Last night about 8:30 we heard two gunshots in the near area. About 15 minutes later alot of crying and wailing was coming from a close by village. Then one of the night guards came to our door and tried to tell us about the "enemy came and killed four people and they need the ambulance". Craig and I went to the main gate and two of our sponsored school boys were there, telling a story about the enemy coming and shooting this family and how bad the wounded were and that the ambulance needed to go and pick them up and take them to Mbale.

Well since the major push by the Army for the disarmament the mission has not allowed the ambulance to travel at night as vehicles have been shot at during the dark hours, and all pick ups in the villages have been suspended because the villagers think it is the Army coming so they shoot at the vehicles. Our ambulance driver said he was willing to take the wounded to the hospital if they could bring them to the front gate of the compound. The boys left, with instruction to get them here quickly, like within the next half hour. Most of the time they wait for the enemy to leave before they are willing to move, hours will pass before they bring the wounded for care.

About twenty minutes went by and an off duty guard came to the gate to tell us of the problem in the village. This one was telling a different story, one of a man, drunk, looking for a little brother who had made him mad and wanted to kill him. But some how these people, all of the same family we are told, got shot in a hut, by a brother. This man is the brother of one of the clinic employees, and brother-in-law of a woman who works on the main compound. This man, who is in the Army and has the right to carry a gun, was upset about something and shot these four people at close range. We told the guard to go and look out for his family,you never know, everyone is related some how to everyone else, and we wanted this man to go home and be with his wife and children and protect them, should there be a need.

A few minutes later the woman who works for us on this compound shows up with her children at the main gate. She is terrified and can't explain why she is come at this late hour, in the dark, with her children. After a few minutes of Karamajon, she starts telling us about her brother-in-law looking for his younger brother, who is sick, to beat him. She doesn't know why the brother-in-law wants to beat this young boy, or just won't tell us why, but she is fearing for her safety and her children's safety and could she spend the night on our compound. This man has a very violent history and for some reason last year beat this woman for no apparent reason. So she has reason to fear him. One of the clinic staff offer her shelter so we let her family spend the night. WE all prayed together for her and her family's safety and for the ones who were shot and for the man who had done all of this.

By this time it is about one and a half hours since the first report of any wounded and a need for the ambulance. The guard comes to the door and tells us that the one who has been shot is here. WE go out to the front gate and there are about fifty people there and four people lying on the ground. I went to each one and checked on what their wound was and where it was. One woman was shot in the calf, one older man was shot in the arm just above the elbow, a younger man was shot in the thigh, and the worst, a fifteen year old boy was shot in the lower back or hip. It was hard to tell exactly where the wound was as there was alot of blood, all over.

Our ambulance is just a Defender,Land Rover, no beds or even bench seats in the very back. We have no stretcher, no real emergency equipment and our clinical officer was on vacation. So what to do but put them all in the ambulance and take them on to Tokora. There who knows what staff will be available and what can be done for them other than transfer to another farther away hospital that has a doctor and a surgery and equipment. We learnt today that two will be transferred when the family can get 450,000 shillings ($250 US) to pay for the trip of about an hour and a half away. Also at hospitals here, there is an up front charge of 100,000 shillings for those who have been brought for treatment of a gunshot. Many have come for surgery and after surgery sneak out in the middle of the night fearing those who shot them will come there looking for them to finish the job.

Family violence is a major problem here, and it takes very little to set off a shooting spree. There is not much regard for human life and no fear of the law or justice to be done. So if you are mad at someone why not just shoot them, then they will be out of your way and no one will do anything to you if you do shoot them. Rarely, the elders step in and hold court, and have been known in the past to exact an eye for an eye. but rarely does this happen, as everyone is so closely related and protective of their relatives.

And this wasn't even New Year's Eve.........

Health care in Uganda......

We recently took one of the school boys to a hospital and a recovery home in Kampala for orthopedic surgery. That was an eye opener, to say the least.... A lot like we have seen on TV and imaged it would be.

We started out with the recovery home, a home for children mainly, but adults too, with mostly ortho needs. The defect of Club foot has been a common occurrence, and this organization was initially started to address this problem, but they have branched out into other areas. This is an Italian run mission, Catholic, run by Nuns and various handicapped people. This is a great idea, to employ the handicap as it shows these children that no matter how severe their defect is there is hope for the future.

In Uganda, all hospitals and recovery houses require that you have a full time care giver with you. Their definition of nursing care is much different than ours and the duties of a nurse are restricted to only giving medicines and some hands on dressing changes if the care giver can not be trained to do them. All the care givers at the recovery home had duties or chores to do daily. Some mop the floors other get water, do KP in the kitchen, and everyone must wash their own sheets and other laundry, and not very often do they have the patient wear gowns, just their own clothing. Patients provide their own plates, cups, spoons, jerry can for water, basin for bathing, soap for laundry, sheets and blankets for the bed. They are given 3 meals a day, a bed and an extra mattress for the care giver, and all medical treatment, such as medicines, x-rays, and equipment. And surgery and hardware like outriggers and crutches or wheelchairs, all of this for 3500 shillings daily, or $2 a day. What a deal!!!!!

The boys were checked into the home on Tuesday afternoon, given a bed in a large dorm room, with mixed patients. Males and females, all ages and many different languages. Each dorm has a foreman who gives out duties. Wednesday is clinic day, starting about 10 AM, the Doctors and PT's come. Everyone lines up out side the PT room and sit on the ground or benches and wait their turn to be seen. In the large room there is an exam table, a few desks, a large file cabinet, and a white sheet hung from the ceiling for a background for pictures. Since most of the patients are ortho with mild to very severe problems, the Doctors take alot of pictures and video of patients, study their ability to walk or not, send some off to have x-rays and others for castings. After x-rays, they are seen again and procedure plans are made.

Most of the Doctors are Italian, and they have students with them from all over the world. They can see deformities first hand that most others only read about. These doctors are very gentle and can communicate very well with the many different languages that they encounter. They remembered our boys very well and spoke very fondly to them and really made them feel comfortable.

Surgery was planned for the next day, and later in the afternoon the ambulance transported both of them, along with all their things, to the Hospital. Because of the holiday season, only a few surgeries had been scheduled and surgery was done by mid afternoon. It only took an hour and half and the patient was back in the ward. Now that was the scary part. The ward was a very large, dark, dirty, smelly, paint peeling from the walls and ceiling, room. There were 4 bare bulbs hanging from the ceiling, only a few windows, no glass or screens on them, and the beds were about a foot apart. They were very old and rusty with cracked, plastic coated mattresses on the frames. It looked like a room from an old World War one movie. L had been out of surgery for about 45 minutes before we arrived to see him, and he hadn't been given any medication for pain yet. He said it didn't hurt very bad, but he had this large outrigger screwed into his upper leg and hip area. It looked very painful!!!! He looked like he was in pain, he couldn't get comfortable and kept moving around in the bed. His caregiver had to keep moving his leg for him, the care giver looked more worried about the patient than the patient looked about himself.

There were 4 other patients in the ward and one nurse. But she wasn't the nurse for L., his nurse was in another ward which was on the other end of this big building. When we found her to ask about the surgery and what was to happen next, she didn't really know who or what we were talking about. It had been 2-3 hours since surgery and she hadn't seen him yet or gotten any record of him. It was really hard to leave the boys there by themselves!!!

When we came back later that night, 6 PM, they have moved them to the other ward, a smaller room with 12 beds in it and one nurse for all these patients. Still no pain medicine and L had been up and out of bed and had been down for an x-ray. His care giver had to carry him to the building because the wheelchair was in use. He was still in pain but it was better. We went back in the morning and L was awake and looked alittle glassy-eyed. Finally they had given him pain meds!!!!!! He was a happy young man!!!!!! He had been given water and a bit of food, and even seen the Doctor that morning. But the nurse still didn't know anything about him or what was next!!!!! They spent the day there and the next morning they were loaded into the ambulance and returned to the recovery home. We were told that it would be at least four weeks before they could come home and that they would call us if anything came up, so we left for Karamoja on Saturday morning.

Wednesday afternoon of the following week, just six days after surgery, we got a phone call stating that they had been discharged!!!! We were in Karamoja, 7 hours away, and so we have to scramble to find a way to get these boys home. We called for a special hire transport and had them driven to Mbale where Pastor Dave lives and he brought them up the next day. Rough trip, in a old van on a very bumpy highway, in alot of pain. But he is doing well, dressing changes twice daily here at the clinic and on antibiotics and doing his exercises. He'll go back at the end of Jan. to have the outrigger removed and be on crutches for a few weeks....All of this for 32,000 USH or about $19 US.

In third world countries all the ortho devices that are used are cleaned and reused. You have to sign a will stating that if you ave an internal device implanted you will allow them to remove it after your death. That is how they keep the costs down!!!!!!!

Christmas in Kampala...

We have been here for three Christmas seasons now and each one is a bigger event than the last one. Kampala is getting more and more commercialized and more western every year. I thought that I would miss all the trimmings and trappings of the Holiday season, but now it is all most funny how strange it all is. Alot of what we saw this year has a cheap look to it, plastic and foils and really not real!!!!!

One of the most annoying things is the ring tones on the cell phones!!! Everyone has a cell phone, even more than in the States. Some have two because there are two or more different carrier services. And they are all set to Christmas music, Jingle Bell, We wish you a Merry Christmas and more. There are two malls in Kampala and when you are there cell phones are ringing constantly, and very loudly. Hearing 20 phones ring with different carols coming from them is really bad!!!! And people all talk so loud!!! You can hear them from one end of the store to the other.

When we returned from the States the first of November, one of the large grocery stores was already putting up Christmas decorations and ads. Out front of the store they have a Coke display manned by a young man in a red plaid skirt and a red Santa hat that has white braided pig tails attached to it, and a young woman in a nice red pant suit. It is one of the same ads like we see in the States, Santa with the train under the tree and the Coke truck with the lights on it, so it looks very western. They aren't giving anything away, coupons or free samples, and there are no special sales on coke products, so I am not sure what they are there for!!!! And in the aisles for Christmas stuff it is alot of tinsel and foil and plastic ornaments and plastic wrapping paper and Charlie Brown looking artificial trees. And the Christmas cards aren't Hallmark to say the least!!!!!! Sometimes you are not sure what that card actually meant!! In the stores you do not see anything religious on display, no nativity scenes or many cards with Jesus or mention of Jesus or anything that leads to the true meaning of Christmas. But you go into the book store and it is all religious fliers and cards and posters. The craft markets have many religious items and all of the cards are of the nativity. Or telling about the birth. And it seems that stores owned by those of different religious background, not Christians, have the most decoration. Their stores are the brightest and have the most decorations. And they have found out that is what attracts the buyers.

One of the nicest, calmest and festive things we have seen has been the palm trees out side of the largest mall. There are maybe 6 very large palm trees and they are decorated with tiny white lights, all wrapped around the trunk on the palm frawns. The lights are so small and so well placed that it really looks like a group of distant stars in the night sky, and the night skies here can be very black and dark. So with this setting they are very pretty and not overpowering at all.

The things we don't miss....all the blaring music in the stores, rows and rows of decorations and lights, aisles and aisles of candy (that no one needs but will buy just because it is Christmas), sales pitches that make you feel guilty because you haven't brought this and that, constant media blasting of the commercial reasons to buy and what to eat and drink and wear, and all those things that take away from the birth of Jesus. And take away from family. We don't miss all the crowds, cold weather (well sometimes when it is 100 and hotter) or snow, icy roads (we just have muddy ones).......

eldeeninkaramoja

Just been reading Katie's blog. She writes very well and tells many funny stories!!!! She would love it if more of you read her blog also. Here is her address trinka89.livejournal.com it will be worth it.

eldeeninkaramoja

Rat Sale in Karamoja!!!

It must have been great year in Nakaale for the rats!!! Many days these last few weeks, there have been rat sales by the dozens!!! These little sheppard boys are making a killing on the sales. They come by the clinic with their stringers full of rats hanging either by their tails or front paws. People swarm these boys and the rats sell like hotcakes!! Some one told me that they go for 100 shilling (6 cents) for 6 of them. What a bargain!!!! These 6-8 boys, all about 5 to 11 years old, have been busy catching and selling many rats. They must be making alot of money, as they come around serveral times a day with their fresh catch to sell. And people are waiting for them with money in hand. Fresh meat!!!

It is raining in Karamoja again. We are having our Christmas rains, I guess. Pastor Al called us and told us that it has been raining so we could be prepared for our trip home in the morning. Or be prepared to spend the night in Mbale. We did that last time we tried to get back after Thanksgiving, we didn't get stuck, but lots of big trucks did and we couldn't get around them. It's the pits!! You know you need to get back so you can return to work, but you can't get there. I guess it is God's way trying to teach us something!!!!
He been doing alot of that these days, bad roads, long waits for getting business done and day long aventures just trying to see a Doctor. But then this is Africa!!!

Birthdays>>>

Josh just turned 7!!!!!! on the 9th and Katie will be 17!!!!!! on the 10th..... Party time>>>>>>

Laurie is cooking for the whole mission and doing pasta and pizzas. I am going to bake the pizzas in my earth oven, which bakes them in just a few minutes instead of 30-40. We do mini make your own pizzas and put them right on the floor of the oven and they are great!!!! What a treat and its a lot of fun!!!!

Sunday night we will surprise Katie with Roast chicken (PEEPS) over the grill!!! We did that a few months ago. Some one send several boxes of PEEPS and I was given a few large boxes which I tossed in the freezer for a later time. Now Marshmallows are hard to come by here, and there has never been a PEEP in any store!!!! So one night we were grilling in the court yard and after we had all eaten the grill was still going and the comment was made about what someone would give for a s'more! Laurie and I put our heads together and ran off to our houses and came back with chocolate bars and Nice biscuits from Laurie and frozen PEEPS and wooden sticks from my house. We stuck the PEEPS on the sticks and grill the chickens and squeezed them between the chocolate and cookies and had a great time. We laughed very hard about the grilled PEEPS and Katie really enjoyed them without the chocolate. So for her birthday we'll surprise her with another box of PEEPS and some sticks for grilling!!!!

What a way for any girl to spend her 17th birthday in Africa!!!!

PS send more PEEPS!!!!!!!!!

The Clinic..

The Karamajon culture is so steeped in the value of cows that men over the age of 25 feel that is what is most important. As I have said before, they value this over lives of their own wives and children. If a wife or child die they can be quickly replaced, but it is harder to replace a cow.

There was a man in the clinic yesterday, mid 40's, well dressed by village standards. He had brought his wife who was pregnant and ill. She looked old and very tired, and not well. He insisted on many types of tests, brucellosis, typhoid, malaria, a few others, that we could not do. His bill was 8000 shillings, $4.50 US, and included all of her antibiotics. He was very unhappy with us, he was arguing with the staff about how we were so bad and are stealing from the Karamajon people and not helping them (not giving them free treatment). When I went to find out about the raised voices, the staff dealing with this man told me what he had said. It is hard not to get very mad at them, because they just don't see it the way we do, or understand that there is not a magic fix for right now healing. But the staff and I told him again the same thing that had been said a few minutes earlier, we have to charge for the tests because we have to buy reagents to do the tests with and they are costly and we buy our medicines, they don't come free to us from the Government, that is why we have the medicines to treat his wife, and an injection won't made his wife well immediately. He wanted her to have an injection so she could walk home and carry the water can while he rode the bike. I asked him why he came to our clinic and did not go to Tokora where treatment is free. He said what everyone says, "because you have staff and medicines and can do the tests". We told him again that is why we must charge some small amount for the tests or we could not afford to do them. And then we offered to pray for his wife and her unborn child, all along he was saying that she is no good to him if she is sick, who will cook and work if she can not. The wife was sitting there very quiet and I kept thinking about how low her self-esteem and self-worth must be. And I wished we had an instant fix pill for that.

We all know that only God can change the heart of this man and heal both the physical and mental state of this woman, but when they are not wanting to hear of truly believe we feel useless in what we can do. We can only keep our faith in His word and keep plugging away, in hopes that someone will hear and they will want the Word.

The dry season in Karamoja....

We wouldn't know this year because it has rained a lot!!!! It would have been a good time for a second crop but we didn't plant one this year. Past years have been so dry by this time that the weeds have all burned in the hot sun. They are calling the rains the "Christmas rain" because normally it will rain the week of Christmas and the week after and then it would be dry for the next month or two until we get closer to the rainy season in March when it rains more than just weekly.

We have a huge crop of big bad weeds in all the fields. Craig is fearing plowing will be very hard this year with all the over growth. And the abuse on the tractors will be hard. He would like to break ground on more acres this year but there is so much work to be done before planting time.

Just when they feel like they are where they should be on the construction, something happens. Like a wind storm that blows the roof of the generator shack, so that needs to be rebuilt, or a flood from 2 1/2 inches of rain in two hours that washed out the recently placed drain field and broke all the newly laid pipes and water tank.

The generator shack has been around for awhile, 20 years or so, so it needed a bit of repair before the roof went. So as long as they are doing the roof Craig is doing the other repair work. He has been putting up more bricks and then steel trusses were used for the roof supports and tin sheets for the roof. The doors are being welded and will be hung next and then Craig will finish by trying to seal all the hole and cracks to make the building rat and snake proof. Which is a big job here in rat country!!! And they (rats) like us too much as they want to be right there with us!!!!

There has been what has been described as rat parties nightly in the main kitchen in the main house. And they are very smart and cunning. they know how to feast on beans, rice and peanut butter without setting off the traps. And they really like Donna's bananas, but just a big bite out of each one!!!!!! I guess they are discriminating eaters. Right now they like Donna.

Now that we are in the dry season (kind of) there are more snakes around. Two nights in a row the dogs alerted us to snakes in the courtyard after frogs. Which we have an over abundance of also. (You must always dump your shoes or boots out before you put them on because that is one of their favorite places to hide). Foxy, a Karamajon dog whose has an Irish accent (she rolls her RRRRR's as a greeting), is very good at detecting the presences of snakes. She really doesn't like them much and she lets us know. She will keep growling until we check on her and then she stands in front of who ever is the brave person that goes out of the house to look for what she is growling at. Praise the Lord for a baseball bat that is our weapon of choice. The guys are wishing it was about a foot longer but it does the job!!!! They haven't had one come after them in a long time now.

One sure sign that we are in the dry season is the wind. In the morning it is very calm and sunny and hot, but by mid to late morning the wind has come up strong and clouds are starting to roll over Mt. Kadam. The wind is great for the laundry hanging on the line but that is about it. Our houses are so full of dust and dirt. you can't shut the windows or it will be so hot in the house you could not stand it, so you have layer upon layer of dust everywhere. Even in the refrigerator at times. I have even had a pan of dust covered brownies, which the dogs just loved!!!!!

Sometimes at night the wind will still be strong and you are awaken to the snapping of the curtains in the breeze. That's are real jolt, it sounds, in your sleep, like a gun shot or cracking of a tree branch. And the wind makes the guavas drop on to our tin sheet roof in the middle of the night. That sounds like bowling balls are being dropped over our heads and rolling off on to the ground. Night time sounds of Africa!!!!!!! Some time I'll tell you all about the cat fights on the tin roofs in the middle of the night!!!!!!!

I'll try to see if my computer is up to sending some pictures of the shack and other things this next week..

We are going to Kampala and I'll write about Christmas sights and sounds of Kampala.