"It's okay, don't worry"

After a wonderful week at the hospital as I described above, I had an amazing weekend. Friday, I met a peace core volunteer who is an American from New Jersey. After only seeing and speaking with Tanzanians for an entire week it was really, really, REALLY nice to be able to use my sarcasm and American humor again. It was really nice trading stories, quirks and observations of our experiences, including how our new names are “muzungu” and how noticeable we are EVERYWHERE  we go.

Mary, me and Chediel's mom cutting vegetables (well, I'm trying)

Saturday morning Chediel’s wonderful family (who I am now just going to refer to as my host family as I spend more time with them than I do at home) invited me to a wedding send off. In TZ, not only do they have a huge wedding ceremony and reception, but the wife’s family hosts a “send off” party where the bride receives gifts and is sent away from her home village or city to live with her new husband and his family. I arrived to the ceremony and was quickly stolen away from Chediel by his mother, who wrapped me in a kitenge (the colorful wraps), sat me down in a chair, handed me a knife, bucket and a bag of onions and put me to work. After a few minutes of me failing miserably to keep up with the onion peeling rate she expected of me, she took it from me and gave me mandaazi (donuts) and tea to sip on instead. As I sipped, I watched dozens of women cut vegetables, stir huge pots of boiling rice over wood burning fires, dance, laugh and prepare for the ceremony. After a while I started to feel really useless so I tried my hand at cutting up green pepper, which was again a miserable failure but the women were very appreciate and commented “it is so amazing and wonderful to see a muzugu (white person) participate in domestic activities!” (I didn’t really know what to say to that so I just smiled and chopped on). After Chediel decided that I was working too hard (I literally only chopped up 1 green pepper and 1 red onion), I went to sit with him and the other men who were congregating in a circle and drinking while the women prepared (I’ve noticed this happens a lot). At this point I realized all the chairs were still empty and it was 11 am-the ceremony was supposed to have started at 10 am. When I asked Chediel about this he looked at me and said, “its African time, so you have to add two hours.” Of course, how could I forget J. An hour later, some noise came the path to the ceremony and I saw a dozen or so men and women singing and clapping. Chediel explained this was the grooms family announcing their arrival (apparently they counted on it not starting on time). After they were greeted with hugs, tears and dancing, they took their seats. Slowly, men starting taking their seats, then Chediel made me sit down and eventually, at 1:30 PM the bride came down the aisle preceded by dancers and accompanied by he rmatron of honor and a “special bridal song” according to the guy sitting next to me.

Chediel emceeing while his parents say goodbye to his cousin 

The next few hours were full of clapping, singing, dancing, giving gifts, crying and the bride saying her goodbyes to her family. Afterwards, the meal was served and eventually the bride was taken by her husband’s family to the city of Arusha where their wedding would be held the next day. The whole ceremony was absolutely beautiful and I feel so lucky and honestly, a little bit awkward, to be there. I don’t know if it was because I was the only muzungu there or if it was because Chediel’s family wanted me to really feel like part of their family, but I felt like a guest of honor. They announced me during the ceremony, I helped Chediel’s mom give a ketenge to her mother and I announced the total amount of gift money given to the bride and groom and presented it to the groom (again, really awkward as this was my first time meeting both of them.) Either way, it was an amazing experience and I cannot thank the Daniel family enough for their karibu-ness.

After the ceremony, unfortunately Chediel’s parents had to travel to Arusha for the wedding (they had originally invited me to stay at their house that evening as they thought they would be there). Chediel and I therefore watched his mom’s store for her and then his sister, Eva, made us dinner (fried bananas, beef and pumpkin leaves) and their parents’ house. As soon as I came up to the house, Chediel’s daughter, Grace, took my bag from me, took my hand, and led me to the living room. We then ate, talked and eventually retired for the night. 

Women lining up with various utensils, plates and bowls to give to the couple

At this time, I want to comment on family roles I have observed in Tanzania. While Chediel has been a wonderful friend and host and without him this experience would not be nearly as rich, the women in his life are phenomenal. I am attempting to portray these gender and age roles in the least biased way possible as they are very different from the general American roles, but I do not believe this is all negative. Every meal that I have been served at Chediel’s house is made by either his mother or his sister Eva. Whenever Chediel and I are ready to eat, we sit around with his dad and any of the other men hanging around while he simply beckons to his sister Eva and BAM! there appears tea, bananas, meat, whatever else we are eating and water to wash my hands with. While this makes me feel really uncomfortable as I am used to everyone participating in the production of a meal (well, mostly everyone), this does not phase Chediel and I feel no resentment or begrudging from Eva. It simply is how the house functions. The children are even more astonishing to me as they do most of the housework and cleaning. The other night as I was about to take my really, really, REALLY muddy shoes off before entering the house he said to me, “don’t do that, we have enough kids around here to clean, they will mop later.” The next day, I saw his 10 year old Grace washing the household laundry and hanging it up to dry. Children as young as 3 or 4 are fully expected to not only participate, but do the majority of, laundry, dishes, running of errands and cleaning. (Suddenly I am feeling way worse about rolling my eyes at my mom when she asked me to empty the dishwasher). Moreover, I have never heard a child lip off, give attitude to, or debate their parents or elders. They are obedient, timid, shy, but also just as rambunctious and energetic as other children. Looking back at my childhood I feel embarrassed at how little I contributed to my household and while I would have put up a fight at the time, I wouldn’t have blamed my mother for making me chop a few more vegetables, do a few more loads of laundry and mop a few more floors. After doing a couple of loads of my own laundry manually, I have a newfound respect for how hard these Tanzanians are working to create a home. 

In addition, I have realized how far removed all of us in developed countries are from our food and from worrying about basic needs. As described above, women and children often spend entire weekends and several hours every day of the week just doing laundry, cleaning and preparing meals. With our technology, grocery stores, dry cleaning, house keepers, etc., some of us spend less than an hour a week on all of these combined. While I am really missing my Trader Joe's and Whirlpool there is something really satisfying and pure about doing your own laundry. In addition, it feels really amazing to eat food that I know was grown right in the village, has had no processing done or preservatives added and hasn't sat on a shelf for 3 weeks. While obviously there are many structural and economic reasons behind all of this, and we are so lucky to live in a country where we have these conveniences, there also is something to be said about doing a little more collective, family manual labor. I think how hard they work, and how much they have to work together, puts an indescribable bond in these families that is sometimes missing in our developed, air-conditioned, water heated homes. 

Off of my soapbox and back to the rest of the weekend, Sunday morning, Chediel and I (after another wonderful breakfast made by Miss Eva and Miss Grace) headed for his favorite site to take visitors-Dooguru Waterfall. Although he warned me that the hike was a little tough, when I asked him how long it would take us to reach the waterfall he said “ehh maybe 15 minutes.” 15 minutes later, we were nowhere near anything that looked like a waterfall and instead continued following two other local guys through farmer’s fields, past a medicine man’s house, down rocky mountain goat paths and finally to the top of a cliff where we saw the waterfall (which was definitely at least 30 minutes later). Chediel then explained that he brought the two other guys along because he wanted to take me to the very bottom of the waterfall, and he wasn’t quite sure of the way. I soon realized that no one really knew the way and found myself sliding the side of the cliff I had just looked over, while trying to grab onto every root, shrub and tree I could find (all of which were infested with nasty little biting ants). About halfway down I was about ready to kill Chediel as he kept telling me, "Its okay, don't worry, just go slow." Yeah, okay, Chediel, I'll just try and go slow as my arms are starting to break out from whatever poisonous bush I just touched and my feet are sliding out from under me. Finally, we reached the bottom, and I have to say, as crabby, dirty, itchy and sweaty as I was, it was absolutely worth it. The waterfall was breathtaking, and we spent the rest of the afternoon washing our feet off in the water and sunbathing on the rocks. The hike back up was much easier and afterward I felt really ready for Kili.

My guides

So fierce

A redbull waterfall selfie

My view during my nap

So happy to have made it back to the top alive!

Grace and I with her new backpack!

That afternoon, Chediel walked me back home, but not before we stopped at a store to get his daughter Grace a haircut (all the girls have to buzz their hair for school for some unknown reason to Chediel). Since she was so sweet to me all weekend I wanted to get also get Grace a small gift, when we went to the shop, she immediately picked out a purple backpack and a compass for her math class. I couldn't believe it-I was expecting her to want candy, or a toy, or anything that other 10 year olds want, but she wanted a school bag and a compass. After taking a really cute picture in our matching backpacks, I said good-bye to the Daniel family and went home for a long, cold shower. 

Karibu

I apologize for the post date posting…I’ve just been able to access internet and only because  apparently the network is only functional at 3 am (I was woken up for a cesarean section at 1 am so I was up J). The way I’m using phone and internet here is so far removed from iMessaging that even dial up seems like advanced technology right now. I currently have to use the SIM card from my 1997 TECNO phone (which I have to buy scratch off cards to load more data on every other day), put the SIM card into  a USB modem, plug it into my computer, then cross my fingers, pray a lot and then patiently wait to see if maybe I can download an HTML formatted webpage.  Aside from being internet silent (which has not really been all that bad I must say), my stay in Tanzania has continued to be peaceful and full of warm, welcoming people. “Karibu” meaning “You are welcome” is said to me everywhere I go and all these villagers continue to do whatever they can to make me feel at home.

My week at the hospital was somewhat eventful, but definitely not as crazy as I was used to at Mulago. Every morning I report for morning report/prayers at 7:45 am (this is of course after my delicious Spanish omelet, chapatti and African tea breakfast). After the entire hospital has been filled with the Swahili hymns, we start morning rounds. First, we go to the two antenatal rooms that are filled with approximately 20 mothers waiting to go into labor (as I said before they come early so that they don’t have to climb the mountain when they go into labor and risk having a baby under an ant infested tree). We do our Leopold’s maneuvers and find baby’s heart beat with the fetoscope; after doing this on so many women here in Africa, I’m so surprised at how much my manual diagnostic skills are improving. I even was able to tell a mom that she was carrying twins on Friday-just by feeling her stomach!

Gonja Lutheran Hospital Docs, Nurses and Midwives

Gonja Lutheran Hospital

Theatre

After antenatal, we head to the rest of the wards. Each ward is filled with approximately 15 cots with a few wooden benches scattered in between for family members to sit. The first two rooms are for women (many postpartum women and some there for general reasons), the next two for men and then then last is the pediatric room, where thankfully usually has the last amount of sick patients. The patients in the ward usually have to stay anywhere from 2-30 days and in general patients stay in the hospital a lot longer than they would in the US. Whereas most patients in the US would be sent home 2 days after a cesarean section or appendectomy (barring any very serious complications), people here stay for at least 7 days due to their worry about going too far away from the hospital lest any infection or complications occur. While I admire the patience of the patients themselves for staying in the hospital that long, I am blown away by the dedication and endurance of the family members. Family members have one wooden bench to sit on (if they are lucky), no television, no magazines, no cafeteria, no lounge, essentially nothing to do but sit and tend to their family members. I have seen several family members every day at the hospital and judging by the fact that they haven’t changed clothes, some of them haven’t left their family member’s bedside at all. The hospital does not provide food for patients or family members (they don’t have the staff or the funds), so family members have to go outside to a little hut that serves as a kitchen and make the food themselves. Every day there are approximately 30-40 women around this hut cooking over a wood burning fire. Not only are they on 24/7 bedside vigil, but family members mostly serve as the nursing staff for their patient as well (again, hospital does not have the nursing power or the budget to hire more staff). I’ve seen family members run to get a doctor when their family member wasn’t responding, I’ve seen them get urinals, I’ve seen them prop beds up so their family member in heart failure can breathe better. It really is amazing to see how much their elders, mothers, fathers, friends, cousins and children mean to them. This also makes me really appreciative of the US nursing staff, because I have realized how much they function as patients’ family members while patients are in the hospital.

I think the head doctor has picked up on my interests because usually after (or actually, most times during) rounds he sends me to the OR to help out with a C section or appendectomy. Here, I usually work with an amazing grab bag of nurse midwives, nurses, nursing assistants, nursing students and two physicians, Apenda (which means to love everyone) and Mama Msewo. Mama Msewo is status post 5 children of her own and is now serving as the general surgeon/OBGYN for Gonja. I really struggle to look at her as an intimidating attending because she acts, talks, walks and jokes more like my beloved Great Aunt Mali than my normally gruff surgical attendings. She is so patient with me and has let me be her one and only assist on many surgeries. While she definitely is using some old school (I mean really old school) surgical techniques, she also gets the job done and does a darn good job at it. She is an amazingly dedicated, smart, humble and compassionate physician and I feel so lucky to have her as a mentor here.

I also gave away the rest of my donations last Thursday, and as soon as I get the pictures I will post them. While my reception in Uganda was very thank-full, my reception in Tanzania was made for a movie. The entire staff got up, sang a song, clapped for me, took pictures and shouted “oo’s and aa’s” like they were watching fireworks every time I pulled out another nasal cannula or box of gloves. The ophthalmoscope and otoscope were again huge hits and I honestly thought they were going to make me crowd surf when I brought them out. At the end, Sister Dora said to me, “Thank you so much, this just shows us that no matter if we are black or white, or rich or poor, we all belong to Jesus and are here to serve him and his people in love and unity.” Thank you again to all you wonderful donors, your impact has been astounding and you deserve a special spot in heaven!

TZ

Sadly, my four weeks in Uganda has ended and I am now writing from one of the most serene places in the world that I have ever been, the mountainous Gonja, Tanzania. (If I’m actually able to post this on day that I write this it will be a Gonja miracle as internet is not even up to dial-up speed yet.) My flight left at 5:35 am from Entebbe, meaning I had to leave my apartment at 1:00 am, which, if you know me, means that I obviously did not sleep that night and instead was with my friends and packing up until the last minute. With a full, but heavy heart, and in denial that this amazing part of my journey was over, I slipped out in the middle of the night, just as I had come.

After two short and uneventful flights, I touched down at Kilimanjaro International Airport to a bright, sunny morning. Immediately, I was struck by the beauty of this country. As I stepped off the plane I was met with a beautiful backdrop of mountains, bright pink flowers, clean cut green shrubbery and crisp, fresh air. Traveling in Kampala was a lot of like traveling with a hyperactive 7 year old; it was adventuresome, covered in dirt, really fun, full of laughter, but always a little bit crazy. Arriving in Tanzania, I felt like that 7 year old was replaced by Ghandi. The calmness and serenity was undeniable. As a stepped out of the airport I couldn’t find my driver, but within seconds there were helpful, friendly guides that gave me a Plan B if my driver didn’t show up. After standing outside of what I thought was a locked bathroom for 5 minutes (turns out I just pushed the door the wrong way :D-hey-I hadn’t slept okay?), my driver finally did arrive and we were on our way. My driver, Eligama, was not the strongest in English but made up for it with enthusiastic smiles and saying “ya, ya” a lot whenever I asked questions. Within the first few minutes he pointed out the snow covered peak of Kilimanjaro. Stupidly, my first thought was, “Wow, that is like, a real mountain” followed by, “OMG, I am going to supposedly climb that mountain in a couple of weeks.” The sight, even though it was mostly cloud covered, was amazing and aided in my anticipation of the trip.

As we left, Eligama told me we would be driving for a few hours and then would start on a very rough road that would take us basically straight up the mountain to Gonja. After a couple of hours of driving through sprawling green fields with women in colorful traditional clothing carrying baskets on their heads, we finally ascended the mountain towards Gonja. I cannot overemphasize how beautiful this drive was, the views of the layered blue mountain silhouettes, the green hills, the beautifully clothed Tanzanians dotting the miles and miles of farmland, and then finally, the breathtaking drive up the mountain to Gonja. Every two minutes Eligama would patiently stop so I could take yet another photo that couldn’t quite capture the beauty I was seeing. (Also, I would love to upload these for you, but by the time that happens I will be back in the States).

Finally, we arrived to Gonja Lutheran Hospital, which is a mission hospital campus nestled in the side of a mountain. It serves all the people that live on the mountain and without it, many of these people would be completely without health care. The hospital has under gone several renovations and is now a white and blue two-story hospital with open balconies that face the valley of the mountain below. Roaming the halls of the hospital are women in beautiful dresses and wraps, doting on their family members or patiently waiting to go into labor. (Women come up here and stay for weeks just so they can be sure they deliver with a provider to help them.) The hospital is grounded in very strong Christian faith and every morning the hospital staff starts their day with prayers in Swahili. Patients have their own area where they can cook, clean and do laundry. The hospital director on staff stays in the house next to mine and his wife is a nurse who works at the hospital as well. Overall the hospital has about 47 employees, but really there are about 20 main ones. It is definitely a close knit community and since my arrival I have been continually astonished at how friendly everyone is. So far, I’ve learned that Tanzanian’s favorite word is “Karibu” which means “Welcome.” They say it to me every time I enter a room and I have been told no less than 30 times since arrival that I should “feel at home.” We ended our tour in the hospital “cafeteria” where I met my mom away from home, Mama Joyce. I want you to picture the friendliest, most beautiful, and impeccably traditionally dressed, older African woman in your head-that is Mama Joyce. She exudes warmth and comfort and within minutes was serving me amazing African tea, rice and beans. She makes each and every meal for me here and I’m seriously contemplating trying to take her home with me so she can take care of me in residency.

 Mama Joyce and I 

My house!

View of the patient's kitchen from my house

Also within a few hours of arriving here I met a Tanzanian friend, whom a previous DMU’er who rotated here told me to contact. Chediel Daniel, is again, one of the warmest and most welcoming people I have met. (I know I’m being redundant but it is so true-these people are so nice!). After only meeting me for an hour, he invited me to his church the next morning. Bright and early Sunday morning he picked me up so we could walk to his church. After about 40 minutes of walking we arrived to a quaint white church with stained glass windows, planted just on top of a hill within the mountain. After the service, which consisted of three different offerings (one of which consists of farmers literally bringing their first harvest of beans, corn, etc. to the altar), some beautiful songs from the choir of 6 and a live auction of fresh fruit, we headed back towards our homes. On our way back we stopped at Chediel’s family store where his mom had prepared us fried bananas, beef, avocados, rice and African tea. His dad sat down with us and after a few hours and some traditional African drinks (apparently Africans love Sunday Funday just as much as I do), his dad invited me to his sister’s wedding sendoff next Saturday and insisted I stay at their house. He said, “My house is your house” at least 15 times. We eventually started heading back toward our homes but not before we stopped at met more of Chediel’s friends and stopped at his grocery store. I made it back just in time for Mama Joyce’s wonderful dinner and crawled into bed exhausted but in shock at how this experience never stops surprising me. Although I arrived in Tanzania feeling very homesick for my friends, life, hospital and dorm style living in Kampala, I have met so many wonderful people here and know that this experience is going to be amazing as well, just in a very different way. I feel so thankful that they have opened up their homes, kitchens and churches to me and am excited for the weeks to come!

Church with Chediel

Our Sunday Funday meal of fried bananas, meat and avocados

Serengetti's and Chediel's dad-a wonderful Sunday Funday mix

Repping my man Obama...apparently they call him "the chocolate boy" in Tanzania...

Learn, Grow and Give Back

I have to admit that I have been putting off blogging about my hospital experience here.  This is mostly because I’m personally still trying to process everything as it has been quite the emotional and educational roller coaster. That being said, I would like to add a disclaimer that some of my thoughts I’m going to blog about here are very raw, honest and I am very aware that I am by no means an expert on medical training or health care systems.   

Anyway, back to my roller coaster, on my overnight shift last night I delivered twins!!! I was by myself, with minimal supervision and the second twin was actually breech (feet first). It was an incredible experience and truly one of the coolest things I have done in my life. However, this amazing experience for me also highlights the health disparities at play between our two countries and systems. In the US, a twin pregnancy would be highly supervised, would most likely result in cesarean section, and no matter what happened, would definitely NOT be handled by a lone 4^th year med student. Additionally, as I was delivering twins, the woman in labor next to me was at risk of rupturing her uterus (and thus most likely losing her own life and her baby’s life) because no operating room was available for her to have a cesarean section due to the water being out and linens not being clean. While I have some guilt over the fact that I was basically alone while delivering these twins, I also think it is sad how much we are shielding our young doctors from experiences like this. We have come so far from trying to do things as naturally as possible, and instead have added a large amount of technology to the process and slowly chipped away at a hands on learning experience when dealing with rare complications. Don’t get me wrong, I am so happy our maternal mortality is much improved due to this technology, but a lot of times I feel the use is driven by litigation and defensive medicine than it is by true patient safety. We have very under served populations in the United States and I feel that adequate, comprehensive training to deal with their complications and events is harder to come by in the US than sometimes it should be.

This one hour of my experience pulls in so many things that I have been struggling with and growing from, but also have been really enjoying throughout my rotation here. Yes, resources are low. Yes, patients come to the hospital quite sicker and later than they should. Yes, sometimes things don’t go as efficiently as they should. However, the doctors, nurses and staff I have met are wicked smart, they are amazing diagnosticians and have skills that most physicians in developed countries have never even thought of having. For example, my first day on OB I was astonished to find that the fetal heart monitoring system was not electronic cords and dopplers surrounding and ensnaring the patient, but was a wooden “fetoscope” which looks more like it belongs in the kitchen than in the OB ward. The first few days I couldn't hear anything, but after a few dozen tries I finally am able to find most heart beats with the fetoscope. Just getting used to using this rudimentary tool developed my diagnostic sense and awareness within a few days.

 Additionally, I have also noticed how well adapted clinicians are to giving the best care they possibly can to patients day in and day out. The acuity and the amount of patients these physicians deal with is incredible. Often times when I am on the ward for merely 2 hours I feel is I have worked a 12 hour shift in the States. For example, I was working in OB triage checking a woman’s cervix when I turned around and saw two feet sticking out of a woman’s vagina. My intern (who is amazingly talented) luckily came in seconds later and delivered the very blue baby in the middle of triage without breaking a sweat (literally, he was completely calm and I was sweating my gazankers off). Afterwards, with nothing more than a drying blanket and a half functioning bag mask, the intern and I worked to resuscitate the baby. I, in no way, possessed the qualifications to be one of two people resuscitating that baby. I am not a pediatrician, I am not even a pediatric resident and I haven’t even taken by pediatric life support course yet. Thankfully, my intern is much more experienced than I and together we did succeed in resuscitating the babe and overall turned a terrifying situation into a really happy one.  Even though this situation turned out well, I have to stress how incredible it is that it was managed by the intern as well as it was. To give you perspective, a third year OBGYN resident from the United States told me she had never seen a breech vaginal delivery (she by the way is amazing to be on a rotation with and I feel so lucky to have her there too!). In the United States we scan and scan and scan and if the baby ever turns breech we try to turn it or we move immediately to Cesarean section. Very, VERY few physicians or midwives will attempt a breech vaginal delivery, and in my two weeks of being here I have been a part of 2.

Another refreshing thing is that patients take a lot of ownership over their health. This might mean that they frustratingly refuse treatment because they feel that it is just evil spirits that will take their disease away, but this also might mean bringing something up in their chart that I completely would have missed had they not pointed it out to me. Patients are incredibly strong, resilient and patient (no pun intended) as well. Women sit for hours in labor on the cold, dirty concrete floor as they wait for a cot to open up. Once they get a bed, they lay a plastic sheet or garbage bag down, labor and deliver with absolutely no anesthesia and minimal supervision. I’ve also seen episiotomies and vaginal laceration repairs done without ANY (not even local) anesthesia, and sometimes the woman doesn't even flinch. At the end of the day, no matter how much they scream, they always end up saying “Thank you so much musawo” (Musawo means doctor). I felt terrible that I was the only one at my patient’s twin delivery, however, judging by the gratitude coming from the patient and her husband, you would have thought I bought them a new house.

I can’t pretend all my thoughts and ideas are processed through rose colored glasses though. A lot of times I sit around with other international students at lunch and just debrief about how inefficient and sometimes just how plain wrong things go. There are many patients dying from preventable mistakes that could have been caught by a number of people (which also happens in our health care system). There is sometimes an incredibly frustrating lack of urgency. Often times, I just want to clean the C section OR myself because there are so many women on the list who needed a C section 1 week ago, but probably won’t be able to get in until the next day. Most frustrating though, is that even though this is exactly the type of patients and the severity of conditions I have a passion for treating, I have little to no say in what happens here. I feel like there are all these things that could be improved but again, I can do little to nothing about it. Furthermore, on the flip side, I feel like it is going to be really hard for me to bring the same empathy to developed patients as I once did. Suddenly a housewife from the suburbs whining about not vaccinating her children against very preventable diseases makes me even more angry as I’m watching children die every day but just not having basic resources available to them. Again, I apologize if this is too harsh, these are merely my knee jerk reactions and might especially be more blunt as I’m writing this after being up for 36 hours J.

While the above paragraph is probably my most negative and harshest critiques of both situations, what it comes down to is that we just come from such different worlds, backgrounds, resources and cultures. However, I do not think this is an excuse to allow one world to suffer so incredibly, while another has ample resources that could easily be shared. I’ve struggled a lot with exactly how to deal with these emotions and frustrations and I have to say the only answer I’ve really been able to come up with is that learning from each other and working with each other can hopefully bring our two worlds closer together. As my very wise global health professor e-mailed me “learn, grown and give back” and right now that is all I think we all can do to start solving these problems. 

Nile Special

I promise I will blog more about my hospital experience in this next week, but I have to recount the amazing last few days I have had. Thursday evening, a few other American students and I were invited over to one of the international directors’ house for a home cooked Ugandan meal. Susan made us one of the best meals I have had in Uganda which consisted of hand squeezed passion fruit/mango juice, the best matoke (a bunch of smashed bananas with seasoning) I have had in Uganda, tilapia, Irish potatoes (normal white potatoes) and salad. The meal was delicious and the company even better. One thing I have learned is that Ugandans are extremely hospitable and Susan was the epitome of that. This week we are having her over for a “traditional” American meal which so far consists of my region famous beer dip, some sort of candy bar salad and either pizza or lasagna for the main dish.

Emily, Becky, Rachel, Susan and Reagan

After our wonderful meal and an eventful Friday at the hospital which I will blog about later, a group of 19 international students, including myself, crowded into a bus early Saturday morning and headed to Jinja, a city 2 hours from Kampala. Here we embarked on an exciting, somewhat crazy and definitely water logged adventure of white water rafting on the River Nile with a company called Adrift. Upon arriving to the Adrift site, we split into groups of  6 or  7 and piled into our respective rafts. Our raft guide was named Tutu, so naturally our team name was Team Tutu. Within 5 minutes, Tutu had us doing safety drills and jumping into the Nile, simulating that we had fallen overboard or flipped our raft (these later would definitely come in handy). 

TEAM TUTU!!!

 After our safety briefing, we headed out to our first rapid. The first rapid was fun, but thankfully uneventful; all paddles, arms, persons and body parts were intact so we headed toward the second rapids. This one was not quite as uneventful. After the first wave, we smashed into a second wave and seconds later I was underwater feeling 6 other bodies kicking and twirling around me with a huge raft on top of the whole mess. I finally was able to surface for air, but as soon as I gasped another wave pummeled me back down. After a few more seconds I popped back up and Emina, the baller extreme kayaking Olympian, came to my rescue and pulled me, along with a few of my friends, back to our raft. After our flip we all were a bit shaken so we took the rest of the rapids a little more easily. The views of the banks of the Nile throughout the entire trip were amazing, and after a few more rapids, 5 hours in the sun, some impromptu back flipping off the raft and a lot of cheering “TEAM TUTU!!!” our day was completed.

Rapid #1

Now begins the sequence of us on our 2nd rapid...here we are heading for our wave of terror.

Just demolished.

And there she went...we all were completely submerged, paddles flying everywhere, feet frantically kicking, and Tutu screaming (and laughing at us) while we tried to grab the boat. 

The rest of the rapids did not result in near drownings but were just as fun. At one point Tutu had us in the "washing machine" where the wave kept pulling us back and forth. : D

Our last rapid...notice me in the front right...not really sure of whether I should laugh, cry or admit that I just peed myself. 

After the trip ended the Adrift staff BBQ’ed meat and served us Nile Specials as we watched our videos and looked at our pictures. We also bought some merchandise from Emina, who will be competing in the summer Olympics for extreme kayaking. All proceeds from her business were helping her buy her plane ticket, so we all bought necklaces that she made out of magazine paper and some headbands.

After our lovely BBQ, we then boarded the bus and headed towards our campsite on the muddiest road I have ever driven on. After less than 2 minutes of driving, we were completely stuck. Knowing that there was little we could do, we all deboarded the bus and began talking to the local villagers and children. I and a couple of friends, along with the Adrift team and some local Ugandans, finally pushed the bus out of the mud, but not before I completely ate it in the mud and had 100 Ugandan children laughing at me. That night our Adrift crew met us at our campsite and we all bonded by climbing into a kayak that hands upside down in the rafters of the local watering hole. Almost our entire group complete the ritual and by the end of the night we all were exhausted and so happy we made it through the day. 

Mid fall as I am trying (obviously unsuccessfully) to get the bus out of the mud

Emily and I...completely covered in mud. 

Our baller savior/olympian, Emina.

As if extreme kayaking wasn't enough...tonight we decided to join an extreme running group. Hash House Harriers is an international "running group with a drinking problem." It is present in most major cities and usually consists of locals, some "in" tourists and expatriates. My running buddy/personal trainer/slave driver and I decided it sounded awesome so we got the "in" information from our friend Adam and convinced our friends Emily and Becky to join. The group meets every Monday in a different location, so you have to know someone in the group who can text you the location of run that night. Luckily Adam is a creepily good stalker and hounded the group enough to let us know the location :). The address took us to the rooftop of a mall where we met 120 other runners, mostly Ugandans, who were drinking beer, stretching, dancing and chatting. At 6 o'clock sharp the run started. Now, the way HHH is set up is that you have "hares" who mark the running route before and "hounds" who follow the route. The hares when they set the route up purposefully put dead ends, loops and "hooks" so that faster runners have to slow down or run farther, thus keeping the group together. After running about a quarter of a mile, our entire caravan stopped suddenly, and realized we were on the wrong route, so we had to completely turn around and join the rest.

Emily, Becky, Katie (my personal trainer) and I at the first checkpoint!

After a couple of miles and a killer hill, we reached our first checkpoint. Again, this is designed to keep the group together. Feeling more confident we pushed up towards the front of the pack and then started again. After getting to the top of another huge hill, and then descending down an even bigger one, a group of about 10 runners stopped in front of us and said, "Ok, you're the first 10 so you make the hook, go back up the hill and come back." I was so astonished I just started laughing and trucked my butt up the HUGE half mile hill we had just descended. After turning around again, descending the hill again and thus meeting up with the rest of the group we hit another check point. This time, it was complete with solo cups of beer. The leader of the group also lead us in a drinking/calisthetic song where we did jumping jacks and some other weird limb motions. Finally, after about 4.5 miles we ended up back in our original location and celebrated with a meal and more Nile Specials (newcomers had to partake even more and embarrass themselves in front of the entire group of course). We met some amazing people along the route, and one named Joseph even gave me the shirt off of his (sweaty) back because I said I liked it so much. At the end of the night the 5 of us were all (sweaty) smiles and became lifelong HHH'ers.

Asanta Sana Squash Banana

In light of all the drama surrounding recent events in Uganda which I will blog about later (don't worry, I'm feeling very safe), I thought I would blog about my Lion King inspired weekend in Murchison Falls. Murchison Falls is a waterfall of the Nile created by the narrowest bank in the Nile, measuring only 7 meters wide. It also is part of Murchison Falls National Park where many tourists and wealthy Ugandans go on safaris. It came highly recommended from several other students rotating with me, so with that a gaggle of 5 Americans, 6 Swedish and 3 Dutch girls all planned a getaway weekend. We left early in the morning and met our drivers, Rogers and Moses. They picked us up in extended jeep-ish cars that had a “pop-up” roofs and handles equipped to keep you in the car on bumpy roads. We set off, and 7 hours later (again-Uganda roads are nothing to mess with) we arrived to a beautiful scene of the Nile River.

We started our weekend off with a boat cruise of the Nile where we saw a family of elephants, a few lazy crocodiles, flocks of beautiful birds and tons of hippos (literally tons). We also fittingly had Nile special beer  and had a great happy hour in front of the beautiful Murchison Falls. After a minor incident where we ran out of gas in the middle of the Nile and had to be rescued by a dingy, we packed back into our jeeps and had  a sunset game drive through Murchison Falls National Park.
 

After our beautiful sunset drive, we arrived at our hotel/glampground, Fort Murchison, which overlooks the Nile. This place was unbelievably beautiful and for the first time since I arrived in Uganda I had a shower with actual water pressure. We had a wonderful four course meal and retired early to our glamping (glamorous camping) sites. The next morning we got up early to game drive. Within minutes of being on the savannah we saw huge troops of buffaloes with their white feathered buddies flocking towards them. They grazed lazily and we eventually moved on to finding a memory of elephants crossing our path. The enormity of these animals was astonishing and watching them feed and play was nothing short of awesome. Throughout the day we also saw towers of giraffes, flocks of beautiful birds, herds upon herds of antelopes, sounders of warthogs and barrels of monkeys (I had to google the group names of all of these animals-great 4^th grade review). After a while we all just put our cameras away because we saw so many beautiful sites and amazing animals that the pictures just weren’t cutting it anymore. Towards the end of the day some of us became adventurous enough to sit on top of the vehicle as we took one more tour of the savannah. Unfortunately we didn’t get to see lions, but the safari we had a beautiful day in the neighborhood with Mr. Rogers anyway.

 The next day we left towards home but stopped at the Rhinoceros Sanctuary on our way back. Sadly, in 1983, rhinos became extinct in Uganda because of poaching. The horns of rhinos are apparently very valuable, so they were hunted ferociously until they became extinct. Years later, the Kenyan government and the US government donated white rhinos to the Ugandan government in order to set up a sanctuary. Land was donated by a wealthy Ugandan and the breeding of a new generation of rhinos began. An especially fun fact for me was that the first baby born in the rhino sanctuary was named Obama (papa rhino was from Kenya and mama rhino was from the US ;)). At the sanctuary we were  guided on foot to a location where a mama rhino and her baby were snoozing. There are no fences or any barriers between you and the rhinos during the tour and so we had to tip toe and be very quiet to keep them from charging. Luckily, mama rhino was pregnant and really tired and we were as quiet as church mice, so no charging incidents occurred.

The Crested Crane-national bird of Uganda

After the rhino sanctuary we headed back and eventually arrived back to the craziness and chaos of Kampala. Overall the weekend was amazing and I feel so lucky to have had that experience. Conservation of land, resources and animals within Uganda is hugely important to their economy, development and growth and so it meant even more to be able to witness how proud Ugandans are of this park. Our tour guides, Moses and Rogers, have been guiding for years and were incredibly knowledgeable not only about the animals and foliage, but also had a lot of knowledge about how these parks and conservation efforts affect their country and economy. Although economically Africa has its struggles, it is rich in natural resources, beautiful landscapes and majestic animals, which are all things Ugandans actively fight to maintain. As an American I had never seen many of these animals outside of a zoo, and it made me proud that we also contributed to the preservation of some of these species.