It must have been 6:30 a.m. when I woke up. There wasn’t any way to know for sure, since the electricity had been out for the past week and I’d been unable to charge the only device I had to tell time. I had grown accustomed to gauging the hours by the strength of the light and the sound of the birds chirping. But I didn’t mind. There was something incredibly pure about it.
I looked out my window and saw an elderly mother with her baby wrapped around her back, washing dishes in a bucket. I can still hear the sound of the plastic bowls being dunked beneath the water, the muffled clang they made under the surface. But once the haziness of sleep cleared from my mind, I was met with the less-than-glorious notion that my day would start at the 10-foot latrine hole. I got up, walked to the bucket of collected rainwater, splashed some water on my face, and left.
As I stood in the grass brushing my teeth, I was struck by how astonishingly beautiful the morning was. Over the fence, I could see Matoke trees and the green outlines of the mountaintops. Every morning looked like this — stunning — yet it was different each day. Sometimes, the rain pounded so loudly on the giant jungle leaves that it felt like the village was alive with the sound of drums. Other days, the sun lit the neighboring summits so delicately that it took my breath away. This was one of those days. Everything felt so peaceful; I wanted to soak it up and put it in a bottle to bring back home.
I sat drinking my Nescafé in a metal camping cup at a sticky, wooden table. The sun was shining through the kitchen window onto the tabletop in front of me, and the little bird that lived in the vent chirped loudly. These were my favorite moments — the minutes before anyone else was awake. It was just me, the coffee, the bird, and the sun. A massive cow ran by the window, a man with a machete chasing after it. The duo hustled into the jungle that surrounded the compound, and I couldn’t help but laugh. It was then that thoughts about the previous day slipped into my mind.
It had been my first day working in the maternity ward, located in a separate building down the road from the main clinic. To get there, I had to pass through the Monday market, which is an aesthetically pleasing but anxiety-inducing experience. Just to paint the picture, the market is complete with crowds of people, swarming scenes, a multitude of smells, and the possibility of being run over by a cow or accidentally swiped with a machete. As I made my way through it all, I took as many mental snapshots as I could: the dirt road congested with people, bicycles, bodas, trucks filled with Matoke, herds of cattle, each with massive horns. More often than not, people carried things on their heads — water, bananas, pieces of wood — as they maneuvered through the mess of roads. Vendors lined the sides of the red-mud roads, selling everything from chicken feed to old cell phone parts. There were even people sitting up on the tree-covered hillside with sewing machines. No matter how many times I saw them, that image shocked me. Sewing machines outside, in the mud… The music blasted a bachata rhythm; everyone seemed to be happy on market day — stressed, but happy.
Eventually, I passed the market and continued up the hill to the maternal ward. When on the property, I often felt frozen by the expanse in front of me and the way the gray haze in the sky seemed to illuminate the green of the trees and the red of the dirt. It was breathtaking.
Later, as I helped take arm measurements of new and soon-to-be mothers, I saw a boda fly up the hill with two women in the back. I knew right away that it was an emergency — there was no other reason to risk driving a boda up that hill. The first woman wore a bright-green dress and was wildly pregnant. The second carried a basket of belongings on her head — clothing, tapestries, and other items I couldn’t quite make out. It was clear that the woman in green was in labor. And as she grew closer, I noticed how young she was.
Moments later, I found myself in the delivery room with a calm, naked Ugandan girl, four years my junior, who was lying on a cold, metal table. She was in the fetal position, making very little noise despite the discomfort she must have been experiencing. Sarah, the main midwife, turned her on her back and hooked her arms around her legs in place of stirrups. The green dress she’d arrived in was placed beneath her pelvic area. The girl’s mother-in-law (the woman with the basket) stood next to her, holding her hand as two midwives at the top of the bed massaged the girl’s chest and abdomen to stimulate contractions. With a few grunts and no pain meds, the girl pushed out the baby’s head in a matter of minutes. Sarah grabbed hold of the head with her palm and helped pull the baby out. In just five seconds, the rest of the baby became visible. It was a boy. Swaddled and cleaned, he was placed on the scale while his mother was stitched up — again, without drugs. He started to cry and didn’t cease until I began patting his stomach in a slow rhythm. Finally, he was peaceful; the only thing moving were his tiny, flaring nostrils. We then passed the baby to his mother and resumed our tasks.
Once more, I was sitting outside taking arm measurements when my attention was captured again, this time by a little girl in a pink dress. She was maybe four years old, and was staring at me relentlessly. We exchanged smiles, and each time I sent one her way, she giggled and ran into her extremely pregnant mother’s embrace. Her mother was pacing back and forth, and her long, skinny legs seemed unable to sustain the weight of her stomach. She’d periodically lean on a wall or post and take long, deep breaths. It seemed like she was going to burst. Moments later, I found myself in the check-up room with this same woman. I was confused as to why she was in for a check-up in the first place — she looked as if she could be having her baby right then and there. I learned that she had been due in May — a full month ago. I listened to the baby’s heartbeat in her stomach. It was incredible. Afterward, she left the check-up room to go home. But it didn’t feel right.
I took a break soon after and began to write in my journal, but before I knew it, I was rushed into the delivery room again. Looking down at the table, I wasn’t surprised to see the woman I’d just helped. This delivery was similar to the first — the woman’s blue dress was placed beneath her pelvis, and she lay naked with her giant belly looking disproportionate to her tiny body. The nurses arranged her arms into stirrups, and then she started to push. Sarah assured us that this labor would be fast because it was the woman’s third child. An unspoken sadness loomed in the room, though, as the woman didn’t have anyone with her. She was there alone, clearly petrified. As she continued pushing silently, I noticed that Sarah looked disappointed. I didn’t know what they were saying to one another, as they spoke the local language of Liguisu. Sarah then turned and told us that this was a very difficult mother. That confused me. I didn’t understand if she meant the mother was difficult or the labor was difficult. The woman began squirming all over the table, her leg unhooked from her arm-stirrup, and she kicked Sarah in the head. Sarah was visibly angry and called for another midwife, Kadisha. Kadisha stood by the woman’s head and assumed the position of guidance and control. She began pushing the baby from the top of the abdomen to assist in the labor. It was four midwives to one woman. As Sarah continued telling us that the mother was difficult, I could see that the baby was coming down the birth canal, but it hadn’t crowned yet. I was nervous about how long it was taking. Sarah asked the woman something, but she didn’t answer. Sarah repeated herself, but was met only with more silence. Nothing about the situation felt right.
After 20 extremely long minutes, the baby’s head came out. Again, Sarah grabbed it with her palm and waited for the child’s shoulders to follow. As soon as they did, she pulled the rest of the child out. But this one didn’t cry. Everyone in the room fell silent. This baby’s body was white. I held my breath as the midwives sucked the fluid from the baby’s nose and mouth. It felt like ages were passing in the dark, electricity-free room.
Finally, a cry came out and the entire room exhaled — everyone except for the mother. Her face was turned toward us, emotionless. As the nurses swaddled the baby, Sarah translated what she and the woman had discussed during labor. The woman had no husband, and was resentful toward the father of the child. She was difficult because she was trying to keep the baby inside of her to suffocate it in the birth canal. This is a phenomenon Sarah had seen before, mothers rejecting their newborns because of the hate they have for the father. She was especially worried about this one and said that she was going to monitor the mother to make sure she wouldn’t take the child’s life when no one was looking. Pain and sadness washed over me as I heard these words.
After they cleaned up the woman, the midwives asked me to bring the baby girl to her. I held the child tightly and tried to fill the 20-foot walk with as much love as I could. I watched her little face as she took breaths, her tiny body moving up and down so peacefully. When I reached the mother, she looked at me with fury. I passed her the baby, and she snatched her quickly and turned toward the wall. I was angry with her. But I also felt for her, and couldn’t help but wonder what had happened to her to make her act this way toward her own child.
I felt sunken for the rest of the day. Every time I fell out of conversation with someone, that baby and her future crept back into my mind. It didn’t seem fair. I couldn’t help but think about how this is only one child who I saw suffer this fate, one child in one small village in one small country. What about the rest?
This is what I contemplated in the kitchen the next morning. I found myself staring at a world, stunning on the outside — a land comprised of color, beautiful people, and awe-inspiring landscapes — but laced with deep suffering. For every beautiful image I saw, it felt like there was twice as much pain. Observing this phenomena early on in my time in Uganda forced me to view future situations through a certain lens, one that braced me for hardship. Because, as it turns out, hardship is a part of this stunning world.