“The man with the key has gone.”

Just basically the whole time
There’s a phrase here in Uganda, ‘the man with the key has gone.’ It means that when you want to get something done, you find that the person who needs to help you is gone. Like at the shop to buy airtime, or the guard to let you through the gate, or the doctor who has the only internet modem within a 40km radius, that I know of.


Baby Time.

The kids here make my days. I’ll be walking in the hospital next to a woman, balancing bananas on her head and then here a little squeek/giggle. Under the cloth going over her back, kind of like a cape is a baby tied to her back. My favorite is when you see the mother walking along (or older brother or sister) and their little feet are bobbing up and round the front of the Mom.

During my time here I have several good friends from the kids who have been at the hospital over extended periods.

Jenifer, was my first friend. I spent my first two weeks of the hospital on the paedeatric ward where her brother was a patient. The entire first week, whenever I would look up she would be there peaking around a corner always with a smile on her face. She was at the hospital for over a month with her family, she helped he mom with the washing and cooking and otherwise had nothing to do. Sometimes we would walk around the hospital together, I brought her a hard-boiled egg a couple times to share with her brother. By the way, she always had her youngest brother tied to her back. Sometimes she would sneak into morning chapel for the staff and wait for me to come (I’m usually late). She would always find me afterwards to walk me down to the ward. The day she left marked my first day at Kagando in which I felt detached from the community. Patients are always coming and going, the same with elective students.

Kule, was an eight year old patient on the surgical ward with a gut perforation. He was in intensive care, with oxygen and IV lines, and he could barely move. I met him my first morning on the surgical ward, I smiled and waved; he was able to wiggle two fingers and the side of his mouth twitched. I visited him every day for the next two weeks as he got better, we communicated through sign language and the occasional friendly attendant who could speak English and Lukonzo. His favorite thing was when I brought my camera and he could look at pictures of himself.

Mumbere, a 10 year old who has been in traction for over a month on the surgical ward, so basically stuck in a bed with nothing to do. I got to know him during my time on the surgical ward and I go to visit him every morning to tickle his foot, partly to make him laugh (he’s absolutely adorable) and also to make sure he can still feel it.

On a really really good note, congratulations to Cay and Juan for their son John Michael Almodovar (Jack) born 08.20.09, 7lb 2oz 19”. Praise the Lord.

The headlong stream is termed violent
But the riverbed hemming it in is
Termed violent by no one.

The storm that bends the birch trees
Is held to be violent
But how about the storm
That bends the backs of the roadworkers?
-Bertolt Brecht, “On Violence”

Scattered Thoughts.

Fleas dream of buying themselves a dog, and nobodies dream of escaping poverty: that one magical day good luck will suddenly rain down on them –will rain down in buckets. But good luck doesn’t rain down yesterday, today, tomorrow, or ever. Good luck doesn’t even fall in a fine drizzle, no matter how hard the nobodies summon it, even if their left hand is tickling, or if they begin the new day with their right foot, or start the new year with a change of brooms.
The nobodies: nobody’s children, owners of nothing. The nobodies: the no ones, the nobodied, running like rabbits, dying through life, screwed every which way.
Who are not, but could be.
Who don’t speak languages, but dialects.
Who don’t have religions but superstitions.
Who don’t create art but handicrafts.
Who don’t have culture, but folklore.
Who are not human beings, but human resources.
Who do not have faces but arms.
Who do not have names, but numbers.
Who do not appear in the history of the world, but in the police blotter of the local paper.
The nobodies, who are not worth the bullet that kills them.

-Eduardo Galeano, “The Nobodies”

The buzzard has nothing to himself with.
Scruples are alien to the black panther.
Piranhas do not doubt the rightness of their actions.
The rattlesnake approves of himself without reservations.

The self-critical jackal does not exist.
The locust, alligator, trichina, horsefly
Live as they live and are glad of it.

The killer-whale’s heart weighs one hundred kilos
But in other respects it is light.

There is nothing more animal-like
Than a clear conscience

On the third planet of the Sun.
-Wislawa Szymborska

A Community

There’s a song that goes ‘It takes a village to raise a child.’ I live across the street from the hospital in a compound with hospital staff and their families. As you can imagine, there are loads of kids, probably over 25 that I know by name now. They all call me ‘Aunt Sarah,’ because as a sign of respect it is culturally appropriate for kids to refer to older people who aren’t their parents as ‘aunt’ and ‘uncle.’ This was a little confusing at first because I just thought everyone was related, Kentucky anyone? But I have come to really appreciate it, it’s a reflection of the strength of the community and the obligation that members feel towards each other and their kids.

On the way home for lunch one of the kids I know shouted out and asked me for 100 shillings, about 10 cents. This is considered very rude as he hadn’t greeted me yet and was yelling from far away and it’s just inappropriate to ask for money like that. So I went over and (I used phrases which would be understood here) told him that he had ‘bad manners’ and I was going to go talk to his father. It carries more weight when I used their names, but I don’t want to use specifics here.

Later when I was reflecting on the episode I realized this was one of those, ‘it takes a village to raise a child’ thing and I really felt a part of the community.

There’s also a 1 ½ year old who lives next door with whom I’ve become good friends. This sounds weird when I write it but the kids here are all very mature for their age. Anyway, I walk past his house on the path to the hospital and he always waddles/walks over to shake my hand and give me a hug. The really cool thing is that, although I don’t know how appropriate it is, he has started to call me ‘mommy.’ I always laugh with the other girls who take care of the kids when he does this, but it makes me feel as though he has just accepted me, regardless of my skin color.

Words, Words, Words…


Expressing myself in language is definitely not a strong point for me. But I really like to reflect on quotes that I gather. I’m going to share some of my favorites with you.

“The Kingdom is to be in the midst of your enemies. And he who will not suffer this does not want to be of the Kingdom of Christ; he wants to be among friends, to sit among roses and lilies, not with the bad people but the devout people. O you blasphemers and betrayers of Christ! If Christ had done what you are doing who would ever have been spared.”

– Dietrich Bonhoeffer,  Life Together

“Do not despise your place, your gifts, or your voice for you cannot have another’s, and it would not fulfill you if you could”

Rats and roaches live by competition under the law of supply and demand; it is the privilege of human beings to live under the laws of justice and mercy.
-Wendell Berry

For Ordering a Life Wisely
Prayer of St. Thomas

O merciful God grant that I may desire ardently, search prudently, recognize truly, and bring to perfect completion whatever is pleasing to You for the praise and glory of Your name.

Put my life in good order, O my God.

Grant that I may know what You require me to do.

Bestow upon me the power to accomplish Your will, as is necessary and fitting for the salvation of my soul.

Making Sense of Suffering


Since so much happens here and it’s hard to decide what to share, I’m just going to tell you a couple stories.

The hospital recently added a Palliative Care Outreach program through the sponsorship of an NGO. Palliative care encompasses end of life care for patients with terminal illnesses. Here, a lot more illnesses are terminal because treatment isn’t available or patients can’t afford it. Tumors, lymphomas and other cancers, which would succumb to radiation and chemotherapy, are terminal here. The only treatment the team can offer are painkillers (oral morphine etc.), laxatives and vitamins etc.

I’ve gone on a couple of these outreaches, we see about three patients a day. It takes so long because the team travels to the patient’s house. They live out in the village where the truck can’t pass sometimes so we have to hike. Think steep mountains.

Dr. Plarr was a good listener. He had been trained to listen. Most of his middle-class patients were accustomed to spending at least ten minutes explaining a simple attack of flu. It was only in the barrio of the poor that he ever encountered suffering in silence, suffering which had no vocabulary to explain a degree of pain, its position or its nature. In those huts of mud or tin where the patient often lay without covering on the dirt floor he had to make his own interpretation from the shiver of the skin or a nervous shift of the eyes.
-Graham Greene, The Honorary Consul

*I pray that in the midst of my helplessness and when I am in the depths, overwhelmed by the magnitude of suffering, that I will be a witness for those who can’t speak.

I’ll share a case I saw the other day. A 28 year old woman with three kids has terminal abdominal cancer. We found her in her father-in-laws house, on a bed of straw, smelling of urine, and too weak to sit up by herself. This was the second time I saw this patient and she remembered me from before! Most of the care that the team gives is emotional support and counseling. Although they do have funding to provide each patient with .5 kilo of sugar and some soap. This seems pretty pathetic considering the conditions they live in.

An old woman with another type of abdominal cancer started to dictate her will while the team was there. Her goat to her sister, her house to her daughter. I get all of this through a translator.

When we come to you
Our rags are torn off us
And you listen all over our naked body.
As to the cause of our illness
One glance at our rags would
Tell you more. It is the same cause that wears out
Our bodies and our clothes.

The pain in our shoulder comes
You say, from the damp; and this is also the reason
For the stain on the wall of our flat.
So tell us:
Where does the damp come from?
-Bertolt Brecht, “A Worker’s Speech to a Doctor”
*Kagando Hospital (where I am) has the motto, ‘We Care and God heals.’ I can’t help thinking that with so much working against these people, that is the only way for change.

Market Day

There’s a market by the border with the Congo that’s open on Tuesdays and Fridays. ON the palliative care outreaches on Tuesdays we always stop there. It’s just one of the many errands we run for everyone and their mother whenever there is a hospital truck out.

The cool thing about the market is that it’s in no-man’s-land between Uganda and the Congo so it’s shared by the two countries. You have to go through a little check point on either side, essentially a guard just opens the gate to let the truck through.

Other than the wide variety of foods the market is known for its fabrics. There are about 30 stalls with fabrics from all over Africa. I’ve splurged a little on fabrics because they’re all one of a kind!