by Carrie R. Sparrevohn
– USA –
In 2005 I traveled to Uganda, East Africa, for the first time. I met Margaret Nangobi on that trip, in Mwanyangiri, a tiny village about an hour’s drive from the capitol. What transpired between us broke my privileged self in pieces and I became the receiver one hundred fold of what I was to give.
My purpose on that first trip was to gather information to facilitate a project aimed at alleviating the high rate of maternal mortality in that part of the world. An anthropologist by education and inclination, a midwife by training and experience, I knew that what was happening to mothers and babies in sub-Saharan Africa was not only a disgrace to the western world but something that could simply, if not easily, be remedied.
For every mother that dies in the US of pregnancy, Uganda loses 50. Around the world, each minute, we lose one mother as a direct result of her pregnancy. Improving women’s access to experienced care providers, antibiotics and medication to prevent or stop hemorrhaging would prevent over half of these deaths.
As I prepared to spend November 2005 in Uganda, a wonderful friend and mentor, Jan McNabb, began to tell her friends what I was planning to do. People began handing her money for the needy in Uganda. As a result, the Sally Clinic Project of With Woman was born.
A few days before leaving, Rebecca Aniku, a Ugandan woman living in my hometown met with me and promised the aid of her son-in-law, Joseph Okia. She also invited me to stay with her friend, Joan Kakwenzire, who, I later learned, was a senior presidential advisor and head of Uganda’s Poverty Alleviation Department. Joan has since become a dear friend and an invaluable ally in the work I am doing in Mwanyangiri.
I had never traveled in the developing world before and as Joseph took me around to several hospital maternity wards, I experienced conditions I was wholly unprepared for. The largest hospital in Kampala delivers 75 to 100 babies a day, staffed with only 8 to 10 midwives and several doctors. The furniture is antique, and the building itself, once sparkling and new, is worn and dilapidated. They are only two delivery rooms, four sets of instruments, and no bed linens or baby blankets. Newborns are wrapped in pieces of cloth their mothers bring from home. After delivery, women are often crowded two in a bed along with their babies. Completely overwhelmed, I left Mulago Hospital in despair, wondering how I could possibly make a difference in this system. And then I met Margaret.
I found Margaret in Mwanyangiri, living like most families in the villages of southeastern Uganda. She was especially typical of an older, widowed woman. Her house was made of wattle and daub and it looked ready to fall in on her in a strong wind.
The years had been unkind to Margaret as well. A thin, old woman, dressed in a ragged gown, kneeled before me in the dirt of her compound. Some previous illness pulled the right side of her face into a grimace, so that when she smiled it looked painful. Her hands showed years of manual labor and her bare feet were covered with the dust of the clay soil. What my heart beheld was a woman whose entire being spoke of a life of hopelessness.
Margaret’s kitchen was a lean-to shack of sticks holding up a dried grass roof. In the center, a pot of leaves and twigs sat boiling over a wood fire. Although English is the national language of Uganda, many, including Margaret, do not speak it. Consequently, Margaret and I communicated through a translator. Curious about the purpose of the stuff on the fire, and fully expecting an answer having to do perhaps with traditional basket making, I asked its purpose. When Margaret responded it would be food for the two small pigs she kept, I thought this a reasonable answer. I was totally unprepared, however, for its other use. It was dinnertime so I wondered aloud what Margaret and her grandchildren would be eating for supper, wondering where that was cooking. “The same as the pigs,” I was told.
As suddenly as if I had been struck, I registered the inequity of this situation and right there, in the heart of Africa, I began to cry. Not silent weeping mind you, but hard, sobbing, wailing, crying – as if my heart would break. Joan held me, trying to comfort me, as she became more and more certain that I would never recover. But the crying did cease, my practical self took hold, and I began my search for solutions.
What could I do to change this situation for Margaret? If I gave her money could she get some better food in the village that night? Yes, I learned that was possible, so I gave Margaret what cash I had, stopped crying and went back to my warm bed, in a nice house, in the capitol, with Joan. As I lay in bed that night I knew I would never be satisfied that Margaret and her grandkids would eat just that night. I didn’t yet know what to do, only that I had to do something.
The following day I went to the market in Kampala to buy some staple foods (rice, beans, salt, maize meal for porridge), planning to take it to Margaret. Joan informed me that it was bad politics to give everything to Margaret and suggested we portion it out among the widowed women and elders of the village. As we distributed the food the following day, my heart became fully engaged with this village and my mind began working on a solution that would assist not only Margaret, but everyone in Mwanyangiri.
I learned Joan had offered to donate iron sheets for a roof on a new house if Margaret could make the bricks to build it, a common practice in Uganda. But Margaret had not been able to begin this task, having only enough energy to complete what absolutely had to be done in a day. So I asked the question that would change not only my life and Margaret’s, but the lives of all the inhabitants of Mwanyangiri: “How much would it cost to buy the bricks?” “Oh probably 360,000 Ugandan shillings ($200 USD),” Joan’s assistant responded. Naively, I thought, ‘$200 and Margaret can have a new house, with a roof that doesn’t leak.’ “No problem,” I said, “I’ll buy the bricks.”
When I returned to the village a week later, Margaret’s new house was under construction. A donation from one of my friends in California was enough to hire the laborers needed to rejuvenate her garden and make it a functional food growing enterprise. As Margaret received help, hope rippled through the entire village. Hope that each of them might receive help to make their lives better.
In an effort to see how we could work together, Joan and I talked about her role as the head of the Poverty Alleviation Department. Her goal is to make every household in Uganda self-reliant using a “model village” concept. When completed, this model ensures that each household in the village has food security and a money making venture. It also ensures primary education for all children and reasonable access to healthcare. Joan needed someone to integrate the health care component – the piece that I could provide.
We realized our goals were complimentary. Joan wouldn’t get far teaching best farming practices to a community so ridden with treatable, debilitating disease that they couldn’t work. And I wouldn’t be successful with maternity care if mothers didn’t have enough to eat. We were both committed to giving the community the tools to bring themselves out of extreme poverty and sustain good health.
I left Uganda planning to open a general medicine clinic in Mwanyangiri to provide treatment for common illnesses, vaccinate children and ensure a safer environment for women giving birth. I had no idea how I would raise the funds, only that I would. A year and a half later in April of 2007, I opened the first Sally Clinic, in Mwanyangiri, Uganda.
My work in the village continues to bring wonderful, dramatic and inspiring changes to my life. I learned that determination and faith go a long way towards changing an intolerable situation. And of course nothing in this world happens without money. Margaret’s house cost a total of $2,000, not just the $200 for bricks. To date the clinic project has cost approximately $30,000, donated in large part from my local community and continues to run at a cost of about $1 per patient visit.
Helping others has been my life’s work, but helping Margaret unleashed experiences and personal growth I never imagined possible. Though my gifts brought security to Margaret’s daily life, they didn’t fix everything for her – she still gathers firewood daily and must retrieve her drinking water from the local spring, carting it up a 100 foot embankment to her home. But she now lives about 500 yards from a well staffed and supplied health clinic; the chances of her losing another grandchild to malaria are slimmer than they were, and she smiles her crooked smile more frequently. She has a garden that she now has the strength to tend and is much less likely to have to eat pig food. Helping Margaret gave me an unbridled release from my privileged existence and a peace of spirit many would give all they own to know.
I will be forever grateful for the gift of helping Margaret as I continue what has become my life’s work in the village of Mwanyangiri.
About the Author
Carrie Sparrevohn has worked in the United States, providing health care to women, for nearly 30 years. She has a bachelor’s degree in Anthropology from the University of California, Riverside and received her education as a midwife in the traditional way, by apprenticing.
As a midwife, Carrie has been active in birth politics for many years as president of the California Association of Midwives, Chair of their Legislative Committee and as a member of the Midwifery Advisory Council (MAC) to the Medical Board of California. She is also the founder and Executive Director of the Sally Clinic Project of With Woman, in Uganda. Carrie received the “Brazen Woman” award from the California Association of Midwives in 2007 and the “Making a Difference for Women” award from her local Soroptimist’s chapter in 2008. She has published articles in Midwifery Today and the California Association of Midwives Newsletter.
Carrie is the mother of seven children and has four grandchildren. In her spare time she reads, gardens and writes.