Tag Archives: missionary nursing

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I am in Uganda, at a mission which 220 orphaned children call home, and host to a fairly new hospital where I have been working. As you will note, I am still seeking God's will for my future, and am developing relationships that will always matter to me in one way or another. These are my journal notes for the past week. My apologies for the delay in posting. I had technical difficulties. The WiFi here is fairly unpredictable.

My Karuma trekking team: Freda, Janet, Shalom, Winnie, Prisca, and Jess "Cool Mom." Eunice joined us after this picture was taken.

Saturday 15/5

Today I walked with a bunch of girls a little over 3 miles (5 kilometers) to the nearby town of Karuma. To call it a town is actually a stretch, but there is a congregation of people gathered for commerce and there is an intersection of two roads, so we call it a town, though it is more like a "village." There are wall-to-wall shops and open-air market vendors, butcher kiosks, and street peddlers. We toured around a little, bought a few things, and, when it was time to head home, found our friend, Robert, who had come in a van to take us back to the campus. Just going along helped me develop relationships with these few ladies, but practicing my Acholi along the way built me some street credit with those we passed.

It was “visitation day," a day when a very few are visited by whatever family member(s) care(s) enough to make the trip, and everybody else just feels left out for a while. I heard the girls talking about how, growing up, they always hated visitation day and cried for weeks, while the favored children ate their special treats and wore their new clothes. Sitting on the floor of the back of the van with several  of these girls, I announced I was there to visit all of them. Their smiles and laughter were priceless.

Librarian and missionary Jess "Cool Mom" Washburn, on her 37th birthday.

When we got back, we were all horribly hot. I returned to Team House and started journaling. Janet, who has been on the Karuma trip, came over and chatted with me at the dining table for a while. She poured out a story about her family that made both of us cry. Without going into much detail, I will say that her story made me think my law enforcement background, nursing foreground, and ministerial heart might be the perfect formula to start a battered women’s shelter. It is a very real need, though it would not be popular with the traditionalists in the area who think women are the property of men, regardless of how they are treated.

After Janet left and I got last weeks’ blog posted, I attended a birthday party for Jessica “Cool Mom” Washburn. She shared her party with everyone else born in May because she is, after all, “Cool Mom.” We watched football (soccer), danced, laughed, and ate chicken, chips (fries), cake, and soda, all of which are real treats. I can’t remember having this much fun at a birthday party. Happy birthday, Jess!

Sunday 16/5

Pastor Gitta Francis brining the Word

Pastor Gitta was on fire preaching this morning. So much so, that two congregants approached him while he preached to add an additional offering. It was kind of a joke, but we all knew he was preaching truth. He was talking about how so many professors of Christ want to claim the blessings of His companionship but fail to accept the discipline of obedience that goes with it, accepting Christ as Savior, but not as Lord. I am happy to hear the mission congregants are receiving this word, since it often gets left out, even in America. Christ’s lordship is how discipline toward sanctification begins.

After a brief nap, I went to the house of my two sponsored children. I had been trying to make plans to take lunch with them since I arrived, but the timing never worked out. Vivian is a busy teenager and school starts tomorrow. Daniel is eleven, so he hasn’t a care in the world. Still, his school starts tomorrow too, so I took the opportunity to share a meal with the house. All the other kids were painfully quiet, shyly giggling and turning away when I spoke to them. Auntie Lydia, the house mom, made a feast of chicken, rice, black beans, and greens. It was delicious! Ugandans have a custom that a young person kneels when introduced to an elder. It is a demonstration of respect, but it does make one uncomfortable who is not used to it. I have remedied this by taking the hand of the youth, lifting them up, and hugging them. This I did a few times at Auntie Lydia’s house. 

I was invited as guest of honor for the closing ceremony of the kids' football tournament. As such, I said a few inspirational words, then presented each of the awards of excellence. I was especially proud that my sponsored child, Daniel, received recognition as “the most disciplined player.” This event closes a football season and marks the end of the kids’ school break, so just about everyone was there. They each received a drink, the younger a fruit juice cup and the older a soda, and they all had a great time. 

During the final match, I was approached by my friend Maryanne, the wife of Dr. Colby Cessnun, who invited me to dinner at the restaurant at the nearby village of Karuma. She even extended an invitation to join her family of eleven for their in-home, Sunday night church service, which I was privileged to attend. 

Dinner out with other missionaries, fellow Americans from Texas, was enjoyable and informative. We shared ideas and concerns well into the night, and the hotel and restaurant staff were very accommodating. 

Monday 17/5

Jess says it takes some time for the stomach to adjust to African food, but each time she visits, the adjustment period gets shorter. So far, my system still has not settled down, and today, I felt it more than usual. I had a light breakfast and skipped lunch to come home and nap. 

Before my nap, though, I re-heated the dinner that was prepared for me and took it to my nursing colleagues, Patrick and Patrishia, at the hospital. They were thrilled to get such a treat and I was happy food wasn’t spoiling in the non-working fridge.

Janet presents her beadwork

After my nap, Jess came over for dinner and Janet walked in as we were finishing up. Janet had bead crafts to sell and I took her entire stock to bring home and sell for her. She was thrilled, and is now funded for a trip to her summer job, where she can hopefully make some of the school-supply money she will need when she starts nursing school.

In a quiet moment after all was settled, Janet asked me, “Why do you love me so much?” I don’t know if this young lady has felt loved much before except by a few here at the mission, so it was a real touching victory to hear that she knew she was loved without my saying so. 

Tuesday 18/5

My stomach feels much better after the rest I got yesterday, but I’m still not at a hundred percent.

I worked with Mirriam and Samuel in the morning. We received an elderly patient transfer from another clinic, who was not responding to malaria treatment and who had developed shortness of breath. After being on our ward only about two hours, she went into respiratory arrest and then cardiac failure. Dr. Cessnun and I performed CPR for about twelve minutes, but with no return of spontaneous circulation. She died at 10:30 AM. 

It was a very busy morning with new arrivals, the death, and treatments that demanded the attention of all three of us. Janet had to work her regular job but somehow managed to arrive earlier than usual on such days, claiming that, because she has only a few days left before she leaves for the summer, she wanted to spend as much time with me as possible.

There was a big staff meeting at 3 PM that all were asked to attend, on duty or not. Given some of the announcements and rumors floating around, many had feared bad news, but there was none. It turned out to be a 2-hour in-service training on blood transfusions. 

While I waited for it, though, I was asked to present the staff devotion on Thursdays as long as I am here. I love bringing the Word, so I jumped at it. I did not want to appear reluctant like I did on my first day.

Jess brought friends, Janet and Sharon to dinner. Finally! No leftovers!

Sharon proved to be quite the bat hunter and disposed of one of the flying critters from out of my dining area. Before you go thinking long, black, leathery vampire, let me redirect your thoughts to a furry, white mouse with wings.

Sister Sophie, the Primary Nursing Officer at the mission hospital, leads us in worship each day at staff devotions

Wednesday 19/5

The day started with strange news at the mission hospital. The clinical directorship was reassigned from Dr. Colby Cessnun to Dr. Otim Robert. There was a lot of shock and disbelief throughout the ranks as Dr. Robert asked for everyone’s support, though he, himself, was recruited in 2000 to this hospital by Dr. Cessnun, who is credited as pioneering the clinic here. It would have been easy to feel numb after such an administrative decision, but Dr. Colby took it in stride, and continued on clinical rounds with a smile and his usual clinical competence.  I was riding the wave of Colby’s disappointment, but his countenance is so high, it is easy to set aside the ill feelings and get on with whatever is necessary. His attitude is amazing!

Thursday 20/5

I led the staff devotion this morning, and didn’t get much sleep, thinking about what I would say. My assigned topic was the immanence of God as articulated in Isaiah 57:15. The British spelling of that word made me wonder if I was to speak of God’s eminence or His immanence, so I talked about both, and how His compassion drove Him to leave the high and royal Heavenly throne to reestablish unity with His fallen creation. I prayed for God’s Spirit to teach me what to say, then wrote a bunch of notes on my phone. During the talk, half my notes were missing from my phone, forcing me to rely only of what God called to my mind. Afterward, the missing notes mysteriously reappeared on my phone. Wild! 

Mirriam, my friend who is honest with me enough to tell me if I use “lazy speech” (American slang with undisciplined annunciation), said I used none and was absolutely clear. Sister Sophie, the Primary Nursing Officer (PNO), closed the meeting by saying, “I couldn’t possibly add anything to that.” I took that as a high compliment.

The day was long and slow on the General Ward, and even more so in Maternity, where they only had two patients. I did what I could, and tried to stay near the fan, because it seemed very hot today, though the Weather App only said 87 degrees. I think it has more to do with how much sun is shining. Overcast days are infinitely cooler, but this “wet season” has been remarkably sunny.

Nurse Patrick (in green) defends against a teaching staff player (in red).

About 3 PM I was in the Lab, and Isaac, the lab tech, told me he was just about to search me out, and declared, “We have a serious problem.” While I thought perhaps I had made a clinical mistake with the lab samples, Isaac showed me his football (soccer) roster and explained the Hospital Staff Men’s team was a man short, and he needed me to fill the spot for “back-up goalkeeper.” I guessed this must be an honorary position since they were asking me, a fat, old Mzungu (white person), to fill it, so I let him put me on the roster of the roster for the Hospital Staff vs. Teaching Staff game this afternoon.

As word spread of my inclusion on the roster, I recognized this was no small thing. Many who addressed me acted as if I would actually play. I got nervous! I went back to my quarters, changed into the only shorts I brought, and applied enough sunscreen to make it through whatever happened. Hallelujah, our first string goalkeeper stayed healthy the whole game, and we won 2:1, with me safely in the sidelines!

At dinner, Jess reconfirmed, “For them to ask you this shows again how accepted you are. They wouldn’t do that for just anyone!” They do take their football seriously around here, and both teams were seriously skilled. It was an honor to be their mascot for the day.

Friday 21/5

Yesterday, a 27-year-old woman arrived with nothing more than a productive cough. This morning, she was attached to every monitor on the ward to piece together enough working components to suffice. When I asked why, I was told her condition worsened overnight, but that was all. I figured I would hear more about it at rounds. While we started rounding at the other end of the ward, we only got through about three patients when the family members of this one woman began to wail, and my friend, Nurse Patrishia began to collect the monitoring devices from off the newly deceased patient. I responded to help with another “last office” (preparation of the deceased). That’s five in my three weeks here. But since this ward serves as ER, Medical-surgical, progressive, and ICU all in one, I guess that’s pretty good.

Later in the day, the nurses told me I was the first visiting missionary to spend time with them or take lunch with them, and that none had ever tried to learn the language. I was shocked but also wondered what else one would do. I feel like the language barrier is keeping me from expressing the love I came to share. Before the day was through, the new clinical director, Dr. Robert, announced to the ward, in jest, that he was canceling my return trip to the U.S. so I could stay here and keep helping. It was a funny joke, but served to affirm that my presence here is appreciated. The others present, Nurses Mirriam and Patrishia, Dr. Judith, and Clinical Officer Jennifer, all echoed this wish that I would stay. That was a good feeling, but I can’t let an ego boost confuse my search for God’s will for me. 

At 5:00, Janet and I walked back to the Team House where she made us toast while we listened to worship music. She is leaving Monday, so she said she is spending as much time with me as she can. 

After dinner with Jess and Janet, I got a visit from Shalom, another of the adult students. She is smart and talented, but has some decisions to make, and is scared to make them. We prayed together and talked about how God has given me directions at times. She knew about Gideon’s fleece (Judges 6), so I told her to pray specifically, and the right doors would open like a wet fleece on the ground.

Imagine every high school Junior or Senior you’ve ever known, or think back to when you were trying to make the decisions that would shape your life. Now complicate that predicament with shattered families, no parents, poverty on a scale you can’t even imagine, and a culture that still believes a woman’s place is in the home, and you might begin to get a glimpse of what goes on in the minds of these young women. Worse yet, polygamy is common and so is domestic violence. Even if a girl hasn’t experienced these things yet, it weighs on her mind as a possibility for her future, because of what many witness in their dysfunctional exposure to what limited family they do have.

I may not be evangelizing on the street corners or winning souls in the hospital ward (yet), but my dinner table has born witness to some tearful exchanges. “Uncle Todd” is gaining the favor of the men and women I serve here, even if I don’t know what is next. Today marks the half-way point in my visit. I have been here three of six weeks. On one hand the time has flown by, and on the other I feel like I have loved these people a lifetime already. How will I ever pull myself away in just three more weeks?

My view from outside the Team House patio

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Typical Ugandan kitchen (Not mine. I'm cooking with gas!)

It is hard to believe I have already been here in Uganda two weeks. The mission at which I am staying has a new place in my heart and I am learning to love so many people here and make my way among them.

Saturday, I spent the whole day indoors, sleeping late, lounging, writing, and watching a movie provided by my friend, Jessica. It rained all day, so most people stayed in. It was a welcome Sabbath of rest. I did manage to post last week’s update on this day, but to do so, I had to visit the WiFi hotspot at a neighboring house, and braved the rain to get there.

Sunday, church services were indoors due to the rain, and the sound of worshipping voices echoing in the concrete gymnasium was deafening. God is good, and the people here generally like to celebrate it.

After church, I went to the boys’ dorm for lunch. K-Morris and Hosman hung out with me and made me very welcome, while we ate beans and posho (moistened white corn flour). Then, Hosman escorted me down the steep, muddy ravine to visit the bank of the Nile River. There is about a 30-foot drop separating the main part of the mission's property from the Nile and the monsters that live beneath its surface. It is that slippery surface I climbed and slid down just to visit the river’s edge. I am told that, at night, one can hear hippos grunting from Team House, where I am staying but, so far, I have not heard them. As recently as a year ago, a boater taking a woman back across the river from the hospital inadvertently came between a hippo cow and her calf and was attacked and killed. This steep climb back was difficult but, since it serves as a barrier between trouble and the residents of the mission, it is welcome. Still, this old guy wore himself out climbing up the slippery slope. 

At the Nile with Hosman

I found a bunch of little kids playing around the Library, and I joined them in a round-about dancing game. They squealed with laughter when “Uncle” shook his booty when his turn came around. After that, they had me play “Hippo,” a game where everyone runs downfield on the football (soccer) pitch to get away from the charging hippo (me, or three other older kids who didn’t give out so quickly).

Janet and K-Morris visited late into the night. Janet told the story of how she came to be at this mission. She said she was only two, but old enough to remember when the LRA came and killed her parents. As she hid in the bush with her Aunt, she remembers talking too much and having to be muffled for the lives of everyone with her. She is an amazing young woman but, like so many here, is starving for genuine love. 

Monday, Janet floated in the hospital, but stayed with me most of the time while I worked mostly on the General Ward (GW). We got a new patient, a teen boy critically ill with malaria. The ward is filling back up, but there were no new babies on the Maternity Ward. The one in the NICU on the warmer needed a new IV cannula, and the girls asked me to try, so I did, but without success. I was partially vindicated, though, because no one else could do it either. Still, it was the first time anybody ever trusted me to poke a hole in a baby. It was a momentous occasion for a guy who spends all night sticking only grown-ups at home. 

Janet

Walking the property, I met up with Pastor Gitta, our very energetic preacher. While we were chatting, we were approached by my friend, Jessica, who invited us into the residence she shares with the children’s spiritual director, Eunice. We were offered sliced bread, a real treat around here. (Not fresh from the oven bread, but recently from the store bread.)

Tuesday was the day of the week I would skip if I could go back over it. Had it not been for the way it concluded, it would have been a terrible, horrible, no good, very bad day. First, the teen boy with malaria was diagnosed with meningitis, which means the inflammation has effected the tissues surrounding his brain and/or spinal cord. 

While that was going on, I watched another teen boy die of the same thing in a bed near that one. As his breaths slowed from 30 per minute to 4, I tried to make him as comfortable and dignified as I could. There are very few things I can do to minister grace to a people who do not speak my language, but one of them is to show that I care. Every time I visited this young man, I put my hand on his shoulder or chest and called him “little brother.” He may not have heard me, but his family did, and they at least know those words of English. One thing more they know — that I cared enough to attend him at his death and prepare him for removal with dignity and respect for him and his whole family. I made that clear with as many non-verbal gestures and what little Acholi I know. 

A few new patients arrived, and it was busy day. As I finally got to take my lunch with Nurses Mirriam and Patrishia well after the 2 o’clock shift change, Evening Nurse Patrick informed us that the malnourished baby admitted on the 4th had also succumbed to his advanced condition. I stayed and performed “last office” (preparing the body for transportation) with Patrick. In Uganda, before you can leave the hospital, you have to pay your bill. With a deceased patient it is no different. Before the body can be claimed, the family must pay the bill. This family had no money to feed their baby, but their community came together and helped them pay their final hospital bill so he could be buried with the family. On one hand, I am moved at the unity of neighbors, but on the other, I wonder where those neighbors were when there was no posho for the child when he first went hungry. 

I skipped prayer meeting and, instead, prayed and quietly sang “The Lord’s Prayer,” walking home with my friend, Janet, as we both were emotionally beaten by the events of the day. I invited Janet to dinner, and she offered to share her favorite movie with Jess and me.

We watched Overcomer. It’s about a fatherless black girl who dreams of a loving relationship with a father. Imagine watching this movie with a 20-year-old African girl who, at age two, watched her parents being brutally killed. She told me this is her favorite movie, and that she has seen it six times. Is your heart broken yet? Because mine has been ever since. If I spent all the time, money, and trouble to come here for nothing else but Janet, it would be worth it! The reality is that there are 220 kids here at the mission, each with an equally touching back-story. I only have permission to share this one.

At 8:00 PM, we stopped the movie and prayed for Cindy, who would be starting her job interview in Jacksonville (at 1:00 PM EDT). Shortly after the movie ended, Cindy reported that she got the job and will start in late June. 

Wednesday, though I am not staff, I was invited to audit the hospital department-head staff meeting. The struggle to do what must be done with the limited resources at hand must be universal, because it sounded just like the troubles we have back home, only amplified exponentially due to the poverty that effects all Uganda. 

Fred, X-ray tech, and refugee from DRC

On the General Ward, we discharged an elderly male stroke survivor for palliation at home. It was sad, but he represents another family I can trust felt my respect and love. One family member actually bowed to me before he left. At rounds first thing this morning, the man was propped up by his son, who had sat behind him on the hospital bed, his legs around his father, as if he was holding him in his lap. It was a beautiful picture of role reversal, as the son cared for the father.

I was horrified to recognize that today is the 12th, and that I had missed the birthday of one of the children Cindy and I sponsor, so I went to the canteen as I left work, and delivered some treats that are favored around here as a late concession. She was gracious and quickly forgave me, then accompanied me to prayer meeting, where we worshipped together. 

When I got back to Team House, I found my quarters spotless, my laundry washed, and my shoes gleaming. Michael and Robina, the Hospitality Team, had swooped in while I was at the hospital and made everything fresh and nice. 

Thursday, I discovered there must be some kind of cobbler elf around here, because when I leave dishes in the strainer overnight, they magically put themselves away by the time the sun comes up. The cobbler elf’s name is Judith and, in between managing the restaurant at the hospital, she makes my dinner each night and always takes great care of me. 

Just about the time I was ready to go home early because of boredom at the hospital, up came an elective Cesarean section! Dr. Robert invited me to watch, so I did. What an amazing procedure, and what a privilege to be present for the delivery of a baby not my own family! Two firsts in one for me. It was a big day. After the delivery, Dr. Robert said that, if I stay long enough, he will have me assisting him in surgery. What a treat that would be!

Janet arrived after her real job to shadow in the hospital at 2:00 PM. Things were so slow, we folded gauze sponges. Yes, fellow nurses, we folded our own gauze sponges! This is how you do things in a country not so rich that sterile sponges come pre-packaged. We folded hundreds of them to be sterilized in an autoclave later. 

I worshipped at the prayer meeting with my sponsored child, Vivian, again. Pastor Gitta made an interesting analogy of Elisha’s axe head to our sin. When the man told Elisha he had lost the borrowed axe head, Elisha asked where it was dropped in the water before making it float to the surface. Similarly, we should be specific about our confessions of sin. When we get off track in our righteousness, it is helpful to point back to exactly where we got off track, where we dropped our axe heads, so to speak. He taught that repentance should come with some amends to it. It does no good to ask God to forgive you for moving your neighbor’s boundary stone if you don’t go back and replace it. That spoke to me. 

The kids are trying to teach me about football (soccer) and are hounding me to pick a Premier League team to support. Winning records apparently do not matter as much as location, colors, and league affiliation, so I’m open for suggestions. 

I was met on the road by one of the adult girls, Shalom, who asked me to accompany her on a walk to the basketball court (a popular meeting place). Jess joined us and several of us went to Team House. I made lemonade for my visitors. (Note to self: Crystal Light lemonade is extremely popular here.) When our dinner arrived, we tried to share it with all those present. As the girls left, K-Morris paid me a visit. He would be leaving the next day for a visit to his home village before school starts. 

Everyone is abuzz about Jess’ birthday party Saturday night. The kids all call her “Cool Mom,” and she likes to live up to the nickname. She has ordered chicken and chips (fries), cake, and soda for her special circle of friends. I am invited, so I feel special too. 

Friday, was so slow at the hospital, Janet and I spent much of the time folding more gauze sponges for placement in the autoclave this afternoon. During a break, she walked me to the place overlooking the Nile behind the hospital. We stood and watched the river roar by, the monkeys swinging in the trees, and some very musical and colorful birds dancing in the sky. It was a beautiful day. While I did not feel like I was engaged in ministry in a very articulable way today, I spent a lot of time building relationships with the other hospital staff. I am learning more Acholi words, and I use them whenever I can. The girls tease me and threaten to stop speaking English since I don’t need it anymore. The clinical officer and doctors giggle when they hear me speak Acholi. When I inquire whether my pronunciation is bad, they say, “No, we just like that you are learning so fast.” Apparently most visitors to the mission do not learn the language, eat the local food, or spend time getting to know the people on a personal level.

I heard nurses talk about how underpaid, understaffed, under-resourced, and under appreciated they are, just like in the United States. The difference is that American nurses can still feed their families on the 16th of the month and Ugandan nurses often cannot because the resources of their pay are depleted by halfway through the month. These nurses never quit serving though, and I am impressed at all they can do with the little they have. 

Even after hearing how impoverished Ugandans are, and how strapped for funds nurses are, I was astonished and honored that one of my favorites told me the nurses are planning a party for me before I return home. Only two weeks into my trip, I have made myself an accepted part of the crew. I asked around, and found that they do not do this for every visitor, and that I should certainly be honored. I’m humbled that those with so little would choose to share what they have to celebrate me being among them. 

Sunrise over the Nile, the view from the patio of Team House

I visited Judith in the Hospital Restaurant, and she treated me with samples of “crunchy daddies” which are miniature snack versions of mendazi, a favorite breakfast pastry around here. She asked me several questions about what I do and do not like. I informed her that g-nut paste and bananas is my favorite Ugandan treat. She has a fun way of making my wishes for Ugandan dishes come true when I mention them. Outside, I learned how to make posho, an African staple. It’s about as difficult as making grits except the corn is ground more finely.

After work, Nurse Patrick honored me by showing me his garden, with which he feeds his family. He drove me on a motorcycle he had borrowed to what was really a small farm, on which he had planted maize (corn), g-nuts (slightly similar to peanuts), beans, okra, and eggplant, with a few experimental plants thrown in. It was amazing to see all that was growing because he had worked hard, and this in between his hospital shifts and caring for his two small boys. 

I walked with Jess in the hour before dinner, and we discussed our view of missions in general and how to be more relevant to the kids. We both struggle with finding God’s role for us in ministry and carrying it out. 

When I returned to Team House, there on the table were sweet bananas (the kind you are used to, not the green cooking ones) and g-nut paste. That sweet Judith must love me!

But maber! (Good night)

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Week One

I regret to report that Internet access is not very reliable and is a hot commodity. I had hoped to post more frequently, but this will have to do. Thank you for understanding the reason for the long post. It is seven days in a single post. More pictures may just have to wait. They require just too much data. Check my Instagram for a few others (Nommelt).

Saturday, my trip got off to a strange start. The loneliness of traveling by myself was compounded when I arrived at the airport and found no one to greet me. Once my Ugandan telephone SIM card was activated, I sat for awhile in the courtyard of the airport, sending messages to everyone I knew at the mission I am visiting. Finally, though it was 4:00 AM her time, Cindy finally found the number of a local one of the mission drivers. I called him and he promised to arrive in an hour. 

This is the Team House, where I am staying.

Jeremiah is a skilled driver, as one has to be to navigate the busy streets of the capital city, Kampala. Traffic laws are just a suggestion, and traffic lights, which are fairly new to Uganda, are almost completely ignored. Motorcycle taxis, called “boda-bodas” sweep every which way, in and out of traffic wherever they fit. I knew I was in Uganda when I saw a cow standing on a raised median inside the busiest intersection through which we had to go. Jeremiah was gracious and told me to make myself at home, so I slept through most of the trip, waking briefly to see that we stopped at police checkpoints at which it was likely a good thing I was lying out of sight. Though he picked me up at 11 AM, Jeremiah delivered me safely to the visiting missionary "Team House" at about 3:30 PM, time which I’m sure could break records. 

At the Team House I met Missionaries Todd and Di Strader of Indianapolis, who were very gracious and welcoming. By this time, word was out everywhere that my arrival had been missed, and everyone was very apologetic. Todd is an environmental contractor and Di a retired nurse. They sit on the mission board and are a wealth of information about all things related to the mission. They have been coming here since its inception, and know practically all 220 kids by name. They told me they would be leaving at the end of the week, so I picked their brain any chance I got. 

The Team House patio overlooks the Nile River. As I toured the house, I was amazed at the Western amenities. There are four dorms in the house, some with eight bunks, each neatly made and ready for guests. There are three bathrooms, each with European commodes (like you are used to) and not the African toilet (which is a porcelain hole in the ground with feet placements). This, and the hot water were my two most welcome surprises of my arrival. I was prepared for the absence of both of these. Each dorm room is equipped with a fan, and the house itself runs primarily on solar power, but has the option for switching to the hospital’s generator if the need arises. 

The mission’s current family-shelters are set up in four pods of seven houses each, with a house mother, called “Auntie” at each house. In addition, there are two houses of children who have reached adulthood, but who are still completing secondary school. The boys’ house is situated between the Team house and the secondary school, with the girls’ house on the other side of the school. The adults are extremely well mannered and welcoming. I was called “Uncle” upon arrival, as apparently most men are. Since there was already an “Uncle Todd” (Strader), I agreed to be called “Uncle Toddrick,” a variation which includes my real first name, Richard. 

Sunday, we attended church services which have been held outdoors since Covid restrictions began. The congregation likes it outside so much, they may continue to meet that way as long as weather permits. The worship was lively and the sermon fiery. Pastor Robert, who is also the campus I.T. wizard, gave the sermon just before departing for the week. Eunice, the Spiritual Director oversaw worship and gave the offering call. The worship team was talented and full of joy. 

After church, the older boys played a basketball game. They play hard and a few sustained injuries. They went to “Momma Di” who directed them straight to me. So, I became sort of a campus nurse right away. Once young man presented to me with a surgical wound that needed a dressing change. I had brought some first aid supplies with me and, between Di and I, we managed to make him more comfortable. Normally, for serious concerns, the kids go to the mission hospital and the cost is included in their sponsorship, but for minor things they report to one of the house mothers who acts as a nursing assistant. At least for now, they see Momma Di and me as more knowledgeable alternatives. 

I met a missionary named Jessie Washburn, who lives here most of the year round and serves as the librarian. She lives in one of the pod houses rather than in the Team house. We made friends quickly, and I am glad she will be here after the Straders leave. 

There is a staff Hospitality Team, Michael and Robina, who bring me my dinner and clean up once a week with laundry services provided at that time (excluding underwear, which visitors are responsible to wash and dry themselves). The other couple living in Team House are James, who is in charge of procurement, and his wife, Judith, who manages the restaurant and cooks most of my meals. Judith is an amazing cook! At about 6 PM each day, meals appear on the dinner table in plastic containers. There is always more than enough, so I usually have the leftovers for lunch the next day after preparing some eggs or oatmeal for breakfast. Ugandans do not eat breakfast when they wake up, but later, about 10:00 AM. When the nurses receive their tea for the morning, they usually include me, occasionally even offering me some of their restaurant-bought breakfast treat — Mendazi. Mendazi is a sweet triangular cake pastry, like a cake doughnut without icing. 

Sunday, after the ball game, several of the older girls were going into the bush to harvest Cassava. You may know it by its Spanish name, Yuca. It is a root that, when cooked, tastes like fresh, warm bread. I accompanied them, and they laughed at me as I stumbled through the brush, as we all made enough noise to scare the wildlife away. The girls warned me that the Forrest Cobra is the worst thing we could come across, but we found none of those, and someone had already harvested any of the good Cassava. Still, the experience of tromping along with the girls was rapport-building and memorable.

Monday morning, the Hospital Clinical Director’s wife, Maryanne Cessnun, escorted me to the hospital and introduced me around. Her husband, Dr. Colby Cessnun was out of the country on an unexpected errand. The two of them live down the road from Team House, and have ten children, so it was a special blessing for Maryanne to spend time with me. 

At the hospital, the Primary Nursing Officer, Sophie, made me right at home. She briefly showed me around and introduced me to the Hospital Managing Director, Dr. Godfrey Lewo, who was also very welcoming. Sophie then led the staff in a devotion and worship that lasted about a half hour. Every morning at 7:30 the staff begins this way, except for Wednesdays, when that time is used for continuing education presentations by one of the staff. Around 8:00 AM, the staff takes their places. I went on rounds with the doctors, hospital clinicians, nurses, and of course, Sophie. 

There are two wards open: a general ward and a maternity ward. Several others are built, but funds are not there to open them, so they are used for storage or isolation patients. Since I have no maternity experience, I stayed in the general ward. Nurses Harriet and Samuel made me quite welcome and were very patient as they taught me how to make do with the limited resources at the hospital. Harriet paid me a high compliment. She said she likes me because I am not like others who visit, who act like they know everything, telling Ugandan nurses what they are doing wrong. She said, “You are not proud, but teachable. I like that.” I reaffirmed that I do not know enough about what she does to be proud, and we got along famously. 

There was one blood pressure machine per ward, but each was in disrepair. The pulse oximeter did not work on the one in the general ward. I happened to have brought one, so we used it and my infrared temporal thermometer to check vital signs on nursing rounds. I changed wound dressings, and assisted the doctors with the placement of nasogastric tubes. Samuel showed me his method of applying a urinary catheter, since I was so spoiled with my experience with only full pre-assembled kits. He pieced together what he needed out of what was available and, while best practices may dictate differently, practices with limited resources are what they are. American nurses reading this will be surprised to know there are not even pre-filled saline flushes (10 mL syringes of normal saline used all day every day in the life of an American nurse). Instead, when a flush is needed, a syringe is filled from a 500 mL bottle. 

I treated my first ever pediatric patient, a six-month-old baby with malaria. She cried every time I accessed her IV cannula, so I tried to spend some time with her that was not related to care. By the time she was discharged a few days later, I even got a smile. There were three critically ill patients, one of which was move to isolation for suspicion of tuberculosis or Covid. 

The nursing shifts are morning, from 8:00 AM to 2:00 PM; evenings, from 2:00 to 8:00 PM; and nights, from 8:00 PM to 8:00 AM. I left at 2:00 with the morning shift. 

English is the national language of Uganda, but few people in this region speak it. The local language is Acholi, or a variation dialect called Alur. I am trying to learn some words, but the dialect of English is hard enough to understand. One of my favorite doctors is named Robert, but we went round and round before I realized he was not saying “Robot.” I was accused by one of my new friends of using “lazy speech,” so I am focusing on trying to annunciate all my syllables, rather than saying, “wanna” or “gonna” like Americans tend to do. In the meantime, I can say “thank you” in Acholi, “Are you in pain?” “Does this hurt?”, “God bless you!” and, more recently, “How are you?” Everyone giggles when they hear me speak Acholi. I have been told it is not because I am doing it wrong, but because they are amused to see a Mzungu (white person) learn their language. 

Tuesday, as I arrived at the hospital, everyone was busy working on an infant malnourished because of poverty. I was surprised to see measures I had never seen before. When the nurses could not initiate intravenous (IV) access, the doctor attempted to access the temporal vein in the side of the baby’s head, even before attempting the external jugular access, which I have seen. Ultimately, access was obtained in the child’s hand, and the other nurses and I administered blood and dextrose, a kind of sugar water solution to help sustain him. 

Our 71-year-old isolation patient took a bad turn, and when I went to assess him, I found him lying on his sleeping mat on the floor instead of in his bed. His pulse oxygenation, which should be between 93 and 100 percent was a horrifying 35%. When I asked the doctor what measure we would take, he said a nasal cannula oxygen delivery system was all there was for adults, and there was nothing more we could do. I suggested an anti-inflammatory steroid to help increase his lung function, but it was not enough. Our patient died by afternoon, and the girls and I performed what they call “last office,” which is preparing and securing the body for transportation. We covered him neatly and expressed our concern, as best we could, to the grieving wife who watched all our activity with saddened interest. 

When we gave report to the oncoming evening shift, we found there was only one nurse in the General Ward that night, and she felt overwhelmed with eleven patients, so I agreed to return after lunch to help her. I stayed until she said, “We are done,” at about 5:00 PM, and went to Team House for a big, goodbye dinner with the Straders and all their sponsored kids. These kids were amazing! (I say “kids” but all are adults except one who was ten.) All of them are perfectly well-mannered, interested in each other and others, and devoted to God. Several took to me like family right off. We feasted on barbecue goat and chicken, and 10-year-old Batista ate more than any of the adults. 

Wednesday morning I left for work early, so I wouldn’t be drenched in sweat by the time I got there and could sit quietly reading my Bible for awhile before morning staff devotions. It was a slow day at the hospital, so I left early, hoping to see the younger kids play their football (soccer) tournament. However, I closed my eyes to rest and woke up two and a half hours later, as everyone was leaving the pitch. Many were headed to a prayer meeting in the gym, so I joined them. Outside, I was privileged to meet one of the kids Cindy and I sponsor, and I recognized her right off. She joined me for worship and made me feel at home. 

The Straders had dinner with the directors, so it was just Jessie and me at the dinner table. We got along great, and were like brother and sister in no time. We made plans to visit Gulu in a couple weeks, where Jessie wants to do some shopping and I have a friend I would like to meet. 

Thursday, I worked with a nurse I had not yet met, but who had heard of me through one of the house mothers. She told her that I was very nice and that she hoped I come back. Apparently they don’t think that about every visitor here. The other nurse, Mirriam, with whom I had already worked a shift, shared her breakfast with me. Lunch, which I thought had been a provision for the nurses who pay for it, was extended to me, and I enjoyed my posho (like grits only from fine corn flour), black beans, and Silverfish (which are not the bugs you think of, but are tiny sardine like fish). Dr. Robert, who is always happy to share with me the clinical conditions and answers for my questions, was even more happy to have me around when I applied my penlight to his suture procedures. It is not very light in the hospital, and he is used to working in shadowed conditions. It was another slow day, so when Mirriam was sent home, I left too. 

At the Team House, I found Todd and Di Strader planning their farewells, accompanied by Jessie the librarian. We walked around the property, a distance of a little over two miles, talking about life in Uganda and the history and workings of the mission organization. It was good exercise, but I will value the walks like this for the friendships I made. 

Dr. Colby Cessnun, recently returned from an unplanned trip, greeted me as I came out of the washroom from doing laundry. He said he looked forward to meeting me at the hospital the next day. 

That evening, several of the kids came over to bid the Straders farewell. One brought mulberries she had picked and made a cobbler, which she called “pie.” No one had heard the word “cobbler” before except as a fixer of shoes. The kids were a delight, and I cannot remember when I laughed so much. We ended the night with the girls braiding each other’s hair. It was funny to see the Ugandan girls try to braid Mzungu hair. 

Friday morning, I said my goodbyes to Todd and Di and then rushed off to join the morning staff devotion already in progress. (Also known as: I was late.) It was bad timing, since the Clinical Director was eager to see me at work. 

Rose, Midwife

Rounds went well, and for the second time, I was able to make a recommendation to Dr. Robert he gladly accepted on behalf of a 17-year-old critically ill meningitis patient. It was another uneventful shift so, at shift change, I went to the Maternity Ward. The nurses there, including Rose, the head maternity nurse, and Brenda, were amazingly welcoming, especially considering my lack of experience in labor and delivery. I was never so welcome! The two of them coached me through caring for the neonates, one of whom was in an incubator at 2.1 kilograms (4.62 pounds). I obviously didn’t get to cuddle these babies, but I got to administer their dextrose solution by IV and pray over them. I swear, they were the most precious little miracles you’ve ever seen! Brenda, who graduated from nursing school the same year I did but as a midwife, taught me about documenting labor according to the government chart. 

There are a couple of secondary school students who shadow at the hospital, for interest in pursuing healthcare professions. One, a 20-year-old girl named Janet, works both the General Ward and the Maternity Ward, floating back and forth, depending on who needs her help. She and I have become friends, and she has walked me home a couple times. She told me that the nurses on the evening shift, when faced with a busy workload, have asked her, “Where is your friend, Todd? Go and get him so he can help us!” They delivered seven babies this week without me. I am determined to get some labor and delivery experience! I stayed there Friday until about 6:00 PM, when I heard the doctor say no one is expected until the morning, when he will induce labor that may take all day. I was too tired to commit to coming in on a Saturday too, so I told them I would see them Monday. 

Janet walked me home, and as I considered that I would be by myself tonight, I invited her to come over and bring friends if she wanted. Most people have left the compound, either for a youth rally in Kitgum, or a wedding in Gulu. Just as I sat down for supper, Janet came to the door, so I was not alone for dinner. One of the boys, K-Morris, arrived shortly after Janet did, and the three of us sat around talking until Uncle Todd announced he was bushed. Shortly after that, Michael, from the Hospitality Team, asked me to move into the front room where Todd and Di had been staying, because the larger dorm was needed for a group that would be arriving Sunday. 

It is now Saturday, the 8th of May, and I am still in my pajamas at 3:00 PM. It is raining, and it has been a great Sabbath day of rest. I stayed in bed well past the rooster crowing, fixed some eggs, and went back to bed. When I got up, Gloria, my house guest in another dorm, was up, and offered me her leftovers from the night before for my lunch. Later, she made popcorn for her friend and for me, and I am sitting here eating it while I journal this entry. 

I still do not know in what capacity or for what purpose God has called me here, but I am more than comfortable here, recognizing it is a God-protected oasis in country that needs just that. There is so much poverty everywhere in Uganda. Even those with jobs struggle to feed their families, and many do not have jobs. People 65 and older are forced into retirement, whether they have savings or not, and usually turn to gardening to feed themselves, as many younger people here do too. This organization is a 700-acre mission compound with a farm, husbandry, hospital, primary and secondary schools, a library, and a multi-purpose building that serves as a worship center. They hope to add a mechanic shop at the border of the property, so people can get their vehicles fixed without entering the compound. One visiting missionary, an arborist, planted Teak trees, which will be an income resource for years. Hearing that, I was impressed that everyone brings something. Whatever your passion is, it can matter to the kids here. While I augment a busy nursing staff, they do an amazing job here without me. Every kid and staff member have heard the Gospel and have access to worshipful fellowship every day of the week. The name of Jesus is on the lips of almost everyone I meet. (It’s Yesu when not speaking English, a closer variant of Yeshua than even we use.) What they lack is personal interaction with someone who cares about them. The house mothers are employed to keep them safe and fed, but often the kids wander around the campus playing under the supervision of each other, with the older ones keeping the younger ones in line and safe. There is even a German Shepherd named Stoney here, who provides protection for the kids, though few care much for him. (Dogs are a necessity here, not a pet.) In fact, he is sitting on the porch of Team House, staying out of the rain, as I write this. 

Pray for Uganda. Pray for me. Pray for God’s will for me to be revealed. I am eager to matter here and to involve myself as much as I am welcome. I am already making a “wish list” for my next trip here. At a minimum, it will include children’s clothes (especially baby clothes), adult oxygen masks, books of any kind, and maybe pocket notebooks for the nurses. They love mine!

Lubanga omedi gum! (God bless you!)