Monthly Archives: September 2013

Christening

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16 September 2013

DSC00567Yesterday, I read Psalm 111:1-2, which says, “Praise the LORD! I will give thanks to the LORD with my whole heart, in the company of the upright, in the congregation.” I knew it was the day to go to the Catholic church of Atiak. So, since our birth center truck is defunct, I took a thirty-five minute walk with my sister-midwife, Sarah, and arrived just after the service had started.

I’m so glad I went! The service was in Acholi, and so I could only understand certain key words (Rwot, which means “God,” Lubango, which means “Lord,” and Jesu Crist), but aspects of the liturgy were familiar, so I knew generally where we were in the order of things. The singing was absolutely beautiful, and Acholi girls processed in and out, dancing, at the beginning and end of service and when the Holy Scriptures were brought to the front of the church and the gospel was read. The priests wore white and green, because we are in Ordinary Time according to the Church calendar, and green is the color of this season: a color and a season of life.

I was so happy to be in church on Sunday, not only because I was together with other people of faith, but because it was the day of christening! About forty newborns and infants were blessed and baptized in water with their mothers and grandmothers and other relatives holding them for the priest to dedicate in the sanctuary. At least two of them, both girls, were ones who had been born at our birth center. I was so delighted to see these mothers and babies!

 I was reminded of the first infant baptism I attended for a baby whose birth I had attended, that of William Edward, the son of Kristin and Mark Frost, at All Saints’ Church in Chicagoland. (I hope you’re reading this, Kristin!) It was a wonderful time for me when I felt like a community midwife. Being a midwife is more than catching babies physically as they are born; I believe being a community midwife means participating in the spiritual lives of families after birth and praying that they will be born again of water and the Holy Spirit.

“Truly, truly, I say to you, unless one is born of water and the Spirit,
he cannot enter the kingdom of God …
Do not marvel that I said to you,
‘You must be born again!’”

~ Jesus (John 3: 5,7)

It means so much to me to see babies dedicated to the Lord.

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Concerning Kevin

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15 September 2013

Kevin is a common girl’s name here. In American, it is a man’s name, but when I said this to Christine, she laughed! To her the idea that a man might be named Kevin (as opposed to a woman) seemed silly.

Recently a woman named Kevin came here in preterm labor – she’s not due til November – brought on by a UTI. It appeared that her water had broken, so we were concerned and planning to transfer her to hospital, but contractions stopped, she stopped leaking water (suggesting that her bag had resealed itself, which can, thank God, happen), and her pain from the infection began to go away as she drank water and took antibiotics (and even received a little prayer on her behalf :)). It made my heart happy to see this woman smile as her condition improved.

After a day or so, Kevin’s mother and husband came to visit her, and they had words (as the saying goes) over her illness. It came out that Kevin’s husband has been very abusive toward her during pregnancy, forcing her to have sex against her will and maltreating her in other ways. So Kate explained to him that this was not acceptable, and then she turned to Christine and urged her to speak freely about the need for him to change his ways. Christine did.

Christine had been about to catch a transport to Gulu to visit her family. “But for this,” she said. “I am willing to delay.”

A New Name

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13 September 2013

Many years ago, I read a beautiful passage of scripture, in which God says to Israel that he will give her a new name, and a crown, one which the hand of the Lord would bestow. This spoke to me. I always had a sense the Lord would give me a new name – I just didn’t know it would be an Acholi name!

Yesterday evening, I was down visiting mamas and their families in the birth center. One TBA, Akongo Scovia, was there with a mom being treated for a UTI. She invited me to eat with them, so I did. Sitting on a grass mat, eating cooked eggplant and posho out of a small pot with our hands, we carried on a conversation, with me speaking in my very limited Acholi. In the course of our exchange, Scovia decided to give me a name: Abey Scovia.

Abey & Scovia

Abey & Scovia

In Acholi culture, it is the responsibility of the midwife to name the baby (though the family may also give the name if the midwife does not). Then, sometimes, TBAs give names to foreigners who have been accepted by the community. So I was blessed!

It was so amazing to me that Scovia decided to do this because earlier in the day, I had been saying to my friend, the extraordinary Laker Christine, that I wished I could have an Acholi name and maybe she could pick one for me. Christine said the TBAs are the ones who choose names, but she would still try to think of a name. So when Christine came to the birth center and found out Scovia had decided to give me a name, we laughed!

Christine said that “Abey” means “a loved one, a beautiful one.” Wow. I said to Christine, “I thought it just meant ‘good’” – because the word for ‘good’ in Acholi is bey. “Yes, that too,” Christine said. “It is the same family of words.” As for Scovia, it is actually an English name, and Scovia has given me her own name to show our connection and that she herself gave this name to me.

Later in the night, Christine said, “I am glad it was not Lanyero,” which means ‘laughing stock,’ “or Akwero,” which means ‘the rejected one.’ “I’m glad it is Abey. That is a good name!”

Homebirth in Okidi

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11 September 2013

DSC00555I woke up on September 11th with a lot of energy. When a labor call came in from Okidi, I had a feeling that I should go with the driver. I packed up some birth supplies (just in case), got Eugenia, and got in the car.

We drove to Okidi on the unpaved red-dirt road that disappears into the tall grass the farther out you go. There are lots of bumps and potholes — and not a few muddy patches. We made it to our destination, a school in Okidi, before the truck got stuck in a boggy place.

It’s no fun to be stuck.

People were nearby who offered to help our driver, and meanwhile, a young man on a bike came to tell Eugenia and me that his family was the one who had called us. Where was the woman? She was supposed to meet us there at the school buildings, which the truck could get to, and not wait at her family’s compound – which could only be reached by walking a dirt footpath.

Nevermind.

I asked the young man if the mother was pushing. He said yes. Assuming the baby would be born by the time we got there, I said to Eugenia we should get our things and go check on the situation. So we started walking.

It turned out to be a half hour walk into the bush. We reached the family compound and found the woman sitting on a mat outside a hut. Her contractions were spaced out. Eugenia said it seemed that she was at the beginning of labor. “That — or the end of it,” I said. Meanwhile, the family said there was another woman in labor nearby. Two laboring mothers? I went to go check on the second mama.

She was only about five minutes away, and she was walking slowly and painfully in my direction, so I helped her the rest of the way to the compound of the family where the first mama was. I did a quick assessment of her fundal height: only four fingers above the umbilicus, suggesting she was only about 6 months along – and that the baby was not ready to come. With the translating skill of an elder in the compound, George, who is also the VHT (Village Health Team) worker, we learned that the woman wasn’t expecting her baby for another three months.

A few more questions revealed the woman was probably badly dehydrated and had a severe UTI. This had brought on contractions and preterm labor. I poured some vitamin C powder into a cup of water and asked her to drink it, but she refused. I was surprised! Eventually I poured out the Emergen-C and gave her clear water, and with a lot of help from George, finally persuaded her to drink.

Meanwhile, Eugenia and I were discussing whether we should try to walk back to the truck with these mamas, whether the truck would be out of the mud, and if we would have 45 minutes to get to the birth center before the first mama gave birth. The answer to that last question was … no! She started pushing as we were talking.

So we put on our gloves. Eugenia was seated in front of the mama to catch, and I was at the mama’s side to assist. The baby’s head emerged completely and started to restitute. Then the baby’s head stopped restituting. Color was still good … still good … and then the baby’s face started turning dark blue. I reached in with two hands to help the baby’s head continue restituting. As I did this, I urged the mama to push. Chol matek! She did, the baby’s shoulders came out, and Eugenia caught her. She cried her birth cry to open her lungs and started pinking up immediately on her mother’s belly. A great relief! A beautiful moment.

“Janie!”

We turned around and looked up only to discover Akwero Katherine was there! She is one of the three main TBAs who helps us at the Ot Nywal Me Kuc birth center. She actually lives in a hut very close by, but she had not been there earlier. Now she helped us with the postpartum details.

There was minimal bleeding after the placenta delivered, and the fundus was firm. We had the mom cleaned up, lying down in a hut, and skin-to-skin breastfeeding her baby in less than ten minutes. Whew!

After checking on the mama and baby over the next two hours, we decided the best thing to do would be to leave them in the care of her family as a half hour walk to a truck that might not be going anywhere didn’t seem wise. (We didn’t want to exhaust the mama, dehydrate her or cause a post-partum hemorrhage). The family gave us a rooster for helping with the birth, which is a traditional gift to midwives (this was our second bird of the week, actually), and Eugenia named the baby Aloyo Aracely. Meanwhile, George told Eugenia that his mother’s name is Eugenia, too!

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the rooster

And then Katherine explained to us why she had not been nearby at the time of this birth even though her hut was so close:  she had been at the funeral of her niece.

The girl, only in primary school grade 4 (about eleven years old), had been walking back from the fields where she was collecting sweet potato leaves. They were in a basket on her head, which she was holding. When she passed under a tree, she brushed against a branch, and a snake was in the tree and bit her, so she was poisoned. The family wanted to take her to the hospital, but she died before they could.

The hospital is very far away from Okidi.

Katherine and I then walked to her hut together to get a hanging scale to weigh the baby. On the way back, she called out to her neighbor in Acholi the good news of the new baby being born. Then, in English, she said to me that she had dreamed last night that she was catching a small baby. “It is this baby!” she said. When we weighed Aracely back at the family compound, it turned out that she was 3700 grams: a very good size for an Acholi newborn!

We still had the second mama with the UTI to transport back to get treated with antibiotics. We walked through the grass to the truck at her pace, all of us following in a line behind her:  her sister-in-law with a baby on her back and firewood on her head, I with our supplies, the husband with his bicycle, and Eugenia with the rooster. Following advice from my friend Laker Christine a few days earlier (who had said I really ought to learn how to carry things on my head to keep my back straight and neck strong), I decided to carry our bowl of medical supplies on my head to free my hands. I only dropped it once when the rooster went crazy and tried to fly away from Eugenia despite its feet being tied. Ay!

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Eugenia with a chicken given
earlier in the week

To make a long story short … The truck was out of the mud when we got back, which was great. But it got stuck a second time on the road, and getting it out that time took hours. The truck overheated once we re-started our drive, and the radiator spouted steam and water – five feet in the air when the driver opened the hood and uncapped the radiator – and by the time we finally got back to the birth center, the engine block was cracked. So we need a new ambulance for sure.

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Kate makes the international sign for
“this truck is kaput”

But we made it back at last, and the mama with the UTI is recovering.

Conversation over Cassava

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10 September 2013

DSC00531I went to visit Sister Margaret at St. Monica’s school next door to the birth center the other morning. She was peeling cassava roots with some others. A ways off, music was playing … That music had been going on for four days.

We talked, and Sister Margaret told me it was music being made at a funeral for a older woman, the mother of the family of that compound, who had died at LaCho Hospital and whose body had been brought back to be buried. Sister Margaret said that for a man, a funeral lasts three days, but for a woman, four. This is like the birth rites: when a baby boy is born, an Acholi woman stays three days in her hut; when a baby girl is born, she stays four. Then she does light work, like cooking, but she won’t go back to fieldwork for some few weeks.

I knew the funeral had been going on because a pregnant mother had come from it to give birth to her child at the birth center, but it was interesting to listen to Sister Margaret talk about the correspondence between the Acholi birth rites and death rites as she peeled the cassava.

The outer skin of the cassava got dropped from the knife to a pile, to be fed to the pigs or poured out on the garden, and the inner part got dropped into a large bowl. Later, Sister Margaret planned to dry the peeled roots for storage, and then they could be ground up and made into posho to feed the students once term resumes. Nothing wasted.

It takes one year to grow cassava. Sister Margaret decided to harvest this cassava now because all the rain was starting to spoil the roots. I was interested – and the next day, I was glad I had seen how she peeled the skin because I ended up eating a fresh cassava for lunch, one that was given to me and that I peeled with my fingers, because our ambulance-truck got stuck on the road … and I was hungry!

Fresh cassava tastes like an Irish potato and a coconut put together. It’s not as hard as potato, not as sweet as coconut, but still, that’s the closest comparison I can think of now.

The Birth of Jacob

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I was so happy to help welcome this little boy into the world. I named him Jacob, the Hebrew form of my brother James’ name (whose birthday is coming up soon!), a name that means “the trickster.” Jacob was born grasping his brother Esau’s heel, and this baby boy was born slowly with the cord wrapped around his foot, where it got compressed, but out he came out and transitioned well to the world!