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Saturday, September 30, 2006

Of Glory and Parenthood

(Friday 29 September)
Today several hundred people flocked into the gates of Christ School, parents, community leaders, siblings, graduates, all dressed festively, the atmosphere one of celebration.  It was our annual Parents’ Day, an open house to allow the community to come and see what is happening in the school.  When you consider that the average parent of a Christ School student has lived their entire life without electricity for so much as a light bulb . . .  you can imagine the polite awe which the computer lab inspires as confident students sit in front of a bank of laptop computers while the screens flash welcome messages in bright colors.  When you consider that the average family lives in a home whose walls are made of mud, furniture is limited to a bed and chair, there are no book shelves let alone books (unless they have one Bible) . . Then you can imagine how overwhelming the shelves of books in the library appear.  When you consider that almost none of the mothers and less than half of the fathers can understand let alone speak Uganda’s official language, English, . . . Then you can appreciate how impressed and proud the parents feel when their children give speeches in that difficult tongue.  When you realize that this is an almost completely unmechanized culture where all agriculture and building is done by hand, hoe, shovel and sweat . . . Then the computer programmable lego robots demonstrated by the technology club seem mysterious.  And that is how the day goes.  For the morning parents in groups of a dozen or so tour the school, peeking into the dorms to admire the neatly made beds and the luxury of mosquito nets, visiting the agricultural projects like the goats and rabbits being raised, shuffling through the labs to peer into microscopes or be shown the digestive system of a dissected live frog, chatting with each other and their children.  

Then about noon the ceremonies begin, a marathon of speeches, songs, dance, drama, poetry, and more speeches.    The dancing was the most fun—wild drumming, calling, traditional grass skirts and ankle bells and kitengis, bodies moving in unbelievable rhythm and energy, a reminder that underneath the veneer of the school uniform these students are still from a culture that is barely 50 years away from the introduction of clothes and a central legal system.  The dramas tend to be a bit like soap operas, quite long and involved and full of dubious characters.  Today’s featured just about every sin rampant in our society here, a complex story line in which every character was revealed to be corrupt or promiscuous or deceptive or violent.  But it culminated in a church service where each character repented, and subsequently the community was able to work together and move forward.  I really enjoyed it in spite of the length.  Christ School is a central piece of our team’s strategy and today was the kind of day when God allows us to glimpse the fruits of what He is accomplishing.  Kevin outlined many of the ‘ebeneezers’ in his speech:  250 students and 25 staff, a sprawling campus of classrooms, dorms, kitchen, dining hall, library, infirmary, of which about a quarter are new in the last year or so.  The top scores in the district on exams with no failures and 8 students qualifying for University scholarships.  The addition of 15 co-curricular clubs this year as diverse as cooking, drama, math, technology, agriculture, and crafts, giving students a fuller educational experience.

 Scott’s position as chairman of the Board of Governors meant he was slated to speak, and in his absence I was invited.   And I was glad to be invited.  As team leaders we are connected with the school administration, as a Bible study leader I feel connected with the teaching staff, as a sponsor of six Ugandan boys and mother of my own two boys I am a very involved parent.  I talked about the essence of parenthood being the giving of life, and how in God’s world giving life involves both sorrow and joy (John 16:21).  The parents before me I knew had sacrificed to have their children in school.  But the joy was before them today, and I read Isaiah 25 about the coming feast where death is conquered and the veil is lifted so that we live in God’s presence.  This day was a taste of that final party!  I ended with Heb 12:1,2, pointing to Jesus who brought life:   He suffered the cost, but He did it for the joy set before him.

Joy was set before us today, a glimpse of the Kingdom come.  And that joy was augmented by the community celebrating together.  

Friday, September 29, 2006

Back from Sudan

Michael and I barely scratched the surface of southern Sudan (SS). We spent one week in a town called Yei in order to attend a collaborative meeting of mission agencies dedicated to reaching SS. And though we didn’t venture a mile beyond the Yei’s edge, Sudan came to us. Missionaries, national pastors, evangelists, and theological students came from the far reaches of SS to meet, share, and pray. Sudan has been at war for nearly twenty years, north against south, Arab against black, and to some extent Muslim against Christian. Two million have died and four million displaced. But in January, 2005 a “Comprehensive Peace Agreement (CPA)” was signed, bringing to an end the longest armed conflict on the African continent. For the next five years, the people of Sudan will look toward the Referendum of 2011 when those of SS will vote on whether to secede from the northern Khartoum government. Until then there will be reconstruction, lobbying, persuading, arguing, and praying. In some ways this Transitional Period may be the final window into the Khartoum north. The door to the north and perhaps even the disputed border zone (Nuba mountains, Abyei, and Upper Nile) may close. So, there is a sense of urgency. Sudan makes Uganda seem like a very well developed, luxurious country. The heat is brutal, the infrastructure (roads, electricity, safe water) absent, government services (hospitals, schools) a distant memory. The learning curve is extremely steep. The geography of a half million square miles of territory, the unfamiliar tribal/language names, dozens of organizations with different personalities and histories, shifting government policies, …it’s dizzying. The bottom line…planting your feet on the moist soil, tearing at the tough goat meat while you listen to the accounts of the hardship and suffering of these tall dark people, and praying through their hopes and needs. Well, Sudan found its way into our hearts. We thank those who prayed for our trip. We hope that we will be taking another exploratory trip into Sudan in the coming months. We’ll keep you posted. (Picture above: Michael and I with our roommate at the conference, a Sudanese man working with a reconciliation ministry)

Monday, September 25, 2006

There were 29 in 12 beds . . .

And the little one said, scoot over (or in Lubwisi, mwesike ) to make room for one more.  

We’ve had to limit our internet use this month but when Scott is traveling he hopes to post some pictures of the pediatric ward construction project.  Today I found 29 patients overflowing our current grungy 12-bed ward.  Two of the beds did have two patients each (sets of twins) and all contain both the patient and the mother.  But to squeeze in 29 means that many are on mats on the floor, between beds, in the aisle, out the door, in the hall.  IV bottles hang from nails in the wall or rickety moveable wooden poles.  I squat down on the floor to examine a dehydrated 3 month old, trying not to be judgmental and angry that a traditional practitioner has charged two-days’ wages to take a razor blade and slice open this baby’s gums in order to remove the “false tooth” that is causing his diarrhea.  Or that a dwindling twin with anemia and heart failure is getting no help from her father because he has four wives and too many children to take care of.  Or that the nurse who was on duty for the weekend failed to show up so that most children missed an entire two days of antibiotics.  I want to be compassionate and wise and think clearly through each child’s presentation and needs, respond carefully.   But by the 29th challenge I’m feeling completely at the end of patience (and patients) . . I’m almost out to the door when I realize there are five more outpatient referrals waiting dutifully on the bench.  

Just as I could be feeling sorry for myself and very weary . . I get to the last lady.  She had twins a week ago and has brought both tiny babies in, because she’s concerned about the leg of one which seems to curve a bit.  This is her focus, but from her book I learn that she tested HIV positive in this pregnancy.  Scott had ultrasounded her and noted that Kato, twin B, was breech.  So I ask about the delivery, a breech presentation being a reasonable explanation for his mild curvature.  She answers my questions and I gradually piece together that she did not deliver in the hospital but at home, it was in the night and she had no help at all, and has no idea which part of which baby came out first because it was too dark to see.  Even her husband seems to have disappeared during the critical moment.  So here she is laughing as she relates the story, a lady with a fatal disease and undersized vulnerable twins a week out from delivering them all by her lonsesome in a dirt house at night.  Puts life into perspective.  

But I’m still looking forward to a more spacious and clean ward!

Invincible by Prayer--Team update 24 September

“They only are invincible who are as ready to die as to live.”
That quote comes from The Scottish Chiefs, a flowery tome I am reading aloud to the kids at night, celebrating the legend of William Wallace.  But it strikes me as a rough translation of one of my favorite verses, Rev 12:11, which describes Satan overcome by the saints who did not love their lives to the death.  We had an extended Kingdom Prayer night this week, and once again as we prayed for the Kingdom to come and God’s will to be done on earth, my own heart was challenged by the image of Jesus.  Long after he taught the disciples to pray, he used those words in His own prayer in Gethsemane.  Thy will be done . . . Even if the cup contains the bitterness of death.  Yet only by living in that freedom can we overcome the evil all around us.  Please pray for us to have that holy disregard, that tough willingness to endure.  

We called the prayer meeting sensing the need for an offensive.  Please join us in praying for the Kingdom to come, in our own hearts and in Bundibugyo:
  1. Scott and Michael fly to Sudan Monday to join with many mission agencies and Sudanese Christians and church leaders in an effort to coordinate the outreach to southern Sudan as war ebbs and opportunities increase.  They will be in Sudan through Thursday, along with Robert Carr, representing WHM.  Please pray for the Spirit to imbue them with vision and calling . . . And for their safety.  NOTE (25 September:  this prayer was already answered in part when the MAF pilot noted a change in the engine’s noise on take-off from Entebbe and brought the plane right back down, only to find a blocked fuel injector that had to be fixed before proceeding to Sudan.  They arrived safely after the mechanical problem was solved.)
  2. Josh Dickenson and Stephanie Jilcott are in the midst of orienting to this new culture and life and team and work.   Pray for their hearts to be encouraged in their initial weeks, for God to give them clear and creative ideas on how to serve, and for their health.  Josh is an engineer who will work with Michael until mid-February, and Stephanie is a nutrition PhD who will be instrumental in addressing the needs of malnourished children and people living with AIDS.  Jesus used water and food and two prime examples of who He is:  pray that people would see Jesus in the work of Josh and of Stephanie!
  3. Join us in praying for God to provide $85,000 for Christ School.  Yes, that’s a lot of money and combines many needs and dreams, but God is certainly able to send it.  Pray for Bob Osborne, WHM executive director, who is including appeals for CSB funding as he meets with major supporters of the mission.  It would encourage the Bartkoviches greatly to have these needs met by the work of others in the mission.  We’ve already been blessed by two other mission teams, Ireland and London, raising money to support scholarships for CSB students.
  4. Quite a few team members have been sick this week, including some pretty significant asthma symptoms for little Aidan.  Besides him, at least six more people  have general gastrointestinal or respiratory viral-seeming draggy illnesses as of today.  Combined with the sense of spiritual attack, and the stress (especially for Karen and me) of having Scott and Michael gone . . . I think you can see that we need your prayers to stay the course and find the strength of Jesus to submit our wills to that of our Father.

Thank you as always for kneeling with us in our Gethsemanes.
With love,
Jennifer for the team

Sunday, September 24, 2006

Pins, needles, and retroactive causality

Ndyezika has been a dear friend of our family for thirteen years now.  We kind of inherited his presence from Betty Herron’s kindness to him, because he was a ten-year-old boy living alone with a mentally handicapped brother when we arrived, fending for himself.  His father was dead and when his mother remarried, the new husband did not accept her previous children.  Over the years he hung out to play, our kids became attached to him, he learned to speak English well from them, served as a translator for my old Bible and Math clubs, did odd jobs, went on some trips with us.  We sponsored him through O Levels at Christ School, where he was much loved by the staff for his humble, honest, sincere heart and his willingness to struggle with studies and repeat years of school in order to pass.  His chaotic primary education and marginal nutrition in those years combined with great anxiety in test taking . . . . mean that academics have not come easily for him.  After O levels we searched for a possible career for him, he so much wanted to go into nursing or medicine but did not have the grades.  Then by God’s grace and Jonah’s wise advice we were able to get him a position in a training school for laboratory technicians.  Again he repeated a year but managed to finish the course.  Last month he took the national board exams to be certified as a lab tech.  Now we are waiting for the results, which should be announced any day.

We love Ndyezika.  And with love comes vulnerability and the possibility of hurt, and I’m on pins and needles waiting for his results.  Maybe more than he is.  He is pretty hopeful, and my motherly heart fears the impact of disappointment if he has not passed.

It is not a question of skill.  On his breaks from school, and now full-time, he’s been working in our lab at the health center.  He has consistently done good work and the certified technician who runs the lab has confidence in his abilities.  Last month in one of those great Kingdom stories of redemption . . .he saved his mother’s life.  His mom has had a chronic cough for nearly a year.  We had treated her several times with antibiotics and I knew she used to use tobacco regularly and thought she had emphysema.  We had asked for sputum samples to be examined for TB but they came back negative.  When Ndyezika got home from school he was concerned about his mom.  (He supports his mother and younger siblings now as she’s a widow again).  So he took her down to the lab and repeated the sputum samples himself.  And he diagnosed TB.  As much as we love him we were not completely sure . . . So we sent her to Bundibugyo Town for a chest xray and sure enough, there was a huge cavitary lesion characteristic of TB.  The TB clinical officer reviewed the sputum smears Ndyezika had done and agreed with his diagnosis.  

So I suppose you could say that his training was worth the life of his mother.  And there have been others:  an orphaned toddler whom we had treated for almost two months for Kwashiorkor (protein deficiency) just was NOT getting better and had constant diarrhea . . Until Ndyezkia found schistosomiasis in his stool sample and we found out that he had been living near an infected lake before his parents died and he was sent to his Grandmother down here.  Now with the proper treatment he was able to improve and go home, a real victory.  I’m proud of Ndyezika already, but I would still like to see him able to get a paid position in the lab and work, and for that he needs to pass the test.  And more than that I would love to see this orphan who has struggled his way through school affirmed and recognized by the stamp of approval this would bring.  The test is over but we’re still praying that he would pass, because God is outside of time so it seems to me the prayers of today can apply to the exams of August.  I should pray that God would be glorified by his success or his failure, but it’s hard to be so nobly dispassionate about the feelings of someone whom we hold dear.

Thursday, September 21, 2006


Mbambu died last night, the little girl whose silence signaled her need.  Too little care too late, her absence on the ward this morning barely discernible, leaves me numb.

On the other hand, a potential redemption.  Dorothy, whose picture and story Scott posted a few days ago, left a child.  Mumbere is 2 years old, having clung improbably to the margins of life throughout his mother’s relentless decline.  As soon as she died his grandmother, Dorothy’s mother, brought him for care.  I realized that while both he and Dorothy had been started on TB therapy, she never gave him his medicine.  So we admitted Mumbere for a week for “DOTS”, directly observed TB therapy, which is supposed to be the standard of care.  The idea is that a responsible staff member WATCHES the pill go into the person because compliance with a once-daily medicine for six months sounds so simple but in practice is so difficult to achieve in the lives of our patients.  The grandmother is diminuitive herself, a quiet lady whose ragged clothes and meager possessions witness to her own desperate state.  A couple of us helped her with food and other things, and we gave Mumbere a double portion from the nutrition program.  Within days he had put on almost a pound, which for him is a nearly 10% increase in weight.  Then he started to smile.  In all his pitiful life I had never seen him smile before.  

Yesterday his grandmother begged to go home.  I asked her how I could be sure he would get the medicine if we let him leave the hospital?  She replied that she would give it faithfully because “this baby is the only picture I have of his mother, my child”.  She said that over and over and it struck me that that is so true.  When someone dies here there is little left to remember that person by, except their children.  I’m praying for the tragedy of Dorothy’s life to be redeemed in the love between her mother and her son.

Tuesday, September 19, 2006

Hearing silence

Once when the kids were much younger we were at a swimming pool at a game park here in Uganda.  I had my attention on Luke and Caleb who were in the water with me while Jack (<1) and Julia (2ish) played out on the edge.  I suddenly realized I didn’t hear Julia anymore.  There was no splash, no scream, just the absence of her voice.  I turned around to see her little face bobbing just below the surface of the water, looking up, frightened, and I rushed to yank her back up into the air.  It was a disconcerting experience because I realized how easily she could have drowned before I realized anything was wrong.  Her survival depended upon me hearing silence.

I thought of this today biking back up the road.  When I went on the ward this morning and looked around to decide where to start amongst the myriad of problems, I could have been distracted by the frantic crying of a little girl with sickle cell disease in pain crisis, or a toddler with extensive burn injuries, or a fussy infant whose mom had left her alone on the bed to go get something.  But it was the silent child who needed attention, the one who was too sick to cry, nearly motionless, held by her dad.  Though I had admitted Mbambu yesterday with plans for care she had not received any medicine until this morning, and though her blood test results showed severe anemia she had not been transfused.  Her parents can not read the results and do not seem to realize her tenuous hold on life.  She needed someone to hear the silence and mobilize!  So we did, I assigned a nursing aid to escort her to the lab immediately and come back with blood.  But again several hours later as I was distracted by a premature baby whose mother is HIV positive and a Christ School student with pus coming out of her leg . .. Scott walked by and said “That baby looks terrible” and I realized that the mom was sitting there quietly with limp little Mbambu in her lap, still waiting for the transfusion.  Back to the lab, there was the blood ready, it just took someone to notice the issue and make something happen.

I’m on a pediatric HIV advocacy mailing list, and I usually skim through the passionate speeches agreeing in my heart without giving due respect to the importance of this advocacy.  Today I’m thinking about the silence of the children of Africa, how many can’t even get the attention of their parents or nurses or doctor (!) to get the help they need.  Unless we hear the silence we won’t mobilize the resources necessary to pull them up out of the water.  They are drowning, very quietly.

Wednesday, September 13, 2006

Riding the Rapids

Last month six women from our team rafted the Nile river together.  This is no lazy sunbathing trip:  the Nile as it pours from its source in Lake Victoria is a raging torrent of whitewater spray, with Class IV and V rapids.  Our guide instructed us in an eddying cove above the first rapids, Bujagali Falls, teaching us how to paddle, when to crouch down, how to hold on, what to do with the paddles, how to float if we were thrown out, how to climb back in (actually it’s good that he was very strong because none of us could climb from water level up over the inflated sides of the raft without a pull).  He told us to listen carefully and do exactly what he said.  A few minutes later we plunged into the first set of falls, and when he said “Paddle forward, HARD, now left side backward, now get down” we obeyed!  We still ended up with a vertical raft and half of us falling out twice--but several rapids we managed to navigate without mishap.  It was exhilerating, frightening, wet, powerful, loud, majestic.

Later I reflected on the parallels with the life of faith.  We did not know the river, we had never been downstream.  But our guide did.  So when he told us to paddle to one side, we had to obey.  Our life (seemed) to depend upon it!  His commands might not have made sense at the moment, but when we got through the rapid we realized he had guided us well.  And our effort had to be a community one:  many times I would have preferred to hide down on the floor of the raft, but teamwork was required.

So much like faith.  In the middle of the crashing roar and spewing spray of the water, we are told to listen to the guide and obey, trusting his commands.  This week I feel like I’ve been slammed about in a Class V life rapid.  Jonah has been waiting for months for his paperwork to be approved so that he can be officially appointed and receive a modest but fair doctor’s  salary for the work he’s been doing in the District since he finished his internship.  We have prayed and prayed.  We had been told that his appointment to Nyahuka Health Center was in the works.  I was so hopeful.  Remember  this is a district of more than 200,000 people with three doctors total, and they should be laying out the red carpet and begging Jonah to give up more lucrative jobs to come here.  Instead they have been making him feel that they did not want or need him—no doubt his refusal to illegally charge patients is shaking things up, and there are people who are afraid of his influence.  Then he found out that the district service commission, the committee which approves people for jobs, had decided that his official appointment as a doctor would only be retroactive to 1 July instead of 1 March when he actually started working.  Meaning he would be out four months of salary.  Since the district leadership has been lukewarm and obstructive all along, this was the last straw for Jonah.  He said that if he was not going to be paid to be a doctor here he was leaving.  I overheard talk discussing which nurse was going to be put into the doctor’s house at the health center because no doctor was coming.  It was a very distressing moment for me.  I care so much about Jonah, his family, our friendship, our future together.  His disgust with the system is legitimate, but painful.  I started to cry and had to leave his home abruptly and come home and collapse in sobs with Scott.  We asked our team to pray.  It felt like we were not just in the rapids, but had fallen out of the boat without a life jacket.  I was gulping water and trying to remember to get my feet downstream and breathe, but it felt impossible.

But our Guide did not leave us there.  We were pulled back in and told to paddle.  Today the District Health Team had a meeting to discuss the findings of a recent inspection tour by a representative of the Belgian Technical Cooperation. I wasn’t sure it made sense for both Scott and I to try and attend, which led to a day-long cascade of implications of things not done from which we are still recovering.  But we sensed the Guide saying paddle on this side and we went.  The consultant was a Belgian doctor with 15 years’ experience all over Africa, but newly appointed to Uganda.  He will work with the Ministry of Health centrally in Kampala, and this was his first fact-finding mission out to the field.  He chose Bundibugyo!  His first point:  this district needs more doctors and the best way for that to happen is to send people from Bundibugyo to medical school.  His second point:  the personnel process in this district is so abysmal that the DDHS should consider appealing for all health personnel decisions to be transferred to the DDHS office.   He had many other good points as well, about transparency in the finances of the district, and about the unfair allocation of funds (NHC sees 75-80% of the case load of the hospital with 5% of the funding level).  It’s hard to express how amazing this was, that just as we were in the depths of despair about Jonah’s case, God sends an unlikely angel to call a meeting and bring up the very points that needed to be expressed.  When he finished talking the DDHS invited me to comment, so I went into an impassioned plea about Jonah’s case.  The Belgians were appalled.  Everyone in the room agreed that the mismanagement of his case was inexcusable and that action needed to be taken immediately.  I offered to come to their meeting with the people involved and cry if it would help; they said come but bring a panga.  In other words it is time for serious action.  I countered that our plan was to start transporting patients up to the doorstep of the chairman of the service commission if Jonah was not retrieved in some way.

Then about three hours after we left the meeting we got a phone call:  the relevant district leaders had all come together that very day, and decided that Jonah should be appointed with a full doctor’s salary retroactive to his actual start date, the first of March.  Scott called Jonah, who had just reached Kampala on the bus.  He said “Come back, they agreed to everything”.  

So we’re out of this rapid for now, but we know that there are more Class V’s ahead.  For Jonah as well as for us.  God went to great lengths to orchestrate the timing of this week, and it is truly amazing to reflect upon the people whom He brought together to make things happen.  So please keep praying.  And there were several other little reminders today that I’m back in the raft and safely in the hands of the guide:  a patient brought me a pineapple after we failed to find one in the market (!) just to make me laugh that God sees the small needs too.  And in the midst of HIV patients there was one little kid whose record caught my eye—in the first week of his life I had written a note on him saying he weighed less than two pounds, was cold, weak, floppy, most likely severely infected and I remember thinking he would not live more than a few days, but we gave him his Nevirapine.  Now he’s a good looking 24 pound 15 month old who is NOT infected with HIV.  Amazing.  

Tuesday, September 12, 2006


Dorothy is dead. Age: 21
Cause of death: AIDS. Poverty. Lack of Education.  Single motherhood.
The Kwejuna Project, our Prevention of Mother to Child Transmission of HIV Project sponsored by the Elizabeth Glaser Pediatric AIDS Foundation, began testing pregnant women attending prenatal clinics in April, 2004.  Dorothy tested positive in the month following our project start. As with most of the other 500 women who have tested positive since our project began, she came into the prenatal clinic completely unaware of the possibility that her life would be turned upside down with the news of a positive HIV test.  Pregnant at 19 years of age is not unusual in Uganda, but the father was “not around”—symptomatic of the very behavior that brought HIV into their relationship.  Like 90% of women in Uganda who unexpectedly receive this diagnosis in the course of routine prenatal care, she kept the information to herself. Fear of being “sent away” by her family, Dorothy dealt with the anger, frustration, denial, and fear … alone.
Despite her anger, though, Dorothy kept returning to a support group for HIV+ women led by Pat Abbott where she was fed, befriended, touched, heard, and encouraged with the good news of God’s love for her.    She kept people at a distance, but she kept coming back. Most of the time.  Lack of education, chaos at home, weakness—they all contributed to her absences from the support group and from the anti-retroviral drug clinic.  Many blamed her for her lack of compliance to the drug regimen, but the challenges were beyond her resources.  Her son born in July, 2004 contracted HIV infection from her.   His needs drained the little energy did have.  Over the course of two years her weight dwindled to 62 pounds, considerably less than an average ten year old child.   
Dorothy’s life was brief, unimaginably confusing, complicated, painful.  However, her angry heart showed signs of softening over the last two years.  There were glimmers of hope.
Dorothy died last week at home—with her mother and son.  
I hope to see her in heaven—restored, healed, reconciled, whole.

(the pix: Dorothy April 2005; Dorothy July, 2006)

Sunday, September 10, 2006

Wrong about People

It’s 9:30 pm on a Sunday night, and Scott was just called by the health center staff for help because the elderly father-in-law of the most senior clinical officer was brought in with extreme hypertension and probably a stroke.  Not that it’s been so restful (see today’s other entry) of a Sabbath, but late night calls are not usual and neither of us welcomes the burden, especially in the one hour of the day when the kids are in bed and we can relax.  Scott will probably end up driving the comatose man and his family to Bundibugyo, more than an hour by the time he makes the round trip, on a road that’s bad enough to drive in full daylight.  Sigh.  The longer we’re here, the more relationships we have that mean we can’t really say no to something like this.

Before the day’s traumas I had intended to write about being wrong.  This week we studied 1 John 5, and in our study a question about praying for people who are difficult or annoying in our lives really struck me.  Not avoiding them, but praying for them.  How often do I do that?  I reflected on several cases in which people who initially seemed like problems had blossomed (?my change or theirs) to become assets, even friends.  One of the students we sponsor used to be a really obnoxious little boy whom I even ended up banning from my yard for a time because of his behaviour.  Now he’s in his final year of O level and was just honored in Chapel last week for having one of the three highest scores on the practice exams.  I have hopes for him to be a doctor.  His transformation started when his little sister was hit by a careening bike, had a head injury, and he got involved in her care with me as she emerged from a coma and miraculously regained nearly normal function.  That was probably 6 years ago, I can’t quite remember.  Another recent example was a medical worker whose skills and manners did not very much impress me . . . But who has been voluntarily helping me with a really difficult patient.  I asked the team to pray for me to approach “problem people” with prayer for their transformation rather than with a wish to see them transferred.

The very next morning I went to the hospital, and after our weekly staff meeting (we alternate medical education and Bible study) I walked onto the ward to see patients.  I picked up the first chart but was distracted by the very labored breathing I heard half way down the line of beds, so went to investigate.  There I found a child with sickle cell anemia who had been limping along with treatment and transfusions all week, but suddenly looked extremely pale, gasping, minimally responsive.  I knew he was within an hour or less of death without blood, and whisked him off to the lab with his dad to get cross-matched for a transfusion right away.  The problem was that no nursing staff seemed to be available, so I busted into the outpatient department to see who could help me.  The only person there was an older man who recently finished a training course in psychiatric nursing, and since completion had (to my view) merely occupied staff housing doing no work at all.  I would see him every day for months sitting on his porch chatting with people, never bothering to work.  This particular nurse I judged to be a problem person, whom I thought (hoped) would be transferred to another health unit, but in the last week he seems to have decided to start working again at Nyahuka sitting at a desk registering patients.  So when I came into the room and he jumped up to help me, I was skeptical, and surprised.  And help me he did.  He’s not very nice to patients but the man is effective when it comes to nursing care, and knows how to make things happen.  

The child died anyway, just as they were about to start the blood transfusion.  His hemoglobin turned out to be immeasurably low, below 3 g/dl we can’t specify.  I took it a bit hard, I still do, when a kid dies right in my hands and I’m the one to confirm to the anxious parents that it’s over.  His mother broke into the traditional wail and staggered out of the ward weeping on the shoulders of relatives.  The nurse and I wrapped the limp pale little body of the boy (named “Chance”) in a blanket for the father to carry home.  It was the father who got to me, he was choking on genuine sobs.  Not many men cry, even when their child dies, but this man had been caring for the boy all week.  Once the patient dies the family is in a big rush to get out of the hospital, it is considered spiritually dangerous for that spirit to leave the body away from home.  So they gathered their pitiful bundle of bowls and pots and kitengi cloths and a mattress and marched out for the sad trek home.

But the point of my story was the nurse.  The last person I wanted to find to help me, completely surprised me by his willingness to take on the extra work.  I was wrong about him, as so often happens.  When can I become a person who looks for transformation, who sees potential, rather than judging others and hoping for the removal of “problem” people?

Of Spears, Bricks, and The Right Thing

We asked you to pray for Monday, a desperate man. . . . Probably not unlike the types that Jesus calmed and healed. He’s most likely schizophrenic, and can spend long periods of time relatively functional or benignly off-balance. In recent weeks however he’s had escalating episodes of threatening and violent behaviour. He lives in close proximity to the mission. Most mornings he comes to the health center, interrupts me on rounds or Pat in support groups, demands money or food, talks about God and healing and lots of other disconnected subjects including his delusions of threat from other people. He’s usually dressed in many layers of brightly colored clothes, with multiple fetishes and charms on his arms and around his neck. More alarmingly, he also usually carries multiple weapons—a spear in one hand, a bow and two arrows over his shoulder, and a stick or a panga (machete) in the other hand. When he comes to church he’ll disarm at the door, come forward for prayer, and re-arm on the way out. He survives by demanding food and money and soda as he goes up and down the road, from duka to duka, a little here and a little there. No one refuses him because they are afraid of him—it seems to me for spiritual reasons they don’t want to cross him, as if he’s possessed by a powerful spirit. But for physical reasons too they don’t want him as an enemy, he’s fit and strong and armed and unpredictable. In the last week there were two mornings at the health center when he was clearly more agitated—once he came partially clothed, yelled at us, threatened to kill his faithful little dogs who follow him around, an took his panga and whacked repeatedly at the metal poles that support the porch. That day George, a mission worker, calmed him and talked him out of a couple of weapons, and Scott bravely approached him and got back my backpack of medicines he had grabbed. Another day when he came agitated I called Scott on the phone, and he brought the police down to arrest him. However the police are as frightened and ineffective as anyone else and basically hid behind a building while Monday threatened Scott with his spear then ran out the gate and down the road. It was a few days later that we watched the movie “Beyond the Gates of Splendor”, about the Saint family and the missionaries who were murdered by Waorani (Auca) Indians in Ecuador in the 1950’s. Then the nearness of Monday’s spear became more chilling. And I noticed that Monday usually tried to deal with Pat, or second choice me, and avoid men. He seems more threatened by men, which was the point of the Rachel Saint and Elizabeth Elliot story, they were able to re-enter Waorani territory and trigger an entire cultural revolution from killing to peace because they were women (maybe that’s why God calls more women than men to missions??). Certainly this story of martyrdom was about a whole culture of spearing, not about one mentally ill person. Even so, I don’t think we have the love and courage for sacrifice that those men did. We may put too much faith in our own wisdom and action. This weekend things escalated, with Monday throwing rocks from behind a high brick wall to lob onto the roof of another mission family’s home and wake them in the early hours of the morning, while yelling aggressively at them. One rock hit the window bars just as the mom was shutting the shutters. We are thankful that no one was hurt. Because of that incident we as a mission have supported the rock-attacked dad in pressuring the police to take action. We may have pressured too hard—this morning (Sunday) the police fired guns in the air in another ineffective arrest attempt. Having just lived through the terrible motorcycle saga in which Magezi ended up killed, we certainly don’t want to inadvertently have a role in another death. This man needs help, medicine, prayer, a family who cares about him, restraint from his own dangerous actions. But what is the Right Thing for us to do in the face of a family who fears him and obstructs his arrest, a police force which is passive, a medical system which is horribly inadequate, and a culture of fear of mental illness combined with reluctance to take action? Certainly we don’t want any of our missionaries (especially our kids) in danger. Nor do we want Monday beat or killed. In pushing the police to act, are we lacking trust in God to care for us? In the midst of all this, kids nearly killed our dog today. We really don’t normally live with this kind of hate expressed so openly towards us, in nearly a decade of having our yellow labs we’ve seen that the children tease and yell and get reactions, but our dogs haven’t hurt them and they’ve never hurt the dogs, at least not seriously. Our kids were playing out in the yard. We keep Sundays as a family day, quiet, no neighbor friends coming over. We need the Sabbath rest. The sides of our yard have a chain link fence with a hedge, though the front is open and freely accessible. Some boys (8-14 age range) had gathered in a group on the side fence and were yelling, taunting our dogs Angie and Star to come running at the fence. I’m sure they were mostly just curious watching our kids play badminton and feeling jealous . . . But one decided to open a hole in the fence by destroying the chain link, then when he got the dogs near enough he threw a brick at Star. Hard. Star fell down, tried to get back up, couldn’t, and started shaking all over, panting. Our kids yelled and we came running. Star was seizing. The crowd ran. Scott thought she might be dying. Caleb and Julia were weeping openly and hard, Luke and Jack ready to attack Star’s attackers. We held her and stroked her head, wiped blood off her nose, prayed. She tried to get up once but fell back down, unable to move her back legs. Then Scott carried her back over closer to the house as our children continued crying. A minute later she tried to get up again and was OK! Now she seems fine. A concussion? A rapid answer to prayer? We think she’s not quite out of the woods. Scott visited the father of one of the perpetrators in the crowd, who immediately blamed another boy. Luke heard kids talking in Lubwisi and pieced together the name of the other boy, so Scott asked our friend Baguma to visit his house and explain his actions to his parents. Yes, it is just a dog, but Star is a huge part of our kids’ lives and sense of home, and it would do great damage to their relationship to neighborhood kids to see her killed by them. So what is the right thing to do, how do we turn the other cheek, how do we pursue healing, how do we practice tough love, in these situations . . . JAM

Tuesday, September 05, 2006

Pray for Bundibugyo Team from Myhres 5 Sep 06

Here is CS Lewis quoting George MacDonald on prayer: ‘But if God is so good as you represent Him, and if He knows all that we need, and better far than we do ourselves, why should it be necessary to ask Him for anything?’ I answer, What if He knows prayer to be the thing we need first and most? What if the main object in God’s idea of prayer be the supplying of our great, our endless need—the need of Himself? . . . Hunger may drive the runaway child home, and he may or may not be fed at once, but he needs his mother more than his dinner. Communion with God is the one need of the soul beyond all other need: prayer is the beginning of that communion, and some need is the motive of that prayer. Please frame all your prayers for us around our true need: the need for communion with our Father in Heaven. He has graciously cared for us this past month in several dramatic ways. Wendy and Rick’s baby looks good on ultrasound; the passage of pertussis through the team seems to have been halted; we are a whole family again with the return of the Massos from HMA and Amy back from a family visit; Pat’s support account had a timely boost from her church. Thankfully He has given us plenty of graphically visible needs to drive us to prayer in order to fill our real need! 1. Pray that as we seek to meet people’s immediate felt needs, we would actually point them to THEIR true need for Jesus, as He did in Mark 2 with the paralyzed man. Imagine Jesus standing in the crowd of AIDS infected hungry people forgiving their sins . . . 2. Pray for wisdom and resources to meet the needs around us in loving ways. Each one of us is stretched beyond the limits daily. In particular pray for Pamela, Karen, Pat, Scott, me (Jennifer) and soon Stephanie Jilcott to reorganize our nutritional outreaches in view of the impending withdrawal (November) of World Food Program. I have four babies in the 2-4 pound range right now, one of whose grandmothers’ breast milk just started to flow. There are also four very pitiful toddlers with Kwashiorkor admitted. I know we are fighting for their lives. Pray for Tumusimwe in particular who was diagnosed by Ndyejika (! Just finished lab training school) with schistosomiasis and treated this week, that the treatment would make a difference. Every day we confront the dilemma of how and when to help. 3. Pray for our ability to faithfully and thoroughly do the work to which we are called in a way that contributes to the big picture of the redemption of this fallen world. Scott is working on a presentation he will give at the EGPAF annual meeting in Tanzania in October, analyzing 3000 survey responses (half before Kwejuna started, and half after two years) to see what kind of community impact we are having in people’s knowledge, attitudes, and practices as they relate to sex, marriage, and HIV. Michael has been moving around the district doing a drama about cooperation on the water project. Pamela, Carol, and I are meeting to plan a more quantifiable follow-up of babies born to HIV positive moms. Karen has just hired to veterinary assistants to augment the breeding of dairy goats. These efforts should help not only Bundibugyo but provide real world data that can inform other similar efforts. 4. Pray for our kids as they begin a new school term today. Caleb is jumping into two new classes at Christ School which will be hard having missed the first two terms (calendar year school here). Please pray for him, and Luke, to have friends, learn what they need to know, be protected, and move cross-culturally with good attitudes. Meanwhile at RMS we are a bit short staffed so Karen and I are filling in, and Amy and Kim are taking on extra work. Pray that all our kids would hunger for God, and have an appetite for learning about His creation. 5. Pray for Christ School-Bundibugyo! Pray for staffing needs to be filled, for income-generating agricultural projects to ease the financial burden of the school, for adequate land and facilities. Pray for David Pierce who begins teaching his first class (S2 additional math, sadly not either of my boys!). Pray that David and Annelise, and Joy, would build solid relationships with the teachers and see Kingdom fruit in the changed lives of students. Would you also pray that Joy would be delivered from debilitating back pain, exacerbated when she stands all day teaching? 6. Pray for the marriage seminar being held Wednesday and Thursday at the Community Center—all the teachers and organizers are Ugandans. The specific target is church leader couples, and those who work around the mission. Marriage is the primary front line of most of our battles. If the love and commitment of husbands and wives is redeemed, then malnutrition and AIDS and the struggle for education will quickly follow. 7. Pray for a few desperate people. Ourselves first and foremost, we need to know the depth of our sin and the pitiful limits of our strength. But in addition pray for Kabasunguzi Grace (as many of you have been praying). God continues to watch out for her and preserve her life. She is admitted at Mulago Hospital and having more tests, but no diagnosis yet. The gifts of one of you have sustained her medical costs, for which I am very grateful. Pray also for Monday, a psychotic man who roams the area, and is variously manically charming and frighteningly agitated. His family, the health center staff, and the police are all afraid of him and very passive. Pray he would allow us to treat him, and pray for Pat who shows him compassion (and is therefore often disturbed by his demands). You can also pray for Kisembo Salezio who has a court hearing this week related to his purported role in the arson death of Magezi. The motorcycle saga remains unresolved, and we continue to ask God for mercy and wisdom. That should be enough need to motivate prayer! We are ever grateful for your intercession. Love, Jennifer for the team

Sunday, September 03, 2006

blog beginning

We’ve logged hundreds of e-mail updates and scores of paper prayer letters, but we’ve decided that the time is now right to join the twenty-first century trend of blogging. We hope to continue to chronicle our faith adventure using this new method, adding some additional resources--more pictures, downloadable prayer letters, links, etc. Please give us feedback as we begin blogging.....