Ot Nywal Me Kuc, House of Birth and Peace

 

Birth Center Photo from my front door.

Ot Nywal Me Kuc (House of Birth and Peace, pronounced oat new-wal mee kooch) is a sustainable, solar-powered birth house located in Atiak, Uganda, 20 miles south of the border to south Sudan. The closest hospital is 50 miles away—more than two hours by truck on unpaved roads with plenty of pot-holes in them and a tendency to flood when it rains, turning the road into a river in some places and into mud in others. The clinic has the only ambulance in the region, and it is essential to getting laboring mothers from their homes to the birth center or from the birth center to the hospital in emergent cases.

Ot Nywal Me Kuc is a government approved health center served by traditional Ugandan midwives (sometimes called “traditional birth attendants” or TBAs) and an international team of certified professional midwives, certified nurse midwives, and student midwives. Our staff translators are an essential part of our team, making it possible for international midwives to communicate across the language barrier as we are still in the process of learning Acholi. Most of the mothers who come here are internally displaced, refugee and recently resettled women and families. (see my last blog post)

Three to five women give birth daily at the center, and close to 50 come weekly for antenatal care. Outcomes here are significantly better than the national average. The clinic’s goals to reduce maternal and infant mortality are met through comprehensive, individualized care that is run by the people, for the people.

The birth clinic in Atiak is truly the first of its kind. Holistic and restorative reproductive care is essential to a future of peace in Uganda. The very heart and soul of this project is to teach the local woman to safely serve other woman during birth. This is the sustainability piece and is greatly needed in a place with maternity services that are brutal, inconsistent, far away and understaffed.  We believe in the intent of the project and, most importantly, that by furthering the skills of the local midwives, this project has the heart of sustainable development at its core.

~ adapted from the Site Orientation Handbook, Uganda, Mother Health International

Me washing clothes in my front yard.

Life Here

This birth center is part of a small compound which is comprised of 6 personal thatched roof houses  made in the local style, kitchen area, bio-composting latrines, gardens (both medicinal and food), chicken coop and of course the birth clinic center. Sometimes I forget there is anyone around us since the grass is so tall and the land around us so flat. Right next door to us is a large sewing school run by a few nuns that offers a year long course for women. Attached is a school for the children who come with their moms to study sewing for the year.

Village Outreach.

It’s hot, but this is the rainy season so it usually cools off everyday with a nice breeze and low temps after the rain. Surrounding us are banana trees, gardens with cassava, sweet potato, and local greens. All of the TBA’s (Traditional Birth Attendants) are responsible for the upkeep of the gardens, which then in turn are used to feed all of us and the patients + families. We otherwise make a run into Gulu every 2 weeks for food. There is no refrigeration here, so the food options are pretty basic and usually the same every shopping trip. The ‘refrigeration’ here consists of a large clay vessel that sits on the floor that actually works quite well. One of the students bought parmesan cheese and butter on the last trip and it has kept beautifully. I equate this to what the ancient Egyptians must have also used. Water is kept in these too, although I tend to just keep refilling my large plastic liter bottle from the hose off the solar tap (before sunset, of course).  

Our meals are based on beans and rice with every meal, sometimes chapattis, sometimes local greens and a paste called sim-sim, which is a mixture of tahini and peanut butter – all it grown right around here. Today was a bit luxurious to have cassava, a potato like root vegetable, boiled for lunch. Tea is pretty much made with every meal with tea leaves that eventually just sink to the bottom. These options leave a lot of room for creativity, which fortunately several of us like the kitchen. With the bare minimum we have exceeded what I ever thought possible. We’ve made bread, cakes, and curries from literally what seems like nothing. It is pure alchemy!

Part of the team.

I am working within a team of 5. Myself + Kate, an American Homebirth midwife from NY, who has worked for the last 9 months in India, are the two midwives here & there is another Israeli Midwife coming in 2 weeks. There are also 3 students here who are studying now for their CPM (Certified Professional Midwife) licensure. In this process I have actually discovered that I enjoy teaching … who knew??... and amaze myself at what I’ve learned the past 2 years that I now have the ability to now pass on to another. Thank you, Vanderbilt, for preparing me so well!

We live in a bit of a Ugandan bubble with a cook, driver and laundress. She washes everything except our underwear, which we are responsible for, which is only fair, right? We also have a 17 yo boy who works on the weekends to keep the grounds. He ‘mowed’ all of the grass with a machete last weekend and then cleaned all of the paths turning over fresh dirt, which the chickens loved. His name is Martin and his dream is to become a doctor. He is one of my favorite people here, not only because of his quiet, unassuming way, but also because he wears big cowboy belt buckles and had never heard of a cowboy before. ha

Village Outreach

10-2 everyday are open hours for Prenatal appointments which women walk >5 miles for. They also come for Postpartum appointments a few weeks after the birth to get the birth certificate and walk the journey in the sun with the baby so that it can also be checked out at the same time. So far, I’ve found the women to be excellent mothers … all of the infants are always clean and no major illnesses in them so far.

We do village outreach twice a week which are mainly for prenatal check. These usually take me all day to do and are very busy. I take one of the students with on these days.

Ok, enough for this post … much more still to tell!