Fearing Like a Man

My hands are soft. I notice it most when cooking. People will grab the thin metal saucepans right off the fire with their are hands, unfazed. The first time I saw this, I assumed that the pan was not very hot, and picked it up to move it elsewhere. You can guess how that worked out, and the painful burns left me wondering how he could have handled it so easily. Occasionally, when a pan is really hot, I've seen someone grab a leaf or two and use them as insulation, I would still burn through the leaf.

The other day I was eating at a friend's house, and was in the little kitchen building with him and his sister in law, marveling at the toughness of her hands. A saucepan of boiling water sat on the crackling fire, to which she added maize flour to make posho (think grits). Posho, however, requires a lot of vigorous stirring, and these saucepans have no handles, so she firmly grabbed this blazing hot pan with one hand and began stirring with the other. Occasionally she would change her grip, probably for a break from the heat, but her hand was usually down on the side of the pan, basically among the flames that were licking around her fingers from below. She didn't flinch, didn't show a hint of discomfort. I told my friend how amazing this was to me, and he told me that women here have much tougher hands than men.

He told me about a saying that women have. When multiple women are together cooking, if one of them reaches for some leaves to protect her hand from the scorching heat of the pan, the others will ridicule her, saying, "Why are you fearing fire like a man?" Cooking is so much a part of the identity of women here, that one can be shamed for not having that food-preparation toughness, and resorting to the soft means of protection that men use.

I'm guessing it's callouses, and nerves damaged due to repeated burning, and simple toughness. One way or another, women here are tough. This discussion leaves out the fact that, before building the fire, women collect and carry the firewood. I've seen women who must be 70, tiny, frail looking, and hunched over, carrying on their backs massive loads of firewood that must weigh 60 pounds or more, bent almost 90 degrees at the waist, looking at the ground, slowly putting one foot in front of the other as they move up the road. It's incredible.

So here's to tough women who provide for their families, who spend most of their days doing the mundane things like hauling and splitting firewood, peeling matooke, and taking hold of blazing hot pans - and who don't fear like a man.

Champions!

Christ School is the champion of Bundibugyo district! Yesterday, we met our biggest rival in the district final. Our first half was brilliant, and the boys did everything I asked of them: keeping their heads in a high-pressure game, possessing the ball, keeping it on the ground, good passing, organized defense, and a high work rate. The only thing lacking was our finishing, and we went into halftime up 1-0 when it should have been 3-0. Nevertheless, I was upbeat and pleased.

I could never have guessed what would follow, as the second half was absolutely horrible. We lost control, the boys lost their poise. I was screaming to my players, "Keep the ball on the ground!" Their coach would then immediately scream to his players, "Don't let them keep the ball on the ground!" One thing I love about soccer is that it is a player's game. The coach can train and prepare, but once the whistle blows, it's up to the players. There's no micromanagement from the sidelines. That aspect of the game drove me crazy in the second half. I was screaming, pacing, shaking my head, my heart pounding, my head in my hands, powerless. Coaching is an entirely different game than playing.

However, we held on for the 1-0 victory, and a wonderful celebration ensued. It took me a couple minutes to transition from my angry coach mode into victory celebration, but it was a lot of fun. One young player in particular impacted me. He's a good kid, very hard working, the kind of player I like to have, and one who will go on to be a big player for this team. He had come on as a substitute to give us a little more defense, and was injured late in the game on a nasty tackle from an opponent and had to be carried off the field, grimacing in pain. As soon as the whistle blew, his arms went in the the air, fists pumping, head back, with pain and joy in his eyes. He looked to me like he might start crying. The emotion in his celebration helped me realize how big this is to these boys. Some of them are orphans, all of them endure a lot of challenges, all of them come from a forgotten corner of this country. This victory which makes them champions may be one of the most meaningful and positive things to happen to them. And now they have the chance to represent their district at the national tournament. There was a crate of Mountain Dew for the celebration, and the boys opened them and shook them like champagne, a fun and happy sight. I helped carry the injured player over the the middle of the celebration so that he could join in the Mountain Dew shower.

Many of these boys have never been outside of Bundibugyo, and I'm excited to have the chance to go with them to Masaka for nationals. We'll meet taller, more skilled players. We'll meet schools with a lot more money. But we'll get to represent Bundibugyo - these 20 boys who get to go on a huge adventure, the biggest opportunity of their playing days. Seeing a new part of the country, opening their eyes, traveling, feeling good about themselves, camaraderie, confidence, learning, growth. That's what I hope for, and I believe it will be a good opportunity for me to invest in them and to show them that I care for and believe in them, even as I prepare to return to the US.

After the game, I told the players that we have a lot to talk about on Monday (not happy things, mind you), but that now was the time to celebrate. And that gave me some freedom to celebrate too.

CSB 1 - 0 Bumadu

We prevailed in the district semifinals yesterday, against what was probably the other strongest team in the district, and we now advance to the district finals where we'll meet Simbya, our arch-rivals from just up the road, with a place at the national tournament on the line.

The match wasn't pretty, despite a beautiful diving header goal in the early minutes. I was missing two of my best players through injury and suspension, and despite the depth of the squad, we felt their absence. Our opponents, a team from Bundibugyo town, are the first team I've seen that also tries to play a similar style to ours; keeping the ball down, passing, control - as opposed to the fast, frantic, wild, and almost random kicking and chasing that prevails here. We didn't do very well at sticking to our game plan, as we seem to sometimes have trouble keeping our heads in big games, but we still managed to maintain better possession and keep a strong defense. The hard-fought match boiled down to a tense last few minutes, but we held on for the 1-0 victory in the fading evening light.

It was wonderful to see the excitement of the students and staff - people I've never spoken to running up to me congratulating and thanking me, dancing in celebration of a major win, one step nearer to the glory of being district champs. The sunset also seemed to celebrate with us, a beautiful sky from horizon to horizon, the orange light hitting the mountains, intense gold and bright yellows in the west, with pink clouds overhead and reaching over the mountains in the east.

We have a lot of work to do and a lot of improvements to make to be a really good team, but it was a good win and an encouragement to the boys that they can win even without some star players. I was proud of my boys, some of whom were asked to play positions they don't usually play, some of whom had subpar performances but fought hard anyway. Back to the training pitch we go, with confidence from a win, but with an awareness of weakness as well.

A Bundibugyo Evening

Life here is simply not predictable.

Saturdays are busy - projects, football practice or games, streams of visitors and requests. It's also generally the night when all the singles have dinner at the Myhre's, which is always something to look forward to. I was late for dinner because I was trying to care for the Pierce's former dog Jessie, who now lives on the mission and has had a really nasty open wound, so I ran back to my house splattered with dog blood, showered, and ran up to dinner late (for the record, Jessie is improving greatly). When I got there, Scott was seeing a patient who has stopped by, so I took the meat and threw it on the grill, while Jennifer and the girls finished preparing everything else. We ate a wonderful dinner, as dinners at the Myhre's usually are, and we had just begun discussing what movie we would like to watch when Scott told me that a patient we had seen earlier was back and in need of care.

This old man needed a catheter, so we set up a relatively clean area on the ground in a small building next to the Myhre's house, sterilized some implements, put on sterile gloves and inserted the catheter. Nothing happened. The second try also failed. Since by this time it was 10PM, taking the man to Bundibugyo hospital wasn't a good option as he probably wouldn't be seen until morning, not to mention that the 30 minute drive over bumpy road would be sheer agony for him. So Scott decided to do a procedure then and there. He sterilized some surgical instruments, injected a local anesthetic, and proceeded to cut open the man's abdomen, stick a catheter directly into his bladder, and stitch him back up with the catheter still in place. Remember that this was late at night, so the only light he had was my headlamp and another flashlight being held by a neighbor of the patient. I stood by hoping, probably in vain, that I was being helpful, holding instruments and keeping light on the procedure. Just to review - surgery, blood, urine, on the floor, in the dark - but still well done. Scott told me I'll be horrified when I look back on this in medical school.

The degree of this man's previous discomfort became clear when, after all of this, these unpleasant procedures, this surgery with minimal local anesthesia, he looked at Scott and said "God bless you Doctor." Scott injected his thigh with an antibiotic that is apparently quite painful, and his parting words to us were, "You have killed my leg." After all of that, it was his leg that we killed.

It was 11PM, still terribly hot, and we were both wound up and not really ready for bed, so Scott, Jennifer, and I watched an episode of Prison Break, and I went home around midnight. I found my fridge out, so I had to hook up a new propane tank, light it, and take my second shower of the night, heading to bed at 1.

Animal care, grilling, tacos, surgery, TV, refrigerator maintenance - an evening with a bit of everything. Jennifer asked to me, "Won't it be boring to go back to a place where these sort of things aren't normal?" It seemed like a half-joking question. And my answer would have to be a half-joking yes.

Kick Off

We had our first football match of the season on Wednesday - it was supposed to be Saturday, but other teams are protesting and causing trouble, a frustrating story that I don't have time to relate now - always a big and exciting event. Especially in the last few months I've been spending a lot of time training the boys, usually at least five days a week for a couple hours. We have talent, and my goal is generally to bring some organization and tactical awareness to the game. The game started a mere two and a half hours late (we had to wait for someone to come and officially commission the match, but he needed to be picked up and driven to the field, and once he arrived he had to lecture everyone involved on the minutiae of the regulations. The bureaucracy here is mind-boggling), but within a minute we were off to a good start with a 1-0 lead. I was really happy with the way the boys played; they have come a long way since I first saw them. Like any coach, I was still frustrated with a lot of things and did more than my fair share of yelling - I wonder what the boys were thinking as I was screaming while we had a 4-0 lead - but it was a good match and was fun to watch.

Football season seems to bring the school together in a special way, and the joy that these boys have in representing their school and being supported by their classmates is clearly visible. Students and young children run onto the field after each goal, dancing and twirling in celebration. The girls beat drums, sing, and chant for the entire match. I think that the matches are a really encouraging experience for the players, and I hope that it's a chance for them to learn teamwork, dedication, and respect.

The game finished an impressive 6-1, so everyone was happy. Except for me, of course, as I was disappointed that we allowed a goal. But it was encouraging start to the season, and I'm hopeful that we'll have a successful year.

Hope

Kabasa went home today. He was admitted for about 6 weeks, and for the first three of those it continually seemed as though he was dying. He came in as a weak, malnourished child, swollen with edema, whose skin was falling apart and who lacked the strength to stand or even cry very much; he left today a happy, energetic boy with a little meat on his bones, running around the ward, throwing his ball to me, with a heartwarming smile on his face. Six weeks, from the very brink of death to curious, playful life.

I don't know what awaits him. At home, he won't get the same high quality milk and food that we can provide to the inpatients. Who can say what his future holds?

Still, Kabasa gives me hope. It is easy to despair in this place, but in the face of suffering, tragedy, and loss, he is a glimmer of beauty. A little boy saved from death. A life preserved. A father spared the loss of his son. I know I have said this before, but I'll say it again - because Kabasa is walking home today, a healthy boy holding his father's hand, I feel that the world is more right than it was yesterday. Undoubtedly, the world has a long way to go - several children this week have demonstrated that in gut-wrenching ways - but Kabasa gives me hope in goodness, wholeness, and healing.

"He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the old order of things has passed away."

Tuesdays

I realize that I provide very little indication of what I actually do on any given day, so here's a glimpse of Tuesday, usually a very long, intense day primarily consisting of malnutrition work.

In the morning I go the health center to do rounds with Jennifer, starting with the severe malnutrition cases. A few of the kids on the ward now:

I first saw Asaba at one of the outpatient programs, and immediately referred him to the health center for the inpatient care that he needs. He's been a troubling case, not responding to receiving the therapeutic milk in the way that we usually see these kids recover. His weight is starting to trend upward, so I'm hopeful that he's finally on the right track.


Tumwine is absolutely pitiful, one of the worst cases I've seen since being here. His body is wasting away, every rib, vertebra, and most other bones are clearly visible, and he is so sick that he has little appetite for the F100 milk that UNICEF supplies to us, so he is another sad case of someone who made it to the health center, but can't seem to turn the corner. Jennifer has said numerous times that she doesn't expect to see him alive the next day, but he has somehow clung to life. Part of his problem is child spacing. His mother just gave birth days ago, so she had stopped breast feeding him during her pregnancy, which was too soon for him. It's painful to see him in such a horrible condition every day, but somehow he's held on, so I try to keep my hope for him alive too.

Finally, a happy story. Kabasa is an object of wonder for me. He's been admitted for a long time, and wasn't responding for several weeks. His protein deficiency had caused major edema, and his skin was deteriorating. About three weeks ago, I said to one of the nurses, "He's going to die by tomorrow. What can we do differently?" Since then, this seemingly hopeless case has been a miraculous recovery. Within days he started smiling, and by now his weight it shooting upward and he's a smiling, playful five year old boy who gives me an energetic high-five whenever I see him, and loves to throw a ball back and forth. Every time I look at him I'm amazed, he brings joy to my day and hope to my heart.

On the first Tuesday of the month we have our motherless program, which supports caregivers to be surrogate breast feeders for children whose mothers died in childbirth, so in the late morning I see these cases. We give beans every month to nourish these heroic aunts and grandmothers, so that they can be strong enough to provide breast milk for these unfortunate infants. Some of the kids to great, and some don't; some families are incredibly dedicated to caring for these kids, while some don't seem to be very invested and are probably looking for any handout they can get a hold of. But I'm always amazed to see aunts, already breast feeding their own child and often struggling to provide for them, taking on the responsibility of caring for another child, or grandmothers who haven't had a child in years but have managed to re-lactate, these wrinkled old women who throw 25-pound sacks of beans on their backs, strap them across their foreheads, and walk slowly, steadily away, perhaps having to cover many kilometers to get back home.

In the afternoon, I jump on a motorcycle with Baguma and head out near the border with Congo for the BBB program, an outpatient nutrition program. The road is always an adventure, especially with the recent unusually heavy and long lasting rains. Their used to be a bridge over the river we have to cross, but it has been gone for years and now the motorcycles drive across when the water is low enough, and men ferry people back and forth on their backs.

Here are some of the kids from the BBB program.


Some do wonderfully on the locally produced peanut paste and soy flour that we distribute, while others don't respond well, but outpatient programs will always have those issues. It's been a great learning experience for me, and I've encountered many interesting cultural issues. For instance, one of the big difficulties with these types of programs is that it is culturally almost impossible for a parent to give a certain food to one child - the supplemental food that we provide, in this instance - without sharing it between all of their children, meaning that often the malnourished child enrolled in the program might not even get the majority of the calories that we give them. But I've had great experiences, worked with some wonderful kids, seen spectacular recoveries, and have built a great relationship with Baguma.

We get back sometime around 4 or 5 usually, and I run down to Christ School for soccer practice. The season starts next week and their are high expectations, so we're training hard every day. After two hours of playing, drilling, talking, running, yelling, and encouraging, I make my way back up the road around 7, with the sun setting behind me, tired, thirsty, hungry, and aching, but usually it's a good ache.