Mama Jude: An Australian Nurse’s Extraordinary Other Life In Africa

by Judy Steel

  To Allan, the love of my life, for his love and strength

  To Fiona, David and Peter, for understanding that their mother did something different

  For Michael, Joshua, Timothy, Zachary, Cameron, Claire, John and Kate, so that one day they will understand why Nanna went to Africa

  Progress of the soul consists

  not in thinking much,

  but in loving much.

  St Teresa of Avila

  Contents

  Cover

  Prologue

  Chapter One

  Chapter Two

  Chapter Three

  Chapter Four

  Chapter Five

  Chapter Six

  Chapter Seven

  Chapter Eight

  Chapter Nine

  Chapter Ten

  Chapter Eleven

  Chapter Twelve

  Chapter Thirteen

  Chapter Fourteen

  Chapter Fifteen

  Chapter Sixteen

  Chapter Seventeen

  Chapter Eighteen

  Chapter Nineteen

  Chapter Twenty

  Chapter Twenty-One

  Chapter Twenty-Two

  Chapter Twenty-Three

  Chapter Twenty-Four

  Chapter Twenty-Five

  Chapter Twenty-Six

  Photographic Inserts

  Acknowledgements

  About the Authors

  To find out more about UACO

  Copyright

  Prologue

  UGANDA IS A COUNTRY where there is much love and much beauty. It is a place where people laugh and dance, broad smiles lighting up black faces. When they dance, Ugandan women ululate in a high pitch, swaying their shoulders and arms while rolling their often ample hips. They love bright clothes that catch the light and complement their rhythm. Mostly dancing takes place outdoors and the foot stomping sends clouds of dust into the air that settles as streaks of mud on sweaty faces and arms. It is an outpouring of an internal joy and can go on for hours. It doesn’t have to be a wedding, but this is where I found myself amongst such exuberance in mid 2008.

  It is the end of my seventh visit to Uganda and, as usual, I am physically and emotionally exhausted. I think back to my first trip almost a decade previously, when I arrived knowing virtually nothing of this extraordinary country. All I’d hoped was to be able to help its people in some way before returning to my ‘normal’ life. At fifty-six years old and at the end of a successful career as a nurse and administrator, my husband, Allan, and I should have been planning our retirement travels and spending time with our growing number of grandchildren, but instead I had stepped off a plane at Entebbe on the edge of Lake Victoria, a forty five-minute drive from Uganda’s capital, Kampala.

  Over the next three months on that first trip, and then during another three months the following year, I saw things that almost broke my spirit. Parts of Uganda are places of deep despair, where serious illness is so common that people expect to die young simply because that is what happens to almost everyone they know or see. When HIV/AIDS spread across the globe, it took deep root in sub-Saharan Africa. Generations have been stripped away leaving the very old caring for the very young, while HIV-positive mothers pass the infection to their babies while still in the womb. Drugs that extend life and ease the pain of HIV in other parts of the world have been unavailable or outrageously expensive in Uganda. When visiting men and women in the agonising final stages of the disease, I could offer almost nothing other than some dignity in death.

  Pauline has AIDS and so does her new husband, Johnson, but this does not stop them dancing at their wedding reception, held in the grounds of the Busabala Road Hospital in Najjanankumbi, a slum area on the edges of Kampala. This is where I first found renewal amid the death and despair all those years ago.

  The hospital was built by the most committed doctor I have ever met, Edward Ssembatya. Out of his own money he had bought the land, paid for the materials and, brick by brick, seen a hospital grow. When we first met in 1999, his generosity had stretched his resources so far that it seemed to me that it would take a miracle to complete the facility he dreamt of. But his commitment inspired me to start a charity which, with the backing of generous Australians, would one day see the hospital complete and filled with beds and equipment. After two visits to Uganda, I returned in 2001 to oversee the delivery of a shipping container packed with donated hospital equipment and medical supplies we had collected in Australia. After being emptied, the container was fashioned into a primary health care clinic in the grounds of Edward’s hospital. Two years later we had collected enough equipment to send a second container. The size of the clinic doubled and a rehabilitation centre for physiotherapy was created.

  It wasn’t long before a vibrant youth movement and a support group for those with HIV/AIDS evolved from these facilities. Widows who have lost husbands to the disease also meet twice a month to socialise and support others in the community, while the clinic provides free immunisation for 7000 children per year and hosts classes to teach the mamas good health practices.

  Micro-loans were the next phase in this remarkable community transformation, and AIDS widows now run cafés, pig farms and an alterations shop to create income streams. To help others qualify for loans there is now an adult literacy school with a growing waiting list. Edward’s initial dream of a hospital for the poor is moving toward a self-sustaining community that is attracting keen interest from across the country.

  Pauline, our bride today, is one of those studying to read and write. When she started literacy classes I asked her what her goal was; she replied that she simply wanted the dignity of being able to write her own name before she died. With the help of treatment and improved diet, that ambition has grown and she has now taken out a small loan to start a business selling charcoal. Now this beautiful young woman stands before me in her wedding dress.

  After the ceremony, Pauline changes into a long, sparkly red dress. Still wearing her tiara and glittery earrings, she looks stunning as I stand in line to present a gift. When my turn comes she starts to dance towards me, and so I dance towards her. There is a huge roar from the crowd and many jump to their feet. We dance and laugh and hug. In this beautiful, precious, terminally ill woman is Uganda.

  I didn’t expect to see any of this but I have. This country has shown me the heights and depths of humanity and tested me in a way I could never imagine. Although I have cried an ocean of tears and sat helplessly watching people waste and die, Uganda has shown me much about loving and caring, about resilience and renewal. Should I sit on the dirt floor of a sweltering shack in despair because another person has succumbed to AIDS, or can something be done?

  How I came to be in Uganda at all is a story that evolves from a child in India and a flash flood in the Australian outback. My name is Judy Steel and in Uganda I am a mzungu, or white person, but they call me Mama Jude.

  Chapter One

  I USUALLY SAY THAT the preparation for my work in Africa began in the final years of my working life in Adelaide, but it probably really started when I was a child growing up in the tiny country town of Nangwarry in the south-east of south Australia. The region has good rainfall and was the first area of Australia to begin commercial forestry after pine plantations were established in the 1870s. After a timber mill was built in 1939, the town quickly expanded as houses sprang up for the growing number of timber workers and their families.

  We moved to Nangwarry in 1947, when I was four. I had been very sick with pneumonia and, on the doctor’s advice, Mum and Dad go
t me out of the city. While a medical condition was the reason for leaving, it was also the reason we were in Adelaide in the first place. My parents met at Calvary Hospital where my father, Laurie McIver, had been admitted to have his appendix out. There he met a nurse named Lenore McCarthy. In those days you couldn’t be engaged and work at Calvary, so Mum moved to Blackwood Hospital in the Adelaide Hills until they were married.

  The day we left Adelaide was one of those summer scorchers and the stuffy car was made all the worse by having three kids crammed in alongside our possessions. The car had curtains fitted instead of glass windows, and I kept losing handkerchiefs out of the little window. We ran out of petrol before getting to Naracoorte and Dad had to hitch a ride to find more. During the wait I managed to cut my toe, so Mum had to find a bandage in all of the packed things.

  Despite this difficult beginning, life in Nangwarry was wonderful. Our childhood was safe and we knew everyone in the town. Dad had been a metal worker at the Islington Railway Yards in Adelaide and had no problem finding work at the sawmill. Us kids all played together, often in a big pine tree in the next street from us; every night in summer after tea we would congregate to climb it. Most of the boys would hang around the bottom to try to look up our skirts. We would go on bike rides together and, if we didn’t have enough, the boys would ride and the girls would sit on the handlebars and steer. One day we were a few miles up the road toward Penola when we had a pile-up. I was on the bottom and finished up with a badly cut and infected knee. Mum had to drive me to Mount Gambier many times for penicillin injections while Dad made me a cradle out of pine to keep the blankets off it while I was in bed.

  When the mill was closed we would climb up the huge hill of sawdust at the back and slide down on a piece of tin. In summer we would go into the pine forest with a bottle of cordial and some biscuits. There was a pond off the Kalangadoo road and we would tie a string around the bottle and drop it in the water to cool it down and then have a picnic when we had finished playing. We were quite wicked when the city cousins came to visit, taking them out to the pines and then hiding from them. In hindsight it was a terrible thing to do.

  My older sister, Elaine, and younger brother, Bob, always seemed a lot smarter than me and did well at school. I don’t remember ever coming first but I did alright. When we were still in primary school, Mum contracted polio so Elaine and I went to live with our grandmother, Catherine McCarthy, in Jamestown. She was our only living grandparent and we developed a loving relationship with her. She was tall, had a wonderful sense of humour and taught us how to make pavlova.

  After Mum recovered she had to learn to walk again. When we came home from Jamestown, she staggered from chair to chair in the kitchen, retraining her limbs. Dad bought a fridge so she didn’t have to bother with the ice chest. Despite this, she always seemed to be happy and smiling and had the love of beautiful friends in Nangwarry.

  In later years a stroke left Grandma paralysed down one side and unable to speak. She came to live with us and slept in my room, and I looked after her during the night if she needed to go to the toilet. This was when I really got to know and love my grandmother. She would play cards managing with one hand and I remember her laughing a lot. I never saw her angry or upset about her lot in life. She died when I was fifteen, and in hindsight this time with her taught me about accepting the good with the bad.

  We were Catholic and along with the Mount Gambier parish priest, Dad and a few of his friends just about built the church at Nangwarry themselves. The building, which was across the road from our house, was used as a school during the week and a church on Sunday. I spent all my primary school years there being taught by the St Joseph nuns. The order was founded in south-eastern South Australia by Mary MacKillop, who came to nearby Penola in 1859 to help the local priest, Father Julian Tenison Woods, establish a school. They decided to start an order of women dedicated to serving the poor in remote country areas and their school in Penola was opened in 1866. Mary moved on to Adelaide and later Sydney, where the Josephite order became known for its work with schools, orphanages and refuges for women and the elderly.

  The nuns lived in the house next door and became an integral part of our life. There was a little gate between our properties where we would slip in and out, because Mum and Dad were always doing something for them. During the holidays, Mum would drive the nuns in our car and take them on picnics. The nuns taught me to play the piano at the convent, though I wish I had learnt to sing as well. Mum played the piano and Dad would accompany her with his lovely, strong tenor voice; the love of music and singing which they instilled in me have been integral parts of my life. I still sing in the church choir and am learning the violin.

  My secondary schooling was at the Josephite convent in Penola. I left during my intermediate year (year 10) to take up a clerical position with the Penola council. A short time later I took a position forty kilometres away in Mount Gambier where my sister, Elaine, was working. We boarded in Mount Gambier during the week and came home on weekends. This was a wonderful time in our lives, with boyfriends and weekly dances at Tarpeena or Mount Gambier. On my sixteenth birthday, Mum, Dad and my brother shifted to Mount Gambier where they bought their first house, so we were all able to live together once more. That same year I made my debut, along with all the other young women in the south-east. Debuts were very popular then and many churches and other organisations had their own balls. There was the Debutante of the Year ball at the end of the season, when all the local girls and their partners were invited to attend a huge function at the Mount Gambier Show Hall.

  While still working at the mill my father became ill with multiple sclerosis, which developed into an inflammation of the spinal cord known as transverse myelitis. He became very disabled and Mum nursed him for twenty-seven years before he finally died on St Patrick’s Day in 1978, aged sixty-eight. He was a beautiful human being and never once did I hear him complain as he battled the disease, eventually becoming bed-bound. When he died we were all around him, and my mother’s last words to him were ‘Goodbye, darling’. I don’t know how Mum did everything that she did for him, and never once did I hear her complain either. Through their actions they taught me a lesson in unconditional love. After Dad died, Mum continued living in Mount Gambier and I would travel from Adelaide to spend a week with her every few months. We would shop, go out for meals and have a ‘happy hour’ before dinner each evening. Often Elaine would join us for lots of girl time and plenty of laughs.

  Shortly after making my debut, I began to like the idea of nursing. I was accepted at Mount Gambier Hospital to commence training but changed my mind and went instead to the Royal Adelaide Hospital, which was the main teaching hospital in South Australia. On 17 July 1961, I started out as a very green young trainee nurse who had no idea what constituted a blood vessel, that the stomach was an organ, or even what the body looked like. Some of the girls had studied science and biology and were streets ahead of me. But what I did know was how to care about a fellow human being, and I quickly fitted into Preliminary Training School (PTS) at Ayres House opposite the Royal Adelaide, which is now an elegant restaurant. We slept in the nurses’ home ‘three to a room’ and some of the nurses I met, such as Pam Henwood from Barmera on the River Murray, became lifelong friends.

  PTS lasted six weeks, after which I was sent to Verco Ward, the first stop on my three-year training journey to become a registered nurse. Verco was a men’s medical ward built pre-war as a temporary building, but was still in use thirty years later. We worked six days a week and never finished our shifts on time. I still have the happiest and saddest memories of this period. I saw my first dead person; sometimes there were three deaths in a day. I learnt that male patients like to play jokes on green nurses, almost all of which are best not repeated. I learnt how to scrub bedpans and urinals and how to wash and powder gloves ready for sterilisation in the autoclave.

  My favourite period was the six months I spent in casualty (now called accid
ent and emergency), which was all about thinking on your feet and responding to every kind of emergency. The only thing that ever turned my stomach was when a lady came in one Sunday afternoon after her big toe had an altercation with a lawnmower.

  During my third year I worked in the operating theatre for six months, often hard going with some operations lasting up to twelve hours. The most challenging was the night shift over Easter, when many accident victims needed emergency surgery. My previous experience in casualty had taught me to react quickly in emergencies. I had fabulous teachers at the Royal Adelaide, both in the classroom and the ward. At the same time, there were a few renowned for making life difficult no matter how hard you worked. Rita Huppatz was matron most of my time at the Royal, a beautiful, gentle woman who could make you feel so special, but if you had done something wrong you would wish the floor would open up and swallow you – like when she found me sitting on the bed of an ill nurse who I had gone to visit in the sick bay. I learnt quickly that you didn’t have to raise your voice to get your point across. In fact, it was far more effective if you spoke quietly.

  It was during my second year on night duty in casualty that I met the man who I was to share my life with. In hindsight I smile to myself remembering that my parents had also met in a hospital. It was a quiet night and I was busying myself in the steriliser room, placing instruments into the autoclave. I heard a noise at the door and looked up to see a handsome St John Ambulance driver watching me. Tall, with clear blue eyes, a ready smile and an obvious love of life and helping others, he had brought a patient in and was enjoying the warmth of the hospital. I thought he was probably after a cup of coffee as it was 3 am and cold outside. We got talking and I remembered seeing him several times during the previous few weeks when he and his attendant had brought other injured and sick people into casualty. Night shift was part of my job, but he had a day job and worked as a St John volunteer at night. We talked easily and this led to many more early morning assignations in casualty over a cup of coffee. I wonder in hindsight if Allan did all those night duties solely out of concern for the suffering or if he had an ulterior motive. One night he said to me, ‘Would you go out with a policeman?’ I replied, ‘I’ve never been asked.’ It transpired that Allan had been accepted as a police recruit and was about to commence his training. Of course I said yes, and our courtship commenced.