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HIV, Breastfeeding, and Endless Chapatti July 25, 2012

Posted by ellaweber in Countries, Individual Fellowship, Uganda.
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Ella Weber

Vicki, one of my translators and research assistants, laughs when we see something that surprises me and repeats over and over again, “spend time in Africa!” Today, for instance, we took a taxi which contained sixteen adults, a baby, and a very unhappy chicken. Having completed my first week of research, however, life in Africa has proved surprisingly easy to adapt to. The air smells like the red earth and herbal-scented fires; people walk slowly, talk slowly, eat slowly, and little children holler “mzungu, mzungu, see you later,” at me when I walk around, and then fall on each other laughing when I respond in broken Lusoga. Some days though, this combination of peace and enthusiasm has been hard to grasp after a day spent at the local hospital or a regional clinic, places I know I wouldn’t have the mental stamina to carry on from.

The health care system here is broken and backwards; mothers in labor are expected to bring their own gloves, gauze, sheets, and other supplies to the hospital, and the dispensary often doesn’t have the necessary medications. Just this morning, I listened to a nurse instructing a mother on proper nutrition and education. In her arms was her four month old baby, who was covered in sores from the chest up. While watching the woman calmly sooth her squirming child, it dawned on me that her baby likely will not survive the year. In the wake of the raging health care debate at home, it can be hard to watch helplessly, fingers crossed that the information I’m gathering will make a difference.

New mothers gathering at Iganga Hospital for infant immunizations and check-ups.

Doom and gloom aside, everyone who has aided me or agreed to an interview here has been helpful beyond my wildest expectations. At one health clinic, the stately older nurse continually looked me up and down skeptically the entire time Vicki explained my project. I was sure we would get turned away, but all morning she quietly brought us woman after woman to interview (and a really cute baby for me to hold), and then laughed like we were old friends at my reaction to the boiled peanuts one of the medical attendants made me try.

My two research assistants with the traditional birth attendant in one of the villages.

One of the best interviews I’ve had so far was with a woman referred to as a “mentor mother,” at the hospital. These women hold individual interviews for new mothers who are found to be HIV positive, in which they share their own experiences as mothers living with HIV and allow frightened women a safe place to discuss their problems, fears, and seek advice. Fear of abuse by nurses, as well as shame from community members and abandonment by husbands and partners, leads many women to lie about their HIV status. Because of this, some women are afraid exclusive breastfeeding will reveal they are HIV positive, so the mentor mothers are working to promote disclosure as a way to prevent mother-to-child transmission.

Visiting the clinic at a local health center.

As the weeks progress, I will be talking to women in smaller, more remote villages, and have more exposure to traditional birth attendants and healers. So far, I have only had a small opportunity to judge where western and traditional medicine are intersecting, but the varying concerns of men and women, as well as those with access to the hospital, have proved incredibly interesting. The traditional birth attendant I spoke with, for instance, always wears a nurse’s uniform when delivering a baby, but has attained all her midwifery knowledge from sources outside a hospital setting. Men in the villages have expressed little interest in being involved in the breastfeeding decision, but their ability to provide (and show they are able to provide) milk and other substances is very important. With each interview, I find myself coming up with more and more questions, and it’s been great fun to watch what started as a theoretical research program turn into something real.  In the meantime, I plan on continuing to practice haggling (poorly) in the marketplace, consuming loads of hot chapatti, and remembering to shower with my headlamp nearby – I learned the hard way that when the power goes out, the lizards emerge.

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