I’m afraid I’m not adjusting well to the time difference on this trip.  I’ve been struggling with headaches, and found it just as difficult to sleep last night as I did in Honduras.  I’m hoping .it will get better.

Today was my orientation at the hospital – and since it was a quiet day (meaning not much staff) I attended my first birth.  Having so many clinical sites and so many preceptors has prepared me for the first couple births with a new midwife – when you are not sure what she is expecting of you, and you don’t really know what the set-up is going to be. Other than feeling completely disorganized, I felt OK.  The mother was amazing and knew what to do, so it didn’t matter that I don’t speak Swahili.

I’ll be back in the hospital tomorrow.

I saw a series of articles from the NYT today. Warning, there are no photographs, but the articles deal with mass rapes.

Here is the first, from earlier this week: http://www.nytimes.com/2010/08/24/world/africa/24congo.html?partner=rss&emc=rss

And the second from today: http://www.nytimes.com/2010/08/26/world/africa/26congo.html?partner=rss&emc=rss

War and violence have been such a part of the lives of families in this part of the world, building a strong foundation seems impossible. My heart aches for these women and their families who continue to be terrorized.

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

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.

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.

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

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“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?”

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.

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.

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.

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.