Monday, September 15, 2008

Gotta love the rainy season

Here are some pics from my recent trip to Mundri. More specifically, the road between Mundri and Juba after it had rained overnight. Fun fun! As you can see the roads are seriously messed up. At one point our vehicle had to be pulled out of the mud by a crane (!!!) Plus there was gorgeous scenery along the way. And we bought some freshly-collected honey.

The trip itself went ok, it was just for two days so nothing too hard core. I went there with one of our donors to assess the VCT services provided by another organization to see if we can potentially support their work to expand services. What was there on the ground was appalling. Worse than Tambura. This org claimed to run 4 VCT sites, but upon further inquiry we found that one site was closed because they had no counselor to work there, one was closed because the roof had blown off the structure back in March 2008, and a third site was actually funded and run by another organization - this org just does supervision to the counselor. So they really only have functional operations in one place. Not to mention that they brought us to the site that was run by the other org as one of "their" sites. There were test kits which had expired in 2007, a sharps container that did not contain disinfectant, no confidential filing system, and it goes on and on and on. And that site was even closed because the counselor was away for the past 3 weeks for training! Their compound was literally built on top of an anthill so there were ants EVERYWHERE (outside, in the mess area, etc), their generator had blown up so there was no electricity, both their vehicles were grounded pending repairs, and all 4 of their motorbikes were also not functioning. Plus the entire 2 days we were there I didn't see them actually doing any work. It's like they just sit around and let their clinics run themselves. If you ever hear me complaining about Juba again, just remind me of the fact that I work for an organization that is able to get things done, whether it is running programs or fixing vehicles, I don't live on an anthill, and I work for a boss who actually provides support to the org instead of sitting around doing nothing.

Saturday, September 13, 2008

A Woman Should Have by Maya Angelou

A friend of mine posted this poem by Maya Angelou on Facebook, and I was reminded how true all these things are, but was also reminded of the few that I don't have because of where I am living at the moment. But I can dream and make plans for what comes next! So this is for all my ladies out there :)

A Woman Should Have
by Maya Angelou

enough money within her control to move out
and rent a place of her own,
even if she never wants to or needs to...

something perfect to wear if the employer,
or date of her dreams wants to see her in an hour...

a youth she's content to leave behind....

a past juicy enough that she's looking forward to
retelling it in her old age....

a set of screwdrivers, a cordless drill, and a black lace bra...

one friend who always makes her laugh... and one who lets her cry...

a good piece of furniture not previously owned by anyone else in her family...

eight matching plates, wine glasses with stems,
and a recipe for a meal,
that will make her guests feel honored...

a feeling of control over her destiny...

how to fall in love without losing herself..

how to quit a job,
break up with a lover,
and confront a friend without;
ruining the friendship...

when to try harder... and WHEN TO WALK AWAY...

that she can't change the length of her calves,
the width of her hips, or the nature of her parents..

that her childhood may not have been perfect...but it's over...

what she would and wouldn't do for love or more...

how to live alone... even if she doesn't like it...

whom she can trust,
whom she can't,
and why she shouldn't take it personally...

where to go...
be it to her best friend's kitchen table.
or a charming Inn in the woods...
when her soul needs soothing...

What she can and can't accomplish in a day...
a month...and a year...


Beatrice, the queen of email chain letter quizzes, has expanded into other mediums and has this quiz up on her blog , so I am doing the same!

… thoroughly enjoying lazing around my tent today but since I am on the computer it can also be said that I am doing work.
I WANT… to leave Sudan with my sanity intact
I HAVE … nothing to lose by living my life the way I dream
I KEEP … thinking today is Sunday instead of Saturday. I have no idea why.
I HATE … malicious people. Does that then make me malicious? Shit.
I FEAR … ending up a bitter, overweight, middle aged aid worker with no family and no life except work. Have run into several and I really don't want to be like that.
I HEAR … voices in my head. Just kidding. Sort of. ;)
I DON’T THINK … one of my programs is going to work unless our donor steps up and realizes that in Juba, peer educators are not going to work forever without getting paid. It's the biggest frustration that we are not allowed to give community based organizations and peer educators the support they need.
I REGRET … nothing. As Beatrice said, life is too damn short.
I LOVE … Simba
I AM NOT … the kind of person who can sit back and take things as they come. I need to be proactive about everything. Some people may say that I have "control issues," but why split hairs :)
I DANCE … every chance I get! Last night was a particularly good session - we had a party at our site. Tunes were good, crowd was good, drinks were good, and there was a huge storm so we danced outside in the rain. Fantastic.
I SING … for myself, not for others. Think of the Harry Chapin song with the lyrics "For music was his life, it was not his livelihood, and it made him feel so happy, and it made him feel so good, and he sang from his heart, and he sang from his soul; he did not know how well he sang, it just made him whole."
I NEVER …again want to go 7 months without seeing my family. That is too long for me.
I RARELY … watch movies nowadays. Don't know why, but the idea of sitting in bed, watching movies on my laptop is for some reason unappealing.
I CRY WHEN I WATCH … the movie Beaches. It's lame, but I don't care. When I was 12 or so I watched that move over and over again and cried every time. I also cry when I watch shows about weddings, like the one on TLC called "Wedding Story."
I AM NOT ALWAYS … sure of myself. Self doubt creeps in and takes ahold sometimes.
I HATE THAT … I am in Sudan and don't have my finger on the pulse of what is really going on with the US Presidential election and I feel like I have no control over any of it.
I’M CONFUSED ABOUT … how on earth people believe they have the right to determine how other people live their life - who they marry, whether to have children, etc. It completely baffles me. There is so much wrong with the world, why do you need to be so concerned with what other people do in the privacy of their own home that is not hurting you and does not really affect you in any way? Sigh.
I NEED … lots and lots of hugs on a regular basis. Really just any kind of physical human contact.
I SHOULD … treat myself more kindly and not beat myself up for not being perfect. Although I do come pretty damn close! j/k

Sunday, September 7, 2008

Welcome to Patience Samuel!

At about 5am on August 17th, my colleague Poni gave birth to her first child, named Patience Samuel. Isn't she cute??? I believe she was about a month premature, because she was very tiny (they did not weigh her at birth, but these pictures were taken when she was 14 days old so she couldn't have been more than 6lbs when she was born) and Poni was not that big when she delivered.

Both Poni and her baby are both health and happy, but unfortunately the delivery did not go entirely well.What Poni told me was that she went into labour at about 10pm on Saturday night, when she went to Juba Teaching Hospital accompanied by her sister. She was in a room in labour for about 7 hours, mostly unattended, when the hospital staff brought her into the delivery room. Then they told her it was her time, and they started the pushing process, and cut her vagina open to assist in the delivery. She had 6 stitches put in, one of which was still in when I went to visit her 2 weeks after the birth.

Now, I know next to nothing about pregnancy, childbirth, etc, but cutting someone open, when they are to deliver a tinier-than-average baby, after only 7 hours (isn't the average something like 8 hours?)? To begin with, I had never heard of women being cut open to begin with, but even so, that seems incredulous to me. Again, I wasn't there, but Poni said even the midwife who came to her house to look after her and take out her stiches said that they should not have cut her open like that.

What it looks like to me is that it was a Saturday night/Sunday morning, the hospital was not fully staffed, and the medical personnel just wanted to hurry things along instead of letting the birth happen naturally. Gotta love that Juba Teaching Hospital is the main referral hospital in the country and this is the kind of care that is rendered there.

Are there any reasons in the above scenario where cutting would have been justified? I know many of you readers have had children or are in the health care profession, so I would appreciate some feedback.


Saturday, September 6, 2008

Ode to the Blogs

Why do I spend so much time online? Simba can't quite figure this one out, to him the internet is used only to check email for work and to maybe spend 5 minutes every couple days on Facebook. But I definitely spend a good chunk of my day on the computer - during the day it's to do work, but in the evenings I also spend a couple hours in front of the screen. I have come to the conclusion that it is mostly because it makes me feel connected to friends and family that I can't actually see or keep in touch with in any meaningful manner. Because I live in Sudan, explaining what my life is like and what I'm thinking and feeling is very very difficult because there is no way I can accurately put words to my situation. I try on this blog with pictures and stories, and I try through skype and phone conversations with people, but I am often left with not much to say. People want to know where I live, what I eat, who I hang out with, how my job is going, and that's easy to communicate, but the larger issues of what I feel and how living here will (inevitably) change me (I'm sure it already has)? Now that is a challenge.

Through writing a blog, you get to read other people's blogs, and there are some out there that are pretty darn good - better at I am anyway in putting to words their experiences. Here are a few that I read, in no particular order:

Written by my dear friend Beatrice, who is living in Santiago, Chile with her Chilean Hubby and writes resturant reviews, comments about her life in Chile, and all things in between

The Wind in your Vagina:
This blog will stay one of my all-time favorites. Don't be scared off by the name. A self-identified "Daddy Blog", this GORGEOUS writing comes from a Dad who writes about raising kids, his past demons, with a health dose of existential ramblings (including *conversations* with his dead friends and comments about music thrown in. Oh, and also discussions about why people refuse to refer to parts of the human anatomy by their "official" names.

Diary of a Mad DC Cabbie
Helps me keep tabs on what is going on in my former home, Washignton, DC, (things both in and out of the news) as told by someone who knows his shit and is not afraid to speak his mind or call people out. Plus the stories about his cab fares are great.

Life's an Adventure:
In August 2006 my Mom and I had the privilege of attending a Women-only Writing and Rafting trip in Colorado, facilitated by writer Page Lambert. Page has a book called In Search of Kinship which is a beautiful account of her years raising her son and daughter on a ranch in Wyoming. Page captures life in the West of the United States with such color, warmth, and sereneness. I highly recommend reading it.

Attack of the Redneck Mommy:
Tanis, who writes from Canada, tells it like it is about most things in life: the death of one of her children, whatever is on her mind, and lots about boobs. I love this one.


Thursday, September 4, 2008

Lack of Coordination

Sometimes I just want to scream. There is a certain organization working here (let's call them Org A) who runs over a dozen VCT (Voluntary Counselling and Testing for HIV) sites. Keeping in mind that care and support services to people who are HIV+ are extremely limited currently in Southern Sudan, this area happens to have an ART center (anti-retroviral therapy - drugs which slow down HIV's effect on a person's immune system). However, there had been no paediatric HIV programs anywhere in the area, or so they thought. At an HIV Partners Meeting a couple weeks ago, another organization (let's call them Org B) stated in a presentation that they were running a PMTCT program (this stands for Prevention of Mother to Child Transmission of HIV) at the same facility (a private hospital) where Org A was providing VCT services. The true definition of a PMTCT program is one that tests pregnant woman for HIV (called ANC testing) as well as the administration of Nevirapine, the drug that when administered in a single dose to both mother and child, reduces the rate of HIV transmission by almost 50%. Up until this point, the common knowledge was that there was no one administering Nevirapine in Southern Sudan, so all the pregnant women who test positive for HIV had to be referred to Uganda.

So the representation from Org A was quite surprised to hear that Org B was claiming to be running a true PMTCT program, in the same site as one of their own programs nonetheless. So after some inquiries on the part of Org A, it turns out that Org B was indeed administering Nevirapine, about 9 doses per month. The problem is, Org A didn't know about this, the heads of the org running the private hospital didn't know about this, the ART center in the area didn't know about this, the County AIDS Department didn't know about this, and the Ministry of Health at the County, State and National level didn't know about this. NO ONE did.

Any explanation I can think of for why Org B was not making this known does not hold water. If they were afraid the demand would be greater than their supply, then they should be screaming at donors and the Ministry of Health for more supplies. Org A told me that they would be able to find money for the drugs, it's just that they have no personnel trained on its administration. If that was the case, they could have bought the drugs for Org B. Had they known.

So what has happened is that dozens of HIV+ women each month were being referred to Uganda (when not many of these women even have ID cards let alone a passport) when the life-saving service they need is available in their same county and has been FOR A WHOLE YEAR.


There is enough that is difficult about working in Southern Sudan, but there is no excuse for this lack of coordination and partnership, especially from an organization who is always present at partners meetings, etc. It makes me ill.