Midwifery and Magic in Uganda

This is Part Three in a series by the director and co-founder of the International Midwife Association (IMA). Read Part One here,
and Two here.

International Midwife Assistance had been training midwives in Afghanistan for two years when things became too dangerous. We were planning to begin a new class of midwifery students in a new location, Badhakshan Province. Badhakshan has the highest rate of maternal mortality ever recorded. The need for skilled care providers is impossible to overstate. But that province was growing a lot of poppies, and foreign aid workers were perceived as a new kind of threat through that lens. In 2006, aid workers were murdered, buildings were burned down, and our Board of Directors brought an end to our work in Afghanistan. I miss Afghanistan terribly and hope that the future holds a day that we can return. For now, our work is elsewhere, currently Uganda and Haiti.

When we were contemplating various possible new projects and partners, northern Uganda stood out. There is a desperate need there, a true crisis, and there is very little humanitarian aid being provided. The people that we serve there are called "IDPs" -- internally displaced persons. They aren't refugees because they are Ugandans in Uganda. They cross no international border as they run from the horrific violence wrought by the "Lord's Resistance Army." Although the LRA doesn't raid where we work anymore, there are thousands "IDPs" living in squalid and overcrowded camps around the town. They are deeply traumatized people, they've seen horrific violence, murder, many of the children have survived abduction and either forced soldierhood or sexual slavery. The moral ambiguity of a conflict in which children are brutalized into committing atrocities has challenged the fabric of the society. Now these people are supposed to leave the camps, to "go home." But no one is sure where that is, or how to start over. Where there were once communities, there is nothing. These people have experienced violence similar to what occurs in Darfur, but they aren't on the media radar.

I traveled to Uganda at the request of a group of nurses who had established a small clinic in partnership with a Ugandan non-profit. Their clinic provided first aid and some medical services to the IDPs. Mostly they treated malaria. Malaria is such a huge part of living in Africa, there is nothing like it in the US. They wanted to add maternity services at the clinic, but they were out of their depth and budget. I traveled to visit their clinic and my board decided to fund a salary for one midwife. She would provide prenatal care to the patients at their clinic. The need was great and it was a terrific little clinic, but I was pretty concerned about the Ugandan partner organization. It looked to me as though the director was a con-man.

I returned to Uganda three months later. Unfortunately the concerns were real, the local non-profit organization was corrupt. The director had no interest in the well-being of the clinic patients. Sadly, this is not really unusual. Corruption in the developing world is endemic. I was there to sort that out. Of course, in order to do any kind of large scale project, we had to feel confident that we could put things in order. What struck me as remarkable was the intense contrast between the folks who were running the little con on some donors, and the amazing medical staff that was in fact providing care to desperately needy people. Even without the money that got pocketed, the clinic staff managed to run the clinic in an admirable way. Certainly the clinical staff and their incredible dedication to their patients influenced our desire to carry on the work there. Now there is this miraculous clinic which serves hundreds of people each month providing medical, prenatal, labor and delivery care, childhood vaccines, and birth-control. It's a very different project than the one in Afghanistan, but it's a great program. And of course, we have all sorts of due diligence in place. Before we invested in the clinic, the finances were all cleaned up.

Uganda is a completely different cultural experience than central Asia and Islam. Uganda was colonized by Anglicans, but the Catholic Church and other evangelicals have been sharing the air with the Anglicans, and perhaps most profoundly, with the residual indigenous beliefs. So much of the gruesome suffering wrought by the LRA is the product of an intersection of sorcery, guilt, shame and loss. The Acholi tribe, from which this movement springs, had suffered terrible losses at the hands of other tribes, and they had perpetrated terrible violence in the process as well. The army part of the Lord's Resistance Army was originally raised by a young woman who did so at the direction of a disembodied spirit called "Lakwena." "Lakwena" and quite a few other spirits ("Wrong Element," and "Franko" were two) would possess Alice and direct the war. There was a promise of victory and redemption for the Acholi, but Alice fled to Kenya after a major defeat in a battle in 1987. Lakwena then lost no time taking possession of a fellow called Joseph Kony, and he is still about. They have laid waste to much of northern Uganda. Joseph Kony leads the LRA to this day, lately from southern Sudan where they have been making their dreadful mischief.

These traumatized people that we serve have two particularly difficult challenges. Many suffer from depression and Post Traumatic Stress Disorder related to their experiences. They have lost family members and experienced violence first hand, much of it sexual violence. As well, they have been impoverished. They had homes, livestock, fields, clothes, cooking pots, lives in communities that were destroyed by LRA raiding and the subsequent conflict between the LRA and the Ugandan army. They have lost so much, and their government is unable or unwilling to help them properly. The politics are complex and in some ways, on the ground in northern Uganda, meaningless. We have to, we simply must help with sustainable change.

Working in this environment has raised different questions and security issues from the Taliban. The rush to vengeance in a society that turns to sorcery to settle scores is a tricky challenge. After divesting from the Ugandan non-profit organization that was corrupt, we had some months of peace and quiet. Then a few things happened that revealed the former corrupt director we had effectively cut-off was on a little campaign to harass some of the staff. This provided my most face-to-face experience of sorcery ever, and I would be happy if it were also my last.

There were just three incidents that made it seem, for a while, that the clinic staff was being harassed. They were unpleasant and tedious, but not actually difficult to resolve. The third was different for me, although not really any more difficult to resolve than the other two, quicker even. The Ugandans didn't experience it as particularly different from the other two incidents. For me it would have to be called at least paranormal -- but for them it was not. It was just another example of revenge on clinic staff, this time targeting our lab man.

He and his wife live in a modest, middle class home. It's brick, with two rooms and cement floors. The back room contains a bed, a small table and their clothes in baskets and stacks on the floor. In the front room are a couple of chairs and a small table, plus a long table against one wall with some shelves beneath. The shelves hold some dishes and a radio, but the whole weekend this was going on, there was no "city power" -- no electricity, as is often the case. They cook outdoors on a charcoal burner. They have a small covered cement slab porch in front, they share an outhouse with their neighbors. The total square footage of their home is about 400 or 500 square feet. There are family photographs, calendars and religious pictures on their walls. They are Anglican.

One Friday afternoon, while recovering from typhoid, his wife left work early and went home to nap. The room she was in has one window with bars, but no glass or screen. There were a few children around outdoors. The oldest, a teenage girl who had recently come from "the village," was pretty quiet and still intimidated by the "city" life. She certainly would not approach a man she didn't know. But the children all saw them, two men, standing at the window. Two adults across the street also watched this unfold. The men did something with their arms, and then walked away. After the men were clear of the compound, the children walked over to the window and saw that many of the clothes on the floor inside the house were on fire. She was still asleep in bed. A girl ran inside and woke her and the two of them struggled to extinguish numerous fires. By the time they succeeded, two walls and the ceiling were black with soot.

No one called the police. If the police do make it to a crime scene, there is a cash charge to the victim. They say they need to be paid for transportation. Many of us gathered at the house. I realize I made an assumption that afternoon. I believed that those men had thrown something flammable into the room. I was, as was everyone, extremely grateful that the mosquito net over the bed hadn't caught fire. That image was difficult to contemplate. We were all very thankful that she was unharmed. We were all unnerved and upset, and I ultimately went to bed that night with my assumption intact.

Three days later, after a very unsettling weekend, I wrote my regular report to my board. It was a hard report to write:

This is considered not an uncommon experience here, a typical way a witch doctor sends a curse to someone -- generally they are hired to send these curses. I am certainly inclined to believe a more mundane, mechanical explanation, but it is widely believed here that these things happen. And, these two are trustworthy in my experience and certainly not hysterical. They tell the same story: they were sitting in their room when suddenly a flame shot up out of some clothes. It happened four times on Saturday. His hand is quite burned from putting out one of the fires. Their mattress, sheets and now all their clothes are ruined.

The priest from their church was there twice on Saturday and had been there once already Sunday when I visited. They are Anglican, I attend the same church that they do when I'm here. I am pretty sure that our US Episcopal Church acknowledges the existence of these nasty spirits, we are just forbidden to associate with them. They are considered satanic. The priest indicated that it usually takes about a week of praying in the house to make the spirits go away.

When it became clear to me that the priest was required to overcome this problem, I looked into whether or not there is anything in it for him. I feel pretty sure there is not, this is not a service he is getting paid for, for example. But neither does he grow in esteem, it seems it is just part of his job. I asked if we could discuss finding them another place to live, somewhere with a wall and a gate, somewhere more secure. The belief is though that the curse will just follow them and they want to stick it out where they are until enough prayers have been said to overcome the bad magic. The house walls are now covered with black soot, way more than what I saw Friday. They are pretty spooked. They stayed in the house to pray today. The other, new lab tech handled the work well without him, although it's a lot for just one person -- she did pretty well.

I honestly cannot even imagine how this goes down in your heads. It sounds strange as I type it, but I suppose you can accept that I wouldn't send you this news if it hadn't been what I experienced. I have talked with a few folks about it, they are all educated people, some highly educated. They all told me the same: these things happen, they are sent by sorcerers, someone paid the sorcerer to send the spirits, God Almighty will prevail but it takes some time. Now I am guessing at least that you have not had to ponder this type of question before in your professional life, but if I am wrong and you have some insight or guidance, please let me know. I have suggested that perhaps some person left something that took some hours to combust in the house, some substance. That is a conversation everyone is willing to have. But then you begin hearing of other, similar spells that are less easy to explain. The consensus of belief here is that it's evil magic.

One of my board members, in reply, pointed out that as an Episcopalian I don't believe anything less fantastic than fire sorcery. I suppose that is true. The comment seemed kind and yet quite funny at the same time. Perhaps we must have some edge of fantastic, intense conviction simply to live in northern Uganda. For me, the most heartwarming and appealing thing about the Ugandan people we serve is their seemingly indestructible belief in the goodness of humanity. In the face of all they have witnessed and experienced, they still feel that most people are basically good. When I ask people to sign permission to tell their story, a release to publish their photo, there is no shying away, no asking for money to take the photo. "Please, please tell our story," I am told constantly. They so firmly believe that once people in the world understand what is happening to them, the help will roll in. Spontaneous combustion is the least of their problems.

Why is it that human beings living on the same planet that we live on have to live in a reality that includes no safe water, so much rape and physical violence, raiding militias, hunger, and always malaria, sickness, misery. I often stumble trying to illuminate something about the apparently obvious statement that these are people, human beings. What would you expect from the world if you and your community lost everything? We came into a world with such disparity already in play that we might not notice our responsibility to correct it. In the US, even the homeless can find safe water to drink. Human beings live in grass-thatched huts on the dirt, without running water, without access to work or good healthcare. Human beings. People. Deserving people, innocent people. Africa is in bad trouble and I believe we all have to stand up against the bad magic.

When I was asked to write an article for Reality Sandwich (about changing the goofy law against homebirth midwifery in Colorado), Steven said that I could put in a link to our website, www.midwifeassist.org and that I could beg a little for IMA. He said that many months, 50,000 people read Reality Sandwich. If half that many people went to our website and donated $50, that would fund our work in Uganda, plus the new project we're doing in Haiti, for more than six years. Our work is concentrated in places where we can make a difference. We are small, but we have accomplished a great deal in a very accountable and tangible way. What helps us do the work is money to pay for the program expenses. IMA was founded by a small group of women who believed they could succeed in sending aid very directly. We have been successful in doing that. Now, four years after that first project in Afghanistan, we are building the community that will support us financially. Thanks for the opportunity to beg.