"What a Woman!" 2nd week at KACCAD-8/10/09

Today is the start of my second week at Kaccad. I have started to get into a routine where almost every morning, I go on 3 house visits to a client of Kaccad’s afflicted with HIV. We bring them Malaria nets donated by The Real Uganda and try to establish if they are able to eat a balanced diet, maintain good hygiene, and find out how they are doing in general. Like I mentioned before, it’s really interesting and quite different the way being ill is treated here versus in the U.S. I keep thinking about how when I am ill, I usually just want to lie down and feel bad for myself. That does NOT happen to include entertaining guests as I am well aware my bees nest hairdo coupled with the sweatpants and XL tshirt is not my most flattering look. Plus, most of the time I am tired and selfishly don’t want to feel obligated to be a good host! Another difference comes with the acknowledgement of serious and life threatening or terminal illness. Most of the time in western culture, when you have a serious illness it is kept private. Details are not asked and usually not freely given. Even if your guests are aware, it’s not something you defer to when having a conversation and certainly isn't the first subject! "Hey I just stopped by to see how that painful STD treatment is coming along?" or, "yeah, I was bored so I came over to hear if those skin lesions they think are a result of you having AIDS are progressing." Here, the exact opposite is the case. It is a sign of compassion and respect to go to a friend or family member’s house and inquire after them. You do not have to clean up, get dressed, or act like you are ok. You welcome the visitor and tell them what is ailing you. After being asked, it also does not seem uncommon to volunteer an honest truth and sometimes some very personal information!

Another striking difference between visiting people in a country like the U.S and a developing country is the type of ailments encountered. I have visited people who are suffering from illnesses they will never recover from and are currently suffering yet still in their home. Most will stay there until they pass away without the opportunity to receive costly check-ups or hospital stays. Not only that, this is rural Uganda. Their poverty reaches all aspects of their life. Combined with trying to stay physically strong, they have to battle the massive stress resulting from searching for opportunities to earn money and eat well to paying school fees for their children.

Having said that, a situation that at first glance appears overwhelmingly hopeless can lead to an environment that molds incredibly strong personalities. I just so happened to meet one and I hope everyone, at some point in their life, has the opportunity to do the same. The person I am referring to (I will call her Mary) is phsycially misleading; I first saw her walking out of her home with a very noticeable limp where it appeared she was not able to comfortably bend her left knee. Mary was wearing a very well-used collared shirt and a skirt that has likely been worn and washed hundreds of times as evidenced by several tears and holes placed throughout. She came straight for us even though another woman I later learned was her daughter-in-law, had already unrolled and sat down on a straw mat next to us. I was confused. Meetings are usually private and with only the client. For Mary, that norm did not seem to register with her "take-charge" personality. I originally thought the younger woman was perhaps her caretaker and Mary was the client. I was completely mistaken. Contrary to what I have heard and seen on other visits, Mary, related only by her son's marriage, was fully invested in the health and spirit of her daughter-in-law. Her son, having died of AIDS, left his wife and 4 children in a difficult situation; with little income to cover food, shelter and school fees, her daughter-in-law was headed down a very difficult path to come out from. I have already heard how when the husband dies first, his family ostracizes or stops caring for his ailing wife and children and she is left to fend for herself. Mary did just the opposite.

She is one of those strong, incredible women where you just have to step back and the only thing that comes to mind is…"wow." She started talking right away to Nicholas, the head of the HIV sector of KACCAD. She expressed condolences for the loss of his father who recently passed and then included me in the conversation by telling me (via Nicholas in Luganda) how I was most welcome and she was so thankful I came. We started asking various questions trying to establish the level of hygiene practiced and to ensure a reduced risk of malaria. Usually this means asking about the area surrounding the house; having it cleared of long grass and standing water as well as covered latrines to help prevent flies and malaria-carrying mosquitos.

The conversation ran a bit different with Mary there. By the end, I felt like perhaps we should be checking where we live to be certain we had done everything properly! Mary explained to us that not only were their latrines covered but they also burned banana leaves and placed them in the pit deterring flies and creating a pleasant scent. Further conversation revealed that she seemed to be one step ahead of every suggestion we provided. This was the first time I had seen a mother-in-law so active and fiercely determined to provide the best care she could. It was obvious Mary prided herself on being able to help her daughter-in-law and most importantly, her grandchildren.

I think the most powerful moment for me was when she began to speak to us about her clothes. Surely, we must notice the holes in her skirt and how old her clothing was. She got up on her knees and turned to the side to make sure we could clearly see her stained and torn skirt and blouse. It was clear that not only had these clothes seen better days but possibly better DECADES. From her previous behavior, I imagine this must have been difficult for her to wear such an outfit. She had such a desire for her family to fare better. She explained she wore clothes like these so all the money could go towards her grandchildren’s school fees. However, even with sacrifices like that, they still do not have enough.

I have been told that often when children are sent to school with unpaid fees, the teachers will harass them and point them out stating how they have not paid. Their classmates might also pick on them and it is an incredibly shameful experience. Mary was a woman who clearly found this consequence unacceptable and therefore decided to do everything in her power to keep her son's family moving forward.

The cost of school fees is the main worry for almost every family I have visited. I am struggling with how I can help or what can be done to allow these kids to go to school. Most of the parents believe that it is the only way for their children to live a better life than they have and yet they are not sure how to enable this to happen. To the people in the rural areas, education is the only sure way to enable options for their children in the future.

So why did this visit stand out to me? I think it had to do with the feisty attitude of a grandmother who realizing the situation she was in, decided to do whatever she could to improve it. She never begged us for money but she wasn’t shy about stating her issues and what the concerns of her family were. She spoke directly to me which Nicholas would translate and she took care of her daughter-in-law and grandchildren like they were her own. It was incredible to see her mental toughness show when she spoke and it left a lasting impression!

Another visit I had today stood out but for a different reason. It was the first home we visited today and in it was an HIV-positive woman living with her twin brother and 2 grandchildren, 1 ½ year old twin boys. Unfortunately her brother has been in the hospital due to STD complications for over 4 months. Before entering her home I saw feces on the ground near the door from the two small diaperless boys too young to knwo better. Inside was the frame of a couch which I almost managed to break sitting in the unsupported middle. A bag was hanging up and it looked like a brush and perhaps clothes spilling out. On the floor were spots I imagine was a urine stains and both children were playing with scraps of paper in the dirt next to it.

This woman has no source of income and the boys are orphans; she is their primary caretaker. Her hope is to be able to start a chapatti stand on her property. In order to do that, she needs to get enough money to purchase the ingredients to make chapatti, a type of bread really popular in Uganda. The closest description I can give is of flash-frying a Mexican tortilla (It is delicious!) Since her home is on a well-trafficked road (by traffic I am referring to people walking, occasional bicycle and of course the goats, chickens and dogs that want a little exercise.) she would hopefully have a steady stream of customers.

(Pictured: 2 twin boys playing in the rarely used charcoal hut next to their home.)

I have really changed my mind on some of my beliefs when it comes to giving aid since coming here and I can now appreciate the rising voices of people claiming foreign aid is debilitating Africa. However, in this instance, I believe it is possible that money could help someone generate her own income sustainably. It is also difficult to see a woman who has already raised children now having to raise another generation when she should be able to enjoy the efforts of her hard work as a wife and mother. Finally, I believe this woman truly needs help. Caring for two young boys while battling HIV is an incredible challenge. She has little to call her own; Her house is bare as she had someone rob her while she was caring for her brother. Unfortunately, they took almost everything of what little she had. I even noticed that for a type of hat, she was wearing the shirt of one of the twins.

This is one of thousands of dire situations but I want this to be a situation where I can assist someone in improving their outcome. Since she lives so close with her two boys and after seeking the opinion of a few others I believe it is a realistic possibility, I am going to use some of the money donated by my incredible friends and family to get the supplies she needs to sell chapatti. Hopefully with this income she can afford to get to the clinic to receive the medication she needs as well as support her grandchildren while her brother remains unable to work. Luckily for us at Kaccad, if she is able to make these daily, she will have several hungry KACCAD employees and volunteers as regular customers! I will make sure to provide updates on what I hope will be a successful opportunity for this family and I will also be sure to sample the product! :)