Beginnings: Haileybury, Ontario, Canada, 1987

In January 1987, the phone rang at four in the morning. I stumbled out of the bedroom to answer it, my heart beating rapidly. A crisp European voice asked, “Is Dr. Roedde there? The doctor who taught at the Liverpool School of Tropical Medicine in England last year? That’s how I got your name.”

The frantic pounding of my heart slowed. Thank God it wasn’t an emergency.

“I’m calling from Geneva. Rosemary McMahon at Liverpool thought you might be interested in this job in Uganda. Could you be ready to go in two weeks?”

I was still struggling to wake up. “Yes, this is Dr. Roedde,” I said sleepily. “Uganda?” I was dimly aware that in Uganda the civil war was just ending and the country was plagued by HIV/AIDS.

“It will be a tough assignment. I am Katja Janovsky. I’ve been working there for years with AMREF [African Medical Research Foundation] before coming to the World Health Organization [WHO]. Whole villages are dying of AIDS, thin, wasted people struggling to keep on living. But they’re luckier than those who have died in the wars. There are fields that are still full of bones where Idi Amin has thrown the bodies of his enemies. I want you to be prepared.”

I collected myself. I was awake now. Almost. With one hand on the phone, I stretched over to add grounds to the automatic coffee maker with the other and switched the pot on, trying to focus.

Katja explained. “I’m building a team for German Technical Assistance [GTZ, now GIZ]. We’re going to help plan a primary health-care project in two poor, remote districts — Kabarole and Bundibugyo in western Uganda.”

Even half asleep I knew that primary health care was the most basic level of health care and included immunization, mother-and-child health, nutrition, water and sanitation, and provision of essential drugs.

Katja continued. “GTZ wants to strengthen primary health care because it’s low cost and saves the most lives. There will be a little hospital strengthening just to back up the primary level, but the major focus is to be on the poor. Can you go twice?”

As the caffeine hit my system, I learned that Katja wanted me for two missions: first, for this German project that she would be coordinating, and then for an AMREF mission that I would conduct on my own.

Over our clear transatlantic line, Katja explained more about the assignments. “There will be a couple of months for you to go home between the two missions, each of which will be four weeks long. The AMREF job is to strengthen the training for several different cadres of primary health staff, work you’ve already been doing in Liverpool. I know you’ve worked in Canada’s own developing world training Indigenous health workers and have had students from Africa, Asia, and the South Pacific at Liverpool. But isn’t it time you take this opportunity to work in the same conditions as your Liverpool students?”

Eager, I answered, “Yes,” but I tried not to let my nervousness show in my voice. “Katja, these will be my first assignments in Africa.”

After I got off the phone and while my family continued to sleep, I wondered how I would actually undertake these challenging journeys and how I could juggle them with the responsibilities I had to my family and my northern Ontario patients where I served as a locum physician in the small towns of Haileybury, New Liskeard, Latchford, Cobalt, and Temagami. At the same time I tried to pull together the fragments I knew about Uganda, many learned from my father, a retired librarian who is currently an artist, or from my husband, Jim, a historian who could provide political commentary on probably every country in the world over his gourmet-cooked meals.

A week later, with a cursory knowledge of German and the aid of a dictionary, I picked my way through the German contract that had arrived by courier. It was a delicate and difficult task, but by then I was fully engaged and energized at the prospect of going to Africa, something I had long wanted to do. But my excitement didn’t dispel my anguish at leaving my family for so long. When my daughter, Anna, was nineteen months old, I had left her for three months to study in Liverpool. I cried every day and was devastated when I returned and discovered that she didn’t recognize me. Over the years, I knew my children, Anna and Alec, who were then respectively eight and five years old, had become used to parents with alternating travel schedules. After Alec was born, it was my turn to hold down the fort while Jim, who worked as an Indigenous land claims historian and travelled extensively to Indigenous communities throughout North America, moved to Toronto for several months for a Supreme Court land claim trial. And so, with Jim’s encouragement and reassurance that he could handle my absence by rearranging his schedule to work from home, and after a discussion with my children that Mum would be away for a little while, I knew I could go.

What I didn’t know was that answering Katja’s phone call that early morning would change the way I worked for the rest of my life.