Taxi Anyone?

When my friend and housemate, Brendon, invited me to go shopping at the mall last Saturday, I was excited and quickly agreed. It was not so much the shopping that interested me but the chance to get my hair done.

Yep, I was desperate for a hair cut!

He, on the other hand, wanted a chance to talk ‘missions stuff’ and drink coffee. Now, how can I say no to that?!
    --That’s two of my favorite things ever!

There was just one catch; we’d have to take a taxi.

Keep in mind that the definition of Taxi in Jo’burg is definitely not same as the definition of a taxi in say... any other American city.

Apparently, it is something feared by many which explains his trepidation when asking me.

The conversation went something like this.

--“But if we go to the mall... we’ll have to take a taxi. You cool with that?”

--“Yes,” I asserted quickly, then added, “By taxi you mean the public transportation, Right?”

--“That’s right...” he hedged a bit then added, “They are not known for being very safe. They drive like psychos.”

--“Oh, that’s no problem. I’ll be ready in five,” I said matter-of-factly, and I meant it.

However before I left, I checked in with the pastors of CC Johannesburg, Chad and Heather Naaktgeboren, just to make sure that using local taxis was not breaking some kind of rule.

When I told them I was going to the mall in a taxi, they laughed nervously then snuck in a few sideways glances. Finally Chad spoke up. “You can take the taxi, if you like. But I’d only feel good about it if Brendon were there to protect you.”

I nodded in agreement. Then Heather chirped in, “Yeah. It’s not safe. Women are often the victims of robberies. They steal your phones... and your wallets.”

--“Oh... so it’s like in the Philippines,” I ventured. They nodded but then stopped.

--“No. It’s worse,” Chad began, “Here, it’s worse. I know some white South Africans that have never taken a taxi in their lives. They are too afraid.”

--“Yaa,” Heather added. “I’ve been here 7 years and I’ve never taken one.”

--“So... should I not go, then?” I asked quite sincerely. I didn’t want to make a cultural blunder.

--“No. But just know... if you don’t like it. We’ll be happy to come pick you up,” they offered kindly.

I laughed in response, but to be honest it made me wonder. Could it be all that different than the Tap-taps in the Philippines with the pick-pocket gangs? Could it be any scarier than the Matatus in Kenya who raced about at neck-break speeds?

It was time to find out. Plus, I love an adventure!

Before I go on, I should explain that Brendon is a white South African with more grit and grizzle than your average bloke. He lives on the CCJ property and has a heart for missions work. God willing, he’ll be preaching up a storm in South America soon.

As a local, Brendon knows his way about town and assures me that taxis are his preferred way of traveling the city.

So we were off.

As we walked to the intersection to catch the taxi, he explained some of the basic rules.

--“You must never jump the line. They don’t like that”, he began. “And make sure you line up from left to right.”

I nodded then repeated dutifully, “Never jump the line. Check. What else?”

--“Hum... oh. Yeah. They don’t like it when you talk really loud in the Taxi,” he explained. “You’ll find people talk in very low voices.”

I smiled. Then laughed. Yes, Americans are not known for being very quiet.

--“Okay. No loud conversations,” I agreed happily. “Anything else?”

--“Yes. One last thing...” he smirked, looking at my shoulder bag sideways, “You don’t have anything in that thing that can be easily lifted, do you?”

I smirked back, “No.”

“Then we’re set.”

As we continued to walk, I continued to pepper him with questions.

How do you know where the taxi is going? Where do they stop? Are they marked? Why do they drive so crazy? Why do people fear using them?

He answered my questions as they came, but it all stopped once we got to the intersection. Then he told me where to stand, and how to make the right hand signals.

--“When the taxi drives past, you have to hold up different fingers to tell him where you intend to go,” he tried to explain while pointing his index downward, palm facing inward. “This way he knows you only intend to go somewhere local.”

I mimicked his action but felt a bit silly doing it. But one quick glance around showed me that everyone was doing it too and I figured I should just go with the flow.  

--“How do you know which is a taxi?” I asked, more than a little confused. They all just looked like unmarked vans.

--“There’s a round sticker in the windshield,” he explained. “Can’t you see it?”

I looked and looked, but it didn’t seem very clear.

--“How long do you typically have to wait for a ride?” I continued to interrogate.

--“Depends. It’s fast... typically no more than 15 or 30 minutes.”

I smiled at his interpretation of ‘fast’ but didn’t comment. Time here is relative.

As we waited, unmarked vans slowed to get a better look at us. And some drivers even flashed hand signals back on their way by.

No one honked; no one hung out from an open door tapping on the roof of the van; and what is more, no one screamed out destinations or solicited riders.

It. was. all. so. very. sophisticated.

Meanwhile, the ever-growing crowd on the side of the road continued to wave different sets of fingers at the on-coming traffic in hopes of taking the next seat.

Vans passed. Fingers waved.

Several minutes ticked by this way, giving me ample time to learn the Finger Code.

“What is the finger code?” you ask.

Excellent question.

Here’s my best attempt at an explanation.

The Finger Code 101:

• Right index finger pointing upward, hand facing inward = going downtown to Jo’burg.

• Right index finger pointing downward, hand facing inward = going somewhere locally, (aka: before you reach downtown).

• Four spread-out fingers pointing upward, with thumb tucked in = going to Fourways (a well-known intersection somewhere about town)

• Right index finger pointing behind your right shoulder, elbow sharply bent = going to Randburg (a neighboring town or sub-burb, I’m not fully sure where).

• Hand spread out flat, palm down, tottering from side to side in an uneasy motion = going to a township (aka: squatter camp or slum) and you might want to reconsider your destination. 

In time and after much finger waving, we found a van with two empty seats and crawled in the back. Hot and cramped explains it well. This is typical of all public transports, but there was something missing.

I couldn’t quite put my finger on it at first, so instead I took a deep breath and settled in for the ride.

The quintessential tour guide, Brendon pointed out sights along the road and eventually helped me take a few pictures of the taxi on his phone since I was NOT allowed to open my bag, and definitely NOT allowed to get my camera out.
           --Ha!

 

He took advantage of this time to also snap off a few pictures of me. As we looked at them, we laughed and I offered to show them to the two young men sitting to my right. They looked at it more out of courtesy than interest, but it was fun interacting with them all the same.

Of the two young men, one was a good 4 inches taller than the other, but both had the same crooked teeth. In fact, their teeth were identically crooked meaning only one thing.

So I looked at them and asked, “Are you brothers?”

The one closest to me looked up in surprise, then nodded shyly. He kept looking to his brother for permission to speak but after waiting a long, uncertain minute and getting nothing, he finally decided to speak a single syllable in response.

--“Yes.”

--“You look alike,” I continued on with my widest smile. “Which of you is older?”

I already knew the answer --it was clearly the taller one-- but I had some time on my hands... and why not talk to them. Life’s more fun that way.

Once the older brother was identified, I teased the younger one by asking, “Is he a good older brother? Or is he a bully?” The younger smiled full-on at that point, showing off a new layer of crooked teeth in response.

--“Yaa. He is a good brother,” he chuckled.
              --Wow! I got more than a syllable. Success!

--“He never beats you up?” I continued to tease. He just laughed and shook his head in response.

--“Yaa, he seems like a good older brother,” I ventured. Then the conversation started to fade.

I could see he was definitely not used to talking to people like me, and I wondered why. Was it the fact that I was clearly this dorky older woman with stupid questions, or was it more?

It’s times like this that make me wonder just how my skin color is perceived around here. Some days, I think it’s nothing. Other days, I think it’s all there is.

One thing is for sure; Brendon and I were the only white people using any of the taxis that day. Despite this fact (or better yet, because of this fact), I felt very safe and secure.

Long story very short.

We arrived to our destination, shopped, then returned home on another taxi after a full day of hair-dos, coffee, and fun.

And only now as I write this all down, does it occur to me what was so vastly different about these taxis.

The silence.

Not once did I hear any hard-core punksters screaming their woes at mind-numbing decibels (as found in Kenya). Nor was I ever subjected to any rap bands blasting to the beat of blown-out sub-woofers (as experienced in the Philippines).

Yes, I would have to agree. In South Africa, silence is definitely key to riding the taxi.

TIA: This is Africa

For those who follow this blog regularly... I’m sure you’re more than a little confused. Didn’t I say I was going to Mozambique? Didn’t I raise all this fuss about support and prayer because I was going to the land of Moz?

Didn’t I?

The clear and easy answer to those questions is YES!

Yes. I fully intended to be in Moz by now... but I’m not.

In fact, I landed in Johannesburg almost two weeks ago and have been here ever since.

The kindly and most hospitable crew at Calvary Chapel Johannesburg has welcomed me into their guest room. And here I have been resting, hanging with the locals, and slowly getting my affairs in order for Mozambique.

“Why the delay?” you ask.

Good question. Reasonable question. But one that is not so simple to explain.

Well, actually it is quite simple.

This is Africa.

When I say TIA (This is Africa), I don’t say it with a sneer; I say it with a sly smile and a quick shake of the head.

Let me explain.

My ride into Moz depends on my directors, Roy and Trish. And although they are deceptively white they are most assuredly not Westerners. I suspect if you took a Brillo pad to their skin, you’d find a brilliantly gorgeous black underneath.

They are Africans. Pure and simple.

So when we arranged to have them come to Jo’burg to pick me up, I was thinking like a Westerner. They were not.

The first day we met up, they told me they wanted to stick around Jo’burg for a few days to get refreshed, and I smiled to myself. For I knew that a few days to them might be more like a few weeks.

I was right.

One week turned into two. And soon it will be three full weeks before I arrive in the ever elusive land of Moz.

At first I was disappointed by the delay --the let down, the dashed expectations, the expense, etc. But I don’t feel that way now.

To be honest, I’m relieved.

I left the States very tired --the constant goodbyes, the relentless repacking, the last-minute details. But now after a time just sitting at His feet in the early morning sun and sipping on coffee in the late-afternoon heat, I’m rested.

Praise Him!

I’m told, however, that we’ll be heading to Mozambique sometime this weekend. So please pray for traveling mercies. The roads are better in Zimbabwe, so we’ll head that way first, then dart over into Mozambique.

I’ll be sure to let you know how it goes!

Also... thank you so much for praying for my bags and my ticket reimbursement. My bags made it here safely within a day or so. And I was finally able to sort out my ticket reimbursement just this week!

What a relief!

Baby Maria

Baby Maria is sitting on the bed next to Trish Perkins.

Baby Maria wasn’t an orphan when she came to Maforga --not exactly. Her father is still living, but he’s old. Very old.

A month ago, he brought her swollen body to Roy and Trish and begged them to help. Her mother had just died of AIDS in the village and she was not far behind.

Afflicted with a severe case of kwashiorikor --a form of malnutrition due to protein deficency—she barely moved from the pain in her joints and the swelling in her limbs. It didn’t help any that she was also HIV positive.

When I first met her, she was sitting up and considerably improved. But even though the swelling from the kwashiorikor had subsided, she still struggled to gain weight.

But we were hopeful.

It was hard to tell her age by looking at her though. Had I gone by the look in her eyes, I would have guessed her to be well passed a hundred. But in actuality, she was about 10 months old. The thing was... she weighed little more than a newborn.

Only time would tell if she would improve.

We prayed for her daily while her caregivers pestered her hourly to eat even the smallest of morsels.

I checked on her from time to time. But when I did, I usually found her sleeping. Her eyes closed, her chin tucked, and her twig-like frame lay listlessly on the cot. When I stroked her face, she wouldn’t flinch. When I pressed her hand, she would not make the slightest acknowledgement.

Once she opened her glassy black eyes to look upon her aggressor, but quickly unimpressed she closed them again to rest. What little energy remained was focused on keeping her heart beating... and her lungs full of air.

Day after day, her caregivers spent hours getting her to swallow a few bites of fortified porrige, but even the will to swallow had passed.

She had clearly given up.

Life clung only to the frayed edges of her soul and stirred softly in the ever darkening expression in her eyes. It was clear she was trying to say goodbye.

Everyday she fought a little less. Everyday she drifted a little further away.

Yesterday she died.

Finaly.

Is it wrong of me to feel relieved? Do you think me heartless for it? I’m heartbroken she passed away, but I’m thankful her suffering has ended.

She is the very reason I want to work here –she and her nameless mother.

Why do we have orphans dying of AIDS in Africa? There is no trite and simple answer to that question. There just isn’t.

But roll back the calendar a year and a half to when Maria’s mother first conceived. How much different could her pregnancy and birth have been had she had a midwife to help her in the village? How much healthier could she have been had she taken the retrovirals... or had access to them in the first place?

What if during her birth, her midwife could have reduced the risk of transmission of HIV and Maria had been born free of this corrosive blood sucking virus?

What if... what if...

I’m not saying I have the solution to all the woes of Mozambique. And I’m certainly not saying that I can save them all.

But seriously what is the alternative... to do nothing? –to watch them die slow, emaciated deaths? --to plant their brittle bones in the ground and walk on?

Is that really an alternative?

Please pray with me today. I seriously need your prayers. Right now all the doors seems to be curiously closed to me and what I want to do. Please plead for God to open the doors and grant favor for me to discuss my ideas with the local powers that be.

I need to start somewhere. Why not here?

Mountain of Confusion.

Saturday I joined some of the Maforga staff for a quick jaunt up the Mountain of Confusion (or in the local tongue Nharo-Nharo). This curiously named mountain is believed to be a spiritual place, and as such is used by witchdoctors to perform ceremonies.

(In fact, due to this spiritual side to the mountain, I’m told many of the locals who have lived here all their lives and never been to its peak; it’s just too scary.)

In addition to its spiritual fear, it also has a very real physical one as well –land mines.

Years ago during the war, Nharo-Nharos’s high elevation made for an ideal look-out spot for rebels. To keep their enemies away, land mines were generously peppered along its slopes. However today, that means there is still the very real danger that unexploded land mines still await anyone foolish enough to tread off the beaten path.

Well, oddly enough witchcraft and land mines didn’t seem to deter our motley crew. There were fourteen of us in all –two Americans, an Aussie, a Brit, a Dutchman, and a medley of missionary kids and orphans.



We made a bit of a scene when we arrived at the mountain’s base. It’s not everyday, I suppose, that 14 people jump out of one truck and march up the steepest slope.

Had I known that we’d be taking the hardest route up the mountain, I would have submitted an official protest, but my one vote would not have mattered much; I am sure.

And had they all known that they’d invited the world’s least fit American up the mountain, they may have pushed me from the truck long before we ever arrived at our destination.
               --But I guess a surprises never hurt anyone, right?

More than once did I see doubt in their eyes as they watched me huff and puff my miserable way up the mountain. I sounded like a winded tea kettle and was equally as hot.

The kids didn’t seem to even notice the near vertical incline; and rarely did the (ridiculously fit and) seasoned missionaries stop in their upward climb; I was the only straggler.

At one point, one of the kids decided to try and walk with me, but I could see she was bored rather quickly. I’d take three steps than stop, huff and puff, turn three shades of red, then take three more steps.
             -- Slow and steady wins the race, right?

It didn’t take us long to reach the top, however, and in the end all my huffing and puffing was worth it. The view was spectacular.

Yellowed under the smoky haze and sparsely planted with trees, the Mozambican landscape stretched out for miles. It vibrated with potential.

It’s a land rich in beauty just begging to burst in green lush-ness… if only the rains would come.



At the top, we had a quick devotion then lunched on egg sandwiches and bananas. Afterward we took pictures and enjoyed the view. But we were not the only ones on top of the mountain; there was a Zionist group there as well.

I am told that the Zionists practice a synchronized religion of Christianity and traditional witchcraft. And naturally, since they believe the ‘high grounds’ get one closer to God, they often go to the Mountain of Confusion to worship.



Coming down the mountain was faster but just as hard as going up. The steep incline made balancing difficult, and many of our group chose to scoot down on their butts. But since the mountain has been scorched (much like the rest of the nation), this meant we arrived soot covered but safe.

All in all, it was a good day. I’m so glad I went.

Mozambican Welcome.

As the plane touched ground then bounced down the runway, I soaked up the sights of this new land. From my plexiglass window, the first thing that struck me was the massive amounts of concrete coating everything.

Strange, I know. But there you have it.

This airport had an honest to goodness tarmac! I’m so used to the half-paved and pot-holed messes often found in South Sudan, that I was deeply impressed with this hardened, grey facade.

Once the seatbelt sign switched off, I scrambled out of my seat, grabbed my back-pack, and bumped down the airplane aisle, pushing past the deep blue seats and scattered newspapers on my way.

As I deplaned, my first breath of Mozambique was curiously cold. At a whopping 8 degrees Celsius, I immediately knew I’d packed optimistically light.

I fished my (one and only) sweater from my bag and hugged it tightly around my shoulders. This surprising drop in temperature was welcomed, however, as it has been ages since I’ve been cold.

As I walked to the main terminal the wind picked up, carrying whiffs of petrol, bon fires, and dirt. Later I would learn that even though Mozambique is just finishing up with its winter months (June, July, and August -which are supposed to be wet), the rains never came.

These unusually dry months have yellowed the grass and stripped the trees, leaving the land wind swept and parched. Plus the water table has dropped dangerously low, much like the gloomy smoke-filled haze that sits just above the horizon.

It’s not good --not good at all.

I’m also told this is the ‘Season of Burning’ which is when the locals torch their fields to clear the land for planting. Often these fires take on a life of their own. And sometimes more than the fields are destroyed.

Day after day, I’ve watched Roy our director get calls to inspect reports of fires heading our way. It’s a constant battle. And today, I learned one of our guard’s homes was burned to the ground.

They burn to clear the lands, but they also burn to hunt for rats. At first I thought the rat hunting was to keep them off their lands and out of their food storages, but I was wrong. Apparently, they like to eat them.

Roughly the size of a kitten, these rats dig tunnels underground, and as a result they must be coaxed out of the ground to be caught.

I’ve yet to see one, but I’m not looking forward to the day. Rats of all shapes and sizes have the honor of being the lone item on my phobia list. Frankly, the idea that they are hunted and eaten here locally makes me cringe deep in my gut.

Lord, please. May I never be asked to eat one. Ever. Amen.

Wait... wait.. How did I get on the subject of rats? Forgive me. I’ve digressed in my tale. Let’s see. Where was I? Yes. My arrival in Mozambique. That was my point.

I landed (on tarmac), slipped on my sweater (for the cold), then stood in line for my visa.

The airport official, a short coffee-colored man with smiling eyes, took my index fingerprints, sixty-six dollars, and my picture before he handed me back my passport. In it he’d pasted an elaborate visa (which included my mug shot!) and the words “Visto Republica de Mocambique”.

Passport in hand, I walked excitedly up to the only Muzungus (white people) waiting outside of customs. They were hard to miss.

A taller than average blond with soulful eyes and a pleasant smile wrung her hands as I approached. So I smiled back and asked, “Are you Trish?”

-- “Oh.Yes. I’m Trish,” she started, then signaled for her husband to join her. “This is Roy.”

-- “Great to meet you both! I’m Stephanie.”

-- “Stephanie! Oh good. For the life of us, we couldn’t remember your name. So it’s “Steph-an-ie”?” she asked slowly, stressing my name into three long syllables.

Surprised I blinked a few times, then nodded.

I couldn’t help but wonder at our odd greeting. This couldn’t be a good sign, could it?

As we shook hands and politely chatted about the flight, my mind raced with questions. Had I really just flown half-way around the world to meet up with people who didn’t even know my name? What had I signed up for?

Nevertheless, Roy took my bag and we headed for the truck; we had to get on the road quickly, or we’d run out of daylight. As we drove the 3 hours back to Maforga, Trish regaled me with stories of Mozambique and asked me questions about my work in South Sudan. Roy, being more of the meditative listener, was happy to drive and listen to us talk.

Roy and Trish are celebrities of sorts in these parts. They started the work at Maforga 27 years ago and have seen more than their share of adventures. In the past few days, I’ve watched them juggle so much that it’s easy to see how they could forget silly things like names.

This week they’ve introduced me to the various government and social welfare offices to see about opening a birthing clinic. And if things go well, we’ll meet with the Ministry of Health in the coming weeks. There is even talk of gathering a number of midwives together for a meet and greet.

Please pray for these meetings as they are essential to any future medical work in this country. Naturally, I want God’s perfect will for my future, so I’m asking God to grant me extraordinary favor with the Ministry of Health if I’m to start a work here. But if He wants me to move on, then to close these doors tightly and show me where to go next.

Will you please join me in this prayer?

Also pray for me to meet up with and interview the midwives of the area, as well as a group of women and several of the village pastors. Thanks.

Arrested?

(I’m going to hop back in time to the end of March, just as I was leaving Sudan. Forgive me the lapse in time, but hopefully the story will be worth the wait. It's a bit long, so grab a cup of tea first!)

Leaving Sudan that last day was hard, but I had already shed all my tears. So my face was dry.

Our flight left early that morning carrying our pilot, me, two other staff members (Dennis and Margaret), and a handful of Kenyan pastors who had been visiting to teach.

Our first stop was Rumbek --a forty-five minute flight from Tonj and our official exit site for Sudan. With the laws changing we needed to get our visas stamped properly to leave the country. But more than that, it was the perfect occasion to meet up with my Rumbukian friends for one final goodbye and to pick up a necklace that was on back-order.

This necklace was a mixture of plastic rods, Sudanese beads, and bullet shell casings. It epitomized the essence of S. Sudan for me, and I wanted it as one last memento.

Since it was finally ready, my friends met me at the airport with the necklace during my lay-over. I was so pleased with how the necklace had turned out, that I put it on immediately.

Touching it lightly with the tips of my fingers, I smiled to think of this last token of  Sudan, then boarded my flight for Loki --the next stop on our flight home.

After Loki, we boarded another puddle-hopper for Nairobi. As we bounced our way back to Kenya, I noted the even weight of the shells on my neck and smiled. The turbulence was particularly difficult that day, but I didn’t notice it much. My heart was already in too much upheaval from my recent goodbyes.

Since our plane was small it took us longer to get to our destination and we landed late in the evening; the hustle of unloading bags and jostling boxes took my full attention and I didn’t pay attention to the guard motioning to my neck. I just walked on past him to the taxi stand.

Initially I thought he was just admiring my prize and so I nodded my thanks and moved on. But as I waited for my ride to show up, the airport guard brought a policeman up to me and pointed accusatorially at my neck.

Finally the blue-suited officer spoke:
-- “This necklace is offensive. Come with me,” he barked, signaling for me to follow.
-- “Huh?”

Confused how a necklace could be ‘offensive’, I wrinkled my brow and asked him to repeat himself.

And he did just that.

-- “This is offensive. This is very offensive. Come with me,” he continued on. Initially I followed him as he marched with irritated purpose... until he took me behind barred gates.

-- “What is the meaning of this? I’m not going to go with you... my friends are there,” I protested politely, signally to my friends standing by the curb. “I don’t understand the problem.” 

Thin-lipped to begin with, he proceeded to pinch his lips into even tighter lines until they all but disappeared. Then he pointed at my necklace with disdain and said, “This is offensive. This is offensive!” He was starting to sound like a broken record.

“This is absurd,” I laughed. “I’ll take it off if it is offensive,” I said, turning my back to him and walking back to my friends. By the time I reached them, the ‘offensive’ object was removed and in my pocket.

I figured that I’d committed some kind of social gaff, and was trying to politely cover up my blunder. But by the time I got back to my portion of the curb, Mr. Thin Lips was at my heels.

-- “You have to go to the police station!” he insisted, pointing to a concrete building around the corner.
-- “What?” I sputtered. “Why?”

It’s at this point my driver, then Dennis, then two of the pastors on my flight all chimed in on my behalf. As they warbled in Kiswalhili, I tuned them out. All I could think of was how ridiculous Kenya was... yet again.

I mean... come on. I’d taken off the ‘offensive’ article. What was the big deal?

By this time the thinned-lipped officer was now red --as red as his charcoal complexion permitted. And as time lapsed, his color deepened.

With more annoyance than fear, I watched my friends banter and beg. They seemed scared for me, but for the life of me I couldn’t understand why.

Eventually, Mr. Thin Lips climbed into our taxi --AK47 cradled in his arms-- and escorted us to the police station. Everyone around me looked stressed, but all I felt was annoyed. This was too much pompous chicken scratching in the dirt for one day. I mean, come on. I’d already taken off the necklace. What else did they want?

The station was literally around the corner and we got there in no time. As we piled out of the taxi, I still couldn’t figure out the hubbub. And... I was too tired to care.

Three steps and we entered the police station only to be greeted by three more thin-lipped Blue Suits. My accuser then confiscated my necklace and handed it to his comrades.
    --Seriously, what was his deal?

He held it high like a prized medallion for all his friends to see. Five copper bullet casings interspersed with plastic and ceramic bobbles hung accusatorially... but I still couldn’t figure out why.

First my friends spoke in my defense. But they switched so quickly between Kiswalhili and English that I could not follow the conversation. But what I did grasp was that they wanted to fine me... no... they wanted to put me in jail.

It’s at this point, I took a step back and watched. What was I missing?

All the while, my heart was calm. I didn’t feel the slightest bit stressed by it all. If they wanted to put me in jail, I’d go. Seriously, what did I care? As best as I could see, this was just another shake down for a bribe.

My necklace exchanged hands a few more times, while the story starting shifting. Only when they started threatening my Kenyan friends with culpability did I perk up. One officer kept insisting that Dennis was Kenyan and therefore should have know about my offensive act. Perhaps he should be fined instead.

It’s at this point things finally clicked in my brain, and I started reinterpreting the conversation in my head.

“Offensive must mean something else in Kenya,” I thought to myself. But the only definition that I could conclude by the circumstances was “Illegal”.

So I inserted “illegal” where they said “offensive”, and it all fell together. They wanted to arrest me, put me in jail, then fine me for bringing in illegal contraband into their country.

Duh!

How could I be so dense? No wonder they were all stressed and I was not!
    -- Ignorance truly is bliss!

Once I realized I was smuggling in contraband, I was even more willing to go to jail. Honestly, part of me was curious what it’d be like. I’ve never been to jail in the States before... why not go to one in Kenya!

But I didn’t tell them I wanted to go to jail. Instead, I interrupted the long discussion with a slight raise of my hand.

-- “Excuse me. May I speak now?” I asked as humbly as I could. The room quieted down to hear what I had to say, and the main Blue Suit motioned for me to speak.

-- “I am so sorry. I am not from here, and I am just now starting to understand,” I began. “I realize now that I’ve done something illegal, is that right?” I stressed the word ‘illegal’ and locked eyes with my accusers. They nodded, a bit relieved that this silly American was finally clueing in to the severity of the situation. 

-- “Also, I must sincerely apologize to you, Sir,” I said motioning to Mr. Thin Lips. “I am so very sorry I did not understand that ‘offensive’ meant ‘illegal’. Had I known I would never have disobeyed you.”

I meant every word.

-- “Sirs, please tell me. What do I need to do to fix this?” This one question settled the room instantly and they switched back to Kiswalhili.

Although we’d already wasted over an hour in discussion by this point, it looked as if I had not yet spoken to everyone; I still needed to speak to the head hancho. It’s at this point I was ushered into the back office to meet their chief.

The room was large but crowded with an oversized conference table, a dozen metal chairs, and a clunky desk. Behind the desk sat a opened-faced man in his forties. He greeted me kindly, indicating the chair before him. And I sat down. 

-- “You know this is very offensive in our country,” he explained with a slight smile. I nodded then apologized again.
-- “Yes. I understand that now. I would never have brought it here if I had known. Please forgive me.” I felt complete peace while we spoke.
-- “Even having one of these shells gives me permission to fine you 10,000 shillings and put you in jail,” he explained clearly. “You have five of them!”
-- “Yes. I do. I am so sorry.”
-- “If I put you in jail, you will have to be here all weekend,” he explained, watching my face while he spoke. “The judge must see your case,” he continued, “and he does not appear until next Monday.”

It was Friday evening. That meant I’d be spending the weekend in jail. I didn’t love the idea... but again. I didn’t mind if I had to go. God would work it out. I had utter peace.

Then he hesitated a bit, so I spoke.
-- “Is that what you want to do?” I asked him kindly. “You tell me. I am a foreigner here. I will do whatever you say. How do I fix this?”

He laughed out loud at this point, and sat back in his chair. As we studied each other, he continued to explain that if he put me in jail, I’d be there all weekend. I think he wanted me to understand the severity of the situation. I assured him that I did.

I listened intently, willing and ready to serve the time for my crime. I told him that if he thought that was necessary, then that was necessary. Then I smiled.

I wasn’t interested in losing my necklace... but I figured that it was long gone by this time. Instead I focused on whether or not I’d be spending the weekend in jail.

I couldn’t tell if he was waiting for a bribe or not. So I continued to smile and waited.

He just looked at me again, laughed, then changed the conversation.
-- “Why would you wear a necklace like this?” he joked, holding the necklace up for us both to admire.
-- “I find it very beautiful. I paid a lot of money for it,” I said sweetly.
That just made him laugh harder.
-- “Why would you pay money for this?” he said with mock surprise.
-- “It’s a beautiful reminder of Sudan. Don’t you see how beautiful it is?”

He laughed whole-heartily by this point, looking back and forth between me and the necklace. I could see he was still not convinced, but there was no denying... he was thoroughly entertained.

He hesitated a few seconds then finally said: “I will not arrest you. Instead I will take all your bullet shells and you will take your beads.”

I nodded that such an agreement was more than fair... then he proceeded to pull my necklace apart.

I was sad to lose my necklace within hours of buying it.... but I was more relieved not to spend the weekend in jail.

With string, beads and plastic bobbles in hand, I stood and thanked him for his kindness, shook his hand briefly, then turned to leave.

With my hand on the doorknob, I turned to tease him one last time. “Make sure you don’t make a necklace with those shells!” I joked “Your wife will not appreciate it!” 

Our eyes met and I held my breath for his response. 

We locked eyes a moment and then he laughed so loud it echoed down the hall and into the lobby. On my way out his officers asked what happened and I explained, “He took my shells and gave me my beads. I can go now.”

I walked toward the door confidently, but my friends hesitated to follow.

Once we were back in the car, Margaret asked, “Did you have to pay a bribe?”
-- “No. He did not ask me for one.”
-- “But...” she hesitated again, “they cannot ask. You have to just offer.”
-- “Well then, no. I did not offer. I was willing to go to jail.” She looked at me in disbelief, so I continued. “I was NOT willing to pay any bribes. I think he realized that and just let me go.”

Only once we were well on our way, did it occur to me how annoyed my friend had been. Apparently, my stubborn refusal to go with the officer, my initial denial of all guilt, and my insistence that he not take my necklace away... had put them in quite the bind. So I apologized.

I really was sorry I’d upset them... but I wasn’t sorry for the experience.

One thing’s for sure... the next time a Kenyan accuses me of being ‘offensive’, I’ll know what he means!

Walking the Streets.

On my last day in Tonj, I went for one last walk in town. I wanted to get a few gifts --if they were to be found-- but I also wanted one last goodbye.

As my friend Mario and I walked about, familiar faces greeted me loudly in the market. Women I’d welcomed into the antenatal program, and who even delivered with me, called me over to their stalls to greet me.

When they saw my camera, they insisted on a photo. Gathering their children in close and squaring their shoulders proudly, they stood and sat stock still for me “to make a design” of them.



I would have stayed to chat, but it was already late. Mario needed to give me something at his sister’s house. So we waved our goodbyes.

As I walked past, a wrinkled woman motioned insistently that I had my fly down. When I checked to see if she was right, laughter rippled through the crowd.

It took me a few seconds to realize she was teasing me, but then I laughed along with her another wave of laughter shook the crowd.

In South Sudan, teasing is a national sport!

Mario called me through the crowd, impatient to get to his sister’s house, so I waved my final goodbyes and walked on.

Mario has worked with In Deed and Truth ministries for years, most recently as a translator and clinic health worker. Although he is young, his English is great.

Over the years, he has been a good friend to me. When I told him I would be leaving earlier than June, he shook his head in protest and said, “I am not comfortable with this...” I initially laughed at his choice of words, but they fit somehow.
    --Changing countries, packing bags, saying goodbye... I’m not comfortable with it either.
As we walked, Mario veered me in the direction of his sister’s house. It was late in the afternoon by then, and she was doing laundry. When she saw us, she wiped her hands on her skirt and then extended her still wet hands with us in greeting.



On our arrival, her children stirred from their naps, and we sat in the plastic chairs next to them. As we talked, they milled about trying not to stare.

Mario explained to his sister that I was leaving early --the next day in fact! Surprise flashed across her face, then she quietly excused herself, saying she had “something small” to get me.

Turning away, she hurried inside her tukel. Meanwhile, Mario and I played with the slingshot I had just bought off a kid in the market.

Made of recycled bike tires, it was surprisingly accurate. But Mario insisted on shooting the goats. Poor, defenseless goats!

A few minutes later, Mario’s sister returned with my gift --a brightly embroidered sheet with two intricately stitched peacocks facing each other. She wanted me to have something to remind me of Sudan.... as if I could forget!

I thanked her over and over, gushing over the beauty and skill involved.

What an honor!

Honestly, saying goodbye has not been easy. The tears come at random times, surprising me by their inconvenient warmth.

The Sudanese --like most African cultures-- do not cry. It is seen as weak and portrays fear rather than love. So in my goodbyes, I did everything I could to not weep.

But I failed.

I failed with silent, languid tears. Large and heavy, they ran down my cheeks before I could bite them back. Excusing them with a wry smile, I tried to explain to my African friends that it was my way of saying I loved them.

They nodded that they understood... but looked away for my benefit.

Three of my translators tried not to cry with me as we said our goodbyes. They succeeded. I failed.

One privately called me aside to say goodbye, saying, “We will not forget you, Akuac.” As we spoke, my eyes filled with tears and I turned away.

Yes. Those are the words I was looking for...

South Sudan, I will not forget you.

Handing-Over.

When I got back to Tonj to pack my things, I met Annie. She is one of the Kenyan nurse-midwife hired to replace me. That first night I didn’t have much time to talk, but by morning I was bursting with things to say.

It was handing-over time.

But how do I tell her two years worth of lessons in three days? How do I show her all the birthing positions and Dinka preferences? How do I explain the superstitions in such a way that she’d understand?

How?

But I was soon to learn that Annie was as keen to learn as I was to teach.

What a blessing!

That first morning as I walked Annie through the prenatal system and explained the medicines used, I rambled on and on about the beliefs and practices I’d seen over the years.

I wanted so much for her to learn and accept the Dinka’s traditions. Knowing that the biggest hurdle she’d encounter would be the Dinka birthing positions, I started there.

-- “The women here have many birthing preferences,” I started to explain, “If you respect them, they will flock to deliver with you. If you don’t, they’ll disappear.”
She nodded pleasantly in response, then asked, “What are these preferences?”
-- “Well... to start, they give birth on their knees...” I paused to watch her face, knowing full-well that such an idea can be strange for most African-trained nurses.
-- “Their knees!” she half laughed, half gauffed, “Why do they do that?”

Annie and Margaret during devotions.

I explained the whys and hows, even falling to the floor to show her the crouch-squat myself. She smiled while I spoke, shaking her head in disbelief.

-- “Okay,” she finally agreed, “but I have never delivered a baby like that... how do you do it?”
Relieved that she was at least willing, I explained the hows and what-nots involved.

She listened attentively, but I could see it was well past her comfort zone. Finally, I added, “Perhaps we’ll have a birth together before I leave. If so, call for me and I’ll show you what I mean.”

She readily agreed and I continued her orientation. There was so much to tell her... and so little time.

I prayed we’d have a birth together for two reasons. One, I desperately wanted to show her how easy it was to deliver a baby in that position. And two, I selfishly desired one last birth in South Sudan.

Our chance came the following night, when I heard a slight knock at my door. It was Annie.
-- “A mama has come in labor,” she started. “I know it’s late, but I’d love if you’d show me how things are done.”
To hear her speak in such a way melted my heart. I could see that she genuinely wanted to work in a culturally sensitive way. Smiling, I agreed to come right over.

My scrubs were packed so I slipped into my jeans and headed over.

Sure it was 1 a.m. and I was tired from my constant packing, but I could think of no place I’d rather be.

Blessed by her eagerness, I talked Annie through the birthing customs as we labor watched. Describing a kneeling birth is harder than I thought. It’s truly a watch-what-I-do kind of thing.

So as the laboring mama progressed from 8 cm to fully, I taught Annie the questions to ask and how to set up the room.

Our labor, Ajak, was expecting her 8th child. Her first seven were all delivered at home, but this time she had decided to deliver with us. I was honored by this choice as it revealed the depth of trust we’d developed in the community over the years.

Her friend, a woman I’d seen many times before, acted as her doula. She never left her side, encouraging Dinka style with sharp comments and disapproving clicks of her tongue.

Ajak’s labor was slow to progress, and her doula-friend disapproved. She kept clicking her tongue impatiently, and speaking gruff remarks. After the third negative comment, I had had enough and I turned to her and asked, “Why are you so upset?”

She looked at me in confusion, so I continued on. “Right now, Ajak is having a normal labor. Everything is okay. I need you to know that so you do not worry... or make her worry.”

I smiled politely while I spoke, but my words were sharp. “Please, if you stay in this room, be happy with your words... I don’t want her to think things are wrong when they are not.”

Her doula friend smiled in agreement, explaining she was tired. Looking around the room, we all laughed with her, and agreed that three o-clock in the morning was rough.

Annie silently took it all in. No doubt watching Ajak labor on the floor was new to her, but she embraced it.

I loved her for this.

We talked softly as Ajak moved about. After several hours, she was finally ready to push. So I asked her, “How do you want to deliver --on the bed or on the floor?”
She looked up at me in surprise, eyes flashing in relief and respect. But she didn’t answer. I could see she was hesitant to speak, so I asked again.
-- “Ajak, do you prefer to give birth on your back or kneeling?”
-- “Kneeling,” she whispered with a smile. Her whole body relaxed at the thought.

I smiled with her, then glanced in Annie’s direction.
    --Excellent!

When it came time to push, Ajak started crawling the room in pain and complaining her hips ached. So I applied pressure and massaged where I could. Eventually she fell to her hands and knees and rocked a bit.

It was close.

Annie sat in the corner of the room wide-eyed in wonder. She looked hesitant and nervous, but hid it well. Ajak was silent but active --very active.

Suddenly there was a noticeable change in her grunts. It was time.

Since she was already on the floor, I slipped a pad under her and seconds later her little girl was in my hands.

I had Ajak sit down on the pad to wait for the placenta, as our translator milled about handing me things.

Her girl was healthy and strong; she yelped sporadically as I wiped her off. Trying to keep her warm, I covered her tiny frame and waited.

As we waited I continued to teach Annie the Dinka birthing traditions (as there are as many for after the birth as there are during).

With time, the placenta was born and we cut the cord. Weighing her and wrapping her tightly in a blanket, I handed her over to Ajak's doula-friend.

She started complaining that she had spittle in her mouth, but then caught herself. Apologizing, she stopped half way through and smiled at me. “I won’t be negative anymore,” she told me with a smile that reached her eyes, “because I see that with you I don’t have to worry.”

What a blessing!

I continued to teach Annie the ropes while Ajak breastfed on the floor. At one point, she looked up at me glowing and said, “I’m so happy.”

I smiled back and told her I was happy too --so very happy!

I’m happy I got to be a part of one last birth before I left. I’m happy I got to show Annie the typical birthing style as well. But more than anything, I’m happy Ajak got to deliver in a way that made her happy.

Lord, bless Annie and Axilla (the other midwife that came a bit later on). Help them to love the women well. Teach them how to be culturally sensitive to the Dinka traditions. Bless them, Lord. And use them powerfully for Your glory. Amen.

Ajak was my 230th birth in South Sudan. I’m going to miss them.

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.

Blacksmiths.

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.

Beautiful.

--“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?

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.

Sigh.

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

I love Sudan.

Hope this video works:

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.