this culture, it is actually something that can help these girls to survive. In the absence of an ability to go to academic institutions, their other options are few.

The girls stay up late into the night. Our room is just on the other side of their dorm. Every night we hear them singing, talking, laughing, bathing, joking…I’m glad they have each other. After twenty years of war, and twenty years before that of the brutal dictatorships of Milton Obote and Idi Amin, we are glad they can laugh with one another now. The other day, children from the Catholic schools from around the area came to gather for mass in the assembly hall. It struck me that just a year or so ago many of these children were still night commuting, or were held captive by the rebel army. Many of them were abducted and trained to be killers. I sat looking around the room. I started noticing all the scars of different girls and boys. A machete scar on one girl’s head, another one on the neck of a teenage boy. The confusion, pain, horror, love, and joy of these child soldiers washed over me. Thank g-d they got out. But now what?

Kevin and I walked home later that afternoon. It is customary to greet someone when you see them so we walked over to the nuns who were in front of a group of little ones. The children (about 15) were singing to the nuns. When we approached the nuns asked them to sing us a song. They started “Hello friends, hello vis-i-toors, we’re so happy, we’re so grateful, we’re sooo happy to be with you…” It was the sweetest song. One of the nuns, Sister Sunta, leaned over and whispered “that one is Kony’s daughter”. I looked over at this beautiful little girl singing to me with her shining eyes. She was probably six years old. How do you reconcile being the daughter of a mass murderer and rebel leader?

June 10th – First day back at the hospital…it was a difficult day. The first baby born did not survive. She ingested a tremendous amount of meconium which, in and of itself, isn’t fatal. I worked on her for a long time. I thought she was going to make it. The power was out so we were limited with what we could use to resuscitate her. Suction tubes and a manual resuscitator machine just aren’t enough. It’s a very helpless feeling to watch a baby die knowing that her life could probably be saved back home. But the people here don’t think that way. They believe that G-d determines the outcome of every life. I believe that too. This was the fourth baby that this mother lost. She still has two living children. The hospital is in worse shape now than it was six months ago. There is a desperate need of supplies, updated medical information, structural renovations, and training. The list is endless. And this is just one small hospital in one town.

June 13th
It’s 10pm and I’m feeling wired. It’s been a long day. Rachel and I were at the hospital for 9 hours straight with only a 15 minute break. I don’t have the energy to write about the day or our experiences at the hospital. I have had to stuff so much of what I’ve witnessed today. I can’t even begin. If I launch into a story it will be out of context and seem so dramatic. Every birth is “dramatic” and is happening in a cultural context that is so different from ours. It piles on – layer upon layer upon layer. The history of colonialism impacts how the midwives are practicing which impacts the care that the women are receiving and on and on….violence against women, lack of funding, HIV, severe poverty, abuse of power – all these issues collide and I’m left with a complexity that is paralyzing to write about. I stayed up late with Rachel talking about our day. I could not have a better birth partner with me. I am learning so much from her knowledge as a midwife. It’s also a tremendous help to have a partner at the hospital. We’re conducting births as a team, processing together, and weeding through the issues to get to the heart of why we’re here. She’s a strong, loving, and determined woman. It turns out that our paths in our lives have crossed before. I put this pilot program out there and feel like what’s come back in return is perfectly aligned. It’s good to trust life!

There is so much we haven't even touched on yet so we will try to write soon!

Sending love to everyone back home.

aimee & kevin

photos: 1) Aimee with Sister Florence (senior midwife in Gulu), Grace (midwife in Gulu), and Rachel (American midwife traveling with Aimee)
2) A & K in extremely wealthy, extremely humid Dubai during our layover...