Most weekends, the Volunteer House empties out as the staff and volunteers all leave for Kampala. Some weekends Kampala is the final destination, and we book a cheap hostel just so we can take a hot shower and enjoy some pizza. Some weekends, it’s just be the starting point of an even further journey, traveling on to destinations like Jinja.

One weekend in December, my roommate Sigbrit and I decided to stay back and just relax in Kasana. We enjoyed a lazy Saturday: reading under the shade of the avocado tree in the morning, doing some yoga in the afternoon, and watching a movie at night.

Sunday morning started out just as calmly as Saturday had. I took a short walk to pick up some chapattis from the stand around the corner, and on the way back, I noticed a woman pacing in front of the house across the road from us. I smiled at her as I passed, went inside our compound, and thought nothing more of it. That is, until about two hours later, when Derrick came to get me and Sigbrit.

Derrick is Sister Josephine’s youngest son, who was home on break from university. He alerted us that a woman seemed to be passed out in front of the neighbor’s house, and he was concerned. We agreed that we should do something, and went out to try to talk to her.

It was the same woman that I had seen earlier, but seeing her now, I realized something I hadn’t noticed earlier — she was pregnant. Very pregnant. As in, we were afraid she might go into labor on the side of the road.

We gently woke her up, and tried asking if she was okay. I’m not sure whether my presence made her uncomfortable or she just couldn’t understand me, but she was clearly uninterested in speaking with me, so I went back inside get Derrick.

Derrick conveyed her message that she was fine, just hungry. She said she had been walking for days and hadn’t eaten. We didn’t have much in the house — just some leftover potatoes and a few eggs. While Derrick heated them on the stove, I brought her some water, and Sigbrit called the Birth House to see if they had any advice for us. Unfortunately Sister Josephine was away for the weekend, or else she could have checked out the woman right there at our house.

When we first tried to convince her to go to the Birth House for a check-up, she refused, laughing that there was no need for her to go a maternal health center because she wasn’t pregnant. The woman had seemed confused throughout our interaction, but we had initially chalked it up to her being tired. After her insistence that she was not pregnant when she looked about to burst, we realized that she was likely mentally ill.

Thankfully, after Derrick brought her food, he was able to convince her. We called for Wyclif, our neighbor and Shanti boda driver, to take her. Wyclif had been in the middle of an errand a town over, but immediately turned back to help. Derrick and I sat with the woman to wait.

In the ten minutes that it took Wyclif to get to us, many people walked passed us on the side of the road. Some smiled and blessed us for helping a stranger, but some were not as gracious. A few people gathered to tell us that they recognized her, and that we shouldn’t be helping her, because she was bewitched.

Unfortunately, mental illness is severely misunderstood in this region — any outward signs of mental illness are taken as signs that a person is cursed. For some of our neighborhoods, the only explanation for the strange behavior of this woman, who was clearly experiencing some kind of psychosis, was black magic. Derrick assured them not to worry.

When Wyclif arrived, it took a few more minutes of convincing for the woman to actually get up and go. Once they got to the Birth House, the midwives were already waiting for her. They confirmed to the woman that she was indeed pregnant — she was reportedly overjoyed at the news. Unfortunately they found that she had some major complications, so had to refer her to Kasana Hospital for care. Wyclif brought her to the hospital, and after that, we lost touch. We figured we’d never find out what happened.

Thankfully, just a few days later, Wyclif called with the good news: the mom had given birth to a healthy baby boy.

From the different pieces of the story that we’ve stitched together, she’d spent one night at Kasana receiving care, and was then discharged. We believe she slept outside on the grounds of the hospital for the next few nights, until going into labor Wednesday morning. It seems like there was a quite a commotion as a passerby noticed what was happening and alerted the nurses, who had to convince her to come back inside the hospital to deliver. Some local boda drivers witnessed the scene, and, recognizing that it was the woman whom Wyclif had brought there a few days before, told him the news.

We packed a care kit full of baby clothes, a blanket, woman’s underwear, and reusable pads, and sent it with Wyclif to take to her at the hospital. She sent back her thanks. After that, we lost touch for good. The woman left the hospital, and we don’t know where she went.

Had she given birth at Shanti, we could have let her stay in the post-natal ward until we figured out a way to help her. Now, even if we knew where she was, there sadly isn’t much we could do for her.

Programs to support homeless people don’t really exist here; shelters are non-existent. We don’t think she had any family in the area, and since many people in the community believed her to be cursed, there was a slim chance of anyone taking her in.

There are also no mental health professionals in the area.

Derrick pointed out another disturbing factor. We’re not sure at when her psychosis began, or for how long she had been sleeping on the streets. But assuming it stretched back more than 9 months, her pregnancy was likely the result of rape. Comprehensive support for survivors of sexual assault is also uncommon.

The issues this woman was facing are hardly unique to Uganda. In the US, it’s estimated almost 50% of homeless women become pregnant, and the overwhelming majority face mental health issues.[1] Thankfully, there are more services available for these women in the US.[2]

It wasn’t until I sat down to write this blog that I realized that I don’t even know the woman’s name. She had refused to tell us at first, and while I assume she eventually gave it to the midwives at the Birth House, it seemed unnecessary to ask at that point.

I struggle with the thought that both the woman and her newborn son are likely sleeping in the streets, scavenging for food. At this point, all I can do is pray that the woman and her baby are safe. I take comfort in knowing that as Shanti’s services continue to expand their reach, there will be less and less women in Luwero going without pre or postnatal care. More than anything else, I’m grateful to know people like Derrick, Wyclif, Sigbrit, and the Shanti midwives who are willing to stop whatever they’re doing to help a stranger in need.





Mental health. Women’s health. Health justice.

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Mental health. Women’s health. Health justice.

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