Hospice Foundation

Final Communication
Final Communication
May 27, 2016

This will be my last communication for this trip to Uganda! Tom and I are half way home in Amsterdam waiting for our flight to Chicago.

Our last days in Uganda were spent with friends in the village and the PCAU staff. Wednesday our friend Anna, Rose's neighbor, closed down her business in Kampala at 3:00 to get back to Kajjansi to host us at her home. This also allowed her sons to leave work to join us as well as other family members. How special is that!!! This is so reflective of the "Ugandan hospitality" and how quickly lasting friends develop – in a country we consider "undeveloped." I guess it is just the way one looks at "undeveloped!"

I don't think anyone, at least not me, can describe the good-bye given by the PCAU staff. They gathered after work prior to leaving for our flight. We sang and had snacks… including a cake saying "Farewell Tom and Roberta." You only have a cake in Uganda on "special" occasions and cutting it is ceremonial! The most warm and touching part of a departure evening is always when each staff member personally says something about your visit. For me, and also this time for Tom, it is a caring and reflective time – and a bit overwhelming. I really cannot begin to adequately put the experience into words, other than to continue to allow their words to remain with me, to ponder them in the weeks to come, and to influence my life in positive ways. They have become friends due to the strong partnership Center for Hospice Care has with PCAU, and that I have been able to be a part of over the years. I have now been able to share these special individuals with Tom. I am grateful to them and for them and for the partnership that continues to grow and evolve for the future of Uganda. 

Thanks to all of you who have followed us on this trip. We felt your presence from a distance and we are also thankful for you – our family and friends.

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Preparing to Leave
Preparing to Leave
May 25, 2016

It is so hard to believe that we are leaving Uganda tomorrow night. The time has passed so quickly!

Tom has enjoyed his visit. He talks about the friendliness of the people, their welcoming spirit, and their acceptance of everyday life, especially here in the village. He loves the colors, the confusion, the noises, and some of the unpredictability of some days. He has his own stories to tell, but I feel pleased that he has been able to come to love this country – and to witness the happiness of the people as well as their struggles.

We managed to get in some extra shopping yesterday in our travels which was on our schedule for today – so today we decided to remain home and take in some of the activities along Entebbe Road, go to the open market and walk through the village area. We had friends over last evening and "the gathering" went on until midnight, so we were happy not to have to move too fast this morning. Tonight we will gather at Rose's neighbor's home! 

There are always so many memories created to carry home and this in itself is the gift of every visit. I remain thankful… and I (we) are anxious to see you again!

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Home Again!
Home Again!
May 21, 2016

We are back from Hoima. Yesterday was a long and busy day. Our first stop was Hoima Regional Hospital. It is under renovation (since 2013), but welcoming to PCAU meetings and training. The training on psycho-social needs in palliative care had been completed prior to our arrival and they were in the middle of instruction on pain control. Typical of the Ugandan way, we were quickly introduced and the three of us invited to address the group. After tea, the PCAU District had their own quarterly meeting. They were pleased with our presence and coming to the meeting affirmed PCAU's interest in the entire country and their efforts as a District. Some of the individuals present for instruction stayed for the District Meeting and became new members.

We also had a meeting with the head of nursing to arrange a three day training program in early June for hospital staff in palliative care. They are very much wanting to scale up palliative care due to an article that appeared in the local newspaper stating that the hospital was doing a poor job of pain control and offering palliative care. The author of the article had attended a PCAU sensitivity training for journalists and went back to the area to examine his own Regional Hospital. The outreach that PCAU does ends with positive results!

While I am talking about hospitals, an article in today's paper stated that according to the Ugandan Cancer Institute cancer survival is only 20%, while the death rate once an individual is diagnosed is at 80%. The Regional Hospitals interviewed for the article all lamented the absence of cancer specialists, including pathologists to carry out diagnosis on specific cancer patients, inadequate supply of drugs and lack of equipment as major factors. Of course, the fact that Uganda's ONLY radiation machine broke down about two months ago does not help the situation and now, Mulago National Referral Hospital is preparing to close down for renovation. The renovation is badly needed, but it is questionable how long this will take. Patients will have to be served in their own Districts with less service. This is just a small glimpse of health care here in Uganda.

During our brief stay in Hoima, we managed to visit Tonny at his pre-seminary school. School break time for him is shortened because his class is held behind for more study since they are in their candidacy year – preparing for tests to advance to the next school level of studies. He is a delight!

Of course, we can not be in this area without stopping to visit Rose's mom. Oh how I wish you could all meet her! We don't understand each other through language, but yet communication takes place. Her smile is bright and beautiful. Since we are the same age we refer to each other as "sisters"… she being the oldest!!!!!

On the political front here, President Museveni's rival Kizza Besigyeis is still in prison and the paper indicates he will be tried for treason! We are also attempting to keep up with the politics back home!!!

Now that Tom and I "are home," we will soon be preparing something to eat. Our days are coming to an end, but we will make the most of them.

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Short Message
Short Message
May 19, 2016

Today, Thursday, turned out to be a catch up day for Tom and I – and we appreciated the time. We were suppose to go around to a few sights in Kampala, but when we returned last night I understood from Ritah that the PCAU car was in the garage. I told Rose not to bother arranging things for us today because she would need her car that we were going to use with the second driver from PCAU. The main car for PCAU, that I spoke of in my communications in March, still does not have the necessary license plates to drive for work.

The car has just been picked up at the garage and Jaffer came by to "take us where ever we needed to go," but we are fine. It is 4:30 and we are not about to move out of our home. I know what the evening traffic jams are like! We figured out what to fix for dinner now that the tank is filled with gas and we went to Kajjansi on our own to get some cash from an ATM. All is well!

We will leave tomorrow morning at 5:45 A.M. for meetings in Hoima. More about our travels and life in Uganda as the days move on. Just know we are thinking of you and have only one week left of our stay.

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Wednesday Night!
Wednesday Night!
May 18, 2016

We spent yesterday mid-afternoon until mid-day today at Queen Elizabeth National Park. We have been on the road a lot! Tom believes the road toward Fort Portal getting to the park is the worse road he has ever ridden on! Yes, for a road leading to one of Uganda's "attractions," it is rough… to say the least!

We went on a nature boat ride yesterday which was relaxing and enjoyable. It's a chance to gain some information about the park and to see many of the birds, hippos, forest buffalo, and elephants in and about the water's edge.

We stayed just outside the park's lodge in a cottage so we could all be together – costing about 80 US dollars for the group of five people. It served our needs well and we hired a guide for this morning's drive through the park. Yes, we saw a variety of animals, but the highlight was the lion who was not to bothered by our presence. After a short time the lion decided to feed on a very large hippo that was killed a short distance away. The guide was surprised because it appeared that the hippo was dead for a couple of days and lion's usually feed on only fresh kills, but certainly not this one! The guide said this was a first for him! I will not go into details about the hippo!!!

The ride back to Kampala was long. We dropped off Tom, our newly made friend that we brought along from our stay at the Poor Clair Monastery, in Mbarara and stretched our legs a bit. We referred to him as Tom "young" and my husband Tom as Tom "two"… not "old." The ride is not "bad" when you are with friends and there is ALWAYS something to see along the way. Off to doze for a few winks!  

Fixing something to eat after getting home was a challenge, but manageable with the help of our neighbor, Ritah. We ran out of gas for cooking this past Thursday night and have not had time to refill the tank. That will be resolved tomorrow! But we are always up for a surprise challenge, and as Rose says, "Things work out with team work!" We do not go hungry.

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Evening!
Evening!
May 16, 2016

I know I wrote earlier in "my day," but wanted to drop a quick message before going to bed. I thought some of you may be interest in knowing Tom and I (and Rose and Dianah) are spending the night at a Poor Clares Monastery! True to PCAU style, we often stay at communities/ organizations that rent rooms as income generating efforts. It is a way of showing our support!

The one and only Sister that we saw, the Sister hosting us, was so friendly. She invited us to tea along with a young man who is doing an internship with the hospice program in Mbarara. He is a doctor from England who we ended up inviting to join us on our journey to Queen Elizabeth National Park tomorrow. The snacks that were served with the tea were a variety of treats made from the scraps of what they make the hosts from for Catholic Masses. Interesting!!!

Coming to Mbarara is a very familiar place to me, and we also got to visit our friend, Martha, who works at the hospice. She and Rose have been friends for, as they would describe, "forever." A lovely lady!

Our surroundings are quiet!  :)  and I anticipate a good nights sleep!

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Traveling
Traveling

Yesterday morning (Sunday) we went to the Conference Center to say good-bye to the children. They were at breakfast and packed up for their travels home. Some will spend the entire day on buses. Each child received a bag of food to take home for their family. They were a bit heavy, but even the smallest said they would manage… of course, with the help of an older child. They are so wonderful to each other and have become friends despite the distances that separate them during the year.

By mid-morning Rose, Dianah, Tom and I were on our way to Kabale to combine some business with pleasure. The country is so beautiful, the roads at times challenging, but I find that over the years I have been coming, are improving in areas. Our destination was Lake Bunyonyi, the second largest lake in Uganda with 20 islands. It was dark when we arrived at Lake Bunyonyi Resort Lodge. The person in charge insisted we stay in cottages and allowed the driver a room at no charge. Only in Uganda!!! We ordered our food and when it was delivered we ate outside Rose's cottage by the light of a very bright moon. We felt relaxed and peaceful! This morning we took a boat ride on the lake around several islands, stopped at one to walk around and ended up at the market off the lake… a very active scene!

We are now preparing to leave to go to a Regional Referral Hospital to visit staff and discuss the progress of their palliative care program. We are looking forward to seeing Marcus, who had taken part in the M-Health training, and interacting with the administration. From there we will go back to Mbarara (passed through there yesterday) to spend the night and head to Queen Elizabeth National Park in the morning.

I do hope to download some pictures from my camera at our next stop to send on to you.

Thinking of you and so wish I could adequately share these experiences of friends, people, culture, food, country, and beauty with ALL of you. Words fail!

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Camp!!!
Camp!!!
May 14, 2016

Today's camp has ended… and I have to say, this will be extremely short. I am indeed tired and we just arrived home!

Each child is precious and has their own story… sad, but also with joys and dreams. They were very quiet at first, but became so outgoing as the day progressed. They are such good children and very respectful. They laughed a lot and interacted with each other in many positive ways.

There is so much to say, but I will end for tonight. We will see the children off in the morning. Some will begin their long journeys by 8:00 A.M. Rose, Dianah, Tom and I hope to also be on the road by 10:00 to head west! We have to pack.

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Chaos!
Chaos!
May 12, 2016

Both of my trips to Uganda this year have been under tight security from the police and military, intimidation of the people and total disruption of everyday life. Back in February/March it was because of the election of Yower Museveni to his fifth term of office. The elections were seen as controversial and corrupt. His strong opposition, Kissa Besigye, was placed under house arrest and all the ballots destroyed before any recount could be accomplished. During this visit (today) President Museveni is being sworn into office. He wants the world to see (and think) that everything is peaceful. He has orchestrated limited access to Kampala by closing roads and having military check points and diversion of traffic. Tanks of tear gas are plentiful. If you know Uganda, diverting traffic means dirt/muddy roads that take you into villages and back roads… and often longs distances out of your way or going nowhere at all.

PCAU is off Entebbe Road, the main road from the airport and government offices (which are near the airport) going into Kampala. For the past two days fast moving motorcades led by motorcycles/police cars and sirens have been continuously up and down the road bringing officials and invited guests into Kampala. A truck or two filled with the military are usually at the end along with an ambulance. Yesterday Entebbe Road was closed to all traffic near the village into Kampala. The same was done to other main roads.

The interesting thing is that Musivine's opposition, Besigye, was sworn into the office of Presidency yesterday at a surprise event. He was under house arrest and his home was under heavy security by Musivine – it is not known how he got out unnoticed and to Kampala. I imagine the "security" are a bit nervous as to what failed on their part. Besigye was again arrested after being sworn in and his supporters were dispersed by tear gas in Kampala.

These are interesting times in Uganda. Some feel they are now a country with two presidents! Of course, not thinking this morning, I wore a blue skirt/white top and my jean jacket to the office and realized after arriving the colors of the opposition are blue and white. I hope I do not meet toooooo many Musivine supporters!!!

There is training going on at the PCAU offices today to expand the M Health Program in Uganda to other areas of the country. The M Health program tracks the distribution of morphine with the use of special mobile phones. The pilot program was successful and the information received is helpful to PCAU and the country as a whole. Two Notre Dame students, Katie and Yutong, are leading the training and will be here for weeks to follow up and provide added support to the new users of M Health at their area palliative care centers. Center for Hospice Care's interactions and collaborations with Notre Dame have been so beneficial to PACU in establishing programs and research projects. It is all about partnerships!

Tom and I met the individuals who have come for training during a morning gathering for prayer and updates. As in the past, some of the new nurses/clinical officers who showed up were people I met during their studies to become prescribers whose added education was made possible through the funding provided by Center for Hospice Care. They are becoming leaders in palliative care.

We joined another meeting with staff to finalize all the plans for this weekend's camp and received our designated "jobs." Tom's primary role is the photographer – being sure sure to take pictures of the individual children for their sponsors as well as a group photo. I will have some prayers and lighting of a candle for Deogratius*, and be available to interact with the children and assist with games. We will both be at the conference center to receive the children as they arrive, provide some activities, and to see them off on Sunday. It is a busy time.

We hope you are all doing well. In the U.S. and here in Uganda we are both dealing with "political issues," but life goes on and things get done with determination and commitment.

* For more information on Deogratius, please read the Blog Entry entitled Unfortunate Update

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Rainy Season!
Rainy Season!
May 10, 2016

It is indeed the rainy season in Uganda! The roads were very wet and muddy when we arrived and after last night's all-night rain, there was nothing but red mud and red water everywhere. I can not imagine how people got to work this morning. By the time Jaffer and Rashida picked us up the rain had let up, but it took them one hour to come from the PCAU office to the village. Those of you who have been to Uganda know that trip is usually 10 to 15 minutes!!! We all have great faith in our drivers, and Jaffer is an expert. It was Tom's first time to really experience "the jams" – boda-boda's darting in and out on the slippery roads, seeing cars and taxis off the road, and how terribly close cars, trucks and taxis pass each other on narrow roads.

We were well received at Annet's school. It is so inspiring to see the children with a wide variety of disabilities in the boarding school for only special needs children. We spoke with her teacher and saw her classroom. They are focusing on her activities of daily living, but have hopes for her future development. She appears to be well cared for and was smiling much of the time. Since it was so close to the end of this school term, they allowed her to go with us for school break and take her to her "granny's." There was no problem getting her into the car since she immediately headed to it. She loves car rides!

Her arrival home was a surprise. I wish you could have seen the welcome she received from the other children cared for by granny, and there was no holding Annet back when granny appeared at the door. I have never seen her smile so bright… and granny was priceless in receiving her home. Granny could not be more thankful for the opportunity the Road to Hope is providing for Annet's training and education. Her thanks was unbounded!!!

The afternoon was full of sunshine and we are hopeful the rains will give the earth some time to soak up some of the standing water. We cooked our meal and then Dianah came down to help me cut up a pineapple and show me how to make fresh pineapple juice. I am always learning something. 

As always… the days are busy and visitors to our home many!

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Arrived!
Arrived!
May 9, 2016

YES, we arrived safely last night. It was a challenge getting all of our suitcases in the limo that took us to Chicago, because there were five of us flying to Uganda – Rose and Mark (PCAU Program Coordinator), an ND student intern spending the summer working on a project, Tom and I. 

The first day is always a "slower" day after the long flight, but also an active day unpacking and trying to get settled in. It is wonderful to have Tom with me and I am so anxious for him to meet people and have experiences.

We took some time to walk around parts of the village and spent some time at the school across the road from "my home." The children were taking exams before their semester break, but the Head Mistress called them all together for an assembly to have Tom tell them about school in South Bend, ask them some questions from the 4th grade students at McKinley Elementary, and then had them ask questions. The class size at Mary Kevin School averages about 50 children to a class, but the second grade tops them all with 100 students in the class. Averages for other schools is around 70 plus. They begin class at 8:00 in the morning and go until 5:00 in the evening. The children were so delightful, respectful and attentive. Their English was clear and they did not have trouble picking up Tom's accent. We had a hard time leaving. Tom was moved by the sparseness of the classrooms and that fact that they have no computers… something the children asked about U.S. schools.

This evening we got a few things at the market and met two ND student interns for dinner. We had good conversation! They are looking forward to working together on the M-Health Project and PCAU is always welcoming and willing to venture into new areas to advance palliative care.

It is getting late and we will be on the road tomorrow to visit the Road to Hope child, Annet, with special needs. I was part of taking her to boarding school earlier this year and it will be good to hear of her adjustment and progress. She will be at the Road to Hope children's camp this weekend. One of the PCAU staff members has volunteered to pick her up and be with her one-on-one. This is an example of the involvement and dedication of the PCAU staff.

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Unfortunate Update
Unfortunate Update
May 2, 2016

It has been awhile since I have been back home from Uganda. Tom and I are getting very close to leaving for Uganda and I am anticipating the joy of introducing him to my friends, the work of the partnership and the beauty of the country.

During my last visit I spoke often of a child I met in the Road to Hope program. Deogratius, who was anxious to return to school, but was also very sick with a new diagnosis of TB, complicated with his being born with AIDS. His father was dead and his mother blind, depending on the child for her everyday needs. Her reliance on Deogratius often interfered with his consistent treatments/care. We received word last evening the Deogratius died. We ask that you keep his mother, the PCAU staff, and the person who sponsored him in your prayers. 

Deogratius was a delightful child with a bright smile. He was caring and attentive to his mother and enjoyed music. He will be remembered by those of us who met him and many who never met him.

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Half Way Home!
March 21, 2016

I am half way home – waiting for my flight from Amsterdam to Chicago. The flight from Entebbe was on time, but it's about a 5 hour layover here in Amsterdam.

My time in Uganda went by fast and there is always work to be accomplished. I take away so much, besides the suitcases filled with craft items for Hospice Foundation's silent auction for PCAU. The experience is always difficult to put into words! I feel so much a part of the PCAU team and the work they are doing bringing palliative care to all of Uganda. They are welcoming, accepting and flexible, and anyone volunteering has to be prepared to be called on for almost anything.

I thought of my friends at the funeral home this past Friday as I was going home down Entebbe Road from giving the closing remarks at a palliative care training. A boda-boda passed by our car with an adult size, white, wooden casket strapped to the back. I only wish I would have had my camera out for a picture. You see everything on those boda-bodas!!!

Palm Sunday at Saint Joseph's Church in the village was a joyous service. We waved our palms for about 25 minutes as the priest struggled to get through the crowds of people in and outside of the church. It sounded like a wind storm, but no breeze was created! Plastic chairs are added to the ends of the pews and there are benches along the walls… so it is a FULL church with the overflow outside. Getting in the church is a challenge and takes a lot of pushing and inching forward as people leave from the previous service. I usually manage a seat on a bench… .and it is a squeeze! 

Rose and Mark will be coming to South Bend next month and are looking forward to some profitable and busy days with the Center for Hospice Care. This will be Mark's (Program Coordinator) first trip to the United States. He is so looking forward to the trip and is grateful he was able to get a travel visa. 

I look forward to seeing you, if you live in and around "the Bend." If not, I hope to be in touch with you.

As always, your interest and support of our partnership is always appreciated, and your friendships valued! Thank you!

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The Home Stretch!
The Home Stretch!
March 18, 2016

Yesterday was my last full day in the office. I said my good-byes to staff, but they refused to think that I would not come by at the end of today to see them. That is something I can't promise.

The staff are all going off in different directions this morning. Rose set off early to travel to Mbarara to accept land from a Rotarian and Mark is already there for the afternoon burial of his grandmother. Other Rotarians will join Rose, and they will have some "festivities" in the evening. Ugandans love to celebrate anything!!!

Some staff are going to the National Medical Store to discuss morphine issues with their staff and provide education. As for me(?)… I am traveling with a driver to Makerere University to close a workshop that has been going on these past four days to sensitize Para-legals on palliative care and how they can use their skills and knowledge to assist patients and families. I hope to be finished by 2:00?! – and then run some errands and get home. Friday traffic jams may play a role in the travel!

It's raining this morning. I love to listen to the rain on my tin roof. As you can guess, rain is always welcomed, but the down side is the mud!

My messages are coming to an end. I appreciate all your interest in PCAU – it's mission and work, the staff and their commitment, and the needs of a country where people struggle in so many ways, but still cope and face each day with enthusiasm and joy and determination. Be assured our partnership with the Center for Hospice Care is stronger than ever and the staff depends not just on the financial support but from the emotional and spiritual support that comes with sharing and friendships developed over the years. I take away a continued sense of gratefulness to represent our partnership and for the lessons that are taught to me along the way. I am humbled and fortunate and thankful!.

Thinking of you and packing up!

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Busy Days and an Unexpected Visitor!
Busy Days and an Unexpected Visitor!

Days in the office and programs offered in the community continue to make any day a very busy one for PCAU. Since PCAU has become so well known in Uganda and so many groups depend on their support and involvement, attendance/participation is essential at various meetings and workshops.

The Ministry of Health told Rose on Monday that they wanted PCAU to present a workshop on Thursday for the Narcotic Officers to better inform them about palliative care, explain the role of the prescribers and to set some policies for obtaining morphine. What a short notice!!! Luckily PCAU was notified yesterday that the meeting would be postponed till Monday because the Ministry had not yet drafted a letter to the officers. A few extra days for preparation was appreciated!!!

Friday is a meeting with the National Health Stores to work with their staff on processing the morphine requests from hospitals/clinics in a more timely manner and ease the delays. Education by PCAU in Uganda is ongoing!!!!

Rose is going to Mbarara on Friday to accept some land from a member of the Rotarian Group in that area. They envision eventually establishing a Training Center in that area for palliative care. They want to be a more active group with responding to issues of comfort care.

These are only a few of the "activities." Every day has its surprises and never without some challenges in a country with so many needs. The staff here is so dedicated and work long hours. I say this every visit!

Mark, PCAU Program Coordinator, notified us this morning that his grandmother has died. He was out of the office yesterday with her in the hospital in Nasambia. They will take her body to Mbarara for burial. Please keep him and his family in your prayers.

Stephen Kasula just came by the office to see me. He traveled this morning to say HELLO and visit for awhile. He is a former student that the Road to Hope program sponsored to become a Clinical Officer. He is working in a small clinic near his village while he applies for other government positions, which are difficult to obtain. He is so thankful for his education and stated he "trusts in God" that something will come his way in the near future. In the mean time, he told us some stories of individuals he has treated and a smile comes to his face when he speaks. He enjoys his work and is a good example of children having dreams that do come true with determination.

I have good news to share – and this is to tell you that the sick child, Deogratius, arrived at Mildmay Hospital Monday night. We are thankful! Rashida and I visited him yesterday. He was so sad to be in the hospital, but he is getting treatment. His mother is with him.....and since Mildmay has a holistic approach, they will get some social work intervention and counseling.

There is a slight breeze coming in through the office windows this morning. It is being enjoyed by all of us!

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Beginning of My Last Week!
Beginning of My Last Week!
March 14, 2016

This is the beginning of my last week in Uganda! I am working from home today – and it is very peaceful, except for Danella and Drake at my door wanting me to "play." I have given them a coloring book and crayons!

The PCAU car was going to be going in many directions today and I felt it best to illiminate one body from all the "action." I will catch up at the end of the day! I could have walked to the end of the village to catch a taxi to the office, but I have things to keep me busy here in my home – and I decided not to be part of all the "run around and waiting." All is well for me!

I have sent a few pictures from yesterday, Sunday. Ritah and I had some visitors in the early afternoon and then Rose's neighbor invited me to vist. My "namesake" was visiting! She is 1 1/2 years old now and growing very tall. She was more shy than last year, but warmed up
as the visit went on. A lot children her age are afraid of "white skin!"

Looking froward to seeing you soon!

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Wrapping Up a Busy Week!
Wrapping Up a Busy Week!
March 12, 2016

We arrived back in Kajjansi Friday night after a very full day. I took care of some things with the Road to Hope children in the area and accomplished some shopping, while Rose helped give some new energy and direction to the Board Members of Rays of Hope Hospice, Jinja.

Our plans to bring Deogratius to Mildmay Hospital did not materialize because the mother had the child take her to town in an attempt to sell some of her CDs, and locating them was not possible. We will continue our efforts!!!

I also realized today that I keep mentioning that I would be back in South Bend next Sunday, but Tom reminded me that I do not fly out until Sunday, arriving Monday!

Today, Saturday, was a slower paced day… or catch up day to clean and do laundry! Harriet from PCAU, visited this evening and we had an enjoyable time together. We have both been at opposite ends of the country and have not seen much of each other!

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A Stop in Jinja Before Heading Home
A Stop in Jinja Before Heading Home
March 10, 2016

We left Tororo by mid afternoon and have arrived in Jinja. The conference/workshop for the Spiritual Leaders was truly a success. I wish you could have experienced the enthusiasm and energy from the group. We had full attendance for all 4 days and a mix of Catholics, Anglicans, Muslims, Born Agains, and Protestants. They hope to continue to meet in the near future. Many became PCAU members and a good number were "sporting" PCAU t-shits and caps on the final day.

We were turned away by the Franciscan Sisters when we arrived in Jinja. We usually stay at their large convent. They rent rooms for generating income, but I feel they didn't want to do business after 5:00?! Rays of Hope Hospice called their driver to take us to a place he knew of that would be adequate and clean – and inexpensive. It's called Lucky Guest House!!!!!  :)  Unfortunately, no fan this time.

Tomorrow, Rose is going to lead in some training for the Hospice Board Members. The hospice has a new coordinator and they are restructuring with the vision to strengthen as a hospice program and team. I'm going off with the driver to take care of some issues regarding a couple Road to Hope children. Wish me luck as I deal with matrons and headmasters!!! This will be a first for me – without Rose. Our hope is to use our time efficiently in order to head back to Kampala/Kajjansi by late afternoon. It will be good to get home!

As for the sick child I spoke of last week… we were finally able to get a Health Worker from the area involved. He confirmed that the child is sick and malnourished. Rose spoke with the worker this evening and we will pay for the fuel for an ambulance to bring him to Mildmay tomorrow… at least that is the plan at this point.

As we traveled today, we were heading up a hill when a man in an adaptive wheelchair was making his way – full speed – down the hill, in the middle of the road, with traffic. I could hardly believe my eyes! Nothing stops these people!

I am aware that next week is my last week for this trip. I face that week with mixed emotions, because I have grown to love my family here, the people, the work of PCAU and the country. However, I do feel I will be ready!

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Conference & Visiting the Kenyan Border
Conference & Visiting the Kenyan Border
March 9, 2016

Our conference is going well. Four of us are coordinating these days and giving the presentations. My talk and discussion yesterday on communications went well. The participants are kind!!! They have been consistent in their attendance and participation.

I just completed my presentation on Spiritual Care. At the end, a clergy person from the group stood and invited all to clap once and then to raise their arms and shake their hands – giving me their hearts. It was a special moment! I will assist with some facilitation this afternoon, but otherwise I am finished for today. 

Yesterday was International Women's Day and a National Holiday for all Ugandans, except for our class! In the evening we (Rose, Dianah, and I) drove to the Kenyan border, but a late in the day rain "slowed down" the usual hectic activity at the border. We did park and after the rain let up we walked to the border. I thought of my friend Grace and felt close to her Kenyan family. Someday maybe I can cross and visit them!?

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Journey to Tororo
Journey to Tororo
March 7, 2016

I arrived last night in Tororo later than we expected. I wrote a brief note, but it disappeared in the sending, so I decided to unpack and went off to bed to wait until today.

We stopped in Jinja along the way and that is what delayed us. Dianah (Rose's daughter) had received a phone call from Lydia, one of the Road to Hope children, and she was having a difficult time adjusting to her new school. We felt we needed to spend some time with her to clarify her concerns and offer support. Lydia does not have much positive attention/contact with extended family so we are her main contact.

She was always so very shy, but has begin to open up – so her phone contact was significant. It is difficult to see a child in tears and looking so sad.  I do think she now knows we will be there for her. We are working with Rashida to respond to her concerns.

Our next stop was to visit Agrey at his new school, Holy Cross Lake View Secondary School. He is now in Senior 1 which is comparable to 8th grade in our country. He reported to school last week lacking a few necessary supplies. He needed 14 notebooks – one for each of his academic subjects. These subjects are all presented throughout the week. Our bags were heavy! It was good to see him smiling when he talked about school and stated he enjoys learning. His future seems bright!!!

Rose and I are staying at the Prime Hotel where the conference is taking place. We looked at a few places that would fit our budget, and Prime was willing to reduce their fees so we could stay. I was pleased because it was the only place that had a fan in the room.....and it is hotter here in Tororo than in Kampala. The fan was the deal maker for me! We are paying 50,000 shillings a night – about $18.00 US Dollars – breakfast included. Do not get me wrong, it is a nice training spot!!! And we could not be more pleased.

We have about 25 Spiritual Leaders present and they seem enthusiastic. They asked everyone to use simple language… so I should be okay!  :)  I did the introductory session first thing this morning and elicited their expectations for the next four days. They do not fear speaking up!

I will try to send some pictures of the children later on!

I hope your week is off to a good start. Tom keeps me informed on local/sports news and also politics!!! The political issues here are still being debated!!!

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Update on DeoGratius
Update on DeoGratius
March 4, 2016

It is the end of the work week, and one thing is the same all over – everyone looks forward to the weekend.

I am at a meeting and it is "break time." 

I have attempted to send pictures, but they have all bounced back. It may be my computer or the internet… or me! I will continue to try later on, but they may have to wait until I get home. Just know I am not forgetting your interest in pictures.

Some have asked about the sick child, DeoGratius. His health remains a concern to all of us. He was discharged from the hospital in less than 24 hours. We all felt he was not there long enough to receive good care. MildMay Hospital, close to PCAU (and the village where I stay) would like him to come there for evaluation and care. It specializes in pediatric care and we have identified a doctor to see him. The mother is a "bit difficult" and did not use the transport money we sent to bring him the following day or yesterday. She told Rashida, who has had numerous contacts with her, that she would come on Monday. We will see!

Rashida also contacted a Health Care Worker from their area who should be visiting the family today. I will try to keep up with Rashida even though I will be away from the office for awhile. If the mother does not report to MildMay on Monday, Rashida will attempt to visit them on Tuesday. We are also trying to illicit the assistance of the teacher at school. Continue to pray for him.

The meeting is about to continue. I will try to remain in contact, even with all the events and travel.

Thanks for your continued interest and caring.

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Busy Days Ahead!
Busy Days Ahead!
March 3, 2016

Today was the last day the team from Notre Dame spent at the office. Tomorrow those involved with the mHealth Initiative will meet at Hospice Africa Uganda along with the four nurses from different Districts using the phones to collect the data/statistics on the morphine flow in their areas. We are anxious to hear their input. It will be a full day! I am learning a lot!

I managed to get home from the office fairly independently today. Rose, I think, fears me being on my own "in traffic" and walking through all the "off roads" to my home. It must have something to do with my age!!!???  However, someone from work dropped me on Entebbe Road, stopped at an ATM machine and then walked to where I would turn up into the village. It had rained all morning and  the red dust was still red mud… .and I pictured in my mind the bumpy roads/mud puddles I would turn on to and decided to get a ride from a driver who was off Entebbe Road. I know where they gather! I bargained down his price and got home safe and sound and without mud all over myself.

Tomorrow late afternoon into the evening is a surprise party for one of Rose's very close friends, Fatia, (works at the African Palliative Care Association). Fatia just came back from Ireland after receiving her diploma in, I believe, Public Health – or something close to that!? I will attend after I do some shopping at a craft market where people gather only on Friday not far from where we will be meeting.

Saturday morning is a thanksgiving prayer gathering for Rose's dad. He has had some CA treatments and is thankful for the positive progress he has made over the past year. And Sunday, we leave for Tororo. So you can see the next few days are full!

Thinking of you and sending some heat your way

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Midweek Report
Midweek Report
March 2, 2016

I was suppose to meet with Rashida first thing this morning after prayer to review the children in the Road to Hope Program (44) and discuss the up coming weekend bereavement camp for the children in May. However, we received some news about three children that need immediate attention. Two of the children who have been caring for their mother are now grieving her death. The children were day students living in Hoima. There names are Douglas Muhohezi (9) and Karen Ahumuza (13). Please keep them in your prayers. A Health Care Worker in the area is trying to fine a relative who will take the children. PCAU has told the worker to assure the family that the RTH Program will continue to assist with any educational fees.

The other disturbing news is that when DeoGratius returned to school he became very ill at the end of the day and was rushed to the hospital. He was so wanting and eager to be in school!!!! It is felt that the medication he was started on is reacting in his system. Rose said being HIV+ and having TB is "tricky!" We need to be assured how he will be cared for in the hospital since his mom, his caregiver, has no sight. Patients are dependent on family while they are in the hospital for food, laundry and some added oversight. Once again we have to rely on a Health Care Worker and we need to find out who that is. The school notified us of his condition so we are working through the school to start. Please pray for him too – and that care can be obtained to meet his needs. Options are being explored.

A team arrived yesterday from Notre Dame University – Lacey, from the Institute for Global Health and Tom, from the Office of Information Technology. They will be giving further assistance to the mHealth Initiative begun last year by a student intern from the university. By using specialized phones, four sites in four different districts have been tracking the use of morphine – providers and services. Tom is working with a few staff to look at data collected, the PCAU computer systems, especially any IT concerns/problems. Lacey has overseen the placement and research of ND students and the continuation and growth of this initiative. Six more sites will be added this May. We are all excited about the results of this program and hope to reach all of Uganda. We will be meeting with the nurses on Friday who have been using the system to get their input and to illicit them as trainers for the additional six.

PCAU has a young man by the name of Peter who has been volunteering in the office two to three days a week to assist with computer problems. Tom (ND guest) talked with him yesterday and Tom said that that Peter is a very sharp young man and really "knows his stuff." Peter is completing his Master's Degree and Rose fears he will get employment elsewhere. Tom asked him to present at the IT Meetings to be a person to continue to assist the staff, and maybe help with the training of the use of the M Health phones with the new group of users. Volunteers are treated as members of the staff and are so useful to PCAU!

Rose, Lacey, Tom and I had a relaxing dinner together last night not far from the Village. For those familiar with the area, it was up by Quality Market! The cool evening was a nice relief from the hot afternoon.

I hope ALL who are interested are receiving these communications. Some bounce back, some seem to send okay. Sending messages is a problem to all of us at the office. I always trust you're understanding. As they say here, "It's Uganda!"

I am going into a meeting and will end here.

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District Update Meeting
District Update Meeting

I thought I would get this note written at the office today, but I thought wrong!

The day went by fast. I did have a meeting in the afternoon with the staff to tell them how positive the Center for Hospice Care feels about all they are doing and how we have all seen the program grow and develop. There is still much to do, but one step at a time is moving forward. The staff is strong and committed. I shared my goals for this visit and they are all helpful to me. I wish you all could meet these individuals!!! Some of the staff from CHC along with some friends know what I am saying since a few have had the opportunity to visit Uganda.

I was going to tell you about the District Update Meeting that was held at PCAU this past Friday. I am always happy to be here during one of the meetings which are held quarterly. As I have talked of in the past, PCAU members come from a wide variety of Districts throughout Uganda. Some were here as early as 6:00 A.M. due to traveling all night and were sleeping in the chairs that had been set up the night before. What dedication! There were 150 in attendance and the topic discussed was Services to Children. I was asked to talk about the children we took to school the day before and the special challenges we faced, especially with DeoGratias. At the end of the morning sessions, prior to lunch (around 1:30) it was decided by the group to continue to focus on the topic of children for the next District Meeting.

PCAU has been doing some outreach to people with special needs this past year, especially the deaf and blind. A deaf person attend the meeting along with a person to sign for him. Another sign of progress. The referral of the child for the Road to Hope with special needs came from the Uganda National Association of the Deaf.

Yes, I saw some friends at the meeting… people I met in the past, especially some of the students whose education to become a prescriber was sponsored by CHC. They continue to remember CHC and remain thankful for what was done to help them to deliver better services to patients and families. 

I had "visitors" as soon as I arrived back in the village this evening. That is the Ugandan way – welcoming and friendly!

Hope your days are good. Do know I think of you!

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Catching Up with an Old Friend
Catching Up with an Old Friend
February 28, 2016

It is Sunday and I was going to write to you about the PCAU update meeting that took place last Friday, but I think I will leave that until tomorrow when I am at work… since the meeting was work related!

Today I went to church with my neighbor Ritah and came home to be surprised by my friend Joel. He has not been around much in my part of the village since he is growing up and involved more at school. However, he learned that I arrived and made his way to the compound.

I gave him a few shillings and told him to buy some food for his family and then we walked to see his mom. We sat outside with his mom and some of his other brothers and a sister and looked at a few family pictures. His mom gave me a picture of herself dressed in a gomesi (traditional dress) so I could remember her when she was "dressed up looking nice." She does not speak much English, but Joel translated. A lot of other children gathered around and it was just a special time together. He walked me home and did a few chores for me – and promised to return.

Joel is now in P7 and is doing well in school. He playes football (soccer) and his school won the championship. He also showed me a picture of himself getting an award at school. He is a special young boy with a wonderful smile!

I ran some errands with Rose and then needed to use time to do laundry and some cooking. Let me just say, doing the cooking is not easy and my selections are very limited!!! The village does not lack for people dropping by and there is much activity. It is best not to have a planned day!

The day has gone by so quickly and I am looking forward to going to bed… but it is still early!

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Long, Busy Days
Long, Busy Days
February 26, 2016
The days have been very busy, the internet very slow, and access to working computers very frustrating. I am using Dianah's tonight and hopefully it will not die before I complete my message.
 
I will limit myself to telling you about my day yesterday (Thursday) that began at 7:00 in the morning and ended when I was dropped off at my home close to 10:00PM. Anyone "on the road" knows what it is like to travel with the PCAU staff. We just keep going from one thing to another until the job is completed. 
 
I had told you Rashida and I, along with Jaffer the driver, were going to take two children to their schools. Our first stop was to pick up Annet, a special needs child, who is a deaf mute with epilepsy. She is 10 years old and lives with her "grandmother." The "grandmother" is really the former landlord of her parents who abandoned Annet as a very young child when they discovered she has special needs. Granny is up in years, husband is deceased, raises the children of her three children who died (2 others still alive), and is paralyzed on one side due to a stroke. All in the living situation are very loving and caring of Annet; even the very young help with her needs. It is apparent Annet loves her granny. Granny felt she was limited in really helping Annet reach her fullest potential and could not afford to put her in a special needs school, which are extremely rare in Uganda. 
 
The special needs boarding school cares for only children with special needs and the staff seems attentive. I am so impressed that Rashida had explored many options to find this school that stressed to us they sometimes fail to accept children that come to them through organizations/placement agencies because they fear the children will just be left behind. It was helpful that granny was with us. It took awhile for us to check her into the school, see the nurse, and settle Annet into the the dormitory. Annet was inquisitive, smiling and interactive with all of us – a delight. She particularly liked my glasses and I am happy to report they are still in one piece after being snatched several times. The girl is fast! It was difficult to leave her behind and her tears came when granny got into the car and Annet was left behind. We trust she will adjust and learn some helpful skills.
 
After dropping granny off we set out to reintroduce DeoGratias (age 13) to a school he had attended, but dropped out of due to lack of school fees. His father abandoned he and his mother and has since died. DeoGratias provides care for his mother who is blind. They could no longer pay for housing and lived wherever they could find someone to take them in until the community built some housing for individuals who are blind. Each person/family has one dark room, off a long dark hallway, with one small window. There is a common outside cooking area. 
 
His story is sad and one that concerns us. There is no steady income and they will often go to churches on Sunday to sing with the hope of getting a few coins to sustain them during the week. He said if there is no food they just try to sleep to not be hungry. The one thing that Rashida noticed immediately is that DeoGratias had lost a lot of weight since she last visited the family. We learned that besides being HIV positive (as is his mother), he was recently diagnosed with TB and is malnourished. The boy is 13 and weighs 20 kilograms. They had no medicines for him and the mother said he is not eating. We took them to a clinic after visiting the school but the clinic informed us after trying to contact doctors, talking with the mother, weighing him, etc. they did have have the drugs he needed. He would have to go to a clinic an hour plus away. We had gotten them food and left them with money for transport to the clinic for today. We pray the mother used the money for that purpose. So much has to be left in God's hands. 
 
I do want to mention that the school, where DeoGratias will be a day student, welcomed him back. They said he was a student who worked hard, was very friendly, and goes out of his way to greet people. His smile would warm your heart!
 
Sometimes we can't do everything for all situations, but we trust what we do will ease some situations, bring about a little comfort and show others they have not been forgotten.....and that we do care. The family who sponsors DeoGratias sent a backpack for me to give to him that was well supplied for school. His face brightened with surprise and pride! They also sent a few pictures of their family and a small map showing where they live and where he lives. He said he wants to carry the pictures with him all the time to remember them – people he will probably never meet, but he knows cares for him..
 
Today was a District Meeting and I will not go into it for this mailing. I have gone on long enough. I will try to send pictures tomorrow… if I am able to use my computer, which I have not been able to do from the village as of now!!!!!
 
Keep the country in your prayers. There are pockets of disruption in other parts. It is calm here, but many wonder if it is the "calm before a storm."
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Change of Plans
Change of Plans
February 24, 2016

Yesterday, Tuesday, went by fast and not much was accomplished. Rose and I went into town – for me it was to get money and for Rose it was to pick up her driver's license. It seemed very simple, except for the traffic. What would communication from me be without stories of traffic jams?! I remember them well from past trips, but experiencing them again and again always makes them real!!! It's good that Rose and I enjoy being together and can "take care of some business" on the road.

Oh yes, the police and military are still present. Much of their presence is just part of being in Uganda. They are always around, but this time it's much more intense and they are well armed. The military with machine guns have belts of bullets around their neck and others carry clubs. They look serious!!!! – and with the addition of bullet proof vests… they look very HOT in the Ugandan sun.

One thing I have not seen before are the blue trucks in the streets that look like tanks. They are full of tear gas in case of a disturbance. As Rose says, "If the city becomes disorganized!" They have rotating sprayers on top! With all of this I do feel very safe, and we are using good judgment.

The children are all returning to school this week. The beginning of the school year (usually the beginning of February) was delayed because of the elections and the fear people had for the children. They are all excited and are out and about getting supplies and uniforms. 

Those who follow my stories of George, the first child in our Road to Hope Program, will he happy to know that he arrived at his school, by himself, appearing rather dirty and unkempt, but, was an "early arrival" and has already settled in. I do believe it shows that school is meaningful to George! The matron of the school, who keeps a "special eye on George," called Rose to "report" on him.

I was supposed to go with Jaffer and Rashida (Road to Hope Coordinator) today to take two of our other children in the RTH to their schools. One is a special needs child who will be going to a school we hope will meet some of her needs. The other is a boy who cares for his blind mother. He is a day student but we want to introduce him to the teachers to be sure they have an understanding of his situation. However, yesterday afternoon the president, Yoweri Museveni, declared today a Public Holiday to honor his re-election. He sure disrupted things!!! Our trip will take place tomorrow! I am looking forward to the journey and meeting these children. Both are new to the program.

This is not much of an enjoyable "public holiday." People are in the state of trying to adjust to 5 more years with Museveni and are not in the mood for celebration – and Ugandans use every opportunity to celebrate! The streets around here look like "business as usual." Very few are taking "holiday!"

PCAU is now down to one transport car so staff is having to do tighter planning for travel and accomplishing business. This is certainly a country where people have to make adjustments.....and know they do not have all the conveniences. When necessary, public taxis can be used by staff, but try to imagine how much longer that takes, and it is always hard to describe the "public taxis" that hold up to 14 plus people.

I am sure I will have some stories after my travels tomorrow with the children. We hope this school year will be a good educational experience for ALL of them.

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Computer is Working!!!
Computer is Working!!!
February 22, 2016

I decided to take advantage of my computer being up and running from the PCAU office. I do admit (as many know) that my IT skills are limited. I know, there is always room for learning. I will remain positive!

Dear Family and Friends,

I decided to take advantage of my computer being up and running from the PCAU office. I do admit (as many know) that my IT skills are limited. I know, there is always room for learning. I will remain positive! But I have to admit that more skilled people at the office had to spend some time trying to connect me to the PCAU network. I will try to connect this evening from my home in the village from a new phone that I am using from the Center for Hospice Care. I am wishing my friends Cyndy and Jim were here to guide me!!!!!!

This along with not being able access money from the ATM machines are my biggest challenges right now.

Things politically are quiet where we are located! I do hear the sirens going up and down Entebbe Road – some are trucks filled with the military. Rose said there would possibly be trouble in Kampala today because the opposition was going to try to nullify the elections, but the reelected President would probably put people under house arrest. I have to admit, I am not following that scene online and no one at the office is talking of "troubles occurring in town." We are praying all will be peaceful!

I don't want to get toooooo wordy on the political scene, because I'm "the visitor." What I do know is that the staff arrived back at the office this morning. They had all been away exercising their right to vote in their own Districts. It was good to see them and reconnect. There is a new staff member who started today to coordinate the morphine flow throughout Uganda. The person in that role moved on to another job elsewhere.

For those of you who "journeyed" with me these past years, I can tell you that Danella and Drake (my neighbor's) have grown. Danella is speaking more English and for Drake, he is still into everything once he enters my home! 

My big joy was meeting Ritah's son (now about 2 months old). Ritah is a co-worker at PCAU and neighbor. He is healthy and very alert when he's awake.....and not yet afraid of someone with white skin! Gabrial is extra special to me because I was asked to name him and to be his "grandmother." So now I have a child named after me and a child I have named. How special is that?????

I will definitely try to have some pictures of the children by the end of the week.

I will be traveling to Tororo (east) on Sunday to participate in a three day workshop for religious leaders. I have three talks to prepare so I'd better get to work!

We all ask for prayers for the country and that peace is maintained.

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Arrived
Arrived
February 21, 2016

I fell like I traveled from home to "home." I am really getting use to coming to Uganda and like I always say… It is coming home!

Dear Family and Friends,

I feel like I traveled from home to "home." I am really getting used to coming to Uganda and like I always say… It is coming home!

My flights went well although we were one hour late leaving Chicago. After boarding we were told there was "technical difficulty"… something nobody likes to hear before a flight. A bit later we were told it was a problem with the air conditioning and we felt a lot better! Other than that it was smooth flying.

The difference this time in coming to Uganda is the political situation. The incumbent won, but to the dissatisfaction of many, especially the younger element. The election results were announced yesterday afternoon and everyone was encouraged – and remain encouraged – to stay close to home. ALL areas are heavily guarded and patrolled. 

My village was like a ghost town driving in last night. No one was out and the small stores were closed. There is more activity today and my guess is that will increase by tomorrow. The government is trying to maintain peace, but… All social media for the country is still unavailable.

I am sure there will be more.

This is a quick note. Rose is on her way to pick me up! I am good!!!!!

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