Saturday, March 31, 2012

Coffee and Friends.


After last year’s elections, Christina returned to South Sudan from Khartoum to find a new life. Even though she spoke no Dinka --having spent the better part of her life in the North-- she knew that her future was here.

So she packed up her children and came.

I first met her last fall, after she stumbled across our church one Sunday. She was overcome with joy to find a Bible believing church just a stone’s throw from her tukel, and has been coming regularly ever since.

Even though our church service is in English and Dinka (not Arabic), she comes for the fellowship and the worship. When I hear her raise her voice in song, I can’t help but delight in her faithfulness.

She’s a joy to know --even if I can’t understand what she’s saying.

Recently, I found the location of her tea shop in town and have been frequenting it regularly. I take anyone who’ll join me so I can practice the handful of Arabic words that she’s taught me, and drink ‘boon’.

‘Boon’ means coffee, which for Sudan means thick, sweet, sirup-y goop that looks like tar but tastes like heaven. She mixes fresh ginger in with the grounds along with a medley of other spices. I asked once which ones, but no one knew the words in English.

I think there might be cinnamon and cardamon, but I’m absolutely sure there’s ginger. Lots of spicy ginger!

My second favorite drink is the hibiscus tea. It’s velvety smooth and refreshing on a hot afternoon. Plus, it’s less likely to keep me up all night!

This week in an effort to say my goodbyes, I went to see Christina one last time. She was surprised to learn that I was leaving but encouraged me to return as soon as possible.

-- “I don’t have plans to come back right away,” I explained, “But if God wills it, I’ll return and speak to you in Arabic.”

She smiled at the thought and said, “Before you go, I want to give you an Arabic name.”
-- “Really?” I asked excitedly, “You have an Arabic name for me?”
-- “Yes. I want to give you the name Nadie (Nah-DEE-Ay).”
-- “I love it!” I said after slowly rolling the sounds around in my mouth. “What does Nadiee mean?”
-- “Nadiee is the name of a beautiful flower.”
-- “Excellent,” I said grinning ear to ear, “Thank you for this honor.”

I don’t know what it is... but when someone names me in a new language, I get excited. It often means I have a new language to learn! And believe me... Sudanese Arabic is high on my lists of languages to learn next.

I’m going to miss the ginger coffee and sticky sweet teas... but I’m going to miss this sweet lady more.


One of the blacksmiths, notice the wheel used to fan the coals.

I’ve wanted to get spearheads and bracelets as gifts for some time now, but I’ve had disappointing luck. No one seems to know where to go. Each time I asked around in Tonj, my friends shook their heads sadly and said, “That. That is only in cattle camp.”
-- “They do not have any in town?”
-- “No. Cattle camp only.”

Would I really have to go to a cattle camp to get a spear? 
      -- I guess so.

Eventually, I attempted to buy stuff off strangers in the streets. But invariably the conversation was always end in the same way.
-- “Hi. Did you rise well from your sleep?” I’d ask in greeting.
They’d smile, stop, then ask in return,“Did you rise well?”
-- “Yes,” I’d respond, “My body is well. Is your body well?”
-- “Yes. My body is well, too.”
-- “My name is Akuac...” I’d continue, extending my hand in greeting. From there we’d exchange names three or four generations back, so we’d know which clan we are from. Naturally this takes a bit of time, but it is always fun.

After the formal greeting was over, I’d find someone with better Dinka skills to translate.
-- “Would you sell me your spear?” I’d ask. It’s best to be clear right off.
-- “Ehh? You want my spear?” they’d gauff in confusion. 
-- “Yes. Will you sell it to me? I’ll give you a good price.”
-- “No. I do not want to sell it. What will I fish with tomorrow?”
-- “But don’t you have another one?”
-- “No,” they’d say, then walk off leaving me pleasantly frustrated.

To be honest, I love that commercialism has yet to come to Tonj. However, that means no spears for me.

Well... Rumbek was a different story.

In Rumbek I found the spears, daggers, and bracelets I’d been looking for all in one place. But I also paid Kowaja prices for them. When my friends in Tonj heard how much I paid, they clicked their tongues in disappointment.
-- “You paid too much,” one friend complained. “Three times more than a Dinka.”

I couldn’t help but smile at his concern. It is true. I paid too much... but at least I didn’t have to go to the cattle camp to find them. And at least I didn’t have to beg them off a stranger in the street.

Anyway back to my story...

Finding the blacksmiths in Rumbek was not easy. I needed a guide.

Jumping on the back of a friend’s motorbike, we zipped through the city center, passing tea stalls and mechanic shops along the way. A right turn down a potholed road, zig-zagged us passed schools, then churches, then a whole mess of tukels.

Another right turn drove us into what looked like someone’s backyard. Bamboo fences. Children running about. Goats.

A few minutes later, we arrived at the cattle auction where dozen of spectators crowded the bamboo corral to get their bids in. Goats complained and cows lowed loudly in protest. It looked interesting, but we didn’t have time to stop; the blacksmiths were just up ahead.

Men hammering out cooking utensils and spears.

Cooking woks made from barrels.
Once the rumble of the bike’s engine cut out, new noises took over. Sharp clanks of metal upon metal cluttered the background.

Steel. Iron. Sparks. Soot. Dirt.

Thin, low-hanging stalls lined one side of the road, each displaying their wares on makeshift tables.

Spears. Daggers. Cow bells. Bracelets.

I found what I was looking for almost immediately, but the price they gave me was high. I wanted to haggle... but the Dinka don’t seem to have learned this skill yet.

Was I willing to fork out three dollars for something I knew should only cost a dollar fifty? When I put it that way... I laughed.

Yes. I was willing.

The bracelets were made out of melted bullet casings. They heat them over coal fires, mold them, then hammer them out.

I also wanted a spear made, but I had to wait for them to fashion it right. While I waited, one of the blacksmiths thrust a large bracelet in my face.

It was easily three times heavier than the other bracelets I’d purchased. Its deep cross-cut patterns were carefully etched on both ends.


--“Is this a nose ring?” I asked, lifting it to my nose jokingly. I was trying to make him laugh.
He smirked and shook his head. So I lifted it to my ear and asked, “Is it for my ear?”

This got me a few chuckles, but again he just shook his head. 

Then I tried to open it by prying it with all my strength, but it wouldn’t budge. So I complained, “How can I wear this... it’s too hard to open.”

One man stepped forward to explain in English. I knew what he was going to say, but I wanted to hear him say it anyway.
-- “This. This you must beat on with hammer.”
-- “Okay. You tell your friend, if he can get it on my arm, I will buy it.”

The blacksmith smiled at this news, then moved under the stall for his hammer. Signaling for me to follow, he pried it open with a crowbar then placed it around my wrist.

Next, he placed both bracelet and wrist on a worn anvil and started pounding.

I can’t say he was careful --as I still have a few bruises-- but I can say he was successful.

What an adventure!

I love my new bracelet but now that it is hammered on my wrist, the question is.... how will I get through airport security?

Saturday, March 24, 2012

Drum & Dance.

In addition to lots of rest and relaxation, Rumbek has afforded me some fun new experiences. My favorite so far has to be dancing with the Jurbel tribe.

My first Saturday here I went to Freedom square with some friends to watch the drum circles and the traditional dances. On this particular day, there happened to be a dozen or so Jurbel women dancing from the Wullu region.

Their dances were different than the Dinka’s jumping and the Bongo’s swaying. It was choreographed. Lined up in a circle, they all faced the same direction and chanted. As they sang, they stomped out a steady rhythm with their feet. Arms cupped to the sky they rocked back and forth.

I asked to join them (which may have been irregular, I’m not sure). But once they realized I was serious, they laughed and started teaching me the moves.

To dance properly, however, I needed props. So they adorned me with a band of cloth tied in the crux of my left arm, and a plastic traditional bracelet for the other.

The cloth band played an important role in the dance --as I was soon to discover. It was used to swat at the other dancers in a mock battle. One would attack with the cloth and the other would evade it, then go stomping on in unison.

This was the dance.
There is no way my dancing could be described as good, but I must admit I enjoyed it tremendously. I could not stop laughing at how fun it was to “fight” these women. They laughed with me --obviously amused at my lack of skills.

But after a few minutes of this, I realized I was disrupting their show and I said goodbye. In parting, they laughed and slapped hands with me. And I handed back their bands and bracelets.

One woman, came up to me as I was about to leave and thanked me for dancing. Then in appreciation, she offered me a ring.

Fortunately, my friends did not know how to work the video on my camera; so my dancing was never recorded.
    -- Euff! So glad I dodged that bullet.

But they did take a few pictures.


It’s times like this that make me never want to leave.

I love Sudan.

Hope this video works:

Friday, March 23, 2012

Bird’s Eye View.

As I mentioned before, Aid Sudan is building a radio tower in Tonj which will be dedicated to health teaching, education, and evangelism. However, Diguna is responsible for making it happen on the technical front.

So earlier this month they sent three Kenyans, an American, and a German to piece it together. They worked alongside a dozen or so Sudanese, and made quick progress.

Half the crew stayed on the ground heaving up sections of the tower, while the other half scampered up the fixture to tighten the bolts.

Naturally, their activities drew crowds of unschooled children and bored adults. It’s not every day a radio tower goes up in a town as small as Tonj.

The Diguna team worked quickly and was able to finish on time. And on the last day of their work, they let a few of us climb it.

Yep, 230 feet --or roughly 23 stories tall-- it’s not your typical mountain. But I confess, I was keen on the idea.

For those who don’t know, a radio tower is shaped like a 23-story needle sticking straight out of the ground. Its three-sided piped frame is light-weight but heavy-duty. And to keep it in place, it is anchored down with cables --lots and lots of thick cables.

Don’t worry. We used climbing gear --of course-- as who wants to fall 230 feet in Sudan!

I have to say, it was a rush scaling the structure. I’ve climbed in the past, but never anything quite like this. I took my time, pausing to rest every few minutes. When I rested, I’d secured myself in with hooks, then hang off it like a hammock. 


At the top, the structure swayed like a blade of grass in the breeze. And the sound of the wind through the bars rang in my ears, calming me. 

Everything looked finger-painted and blurry. Houses were dots; huge trees were bushes; and even the dry riverbed looked like a scratch in the sand.

Turning my eyes South, the town stopped abruptly at the river’s edge, then there was nothing. To the East, yellow grasslands rolled out like a speckled blanket; but Northward it was all business.
There were a handful of thatched roofs, but the largest eyesore was the road to Wau. It cut the earth unnaturally, taking a corner where no corner needed to be taken. So I turned my eyes Westward to find the sun robing itself in the rusted-oranges of dusk.


At one point, a hawk spotted me and circled back to get a better view. He made three passes then moved on, gliding higher still in the wind.


It’s times like this that remind me why I love it here so much. 

The In Deed & Truth compound viewed from tower.

Thursday, March 22, 2012

A Breech of Trust.

Two weeks ago one of my prenatal ladies came to the clinic in labor. I had followed her pregnancy for several months, and during that time we’d developed a sense of trust  --or so I thought.

When she arrived, she was 6 to 7 centimeters dilated with consistent contractions. Since it was her 5th child, I expected things to go quickly.

However, there were a few concerns.

Abdominally, her baby appeared to be breech. But when I tried to confirm vaginally, I had more questions than answers. The membranes wouldn’t allow for a clear diagnosis, and I was unwilling to rupture them to find out.

During her prenatals, she had never palpated breech before, so it came as a surprise. I questioned my suspicions though, saying that perhaps the heart-tones were high because the head was not engaged. Maybe what I felt in the fundus was just a really boney butt. So I noted it in her charted and waited.

Time would tell.

I re-examined her 6 hours later and she had not progressed at all. Moreover, the presenting parts were still unengaged despite increasingly effective contractions. This worried me.

Even though I had oxytocin at my disposal, and theoretically I could rupture her membranes, I hesitated to push things along. I could not rationalize the risks.

With the baby still unengaged, such actions could lead to cord compression... or worse. Cord prolapse. Maybe we just needed more time.

So I waited... and prayed.

Another 4 hours went by and she got more and more active. Outwardly, her contractions indicated birth was close and I considered doing another vaginal exam to reassure everyone. But I hesitated... what if there had been no progress? What if the head was still high? But if so, wouldn’t it be better to know?

This internal debate went on for sometime, but eventually, I caved in and did one.

The news wasn’t good; she had not budged at all. After close to 10 hours of stronger and longer contractions, she had dilated just one extra centimeter... but even that was iffy.

What was the hold up? Why wouldn’t the baby descend?

Over dinner, I casually mentioned her case to Dr. Tom, suggesting we might need a cesarean. I told him my hesitations and concerns, and together we agreed to stop her labor if she did not show significant progress within the next few hours. That way she could get some sleep and her family could start preparing money for a transport.

But an hour later her water broke.

I was pleased that things had progressed to this point, but did not do another vaginal exam. I figured that as long as the heart tones were good and moving lower on her abdomen we were golden.

Looking back, I regret that choice. I regret it a lot.

An hour later my shift ended and Margaret took over. Since the water had broken, I figured she’d deliver shortly and didn’t think to tell Margaret my suspicions.

That too, I regret.

Exhausted from the long labor watch, I turned in early. But by 3 a.m. there was a knock at the door. Groggily, I asked what the problem was.
-- “Margaret says she needs your help,” our health worker said quietly.
-- “Is there a new labor?” I asked.
-- “No. Same woman.”
-- “I’ll be there in two minutes.”
While my body changed into scrubs, my brain struggled to connect the dots. I had assumed she’d delivered hours before.

I was wrong.

I arrived to find her pushing and got hopeful, but it didn’t last long. I quickly realized that Margaret had decided to break her waters a few hours before (apparently the first rupture sealed off again or hadn’t happened at all). However, when that didn’t bring the baby down, she augmented with oxytocin. 

After she explained the various measures she’d taken to spur on her labor, she told me why she had called for help. “I just did a vaginal exam, Steph. She’s fully, but I’m not sure if it’s the baby’s foot or arm.”

I asked her a number of questions, probing here and there. Then I put on gloves. If she was presenting a shoulder or a hand, we couldn’t let her push. So I stopped the oxytocin and asked her to breathe through her contractions.

A quick exam told me a lot. I measured her to still be about 8 cm dilated. And although there seemed to be more than enough room for a baby, the fetal parts were high. With the membranes out of the way, I could feel a squishy butt and what appeared to be toes. But honestly, the baby was just too high to get a good read on it.

Only then did I tell Margaret my suspicions. As I related the subtle warning signs I had observed, she seemed irritated. Why hadn’t I told her this hours ago?

I apologized. There was no good excuse.... except I honestly thought she’d already delivered and my suspicions were groundless.

Once it was decided to transport her for a cesarean, we worked quickly to inform the family and stop her contractions. The baby was alive, but the variables in his heart-rate worried me.

Sunlight was just a few hours off, so Margaret worked with the family to get money prepared for a transport. And I went back to sleep.

Just before 7 a.m., there was another knock at the door. It was louder this time. I opened the door to find Margaret’s lips pressed thin with disappointment.
-- “Is everything okay, Margaret? Is the baby alive?” I asked with an urgency I couldn’t suppress.
-- “There’s another labor. She just arrived,” she started to explain. “The woman from last night... well, I don’t know what happened. I’m still figuring out the details...”
-- “What do you mean?” I asked in confusion. “Did her family get the money for a transport?”
-- “They got some money... but when they could not find it all, they brought in a TBA (traditional birth attendant) to deliver the baby....”
-- “They did WHAT?” My mind jolted awake instantly. What was she saying?
-- “I don’t have the whole story yet... all I know is I went to check on her a few minutes ago and a TBA was there... I’ll explain later.”

I thanked her, closed my door, and then took a deep breath. I couldn’t worry about that just now. I had another labor to take care of.

When I got to the clinic, the other mama was active. Although she was not one of my prenatal ladies, she had heard good things about the clinic and wanted to see for herself. The friend that brought her used to work for us. I was happy they trusted us enough to come.

She delivered an hour later on her knees.

The peacefulness of her birth stood in stark contrast to the turmoil in my heart. I kept having to force my thoughts back on the woman before me. I couldn’t stop thinking about what was happening in the next room.

My mind raced round and round. “What was happening in there? Was the baby already born? What did Margaret mean that a TBA had come to help? Were they transporting still?”

By the time my labor had delivered and we got things cleaned up, the clinic was bustling. A line of women waited patiently outside on benches. The day had begun.

I didn’t hear the full story until late that afternoon when Margaret and I had time to connect again. The story she told doused my heart with indignation, then set it on fire.

Picking up were she left off that morning, she explained, “The woman’s husband didn’t go for money. He went for a TBA. Apparently, she arrived around 4 or 5 this morning, and the clinic worker just let her in...”
-- “Our health worker didn’t stop her?” I asked incredulously.
-- “No. He couldn’t explain why... but he gave her gloves,” she paused a moment then went on, “As you know, when we left last night, her contractions were stalled and she was sleeping (because of the medicines we gave her), so I can’t figure out how she pushed.”
-- “Yeah... how could the TBA get her to push if she was so drugged?”
-- “I don’t know... I don’t know. All I know is that when I went to check on her this morning, the baby was dead and she was covered in blood.”
-- “What did the TBA do?”
-- “The health worker said she reached inside vaginally and tried to pull the baby out.”
-- “Why didn’t he stop her?” I demanded with more indignation in my voice than I intended. 
-- “He did not say. I don’t know...” she continued defeatedly. “But when I found her she was still wearing the bloody gloves and was trying to deliver your labor as well...”

Since neither of us were there, it’s hard to know for sure. I’m left to my imagination as to what really happened. What I suspect is that her husband assumed we were just not good enough midwives to get the baby out. He figured another one would do better.

But instead of fixing the problem, this woman made things worse. By trying to force the baby out (which failed), she killed him.

I suspect some kind of cord compression combined with fundal pressure.

We had spent 20 hours laboring with her to avoid this very thing. We’d given her our best. We’d done everything to keep that baby alive. And yet it was all for naught.

Her baby died... and she still had to have a cesarean.

I’ve thought about her labor a lot over the past few weeks, playing the what-if game in my head. I’ve gone over it again and again but to no avail. I have, however, made a few cultural observations.

The Sudanese seem to believe that:
-- the death of the baby is an acceptable, although disappointing risk of birth.
-- cesareans are to be avoided at all costs (not always for financial reasons).
-- cesareans should only be done to save the mother’s life, if the baby lives then good. 
-- women have little to no say in their health care choices.

Many other lessons can be extrapolated, of course. And if I had it to do all over again, I’d do it much differently.

Suffice it to say... I’ve learned many lessons --the greatest of which is trust.

Trust is essential.

Thursday, March 15, 2012

Seeing Double.

This last week I got a special visit from Akout and her twin boys. She wanted to let me hold them and kiss them, and show me how much they’d grown.

The oldest was all grins. He cooed and drooled happily as I made silly faces. They named him Santino Ngor. His younger brother by three minutes is named Jacob Lual.

It was such a joy to see them growing so well and to be able to hold them in my arms! Aren’t they adorable!

A Place of Rest.

Right now I’m in Rumbek, a city a few hours drive from Tonj. I decided to take my R&R here instead of going to Kenya because it comes out much cheaper for me. Plus, the low-key atmosphere is healing.

Each morning I wake to birds chirping and the gentle swish of the grounds keeper sweeping outside my cabin door. Some mornings I lay in bed longer than usual just to listen... and soak up the peace it brings.

The new baby Bush Buck.
The hotel I stay at is full of bird-crowded trees, including a mess of vultures and a spattering of woolly-necked storks. Red-Breasted bee-catchers hop from branch to branch, while Abyssinian Rollers saunter aimlessly among the blighted grasses.

It’s delightful!

But birds are not the only wildlife about. There are also countless Duiker (small, horned, skittish deer-like creatures) who scour the grounds for fallen leaves. Plus they just got a baby Bush Buck which I’m told will grow to be larger than the Duiker but shorter than an antelope.
One of the Duiker that lives here.

I love it here.

The staff is friendly. The food is amazing. And well... there’s also a pool. What a blessing! I can’t think of a better place to be as I stop and pray about my future.

I can’t imagine too many of you are planning on coming this direction. But if you do, I recommend staying at Safari Style. It’s the best!

Monday, March 12, 2012


No doubt for many of those who read this blog regularly, you are confused by my silence. Perhaps you are even a bit concerned.

If so, let me reassure you. I’m alive and well --for the most part.

Considering that writing is my greatest catharsis, it can well be assumed something is wrong when I grow silent.

My silence stems not from a lack of stories but the energy to do it well.

Weeks have flown by at a mind-numbing speed while my brain swirls in a kaleidoscope of colors and words --of conversations and images. Dizzy I sputtered to a stop this week, only to have it race on. And on.

And on.

Admittedly, I’ve been coping in various ways. Hiding. Crying. Venting. Working. Praying. Hiding some more.

It has been a season of finding balance --of stopping to breathe --of learning to be still.

Now, I’m finally in a place where I can write again.


The largest tidbit of news I have to share, as I watch the dust settle over my quieted heart, is that my season with this ministry is over.

Originally, I intended to complete my two years and take my furlough in June. But for various reasons (fatigue, new ministry directions, etc.), I asked my directors to consider replacing me before then.

I was not sure how long it would take to find my replacements, so I was unable to guess how much longer I had in Tonj. However, last Friday, one of my directors informed me that my replacements would be arriving in two weeks.

Two Kenyan midwives (or possibly nurses, I’m not sure) are coming to take over.

What that means is... the gentle birth I had on Thursday, was my last.

What that means is... I will not be returning to work at the clinic.

I’m not sure what the future holds right now. All I know is that a new season has begun... and it’s bitter-sweet.

Please pray for me as I transition out of this ministry, and make plans for the coming months. My heart is to stay in South Sudan and continue working as a midwife while training local midwives.

But honestly... I want God’s plans for me, not my own.

Pray specifically for me as...
  • I’m trying to get to Yei to speak with various ministries about starting a birthing clinic there.
  • I’m arranging to meet with the Ministry of Health in this region in hopes of learning what that will entail. 
  • I’m filling out applications for a wonderful ministry in the East working with refugees.
I trust God to guide me, and ask only that you’d stand with me in prayer.

Also... don’t be surprised if I start sharing some of the crazy things that have happened during these weeks of silence. I have TONS of stories to share... even if they are a bit late.

So keep and eye out for them. They’re coming...