Operation Fathers Day

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It’s been officially one month since we’ve landed in Uganda, and exactly sixty days until I put my feet back on Canadian soil. I try not to dwell on the time remaining, and appreciate the present instead. I try to limit my Internet use, and remind myself not to grow too accustomed to the routine of daily life here. It is easy to miss moments when you grow used to things; I never stop looking around on the back of a boda boda, I wave back eagerly at every single man, woman, and child, and keep motivated in my work and in my time off. Take nothing for granted, leave no stone unturned.

I was placed in the Out Patient Department this week. This is the first point of entry to care at the clinic, where patients are assessed, diagnosed, and either given treatment or admitted to the Inpatient Wards. However I spent very few hours actually in the clinic, as this week’s primary focus has been data collection for our community project. My group, Team A, has chosen increasing male involvement in maternal and child health as our focus, with our measurable goal being increasing the attendance of males at antenatal care. Antenatal clinics run on Mondays, Tuesdays, and Thursdays, so those days I spent transcribing into excel the surveys conducted by the local students who speak the language. So far we have completed 60 interviews; we will continue into next week until we have at least 100.

Wednesday was my only full shift at the clinic. We woke up to torrential rains; I lingered in my room until 9:15, hoping for a let up, but decided to make the run to the clinic. Scrubs do not dry quickly, I learned. The patients were abundant that morning, but the workers were not. There was only one physician when I arrived, so I observed and assessed with him for the first part of the morning. Eventually I grew curious about the other departments in Outpatient, so I wandered over to the lab to see how they carry out their procedures. I was surprised to see Britany and Dayna, fellow classmates from U of S, as the only people in the lab. The rain had deterred literally every other student – us three, plus Brooklyn and Tenielle were the only ones who showed up for work that day. While we are not technically trained in laboratory work, the girls are clever and went to work doing over 60 malaria and HIV tests. It is a kind of way of thinking we are all learning to adopt when working with minimal resources in disjointed systems – you do whatever you can, as competently as you can, because sometimes you are literally the only person there, and that is how you help patients. These same two girls have also been the ones to go banging on our fellow Ugandan students door in the morning, to tell them to get to work because we need them in the lab to do their job! I felt great pride for them on Wednesday, for taking the initiative to do the work that everyone else failed to show up to do. It is what sets great nurses apart from good ones, doing literally whatever it takes to get your patients what they need. Eventually the rain let up, and some of the hired workers showed up after noon and opened the part of the lab required for CBCs (blood counts) and other more advanced lab tests.

When we returned home, one Ugandan told us with a smile he was “sick” that morning; another asked in surprise – “Ah! You went to clinic today?!”. My quick response was “Boy, it takes a hell of a lot more than rain to stop a Canadian.” They laugh at us when we cook over charcoal, do laundry by hand – they think we are soft because we have machines to operate our life with. But they underestimate us; Saskatchewan girls are hardy and tough, with good work ethic. Last week I chided them, saying “Wow you Ugandans sure are lucky, you get a public holiday every week!” As the weeks pass, more and more people show up later and later, if at all, to work. Although there are times when the clinic is slow, and we aren’t exactly needed, there is still so much for us to observe and learn, and one can always take initiative and find work to do. It is has been so engrained into the U of Sers during our three years of clinical nursing that you always show up on time, stay until the bitter end, no matter what (apart from death in the family). “Slacking” is not a word in the College of Nursing vocabulary. I spoke to Ambrose about my observations about the differences in work ethics; he explained that during the regular terms, they are held to the same expectations as we are, but since they are unsupervised here, it is easier to do less than in other terms. Also, these students were supposed to have the whole month of July as vacation, but were unfortunately informed on the first day of our orientation that their break was now revoked, and they would be working nearly straight until their next semester begins in early August. So I eased up on him. To be fair, Canadian students have far more rights than them, and would never, ever, stand for an extension of over a month of school with literally zero notice. I think I also would slack a little bit, as a method of passive aggression...

I spent another hour in the morning on Friday in the Outpatient Department; the most memorable part was a little girl whose teacher brought her in, because she was trembling when she arrived to school. The poor little thing likely had malaria and a pneumonia. When she began to wipe tears I couldn't resist scooping her up and holding her close in my lap, warming her little feet and hands in mine. My heart went out to her, I remember how much I needed my mother when I was little and sick. I hope she made a quick recovery, and we won't be seeing her again this week.

At 10:30 that same morning, most of my group and three girls from Group B headed to the Sedes Sapiente Kindergarten and Primary School that is in the village we were assigned. Because our focus is on father involvement, and Fathers Day is not celebrated here, I had arranged with the school to do a Fathers Day activity. The children were each given a paper on which they wrote “Happy Fathers Day”, and they drew a picture of them doing their favorite things with their Dads. There were 330 students in total, so it was a hectic hour and a half, but a lot of fun. The students responded well – the older ones did a great job, while the five, four, and three year olds were just plain old cute. We sent invitations home with the children on Friday to give to their parents, inviting them to come back to the school on Sunday to receive their cards, and attend a Fathers Day program we organized. I had no idea what to expect, but was hoping for a turn out of thirty – which we managed to exceed, to my surprise and delight. We set the invite from 2:00 - 4:00, and I was shocked when people actually started arriving at 2:00 – another delight and surprise! We handed out the children’s cards to their parents, along with the badges I created for my social marketing campaign. For the badges, I had a seamstress sew a yard of local fabric into 400 tiny squares, which I then cut out myself. I attached them with 400 tiny safety pins to the 400 little cards I printed off and also cut out. The cards read “Good Dads = Good Communities! I wear this badge to show that I value the fathers of Rugazi”, with the same message translated into Runyankole on the back. I wasn’t sure how they would respond to the cards, but everyone was eager to wear one. After the event, I handed some out at some shops around the clinic, and men and women came up to me asking “Where is mine? Where is mine?” so I think they were well received. I told everyone “Happy Fathers Day!” as a I passed them out, and they were all very grateful, some even said “God Bless you!” The tedious work was totally worth the effort. I left twenty “Good Dad Badges” at the place where I buy my beer, a common gathering place for men, so I hope when I go back in a few days the badges will be gone and I can replenish their stock.

The Fathers Day program itself consisted of an opening prayer, then the national anthem, an opening address from the Headmistress, introductions to our team, a speech from myself on behalf of the “whites”, and then a brief lecture I wrote (and Ambrose translated and delivered) on the benefits to children when they have engaged fathers. The event went well, for the amount of time we had to organize it. As I said in my speech, I am sorry I cannot be at home to celebrate with my own father and family, but I am happy that I could be there today to celebrate with the fathers and mothers who came. (I almost choked up when I said I would be missing a BBQ, beers, music and laughter in Saskatchewan!).

I hope those we reached will continue to celebrate Father’s Day next year and that it is a tradition that is carried on, even if only in a few homes. My intent with the project was to create awareness of our team and what we are doing at Rugazi Health Centre, and to recognize and commend the fathers. Maybe they will be more willing to work with us towards our goal; we were able to conduct two focus groups after the program, and received a lot of contacts of people who might be willing to work with us in our project of male engagement in family health. I dare say the event was a success.

On another note, Saturday I returned again to the House of Love orphanage. The children all remembered us, as they are wont to do with mzungus. We played games for a couple of hours with them, and my heart was warmed up again. I was feeling a little blue on Saturday - the skies were overcast, and I was dwelling a lot on the shootings in Orlando, and a shooting that happened in Kenya where 148 students were killed at a university. It was a morning where I felt myself being worn by the dark and hatred that is so rampant in this world, but after a few hours with the children my optimism returned and I felt the balance of good return. Hatred and evil will not breed in my heart, otherwise they have won, and I have lost. Anyone who knows me, knows I am a sore, sore loser. So - love! Love, love, love.

It is difficult to believe that this is (possibly) my last week in the community. Half of the girls are staying on for another week and a half, while the other half are going back to Mbarara, according to the original plan, to begin work in the hospital. I was planning to stay behind with the others, but tensions in my group have reached an all time high; I am having a moral dilemma as to what the right path to take is. As much as I love the work here in Rugazi, I feel that my group may be better of without me. I have until tomorrow to decide. My personal philosophy is to always do whatever is the hardest and what you are most resistant to, because that is usually exactly what you need to grow, so in that sense I should stay. However, I don’t want to let my personal growth supersede the good of the group, or risk my sanity for that matter. So, the next time you hear from me, I will either be back in the city, preparing myself to hit the surgery ward; or – I will be reporting on my latest community intervention and my success (or possibly failure) in refraining from beating one particular team member (whose name starts with an S and isn’t Stevo) around the head.

Wish me luck, whichever way I choose!

Carrie Ann

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Photos

Sooooo Cute!
Dem braids!

Kindergartens Push Starting the Bus!
Don't worry - we went and helped and got it started

Successful Day!
Stephen, Carrie, Headmistress, Steven, Children and Father

Walking to the Orphanage
Carrie, Ambrose, Tenielle, Brooklyn