We will have our last clinic day tomorrow! It seems impossible in many ways that our time here is nearly finished. I was talking with Joey, my translator from Congo, he was sharing with me his experiences over the last few months, seeing teams come and go. When the first team had to leave, he was not prepared to say good-bye. He talked about how he wanted to "weep too much". He says he now knows that each time he meets someone new, that soon they will be leaving and he tries to remember that so it won't be so difficult. I hope that philosophy works for me tomorrow but I am certain I will weep too much.

Yesterday, we had a little accident on the way to Nakivale to the clinic. Apparently it was the day that many schools were resuming their session and the dirt road we travel was very busy. Many small cars that serve as taxis were on the road. They will cram 9-10 people in a Toyota Corolla!! A car like that came over on our side of the road hit the front of the Land Rover, then the back, which knocked us off the road. Peter, our driver, was very quick to recover and we were up on the road right away. Fortunately no one was injured, but the Toyota Corolla suffered serious injuries! These drivers are so careless. (not our Peter) So Ian and I were late for work!

I worked in the antenatal clinic with Loida, the midwife. Joey and I helped gather weights, BPs, and registered new patients. I also gave all the mamas their tetanus vaccine. There are so many mamas!!! Part of the antenatal program is to provide HIV testing for all the women so if they are positive they can be given the medications to help decrease the transmission of HIV to the baby. Unfortunately, yesterday a mother tested positive. Hakim, the nurse that does the testing, told me that each clinic (Monday & Friday) there has been at least one positive and sometimes 2-3) Sometimes the women will not return for follow up, which is so tragic because with the medication transmission to baby is very low.

Malaria is on the rise in Uganda. David Alula tells us that last year, in the months of June, July , and August, there was a 100% increase in the number of Malaria cases. Already this month the WHO is reporting a 65% increase. Money for testing kits which cost approximately $1.00 per kit, medications which cost $8.00 per treatment, and mosquito nets is needed. You can help by giving to Medical Teams International. Just visit their website: www.medicalteams.org. Okay that was my PSA!

This trip has been an amazing experience. I pray that I will use this time as God desires. Thank you to everyone for your prayer support, to my family for loving my kids while I am away, to my Ste. Genevieve OB buddies for their love and support, and to Jon for always letting me go where God leads me.

Mungu akubariki!

It is Sunday evening here, our day off from working. My time here is quickly passing, with only 3 more days of working in the clinic before starting the trek back home. I can hardly believe that one week from today I will be sitting in the comfort of my church, with my family! It is bittersweet, the time for leaving. I can hardly wait to see everyone but it is always difficult to leave behind new and some old friends. There is so much to be done here.

Speaking of new friends, our driver Peter, stoically informed us Saturday morning that he had received a phone call informing him that his wife had delivered a stillborn baby Friday night. He trusts in God, stating "it will be alright". He was unable to return to Lira, where his wife was because there was no replacement for him. Please pray for Peter and his wife Lydia.

I have struggled to write my feelings or experience adequately, or "creatively" enough to truly give to you this experience. It is really all I have wanted to do, to be a voice. A voice for the children, with chronic runny noses, rounded tummies, and dirty little bodies covered in thread bare clothing. To be a voice for the women who believe their worth is in childbearing, and after 10 babies, age well beyond their years....For the women who walk for miles with babies on their backs, to fill their gerry cans with clean water, only to carry that back on their head as well. I want to carry home the faith and spirit of hope of the MTI Uganda staff, as the work tirelessly everyday to care for people regardless of their tribe, language or religion.

Each day for the last several weeks, we have traveled the same bumpy, dusty road to the camp. Always, I am moved by the contrast before me. Tiny homes constructed of mud, sticks and tin dot the roadside, the background is incredible green hills, lush with banana trees. Uganda is truly a beautiful place. I watch the children, waving and shouting "Muzungu!" as we walk down the road. They giggle and ask "How are you?" (I think this is the only English many know) Always trusting enough to hold my hand. I can't help but think about the difference between the life of my grandaughter, Mia, and Zawa, the little girl with a dusty face and a smile that will melt your heart! Or Jibu, a little boy, wearing a month's worth of grime, a spark in his eyes, and a little swagger in his walk. He is absolutely adorable!

There are moments when all of this seems overwhelmingly sad, when it seems that nothing will change here. That the unfairness of the extreme poverty and constant threat of violence that many have lived with is never going to end. Just as these thoughts seep in, I see the excitement in David Alula (medical officer with MTI Uganda) as he talks about all the projects to improve child health, malaria prevention and treatment and clinic outreach for Medical Teams Intl. His enthusiasm is contagious and I find myself thinking about when I can come back!!

I have seen God working here, everyday. From truly live saving treatments to the hope given to a traumatized refugee by the kind touch of the staff, God is here. Much of the world may forget the incredibly difficult life these people face, but God is faithful. He has not forgotten them, He is just waiting for us to "pick up the towel". For me, He has allowed the hands of these children to grab hold of my heart. For this, I am greatly blessed. And I know I will not soon forget their precious faces.

Please pray for peace. Mungu akubariki!

It is Wednesday afternoon here, we just finished clinic, and came to town to try to email some pictures to MTI for a fundraiser they have coming up. No luck though.
We had the busiest day yet on Monday. I think we must have had over 300 patients, plus the antenatal clinic. We continue to see lots of children with malaria, babies with pneumonia and dehydration. This week it seems that there are so many newborns! Lots of women have their babies at home and then bring them to the clinic to be evaluated.

You cannot imagine the living conditions here, for the refugees. The tiny huts they make out of sticks, mud and the plastic tarp they are given from UNHCR looks to be about 5' x 4'. It is so tiny, with a dirt floor. The whole family stays in this tiny space. Often times, the crops they are trying to grow for food are right around the hut. This makes for a good environment for snakes. A Black Mamba crawled in the hut of one family and bit the 3 year old daughter on the arm. (this was in late February) This snake is extremely poisonous, people were amazed the little girl was still living when the parents brought her the MTI's clinic 8 hours later. She ended up being transferred to Kampala Hospital for surgery. They managed to save her arm, did some grafting, and now she has contractures, but can hopefully be surgically corrected. She came to the clinic this week for follow up. She looks great all things considered.

Each day, I am so touched by the patience of the people. We arrive to see a large crowd of people lined up at the entrance to our makeshift clinic. Women with babies on their backs, toddlers at their legs, wait patiently to describe what is wrong and hope that we have the answer to their problem. Some will wait for 6 hours or more, in the hot sun, never complaining. The children play in the dusty area around the clinic, with each other, because they have no toys. Yet you can here them laughing. Yesterday, I heard a sweet voice singing a song, Hallelujah, hallelujah, this little girl was singing. The smile on a face just because you greet them with a handshake and "Jambo", warms my heart. I wish you could see what I see, it really is amazing.

Mungu akubariki
Lisa

We have just finished week 2 in the camp. It has been fairly busy, seeing about 1,000 patients each week. We continue to see children with malaria, pneumonia, lots of diarrhea and dehydration, and many wounds. Wound care is an important part of the work we are doing here, due to poor sanitation and hygiene. Some patients walk each day for several miles to have their wound cleaned and dressed. Today, a little girl had smashed her middle finger of her left hand in the water pump at the well, getting water. Her injury was horrific, basically removing the skin and tissue down to the bone. We cleaned it up, gave her pain medication and sent her to Mbararra for further evaluation. I felt so bad for her, I know she was in so much pain.

Yesterday, I was talking with Micah, the new "clinical officer" for this project. ( similar to physician assistant in training). He is such a pleasant young man. I discovered that he is 23 years old and has been out of his training program for 7 months. I was asking him about his future plans for marriage and such. He told me that marriage would be difficult for him now, as he has 3 younger siblings. His mother died several years ago of AIDS and he is now responsible for the 3 younger children. He supports them financially so they may attend school. You would never know when interacting with Micah that he faces such hardship. He does so with grace.

Davis, a Ugandan nurse with MTI, will be providing community health in the refugee camp. He also is a fine young man, always smiling, pleasant, and so bright. He told me today about his belief that God is always faithful. He left his village when he was a young man, with a small suitcase, to go to the University in Kampala, many hours away. His family discouraged him, knowing he did not have enough money. He continued telling them that God would be faithful to him. He went to the University, managed to get free room and board from a professor, after telling the teacher about his faith. He tells of how each time he needed money for books or fees, it came through with support from many different people. He has such a heart for people. Davis's faith and perserverance is inspiring.

Since it is Saturday, when we finished with the patients, we walked from the clinic to the little church the Adventists have built in the camp. (I mentioned it before) Once again, we were welcomed with opened arms, beautiful singing and drums! This time it was Calla and Kathy's turn to address the people. They had two groups sing songs for us. I am always amazed at their ability to harmonize so beautifully, of course I find it amazing that others can carry a tune! (I can't) Once again, I was able to experience worship "unplugged". No lights, audio equipment, fancy windows, or special clothes, just praise for God. It was beautiful.

Please pray for the people of Uganda, and all the refugees struggling to exist here in Nakivale camp.
Mungu akubariki!
Lisa

It is now Wednescay evening as I write, we have just finished clinic and asked to be dropped off at the internet center. Our team is now 4, with Cathy and Calla Holmgren joining us on Monday evening. Poor Dr. Ian is surrounded by women, 2 of which work OB, Calla is an OB/GYN in Utah. We inconsiderately were talking of labors, and breastfeeding a large part of the time on the drive to the camp today. He is a pretty good sport though!
THe clinic has been busier the last few days, with seemingly more acute illnesses as well. I cared for 2 babies very sick with malaria yesterday and the mama tested positive also. Calla and I started the day off with a man with an incredible ulcer on his foot. We are hoping it is only related to an old burn from 2007, and not cancer. He went through a painful cleaning of the wound and then was referred and taken by our ambulance to the clinic in Nakivale for further treatment and evaluation.
At the end of the day, right as we were packing up, a bicycle brought a man to us. He was having an acute asthma attack, unable to breath. Quickly given steroids and aminophyline, he recovered. Upon feeling relief, he began dancing and praising God. Today he returned all smiles. Again, it is by the grace of God that MTI has been allowed to work here.
One of the refugees, working as a security guard for the clinic told us that in the last few days there has been more fighting in D.R. Congo. A village was looted and burned by the Mai Mai rebels. We are anticipating more refugees will be arriving to the Nakivale camp due to this outbreak. The Nakivale resettlement area was established by the UN in the 1950s. There are refugees from Ethiopia, Sudan, Kenya, Eritea, Somalia, Congo, Rwanda, & Burundi. Just recently, the first group of refugees from Rwanda were transported back to their country to be repatriated. Many Rwandans do not want to return, as they fear they will be treated badly and have nothing to return to. Basically they will go from being a refugee to an internally displaced person (IDP).
I cannot describe adaquetly to you the incredibly sweet spirit of the Ugandan people we are working with. They are so patient with us, eager to work and serve, and do everything with a love for people and each other. I love watching them interact with one another. They often hold hands with each other, as friends, regardless of gender. What if we held hands a little more?
Tomorrow will be the first time in 19 years I have not celebrated my son's birthday with him. Happy birthday Ross! You know I am thinking about you!
Mungu akubariki!

Today we only worked a half day because it is Saturday. The clinic was fairly light so we were able to walk about the area and interact with the children. They love to have their picture taken and look at it on the screen on my camera. That sight would make a great picture, their smiling faces, giggles as they see themselves!

As I was walking a short distance from the clinic, I could hear this beautiful singing, and drums playing. I came upon a mud "building" with a tarp roof, the Adventist church built by refugees, in the camp. Inside this tiny space, there must have been at least 50 people singing and dancing, praising God. I am always humbled by the African spirit, their faith. It is truly inspiring. Immediately, a young man who could speak English, welcomed me. "Please come in and hear the word of God, I will translate for you", he offered. You rarely meet a stranger here. I slipped in the side door, to be discreet, but there was nothing to do about my glowing white skin! Ian joined me and soon we were clapping along with them. After the song, prayers followed, with all the women kneeling on the ground before us, babies on their backs. I cannot describe to you, accurately, the scene before me or the feelings it stirred. I found myself praying for the people before me, and that I would not soon forget them upon returning to the comfort of my American life. I prayed that I will be the hands and feet of Christ, an ambassador for them at home. And I thanked God for that moment in my life.

Tomorrow is Mother's Day. I will miss my mom and miss sharing the day with her, Bethany and my sisters. I am blessed to have such wonderful women in my life! Happy Mother's Day to all "mamas" everywhere. Mungu akubariki!

The past several days have been busy days. Today, the antenatal clinic was held, in addition to, the regular clinic. So many mamas and babies! I actually had a mother offer me her beautiful, cheerful, 4 month old! According to my translator, "she has many children, she thinks you should take this child to America". Of course, I was tempted, but checking a baby through Customs upon re-entry in the U.S. is unlikely. What a precious girl!

Yesterday, I met a woman that was at the clinic with complaint of chest pain, heart pounding, and headache. After talking with her a bit, we discovered she has been "seeing images that make my heart pound, then my head". She came to the refugee camp from Rwanda 3 years ago, where in the genocide, she lost 7 members of her family. She stated that when she feels this, "I have no hope of living", head hanging low. We prayed together, for resolution of her past, and hope in Christ for her future. (medicine for sleep too!) My heart aches for her.

Everyone has a story. I am constantly amazed at the strength and resilience of the African people. Peter, our driver to the clinic each day, told me this morning that he and his family lived in an IDP camp in northern Uganda from 2003 thru 2006 due to the conflict with the rebel Lord's Resistance Army. He is currently trying to get his land back. When the refugees or IDPs are away due to the fighting, they often return to find they have lost their homes and land to someone. They start over.

We are running out of some staple drugs. Please pray that the much needed medications will arrive very soon. It is very difficult to tell someone that has waited for hours to be seen that we don't have what they need!

On a lighter note....this is the one month each year that these huge green grasshoppers come to Mbarrara. The local people gather in the lot next to our team house and pick up grasshoppers every morning, and snatch them from the air near a light every evening. Meanwhile, Ian and I are killing dozens in the house. They have invaded our space! We must be a sight, swatting bugs left and right each evening. Normally I would catch and release, but these things are everywhere!!! The Ugandans fry them up and eat them. I've never been that hungry.

Anyway, I feel very blessed to be here. Thanks to all for the prayers. Until next time!
Mungu akubariki!!!

Jambo! Bonjour! Hello!

What a mixture of languages we are hearing! We arrived safely to the MTI team house on Saturday night in Mbarara town. There we are well cared for by Opio and Sheila, who cook for us. It is like a Walk to Emmaeus, their service is very Christ like. I am teamed up with a wonderful physician from D.C., Ian Shenk. He is an MTI veteran, so I am great company.

We travel each day about 1 hour to the Nakivale resettlement area, where the refugees are living. Upon our arrival the "clinic", we are greeted by the sweet faces of women, babies on their backs, children, and men of all ages, patiently waiting to be seen. I am working with a translator, Joey, a young Congolese man. He was a teacher in North Kivu, DRC, before fleeing due to the war in his area. Now he makes $2.00 as a translator, for this Muzungu woman, who often realizes that a medication is not going to heal the trauma the patient before has experienced.

Today, a woman sat before me, with a history of asthma. She reported feeling as if her heart was "pounding", and had difficulty sleeping at night. Upon further conversation, she told us that her husband had been killed in the fighting in Congo. She was 8 months pregnant when she crossed the border into Uganda, and became a refugee. She became ill during the journey with vomiting, and diarrhea, and she delivered a stillborn baby. I wanted to wrap my arms around her, but prayed instead that God will wrap her in comfort and grace. Please pray for Rebeka.

There is a Save the Children "school" behind the area where we are working. The laughter of the children soothes my heart as I fumble at times to say the right thing, or provide an answer to the patient before me. The children are amazing little souls, so resilient and happy! Domeson, the teacher, fled the Congo where he was a teacher in December. Now, he teaches the refugee children in a makeshift school. I am impressed that an education is being provided.

Yesterday, we sent a young woman, first pregnancy, to the referral hospital in Nakivale for a cesarean section. She had been laboring for 3 days. Upon exam her pelvis appeared to be too small to deliver the baby. However, using the doppler that MTI had sent with me, I was able to get fetal heart tones! We were told today, that the Nakivale hospital did not do a cesarean, and the baby died.

We have seen many sick babies, lots of pneumonia, some malaria, and always diarrhea. Moses the IV master, can get an IV in almost anyone! He is a Ugandan nurse working with MTI and he is amazing! I cannot imagine what would be happening here if not by the grace of God, that MTI has been allowed to work here.

Mungu akubariki!