Nutrition teaching at my house

Here's a photo from a nutrition class which was held at my house a few days ago. In the background you can see my wood fired oven and the support poles for the roof. In the foreground there are Ugandan men and women who were representatives from three different churches who came to learn. In addition to some basic nutrition teaching, I include practical applications. From prior teachings and some seed assistance, a number of people in these churches have started home vegetable gardens. With this group, I have previously done teaching which included how to make a carrot cake. Carrot cake is an incentive to plant carrots which are high in vitamin A, a common deficiency in Africa. Ugandans are typically crazy about cakes-- something they know as they get one bite servings at weddings. (The cake is cut into small pieces and passed around.) This group wanted to know how to use the vegetables they are growing including carrots and zucchini, plus they wanted more on cakes. So, this teaching featured a vegetable bean soup with zucchini, carrots, green peppers, onion, tomatoes etc. We also did a high protein "cake" I created which is basically a modified cornbread-- it contains soy, 2 eggs and a cup of milk per cake with only 4 spoonfuls of sugar per cake. I added spices (cinnamon and what they call here "mixed spice") to cover the flavor of the soy. It makes a mildly sweet slightly spiced cake which takes advantage of the natural sweetness of maize. We had three teams doing the cooking, and a great time was had by all. Don't be fooled by the photo--Ugandans' typically put on a serious face for photos, kind of like some of the early days of photography in the US.

We cooked the cakes in my WFO since I could cook all the cakes at once while they watched. The cake's rising in the oven took those who hadn't attended the prior class by surprise. Here most people have never seen a cake baking. The wood fired oven worked great and the cakes came out perfectly. Many people were intrigued by the oven too. It is built out of mud and brick so I wouldn't be surpised if people start building there own. I made it by combining an old roman design with the mexican horno oven. Here most people cook over a three stone open fire, but I wanted my baked goods:) For those who don't have an oven, I also explained how to use local pans as a Dutch oven and how to build a simple oven out of the heavy aluminum pans found here. I'm also reseaching low-firewood ovens, and may modify my oven to include a low firewood option based on the rocket stove (lots of videos of Utube if you don't know what a rocket stove is.) The one drawback to the oven is that it uses a lot of firewood. Cooks great though!

The groups organizer, a lay reader named Apollo, also came back today and we arranged for a low-cost mosquito net sale and scheduled a nutrition teaching at a church 3 miles from here on Satuday. P.S. Those who pray, you could pray for my safety traveling to that church. I'll be riding my 90 cc motorcycle out there. The road we take is a road I hate where it is in poor condition but large trucks still zoom by you--sometimes inches away and kicking up a cloud of dust that blinds you. Oh, and while 3 miles doesn't sound that far, distances are often vastly underestimated. The last "5 mile" trip I took was around 30 kilometers and over an hour by pickup truck.

A Huge Party--25th Wedding Anniverary Party

On Sunday I went to a Silver Jubilee 25th Wedding Anniversary Party for Rev. Canon and Mrs. Jonathon Isingoma. When people think of Uganda, they usually think of all the problems we have. However, we also have lots of weddings and joyous occasions too. Ugandan's, like all people, love to celebrate. Great care is taken in dressing and decorating. Brides dream of a western style wedding dress--I even know of one man whose fiance will not marry him in the church until he buys her a fancy wedding dress! Here my friends are celebrating their 25 wedding aniversary in style. I don't know what their wedding was like, but now they have gone all out and are celebrating in style.

The Thanksgiving for their years of marriage was held about an hour from here in Bulima Church of Uganda. Transport is always a challenge here, but many people got to ride on the lorry (truck) from a local school here. See the picture below:

We had a several hour service including the thanksgiving for 25 years of marriage. When you consider the average life expectancy here (about 47 years as opposed to seventy plus years in the US), 25 years of marriage takes both strong committment to each other and good health.

After the service, we went to the couple's home where they had set up rented tents all beautifully decorated. There was a huge number of people, and of course many could not get seats under the tent. Then the rain came--pouring down. Everybody crowded under the tents. Ugandans can really pack in closely. I think the only time I have been in a similar crush was in Shinjuku, Japan, where the trains have "pushers" who physically push people into the trains so the doors can close. Under the tent I counted eight people physically pressed against me and we stayed that way for maybe an hour. The eighth person was a little girl--at first I was worried for her in the crowd, but she was relaxed and playing with my purse and had no problems. I managed to snap a photo of her in the crush. After the rains let up, the food was served. The food also was quite good--steamed banannas, beef soup, rice, and beans. (My plate had bananna and beef so I didn't try the rice or beans but my food was very tasty.) Here in Uganda, I was surpised the first time I was served food out of what looked like a trash can--here plastic buckets are a practical way of holding food. In the picture you can see the bucket which had the beef soup. The basket with a bunch of leaves is the bananna which is steamed in plant leaves. It was a very nice celebration, beautifully done and with good food. The rain was a bit of a challenge, but everyone endured it patiently, and it was a good day. Thanks to Rev. Canon and Mrs. Isingoma for a fine party.

Bees falling like rain

It is about an hour before dawn, and I am sleeping peacefully. A shout from the night guard outside the house awakens me. What's the problem? Not a intruder--a swarm of bees. In America you have "Africanized bees" but here we have real African bees. Those who know me may recall I hate/fear bees, my fear goes all the way back to a time early in childhood when I stepped on a bee. I've gotten better about my fears, but can still be sent into a panic by a bee if surprised.

I unbarr the door, dashing (bravely for me!) outside to bring my dog inside to safety. Here bees may kill dogs. Fortunately the bees are swarming on a different corner of the house. In the meantime, my guard has gotten the sprayer filled with a chemical called "Ambush" and is attacking the bees. My hero! (My guard is Thomas, a brave man.) He is stung just once, but wisely doesn't swat at the bee that gets him--other bees can smell the chemicals if you do and may attack in mass.

Inside the main room, I wait rather fearfully. The buzzing of the bees is amazing, like something out of a Hitchock movie, and I can see them pressing up against the screens. About 5 bees manage to make there way inside. I grab an aerosol can of bug spray, mist the room and retreat to a room at the back of the house. I'm as far as I can retreat, fearing the bees, fearing for brave Thomas, fearing the chemicals of the cloud of insecticide taking over the house, and worrying that all the stuff in the air will trigger an asthma attack. Then the power goes out, so I get to do all this in the dark!

Fortunately, the chemicals do there work and dissipate. Thomas is unscathed except for one sting which doesn't even swell much--obviously he is not allergic or even very sensitive to the bees. I come out from my retreat, and see that dead bees have fallen like rain around the house. Yes, I know there is a place for bees and all the good they do, but when they try to move into my house I am not sorry for them. This is not the first time, either--they have tried to move into this house a number of times now though this was the first attempt in the dark. We also have to fight off masses of bad ants which have painful bites and come in huge numbers. In some ways this is like frontier living. Between the malarial mosquitoes, biting ants and bees the insects here can really get to you!

Build your own oven

Left: Oven base with sand form

Right: building oven walls.
I have been in Masindi for a year and a half now, but I didn't have an oven. When I first moved in, I had a kitchen counter built and brought a refrigerator up from Kampala. The fridge has been of limited use, as over the last month for about 3 1/2 weeks power wasn't strong enough to run it. It is great when it is working; a coke with ice is a real comfort food for me! I moved a sink and put in a soak pit for drainage -- no sewer lines here. I have a two burner propane stove (with an unfortunate and unsafe tendency for the gas pipe to drop out of the bottom). I have felt limited in cooking. I have learned about cooking with a local charcoal stove. I have experimented with a "dutch oven" pan. I have made a makeshift pan-in-pan; it does cakes but is limited in size and won't make a good roast chicken or baguette. The pan-in-pan oven is two large pans on top of each other with the top pan inverted to form the oven walls, and you place a separate smaller cooking pan inside plus put charcoal above and below the larger pans--an elaboration on a dutch oven. I've used a solar oven for some cooking also. I just wasn't satisfied. I really missed good breads, roast chicken and other oven baked foods, so I decided to build an outdoor wood-fired oven. With the help of my security guard, I built this monster oven. We made a cylindrical base (figuring this would support the load best due to the round shape of the oven) from local mud bricks and cement. I got a lot of help from an online forum-- www.fornobravo.com/forum is a great resource for info on wood ovens and they have lots of great people online willing to help you.

After building a base, I put down a layer of adobe for insulation--regular cement doesn't like hot oven temperatures. We built the oven floor from bricks and clay then made a form of wet sand (a big sandcastle) for the shaping the oven. We mortared local bricks with termite mud mixed with sand to build the oven walls and doorway. Then covered the oven in a layer of adobe for insulation.

I had a series of firings to dry the oven, and believe it or not, the oven works great! You push the fire to the side of the oven to cook things like pizzas and flat breads. Let the oven cool a bit and you have baguettes of french bread, cornmeal muffins, roast chicken, pork ribs etc. You can even close up the oven with a door and cook on the retained heat. I've had two pizza parties for expatriates here and have been told I have "the best pizza in Uganda." There is some pizza here, mostly in the capital--some of my Ugandan friends have heard of pizza though few have tasted it until now.

The oven build has drawn a great deal of interest as none of the locals have seen anything like it--guesses on it ran from water tank to doghouse, with some people thinking it was just an anthill. When they see fire coming from it the really wonder! I often have people coming by to see the oven, and currently have at least two people organizing groups to come to my house for cooking lessons. Along with cooking demonstrations, I teach the basics of nutrition, and sometime even some agriculture on how to grow vegetables like carrots (for Vitamin A). So, even though I really built the oven due to my desire for baked goods, it is finding a place in my health ministry.

Backporch medicine

I try to stay away from the clinical side of medicine. I honestly believe that focusing on prevention and basics to promote good health will do more good for more people overall. So, I work on things like getting churches to have hand-washing stations and latrines so they can be an example and teachers of the communities. Nonetheless, people come to me for help. Whenever possible, I try to send them to the health system we have here, even with all its shortcomings. However, sometimes mercy demands that you try to help, so sometimes I try. For example, a single mother with two children, who lives near me asks for malaria tablets for her son who is running a fever. I know she is barely managing to get enough food from day to day-- she lives off of lots of odd jobs of manual labor such as digging fields. Before, when I referred her to the hospital she waited all day, and had to buy some items such as gloves so her child would be seen. After a full day, she got a diagnosis (malaria) but no treatment. Often the hospitals run out of drugs which are supposed to be given free and patients have to buy them. She has little enough money for food right now. So, this time, I give her some Coartem tablets. Another case, a Ugandan nurse has an employee injured in a bicycle accident and she comes to me for help. I think she didn't have any bandages. I help her with first aide supplies (kindly donated by Jere Bethune) and have her clean and bandage the wounds. Last week, a man named Christopher and his wife brought his son to me. They had already been through the local hospital trying to get help for their developmentally delayed son. He has trouble holding his head upright and isn't sitting up yet. I told them this was not an area I was trained in, but they really wanted me to try to help them as they had nowhere else to go. Our next medical team isn't coming until December, and I am not sure if they will include physical/occupational therapists this time. I got him a book to study on helping village children with disabilities and we found some exercises and suggestions on making your own aides. Hopefully that will help him until the December medical team comes and hopefully they can take it from there. Here there are always many people looking for help, and death is far too common. Here if somebody is ill at home or hospitalized, all their friends rush to see them. If you're sick, everyone comes to visit--they don't want to delay seeing you in case you will die. I've been here long enough now that I understand that. Here you shouldn't think "Oh, they're hospitalized now; they'll get care and be OK," as for too many a hospital is just a place to die. Some here even die at home without even an over-the-counter dose of painkiller. In many ways Uganda is a great place to live: great climate, beautiful country, friendly people, incredible wildlife. However, it isn't a good place to be ill or injured.

My dog named "elephant"

This is my German Shepherd, Enjojo, which I got as a puppy in Kampala, the capital city. I first called him "Jojo" after a friend's dog and in memory of a great dog I had in the past. However, when people here heard that name everyone heard "Enjojo" which means "elephant" in Runyoro, the local language. He is much bigger than most of the local dogs, so it fits and the name has stuck.

Recently Enjojo became very ill. Soon, I tried to call my vet but couldn't reach him. Here the cell phone networks go out, plus often people don't have electrical power to charge their phones so these types of problems happen a lot. But Enjojo was very sick with bloody diarrhea and not eating, so I had to do something. Even though the symptoms didn't exactly fit, my mind kept coming back to a disease I haven't seen very often call Ehrliciosis, a blood parasite. I looked it up in a veterinary book and found the treatment was the same medicine I take as malaria prevention, an antibiotic called doxycyline. So I started the dog on my medicine. The next day I was able to contact my vet by phone, but he was in Kampala (the capital city) and it was several more days until he could come and see my dog and he wouldn't give me any advice over the phone. When he did get out to see Enjojo, he confirmed the diagnosis and told me that it was a good thing I had started treatment or the dog would have already been dead. I think God was whispering in my ear what the disease was--I don't think it was my skill that diagnosed this one! Praise god for his care over us, and thank God I was wise enough to listen to that quiet little voice that kept on nagging at me. Now Enjojo is fully recovered, eating like a horse (or should that be like an elephant?), and putting back on the weight he lost during his sickness. Thanks be to God!

The Face of Malnutrition

What does severe malnutrion look like? Here is a 2 year old child, named Mbabazi (Faith) whose caregiver was sent to me for training in nutrition last week.

The baby had been brought to Masindi Hospital where I teach a weekly class on nutrition. What you see is what happens when a child's diet does not have enough protein. Simply adding protein to the diet would have prevented this illness. Mbabazi was hospitalized and given treatment, but despite the care, for her it was too late. May she rest in peace.

Peas!

Fresh peas! This may not seem like much to you, but today I saw peas in the market square. This is the first time I have eaten peas in over 1 1/2 years. I also picked up some wonderful tomatoes. Good tomatoes are fairly common here, as are bananas. I think Uganda eats more bananas per person than anywhere else in the world. Shown here are a type of sweet bananas that make a nice snack. Basically, all the food you buy in the markets is fresh and virtually always organic. Tonight's dinner was cream of tomato soup with a side of fresh peas plus a few of the sweet bananas, quite a nice meal.

Words from my Bishop

The Right Reverend Stanley Ntagali of Masindi, Uganda wrote:

The Diocese of Masindi-Kitara in the Province of the Church of Uganda (Anglican) is very blessed to have, since April 2008, Ms. Janine LeGrand as the first Missionary officially sent by the South American Missionary Society (SAMS).
On arrival Janine started working as the Diocesan Health advisor concentrating on nutrition and hygiene. She has taught many individuals and families to improve their diet and control disease especially malaria which is a major killer disease in Uganda. Children and pregnant mothers are the most affected members of the community.

Janine is a very instrumental and creative person. She has been very helpful in the coordination of mobile clinics throughout the Diocese in partnership with Medical Mission teams from South Carolina. Because of her dedicated and faithful work within the diocese, we recently appointed her to work as the Diocesan Health Coordinator.

She is a humble and faithful missionary who respects the culture and values of her hosts. She loves the people of Masindi and relates with them well. She is very busy learning the local dialect which is “Runyoro”. She is loved and commonly referred to as Aunt Janine. She joyfully accepted a local pet name of “Abwoli”.

Masindi-Kitara Diocese is benefiting from her dedicated work and I am very thankful to her for her personal contribution to the growth and development of the young Diocese. We shall be celebrating our 5th anniversary in December 2009.

I would also like to thank the South American Missionary Society for sending a mature, hardworking and faithful missionary. We are very pleased with our partnership with SAMS.

Janine is seen as a real gift and blessing to the clergy and Christians of Masindi-Kitara Diocese in particular and Uganda in general. I would like to thank to all those who have supported her work and stay here.

Now Blogging Again

I have now been in Uganda for about a year and a half, and with the initial move into rural Africa, I was unable to continue blogging. Now, I am better set up here for communications and am getting adjusted to life here. So, now I will be picking up the blog again. Hope you enjoy the stories--life here seems to always be an adventure!