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.