Birth in Central Africa

This blog has migrated

2010-08-25T15:55:00.002-04:00

I moved the blog to my regular website to make it easier to maintain. Follow us here: http://birthingnaturally.net/missionblog/

Thank you!

Updates from Flory and upcoming Rwanda Experience

2010-06-18T14:00:00.000-04:00

So this has been a busy week. I was contacted earlier this week by a friend of a friend who was given an opportunity to travel to Rwanda with her husband. Her husband will be doing some teaching, and she was given permission to try to work with the local women to educate them about pregnancy and birth. You see, she just happened to be going to one of the main rural towns that women go to for birth. There is a clinic, and like so many other rural areas of central Africa, the women travel to the clinic weeks before labor because they don't know when to expect the baby.

I have been trying to answer as many questions for her as possible, and connecting her with people actually in the country. Specifically, I want her to be able to meet with Akeysu, the wonderful woman who fought to attend the training desperate to bring information back to the women in her area.

And that is how I received an update from Flory. The good news is that they have been successful at starting a medical school. The midwives are working hard to build a midwifery school as part of the medical school, but they have a problem securing teachers. Isn't that funny, that is one of the big problems here in the US too. Why teach when you can make more money doing.

Anyway, I am going to see if I can help in some way from here in the states. My plan is to set up a volunteer rotation for midwives from the US, Canada and other nations to spend a month or so at the school teaching. Definitely let me know if you are interested, but understand the details take time to work out. I do not know the schedule, the costs or any other information.

In the mean time, let me know if you want to be on the "keep me updated list." And if you want to help send supplies to Akeysu on this trip, I'll be happy to get you connected.

All Moved In

2010-05-26T00:07:00.000-04:00

As I type this, my family is all soundly asleep in our new home - a small apartment in Atlanta. It has been a crazy six weeks, but we are here and our things are unpacked. The kids were able to spend a few days at school; Jeff is accustoming himself to work from home and I'm in a sort of waiting.

You see, we are here but classes will not begin until the last day of August. I passed my NCLEX exam and am a nurse, but I can't seem to find a job and am not sure it is the best use of my time to get one. I can get internet on my laptop sometimes from "free wi-fi" places, but I cannot make any updates to the website. So, I'm waiting.

Don't worry, I'm not the type to be bored. It is just that this doesn't feel much like the life I was leaving for.

About a week before the move I was enjoying a long walk thinking about the difference in what people perceive as a life of "missions" work, and the reality of it. Many people become very excited when they learn about what I do and why I am in school. They share about their desire to travel to far off places to do good deeds - it does have a certain romantic ring to it.

The reality of it is a little less exotic and a lot less romantic. We just moved 800 miles away so I could be trained for the job I am about to do. We had to sell a house we were comfortable in; we had to let go of half our possessions, we had to leave everyone we know behind; Jeff had to give up his job. And now we face a very long, lonely summer while we do our best to make new friends and wait for the fall to begin. And all this just to do it again in four years - all to leave everything we have been a part of to pursue the next piece of the puzzle.

I think romanticizing is common in just about every part of life. We see the people who have things we want to have and we don't think about the pain and work it took to get there, we just see what they have. We want to be thin, but don't want to exercise and change our eating habits. We want to understand more, but we don't want to do the research and reading. We want to be a better friend, but we don't want to give up any more of ourselves.

You may or may not be called to serve in Africa - and the truth is it doesn't matter what you are called to. It only matters that you are faithful to that call. Do what you can now, however small it seems. Educate yourself with books or journals. Spend time with the people you feel called to serve. Chose to do one thing differently today that will get you a small step closer to your calling. My journey to serve in Africa began over 11 years ago, and it will take me at least another four before I am able to begin what I am called to do. It doesn't happen in big leaps - it happens in small steps, the small steps you take every day.

Five Semesters to Midwife

2010-03-27T22:27:00.000-04:00

I'm pretty sure I had reported that I was accepted into the School of Nursing at Emory University for the Family Nurse Midwife program. It is a five semester program that will prepare me to be a baby-catcher, but will also prepare me to provide primary care to everyone from infant to elderly. Think family physician with a nursing focus.

I may also have mentioned that I will be participating in a dual degree program with the School of Public Health. I will be studying global health with a concentration on community development. This will train me to enter a community, assess the needs and resources, and help the community develop solutions that work for them.

This is tremendously exciting in itself, but the blessings continue to flow.

I traveled to Atlanta for an interview last week. I was one of 16 finalist for a Woodruff Fellowship - four years of tuition and fees for the School of Nursing paid. When my flight touched down in Albany to return home I found a message on my phone from the school. I quickly called back to learn I had been awarded the Fellowship. This is a tremendous blessing, and means I will not have to take out loans for about $70,000 of the education. This means I will be able to start schools and clinics faster.

Moving requires many changes for our family. We have put our house on the market, and it has sold. We leave Albany May 17 for a two bedroom apartment across from campus. We love that I can bike or walk to classes, we love the amenities at the apartment and we anticipate loving the children's schools (yes, we have already looked into them). We will be spending a few days in Atlanta for spring break so we can all begin to feel comfortable in our new home.

So the next few weeks will be filled with packing and moving. In addition to moving our home, we have to move my Birthing Naturally business and Jeff's job. Jeff's job is even more difficult because in addition to changing locations he will be changing roles. I'm sure he will be excited to tell everyone all about that.

So that is life around here for the moment.

Midwifery During Crisis

2010-02-01T19:06:00.000-05:00

I wanted to share two recent newscasts with you.

The first is a PBS segment on the need for midwifery post earthquake in Haiti. It can be viewed at the PBS website here: http://www.pbs.org/now/shows/605/index.html

The second is a BBC documentary on the efforts to reduce maternal mortality in Afghanistan. It can be viewed at the BBC News website here: http://news.bbc.co.uk/2/hi/programmes/newsnight/8326102.stm

To Give, or Not to Give

2010-01-29T09:13:00.000-05:00

Before I left for the trip to Congo, Jeff was gathering as much information as possible about the do's and don'ts of international missions work. He has so many missionary contacts it was easy. One story shared with him was a heartbreaking reality check on the unintended impact of every thing you do on a mission trip.

The friend explained his organization has a policy that nothing is to be given to the local people from participants on trips. They understood that when Americans witness the poverty of developing countries the first response is almost always guilt for the abundant life lived in the United States. This guilt causes the traveler to give away nearly everything they brought with them on their trip or even hand out money to the local people.

While the organization will accept items for donations which they can then distribute through the local churches, they do not want personal gifts to become the norm. Not only does this set up a culture where the visiting missionaries are seen as a source of material items, it can actually leave the locals worse off than before the missionary came.

At one of their locations, travelers are encouraged to employ the services of a laundress - an act which provides an additional customer to one of the local women. "Consider the traveler who hires a local woman to do his laundry. He can easily pay the set fee, and because he wants to feel he's made a difference he overpays her. $20 USD is nothing to him, and he can leave the country feeling like he had done a good thing. But what he doesn't realize is that $20 USD is an enormous amount for this woman -- she can live on that for two weeks or more, which she does."

"But when the money is spent, she must return to work. But by this time her regular customers have had to find a new laundress. She now has no money, and no regular customers. Her situation is worse than before the traveler hired her."

Asking why she doesn't save the money -- continue working and use the money to improve her situation -- is to ask her why she is not American. She lives her life working for the money she needs to live every day. If she does not need money she does not need to work.

This concept is so foreign to Americans, but explains in painful detail why culture will change the impact of what you do. Your generous gift may not be helpful at all. To be truly effective at meeting the needs of families in developing countries, you need to be able to look beyond your cultural norms to understand the potential consequences of your actions.

Finding Your Path

2010-01-29T07:58:00.000-05:00

I've shared a bit about the heavier topics on my mind during the trip so decided to share something I found very funny - so amusing I was laughing at it while it was happening. What you are looking at is aloe, or its Guatemalan cousin. The plants have very sharp points, which make them perfect for keeping people and animals off your land.

Every time we drove to the mountains we saw aloe lined up as fences framing yards. This may seem excessive protection for families in extreme poverty, but makes perfect sense when you realize the cattle, chickens, goats and pigs run around pretty free during the day. So if you want to protect your garden-- or banana trees, or the palm leaves that make up your home-- from the teeth of your neighbors future dinner, you build an aloe fence.

With that background, onto my story.

Our group had been split in two one afternoon, and while the other half were diligently repairing a house we were sitting at the van waiting. After about an hour of waiting, I decided we could wait no more and convinced the pastor's 10 year old son to take me to the home (he had been there less than an hour ago to tell the group we had finished our job and that we could come to help). Off we went down the path.

At the first fork he started on the lower trail. I was a bit suspicious as I counted the cows munching weeds around the trail and the waist high cement block wall about 100 yards ahead.

"This isn't the trail we took yesterday."
"No, this is the way to the house."
"But they got to the house from the other trail yesterday"
"This is the way."

So off we went down the trail, shooing the cows out of our way. When we got to the wall he looked around and noticed the upper trail. He decided that was where we were supposed to be and so back to the fork we went.

He hesitated on the upper trail. This didn't look right to him either. Scanning through the trees he saw the blue of the tarp our team was using. The house was in that direction.

"This is the trail." He started into the trees.
"I don't think that is the trail"
"Yes, see the house. We need to get down there. This is the trail."
"But there isn't a path here."
"Yes, they had to use the machete to get here, remember."

I did remember we purchased a machete the day before and could accept that they had said something of cutting a new trail. But I could not see any evidence of a trail actually having been cut.

"I don't think this is the right way, we need to stay on the trail."
"No, they used the machete."

We headed into the trees, doing our best to avoid getting scratched by branches and the sharp weeds on the ground. A few feet into the trees I saw the aloe that meant we were at a fence.

"You cannot go through that, it is a fence. We need to go back and get on the trail."

He called out to the team. They heard him and replied, "Come this way, toward our voice."

"See, this is the way."

We started to walk along the fence being even more careful not to get cut. I glanced up and saw rope stretched between trees ahead. The team had talked about finding a way to make the steep path to the house safer, this must have been what they came up with.

"See the rope, this is the way."
"No, the rope starts up there at the trail. We should have stayed on the trail and we could have come down that way."

We were close enough to hear the team, but the fence and trees meant we were still far away.

"Stay there, we'll send the boy who lives here to lead the way."

They had heard us talking. The boy emerged from the trees ahead of us and waved us to come to him. We traveled slowly, though it felt faster now that we had a purpose.

When we got to the rope I showed him how we could have stayed on the path.

"Oh. Well, I didn't know where they were working. Our path worked too."

The team finished their work, and as we headed back to the van we asked the family if there was a different path to the road. They pointed down the hill/cliff to a trail. It was less steep than the one we used to get there, so we went that way. About a 100 yards from the house we came to a waist high cement wall with some makeshift steps. We climbed over and followed the lower path right past the cows and to the van.

Climb Every Mountain

2010-01-28T23:35:00.000-05:00

I just realized I should show you this photo of a path up the mountain. Yes, what you are looking at is a path. If you fallow this path up the hill and around a shallow ravine you will pass two or three houses (one being a store) and come to the local government school. Let me interpret for you the other things you may not realize you see in this photo.

The man with the packages is basically the delivery truck for the local store. He is the home owner returning from the town with the goods he purchased in bulk. He was on road to this point, which provides an easier trek up the mountain, but it took us nearly half an hour to drive to this point from the closest town.

In the bags he is carrying are small packages of chips - junk food. While we were visiting the school one of the boys with us purchased 5 or six of those bags for less than $1US. He is probably also carrying some of the cereal we distributed and a few other items.

Notice the steep grade of the path. This patch of mountain is not unique--in fact, at the other mountain school we had to basically walk a few yards up a cliff to get to the store. This is the landscape of the mountains. Steep grades, difficult climbs and the people who live here use their bodies to move everything. So as you can probably guess, joint issues and pain are common in people as young as 20.

This is the steepness of the terrain in which you will find coffee fields - although we are not high enough on this mountain to see coffee. This is the terrain the farmers must navigate to care for and grow their coffee, pick beans and deliver it to the weigh station. It is difficult work that provides little pay. This is the terrain families use for growing food. I can still see the images of the farmers standing on the near vertical hills, picking their coffee, but I wasn't brave enough to let go of the truck to snap photos to share.

Just something to think about as you enjoy your next cup of coffee.

Food for a Day

2010-01-28T12:16:00.000-05:00

What you see is food. Black beans (the traditional bean in Guatemala) and corn meal that can be made into a type of cereal. Twice on this trip we purchased and distributed food to rural mountain families. This caused great internal conflict for me.

According to the World Bank, 18% of Guatemala's children under age 5 live with hunger. (For comparison, 1% of the children in the US live with hunger, and 34% in DR Congo.) 13% of the population live in extreme poverty - live on less than $1.25 a day.(There is no data for extreme poverty in the US, and 59% of individuals in DR Congo live in extreme poverty). And as is true in just about every country, rural communities are more poor than urban communities - which means mountain families have higher rates of malnutrition and extreme poverty than the country as a whole. It was easy to see in the children.

So everything inside me wanted to feed these families. With the money we had we were about to provide about 5 pounds of beans and two bags of cereal to about 75-80 families in one community. In the other we were able to provide 10 pounds of beans, 5 pounds of rice and 5 bags of cereal to 50 families. But this amount of food will not even get the average family through a week. And this is where the internal conflict begins.

Providing free food is merely a temporary fix to the long-term problem of poverty. And while these families will be able to eat for the next few days - or more likely to continue their inadequate eating by stretching the food out longer - eventually they will run out of the free food. Yes, it gives short term relief. But I know the only way to really end poverty is with longer term solutions - education and improving the economy of the area.

As we passed out the food I kept running through possible solutions in my mind - could we have used the money to help the community develop a food co-op where they purchase larger quantities of beans and rice at cheaper prices? Could we have used the money to help educate the people about better farming techniques? Any real solution will take time - something we did not have on this trip. Any real solution will take a good relationship with the communities - which is what the organization is trying to build by providing free food. And so the reality was all we could do was to help alleviate some of their hunger for a few days.

The Economy of Coffee

2010-01-28T10:58:00.000-05:00

I have only recently become a coffee drinker. It was part an aversion to bitter flavors and part the superior feeling I got from being the only person I knew who didn't need a cup a day. I learned how to drink the stuff this past spring, and am actually at a point that I can enjoy a cup - though still not addicted. All of which made me slightly more interested in the mountain economy than mere concern for the Guatemalan people.

What you see in the photo above is coffee beans drying in the sun. This is probably about half-way through the economic life-cycle of a coffee bean. They start out by growing on bushes high in the mountains. I'd seen tea plantations in Rwanda, and expected the same beautiful fields in Guatemala. The colors were beautiful-the deep greens of plants growing in wet areas always make me feel earthy- but forget the orderly fields. The mountains are steep, and the coffee is planted in as close to rows and you can get on a steep mountain side.

The bushes are cared for by the local people who are called the Chortie. I was a bit confused about the delineation of the sub-population but from what I gathered they are Mayan descendants. They are a bit of a closed community, and unless you are in an area near a town they will hide from outsiders. They will speak Spanish, but as you get further from towns they have their own language.

The life of the Chortie is simple and difficult. The male head of house (and when possible female head of house and children) will pick coffee beans all day. The beans will be carried (on your back) down the mountain to the closest weigh station where the volume of beans is determined. Payment is made per weight, and the farmer returns up the mountain to get home. I didn't understand who owned the plants, whether individual families owned the property and sold their beans or if coffee companies owned the land and paid families as workers.

Homes are made of a combination of palm branches and clay bricks. Families who are close to towns may use cement bricks for part of their home but there are some limits to this. Cement blocks cost money, but clay bricks can be made freely by anyone. Cement blocks need to be transported to the home site, so will need to be carried one at a time or a truck will need to be hired (more money). So most families will use the clay bricks and branches. This means their homes are constantly at risk for pests and insect nests. Below is a picture of the type of palm branches used to build homes and structures.

Cooking is done outside. The diet is very plain and nutritionally inadequate. Corn and black beans are the staples. Bananas grow in the mountains so can be added to the diet. We saw some melon fields on the lower slopes of the mountains, but these were obviously a business with the product being sold in the nearest towns rather than being intended for families up the mountains. The furthest we went into the mountains (about a 45 minute drive from the nearest small town), still had a small supply of junk food available - small bags of chips and some soda for sale at a store (the home of a family living next to the government school). Here is a kitchen from a different family who operates a store from their home - again right next to the local government school.

After the coffee is weighed, it is taken to the drying center as seen in the photo above. Coffee is dried, roasted and then packaged for sale. I was able to purchase a pound of roasted and ground coffee from a local plantation for $35Q - with $1USD being equal to $8.2Q this means my coffee cost less than $5. And as a recent coffee connoisseur I will admit to finding the Guatemalan coffee to be lacking the harsh acidic taste I sometimes find in coffee. At my local grocery store or Target I can purchase a pound of good coffee (sorry, I don't buy Folgers) for about $8 per pound. I have been paying more lately because Josette and I had been trying to purchase fair trade items rather than "regular" items.

The Fair Trade concept sounds good. Basically the corporation selling the product contracts with a farmer or group of farmers to purchase the item at a living wage. This way the farmer is not paid pennies a day for their work. But there are flaws to the system - mostly the price. Few people are willing to pay a higher price for a Fair Trade product. I can get Fair Trade coffee from two companies during my regular shopping trips. They sell their beans in 12 oz contains instead of the 16oz pound and the prices are higher than the other brands. But the prices for all their products are higher than the other brands. Check out the fair trade products in your coffee and chocolate aisles by looking for this symbol (if you live near a Target, you can purchase Fair Trade coffee):

I have many questions about the impact of Fair Trade on communities. I have significant doubts that fair trade alone is able to end the poverty cycle. I also wonder why price setting (refusing to lower the price when market prices drop) is considered a good thing because the farmers are poor when similar high price setting by companies in developed countries is considered greedy. One concern I have read about Fair Trade is the way the price setting can influence increased production without increasing demand - which leads to overall lower prices. It reminds me a lot of the problem when sugar companies began paying farmers in parts of Africa (I'm pretty sure it was DR Congo, but its been 15 years since I took that class) to produce sugar. The money received for the product was welcome, but families spent less and less of their agricultural resources on food for the family. The money received for the sugar needed to supply the families food, but the family structure and the culture did not support this lifestyle. The men (who by law owned the money) spent the money on drinking and other fun things, while their wives and children were left to try to provide food with fewer and fewer fields. It was a cultural disaster. No matter how good it may sound to pay farmers in developing countries to grow what you want, it is important to remember that their society may not operate in the way you expect. Giving them more money to produce your food isn't really a way to prevent that. That being said, I do still purchase Fair Trade. I'm just more of a fan of purchasing and using local products - which is again more expensive and time consuming than the regular grocery store trip.

So yeah, this is what I was thinking about as I road up and down the mountain standing up in the back of an old pickup truck. It is a wonderful experience to have had, the view was amazing - but it was very cold, damp air and the truck went very fast on a one lane dirt road. My heart broke as I saw families picking beans or carrying bundles down the mountain. Poverty is real, and I am blessed to not experience (even if my family lives below what most Americans consider adequate income levels).

Guatemala Facts

2010-01-28T10:08:00.001-05:00

Welcome to Guatemala! OK, so actually I've been home for nearly two weeks. I needed time to recuperate from the hectic schedule I created for myself. But I am ready to share the stories and photos now, so lets begin with some basic facts about the country of Guatemala.

If you are geographically challenged, Guatemala is in Central America. Sharing borders with Mexico and Belize to the north, Honduras and El Salvador to the southeast. The Pacific Ocean is to the west, and a small piece of coastline on the Gulf of Mexico completes the borders.

When you think of Guatemala think of mountains. Lots of them. Also think volcanoes. This creates a beautiful country with very fertile soil, but makes travel slow and difficult. The occasional earthquake or volcanic eruption can cause devastation. In fact, the colonial city of La Antigua had been destroyed two or three times. And though you may guess the country is nothing but rain forest, you'd be as surprised as I was to be staying in a desert. Turns out Guatemala boasts multiple eco-systems. There are lowlands where it gets hot, highlands were it gets cold. Areas of high humidity and wide arid expanses. So if you are touring the country, pack for anything.

The beautiful and fertile landscape makes it easy to understand why the Mayan people built their cities in the region. Although I would have loved to see the ruins, it was not part of this trip. Today the population of Guatemala is estimated to be about 14.5 million with less than 4% of the population over the age of 65. Literacy rate is 70% - which means 30% of the population over the age of 15 is not able to read and write. And most importantly to me, the infant mortality rate is 35.5/1000 live births (this is about 3.5 babies dieing per 100 born). Maternal Mortality is 240 per 100,000 live births, or .2 per 100 births. These are much better statistics than Sub-Saharan Africa, but still higher than they need to be.

Economically the country is just as varied. Guatemala City is bustling and modern, but it is estimated that at least 75% of the country lives below the poverty line. 50% of the workforce is agricultural and 35% is service. That leaves a mere 15% employed in industry. Agriculture accounts for a quarter of the GDP and a third of all exports - you may have enjoyed coffee, bananas or sugar from Guatemala. I was delighted to find several of the articles of clothing I purchased for the trip (from a thrift store intending to leave in Guatemala) were actually made in Guatemala.

Politically, the country is becoming more stable. Officially the civil war ended in 1996 with the signing of a peace accord. But ongoing political violence and corruption scandals make it difficult for foreign investors to feel confident enough to invest.

And that is Guatemala in a nutshell, or at least in a list of facts. But it does give you some background to understand more about the trip.

Are you on Facebook?

2009-10-28T14:20:00.000-04:00

I was excited to find Georgette on Facebook. There is no electricity or internet in Nayngezi, so she only has access when she travels into Bukavu. But she is on Facebook and you can give her encouragement that way!

The easiest way is probably to follow this link: http://www.facebook.com/profile.php?id=1777705894&ref=ts

Guatemala

2009-10-28T14:09:00.000-04:00

I am excited about an opportunity I have to spend a week on a humanitarian trip to Guatemala with some college students. The trip will happen in January 2010, and the sending organization has said they can set up a nursing clinic for me to participate in.

I intend to make full use of this gift, ensuring I learn about the structure of organizations who do humanitarian work overseas; running a clinic and performing nursing tasks in a foreign country; working within a foreign culture. The skills I learn on this trip will be directly applicable to the work I have set before me in the Congo.

Because I do need to raise my own support for this trip, I welcome all gifts. You can make a donation at http://www.globalinfusion.org - be sure to indicate the gift is for Jennifer Vanderlaan for the January 2010 Guatemala trip. I need to raise $1600, which works out to $200 per day. The fee covers my flight, visa, accommodations and food while there. I already have my passport and the necessary vaccinations, so no need on that end this time.

Thankful for your prayers and support, and check back for updates. If possible, I will write updates while in Guatemala - but even if I cannot photos and information will be posted as soon as I return.

Website about the Clinics

2009-10-09T10:31:00.000-04:00

Flory sent me a link to the new website describing the health work that continues. Check it out: http://www.fochi.org/health/

News From Georgette

2009-03-27T15:05:00.000-04:00

Tammy and I were very excited to find an email this morning from a friend who had spoken to Georgette. The email we had hoped to use to speak with Georgette did not work properly, so we have only received updates through Flory. With my school schedule being so hectic, we haven't been able to keep up with him as we had hopped.

The exciting news is that the Midwives continue to work towards having a viable group. They have been working to raise funds to purchase goats and chickens in addition to their garden. At least we know the midwives in Nayngezi are moving forward. I wish we could get news from the other regions.

Teaching in Multiple Languages

2009-01-12T12:36:00.000-05:00

I was really curious how the teaching would go, knowing the women who were coming would be from at least three different countries. As it turned out we had women speaking four languages attend, but most of them knew at least Swahili. The funniest day was Sunday, when Flory hosted a church service for the women. Flory was speaking Swahili, and one of the women was translating for us. But five minutes into his teaching a woman from Rwanda jumped up and complained that the other Rwandans could not understand him. So he taught in Swahili, she stood next to him and translated it to Rwandeze and our dear friend Akyasu translated that into English for us.

Even trying to give them forms to use to keep track of information proved a challenge. I had to write it out in English, explain the meanings to Flory and Georgette, and they had to translate it into two languages so the women understood what was being asked of them. We used a makeshift chalk board to write things out so they could see it.

We learned very quickly that question and answer sessions would be more difficult than anticipated too. Georgette was fantastic in trying to translate questions for us, but the cultural differences made many of the solutions we knew to be impracticable for the women or offensive to their husbands. It was a very slow learning process, which we hope ended with the women feeling equipped to find their own solutions to their problems.

Birth in a Clinic

2009-01-12T12:26:00.000-05:00

One of our saddest realizations was that the clinic, despite its best intentions, could do very little for the people of the community. There is no way to contact the doctors after they leave the clinic for the night, so birth emergencies may be better off happening at home except there is one nurse in the clinic all night, and he or she does have access to some supplies.

This is the supply shelf in the maternity room. If you don't see it here, they don't have it. This is actually very well stocked because a medical group from the US had just come and brought 19 suitcases of supplies with them.

This is the pharmacy in the clinic. Again, it is well stocked because of the group from the US that donated these medications.

Before you start thinking you need to get as many medical supplies as possible to send consider this item donated by a group in the United States. Their intentions were honorable, to save babies that are born premature. However their donation is not usable because there is no power at the clinic. The generator barely keeps the lights on, it cannot handle equipment like this.

Inside the House

2009-01-12T12:08:00.000-05:00

Tammy had enough foresight to take photos inside the places we stayed. I thought I would add these shots because they really display the cultural shock that met us on our journey. Do you remember the views from the house we stayed in while spending the night in Bukavu?

The house is in this photos, the white one behind the brick house:

Inside it is modern, and not modern.

For example, here is the living/dining room, fully equipped with satellite television.

But in the same house, right around the corner, is this kitchen:

There is running water, but no place to store food, no refrigeration (a mini-fringe was brought in by the owner to use while he was in town), and the cooking is done on a small electric hot plate.

Tammy's Photos and the Latest News

2009-01-12T11:59:00.000-05:00

As promised, I am actually sitting down and going through Tammy's photos to get them on the Blog. It just happens to be a few months later than I had hoped to have time to complete it. It was strange to sort through pictures today, it brought up so many memories and almost made it difficult to work - almost. I will work today on putting up the pictures that tell more of the story, so you don't have to look at more of the same.

I haven't received a recent update from Flory - It can take a while to hear from him and now I have a better understanding why. The few days we spent allowed us to see just how much this pastor cares about his people, the sacrifices he is willing to make to help them build a better life. Travel for him is difficult - expensive and time consuming. He never knows where he will be staying, and doesn't always know when he will be able to complete the tasks he as set out to do. It is simply the reality of the culture and infrastructure in his corner of the world. It makes me think of Paul on his missionary journeys and the problems he must have had as he tried to help grow so many churches.

Tammy and I have officially decided we will not be returning to the Congo this summer. Between finances, threats of war and school commitments we feel the timing is not right. We feel a much better use of our time and the donated money this year will be to collect supplies for birth kits which we can ship to Flory to distribute. We will have more information about that soon.

Updates from Flory

2008-10-17T09:40:00.000-04:00

I received an email from Flory last week. Amina (Bujumbura, Burundi), Georgette (Nayngezi, DR Congo) and Akayesu (Kigali, Rwanda) were able to meet to discuss how things are going.

Things move much slower in Central Africa than they do in the US. In the two months since I left, there was very little progress among the trained midwives. There were no reports of any woman receiving care, and they sent no information about the process of getting into the clinics.

The last thing I did before I left Burundi was design some forms the women could use to keep track of the care they give. This allows them to see what they are doing and will give us solid date to make decisions from. Because of the distances, only Flory in Bujumbura had a copy of the forms. He made copies for the women and gave them to Georgette and Akayesu to distribute to the women in their area.

I will have to wait a few more weeks or months to find out what other help the women need to actually get started.

There was no update from the deep forest. We simply need to wait for someone (probably a pastor) to come to one of the closer towns and bring back word - it will then make its way back to us.

Sending out Information

2008-09-25T17:08:00.000-04:00

The last month has really been a blur. In addition to getting information about the trip into a format that can be shared, I have also started my second semester of nursing school. This has really caused me to change my focus from the women to my studies, but I have not forgotten them or the reason I am in school.

If Tammy or I have your address, you should have already received a newsletter with highlights from the trip. I do have a few extra so let me or Tammy know if you want more copies to share with others.

If you gave money to the trip, you should receive very soon a CD-ROM with more photos and stories to enjoy. Jeff just finished making the copies for me, they are in the mailers and addressed. Now I just need to find time to stop at the post office. They will be coming, so watch your mailbox!

New Photos

2008-09-07T19:56:00.001-04:00

I received a CD with Tammy's pictures from the trip this weekend. I have successfully uploaded the photos to the computer, but I'm afraid studying and getting some business things in order has to be done before the photos can be added to the blog. So stay tuned, I should have them uploaded before the end of the week.

Finances

2008-09-01T17:48:00.000-04:00

One of the things we needed to pay attention to with this trip is the amount of money it actually costs to do this. We had no idea how much money to budget, how much things cost or what types of bills we would need to pay. Thanks to the smart planning of my husband, we took extra money to cover the fees (extortion) that is just a way of life in the Congo.

So, as a recap, we paid for:

two Americans to travel to Central Africa, with the proper vaccinations, visas and evacuation insurance
35 women to travel to a conference center
use of the conference center meeting room and accommodations for 8 nights
Food for us and the 35 women (and their children, plus the extra help we had and the women who came in only for the day)
Materials for the attendees
Travel, hotels and food for us as we continued to explore the area and the culture - while making future plans after the conference
Incidental expenses (like the radio, video, use of the electricity, protection with police and army)

And the total cost to train the 53 midwives and beginning the planing for midwives in Central Africa: $15,000

This seems awfully high and really low at the same time. One thing to remember is that we spent about $6000 before we ever left the US, because we needed to travel to the area. We also needed special supplies like water filter bottles and malaria pills.

We will be much better prepared for the next trip.

Flights

2008-09-01T17:40:00.000-04:00

All was well with the world of airline travel until we attempted to leave Dulles airport. Tammy was scheduled to leave first, just a few hours after we arrived. I had a seat on a 5 o'clock flight, and opted to go stand-by on one that left a few hours earlier. We had a quick breakfast/lunch and said our good-byes.

Tammy's flight boarded as scheduled, but had to wait for mechanical problems. Something with the brakes or landing gear I thought she said. They had one false take-off (went up and came right back down) which I'm sure was a bit off-putting, but Tammy made it to her next connection and is home safe and sound. I think her total travel time was 37 hours.

I didn't get a seat on the earlier standby flight, so waited at the airport for the one I booked. There were, of course, mechanical issues with the plane and we would be boarding half an hour late. Still issues, wait another hour. Waiting on a part to come in on another plane... now we are waiting for the clearance to leave. My flight took off 4 and a half hours later than scheduled which got me home cranky and tired. I think my total travel time was 40 hours.

The exciting thing is neither of us suffered "jet lag" going either direction. Our secret - set your watch to the new time zone when you step into the airport and live by it. Then of course it helps to arrive at your destination in time to go to bed for the night and be exhausted enough to fall asleep.

Back Home

2008-09-01T17:34:00.000-04:00

Tammy and I have been back home for a couple weeks now. That first week back was super busy; my sister was visiting and Tammy had two sons heading off to college. The second week allowed us a little rest as we moved back to the swing of daily life. But there were still odds and ends from the trip to attend to.

I got to work on a newsletter for the people who were following the trip, and almost have it ready to mail out. I also put photos and stories from the trip into a powerpoint presentation so I can send copies of it to the people who supported the trip. I also needed to work through the finances to make sure we knew just how much it costs to send a team.

We have already been in email contact with Flory and Georgette, senator David and even Justin (the thug *grin*). Georgette has found a piece of land she feels will be suitable for the midwives garden, but I didn't understand everything she wrote. So goes the conversation when only one of the parties can speak both languages. I'll keep you posted.

Life in Bujumbura

2008-08-12T03:33:00.000-04:00

We are getting ready to leave Bujumbura, but wanted to say a few words about our experience here. This is the first time I have actually tried to live in an area of such poverty, and the reality was eye opening.

The selection at the market was slim, and even slimmer because we were trying to avoid unpasteurized milk and fruit we could not peel. Bread really was one of our only choices here.

But this morning we couldn't even buy bread. The hotel, a small but very high quality establishment had simply run out. We had the same problem trying to buy minutes for Tammy's phone, they simply ran out. Everything we see for sale looks as if it has come from other countries as donations. The things that are new are very expensive. We thought we wold look for a computer to leave with Flory, but the computer store only carries one model and it costs the equivalent of $1500 US. As a point of reference, a cup of coffee at this fancy hotel is about 80 cents US.

We were able to finally find soccer jerseys as gifts, but they are from the 2002 season. There simply is not a supply of things in Bujumbura for people to buy. It is a strange reality, to see things that are becoming modern but still so far from what they could be.

We checked the World Bank lists yesterday. Burundi is the 4th or 5th poorest country in the World, DR Congo is the third. I wonder just how bad off Zimbabwe is at the number one spot.

We will be on a plane to Addis Ababa in just a few hours, and home in less than 36 hours. It is almost sad to leave, and we are not sure how easy it will be to readjust to the luxuries we take for granted in the United States. We haven't gotten too used to poverty though. We are both looking forward to the movies on the plane and plan to take hot showers as soon as we get home.

Notes of Thanks

2008-08-11T11:21:00.000-04:00

We were lucky enough to receive a variety of thank you notes from the women we trained, and between the three people who spoke both Swahili and English we got them translated. Here are a few excerpts:

"We have found that women are dying because of ignorance. We are promising you to teach or train others so that the number of deaths can decrease in Rwandas women."

"We are promising to do whatever taught by Jennifer; she did not waste her time here"

"We thank those who contributed to rend this adventure a reality to enable millions of lives to be saved. All of Pastors; and church members have prayed since last year fo this and God has answered our prayer."

"We are happy because we know now how to serve pregnant mothers and their new babies."

"If you have sacrificed yourself coming from America, how far can I go on my own continent?"

"I promise you and Tammy that your being here with us is not a waste of time."

"We hope that you will continue to pray for us in this vision that we have of helping pregnant women"

"We hope that many midwives of USA will continue to come to train and assist us in Africa"

Ahhhh...American Food

2008-08-11T11:09:00.000-04:00

We were very excited in Kigali to find a restaurant that served American food. We made Flory try some breakfast pastries, but when we came back for lunch he just couldn't bring himself to order a burger. Instead he had the waiter bring him his food Congolese style.

Tammy and I jumped right in, ordering sandwiches. Tammy even got an Iced Mocha Late. After a few weeks of mostly bread and potatoes, a panini tasted really good...until about an hour later when Tammy started feeling sick in the belly. As we walked around Kigali following Flory on his quest for information about a Safari, Tammy started asking for a bathroom. By the time we made it up the stairs to the travel office her face was pale and she couldn't get out more than "bathroom." But the lady in the shop recognized her extreme distress, grabbed a key and was out the door dragging Tammy by her arm in record time.

I didn't even see which way they went. When the Woman returned, Tammy was not with her. Flory started talking to her, oblivious to the fact that Tammy was gone. Then I heard a woman scream. I had a picture in my mind of some lady in the restroom trying to take Tammy"s bag and she couldn't do anything about it because of her intestinal distress. Then came the faint moans and I knew Tammy must be really sick and needed help, but I had no idea which direction she had gone. Flory just kept talking to the travel agent on the phone. Finally the woman noticed my panic and went to rescue Tammy.

Tammy was fine physically; the screams had not been her. But the bathroom she had been taken too had no water in the tank or the bowl. She quickly decided this was an emergency and she needed to go anyway. But then the cold sweat and awful feeling of oncoming puke petrified her. What was she supposed to do now! Fortunately, the nausea subsided and she got some relief.

We still cannot talk about it without laughing hysterically that Tammy did fine all week with the unrefrigerated Congo food, but one iced late made her sick.

Instead of a Safari

2008-08-11T10:28:00.000-04:00

Since the Safari was not going to happen, we went with plan B - return to Bujumbura so Tammy could be that much closer to getting on a plane home. We packed our bags and headed to the bus station for the 4 hour dive. Flory promised it was shorter than the drive to Kigali.

Flory was wrong. It took close to eight hours, and we had back seats withe the wheel well blocking our feet. The woman in front refused to let us have the window open, and we could smell the exhaust from the van. I'm pretty sure we wrote about this before, so we won't go into too much detail.

We arrived in Bujumbura alive and began the recovery from the mild case of carbon monoxide poisoning. We are at a beautiful Hotel that gives us internet in our room and has the most darling restaurant on the top floor balcony with a view of the mountains. American food, air conditioning, internet, Tammy didn't even complain that there was no hot water. We even have the 24 hour french news channel on the TV.

The view from our hotel balcony - it is actually prettier in the picture than in real life.

When Flory and Amina came to get us last night he asked about our hot water that Tammy had wanted so badly. We told him the hotel didn't have any. He was shocked and went to the desk to complain and apparently he was right that something was wrong with the plumbing to our room. We had gotten so accustomed to not having hot water it didn't even occur to us that something might not be working right.

So we have been in the room updating the blog, answering email and getting our bags ready to leave. We went out this morning to buy some gifts and made a visit to the Batwa village - it is like a native American reservation only for Pygmies; The government moved the people right outside the city in 2000 to try to accustom them to modern life and to begin education for the children. Apparently it did not go as planned. Instead of living in the brick houses built by the government the people built their own mud huts and have not joined the rest of Bujumbura society.

Here are some shots of us in the Batwa village, note the beautiful Congolese dresses Georgette helped us buy.

On the way to and from the Batwa village, we passed a garbage dump outside Bujumbura. It was next to a pond where the Batwa and some people living on the outskirts of Bujumbura fish and bathe. We saw people digging through the garbage, Flory said they were looking for bread crusts or anything they could eat. It seemed so common to Flory, but was another shock to the level of poverty we were seeing. He couldn't believe this doesn't happen in the US, or that people make good money disposing of the garbage.

Short Stay in Rwanda

2008-08-11T10:14:00.000-04:00

After the rain forest, The Rwandan landscape is a patchwork of farms. But the road is all paved and you can see electric lines in some areas. Pretty modern for this corner of the world.

We ended up only spending one day in Rwanda, since hiring a car with short notice on a Saturday is impossible. But we got some great gifts to bring home when we went shopping with Flory. We even mad a visit to the Genocide Memorial in Kigali.

We spent the night in a small ministry center with beautiful gardens and of course, no hot water.

Flory left to use the internet Cafe and we decided to settle in. The room did not seem to have been used in a while, there was a very large dead cockroach in the tub - not like American tubs, really just a drain on the floor. I volunteered Tammy to get rid of it, and gave her some tissue. She screamed as she grabbed it-the thing was alive! She yelled for me to open the door and thew it out as quickly as possible.

As we closed the curtains for the night we found a little friend intending to spend the night with us. I rushed outside and found Patrick, a young man from the UK who was there to teach English to the Genocide survivors. He took the time to shoo the Gecko out of the Room.

After he left, we found another gecko in the bathroom. Tammy was beside herself by this point. No hot water and a room full of critters. We waited for Flory to return. He laughed at us for being scared of a gecko and calmly beat the poor thing to death.

We spent the next day in the city of Kigali tracking down baskets and other souvenirs. I even gave Flory a pair of sunglasses so he could be a tourist with us. It was the first time we had worn pants since arriving in DC. Here is a city view and the famous Hotel Rwanda hotel:

On the Road Again

2008-08-11T10:05:00.001-04:00

Amina had left from Nayngezi with the women to Uvira since she did not have the right papers to go through Rwanda. We left with Flory to go through Rwanda since we did not have the right papers to take the good road straight back to Bujumbura. We piled into a taxi and headed for boarder. In just a few minutes we were there and safely on the way to the bus station.

We knew we would go through the rain forest, so we got our cameras ready. I don't remember if I described the bus rides to you. Very crowed, driving fast up and down the narrow mountain roads, the same music tape repeating for hours. But it is cheap and gets you from point A to point B, just don't try it without Dramamine.

So, here are some shots of the rain forest:

And as abruptly as it started, it stopped. I am sure it is only because of the work being done to conserve this habitat for Gorillas. No, we didn't see any on the side of the road, they are too smart for that. But we did see monkeys and some type of deer.

Try to keep a straight face

2008-08-11T09:37:00.000-04:00

We wanted to share with you some of the funniest things the women asked us, and a few things that were hysterical because of the translation. Please keep in mind that we really do love most of these women and understand we were the first people that taught them anything about their bodies.
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"Why is it when you stick your finger in a woman's anus that in some women the finger stops, and for other women the finger can go deep in?"

Jennifer's answer "Why do you stick your finger in omen's anuses?" We found out the next day about the level of internal cleanliness the women are required to keep.

_

"Why is it that when you do an enema once a month, the baby may still be born with mucus"

_

"Why do they tell us to go to the hospital for surgery to have a baby because we are short"

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"Why is it that when you breastfeed, the baby turns brown even though it was born with light skin"

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"Why when I am pregnant for four or five months do I stop wanting to have sex with my husband"

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Regarding natural family planning "this is great, but how do you get the husband to agree to wait to have sex?"

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"When are you going to teach us how to cut the cord" asked nearly daily

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"Are you sure this is safe, the midwives teach us hands and knees is a bad position, I might kill my baby"

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"Why is it that if you make fufu during your monthly bleeding your husband cannot eat it?"

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When discussing other ways couples can be intimate during the postpartum recovery period, "What do you do with your hands?"

Overnight in Bukavu

2008-08-11T09:29:00.000-04:00

We enjoyed the night in Bukavu, it was the first and still only time we had hot water on this trip. Tammy took two hot baths before we left. Georgette left before dinner, and we didn't hear from Flory until the morning so we were on our own for food. We were a little freaked out by the overly helpful security guard, so just ate some protein bars in our room. We had beautiful views of Lake Kivu.

We had printed up a report for the Ministry of Health at the hotels internet cafe, and in the morning we walked over to deliver it. We met the minister again, and this time I didn't sit quietly. I reported on what we taught, and told the minister what the women had said about the clinics, "since I knew you would want to be informed." He looked a little embarrassed, said it was a problem that he would look into.

He asked for a picture of us when we left. Either it is true that proving you know Muzungu brings status or Tammy is right and we needed to get out of the country ASAP because I had upset too many people.

Driving with the Senator

2008-08-11T09:15:00.000-04:00

We had lunch with Senator David and learned that our ride back to Bukavu was arranged with him. He allowed us to bring Georgette back to Bukavu with us to translate so we could shop. We talked a bit about the conference over lunch, and I took the opportunity to tell him about the women not going to the clinics because of the bad treatment they receive. He asked Georgette a lot of questions about the clinics and what the women say. I didn't know if he could do anything about it, but I knew from the little time I spent with him that if he could, he would.

It was a long ride, because as an official vehicle, his driver is not allowed to drive fast. We spent the hour chatting with the senator with Georgette translating. They had gone to school together in Nayngezi, which may have been the only reason she was as candid with him about the clinic abuses as she was.

He told us he would do whatever we needed to start a midwives school in Nayngezi. I told him we would need electricity and clean water as a start. He also asked us to bring our husbands back with us next year and train the family's about sex (we think he meant family planning) so the men don't keep having 10 children without having a job.

He took us to our hotel and offered us the use of his car and driver to go shopping.

Graduation Day

2008-08-11T08:58:00.000-04:00

On the last day of the training Tammy and I noticed more people than usual milling about. The van driver from Uvira as there-we knew Flory had arranged for him to transport some of the women. But there were other people we did not know. We figured everyone knew the Muzungu were leaving and were hoping to get something from us.

We had a short session after breakfast, naming off women who have made a difference in women's health and encouraging the women to not give up. Then it was the women's turn. Five of the women had prepared a skit for us and we were not sure what to expect. As it turned out, the skit was hysterically funny. They portrayed a couple with the typical Congolese brute of a husband demanding everything of his pregnant wife. The midwife came to teach her and her husband how to be healthy and took the woman to the clinic since she seemed to have signs of anemia. I couldn't believe it, they had not only understood the formal lessons; but the women also learned to serve each other without demanding payment, to stand up for each other against the unhealthy demands of uncaring husbands and to seek help when needed. They had come a long way from the group we had met just a week before.

During the short break Senator David showed up. We had met him the day we left Bukavu for Nayngezi. He was happy to see us and came bearing the certificates that had been made for the women. He gave a short speech, then we called each woman up to receive her certificate.

Tammy and I were not prepared for the outpouring of emotion these women showed. It turned out that the people milling about had been friends and family members come to celebrate the graduation. It didn't occur to us that without any formal education this was as close to high school or even college some of these women would ever get.

The Congo Mafia

2008-08-10T14:53:00.000-04:00

Tammy and I got a kick out of Flory's cousin Florimond. He seems to be a well connected, important person here in the Congo. He has men who follow his orders, three cars at his disposal and even the general brought him a goat to thank him for giving him a bottle of wine. When we were sent off to Nayngezi, it was his man Justin who drove us. Justin was also responsible for staying at Nayngezi while our group was there. He walked around with a cell phone or two way radio-I couldn't figure out which-and it made us think of the old Mafia movies in the US. Poor Justin, we started referring to him as Florimond's Thug.

We found out later in the week that the term Thug would fit Justin in the states. He played his radio in the middle of the night, and we ignored it for a few nights until I got so angry that I got up and made him turn it off.

It was Justin who refused to let us use the generator unless we paid for the fuel. He demanded 46 dollars a day to run the generator for four hours. Flory negotiated 10 dollars a day for two hours-he didn't ask me or tell me who was demanding the money. When we asked Florimond on Sunday he said things were just so expensive in the Congo and that the generator was not included in the price. My scowl showed my anger as I explained to Florimond that so far I have found nothing that cost more in the Congo than in the United States and that if he did not include the price of the generator than we would not have electricity because I was not paying another dollar. But the electricity continued because Flory had already paid.

On our last day, Flory came to me to let me know we had some bills to pay. There was the extortion money from the Army and the Police - standard for any Congo event. We wold also need to pay the local and regional radio stations to come cover our event. He then told me we needed to pay 60 dollars for video taping of the training and they demanded more money for the generator.

I told Flory I didn't know I had agreed to pay for the video taping, that I had been asked if they could tape parts of it to advertise for the Center. He said he had given Justin 60 dollars for video tapes out of the translator budget. I was now angry. Flory admitted that Justin had been a problem all week demanding money and he apparently thought he was saving me the hassle by dealing with him by himself. I told Flory I had no intention of paying for video tapes unless I went home with them; and that he was not to pay another cent for the generator because he had already given 80 dollars to cover the 8 nights. Flory said he would go with me to tell Justin.

Poor Justin didn't know what hit him. He explained how the fuel was gone, and I explained that was not our problem, that we had already paid to use the generator for 8 nights. He then tried to tell me we had already used eight nights, so I wrote it out for him to show that he actually still owed us two nights-the subject was immediately dropped since he had no intention of giving us a refund. I also told him I needed a receipt for the video tapes and the tapes themselves, and I needed a receipt from Florimond for all the expenses. Flory just smiled as we walked away. He told us later that Justin had been mistreating the women and causing other problems too. The lights came on no problem that night. Poor Justin.

The Clashing of Cultures

2008-08-10T13:27:00.000-04:00

While Tammy was enjoying the scenic drives too and from Bukavu-a little too close to the cliffs for comfort- I was teaching the ladies about the almost common reasons for maternal death and what they could do to prevent it. I stated the day by having the women pull their chairs in close, told them we were talking about a very serious subject and that because we were talking about death we would not sing until we were done.

We spent the morning talking about hemorrhage and labor obstructions, then broke for lunch. My appetite had been gone for a few days, so I walked down the street to buy a bignet with Georgette. After lunch the women asked me if I was so quiet because I missed Tammy. I couldn't believe they asked that-hadn't I told them this morning we were talking about a serious subject?

So I told them I was quiet because of the subject and how I had learned about the maternal death rate in that area-how it made me cry and that it was shy I was there. I told them the worst part was that the deaths were preventable with the things I was teaching them, and that I hope they cared enough about the lives of their friends and neighbors to tell other women.

They sat staring at me, stunned I think. Then someone asked why the death rate was so much higher for them. I suddenly realized that they didn't know there was a problem. They have been invisible to the world and for all practical purposes the world has been invisible to them. Death in birth was normal as far as they knew, and for me to suggest that it didn't happen in my world was amazing to them. We talked a little about the reasons why, that there was no easy fix but that they could fight it.

Then later that day as we talked about babies who are born too small I held up a picture of a mother sleeping net to her baby to keep it warm. One of the women asked what else you could do because the husband will not want the baby in bed. I answered in my typical American that you marry a better man and how we need to explain that it is necessary for the baby. The conversation continued with the women very upset because they said their husbands would beat them if they tried. This time it was I who was speechless.

I asked Georgette, are they really telling me that they do the work to make the money, they do the cooking, the husband beats them and they stay. 'Where else could I go' said one of the older women. I was speechless. I took a moment to collect myself-a room of 52 women and only two or three are not beaten by their husbands-but they accept it.

I told Georgette later that I couldn't understand it. If my husband ever hurt me my sisters would take me and the kids. That as a culture we do everything we can to prevent it. She calmly said that in Congo there is no police to enforce it. I asked if she had been beaten. No, she said, her husband knew she had gone to high school so she knew her rights. She could call a family meeting if he hit her. This is why the women are not sent to high school, she said, because men do not want to marry a woman who knows the law.

The Quest for Manuals

2008-08-10T13:04:00.000-04:00

By Sunday when Florimond came out to the center we still had not received the training manuals we paid for. It was agreed that Flory would go to town to get the copies. When the plan changed because it was too late to get a ride in and out of town, we decided one of us was going. It had to be Tammy because the teachings for that day wold be problems which I had been studying about for a month to prepare. Flory assured her everything was ready and they would leave at 7 am.

We had breakfast and Tammy left. We expected her return around lunch time and when she didn't get back by three I was getting worried. She finally pulled in on the back of a motorbike covered in dirt at 6. I grabbed her away from the women who were all excited to see her, and see her on a motorbike, and we went to the room.

I have never seen anyone laugh and cry at the same time, but Tammy did. The words "We are never separating again" come out of her mouth as she collapsed onto the bed. Through tears and half laughing at the absurdity of what had happened she told me the day began with a walk into town to get a ride to Bukavu.

Apparently the Congo term 'things are all set' and the American term 'things are all set' mean two different things. Tammy and Flory spent half an hour in Nayngezi until they could find a car with enough room for two and hitchhiked into Bukavu. They walked several places before they found the man with the book and then had to travel back to Florimond's office to make copies. Bukavu is no small town; and Tammy was glad she had my sneaker sandals because of all the walking.

They hadn't completed making ten copies-we paid for 35- when the power went out. They decided to wait to see if it would come back on. Three hours later Roland wandered by and told them not to wait because the power never comes back on this late. Someone knew a place they could go that never loses power, so They loaded Tammy, the copies, the paper and the copier into a taxi to go to a hotel and make the copies.

At the hotel room they nearly completed a second ten copies but were thwarted when the ink and paper ran out-the secretary apparently didn't think ahead to bring more. By this point it was already 4 so Tammy was insistent they needed to leave or it would get dark. So they packed the 10 completed copies into the backpack and walked up and down the hills of Bukavu looking for a ride back to town. Most people did not want to make the trip to Nayngezi because it would be dark soon. They finally found two motorbike drivers who agreed to do it, but Flory thought 8 dollars each was too much to pay. Tammy firmly disagreed, gave them the money and started back to the center.

Flory kept screaming for the driver to protect Tammy's head, so the driver gave Tammy the spare helmet which did not have a chin strap. Poor Tammy was holding the helmet on with one hand and holding on to the bike with the other. Flory kept yelling "poly poly" which means slow, but the driver didn't listen. He did take pity on Tammy and traded helmets so she could hold onto the bike with two hands. But the drivers helmet had no visor. When they pulled up to the gate in Nayngezi, Flory yelled at her to wipe her face, which she did and he yelled to do it again. She tried but they were off again up the road to the center. By the time she pulled up at the door her legs were weak and numb from the walking and the bike, she was covered in dirt from head to toe and only had 10 copies of the manual.

On the last day the Senator brought the 10 copies Tammy had left unfinished. We never did receive the other 15 we paid for.

The Baby Catcher

2008-08-10T12:44:00.000-04:00

On our first full day in Nayngezi after the Americans had left and the Dr tried to get money from us, the other doctor came to ask if we would like to assist with a birth. I was working with Georgette on translations and thought Tammy would love to see what they do anyway so asked if she wanted to help with this first one. She followed the doctor to the clinic and I kept working.

About an hour later Tammy returned and asked if we could go relax in the room, she obviously was upset and needed to talk. Tammy talks when she is upset, I get quiet. It has been the perfect match.

We lock the door and close the windows and she tells me in one breath that she just almost watched a baby cry, saw them abuse the mother and is pretty sure the mother is bleeding too much but they don't care. She told me bits of the story as she tried to calm down.

Tammy didn't get called to help with a labor, they called to have us manage the birth. She walked into the clinic to find the mother tied to the table already crowning. One doctor asked if she wanted to cut the episiotomy, and when Tammy said "no, no" the other doctor seemed to say they don't do that in America. They had no translator, told Tammy nothing about the labor and just expected her to come in and catch the baby.

One of the doctors started pushing on the mothers belly even between contractions and would pinch the mother to try to bring on more and stronger contractions. Tammy tried to tell her to stop, but she only stopped between contractions. Tammy caught the baby, put her on her mothers chest which amazed the doctors. The cord was cut before Tammy knew what happened, but the baby didn't breathe. Tammy rubbed the baby's back which got some small breaths.

The male nurse took the baby to the side bed while he and the doctors looked at the mother. Tammy got their attention about the baby needing help, and they decided to use the rescue breather donated by the previous group. It was obvious they had no idea how to use the rescue breather but they tried while they sent Tammy to deliver the placenta. The cord had too much tension for Tammy to feel comfortable having never assisted with a placenta before so she decided to wait. The doctor looked over, basically slugged the mother in the stomach and the placenta fell out. The doctor yelled at her to drop the placenta in the bucket: it was never checked.

Tammy then turned her attention to the baby and showed them how to use the rescue breather. She was still not satisfied that the baby was OK when they sent her out. She finally got them to give the mother a shot of oxytocin because of her bleeding. She walked out of the clinic absolutely horrified at what had just happened.

We had been told by the previous group that birth here is terrible, but had no idea it was that bad. Suddenly the problems women face in the United States seemed minor.

Flory

2008-08-10T09:00:00.000-04:00

Flory was such a good sport during the whole training. He did some of the more difficult translations for us and sat in on most of the sessions. When talk got a little to improper for a Pastor, he would cover his face and wait for us to stop talking about mucus and girlie parts. A few times he just left the room.

We pulled Flory into our lunches several days to explain to him that we may be starting wars between the men and women. He listened intently and asked questions to understand the issues the women faced, and the reality of their lives. We talked with him about breastfeeding, and how accepting the cultural norm of leaving the baby with the mother in law all day was probably responsible for some of the high infant death rates. We talked about the sex in the clinic and the need for a woman's body to heal to prevent damage and infection. We talked about the abuse the women admitted to suffering and their belief they have no other options.

Flory was amazing. He took everything we said and began to make it real. His sermon on Sunday was about the importance of not following the customs and Taboos of the culture; but of following Christ. He told the women that neglecting their babies to make their mother in law happy went against Christianity. He challenged the women to use their newly found knowledge to help others identify the lies they believed. Victoria could not believe a pastor would say these things, let alone a pastor in charge of other pastors. But he said it, and the pastors who were helping heard it. Change has started.

By the end of the training Flory was no longer embarrassed by the words for girl parts and stayed for most of the sessions helping Georgette translate and explaining the truth to the women.

Surprises and Sex Ed

2008-08-10T08:44:00.000-04:00

The women were very interested in everything we were teaching. It didn't occur to us just how much they didn't know. With no formal education, no libraries and no one to ask questions, there were quite a few surprises.

Our first surprise was the day we were teaching about infections, a topic we figured would be easy. But as it turns out the idea that you only rinse the external vagina, not using soap and not cleansing the inside was a shock to them. They had all been taught that the inside was dirty because of the mucus, so it needed to be cleaned daily. Their husbands actually demanded it. They had so many questions we were pretty sure they were all suffering from chronic vaginitis.

The second surprise was their question about why doing an enema once a month didn't always prevent the baby from being born with mucus. We figured out by mucus they meant vernix and went on to explain that the vagina and anus are separate canals and discussed the role of vernix.

Our biggest surprise was when we discussed postpartum care and Tammy gave the recommendation that they abstain from sex for two weeks to ensure the vagina had a chance to heal from any tears and minimize the risk of infection. The women asked how they could do that since the husbands follow the woman to the clinic for sex. Apparently the husband asks everyone to leave the resting room and they get to work. We told them about other forms of sexual intimacy that wold not include the vagina and the women didn't get it right away. Georgette turned back to me and asked "What do you do with the hands?" Tammy just stared as I tried to figure out how to not demonstrate oral sex or a hand job, but making sure the women understood. In the end Georgette told us the women thought we were crazy and said that type of thing is fine for Muzungu, but they didn't want it.

We were able to calm the uproar by pulling the verse from the Bible that says a woman is unclean after giving birth. Debatable, but it gave them an opportunity to accept that maybe sex in the recovery room isn't the best way to go.

Lobo

2008-08-10T08:36:00.000-04:00

This is Lobo, a man who works at the center. Lobo became friends with us instantly, even though he spoke no English. He taught us some phrases in the local language and came to greet us every day. He never asked us for anything, unlike just about everyone else we had met.

On our last night we gave Lobo a package of treats, some beef Jerky and Granola. We found out the next morning that the other men were giving him a hard time for being friends with Muzungu. Even Georgette would have problems for being friends with us. If you are friends with Muzungu everyone assumes they have given you things and that you have money now. They want a part of it. The nurses and doctors at the clinic may have their rent raised because the landlord knows Muzungu came to work there. That made Lobo's friendship even more precious.

We think it was Lobo who brought us food that first night. Another woman was translating for us when he asked why we didn't eat. He knew we were left without food and had gone to a neighbor to beg for us so we would not be hungry. I've never had anyone do something so sacrificing for me before. He had almost no food himself, only eats once a day if that. And being associated with Muzungu would put him at risk.

Kayesu

2008-08-10T08:27:00.000-04:00

When Flory arrived at the training center he informed us there had been a problem with some of the women from Rwanda and that was what had kept him. They did not have the right paperwork to leave the country, and in the end he had to leave them behind.

We got more of the story later from Kayesu, a woman from Kigali on the left. The woman on the right is also from Rwanda.

Kayesu told us that the women had gone to get their passports at the office, and they had filled out the forms and paid their money. But the officials would not give the passports. They said the Congo was too dangerous and told the women to go home. The women put up a fight, but at the end of the day most of them went home. Kayesu would not leave. She demanded they give her the passport or give her the money back. They continued to refuse and told her to go home. She told them she was not leaving until she got her passport or her money back and she slept on the stairs of the building waiting for them to return in the morning. She wore the officials out and they gave her the passport.

Only three women from Rwanda were able to come. We sent Kayesu home with a full English copy of the book and a teaching kit so she could teach the women of Rwanda what she had learned. From what I know of her, she will not rest until the job is done.

Hands On Training

2008-08-10T08:18:00.000-04:00

We knew we couldn't just lecture to these women, so we were prepared with all manner of hands on activities for them.

We stuffed the birth kits into plastic bags full of air and placed them under a pair of pants to have them learn about finding the baby's position.

Later in the week we put the pants on and actually gave birth through the hole we had cut. I can't believe we have no pictures of that, it worked so well.

One of the nurses helped explain some of the things in Swahili which really helped. We loved Hortense, she was patient and a good teacher. She didn't have a stethoscope of her own so we gave her one when we left.

We used models for everything, it really helped to let the women touch them and try things on their own.

We even had them make a bracelet that tracked the fertile days of their cycle when we talked about family planning methods.

Georgette

2008-08-10T08:03:00.000-04:00

We were so excited to meet Georgette, and the training would not have been successful without her. On the first day as we discussed eating in pregnancy the women complained that they could not eat well because they did not have money. I was getting ready to give a rehearsed answer about doing the best you can when Georgette said she was going to tell them eating well was not having money. She talked for fifteen minutes, going back and forth with the women in what we can only assume was the best nutrition talk many of them have ever heard. Georgette had studied Agriculture at the high school, she knew what she was talking about. We never doubted her after that, and many times she took the lead in discussing topics with the women.

During the breaks we would try to help Georgette be prepared for the next session, but once the music started her body rocked and she had to go dance. Here she is during a dancing game where everyone has to find something to put on their head.

On Sunday, Georgette brought her children to the church service to meet us. The baby is on her back.

Her husband joined us during church; and we went to their home for lunch.

This bowel is used to make banana juice.

We love her family, and tried to convince her to visit us in the United States. We don't know if she will, she thought most of the stuff we told her about was funny; like shower curtains, why would you get a curtain wet? If we come back next year she will help us teach again.

The last day we handed out the supplies we brought and had a lottery. The last item we gave was a teaching kit. It was our gift to Georgette so she will continue to teach the women of Congo about woman's health. I think she cried for five minutes straight.

She rode with us to Bukavu when we left to spend a few extra hours with us. She helped us buy dresses and taught us to wrap our hair like a Congolese woman. To do this meant she would have to pay for a ride home on a motorbike or on the back of a brick truck. She only goes to town every three weeks or so, it was a big deal for her to do this.

I miss her already.

Around Nayngezi

2008-08-10T07:55:00.000-04:00

Our nightly walks put us face to face with the people of Nayngezi. We were able to greet them in Swahili and even learned traditional greetings in the local language. That's right, three different languages are spoken in Nayngezi and we didn't always know witch one was being used.

Here is the Army camp up the hill. We had to pay for their protection. Extortion is just as much a way of life in the Congo as the bribery. If we did not pay, our women would be harassed by the Army. We also had to pay the police to ensure they would do their job.

This is the Market. We did not shop here, but I did buy some bignets and avocados from a street vendor closer to the Center on an afternoon walk.

This is a hot stream. Flory asked me why it would be hot. I knew it had to be lava underground, but was surprised that he did not know that. Just another shock to the reality of lack of education due to poverty.

Kitchen and Eating

2008-08-10T07:41:00.000-04:00

The kitchen was in the back of the center in a small flat area dug out of the dirt. Women from the community who work at the center were helped by the women we trained to prepare food. Here is the kitchen and staff:

Flory and Amina had budgeted for 35 women to be fed at the training. There estimate also included food for Tammy and I, Flory and Amina and two pastors who came to help as necessary. On the first day when I asked Flory how many women were coming he said it would be a surprise. I think that was his way of saying he didn't know. At the end of day one we had 45 women, and by the end of day two there were 52. The village chief had heard we were there and sent local women to be trained. In the end, we gave out 53 certificates. We were feeding lunch to the 53 women, their children, us, the volunteer pastors and other people who may have included the kitchen help, men who work at the center and the security people. I don't know how Amina did it, but we never ran out of food.

Dinner for Tammy and I was separate from the women. It was a cultural thing, as teachers we ate first and were left undisturbed. It was isolating even though it was meant to honor. Because of issues with electricity, we were served dinner in our room.

The food was rice, fried potatoes, meat in sauce and fresh pineapple or banana. Breakfast was bread; eggs and coffee. We had lost our appetites by the end of the week, and had Amina give the rest of the meat for us to the women. The women ate bread and tea for breakfast, and had fufu or rice with beans for dinner and lunch.

One lunch:

Midwives Garden

2008-08-10T07:35:00.002-04:00

One of the sessions was used to help the women from each village determine how they could support themselves working as midwives. Their husbands would not allow them to help women if they could not make money.

The midwives from Nayngezi had already decided before the training began to prepare a garden they would share. They would work together to sell the harvest and support their work. They would also raise small animals that could be sold to help support them.

This is the midwives standing in their garden.

The women from other villages all decided on similar programs to support their work.

Wildlife

2008-08-10T07:27:00.000-04:00

The Shilo Center has some wildlife, because it is run like a farm. There are goats, which I chased out of the kitchen several times before the ladies asked me why I hated goats. They thought it was funny that I didn't want them near the food, since they considered near the warm fires the best place for them.

There were pigs, rabbits, guinea pigs a monkey and a baby chimpanzee the owner had rescued from poachers who killed his mother. The poor chimp has a skin infection so he is losing his hair, may be malnourished and is suffering from being isolated from other chimps. But the caretakers loved him and did their best to help him.

Positions for Labor

2008-08-10T07:23:00.000-04:00

We had a very fun experience teaching positions for labor and comfort measures. We were pretty sure some of these women had not been touched except by their husband or children in years. Getting them comfortable with touch was a priority. We started by giving them lotion and teaching them to perform hand massages. It took off from there.

We did get some strange looks when we suggested hands and knees. It seems the midwives have always told women hands and knees is a bad position and will kill the baby.

Children

2008-08-10T07:18:00.000-04:00

Many of the women brought their children to the training with them. We also meet many of the children of Nayngezi on our evening walks.

Rest of the Training: Singing and Dancing

2008-08-10T05:31:00.000-04:00

The women, some of whom did not learn to read, were not comfortable with long study sessions. The days were broken up with singing and dancing, and a long rest for lunch.

Day Five: Healthy Pregnancy

2008-08-10T05:25:00.000-04:00

We started the day with a big laugh. I had purchased a very large stretchy dress to bring on the trip, and stuffed the dress with a teaching model and some towels. The women laughed hysterically when I walked in with a big pregnant belly.

The women spent the day learning how to check pulse and temperature, how to identify infection, how to find baby's location in the belly and listen to the heart rate.

Day Five: Training Begins

2008-08-10T05:14:00.000-04:00

The day stared with bead, eggs and coffee. It was to become the standard meal while under Amina's care since she had no idea what to feed the American women. Things began looking up when Flory arrived early in the day with a van full of women. We had not been abandoned, the training would happen. The women settled into their rooms and we began to prepare for the teaching to begin after lunch.

We decided to break the ice by wearing the model baby on our backs, which combined with our Swahili greetings made the women laugh.

We told Flory about Georgette being a natural teacher, and he arranged for her to be the translator for the training. The day began with an introduction into the world of maternity care, and the ways a trained midwife could help.

The representative from the ministry of health came to officially start the training, warning the women that if they tried to assist a woman at home they would be put in jail. He left and we continued with infection control.

Women wandered in the rest of the day.

Flory had planned to spend an hour every afternoon walking aground Nayngezi visiting the local sites; so we ended the day with a walk to the hilltop to see the view.

We were feeling much better about our quest, and looked forward to the next day of training.

Day Four: Alone

2008-08-10T04:47:00.001-04:00

We knew the group from the US was leaving that afternoon, and had expected Amina and Flory to join us. We spent the morning exploring the center and upon our first exit from the building were greeted by a man at the clinic who asked if we had something for him. We retreated to the Center where members of the other group warned us not to walk out with a bag or the people think you are handing things out. Seems a member of their group took great pleasure in passing out candy to the local children, and now it was expected. The American group spent their morning passing out their clothes, snacks and anything else they wold not need before they got home to the staff of the center.

Florimond and his cars came to pick up the group around 11. We asked him for a translator to begin learning girl-part words in Swahili and he brought us Georgette. We spent the rest of the day working with her. As we talked and showed her the materials she began teaching everything to the kitchen help. She was amazing.

The group finally packed all their stuff in the cars and drove away. There was not enough room so some of the locals stayed to wait for the cars to return. There were only two people who spoke English, Georgette and Roland; Flormond nephew who would be translating for us at the training. We had no food and no way to buy lunch but knew the cars would be right back to pick up the rest of the locals and bring Amina and Flory.

The Dr from the clinic came to speak with us using Roland as a translator. He said that he knew we would be using the clinic as a training site and that he expected us to pay him 400 dollars to do that. Just to put it in perspective, a nurse makes 40 dollars a month here. We were shocked and told him we would speak with Florimond about it; since we had given him the entire fee for use of the facilities.

Florimond did not return. His driver came, loaded up the rest of the locals and the dishes and drove away. No Amina, No Flory. Roland and Georgette went home for the night. No one knew English. Uncomfortable puts it lightly. We sat outside waiting, not really knowing what for. A man we did not know came to us and waved for us to follow him. He took us to the room we knew was Florimond's private and showed us a bowl of food. We didn't understand if he was asking if he could eat it or if he wanted us to eat it. We just shook our heads and walked back outside. The absurdity of our situation hit us and tears streamed down our cheeks. Had we been abandoned here to fend for ourselves for a week? Had we just traveled two days to be scammed out of the money that had been donated? We gave them about six thousand dollars the night before and now were were alone in a small village without anyone who spoke English.

Someone turned on the generator to give us electricity and we ran into the building to use the laptop that had been donated. We sat playing solitaire and listening to the music that had been loaded before I received it so we could have some sense of normalcy. It was after nine when a car pulled up with Amina in it. She apologized as well as she could with her little English, but we both knew she had less control over Florimond's drivers than we did. Fearing we had not eaten all day she fed us bread and coffee. Then we wen to bed not knowing what to expect next. The training was supposed to start in the morning but no one was here but us and Amina.

Day Three: To Nayngezi

2008-08-10T04:25:00.000-04:00

Having experienced the shock of the poverty the day before, I was better prepared for the drive back out to Nayngezi. We stopped for bread, and while we waited in the car we watched the police hassle drivers to get money out of them. I just kept thinking "please don't drive down that road, we are muzungu." Luckily our road went the other direction. Here you can see some shots of the trip out of Bukavu.

We got out of the city and into the beautiful rolling hills of banana trees.

And eventually ended in Nayngezi at the Shiloh Center. It turned out to be a half completed building with a dorm on one side and a meeting room on the other. There was a small clinic out front. They were putting together beds purchased with our payment for the women in the large meeting room.

Some shots inside the Clinic:

This is the labor room:

We had dinner with the group from the US and thought they were rather cynical about the people of Nayngezi. It seems the plumbing was tricky, choosing to only work in one room at a time, the help asked for everything and the people took anything they could get their hands on, including digging through the trash to find useful things. They only got electricity at certain times, and we waited for the hour to come when it would be turned on. We had been in Africa for three nights, and slept in a different bed each night.

Day Three: Plans begin to change

2008-08-10T04:05:00.000-04:00

We had thought the plan was to leave for Nayngezi the next day when Flory returned from his trip. It had been decided for us that our training would not start until Wednesday for various reasons we did not understand that included the presence of the other US group and the arrangements for transporting the women. So we spent the morning seeing some of Bukavu with Flory's cousin.

The city turned out to be larger and busier than we imagined. Here are a couple views from our morning.

I began to understand what Victoria had meant by the women of Congo being so elegant. Bukavu was not the poor village I had imagined, it was a huge metropolitan area. We began to see the dangers of having some modern conveniences without a modern infrastructure. No real parking, traffic controls, sidewalks or even a way to maintain the roads.

Our first stop was to change a tire, which was fixed on the side of the road at a sidewalk shop. Then off to meet the minister of health. Florimond had told us we were to the fee to the ministry of health. We were instructed to put the money in an envelope and hand it personally to the minister. We did not receive a receipt and had no official paperwork to fill out. Our first bribe was paid. But bribes are the way things work here, not to get something illegal done but to accomplish things that are completely legal. Your paperwork is simply not processed until you bribe all the right people.

We were going to use the internet at Florimond's office, but since there was no electricity that day we decided to go to an internet cafe where we met Victoria. She had been in the group that came from the church the night before, but this was our first real opportunity to spend time with her and learn about her work. One hour and one email later we were picked up and taken out to lunch which was the most amazing Tilapia I have ever eaten.

We were then told we were leaving for Nayngezi that afternoon. It was back to Florimond's house to wait for the driver. It was not until we were loaded into the car that we understood we were to be left in Nayngezi with the other Americans, and our contacts would meet us the next day.

Day Two: Spending the Night in Bukavu

2008-08-10T03:34:00.000-04:00

We had no idea where we were going to spend the night in Bukavu. As it turned out, Flory's cousin had a house in Bukavu and he had arranged for us to spend the night there. The house was nice in Bukavu standards. It overlooked Lake Kivu and was next door to the General's house. From here, Bukavu looked like a town on the Mediterranean.

We found out the next morning that we are guarded by the army because of the proximity to the General. Some of the men let us take their picture.

The view of the lake was so beautiful. It actually made me sad to know that because of the location most people in the world would never consider coming to see it:

We were to spend a few nights in Bukavu because Flory needed to take an American pastor back to Burundi to speak. The pastor was with Flory's cousin and was on his way to the house. We waited, and waited until Flory even got impatient. Seems on their way meant they were at church and stopping for dinner before coming home. Flory and Amina had been a little later than they said while we were in Bujumbura, but this was our first real introduction to Congo time.

When they finally arrived we found out it was a whole team from a church in the US who were working at the clinic in Nayngezi. Several of them had come into the town for the day. They started telling us about the work at the clinic; how much help they needed with techniques and got our first bits of information about the center we would be staying at.

We quickly turned our attention to business, paid Flory's cousin for the use of his center and gave Flory the money for food and other arrangements he was making. THe group from the US left with the cousin except the pastor who would be staing the night and leaving in the morning with Flory: by this time it was too late to leave because the boarder would be closed.

We sensed some agitation in Flory, we assumed was from the lateness and his inability to prepare us for it. He wanted us fed and the only way to do hat was to go out to eat since the markets would all be closed. The pastor went with us to be sociable. After we got to know him we began to wish he had not come. I don't think the man stopped talking for two minutes the whole time. He also had a very different understanding of Africa than anyone we would have ever called Christian. He described the serving culture and how white people were celebrities and honored guests, but in such a way as to say it was OK not to care at the poor treatment of others. We listened to his stories and were glad he was leaving before we woke up.

I love trying new foods, and was excited to be at what is considered a good restaurant. We had stopped at a travelers restaurant on the road from Uvira where we ate basically a bite of goat meat and nothing else. We got laughed at for not eating the fat and they explained Congolese love to eat the fat. We were allowed to only try a small bit of the Fufu because Flory did not want us sick. So this was going to be a great opportunity to try something new. Flory was very worried about everything I chose to try, so I finally agreed to have him pick out something I couldn't get in the US that he felt comfortable with me eating. After two minutes of looking trough the menu, he looked at me and very desperately asked "can't you just eat the rice." So I ordered plain white rice and what they called a steak.

Day Two: Driving to Bukavu

2008-08-10T02:38:00.000-04:00

We drove out of Uvira and saw some of the highlights of life in the Congo. For example, the women doing the laundry in the river.

We started to see some of the variety of architecture we associate with Africa, such as the round hut.

We even had opportunity to stop by a roadside stand for oranges. This was the Congo equivalent of a Quick Stop on the express way. The children we passed all wanted to see Muzungu and everyone wanted their photo taken.

Then we hit the mountains. Because we did not have multiple entry into Congo, we could not take the good road that meandered into Rwanda and back to the Congo. So we drove along the mountains on the Congo side: Across the river you can see Rwanda.

The drive was more bumpy than I can figure out how to explain. It made me think the uncomfortable Safari ride at Disney Animal Kingdom was pretty accurate. We drove for a few hours on the side of the mountain, frequently coming closer to the edge than we thought was necessary. Tammy and I laughed about it that night, we had hit so many other rocks and holes did we really need to risk rolling off the cliff to avoid one?

Eventually we began to see signs of life and we passed through Nayngezi where we would teach on our way to Bukavu where we would stay for a few days. Our first views of Bukavu were small brown rooftops lining the hills. It seemed to stretch forever before we got into the city.

The city roads were just as bumpy as the mountain road but now with people and oncoming traffic everywhere you looked.

Flory asked me later why I didn't take more pictures coming into Bukavu. I didn't know how to explain it to him. The houses were pitiful little wood and mud structures and the ragged people were everywhere. The women carrying heavy bundles on their heads and backs were so dusty, it was obvious they had been walking for miles. The thought of taking pictures to highlight the extreme poverty made me sick to my stomach. I just sat and watched this world I would probably never know and tried to make sense of what I was seeing.

Day Two: Uvira

2008-08-10T02:22:00.001-04:00

After the exciting ride out of Bujumbura we were at the boarder to the Congo. You are not allowed to take photos at the boarder so I will have to describe it. First, you come to a gate and have to get out of the car. You go to a small dimly lit room where you hand over your passport and answer some questions while they write your information in their log book. There are a lot of people just standing around outside the office with no apparent reason. After being approved, you walk past the gate, through the neutral zone to the next gate where you show your passport and get logged again. The neutral zone has people selling oil, produce and other things, as well as money changers who will ensure the exchange is not in your favor. Once past this second boarder check you are allowed back in the vehicle to continue your trip.

The taxi took us as far as Uvira, where we were to wait for a bus. We had read Victoria's comments on the buses and had the privilege of seeing the over crowded things so were ready for the worst. There were many people waiting at the bus station, and though Uvira was a smaller place than Bujumbura it was still busy.

We were pleasantly surprised when we realized Flory had arranged a private bus for us and our things. The four of us, all our luggage and two operators piled in and headed for Bukavu.

Day Two: Leaving Bujumbura

2008-08-10T02:09:00.000-04:00

Driving to Bukavu from Bujumbura was an adventure. Flory began calling it our "Safari" and we complained about the lack of lions. As we wrote before, city streets in this part of the world are busy places. They may not have the heavy motor traffic seen in more developed countries, but the motor vehicles are there in high enough quantities to cause congestion. On either side of the street you will find crowds of people walking fom here to there. The motorbikes and bicycles carry thier paying passengers, and the livestock must be moved. Like we said, busy places.

To make it even more interesting, the drivers have no traffic rules to follow. So on this particular ride, with oncoming traffic, bad roads and flanked by pedestrians our driver found 110 to 120 to be about the right speed. For those of you who say "yeah, but that is kilometers" let us just remind you that 100 km is the same as 60 miles. Would you be comfortable driving 60 to 80 mph on a barely two lane road with oncoming traffic and pedestrians in the road?

Day One: Bujumbura

2008-08-10T01:53:00.000-04:00

We were picked up at the airport and taken to a hotel for pastors. At only $10 a night the price was right, but we were not able to leave the hotel without Flory.

We walked to the market and down to the lake to see some of the sights. This is Flory and Amina on the beach of Lake Tanganyika:

This first night was a difficult one. We were dropped into a city we did not know where they spoke languages we barely understood. Then we were left alone at a hotel. We are so accustomed to our lives in the US that not being invited to stay at their home felt strange.

The hotel was as friendly as they could be to two foreigners that could not understand what was said to them, but it was still an unsettling experience. Having been in Juarez, and having spoken to Flory via internet over the past year, I felt more comfortable than Tammy who had never seen such poverty before and did not really know anything about our host.

Back in Bujumbura

2008-08-09T11:32:00.000-04:00

We were not successful at hiring a car and driver to do a safari, so we took the bus back to Bujumbura. our flight is not until Tuesday, so we have a few days to visit the town and do some shopping. It also gives us time to relax, process all the events of the last weeks and prepare to go home.

Tonight is our first shower since we left the US. We did have hot water at one hotel, and were able to take a bath. This hotel is a shower but no hot water. I am completely exhausted from the journey. We spent over seven hours on a bus through the mountains, but not greyhound. Think 15 passenger van outfitted to hold five rows of four people each; plus three in the front: Now add an extra person or two in some rows; all the luggage blocking the door, and close all the windows because for some reason the Rawandise do not like fresh air. We had no breakfast or lunch, but did buy some snacks at a stop.

I am getting a bit ahead of myself because I am telling you that we had our first accident today, but have not yet explained the driving habits of Central Africa. They drive fast through the mountains and only honk to warn everyone to get out of the way. By fast I mean 60 mph or faster, on very narrow two lane roads with people walking along them. We were sure we would see an accident before we left Africa. We were right, as our bus was passing a slower truck a bus going the other direction came close enough to take off our mirror. We stopped long enough for the assistant - every bus has a driver and an assistant - to climb out the window - remember the door is blocked by the luggage- to be sure the side mirror was off and we were running again. The other bus never even slowed down.

The good news is that we have a few days here ) internet in our room and two cameras worth of photos to upload for your pleasure. The bad news is this keyboard isn't American. So we will tell the whole story of our trip-but the grammar may be bad:

Lies from the Village

2008-08-08T11:36:00.000-04:00

What if everything you thought you knew about life in Africa was wrong. Tammy and I prepared for the lack of clean water, no electricity and primitive plumbing awaiting us, but we had no idea to be prepared for the reality of life for the Africa women.

There is no reverence for women or birth. Women are abused at the clinics. Their husbands demand sex immediately after birth. There used to be midwives, but they have died out. There is no sharing about the female body between mother and daughter. Breastfeeding is basically abandoned by 2 months of age because the mother in law demands the woman work. Women are taught to clean out their vagina at least once a day because mucus is dirty. Children are left at home with older siblings (6 years old) while the parents go work.

The beautiful ideal of village life where family and women are honored and people work together is a lie - at least in this part of Africa.

Tourist in Rwanda

2008-08-08T11:20:00.000-04:00

We arrived in Kigali last night. What we thought was going to be a short trip to Rwanda was actually a 6 hour drive! Yes, the Rwanda boarder is only minutes outside Bukavu, but Kigali is in the center of Rwanda. So we piled into the cramped bus and by some miracle we and our luggage all arrived in once piece.

The drive was actually interesting, in a cramped six hours with one bathroom stop sort of way. We spent two hours driving through the rain forest - and yes I saw monkeys on the side of the road. When we thought about it, monkeys on the side of the road is no different than the squirrels and other small wildlife that visit the US roadways. Unfortunately, they are fast and I didn't get any photos of them.

Rwanda, like the rest of this part of Africa, has turned out to be a world of contrast. The two hours before the rain forest were hills full of tea, the two hours after the rain forest were hills full of farms and a patchwork of fields. Some amazing greens - but they just don't come across correctly in the photos - which once again I can not share because high-speed internet doesn't translate well. Then of course there is Kigali - an overcrowded city and the most modern we have seen yet - the roads are all paved and they have streetlights and traffic signs!

We spent today shopping for small gifts for family back home, and are hoping to go on a safari on the Tanzanian boarder tomorrow before we head back to Burundi.

Copy of the Report Filed with The Ministry of Health

2008-08-07T09:41:00.000-04:00

Report to the Ministry of Health, RDC

From the Training of Midwives, Birthing Naturally

Wednesday, August 8, 2008

We have conducted an eight day intensive training for 52 women from the villages of Nangezi, Uvira, Bukavu, Mwenga and Shabunda. Also at the training were representatives from Burundi and Rwanda.

The women have been instructed in:

Prenatal Nutrition
Basic Pre-natal Health Assessment
Identification of Danger Signs in Pregnancy
Emergency Transport Planning
Providing Comfort to Mothers During Labor
Signs of Danger During Labor
Labor Assistance in Health Centers
Emergency Labor Procedures
Care of Mothers in the Post-Partum
Identifying Problems in the Post-Partum
Breastfeeding Assistance
Natural Family Planning Techniques

After having tested the women, we find them to be competent at the preliminary training level. We feel the women will be an asset to their communities through educating families, providing labor assistance and support in health clinics and providing post-partum education and support.

As this training was an introduction to pregnancy, birth and postpartum without practical experience, we recommend the women not be required to provide labor assistance without supervision until such time as both the medical staff and the midwife feel confident in the midwife's ability.

Because the communities of Mwenga and Shabunda have limited access to health centers, we recommend the midwives from these regions be offered additional training as per the World Health Organization standards for Skilled Birth Attendants in remote areas.

Back in Bukavu

2008-08-06T12:52:00.001-04:00

We ended the training this morning, and rode back to Bukavu with Senator David. We leave for Rwanda tomorrow morning. But tonight, sleep!

Maternal health stays in the new in the DRC

2008-08-05T15:11:00.000-04:00

This Article was put out today by Ruetgers:

BRAZZAVILLE, 5 August 2008 (IRIN) - Maternal and infant mortality rates in the Republic of Congo have remained worryingly high despite measures to reduce them, a senior government official said.
"The situation is still worrying," Emilienne Raoul, the minister of health and social affairs, said on 3 August in the capital, Brazzaville. "We will continue with efforts aimed at reversing this level of maternal mortality."
Some 510 women out of every 100,000 die during childbirth in the Congo, according to the UN Population Fund (UNFPA). "The fight to lower maternal and infant mortality will remain a preoccupation in the coming years," the minister added.
At least 86.2 percent of the deliveries in the Congo are supervised by skilled health personnel, but maternal mortality remains high. "While maternal mortality fell from 890 deaths per 100,000 live births in 1990 ... the government feels this is still too high, as are infant and childhood mortality rates," UNFPA said.
The high number of deaths is attributed, among other factors, to the lack of community training on safe maternal and neo-natal care, poor quality of care and post-partum depression.
There is also a lack of sufficient equipment and medical personnel in health centres, coupled with low-quality care during obstetric operations.
So far, the government has adopted two national health plans to reduce maternal, neo-natal and infant-related deaths.

No Contact, but check out this new news.

2008-08-05T15:07:00.001-04:00

Ruetgers news outlet published this story the day Jennifer left.

Emilienne Raoul -- the Republic of Congo's minister of health, social affairs and family -- on Sunday called on Congolese men to take a more active role in improving maternal health in the country, IRIN News reports. Congo's maternal mortality rate is higher than the average rate in Africa. About 890 of every 100,000 pregnant women in Congo die in child birth from complications including postpartum hemorrhages, hypertension and infections, according to IRIN News.Speaking in Pointe Noire, Congo, Raoul said, "Men have to get involved and participate in promoting reproductive health. To do so, we have to make information available and create sufficient awareness on the subject." She added, "Support from a husband well informed about the issues of pregnancy and delivery can make the difference between life and death. We do not want thousands of women to die because of complications during pregnancy."

Ministry of Health and Pygmies

2008-07-28T06:37:00.000-04:00

One of our tasks while in Bukavu is to meet with the Minister of Health to get final permission for the training. We actually met with him this morning - again, very interesting. It seems Dr. Florimond is a very important man in Congo, and knows many of the people in government. The Minister of Health even drove to Nayngezi to meet us yesterday - but unfortunately we were brought to Bukavu instead.

The Minister of Health is not feeling well today, so will not be in his office. So Dr. Florimond called him and we stopped by his home to meet with him and give him the money for the government approval. He was there watching television with his children and we met with him. Dr. Florimond translated for us. He thanked us, shook our hands and sent us off to his office to get what seems to be a cross between a work visa and permission to train medical personnel.

A personal meeting with the minister of health of a large country of 30 million people - that is the most powerful person I have ever met. He may not be the only high official we meet while here.

Though we were able to meet with the powerful, we may have lost our opportunity to meet with the weak. I have been told the Pygmy woman who agreed to come to the training is very afraid to be in a city for 8 days. They are working hard to encourage her to attend, but her fear may stop her. We are starting on Wednesday now, so if we all pray for courage for her she may still make it.

Bukavu

2008-07-28T06:20:00.000-04:00

Bukavu really surprised us. It is a huge city that looks like what you would expect along the Medeteranian coast. Dr. Florimond told us the city is home to over 1 million people, but was designed to hold only 300,000. It is very modern in many ways - people dress modern, motorcycles and taxis are zooming around. But almost all the women wear skirts, the electricity goes off regularly and the roads are full of potholes or made of dirt.

I noticed a few similarities between Congo and what I saw in France. Everyone here has a gate around their home, just like Paris. And Dr. Florimond's home, where we are staying, has a lock on every door - and they insist we lock them- just like in Paris. I don't know how much that is a coincidence and how much it is the French influence.

It seems so strange that a city as beautiful as Bukavu is only two hours drive from circular grass "huts" and people so poor they have no shoes. Picture New York City placed in southern France and you will get a good picture of Bukavu. The houses are built up the mountain facing the lake, and they are so beautiful. Granted, these are the homes of the wealthy, but every city has both rich and poor.

The differences between urban and rural here are so much more distinct than in the US. In the rural areas, the only cars we saw were the ones driving through - we only passed two cars in the three hours from Uvira to Bukavu. Most of the places we saw had little or no clean water, no electricity. Even Bukavu, this amazingly large city, suffers from the lack of electricity.

We are leaving Bukavu this afternoon and will spend at least 9 days in Nayngezyi for the training. We have been told there is no internet there, but we may be surprised.

Driving to Bukavu

2008-07-28T05:48:00.000-04:00

We arrived safely in Bukavu yesterday. Interesting story, to say the least. Unfortunately, we are still dealing with the slow internet connections at internet cafes, so I cannot upload the photos.

We were told we would leave at 7:00am We were up, packed and ready. Flory and Amina showed up a little after 8:00am. Apparently there was trouble exchanging some of our money (they demand perfect bills if you pay in American), and it was more difficult than they expected to hire a car. But they made it, we all piled into the car and off we left for Uvira were we were to catch a bus.

We took a photo of the speedometer because we knew no one would believe us how quickly they drive here. We were driving 110-120 down a only large enough to fit two cars - mostly paved road with people walking on each side. There are no speed limits, no traffic lights and no stop signs. It is the "law of the jungle" as Dr. Florimond put it - the one who gets there first goes. So the drivers are like NYC taxi drives on speed and/or cocaine. They honk as they come to corners to warn oncoming traffic and people. You must get out of the way - they will not stop. And they drive so close to the people we were sure we were going to kill someone. Thankfully, everyone survived.

In Uvira we got our first taste of Muzungu "white person" celebrity. They had us sit inside the bus office, and people walked by just to look in. Some people even came in to shake our hands and try to show off their English. We stepped outside with Aminia and caused enough commotion for the bus station workers to send us back inside.

We only saw a small part of Uvira, but it reminded us of Bujumbura - which reminded me of Juarez, Mexico. Walls everywhere, old run down buildings, dirt roads and sidewalks. But it is a very busy city. It was here that Tammy bought a sim card for her phone. The bus we were to take was a van that Flory had hired to take us to Bukavu - so we were not piled in with 14 other passengers. But the seats were hard and the roads - even the good ones- are bumpy and full of pot holes. We knew it would be a long bumpy ride, so we had prepared by taking a Dramamine before we left Bujumbura.

Neither I nor Tammy realized that to get from Bujumbura to Bukavu you need to travel into Congo, into Rwanda and then back into Congo. We only had single entry visas into Congo - so we had to take the "bad" road from Uvira to Bukavu. It was definitely a road - carved out of the mountain. It was dirt, and just wide enough for two cars (although that would be a very tight squeeze in parts of it). You looked over the edge of the mountain, with no guard rail, at the beautiful scenery. We saw the river and the mountains in Rwanda. So why is it the bad road? The rocks and potholes made for a very slow, very bumpy ride. The van shook so much you would have thought it would fall apart, and twice I swore we broke something under the van. The strangest thing to us was that despite the bumps and driving on the edge of a cliff Tammy and I were so calm the whole time. We don't know if it was the peace of God or the Dramamine.

We drove through several smaller towns on the way, and stopped for lunch at a restaurant where we had our first taste of fufu. We drove through Nayngezi and ended in Bukavu late in the afternoon. I have pictures of the people, mountains and houses along the way - but those will have to wait until we get a better internet connection.

Arrived in Bujumbura

2008-07-26T13:24:00.000-04:00

We arrived in Bujumbura this afternoon. It is a very busy city. We were able to see the market and spend some time drinking a coke at the Lake. I tried to upload a photo, but I think it was too big for the slow connection at this internet cafe.

We start off for Bukavu in the morning. We have been informed that the training will now begin on Tuesday night or Wednesday, so we will spend an extra day in Bukavu and head for Nayngeyzi on Tuesday. We will get a chance to view the market and talk with the women who will be part of the training.

The training has grown so now we have 45 women coming. Everyone begged Flory to let them send someone to be trained. He said that it was an opportunity everyone wanted to be part of - even the doctor at the clinic plans to attend so she can gain new labor skills!

Tonight we are going out to eat and will discuss more details about the training and the trip. I'm sorry the picture won't upload, but what can I do - this is Burundi!

Day One - Washington DC

2008-07-24T21:13:00.000-04:00

So, it was an interesting start to the trip. Nothing major going wrong, but things didn't go exactly right. Like I said, it was interesting.

It started at church when I went to get a check for the money that had been raised. While there I was offered a box of medical exam gloves that were donated for a future trip to Mexico (building houses so the medical gloves were not necessary). So I sat with Jeff and the kids to open the sample packets and sort the gloves. Half an hour later we had quite a collection to give the midwife.

Then off to the bank to exchange the check for cash. But that didn't work quite right because our money hadn't been deposited yet -- but half an hour and one visit from the pastor later and we had cash in hand. But not just any cash. In Central Africa the quality of your money can decrease its value. So we had to wait while the bank cashiers swapped out ripped, written on or old money for crisp, fresh bills.

No time for lunch with the kids, it was straight to the airport. After Jeff and the kids left, and I was alone behind the security check they put up a sign that said the flight was delayed at least an hour. I did make it into the air and was able to meet up with Tammy after walking the entire length of baggage claim at Dulles twice.

Tammy had a similarly interesting morning. As she was leaving for the airport she received a call that someone wanted to make a donation. She also rushed to the bank to get appropriate cash for the trip, but didn't have the hours to spare at the airport. She checked in two minutes before they were closing the flight and ran to the gate as they were calling her name for the last boarding call. She didn't have a direct flight, but she felt safe that her layover was adequate --until the plane spent over 30 minutes on the ground.

Like I said, we both made it, stretched our legs as we looked for each other in baggage claim and made our way to the taxi stand. Our poor taxi driver couldn't figure out where our hotel was. What should have been a 15 minute $10 taxi ride was 45 minutes, three phone calls to get correct directions and one stop at a wrong hotel that totaled $45 on the meter. But since it was his fault he didn't charge us at all for the ride.

Jennifer begins the long journey

2008-07-24T16:12:00.000-04:00

Jennifer began the first leg of her long journey to Africa today at 2:23PM taking off from Albany International Airport and flying to Washington DC. Where she will be meeting up with Tammy, the childbirth educator who will be going on the trip with her. They will be staying at a hotel in the DC area then returning to the airport to take off early Friday morning.

We already miss her.

A Gift From God

2008-07-24T15:57:00.001-04:00

While dropping of the donations at the church God gave us a special gift. While collecting donations for a recent event the church was donated over 1,000 pairs of medical grade latex gloves which the church has given Jennifer to disperse to the women. Truly and unexpected gift from above.
Jennifer's trip has been blessed by the generosity of 41 people covering 15 of the 21 days of Jen's Travel and 23.5 of the 30 woman's training costs.
Please be praying and consider giving to provide for the last 6 days of travel and 6.5 woman's expenses.

Jennifer Gets Ready to Leave

2008-07-24T15:45:00.000-04:00

This morning Jennifer got up early. She packed her stuff and went to take her Micro Biology final before leaving. She got her results immediately finding out she got an A. Way to go Jen. We plan to meet her at the church offices to turn in the last of the donations, go to the bank, catch lunch, and drop her off at the airport. With the test out of the way, Jen is ready to leave stress free.

Still Not Nervous

2008-07-22T10:02:00.000-04:00

A few people have asked me if I'm nervous, scared or excited about the trip. I haven't been nervous about it at all, and have also never been scared. I'm not a fan of avoiding the things that scare me anyway. I think fear should make me careful, smarter and better prepared. But fear should never control me or keep me from doing things I want.

When I stop to think about it, I'm usually excited. The "problem" is that I have been so busy I don't really get a chance to think about it. Between the family events of this trip to Michigan and studying for microbiology I've been so preoccupied that I haven't had much time to even realize how soon the trip is. I leave in two days, but my focus is on enjoying my last day with family, picking up the last few items and studying.

Shoes

2008-07-21T10:00:00.000-04:00

After speaking to a friend who spent last summer in Uganda we have decided the shoes I have are not going to work. Because almost everywhere I walk will be dirt and/or mud, the best shoes for the trip will be sandals that can be washed or rinsed off every night and be dry again in the morning. So now we add shoes to the list of last minute purchases before the trip.

Pygmee!

2008-07-15T23:55:00.000-04:00

I received an email from Flory tonight and can not believe how amazing this training is becoming. This is what he writes:

"Again, I thank God for what this training will achieve in Africa. I have been contacted by one of my pastors who have told me that he is going to send to the training a MUTWA Woman or Pygmee woman. These people are the uncivilised first habitants of Africa and have not responded to civilisation. Many of them live in deep forest far from people and don't like to wear clothes. They don't have either clinic, pharmacy nor school. But, our church is trying to work among them. Now, we will have one of them come to the training."

I did not realize the Pygmee still existed as a people, and I cannot believe that I have the honor to meet a Pygmee woman! I am amazed at how God is able to use this training--it goes so much further than my original goal of saving lives.

See Photos of Where we will be!!

2008-07-13T14:30:00.000-04:00

Victoria Bentley is a psychologist from California who has been working with Flory Zozo on the Women's Trauma and Healing Center. She was in DR Congo in June and is leaving again shortly - I will have the opportunity to meet her while there.

You can see some of the amazing work being done by Foundation Chirezi through the pictures and stores of at Victoria's blog: Healing Trauma in DR Congo

Some Interesting Maps

2008-07-12T23:02:00.000-04:00

WorldMapper.org creates maps that depict the proportion of various traits around the globe and lets you compare them to the traditional land mass maps we are most familiar with. For example, the population map has enlarged areas such as India and China and shrunk land masses with lower population.

Some interesting maps that relate to our trip:

Access to Midwives: http://www.worldmapper.org/display.php?selected=215
Maternal Death Rate: http://www.worldmapper.org/display.php?selected=258
Female Life Expectancy: http://www.worldmapper.org/display.php?selected=257
Infant Mortality: http://www.worldmapper.org/display.php?selected=261
Birth Injury Related Deaths: http://www.worldmapper.org/display_extra.php?selected=410
Total Births: http://www.worldmapper.org/display.php?selected=3

Birth Pants

2008-07-12T22:55:00.000-04:00

I convinced Jeff to let me see how the birth pants will work (sorry, no photos). It was not what I had imagined, it was actually even better. The stretchy pants are not too baggy, but the baby will need to be "guided" by someone to stay in place. It works in hands and knees and squatting positions. And because it is stretchy, I can stick my hand in the opening to demonstrate techniques for working with a shoulder dystocia (I was able to learn those earlier this year at a Midwifery Today conference).

I want to play with the pants a little more to see if I can use the pants with my model pelvis without someone wearing them. This would allow more people to see some of the maneuvers.

So, it is not exactly like having someone in labor. But the birth pants will work very well for demonstrating birth.

The Journey Begins

2008-07-12T22:46:00.000-04:00

Although I will not leave for Central Africa until the 24th of the month, the women who are traveling from the farthest distances (Uganda and Tanzania) will be beginning their journey this week. It is hard to imagine that it will take two weeks for the journey, especially when I could drive from New York to California in just a few days. But in the United States, we have access to reliable transportation, paved roads and expressways. We have trains and safe airports that can make the journey even faster.

It really makes me appreciate even more how committed these women are to helping their communities. I don't know that I would be as willing to travel two weeks there and two weeks back to learn about midwifery - and I love everything birth related.

It also makes me appreciate just how much these women are giving up to do this. The $206 per midwife we estimated only covered the costs of the training; the travel, food, accommodations and supplies. It did not include the lost income and other costs associated with being away from your home and family for six weeks.

There is only one word I can think of to describe these women -- heroes.

Latex Gloves and Baby Scales

2008-07-11T22:52:00.000-04:00

It occurred to me today that Tammy had asked/recommended we each attempt to get donations of rubber gloves and bulb syringes last week. Now I leave for Michigan on Monday and I haven't asked a single midwife for a donation. This was a sobering reminder of the tremendous pressure I have put on myself this summer. I haven't even had a moment to think about bringing more - I have supplies that have already been promised that I haven't picked up yet.

I was hoping to get donations through Midwifery Today, but travel schedules conflict and so I don't think that is going to work. The good news is I found a luggage scale for $10 at Target. I want to be sure to buy one and take it to demonstrate the use of a hanging scale and to talk about how the midwives can use baby-weighing as a way to continue to help families. The $10 price is much cheaper than the "real" thing, but will be much less accurate. It will still work for demonstration purposes and is better than having nothing.

Luggage

2008-07-11T22:48:00.000-04:00

So I had realized yesterday that I did not actually have a suitcase, let alone two suitcases. I told Jeff that I did not know what to pack in, and he started looking for a cheap way to purchase luggage. It seems when you don't spend much money on a suitcase you don't get much of a suitcase. Jeff insisted that what I pack in be up to the rigors of this journey.

We came up with the great idea of borrowing a suitcase from his Grandparents. The only problem is I cannot guarantee the suitcase will make it back in one piece -- or even make it back. Surprisingly, this was not an issue for the Grandparents. Because they don't expect to be taking any more long vacations, they have a suitcase we can have. Now that what to pack in is settled, I need to finish making my piles of what to pack.

Birth Pants

2008-07-11T22:41:00.000-04:00

A friend donated some old stretchy pants yesterday, so I took the time to make the Birth Pants as recommended in the Hesperian Foundation book for Midwives. I wasn't sure how big to make the opening, so I used the dolls from the teaching kits as models.

I made the opening large enough to let the doll slide through, but because the material was stretchy I was able to leave it small enough to demonstrate crowning. So the idea is cool, but I have not tested the pants yet. I asked Jeff to try them on to let me see what I would be working with and he recommended I try them on myself and he could take a photo. I'll have to see if I can get him to volunteer when the kids are asleep and there is no danger of neighbors looking in the windows.

Bag Packing

2008-07-10T09:50:00.000-04:00

I am off to the store to purchase my travel supplies today. I have a few lists of "what to pack to visit Africa" I found on the internet. Most of the lists are from Safari companies so that does not really apply to our trip. We won't be in a comfortable hotel with laundry services, and we won't be with guides who deal with tourists all the time. But overall, I think I have some pretty good lists.

The idea is to pack as light as possible, which is a bit of a problem for this trip. Although I am only bringing a few outfits, I still need to bring any toiletries, shoes and other items I need along with all the teaching supplies and any medical donations we were able to get. I also realized today that we don't actually own suitcases anymore. So I am not quite sure how to pack. I think I'll borrow from my mother and have my sister return them after her visit - but that means the acutal packing cannot happen until my 24 hour stop over between the Michigan and Africa Trips.

I keep telling myself that I don't have very much to pack, but then reality hits when I look at the very large bag of things in my closet. Yikes! Two full teaching models (uterus, placenta, baby and cord) will fill 1/3 of a suitcase easily. At least I don't have to print and bring teaching modules - that would have been the rest of the suitcase.

I also need to put anything of value in my backpack for on the plane. So the laptop and my camera have to stay with me. Then of course I need to keep clothes with me just in case - and since our travel time is over 24 hours I definitely want my toothbrush, soap, deodorant, etc. And I want the training manual to keep notes and plan with Tammy. So the backpack is already over full. I'll just have to make it fit. :-)

Hotel

2008-07-09T09:59:00.000-04:00

We had planned to spend our night in DC with a friend, which meant renting a car for a 45 minute drive to her home and then 45 minutes back first thing in the morning. Not ideal, but it would work. The worst part is that all this would happen before our 24 hours of flying - which leads right into our 6 hour drive. I get carsick just thinking about it.

In another example of how God is bigger than anything this trip can throw at him, I am happy to tell you that someone has donated a night at a hotel close to the airport in DC! This saves us the money from the car rental and the travel time so we can get some much needed sleep.

Continuing on the same good news theme, my email from Flory today recommended that we spend one night in Bujumbura before we travel on to DR Congo. He said he would arrange accommodations for us at a $10 a night hotel. I can't imagine how tired I am going to be after the plane ride, and how thankful I will be to not make the most amazing part of the journey half asleep and motion-sick.

Visas!

2008-07-08T19:30:00.000-04:00

AAA gave us a discount to use a Visa service. It seemed reasonable to not have to travel to the UN or DC to get a visa so I did it. I got mine back in the mail today!

Overall it took just over three weeks to get the two visas. This includes mailing time. I had assumed you just go to the embassy and they issue you a visa. I found out it takes a few days (they schedule four at this place) to be able to pick it up. And since you need to have your passport they can only do one visa at a time. I am glad I took care of this detail earlier than I thought I should.

I have two visas, one for a multiple entry into Burundi and one for a single entry into DRC. We do have to stop in a few other countries (Italy, Ethiopia and Rwanda) but since we will not be leaving the airport (may not even get off the plane) we don't think we need visas.

We have the legal paperwork, but the US Department of State website says we may still have issues with customs. Apparently customs officers occasionally ask foreigners for "special" fees to enter the country. We have no control over this, and there really is no way to complain to the governments who don't have the resources to prevent it. So this has to be a matter of prayer.

Flying to DC

2008-07-08T10:05:00.000-04:00

Something to add to the "I should have taken care of that sooner" files is the flight to DC. Not a big deal right? Southwest has direct flights super cheap.

Except Southwest flies to BWI and the flight to and from Rome (the first leg of the trip) is from IAD. So while that is not a problem for the 24th, when we have to spend the night in DC, it causes big issues for the return in August when we get back at 7 am and I would have to try to shuttle between airports. The cheapest we could find to do it with two bags and a backpack was $85. So no real savings and a big hassle. OK, no cheap Southwest flight.

But lots of airlines fly from Albany, I can get a flight on one of them. True--but... the only airline that flies direct to IAD is United. If I went with any other airline it would add another airport stop to my journey - not something I want after 24 hours of flying and 4 airport stops (the last time I flew with four stops I was quite green by the last flight and actually happy to have been bumped off the last leg and sent home on the train instead). So, my only choice is United.

United will work, they have four direct flights a day between Albany and DC. Except the flight that gets me in at about the same time as my travel companion is $50 more than the later flight that day. And my choices for return flight are either running the risk of missing my flight if the lines in customs are long or spending the whole day at the airport. Oh, and United charges for a second bag.

Why should I have taken care of this sooner? Jeff found an email today that if we had booked the ticket just 4 days earlier we would have saved over $200. Live and learn.

The Last Details

2008-07-07T15:03:00.000-04:00

I have the unfortunate pleasure of visiting family in Michigan for two weeks right before I leave for DR Congo. This means everything must be ready for me to fly out by the end of this week. It has been hectic - especially with the work I am doing to be finished with a microbiology course so I can continue my nursing school in the fall.

One of the more frustrating details is clothing. I tend to wear very simple shorts and tank tops during the summer months. I do own a dress, but it is sleeveless. This won't do for the Congo where the women dress in long skirts and have clothing with sleeves. If we want to be accepted as professionals, we need to look the part. So I went shopping.

We have a discount shop near our home where I was able to purchase used clothing super cheap. I am now the happy owner of four long skirts with matching tops and one long summer dress with short sleeves. Best part, it was less than $50. I don't know if 5 outfits will be enough, but it is all I have money or time for before we leave for Michigan.

Laptop Computer!

2008-07-02T15:31:00.000-04:00

Hurray for dear friends!

One of my best friends actually had an old laptop she was no longer using. She does not care how we have to change the settings to make it work or even if it ends up stolen while we are in Africa. So we now have a laptop to use.

Another friend has gone through the machine, taken off unnecessary settings and increasing its capacity so we can use it to show videos during the training.

Now the hard part will be timing it so the batteries are always charged. We have been told access to electricity is sporadic, and to only expect it every few days or so. The computer came with two batteries, one which appears to be unusable. We still need to find out what type of power converter is needed to use electricity in Congo. So, that will be the next task.

Names of the Midwives

2008-07-02T15:17:00.001-04:00

We finally have the names of the women who will be at the training - all but 7 who live the furthest away. So, for those of you who wanted a list of names to be praying for these women and their families, here is the partial list we have available:

Uvira

1. Maman David Bahati

2. Elisabeth Oredi

3. Bora Uzima Djamilla

4. Martha Kapoda

5. Johari Baleke

Mboko

6. Martha Sungura

7. Kashindi Kabwe

Bukavu I

8. Maman Furaha

9. Maman Nathalie

Shabunda

10. Maman Mbila

11. Maman Jerome

Mwenga

12. Maman Mumate

13. Maman Etienne

Walungu

14. Maman Songa

15. Maman Wendilungu

Kamituga

16. Maman Bitendanwa

17. Maman Nyassa

Bujumbura Burundi

18. Maman Agnes

19. Maman Riziki

20. Maman Salima

Rugombo - Burundi

21. Maman Esther

22. Maman Marianne

Ouganda

23. Nahimana Mary

The total Costs

2008-07-01T15:10:00.000-04:00

Jeff has done the math for me and the numbers are interesting. It seems the cost to train one midwife (her supplies, transportation, food and lodging and materials) is $206. This also includes the necessary translators and Ministry of Health delegates.

It also seems that when my costs are broken down by day for the 18 days of travel, it comes out to $179 per day. I wish I could be cheaper, but unlike the volunteer midwives I needed shots, visas, airline tickets and other supplies to ensure I come home healthy.

High Costs of Oil

2008-06-30T16:00:00.000-04:00

One thing we were not counting on when we originally planned the trip was the tremendous jump in oil prices. The truth is, as gas prices continued to increase here in the United States it still did not occur to me that prices may be similarly increasing in the Congo. So, you can imagine my surprise when the final costs were nearly doubled what had been estimated last summer. I even had people suggest the price was artificially inflated to line the pockets of those coordinating the trip.

I was somewhat revealed and somewhat heartbroken to learn that indeed, the high cost of oil and food is affecting even the most forgotten places on Earth. Ben Affleck traveled to the Congo and reported on what he found for ABC News. You can use that link to find videos, photos and other information. When Mr. Affleck talks about being in Goma, he is in the North Kivu Province in Eastern DRC. We will be in Bukavu which is in South Kivu, not too far from where he was.

So, although this makes it more costly for this training it also means the people of the DRC will have that much more of a struggle to stay healthy during pregnancy.

Midwifery Skills

2008-06-26T14:47:00.000-04:00

Although Tammy and I both have experience at birth, neither of us is actually a midwife. This means neither of us have done a vaginal exam, caught the baby or assessed the fetal heart tones. Something that needed to be changed before we traveled to teach these skills.

A midwife in Tammy's community has graciously offered to give Tammy some basic midwifery training by allowing her to assist at some prenatal appointments and during a few labors. The midwife felt this was important, because a vaginal exam feels very different when the cervix is dilating.

Though we will be teaching the avoidance of vaginal exams at the training (simply not able to prevent infection when there is no clean water or gloves readily available), we accept that there will be times the midwives need to use this skill to determine if a mother needs to go to the hospital. We are both very glad that at least one of us will have a familiarity of the techniques that goes beyond our reading about them.

Ministry of Health Approval

2008-06-23T16:17:00.000-04:00

The information is being submitted for the final Ministry of Health approval. The total cost of the training (not including our travel or the materials we will be bringing) is $8,690. With 30 Midwives being trained, this equates to about $300 per midwife. This is higher than we had anticipated, but involves some required items from the Ministry of Health.

The cost covers their travel, accommodations, food and a printed training manual. It also covers three delegates from the Ministry of Health to be present for observation and for translation services (since we do not speak French or Swahili).

The Planning Continues

2008-06-20T09:08:00.001-04:00

While Tammy and I gather supplies, raise money and determine the content of the training, Flory Zozo is working in DR Congo to ensure the success of the project. In his latest email, he sent me the following list of projects he is working on for the training:

Meet the provincial minister of Health to finalize and give him dates of the training
Get the minister’s approval to make the provincial health logo to our certificate
Design the certificates and put the 4 logos on them
Go and meet UNICEF organization to convince them to be part of the training and see if they can help in some ways with may be the training hall.
Go and look for the accommodation that can fit all including you two to cut down some expenses, and book in advance to secure the accommodation.
Try to get also the training hall included at the place where we can be staying, if it is possible. If not possible then arrange another really cheaper hall not far from the sleeping place to avoid people to be late. I will also book it in advance to secure it.
Send the money to women who will come from far places. Some will do two weeks on the road before reaching us here. The sooner, the better.
Travel for Goma to get the CD. (The CD he is referring to is an electronic version of A Book for Midwives in Swahili. It isn't as extensive as the English Version, but we want to make copies for all the women we are training.)

As much work as it as been for Tammy and I to prepare to go to DR Congo, I cannot imagine the preparations these volunteers have needed to make. I also cannot imagine it taking me two weeks to travel to anywhere. I am not sure I appreciate the blessings of transportation we have in developed countries.

Transportation is one of the unique burdens of many parts of the African Continent. When the countries were governed by European powers, roads and rail were built not to connect the countries, but to get the resources to shipping lanes. I will not debate the "good or bad" of this development, but simply say that dealing with inadequate transportation systems now is still an issue. There are no railroads to connect major cities, few roads between countries and the roads that do exist are dirt roads with many potholes. Not only will the volunteers have to deal with this to attend the training, but the families in their communities face this reality if and when they need medical care. This is one of the reasons skilled birth attendants are so needed--traveling to a hospital is usually out of the question.

Fertility Awareness

2008-06-18T12:29:00.001-04:00

One of the challenges we will face is helping the women prevent unwanted pregnancy. It may seem easy from the perspective of the developed world, but remember that access to any method of birth control for women in rural areas of Central Africa will be limited.

Although we will talk about the methods available, the only tool we can leave them with that any woman could use is fertility awareness. The photo on your left is of three different sets of beads that all do the same thing-let a woman keep track of her fertile days so she knows when she is likely to become pregnant. The user simply moves a charm or string along the beads to keep track of where she is in her cycle.

I am not sure what we will find in terms of pregnancy prevention or encouragement when we get there. But helping women get accurate information about the methods available to them (even if it means investigating specific herbs when we return home) will only improve their ability to maintain their health.