A Year in Africa – Preparations & Orientation

Continuing to show that ministry can take on many forms. In 2016 Julia Taylor signed up to spend a year with the Peace Corps in Uganda.

Julia Taylor 15 minute read.   Resources

In 2015 I applied for and was accepted in a Peace Corps program sending doctors and nurses to Africa for one year. Now, (2016) I will be part of the Global Health Service Partnership (GHSP) to work with medical and nursing schools teaching and working with school facility and administration to improve the educational opportunities for healthcare professionals in Malawi, Tanzania, Uganda, Swaziland and Liberia.

“My bags are packed – I’m ready to go”… to Uganda

Julia Taylor at her official swearing into the Peace Corps – US ambassador’s house, Uganda. Image credit: Julia Taylor

I organized my house, and was very happy to have a Mercy co-worker to rent/house sit while I was gone. I had to complete my on-line training and endure numerous immunizations, including a series of three “pre-exposure” rabies shots.

More enjoyable by far were all the “farewells”: a bon voyage Cardinals baseball game with my sisters, a wonderful weekend visit with six college friends and a goodbye luncheon given by my coworkers at Mercy Hospital. I took my Missouri grandchildren on trips to Virginia and Kimberling City. I flew to Montana to celebrate Anita (my second daughter’s) Air Force change of command.

Finally, after a rousing Independence Day celebration, I packed my 12 year old canine companion Ginger in the car and drove 1,200+ miles to Arizona. I was fueled by a combination of Red Bull and diet Dr. Pepper (I don’t recommend it) and entertained by a recording of “Murder on the Iditarod Trail”, hundreds of miles of highway construction through Oklahoma and endless radio commentaries on the 2016 presidential candidates.

I had dinner with my Arizona family and bought the grandchildren birthday presents in advance for the birthdays I would miss while I was gone. I was fortunate that I had family farewells with all my grandchildren, my sisters and four out of five of my children. My brother in California and my son in Hawaii said their goodbyes via telephone.

I was finally ready to head for Phoenix Sky Harbor Airport. Thank heaven I had some help. I could have never handled the luggage by myself. Two bags weighing 49.5 lbs. each and a smaller one weighing only 38 lbs. Total baggage fees: $210.

When I arrived at Washington National airport, I tipped generously – the baggage handler, the taxi driver and the bellhop at the hotel. I was there for ten days of Peace Corps training. There were 58 other volunteers – doctors and nurses – preparing to teach. Our studies included lectures on teaching techniques, writing test questions, malaria, parasites, HIV/AIDS, hemorrhagic viruses, mental health and communication methods. A display in the lobby of the Peace Corps headquarters gave me pause. It was a memorial to all the volunteers who died during their time of service. I learned that motor vehicle accidents were the most common reason.

Some highlights of these ten days were: a visit by the Secretary of State, receiving our malaria medications and a simulation session where those of us who were out of practice were given an opportunity to return and practice IV starting techniques. During that session I also gave an Emmy worthy performance as an annoying family member in a tense clinical situation.

I realized that several of the dresses I packed were too short (I know – a strange situation for me but in Uganda knees needed to be well covered). I mailed them back home and shopped for replacements. I completely repacked all three suitcases, saw a Washington Nationals game, attended a performance at the Kennedy Center, reacquainted myself with the Metro system, visited friends from Ft Huachuca days, and walked a lot seeing the monuments and buildings that are essential to any visit to the Capitol. I took advantage of the outstanding restaurants focusing on food that I don’t think I’ll see a lot of in Uganda: Thai, Korean, tapas, and crème brulee.

We ended our Washington DC orientation with a send off from the director of the Peace Corps and the ambassador from Uganda (she gave me her card and her daughter’s telephone number). We received teaching supplies, a lab coat and medical equipment (everyone was stressed about the weight limit for baggage). Our last lectures included recommended actions for trauma in the marketplace, treatment of chronic illnesses and a recommendation to keep our mouths shut for at least three months – to listen and to learn. It will be hard but I will try!

Tomorrow at 6 am I will be leaving with my 140 pounds of luggage flying on Ethiopian Airlines for 13 hours to Addis Ababa and then on to Entebbe, Uganda.

Uganda – Travel and more orientation

Welcome to Uganda. Image credit: Julia Taylor

The 6 am pick up at the hotel in Washington DC didn’t happen. When the bus didn’t appear, we called the Peace Corps emergency number. It didn’t work! Finally the buses, which had gone to the wrong hotel, appeared. After a long check process at Dulles and $200 fee for the third piece of luggage we boarded Ethiopian Airlines. I was in a middle seat for the entire flight. We were fed often and landed in Addis Ababa without delay. The two hours flight to Entebbe included another meal.

Everyone had to present proof of immunization against yellow fever before we could pass through the Immigration checkpoint. Thirty pieces of Peace Corps luggage did not arrive. After long wait, we decided that some would take the bus back to the hotel and the rest would complete lost baggage forms and wait four hours for the next plane from Addis. I was in waiting group. There was a liquor store in the baggage claim area so four six-packs of beer appeared. Finally next plane landed. Great cheers went up each time one of our suitcases appeared on baggage carousel. Two Nigerian women in traditional dress were also waiting for luggage. They cheered with us. When all the lost luggage had been safely retrieved, there were high fives all around and a group picture taken by one of the Nigerians. Apparently the missing luggage had sat on the tarmac during a rainstorm for quite a while because the contents of my soft sided suitcase were quite damp.

“The first of many mosquito nets”Image credit: Julia Taylor

Then we were a bus to Kampala. We were told it would be a 45 minutes trip which sounded reasonable for a 23 mile trip through crowded streets. The trip took three hours which was better than the first bus. It took them 4.5 hours. The Kolping Hotel room was basic with mosquito net which is sprayed with insect repellent before bed. After 32 hours of travel, I finally got to sleep.

The next day we each received a Peace Corps cell phone. It is old style – the kind where you push the 2 key three times for a “c” when you are entering information), I set up account information for a local bank (US $1 = Ugandan 3316 shillings), received more information on malaria including practicing with a rapid detection test (I am negative for malaria for now) and were presented with a water filtration system for new residents.

Learning the test for malaria. Supplied image

One volunteer brought a yoga tape. Every evening in Kampala we met at 6:00 p.m. in the classroom. It was very popular with the volunteers and the local staff, especially since we were told that running was not advisable because of the truly horrific traffic. I learned that fresh produce needs to be peeled or soaked in bleach water. Apparently I won’t be having many salads this year. The Peace Corps office will be holding both passports and immunization records to prevent us from leaving the country without letting them know.

After Lecture Yoga. Image credit: Julia Taylor

The motto for Global Health Service Partnership Uganda is “to increase capacity and strengthen the quality and sustainability of medical and nursing education”

I’m trying to stick to a vegetarian diet but did try a small piece of goat which tastes like … meat. Each day the buffet includes at least one type of fresh banana (sometimes two) plus matookay – plantains – both mashed and steamed. Every day there is a very good sauce with peas which I eat over rice. We also break for tea (complete with pastries) twice each day. We received a small Peace Corps cookbook with suggestions for meals using products available in Uganda.

At the recommendation of the Washington DC Peace Corps staff (in order to make it through the difficult days) I started gratitude list making three entries a day of things for which I am thankful. So far, it hasn’t been hard to list three items.

Our classes on security and safety convinced everyone to stay inside with doors and windows bolted at all times. The briefings were very negative (probably realistic but …). This was followed by a trip to a mall (quite nice) for electronics purchases. Almost the entire group descended on the Africell office so I was there for over four hours. I purchased a mobile hotspot so now I have a laptop, Verizon cell phone, Africell cell phone, a small projector, multiple outlet adapters, power protector and lots of accessories to support this equipment. I wanted to buy skirts since I have learned that “trousers” are not acceptable clothing for women here but most clothing stores were closed for Sunday.

The husband of one of the doctors is an IT whiz and helped me with several electronics issues. Dennis is number 1 on my gratitude list for 25 July.

One of the highlights of today was a great lecture by a university professor on the history of Uganda. There are 117 districts (similar to our states) with 52 ethnic groups and languages. Uganda didn’t exist in any way until the British in 1894 decided the area should be part of the Empire. The British determined the borders of their newly created colony. According to the lecturer the country is still not totally unified. Districts are often more important than the country as a whole.

We started our language classes. The eight doctors and seven nurses on our group are going to five locations. Each area speaks a different language so there are five separate language classes. The language in my area is Lumusaaba. After one 45 minute lesson, I am already lost. However I did learn something: “Wakonile uyrena? Nakonile bulayi” This is a greeting which means “How did you sleep? I slept well.”

I am beginning to adjust to the eight hour time change. After several mostly sleepless nights, I am now able to go to sleep by 11:00 p.m. and wake up in time to hear the Muslim morning call to prayer (about 5:30 – 6:00 a.m.).

We also received some information about our home stay. We are going to our permanent stations on Wednesday for an eight day stay with a local family. This is being done to get us acclimated to the culture. We may not have hot water or flush toilets. The host families have been warned that Americans generally eat dinner earlier than 10:00 p.m. During my stay in Mbale (I’ve been told that it is a four hour trip) my group will meet the administrators and our co-teachers at the university. Then we will return to Kampala for additional classes and finally the Peace Corps swearing in.

The weather has been very pleasant – in the 70s and 80s. I am now repacking my three heavy suitcases preparing to depart from Kampala to Mbale at 8:00 a.m. tomorrow.

Home Stay in Mbale

It was a five hour trip from Kampala to Mbale on a very crowded bus. We crossed the source of the Nile (which flows north). No one was allowed to take pictures. It had nothing to do with Nile River itself. The issue was military security because of the bridge over it. On our bus were some “real” Peace Corps volunteers – the ones who sign up for 27 months and mostly live in very remote places. My group is very much in awe of them.

We are Mbale for eight days for our home stay (to help orient us to the local culture), introductions to university and hospital administration and more language instruction.

My home stay family is the second wife in a polygamous marriage. She has four children, three of whom are in boarding school. The child at home is a 6 year old boy named Moses and called Momo. There is no hot water (only a cold water bucket shower for the next eight days). There is a pit (indoor thankfully) toilet. No running water after about 6:30 p.m. The host “mom” is gracious. She was told that Americans eat huge breakfasts so the first day she overloaded me with carbs. I told her a banana and cereal is just fine. Here they serve cold cereal with hot milk. A dozen chickens sleep in a room off the kitchen at night. Otherwise they are truly free range.

We were given a tour of the building where we will be staying. There are seven apartments and the Peace Corps volunteers will occupy five of them. The building is still being completed and the university will provide some furnishings so I’m not exactly certain what it will finally look like and what I will need to buy to furnish it. I know I will have to get a refrigerator, pots and pans, glasses, silverware, etc. Also complicating the situation is the fact that the administrative and support staff of the university are on strike, so it is possible that our furniture will have to wait until everyone is back to work.

Cooking lunch. Image credit: Julia Taylor

There is a coffee shop/hostel just a few buildings away from what will be my new residence. Free wifi, laundromat, interesting menu, Afro-Zumba classes. We all think this will be where we spend a lot of time. I visited a second coffee shop that serves Mexican food each Tuesday and Saturday. I am looking forward to trying some Ugandan enchiladas.

Circumcision festival is a huge deal. It finishes August 8 but the leadups to the event are already happening. There are parades of many walking, laughing people – everyone except the one on whom the surgery will be performed. The age for circumcision here is 18 years and apparently the boy is not to flinch or faint. If he does it will be a point of shame for the rest of his life. The procedure is done by a layperson who apparently is beaten to death if he makes a mistake. This is a ritual for a tribe of 6,000 persons who live in eastern Uganda and western Kenya. Most gather on even numbered years for the event. The number of young men who are circumcised ranges from 15 to 100. This year the presidents of both Uganda and Kenya are scheduled to visit the festival. We viewed the area for the event. It looked like a county fairground.

the infant mortality rate is 76 deaths per 1,000 births. For comparison, it is 6.1 per 1,000 in the US.

We have made the rounds of the local, district, university and hospital officials. Routine protocol visits seem to be the same the world over except that here all visitors sign an official logbook. The one we signed started in 1957. I learned that the infant mortality rate is 76 deaths per 1,000 births. For comparison, it is 6.1 per 1,000 in the US. Life expectancy in Uganda is 59 years. In the US it is 76 years for men and 81 years for women.

Image credit: Julia Taylor

The only way you can tell who is a boy and who is a girl here is by the clothes the child is wearing. Girls always wear skirts and dresses. All children have their heads shaved – much cooler and cleaner that way.

Using the app Whatsapp? I was able to call my cousin Mary just before her 50th wedding anniversary party. I was glad to talk to her but very sorry to miss the celebration.

We took a field trip to a synagogue outside Mbale. The rabbi who is the only trained rabbi in sub-Saharan Africa was extremely gracious and without notice took lots of time to talk to us. . There are 400 people in the local congregation and approximately 2,000 Jews in Uganda. Three of our group of seven are Jewish so we plan to be back for services.

Ugandan street scene. Image credit: Julia Taylor

Shopping in the marketplace was chaotic and confusing but fortunately we had our language teacher with us so I was able to replace my forgotten underwear, buy African fabric for the Peace Corps swearing in on August 11, and locate a dressmaker who promised to make the dress before we leave Mbale on August 4.

Walking here is a challenge both due to number of motorcycles and the fact that I can never remember which way to look when crossing the street since they drive on the left side of the road.

Mt Elgon Waterfall. Image credit: Julia Taylor

It was a long, very bumpy bus ride (with a full bladder – very poor planning on my part) to the top of Mt Elgon which I was told is approximately 9,000 ft. in elevation. We saw lots of very isolated villages on the way. There was a great hike to a waterfall – definitely got my exercise for the day. The view was magnificent.

St Andrew’s Anglican Cathedral has three Sunday services (English, Lumusaaba – the language I am attempting to learn, and Lugandan – the language used in the capitol). The English service I attended included some African music. We also sang two verses of “What a Friend We Have in Jesus.” Each service was over two hours long. An American fire marshal would have emptied half the church. At my service there were at least 550 probably 600 people jammed in. After we stood up for a song, I was slow to sit down and almost lost my end of the pew. Afterwards, one of the priests invited me to his house for lunch (two other Peace Corps volunteers were staying with him). I even saw a little CNN. Then I did some shopping and walked to the coffee shop for African tea (lots of milk), and Kindle time.

One day we visited the main campus of the university where we will be teaching. It was about a two hour drive. The vice chancellor was most gracious. She was certain we had met before. We decided that it must have been in Hawaii. She had been on Oahu for a week-long meeting at the University of Hawaii. Since we were near Kenya, we drove to see the border. A policeman gave us a tour of the border area – we definitely stayed on the Ugandan side. The sight of very long lines of very large trucks waiting to be inspected before crossing the border seemed quite familiar. It was similar to the Arizona-Sonoran crossing at Nogales.

On the last full day in Mbale, we had a dinner for our host families. Several medical faculty members also attended. The site coordinator surprised me with a birthday cake. Everyone sang to me and then three large sparklers were placed on the cake and lit. It was a great time. A perfect ending to our week!

Birthday Cake, complete with fireworks! Supplied image

Back to Kampala

We left Mbale in an air-conditioned bus! The highlights of our trip back to the capitol included lots of sugar cane pieces provided by a fellow Peace Corps volunteer who cut them down in his home stay family’s back yard, a purchase of habanero oil, and a great lunch of vegetable curry & naan.

Back at the Kampala Kolping Hotel, the reunion among the volunteers from five locations in Uganda was joyous. After all, we hadn’t seen each other in eight days. The comments were either bragging about how luxurious the home stay accommodations were (hot water, actual showers) or trying to be the person in the most challenging situation (only cold water bucket showers, a five hour church service). I was excited to feel hot water again and I had no trouble remembering to turn on the heater for hot water a few hours before my shower.

There is a small television in my room. I can watch the international version of CNN and two local stations broadcast in Lugandan. However, one evening one station had the Olympics on – in Portuguese. Unfortunately in the middle of a swimming event with the American relay team in the lead, the programming was switched back to local Ugandan news. I still don’t know the result of the race.

My exercise routine is mainly walking up and down four flights of hotel stairs for 30 minutes each morning since it isn’t considered safe to go to the Kampala streets alone. Each morning starts at 5:00 a.m. with the Muslim call to prayer broadcast loudly from all mosques. The call (broadcast five times a day) does not last long but it does remind the roosters that it is time to get up and crow for the rest of the morning. Not to be outdone, the Christians broadcast music with singing all morning on Sundays.

Almost every business – banks, hotels, malls – are protected by rolls of nasty looking barbed wire across the top of walls, and guards, usually men in uniform, with long rifles. You are required to pass through metal detectors to get into the mall.

Whites and Asians are called muzungus by everyone. I think it means foreigner in Swahili.

I went shopping for household goods at a local department store where irons cost 56,000 – Ugandan shillings, thankfully not US dollars. There were quite a few items in the store that carried the Target brand name. The bedding is being individually ordered (sheets, pillowcases, mattress pads, etc.) and then sent to a seamstress who is custom making them. We missed lunch at the hotel but fortunately there was a “Mr. Tasty” chicken shop which in addition to chicken, fish and pizza also sold ice cream. I had a scoop of butterscotch. Ice cream is hard to find here and is a real treat.

On a second shopping trip I purchased some essentials that I am certain I cannot find in Mbale: olive oil, balsamic vinegar and macadamia nuts. I am still looking for white chocolate.

We had more classes and a trip to the Peace Corps office. Once returning to the hotel, Kampala Friday evening traffic was so bad, we all got out of the bus and walked to a very upscale mall. It had a bookstore, gelato, a fitness center, numerous clothing shops and much more. I had my eyebrows threaded & got a supper of hummus and vegetables. One member of our group, a retired pediatrician from Ohio, had volunteered with the initial class of the Global Health Service Partnership in 2013. He has already seen three students that he taught at that time including one we ran into in the mall.

There are multiple starches for every meal – mashed plantains, yams, rice, pasta and occasionally mashed “Irish” (white potatoes). Every morning I was thankful for cold milk on my cereal. We have “break tea” every day at 10 am (tea, coffee, pastry) and evening tea at 4:00 p.m.

Lectures included psychiatry (which included a reminder that homosexuality is still a crime in Uganda) and African traditional medicine. The lecturer reported that 60% of Ugandans use a traditional healer as their primary care provider. She mentioned that if there is a doubt that the baby was fathered by a member of the clan, the baby is in the doorway. If the domestic animals step over the baby that indicates that the father is a clan member and all is well. If the animals step on the baby, the child does not belong to the clan.

We did practice teaching with students from a local university as the target audience. There were several lectures on HIV/AIDS which is still a major problem in Uganda. Adding to this problem, TB is also a huge issue here. Death from AIDS plus TB is four times greater than death from AIDS alone.

We also visited an 84 year old traditional healer who says she is successful in treating all diseases except epilepsy. Traditional healers are licensed by the government and supposedly the herbs they use are tested. On the same day we saw a bone setter. This family ran a practice and a hospital. Many people go to the hospital for x-rays then take the x-rays to the bone setter (who is trained only by his/her family – no formal education is required). The patient has gauze, herbs and then a bamboo split applied. Some people then go home and come back for checkups. The more serious breaks, such as the femur, stay in the bone setter hospital for three to four months until the bones are healed.

We had a cultural afternoon visiting the Ugandan National Museum, the tombs of the kings of Uganda, (official title is the Kabaka of Buganda). Four kings are buried there but they don’t really die so they each have nine wives living on the burial grounds. The women are supported by the kingdom of Uganda (which as far as I can tell is physically the same as the country of Uganda so Uganda has a president with political power and a king with no power but tradition and respect). Kingship is passed down by family: the oldest son gets land and the youngest son gets authority so the current king’s youngest son will one day be king. We visited the National Theater which has lots of craft shops. I bought a pair of earrings and a Ugandan nativity set to add to my collection of 70+ crèches.

Another cultural experience was the trip to the Ndere Centre where we watched amazing performances of variety of traditional African dances. The energy and stamina required for the three hour program was incredible. The audience included people from the USA, Canada, China, England, the Netherlands, Switzerland and several other African countries in addition to Uganda. It seemed to me the local version of the Polynesian Cultural Center (those who lived in Hawaii will understand this).

As our time in Kampala draws to a close, the festivities began. One night we had a happy hour complete with heavy pupus and a trampoline. A very welcome treat was the mango margaritas. 

Our official swearing into the Peace Corps took place at US ambassador’s house. I wore my new outfit that I had made from African material and tailored in Mbale. In addition to the seven doctors, eight nurses, one librarian, one computer scientist and one accountant in our Global Health Service Partnership volunteers, we were joined by 44 “real” Peace Corps volunteers. It was a surprisingly moving ceremony. I am proud to be part of the Peace Corps!

Orientation is finally finished. Now it is time to get to work!

Three Months (30 Days) In India

Ministry can take on many forms. In 2015 Julia Taylor embarked on what she thought was to be a three month stay in India, working at the NRI General Hospital, Mangalagiri, Andhra Pradesh, India with Project Hope.

Julia Taylor 15 minute read.   Resources
Saying Goodbyes. Supplied image

My journey for three months with Project Hope began with two boring days driving to Arizona. After I arrived in Phoenix (the temperature was 105°F) I read the instructions for my trip to India (I thought I had read them several times, but apparently I had only printed them). I discovered that I needed a visa! And antimalarial medicine! I completed my online application for an e-visa and contacted my primary care provider in Ozark who sent a prescription for doxycycline (antimalarial) to Hawaii (my next stop).

With my e-visa approved, but only for 30 days — I could renew it in India (or so I thought) — I left for Honolulu.

I spent five days in Hawaii, and while I was there, I attended church at St. Andrew’s Episcopal Cathedral. I went to the 8 a.m. service which is mainly in Hawaiian. It was a special service remembering Prince Albert’s (son of Queen Emma and King Kamehameha) baptism. Because in 1862 the four year old prince had become an honorary member of a fire fighting company, the Honolulu Fire Department was there in uniform and with a fire truck. Hawaii’s governor and first lady were also at the service as well as black gowned descendants of Hawaiian royalty. The school my three daughters attended while we lived in Hawaii, St. Andrew’s Priory, is on the same property as the cathedral so I took a few pictures for them.

All too soon my time in Hawaii was over, and I was up early for my flight. I had a quick walk around Waikiki to say aloha to Oahu and then went to the airport. I was flying China Eastern Airlines to Shanghai and was the only Caucasian passenger. The seat next to me was empty so I enjoyed good food, my Kindle, and some sleep during my ten-hour flight. I had to get a one day visa just to spend eight hours in the airport. I walked a lot during my layover.

My flight to Delhi was almost all men. After we landed I slept in one of few comfortable chairs in the airport. My Kindle continued to supply me with great reading material and I found some tea and pastries when the food court opened at 4:30 a.m. Although there was an earlier flight directly from Delhi to Vijayawada (my final destination), Expedia had booked me through Hyderabad. That added ten hours to my trip. Hyderabad airport had terrible food but there was diet Coke available. There were many heavily veiled women including one with thick black gloves to coordinate with her total body black covering. I watched with interest as she gave her husband money and apparently told him to go buy some food for the children (which he did). Another stereotype slightly damaged! Airport security was now segregated by sexes with full body pat down for everyone. Other than being a very long trip (over 40 hours from Honolulu) it was not a bad experience. There were at least two meals on each leg of the trip and vegetarian options on all.

My destination was definitely not a tourist attraction. On my last two flights I was asked if I were on the right plane. From Shanghai on, I was the only non-Indian passenger.

Vijayawada airport is tiny. I was supposed to be met on arrival. However, my pick up was 90 minutes late. I was beginning to be concerned – it was getting dark and the airport closed after my Air India plane returned to Hyderabad – when my ride with two nurses and a driver arrived. The hour-long ride to the hospital showed that the most important car accessory in India is the horn. The traffic was crazy. Buses, people, motorcycles, three wheeled motorized carts, bicycles and cars. All was chaos but everyone survived. I was housed in the hospital’s “staff quarters.” My room was basic but clean. I had a private bath and shower. The shower was a bucket and small pitcher but I had hot water.

The next day I learned three important things:

  1. The tea was great – just like chai latte.
  2. I was wrong about the visa. It could not be extended. I would have to leave the country and reapply for a new visa. That was not an option since any country near India also requires a visa so I would have to leave India for home in 30 days.
  3. Although the doctors and nurses were taught in English and the hospital officially used English, actually everything was done in Telugu. Even the people who spoke English reasonably well had difficulty understanding me because my American accented English was very different to the Telugu accented English they heard in school.

Hospital

Julia at work. Supplied image

They wanted to assign volunteers to the area in which they were currently working. However, they had no concept of Case Management – arranging for patient care after hospital discharge — In India that is a family responsibility. In fact, unless it is an emergency, patients are not admitted to the hospital without a family member (or neighbor or someone) to care for them. That care giver goes to the pharmacy to buy the medications and supplies the patient needs, provides meals and in general cares for the patient. Some of the hospital wards are 60 beds with only one or two nurses. Family assistance is required. Often entire families stay at the hospital for the totality of the patient’s stay. There are always people sleeping in the hallways. At night the hallways are crowded with families sleeping.

Nurses rotate through three shifts: 8 am – 2:30 p.m., 2 p.m. – 8:30 p.m. and 8 p.m. – 8:30 a.m. Transportation (or lack of transportation) is the reason for the arrangement of the shifts.

There is no way for nurses to get to or from the hospital at 11 p.m. If it safe to do so, nurses are allowed to sleep during the overnight shift.

The hospital and associated medical and nursing schools were started by Indian doctors originally from that area of India, who had practiced in the United States. The hospital offered a wide range of services including open heart surgeries and renal transplants. Since I had experience in the Post Anesthesia Care Unit (PACU – the recovery room) I was assigned there. One of the highlights was attending a nurses’ conference on Stress Management. At the end of the two day program, a yoga master was introduced. After a brief lecture, he led 250 nurses to a large room where we lay on the floor and “relaxed.”

Church

Julia Taylor ‘Preaches’ at Shalem Evangelical Church.
Shalem Evangelical Church. Image: Julia Taylor

One of PACU nurses was the wife of a pastor of a Christian church. Vimala asked if I would attend the church and (I thought) she asked if I would pray for them. Of course, I agreed. Later I learned that I had agreed to preach at the Shalem Evangelical Church. I also learned that I should wear white to church. Santhi, the PACU charge nurse, took me shopping for white church clothes and a sari.

Julia Taylor at Shalem Evangelical Church. Supplied image

That Sunday at the church and I was nervous at the beginning. The congregation was Telugu speaking so everything I said was translated by the pastor. Any Bible verse mentioned was immediately located in their Bibles. The women covered their heads. Men and women sat on opposite sides of the small church. The service was over three hours long and filled with lots of music and enthusiastic singing. Communion in the form of dense bread and a sweet liquid was given to all. Everyone was so gracious and encouraging. It was a wonderful experience.

Hindu Worship

Hospital Shrine. Image: Julia Taylor

In the room across the hall from me was a doctor from Calcutta who was at the hospital to administer tests to the medical students. He was visiting a temple and asked if I would like to go too. The visit was interesting and very confusing. We had to be barefoot. I received a tap on the head with a silver vase, sweet water and a handful of spicy cooked rice. I later learned that food – often rice and small yellow chick peas – is often associated with Hindu worship. The hospital had a temple across from the main lobby and a small shrine in one of the hallways. I often noticed hospital personnel stopping for a few minutes in front of the shrine. It is common for families to have shrines in their homes. At first I thought I had caught a man just coming out of a shower – he had just a towel wrapped around his waist. Later I learned that Hindu men often pray wearing only a prayer towel.

Praying at the hospital shrine. Image: Julia Taylor

There is a trinity of gods in the Hindu belief: Shiva the destroyer, Vishnu the preserver and Brahma the creator (The total number of gods in the Hindu pantheon is difficult to pin down, varying from three to 33 million).

Ganesh in the hospital foyer. Image: Julia Taylor

I knew September 17 was a holiday for some reason, but I could not understand the reason for the holiday. I learned from Wikipedia that it was Ganesh Chaturthi, the festival of the elephant headed god. A temporary shrine to Ganesh was constructed in the hospital lobby. At first the elephant face was covered in newspaper. The priest / monk/ Hindu altar guild member(!?) uncovered the face, dressed the statue in cloth and flowers, poured a sack of rice at feet of Ganesh, then added more flowers and some fruit. All this took about one hour. People came and watched and prayed at the shrine. Within a day the fruit was gone and flowers had wilted. The statue was supposed to remain in place for 10 days However, after three days the statue was moved with great ceremony. There were fireworks, bands, loud speakers, and much dancing as the statue was moved via tractor to the canal where it was “drowned.” Every small community had its own celebration. It was an amazing cultural experience. I danced, was pelted with pink powder (my hair was still pink on my return to the US), had my hands painted with henna and had a wonderful time.

Celebrating Ganesh Chaturthi. Supplied image

During the four weeks at the hospital I discovered:

  • Banana juice is wonderful!
  • There is life without toilet paper.
  • Plain yogurt with salt is not my idea of great dessert.
  • Putting on a sari is very complex.
  • Hawaii is not crowded. India is crowded!
  • One issue I had never considered – how to keep monkeys from stealing the food you are preparing for dinner.
  • How to drink from a plastic water bottle without my lips touching the bottle (because the bottles are reused multiple times!)
  • Both the rules of cricket and the Hindu beliefs are too complicated for an ordinary human to comprehend.
  • Many Hindus also pray to Jesus.
  • Doxycycline for malaria prevention is hard to take. Every morning I was reminded of morning sickness.
  • My laptop allowed me to listen to the St Louis Cardinals games. The 10.5 hour time difference did make catching all the action almost impossible.
  • “Had your breakfast?” seems to be a greeting similar to “how are you?” Or perhaps everyone was worried that I was starving.
  • In India after a woman gives birth, she gets 84 days paid maternity leave.
  • Everyone eats with their hands. Apparently I was incompetent at this task. Someone usually gave me a spoon after a few minutes.
  • Transportation is normally by three wheeled motorized cart. There was a bench for three passengers. One trip I took carried 11 passengers. It was crowded! Another method of traveling was by motorcycle. I rode as the fourth rider on one. Not necessarily safe but fun.
  • As India is a former member of the British Commonwealth, residents refer to nurses as “sisters”, elevators as “lifts” and lab coats as “aprons”. I was “madame” and the nurses stood up when I came into the room.
  • The only person I saw during my days in Mangalagiri who was lighter skinned than me was an albino Indian man. I got used to stares everywhere I went.
  • I nearly caused a riot in a girls’ orphanage when I brought out bottles of bubbles for the girls.
  • This is a middle-class home (wife is a nurse, husband an accountant): a two room apartment – one bedroom with a double bed for the couple, nine year old daughter and six year old son, squat toilet, no hot water, no oven, no refrigerator, dishes and clothes were washed outside, a motorcycle, and lots of beautiful saris.
“Everyone eats with their hands. Apparently I was incompetent at this task. Someone usually gave me a spoon after a few minutes.” Supplied image

Soon it was 22 September, my last full day in the hospital. Time had gone by so fast. I really was not ready to leave but I had to.

During my brief stay my work accomplishments were:

  • I observed both the PACU (Post Anesthesia Care Unit) and the step-down Post-Op ward. For each unit I wrote up my findings and submitted them to the hospital administration.
  • I participated in an EKG class taught by the hospital nursing educator. Later I developed student worksheets for identifying various cardiac rhythms.
  • I created information papers on the ACLS (Advanced Cardiac Life Support) medications.

These papers will be used as the hospital develops an ACLS certification class for the ICU and PACU nurses.

“… the PACU nurses dressed me in my sari. I had absolutely no idea how to do it myself.” Supplied image

In the afternoon the PACU nurses dressed me in my sari. I had absolutely no idea how to do it myself. The nurses were really amazed at that I had no experience with a sari.

Dressed like, but not looking like a native resident of India, I made the rounds to say goodbye to the hospital executives. PACU had a party for me complete with a gift of a replica of a Hindu temple and a cake. Apologies were made because my name was spelled wrong on the cake but no one noticed that the cake read “Happy birthday July”. It was the first real dessert I had tasted in over four weeks, and it was very good.

Next I went to a gathering of the head nurses of the hospital who had prepared a farewell gathering for me. There were speeches and refreshments. I was presented with a beautiful cloth (apparently the giving of a cloth is an Indian tradition). One of the comments I heard several times during the good-byes is that it is amazing how long (how old) Americans keep working. Apparently by the time someone in India is my age, he or she spends their days in bed having children and grandchildren wait on them.

Julia on her last day at NRI General Hospital, Mangalagiri. Supplied image

I left clothes including my white church outfit which was now permanently pink and Project Hope t-shirts with the staff. I gave the last of my bubbles to a boy waiting somewhat patiently outside the OBGYN ward and presented an 11-year-old girl hospitalized for electrical burns with a small bottle of hand lotion.

Julia gives an 11-year-old girl hospitalized for electrical burns a small bottle of hand lotion. Supplied image

Early on 23 September I was packed and ready to go. Santhi (the PACU charge nurse) and her husband accompanied me to Vijayawada airport from which I left for a two-hour flight to Delhi.

At Delhi airport I was met by a tour guide and driver, and was delivered to my five-star hotel. I had gone from Spartan living to the lap of luxury. After a lunch of Thai curry (I needed a change from Indian) I had a brow threading, facial and scheduled a hot stone massage for later. There was a fourth floor outdoor pool that overlooks the city and several trendy looking bars. However, I did have time for some culture. I toured the National Museum. There were lots and lots of statues of Hindu gods. Santhi and her husband had given me a print out of what was essentially “Hindu for Dummies”. I planned to study it and then go over the multiple pictures I took at the museum. Hopefully I would be able to link a picture with a god. I also walked around India Gate, the giant memorial for soldiers killed during World War II. Back at the hotel the doorbell for my hotel room rang! It was a bellman who asked if I wanted the turn down service. I declined. Too much luxury too fast might be harmful.

The 75-minute hot stone massage was awesome. And there was fresh fruit in my room! My supper was two bananas and two apples. I did not try walking or running outside the hotel now that I was in a big city. The traffic was unbelievable, and I was lucky not to get run over because I couldn’t figure out which way to look when crossing a street (they drive on the left). I checked out the television stations. The listing identified programs in English, Hindi, Punjabi, Spanish, French, German, Arabic, Chinese, Korean and … Australian!

The next day I traveled to Agra – home of the Taj Mahal. The trip took almost four hours and was interrupted only by a 45 minute stop with a man shouting and claiming my driver had hit his car. Somehow it was resolved without involving the police and we continued on our way. We passed a restaurant advertising ‘multi-cuisine pesto bar”. I was sorry we couldn’t stop. We passed a fresh meat market – the goats were waiting at the door to be selected for dinner. I was becoming more vegetarian every day.

The trip took me through rural India for the first time. There were grass huts that I think were for storing crops, not for housing, but I could not be sure. I think I glimpsed an even deeper level of poverty than I had seen previously.

Nevertheless, I proceeded on to my next five-star hotel where one of the many services offered was “astrologer available on request.” Compared to the Western tourists I saw, I was dressed like a very poor country relative or a missionary. I had no other clothes except those I wore in Mangalagiri which is much more restrictive in acceptable fashion than are the cities of Delhi and Agra.

I visited the Taj Mahal. As expected, it was awesome. A few facts:

  • It was built in the seventeenth century by Shah Jahan as a tomb for his favorite wife who died at age 39 after her fourteenth pregnancy.
  • He had planned a matching black Taj Mahal for his tomb but that did not happen because the Shah was jailed by his son during the last eight years of his life.
  • The scripts on the front of the building are chapters from the Koran. They are not painted but are made of precious stones.
  • The exterior is cleaned with layers of Pakistani mud which is rinsed with distilled water.
  • The entire building is an amazing work of symmetry and detail – all completed without the aid of a computer.
  • One of the most popular places to have a picture taken is at the “Lady Di” bench, the location where Princess Diana sat and viewed the Taj Mahal when she visited.

One of the newest attractions I visited was the Swaminarayan Akshardham, a ten year old temple which includes boat rides, movie theaters and displays promoting a vegetarian diet. The focus was an 11 foot high gold covered statue of the holy man Swaminarayan. Also on the 100 acre campus (because of the importance of the elephant in Hindu culture and India’s history) are carvings of 148 life sized elephants. Even though I injured several toes walking into recessed lighting (you have to be barefoot in a temple) it was a great experience.

“My hair was still pink on my return to the US.” Supplied image

I finished my time in India with visits to the Red Fort and Agra Fort, both planned by Shah Jahan who designed the Taj Mahal. I also visited a carpet factory and, of course, bought a knotted wool carpet. Hopefully it will go well with the silk carpet I bought in China. I rode in a bicycle rickshaw through the streets of Old Delhi (it was terrifying – so crowded!) and visited the site of Gandhi’s death – he was killed by a fellow Hindu who disagreed with his policy of allowing Muslims to live in India.

I spent my final hours packing and repacking and leaving clothes in my hotel room (hoping that someone could use them and that I would be under the 50 pound weight limit on luggage). At last I was ready for my 15-hour flight from Delhi to Newark, NJ then on to Phoenix and finally a 1,300 mile drive back to Missouri.

I was not certain what my next adventure would be, but I did know that my first priority at home would be to do something about my fluorescent pink-orange hair. Even though it was a reminder of a great time in India, it just wasn’t my style.

This article was originally published as a series of posts on Julia’s personal Facebook account.

Julia Taylor attends Christ Episcopal Church, Springfield, Missouri