by Judy Steel
One of Lubega’s patients was forty-five years old and had suffered a stroke. She was paralysed on the left side and couldn’t talk. After undergoing treatment, she started walking using a stick; her left arm was in a sling and couldn’t be rehabilitated but she could talk slowly. In some ways, rehabilitation is the least glamorous work, but so many people in Uganda are completely and unnecessarily housebound and need help.
Edward and Florence presented me with a huge number of folders to audit. Looking through them, it was clear that everything in the past two years had been noted. The loan scheme documentation was particularly remarkable: it had been operating for two months without any problems and all twenty-four people involved had repaid on time. There was a well-constructed process of application, recommendation, interview and then loan. As I audited, every single piece of paper or docket was in the correct place. It was simply outstanding.
It was exciting to see the micro-loan scheme in action. The pigs looked great and were well cared for. One of the widows spent so much time with her sow that it became the family pet - as soon as she scratched the pig’s ears it would lay down for more. The youth group had several pens with two boars and seven sows, two of which were expecting a litter. Everyone was very excited about their ventures and it was thrilling to see the loans helping those involved both financially and in building self-esteem.
A friend from the hostel, Julie Bolz, got in contact to say she was returning home to America. Before she flew out, we toured the hospital and clinic together; she was amazed and suggested contacting Bill Gates for support. We had previously applied to the Bill Gates Foundation but were told the only money available was for AIDS research. It did make me think about what could be achieved if we managed to raise the money for the operating theatre or an extension of services for AIDS sufferers, especially by offering the expensive and life-enhancing drugs that we just couldn’t afford. That night I was surprised when Allan emailed suggesting perhaps the need for another container.
It all came against a horrible backdrop of lost medical services in Uganda. Edward was desperate to expand the hospital to include a theatre, delivery room, recovery area and consulting rooms, because Mulago Hospital was in a dreadful mess. Mulago is the size of a major public hospital in Australia and was about eight kilometers from Busabala Road. The doctors had recently been on strike because they lacked basic resources such as gloves (let alone drugs), and some of the time they weren’t even being paid.
As a result, women in labour had died because they needed Caesarean sections. Accident victims and other patients died while lined up in the corridors, waiting to see doctors. People were told to go home because hospital staff could do nothing for them. And there was talk of further strike action.
Several doctors asked Edward if they could work with him at Busabala Road Hospital – all they needed was a theatre suite. These were senior consultants, including an obstetrician/gynecologist and an orthopedic surgeon. There was a lot to think about. If we brought out another container then perhaps it should focus on setting up the operating theatre; we already had the table and anaesthetic machine. Allan, Fred and Ailee all emailed how excited they were about the possibility of another container and the expansion of the clinic. It seemed as though our home was about to become a warehouse again, with Allan and Fred already collecting equipment from various places. Edward was so excited he couldn’t sleep thinking about it all.
Despite the hot and dusty conditions, my first walking clinic was full of laughter, tears and prayers as we handed out beans, sugar and soap. When I spoke to one of the jajas in Luganda, she did a double take and asked how I knew her language. The others told her my name here is Nambatya, a term applied to some women meaning ‘you do not have enemies, everything is handled by God’ (the same meaning that Edward’s surname, Ssembatya, has for men).
The stifling humidity at the tail end of the wet season in May was taking its toll on me on walking clinics, but it wasn’t my only concern. I had a flare up of my arthritis and the injections I’d had after a similar event back in Adelaide seemed to have had little effect. My bones ached, with one finger on my left hand and my right thumb ceasing to work for several days. It did ease after some medication.
I was feeling quite off when I went to a meeting of the Kisakye widows at Masajja, the slum area next to Najjanankumbi. Masajja was now included in the walking clinics and so some widows from that area were involved with UACO projects. There were about thirty widows there, all in their best dresses. After some wonderful speeches of welcome came discussions about the loan scheme and pigs. Then the fun started. They sang and danced and even got me up to dance, teaching me to get my rear end going the Ugandan way, all the time screaming with delight. Then I was presented with three lovely baskets with my name woven into them, three pineapples, two hands of bananas, a two-metre long stick of sugar cane and probably three dozen avocados. I went feeling less than well but returned feeling totally blessed.
I took some of these Masajja widows with me on a piggery tour a few days later. For three hours we wandered up and down the hills, over piles of rubbish, through matoke (plantain) groves until we were smothered in the fine red dust of the Busabala Road. The pigs were, with only one exception, in very good condition.
Things got a bit silly when I was asked to name them all: I started out with Wilbur and Hermione, which were names sent to us in response to our call for donations to buy pigs. Then I resorted to Matilda and Babe and got stuck, so suggested Judy. This turned out to the name they had all been waiting for, and then anticipation began building about who would have the honour of naming one of their boars Allan. Eventually I ran out of names so resorted to the Bible: Rachel, Rebecca, Esther and Sarah. We decided they were all strong women and so these pigs should grow up to be equally strong and deliver strong babies. The last pig was very cheeky, resting her two front legs over the pen and almost smiling. Raising pigs seemed the way to go in this area because there was a ready demand for pork by the butchers selling from roadside stalls.
Although there was little we could do to treat those with AIDS, we decided to start an AIDS support group at the clinic. This was a challenge because the disease carries such a stigma that many people refuse to even acknowledge they are sick. There were twenty women (and no men) at the first meeting, and I told them how proud I was to see them there. It takes courage to make such a public statement about their illness, and their bravery saw the group grow as more women sought help. Edward gave an excellent blackboard lecture on what we could and could not do for them. One of the victims was sleeping at her father’s house, and they had forgotten to lock the door when a man broke in, raped and infected her. She was nine years old at the time; it was all I could do not to cry. She looked really ill and I suspected she wouldn’t live for many more years – maybe not even one more. I just wanted to put my arms around her. She was eighteen years old but looked much older.
In contrast, most of the babies brought to the clinic by their mamas were in great shape. They were gorgeous and chubby and captured my heart. It was easy to spot those who were struggling when they arrived for immunisations, so we would steer them to the nurse, Ronald, for extra attention. One day a baby boy of about six months old, wearing a pair of pants fashioned out of some men’s trousers, was crying. I picked him up and he stopped and stared at my white face with the biggest brown eyes, then gurgled and smiled. Later, as the clinic was nearing an end, I was sitting inside waiting for the nurse to finish when a little boy about three years old crawled up onto my lap. He snuggled in, chattering away in Luganda, then said goodbye and went home after his mama had seen the nurse. In those moments I felt blessed: I had been homesick and tired and suddenly felt loved and needed.
In between regular commitments at the clinic, it was wonderful to see the progress many old friends were making. Little Thomas, who I had met as a scruffy, scarred, three-year-old urchin at the Florence Nightingale Clinic on my first visit, was now going to Frank and Michele
’s school, started for sponsored orphans after they became frustrated with the poor education available. It had grown from a few classes, increasing every year as children went up to the next level. The school was fast gathering a reputation for the quality of the teaching.
Thomas was clean, polite and excited to see me. I gave him some new clothes and a plush gorilla that had been delivered to me in Adelaide by a member of the congregation at Westbourne Park whose grandson had decided to give his best toy to someone in Uganda. I knew straightaway it was for Thomas. His smile got bigger when I told him that, if he came to school on time every day for the term, he could keep the gorilla. He had only turned up for about half of the past term, so I was hoping the gorilla would inspire great things. Thomas’s class sang me a welcome song. The teacher told me that when he arrived at this school he didn’t know his letters, even though I had been paying for him to go to another school for two years.
Michele had brought Suzan to see me and she had grown quite tall and was animated and easy company. But her abdominal scarring was becoming very tight; Edward examined her and believed although previous surgery to the scars in her groin had allowed her to stand upright she would need more operations. It had always been a dream of mine to bring her to the Adelaide Women’s and Children’s Hospital to have all her scarring removed – without such a procedure she wouldn’t develop breast tissue normally and could never have a child.
Bosco, once confined to a wheelchair, had improved dramatically and no longer needed the walking frame because he could manage with just a stick. His main problem was a urinary catheter which came out of his abdomen and drained into an old washing powder bucket. I wanted to get him a urinary drainage leg bag to lessen this indignity and later wrote home to see if Ruth Telfer at Resthaven could send some. I asked Bosco to clean and return his wheelchair to the hospital because he no longer needed it. Bosco had successfully applied for a micro-loan from UACO and set up a small roadside café with his wife, Aisha. She told me that her children no longer went to bed hungry and she could clothe them, put shoes on their feet and pay their school fees.
Tiny Noellina, who had been paralysed from the waist down, died while I was away. Florence reclaimed the bed that had been specially made for her by the hospital carpenter, and it wasn’t long before we had a new use for it. On a walking clinic I met Godfrey, a paraplegic for fifteen years who slept on a mattress on the floor. We arranged for Noellina’s old bed to be moved into his house, along with a back rest. Godfrey had two teenage daughters and a sister who lived nearby; his wife left him after the car accident that left him paralysed and was now dead. Although he had an old wheelchair, he never got out because he lived down a hill along a very bumpy road. There were already plans being made for a UACO celebration day toward the end of my stay and I invited Godfrey to come. It meant arranging special transport to bring him but everyone on the walking clinic was instantly excited.
There was a strange surprise one day when Recheal turned up to see me. I had been personally supporting her midwifery training since meeting her years before, but things had gone badly. While in Australia I received a letter from Recheal saying she was being poorly treated by the hospital administration staff and they were threatening to dismiss her. I wrote the medical superintendant an urgent email to find out what was happening. He replied that Recheal had lied about her name and qualifications. That plus her rudeness had led her to being sacked and I was devastated at the news. Despite all this, I still loved her and wanted to make sure she was alright. She arrived with her two-month-old son in her arms; there was an absentee father who sometimes saw him and gave her soap and washing powder. I reminded her of her past family planning lectures and she assured me that she didn’t want to get pregnant again. She told me her mother had sold some land to pay for her to finish her training elsewhere. She had been accepted at another hospital and completed her certificate, and was now apparently a registered midwife and working in a clinic. In a way she had sorted herself out and seemed happy with her lot but I couldn’t help wondering what else she could have achieved.
One night we received word that twelve piglets had been born to the two sows. They had both farrowed in one night and we had two very happy widows. It was so exciting to see the impact that the project could have on people’s lives, especially those who had never experienced having money. The joy of piglets was to be shared: from each litter, the pig owner must give one piglet to someone who has nothing, and the only cost to that person is that when their pig grows and farrows, they must do the same. The loan recipients elected a supervisory committee from among themselves that visited each person with a loan every month to see how they were going. Bukenya organised a seminar on how to manage their money and used the language of the poor, not accountant-speak.
One of those with a piggery loan was Ritah, chair of the Najjanankumbi widows group. She had given a lot of input to the start of the group and during one of their regular meetings she spoke passionately about what UACO had done for her and other members. After the meeting and in recognition of her hard work, I told Ritah that UACO would help to fix her pig shed. She praised God and thanked us and then pleaded for me to go to her church so the pastors could bless me. This wasn’t the first time she had asked me to do so, but for some reason I had always resisted and continued to. I was to find out why before long.
Like the widows, the youth group was making progress with their loan. They made money from growing cabbages and maize, despite a few problems with the maize such as flooding, thieves and then the landowner requiring the block back. Next came the youth’s ambitious piggery project for which we had found sponsors back in Australia, starting with ten piglets and a plan to breed until each of the twenty-nine members had one piglet. It was difficult for them all to have a pen at home so they extended the piggery to include several growing pens. When the pig was old enough they could each decide whether to sell or breed from it. One conundrum that emerged was that Muslims cannot keep pigs, so there was talk of switching to goats. When they asked for my advice I said they all had good heads for thinking through problems; it was not for me to tell them what they want or need.
The youth group had formed a drama group that included young men and women and they were doing great things in the community. They saw their role as educating the community through song, performance and dance, particularly the young people, about HIV/AIDS, STDs and unplanned pregnancies. My plan was that when the next container was emptied, it would provide them with a place to meet, watch television and play games – like a clubroom.
In addition to the micro-loans for piggeries, UACO had built its own large-scale communal piggery. It was a short walk from the hospital in the middle of the slums. Edward’s idea was that it could serve as a demonstration project to show others. It cost about $1500 but was well made of wood with an iron roof and iron sides to protect the pigs from the prevailing weather. There was one large pen for the boar, three pens for the pregnant sows and a pen adjoining for the piglets when they were weaned. The open areas were fenced off with barbed wire to discourage thieves. The land had been loaned to UACO by a widow who was sharing a small pigpen next door with another widow, where each had a sow.
Although farming in Uganda is very different from Nairne in the Adelaide Hills where we had our farm, I was able to pass on some techniques. The widows were fascinated that I could pick up a piglet by one leg and it didn’t squeal. The biggest lesson was showing the women how much extra work was involved to keep the runts alive. There were always going to be more deaths here than in an intensive piggery in a developed country, but it was important they made the most of their animals.
The women who borrowed money were making their repayments on time and the one per cent interest paid was being used to fund more UACO projects. The management of the loans seemed to be going like clockwork – almost. I had a growing unease about something the widows called their ‘revolving fund’ and became more uncomfortable when I couldn’t see any pap
erwork for it. It turned out the only woman not repaying on time was Ritah, the chair of the Najjanankumbi widows group. After some investigation, I discovered the paperwork showed no record of Ritah borrowing 160,000 shillings (about A$120) in August 2003 and there hadn’t been a single shilling repaid. This presented me with a major problem because I had told Ritah a few days earlier that, because of her hard work and commitment to UACO over the years, we would renovate her pig shed to the tune of 700,000 shillings (A$500).
A community celebration day for UACO had been planned long before my arrival and the day was almost upon us. I didn’t want to have a difference of opinion with Ritah when she was involved in organising the day, so let it wait. In the lead-up to UACO day Rose had taken me shopping for an African dress. Unlike a gomez, an African dress can be worn in any country on the continent and are always brightly coloured. The driver, Charles, also became intimately involved in the shopping expedition, freely giving his opinion on style and material. They decided on a vivid royal blue with gold embroidery. Rose promised to keep it a secret and as she dropped me off reminded me to dress ‘very, very smart’ on the day.
I’m not sure whether it was my outfit or the anticipation of a party, but when the day arrived I received a riotous welcome at the clinic, with joyful calling and ululating. Despite being hot and very dusty, everyone involved with UACO was there. The widows looked glamorous in their bright dresses. Edward sent his car to bring the jajas who otherwise wouldn’t have been able to make it from their houses. It seemed to be more than a hundred people including community, police and church leaders. Shelters had been erected and decorated with streamers and balloons. Formalities got under way with lots of welcoming speeches followed by brilliant singing and dancing from the drama group as well as the widows groups from Najjanankumbi and Masajja.