First Comes Love, Then Comes Malaria

by Eve Brown-Waite

  Rose had taken over the bulk of my domestic duties at home. And frankly, when she was in the house, I really had to get out. She was a fine worker and a decent cook. But the body odor, which at first seemed like a mildly unpleasant scent, had now aged to a full-blown stench. Put plainly, Rose reeked.

  “Bathing is a luxury that not all Ugandans enjoy, Eve,” John said when I complained about it. Ah, there was Saint John being culturally sensitive again, while I was smelling it and telling it like it was.

  “Well, Rose can enjoy it all she wants,” I moaned. “I told her to use our shower. I took her to the dead mzungu market and bought her new dresses. Well, new used dresses.” A huge portion of Arua's economy depended on the brisk business of selling clothing donated by the Salvation Army and Goodwills of the world. The locals called them “dead mzungu” clothing, because they couldn't conceive of any other reason to give away clothing. But new dresses or not, Rose continued to stink, and I took to finding reasons to get out of the house each day. But one could only spend so much time quacking and coloring with the neighbors' kids.

  I hadn't quite given up all hope of finding work, but I had decided to stop running around the country like a jobless hussy. So far, it had only left me frustrated and still unemployed. And besides, I figured, I hadn't followed John halfway across the world just to spend the bulk of my time halfway across the country. So I tried to find ways to keep myself occupied in Arua.

  “I would like to volunteer to do AIDS education in Arua's schools,” I told Arua's district health educator when I went to meet him in his office. “I used to set up AIDS education programs in schools in America.”

  “Yes, that would be good,” he said as his secretary handed me a plastic mug full of dark, sweet tea. “If only we had the resources.”

  “Well, it really wouldn't take much. I mean, I would volunteer my time and I'm sure I could get any materials we needed donated from my friends back home.” He offered me a plate of groundnuts. I took a handful then remembered that one of the Italians recently told me that the red papery coating causes cancer.

  “Yes, but we'd need a vehicle to get around,” the district health educator said, popping a handful of the red nuts into his mouth and chewing. “Perhaps CARE could give us a vehicle.”

  “Well, I doubt that,” I told him, trying to unobtrusively scrape the papery coating off the nuts, one at a time, before I ate them.

  “But you work for CARE. They have many vehicles. I see them around town all the time.”

  “I don't work for CARE,” I reiterated, although I had made that clear when I introduced myself. “But many of the schools are right here in town. We wouldn't even need a vehicle to get to them. We could walk.”

  “Oh, imagine that!” he said, laughing so hard I thought groundnuts might start shooting out of his nose. “The district health educator walking to school! Yes, very funny,” he said, sipping his tea. “And don't forget my per diem.”

  “Per diem?” I asked. “Doesn't the district pay your salary?”

  “Of course they pay my salary,” he said, helping himself to more groundnuts. “But if you want to go out in the field, then as the district health educator I must accompany you. And for that, I have to get a per diem.” Ah, yes, Elizabeth Marum had warned me about this. Bureaucrats who do next to nothing and who ensure that no one else does anything, either, since that might cause them to look bad and lose their jobs.

  “Oh,” I said, giving up and popping the whole damn handful of groundnuts in my mouth. If they really were carcinogenic, maybe I could eat enough to kill myself.

  In the end, the district health educator did invite me to make a presentation at Arua's HIV educators meeting the following week and I gladly accepted his invitation.

  At the meeting I handed out index cards to the thirty community educators who had gathered in the bare cement-walled hut on the outskirts of town. The cards were all blank except for three that each had a small X on the back. I instructed everyone to go around the room, shake hands and get the signatures of three different people. This was an instant hit, as Ugandans are very fond of meeting and greeting. I was immediately inundated with people wanting to shake my hand—although I wasn't playing the game.

  “Okay, turn your cards over,” I instructed when everyone was finally back in their seats. “Stand up if your card has an X on it.” Three people stood.

  “They are in trouble!” a young man shouted from the back of the room.

  “Well, not trouble,” I said. “But for the purposes of this game, the X on their card represents being HIV-positive.” Great peals of laughter erupted from everyone—including the three who were standing.

  “Unlucky!” someone else yelled.

  “Now, remember, this is only an illustration. I am not saying that these three people actually are infected.” My days of doing this in New York had taught me to be very careful about insinuating that someone was HIV-positive, even if it was just pretend.

  “Yes, yes, we understand,” the district health educator interrupted my disclaimer. “No need to be worried.” Apparently Ugandans were not nearly as touchy about this as Americans.

  “Now, would the three people who are standing please read the names of the people you shook hands with. And would those people please stand.” With each name that was read, the group erupted in laughter and applause. “Each of you have now been infected, too,” I said to more howls of laughter.

  “Now,” I said to the newly standing. “Would each one of you—”

  “Yes! We know what to do,” shouted someone who was standing as he began reading the names on his card. And without further instruction from me, the reading and standing continued until nearly everyone in the room was “infected.”

  “Oh, very good. Very good,” said the district health educator, standing up beside me. “This is a fine illustration of how HIV can spread throughout a community.”

  “And good fun!” someone called from the back of the room.

  The day ended, of course, with a closing ceremony. I was seated up front, as the “Guest of Honor,” as was John, who had only come to take me home.

  “Would you be so kind as to say a few words?” the district health educator asked John when he arrived.

  John looked over at me and mouthed, What are we doing here? But he smoothly turned to the group. “Thank you for all the work you are doing to help your communities,” he said. “And thank you for letting my wife join you today. She really knows a lot about AIDS, and I think she can help the wonderful people of the Arua district.” The group applauded as John sat down beside me.

  “Oh, yes, she has helped us already,” the district health educator said. “In fact, the group is so grateful for her help today that they have prepared a special presentation for her.”

  A group of women stood in a semicircle in the front of the room. “Please come join us,” one of the women said, pulling me up by the arm and holding on to my hand. “You have taught us something which we will use to the benefit of our communities. We thank you for that,” she said, bowing slightly at me. “And now we have a something for you.”

  A job, perhaps?

  The women broke into a raucous song whose words—being in Lugbara but not a shopping list—I couldn't quite make out. But the stomping, hand clapping, and trilling told me it was a happy song. I smiled and swayed and saw John stomping his feet.

  When the song finished, the woman holding my hand said, “Today, Eve, you are one of us. Living together with us and helping the people of Arua. Because of this, we give you a new name. A Lugbara name. We call you ‘Ayikoru.’”

  “Ayikoru,” I repeated. “It's beautiful.” I looked at John, who was beaming back at me.

  “It is from the word ayiko. It means ‘joyful.’”

  “Joyful… I like that. Awadifo saaru,” I thanked them.

  Dear Susan,

  Well, it's 9:30 p.m. and the lights keep going off. No problem for us, though, since my handy-dandy husband install
ed two solar panels on our roof and a couple of solar lights in the house. (He also fell through the kitchen ceiling while installing the lights, thus also creating a sunroof in the kitchen.) He says we can get a battery that stores solar power, too, and maybe even be able to run the TV and VCR when we have no electricity. We will be living the high life then! Things are great with John. Even when everything else stinks, I'm glad we are together. Sometimes it's like a honeymoon. When the lights go out, we have dinner by candlelight and plenty of romantic evenings. The nights are long and full of stars and not a lot of other entertainment options. Hey, maybe that explains why developing countries have such high fertility rates!

  Speaking of which (hold on to your cervical cap), we have decided to try to get pregnant! I know, you think it's a horrible place to be pregnant. But I know a bunch of expat women who've had babies here and they all say it's fine. And three of them are married to doctors! So after trying for a month, my period came early. Of course, I'm disappointed already. Have you ever known me to be patient?

  I'll keep you posted,

  Eve

  A Little Bit Pregnant in Uganda

  The last thing my mother yelled before we got on the plane to Uganda was something along the lines of, “YOU'D BETTER NOT GET PREGNANT OVER THERE!” This was not so much out of concern for my health or even the baby's, but rather out of fear that she would miss all the fun of watching my belly grow and of buying me maternity clothes. But I knew she couldn't wait to be a grandmother. She's a Jewish mother after all; it comes with the territory.

  But getting pregnant—or not—wasn't even on my radar screen at the time. It wasn't that I was determined not to get pregnant in Uganda. But at that point in my life my focus was on my career. I had assumed—erroneously, in retrospect—that I'd be too busy fighting AIDS in Uganda for the next two years to even think about having a baby. But three months of fruitless job searches, combined with all the healthy expat mothers and babies around me, convinced me—and John—that now might be the perfect time to have a baby.

  “Don't forget, Evie, it's not always so easy to get pregnant. My gynecologist said it might take a whole year at your age.” I was all of thirty-one. But this was my mother's response when I wrote to tell her of our plans. I actually thought it rather uncouth to tell people we were trying to get pregnant. It was like announcing: HEY, WE'RE HAVING LOTS OF UNPROTECTED SEX OVER HERE! But hell, everyone was having lots of unprotected sex over here. And besides, being uncouth had never stopped me before.

  It was just after Thanksgiving, a regular day in Uganda, although all the Americans in town did get together for a turkey supper after work. I didn't really think that I was pregnant after just two months of lots of unprotected sex—er, I mean trying—even though my period was a few days late. When my breasts started aching and I had steady cramping, I was sure these were signs that my period was on its way. But when the cramping didn't subside and my period didn't start, I began to wonder if I might be pregnant.

  “Hey, didn't you swipe a bunch of pregnancy tests from the hospital before you left?” John asked, remembering a box we had brought with us and stashed away in a closet.

  “I didn't swipe them,” I said defensively. “They were given to me.” Susan had swiped them for me from a supply cabinet of the hospital where we both had worked.

  “Don't even think about getting pregnant while you're over there,” Susan had warned at the time. “An ectopic pregnancy in the middle of nowhere can kill you. But take these just in case,” she said, handing me a box full of pregnancy tests. “There ought to be enough here to do one a month—just for fun. At least then you'll know if you should worry.”

  “Why don't we just do one of them and find out?” John suggested.

  So first thing the next morning I did one of the tests. Pee on a stick; now what could be simpler? Not much, except that our tests, pilfered from a case that was never intended for individual sale, did not come with instructions. I figured out the peeing-on-the-stick part, no problem. But I had no idea when—or how—to read the results.

  “I don't know what this means,” I said to John, waving the stick that now had a line that had gone from pink to blue. This was before the days when they figured out how to make these things simple enough so that even an illiterate—and hormonally imbalanced—woman could tell whether or not she was pregnant. “But I guess we'll figure it out eventually. Why worry about it now?”

  There really was no reason to worry about it—until the continuous cramping became sharp enough to wake me in the middle of the night. So I went to see David Morton, the American missionary doctor at Kuluva, the mission hospital just outside of town.

  “Sharp pains in your abdomen and a missed period?” he said. “We need to rule out an ectopic pregnancy. That's where the developing embryo attaches to one of the fallopian tubes.”

  “Yeah, I know what that is. But first we need to rule in a pregnancy, David. Can't you do a pregnancy test?”

  “We don't have those here. Honestly, by the time a woman comes to us, it's pretty obvious that she's pregnant.”

  “Well, I brought one of the tests that I have from the hospital where I used to work,” I said, producing a pee stick from my bag. “Maybe you'll know how to read it.”

  “Eve, I've been practicing medicine in the bush here for eight years now. I don't know how to read those things. But let's do a physical and we'll see what we can find out. Just slip off your underwear, hike up your skirt, and try to get comfortable on this examining table.”

  “Here?” I asked, looking around the bare cement room. Just outside the wide-open window on one side of the room I watched people shuffling in the dust on their way up the road to the leprosy clinic and down the road to the church. Through the other window I saw a long line of haggard-looking people waiting to collect medicines from the pharmacy. I've never been a whiz at physics, but if I could see them clear as day, couldn't they see me?

  “Oh … um, just a second. Let's see if we can rig up something here.” David scrounged around and found a folding screen to provide me with some privacy. The lengths that he had to go to in order to provide me with this told me that this was an unusual request.

  “Well, your uterus does seem slightly enlarged. But without further tests I really can't be sure,” he said after poking around gently on my insides. “If you are pregnant, you'll be fine. We can do your basic prenatal care right here.” He turned his back while I pulled myself together. “And since it's your first pregnancy, I'd strongly recommend that you go back to the States, or at least to Kampala, to give birth.”

  Like I was going to give birth in a place that couldn't even tell me if I was pregnant! “But I am concerned about the sharp pains in your abdomen. So let's get you to Kampala as soon as possible and have them rule out an ectopic pregnancy.”

  “John and I are going to Kampala tomorrow,” I told him.

  “Good. Radio down today and have someone get you an appointment right away at the Surgery.”

  “Surgery?” I croaked.

  “They're British doctors.” David patted my arm. “Their office is called the Surgery. Try not to worry.”

  “We're planning on driving down. Do you think that's safe?” I asked.

  “I haven't heard of any hijackings in Murchison Falls in the last few months. I think it's safe.”

  “No, I mean, if I am pregnant. The awful tarmac. All that bouncing. Is that safe? For the baby, I mean. If there is one.”

  “Eve, if you are pregnant, that baby is in the safest place there is. Trust me. If bouncing over these roads could induce a miscarriage, well, no one here would stay pregnant for very long. But you could probably get a seat on MAF if that's more comfortable.”

  “We were hoping to do some shopping,” I said. “Need anything?”

  “No. I think we're good. But thanks,” David answered. What was it about the missionaries and their damned simple lifestyles? Didn't they hanker for a nice Italian salami now and then? Didn't they need
Tupperware like the rest of us?

  I drove to the CARE office and sent a radio message to Kampala asking the CARE secretary to schedule an appointment for me at the Surgery.

  Driving to Kampala would be much less pleasant, not to mention seven hours longer, than going by plane. But flying meant we could only carry back what we could fit on our laps. Whereas driving to Kampala meant stuffing the Pajero full of things we could only get in Kampala. So the awful drive down would be worth it for the goodies we could bring back home. Smoked meats, cheeses, and breads from Kampala's new Italian deli; gin, tonic, and Baileys Irish Cream from the duty-free shops; modern-day wonders like tin foil and canned cat food from the more cosmopolitan stores; and magazines, videos, and books passed around by Kampala's sizeable and generous expat population.

  “There is a boy at the gate who would like a ride to Kampala,” James told us as we loaded up the Pajero early the next morning.

  “Who is this boy?” John asked.

  “I myself do not know him. But his name is Robert. He is thirteen and he lives up on the hill by the Catholic diocese and he is going to Kampala to stay with his uncle.”

  “Well, how does he even know we are going to Kampala today?” I asked.

  James shrugged. “You are mzungus,” he said. As if that explained precisely how everyone in town knew our business.

  “Well, we have room. Of course we'll give him a ride.” It would be no trouble. Or so we thought, until midway through the trip when we stopped for lunch and Robert had no lunch. But it was no trouble to share our lunch with him and no trouble to buy him a warm soda at a roadside shop, because he had no money of his own. And then we got back on the road and Robert vomited up his entire lunch onto the back of my car seat.

  “I did not wish to trouble you to stop,” he said.

  Oh, no trouble. We mopped him up and said good-bye to Robert when we reached Kampala, hoping he'd be no trouble to his uncle either.

  “You are unequivocally pregnant,” Dr. Stockley said when we went to see him at the Surgery the next morning. He was looking through the small microscope at the slide that contained a drop of my pee along with some chemical that he had mixed with it. “Or maybe not,” he added. “Have a look for yourself.” He slid the microscope across the table to where John and I were sitting. Dr. Stockley's many years of living in Uganda gave him a distinctly African outlook on life. He had a you-could-die … but-then-again-you-might-not kind of air that I wasn't finding especially reassuring at the moment. But if anyone suddenly needed a tracheotomy while out in the bush, I suspect Dr. Stockley could do it with a ballpoint pen and a rusty pocketknife.