Mama Jude: An Australian Nurse’s Extraordinary Other Life In Africa

by Judy Steel

  The literacy program had also begun thanks to the generosity of a Janet Sutherland from Perth whom I had never met but who believed in the power of education. After hearing about UACO, she sent an email to Fred saying that she was asking guests at her fortieth birthday party to give a donation. It resulted in almost $1000 being sent. When asked if there was a specific program she would like the money directed toward, she answered that as a migrant who had arrived from South Africa a decade ago, the idea of funding a literacy school sat well with her. She has continued to support the project year after year, even as the cost of running the school tripled with the increase in students.

  Eight students enrolled in the first course, committing themselves to three days tuition per week for nine months. The course began with reading, writing and numeracy and then branched into health lessons and civic education.

  In a sign of growing respect for UACO, in 2004 the Ugandan Ministry of Health declared the clinic a designated immunisation area, which meant the government supplied the materials and UACO carried out the work. The government targets eight killer diseases: diphtheria, whooping cough, measles, hepatitis B, influenza, polio, tetanus and tuberculosis. At the same time we focused on diarrhoeal disease, nutrition, sanitation and hygiene (which included de-worming and vitamins). The result was 3000 children from nearby schools coming to the clinic.

  That Christmas Fiona introduced Warrick to Australia and her Aussie friends, and we held a special blessing for baby John in the garden of our house. It was an opportunity for all of our friends and relatives to meet this new little family.

  However amid the excitement of family reunions and the successes of UACO came an unexpected turn that forced me to rethink my work. It was late in 2004 when I was diagnosed with Parkinson’s disease, a degenerative disorder of the nervous system that can take a toll on coordination and speech. I certainly had noticed a significant tremor, which got a lot worse when I was tired. The diagnosis was a shock and upset me for a while, especially as I feared major lifestyle changes including not being able to return to Uganda, as Parkinson’s is a chronic and degenerative condition with no cure.

  After a while I decided to just get on with life and not take too much notice of it. I had two dear friends who were significantly worse than me with this disease and I thanked God that mine was manageable for now – no two people are affected by it in the same way. But I was forced to review my lifestyle and decided my next visit to Uganda would be only six weeks rather than the three months I was considering. I began to wonder too how many more times I could visit Africa.

  In the new year Allan and I headed off in the caravan for a few months on an extended getaway. We headed north from Adelaide via Alice Springs, and then on to Queensland along the Barkley Highway. We ate barramundi in Karumba on the Gulf of Carpentaria and camped by waterholes and rivers where we could hear the fish jumping at night. We left the van behind for a couple of days at Mount Carbine north of Mareeba to travel to Cooktown and then down the coast on a four-wheel drive track in the beautiful Daintree National Park.

  Along the way I was devastated to learn that my dearest friend, Tanya Page, had died suddenly and unexpectedly. We had been work colleagues, friends and confidantes for years. It was so hard not to be able to go to the funeral but it was impossible to get back to Adelaide in time. I have missed her every day since. I think I always will.

  We had only been back in Adelaide for one day when we were on the move again, this time in a different way. Several years before we had sold our holiday home at Port Elliot and bought the camper trailer. Allan and I had talked about selling our house in the city and moving permanently to Port Elliot, and then we learned about a house for sale there. Generations of Allan’s family had holidayed in Port Elliot since the 1880s and we had continued the tradition; from an early age our children had gone digging for cockles in the surf and fished off the jetties. We bought the house at Port Elliot and sold our home in Adelaide very quickly. The house was thirty years old and very small so, although we were in theory downsizing, we planned an extension. Peter and Katrina were increasing the size of their family with a fourth child in August, so we’d need some room for visitors.

  Amid the move, I was thrilled to be notified by the Zonta Club of Adelaide Torrens that they had awarded me their Woman of Achievement Award, in recognition particularly of the micro-loan scheme which had financially empowered many women. This was recognition of the work of many people, not just me, and I was delighted to receive it. Zonta is a service club for professional women, set up in America in 1919, which now has 1250 branches worldwide. In Australia, one of its projects is the provision of birthing kits for developing countries. The idea was formed in the Adelaide Hills where members had heard of its success in Nepal. After consulting with Anthony Radford, my teacher in international health, the group began packing basic medical supplies to help women who had little access to treatment during delivery. The kits cover what Anthony calls the ‘seven cleans’ of delivery: clean birth site, clean hands, clean ties (preventing bleeding from the umbilical cord), clean razor, clean gauze (to wipe the babies eyes clean of birth canal secretions and venereal disease germs before they enter the surface of the eyes, significantly decreasing infections), clean umbilical cord and clean perineum (birth area). He likes to add an eighth – a clean heart. What all that boils down to is a kit containing a square metre of black plastic, one scalpel blade, gloves, soap, three gauze swabs and two umbilical tapes.

  The Australian Government aid agency AusAID funds the kits dollar for dollar with Zonta, and after being packed by volunteers they work out at a cost of just sixty-five cents each. In the late 1990s, the World Health Organization estimated that more than half a million women died annually in childbirth, 99 per cent of whom were in developing countries. For every woman who dies in childbirth there are another thirty who incur injuries and infections which can often be painful, disabling and embarrassing for life. Sixty million babies per year are delivered by a traditional birth attendant or with no assistance at all: this is the way the majority of babies are delivered in rural Uganda. UACO had become the Ugandan distribution centre for these kits and would eventually deliver thousands of Zonta birthing kits to remote clinics.

  We were delighted with the move to Port Elliot and soon made wonderful friends at the Uniting Church there. In addition, Allan’s sister Margaret and her husband Jeff retired from Sydney to nearby Victor Harbor. I loved the southern ocean coastline and walking Annie there every day. Sometimes we would see sea lions visiting from Kangaroo Island sunning themselves on rocks or surfing. I took photos on my new digital camera to show Edward and Rose what my new home and Australian village looked like. My mind easily drifted to Africa wondering how the projects were going. This was an important time for reflection.

  The day before I left for Africa was a frosty morning and Allan and I drove along the esplanade so I could deeply breathe in the sea air and take it with me. This time I would be away for eight weeks in total, six weeks in Uganda and two weeks in London to visit Fiona, Warwick and John.

  As I headed off, Allan was left living in our house while it was pulled down and rebuilt around him. I think I was getting the better part of the deal by living in a hostel in Uganda. At least I had a toilet and a shower – Allan often had to go to friends for one.

  Chapter Twenty

  THE PLANE TO KAMPALA was packed and as usual mine was one of only a few white faces. That would change a little in the next few weeks with three Australian women joining me in Uganda: Iva Quarisa, the daughter of our supporters and friends the Quarisas in Griffith; Sandy Lee, a radiographer from Sydney; and Viv Maskill, a registered nurse from Melbourne, who had heard about UACo and wanted to help and learn where they could.

  Waiting at Entebbe were Edward, Rose and little Judy, who was now six years old. They introduced me to Frank, their new driver – I was shattered to learn that their previous driver, Charles, had been diagnosed with HIV/AIDS and taken his own life
. Edward had loved him like a brother and missed him dearly.

  The country was still tense after the turbulent general election a few months earlier that had seen president Museveni returned to office. It was the first multi-party election held for twenty-five years and there was plenty of bad blood between the six candidates. The main opposition leader, Kizza Besigye, used to be Museveni’s doctor and fought in the bush war alongside him until he grew disillusioned and now led the Forum for Democratic Change.

  Shortly after the election was announced, Besigye was arrested for treason and rape. He was accused of being connected to the brutal Lord’s Resistance Army, a rebel group operating in the north of the country. His arrest resulted in riots, demonstrations and looting. At least one demonstrator was shot dead by police and Edward had to treat many casualties because the fighting was heavy near the hospital. An opposition office near the Busabala Road Hospital was frequently targeted and many were injured. Edward was grateful for the fence and barbed wire around the compound.

  Museveni won the election with 59 per cent of the popular vote to 37 per cent, but Dr Besigye challenged the result, alleging it was fraudulent. The police had to use tear gas to disperse opposition supporters in Kampala.

  In addition to the political upheavals, Uganda had been hit by a serious drought and water levels had fallen in Lake Victoria. This had affected the hydro-electric scheme and supply was a problem. Now when the power went off it usually stayed off for twelve to twenty-four hours.

  The roads were constantly chaotic. Several nights I was awoken by car accidents outside the hostel and the city’s tension grew with the frustration of deteriorating road conditions. On top of that, a lot of the extra traffic snarls were caused by preparations for the Commonwealth Heads of Government Meeting (CHOGM), scheduled to be held in Kampala in a year’s time. New hotels were being built and old ones upgraded. Anywhere Queen Elizabeth would be driven was being fixed, and I was told any buildings on her route not finished in time would be bulldozed. It was hard not to think how much better it would be to put the effort into clean drinking water.

  There was much news to catch up on and many people to see. I was thrilled to finally meet the new clinic administrator, Persis Kanabi Nsubuga, who had replaced Florence when she left to take up a position with the HIV/AIDS charity Mildmay. Persis was very gentle and quietly spoken. Although she was sixty-five years old, she looked fifteen years younger. It was exciting to have her working for UACO especially with her experience in development, small loan schemes and nursing. She hadn’t worked for a long time but had returned to work after her husband died of cancer four years before. She lived on an acre of land, most of which was under some kind of food production including about 150 chickens.

  The clinic needed immediate maintenance to fix the baby scales and the water tank used for inside hand-washing. The babies were being weighed on ordinary scales using a complicated system: first the mama held the baby and stood on the scales, then she gave the baby to someone else and was weighed again. The baby’s weight was recorded by subtracting one from the other. It was easier to fix the scales.

  Sandy Lee arrived the week following me after three weeks working in Rwanda. As a radiographer, she was part of a cardiac team called Operation Open Heart which functioned out of the Adventist Hospital in Sydney, each member volunteering their skills to provide cardiac surgery in areas of need. She was in her late twenties and planned to stay a fortnight in Uganda. When Edward and I picked her up from the airport she looked desperately tired and it turned out she was quite unwell. Soon after that, Iva Quarisa arrived in Kampala and they both joined me at the clinic.

  Sandy and Iva were amazed at the dozens of mothers and their babies lining up for immunisation. Compared to what she had seen in Rwanda, Sandy was impressed with the hospital but to me it looked in need of a coat of paint. Edward had upgraded the maternity house to include two bedrooms, a lounge room and bathroom. He had also spent a lot of his own money demolishing and then rebuilding the physiotherapy area. When I went to have a look there was a great kerfuffle and I was shooed away and told I wasn’t allowed to see it until the formal opening in a week.

  Some of the youths came to greet me, but in reality they were more interested in speaking with my two young friends. It was funny watching them jostling for positions and flirting. When they found out Iva was going to play volleyball with them they were beside themselves. Iva had brought soft balls with her to teach the kids how to juggle; she’d really put a lot of thought into what she packed in her suitcase. The young people loved her and I later felt sure that of all the people who had visited UACO, she would be back. She has a real heart for helping young ones.

  Iva confessed she was a little anxious when she arrived in Africa. I promised her parents I’d look after her but the three weeks she spent in Uganda were a steep learning curve – starting with a full clinic day and then venturing out into the community. The first walking clinic was full of shouting and joy. It was true to say that many of the people I introduced to Iva and Sandy were only alive because of UACO: previously there had been no services for them and many were in such a state they would barely leave their houses.

  The last of my mzungu team arrived exhausted after flying from Melbourne to Kampala via Singapore, Dubai, Addis Ababa and Nairobi. Viv Maskill was a midwife who had also completed Anthony Radford’s international health and medicine course; it was after I spoke to her student group about UACO that she enquired about visiting us in Uganda. Over the next two weeks she joined in every aspect of the outreach, including her particular interest of maternity. Although she missed two deliveries, she helped with the postnatal care – including watching the mothers climb on the back of a boda-boda, hanging onto their babies within hours of delivery for their ride home.

  Bosco was delighted to have his urinary drainage leg bag but was desperately in need of more. He had been wearing his last one for months and it was dirty and blood-stained; I wrote to Allan asking him to send some. Bosco needed some work for both income and self-esteem: the café he and his wife, Aisha, had started with a micro-loan was no more, as the owner of the area they had used for it wanted to build a shop there. The family was all very thin and now had no way of repaying the loan.

  While we were visiting them we came across a tiny baby boy who had been abandoned and was being cared for by a lady nearby. Ronald, the nurse, came along on the walking clinics and agreed to provide follow-up care but, in the meantime, the baby didn’t have a name. They asked me to think of one so I named him after my first-born grandson, Michael. I looked out for him at immunisation the next Tuesday and worked on a plan for him to survive. Sandy and Iva were challenged by what they saw on the walking clinic. They were like magnets to the children who followed them, running up to touch them and then race away to hide. Iva had handed out balloons and sweets she had brought from home. I wasn’t sure who enjoyed it more, the Australians or the village children.

  A few weeks later at the clinic I was asking about baby Michael when everyone smiled a little sheepishly. It turned out the name should have been Michelle, not Michael. Ruth, the woman who had adopted her, already had a seven-month-old baby but was happy to keep Michelle too. We tried teaching Ruth to breastfeed both but she resisted this, so we supplied her with formula.

  The clinic figures gave a comprehensive snapshot of the health needs of the community. In the past twelve months almost 1000 patients had been treated, a third of whom were children under the age of five. Over 700 babies and children had been immunised. Gastroenteritis remained a huge problem with 75 per cent of the children reporting to the clinic being affected by it. There was also an outbreak of measles, and peptic ulcers and skin diseases were also a problem. Many conditions that wouldn’t be a concern in Australia become very serious because of poor hygiene and malnutrition.

  Among adults, poor nutrition and the stress of poverty led to cases of anaemia, hypertension, arthritis, infections, worms and malnutrition. There were many cas
es of sexually transmitted diseases, asthma and typhoid. But still the most common complaints were those resulting from HIV/AIDS patients who had infections, herpes, skin cancers, tuberculosis, chronic fever and coughs, all as a result of their immune systems slowly breaking down.

  Each day as we drove down Busabala Road to the clinic, we passed successful projects as the result of small loans. One was a chapati stall made of sheets of corrugated iron which served the best I had ever eaten. Owned by a widow named Aisha, her two sons worked at the back of the stall, rolling the dough into lumps the size of tennis balls. They would then roll them out before putting them on a hotplate shaped like a shallow wok. After adding a little oil, a wad of newspaper was used to flatten them down while they were cooking. As well as the best chapatis around, they also sold charcoal to use as a cooking fuel. The business seemed to be going very well with a steady stream of customers.

  Hadijah was another widow who was caring for seven grandchildren. She owned her own house and a bit of land where she had built quite a big stall to use as a warehouse, buying matoke in large amounts and then on-selling it to other stallholders. Rob ina was another AIDS widow selling matoke and vegetables in a small way, while Sofia sold charcoal and matoke. She also had a cow that was producing about three litres of milk per day; her business was going so well that she soon declared she was now ‘in the middle classes’.

  I developed a good working relationship with Persis and Ronald. Persis had a huge task as social worker, being responsible for community development, education and managing projects. She had a beautiful way with people, always being sensitive in her dealings with others. In his role as clinic nurse, Ronald was much loved by everyone, especially the elderly. In addition to running the clinic, Ronald counselled the HIV/AIDS and youth groups. At just twenty-seven, his maturity and commitment were amazing. As well as being a fully trained enrolled nurse and midwife, he had a diploma in HIV/AIDS counselling and was studying for a diploma in child psychotherapy so he could better manage the problems of the youth. He worked three half-days a week in the clinic and went to university in his time off.