great north roads

It is still dark out but the alarm is blaring from Olivia's room and I can hear it through the tin walls as if it is were in the bed with me. I roll over in hopes of blocking out the noise but soon there is a knock at the door. It's 6:00. Get up.
We are driving to Atiak this morning for our first workshop with the Traditional Birth Attendants who will staff the clinic.

Breakfast is dry white bread with peanut butter and hot water with lemon.
Chioke has volunteered to drive the old white truck that Sister Rosemary has given us (now that she has a fancy Safari vehicle). Better him than me. It is a stick shift, but the gear shifter is up by the wheel, and there only appear to be two gears. We cannot find reverse, so our first moment involves Olivia and I jumping out and pushing the car out of the driveway.

'The Great North Road' stretches from Cape Town to Cairo. The stretch from Uganda to the Sudan is a thin strip of unpacked red dirt that has more pot holes and puddles than actual road. It is the kind of road that would make a chiropractor rich and makes a girl wish she had a better bra. There is never a moment of relief in which one can shift into a higher gear and just drive, it is a constant navigation of holes, bumps, puddles, mud and of course, people, chicken, cows, goats, motorcycles and huge trucks and busses carrying dry goods, soldiers and villagers alike, into the Sudan.
After about ten minutes on this road, Chioke turned to me and said 'Why are we doing this alone?'- to which I had no good answer.

One hour into our two hour journey we were flagged over by soldiers with guns. I realized as soon as Chioke slowed the truck what they wanted, but it was too late.
"Please, help these refugees get to the next town". We looked over to see about fifty people, babies, luggage, animals by the side of the road.
"How can we take all of them?"
"Please, just take the women and children"- and who can say no to that?
If in doubt, always play the women and children card to passing Americans.
So suddenly there was a rush of bags, pots of water, babies, women (and a few sneaky men), chickens loaded up into the cab of the car, piled on top of one other and spilling upward so that the final passengers rode on top of the truck.
Chioke, who now had the grave responsibility of driving smoothly enough to not knock any of these people onto the road, placed his face in his hands and took a deep breath. I felt bad, but not that bad as I was also hysterically laughing at the madness of it all.

The IDP camps of Atiak are located along the Great North Road (only great because of its length). Because of its proximity to this road and its proximity to the border of Sudan it is what most people call the 'pathway for the rebels'. It was the first village in Northern Uganda to be devastated by the war and the last to receive aid. The World Food Program only came in six months ago. There was a major massacre in this village on April 20th, 1995. Someone pointed out this was also the day of the Columbine Shootings which the entire world heard about, but very few have heard that on this day 250 people were lined up and shot while the rest of the village watched. In fact, this tiny Wikepedia article was all I could find on it.

We arrived 20 minutes late, to a group of thirty five traditional birth attendants (34 women and one man). More than we expected. They sang and danced to greet us and we soon settled into a comfortable circle under a large tree.
The training went amazingly well. It was a true sharing of practices, knowledge, ideas and stories. We began by having everyone speak about their first experience at a birth. Many of them had attended the births of their 'co-wives' as young girls who were first married. In all of the stories, history was reflected- they all got 'trained' in 1989 by World Vision and this was when they considered themselves official TBAs, and also the time they were taught to keep women lying on their backs throughout labor, to restrict them from food and water and to refer, refer, refer to the health unit (at that time the closest one was 7 miles away).

We then invoked an image of a large pot and asked for everyone's collective knowledge. Olivia and I enacted a 'normal' birth one of us in labor, the other the midwife, and we asked them to tell us what to do in order to manage it. We then acted out complications and asked for the same feedback. It was really fun for everyone (most who cannot read or write) and tt was an incredible tool for gathering what they do know and also seeing where the gaps in knowledge are (ie, when Olivia fake fainted from a hemorrhage they said, give her tea and wipe the blood).

We spent a lot of the day focusing on labor positions and comfort, which was also really fun. Massage, comfort and one on one support are arts that have been lost in the flurry of technocratic trainings and trauma of war- and yet were able to pull out some of their 'old knowledge' and also add a few of our tricks to the bag- and lastly, on our little laptop screen in the middle of a refugee camp, we showed a video of a home birth in America, which really caused some tong clicking and oohs and ahhs as the woman in the video squatted down and leaned on her husband for support as her baby was born.

I once again question the line between offering 'too much' information and allowing what they know to be trusted as well. I think we were as successful as we could be- allowing for a group knowledge that grows and builds on itself and where best practices are valued as those that are safest and most culturally relevant.

The drive back was pure misery. We got stuck in the mud and once again, Olivia and I hopped out to push the truck which slid and skidded all over the place, blowing black smoke and red clay like mud all over us. Eventually a truck stopped and with the help of a few more men we were soon bouncing down the road to Gulu. I can't quite imagine how we will do this every Monday.

A long update today. I suppose the great north road is a good metaphor for this project- it is something you can navigate, but it twists and turns in the most unexpected places, it is longer, it is deeper, it is more expansive than any one person, one project, could ever know.