The fall of 2008 found me in northern Uganda on a mission with Doctors Without Borders. Northern Uganda has experienced extreme disruption for two decades because of the activity of the Lords Resistance Army. Northern Ugandans have felt physical and emotional insecurity, and have lived for two generations in large refugee camps. These camps involve thousands of people living in mud huts with communal water and latrines.
In this setting, there had been an outbreak of hepatitis E, a waterborne infection that was spreading through all the camps in northern Uganda. Doctors Without Borders quickly initiated a program that involved medical care, water, sanitation and community education.
I was sent as the hepatitis E doctor to the district hospital and the community health clinics farther away. It was a small project with only four of us in the field: myself, a Norwegian doctor who managed the hospital, an American nurse who supervised the nursing and pharmacy activities for the hospital, and a German nurse who managed the recruitment and training of community workers.
It was hard being away from home that fall. Autumn is my favorite time of year with the cooler weather, beautiful leaves, my birthday and the birthdays of other family members, Halloween and, of course, Thanksgiving. The American nurse and I were plotting to have a real American-style Thanksgiving, telling our cook to be on the lookout for a turkey. Of course, the actual day would be like any other day in the field, but we planned to hold our feast on the weekend.
I was struggling to maintain a positive attitude when both the American nurse and the Norwegian doctor left within a week of each other at the end of October. Into November, fighting bitterness was a daily task, and I didn't always succeed. I missed my American colleague.
So Thanksgiving arrived without any fanfare. There were no grocery store freezers full of turkeys, no cherubic school kids dressed as pilgrims or Indians, no football. As far as I knew, I was the only one in a 100-mile radius who even knew it was Thanksgiving back in the states.
I determined that I would salvage the day for myself. Though it felt risky because I wasn't sure how it would be received, I decided that I would let all our national staff, the 50 or so Ugandans who were our nurses, lab techs, counselors and community workers, know about the holiday and include them in what for many of us is a ritual -- going around the table to say what we're thankful for.
We met each weekday for a morning report. We sat in the stark, unadorned concrete foyer of our hospital on wooden benches while we reviewed who had been admitted the night before, whether there were any deaths or deliveries, and whether there were any security threats. The meeting was often a tedious recitation; something to be tolerated before we got down to the work of the day.
I waited until all the business of the morning had been done, and then I asked if I could tell them about American Thanksgiving. Recall that the fall of 2008 was the presidential campaign of Barack Obama and America, which already had great cache in Africa, took on even greater prestige. They were eager to hear about anything American.
I gave them a brief history of Thanksgiving and then told them that many families went around the dining table and mentioned something for which they were thankful. I started off, to give them an idea, by saying something fairly predictable about family and health.
Our Ugandan staffers were deeply spiritual people, and they warmed immediately to the task. One by one, they spoke of gratitude, but theirs were not perfunctory blessings. They spoke of how they were grateful that no one on our team had died from hepatitis E. Until then, it hadn't even occurred to me that they felt vulnerable since I arrived as the epidemic was waning.
They talked about their gratitude that there had been no violence recently, that they had jobs and important work to do. Instead of being awkward, as I feared, it was a time of warmth and intimacy. Each one spoke easily, and many with great eloquence.
I was humbled by their grace and depth. They all agreed that Thanksgiving sounded like a fine idea, and they hoped Uganda might adopt something similar one day. For me, Thanksgiving had been reclaimed, though there'd be no turkey, sweet potatoes or football.
Carolyn Thiedke, is a family physician who lives on Sullivan's island with her husband.