Grief and Fear

Those two emotions wave over us hourly.  The church had previously called for a multi-denominational day of prayer and fasting so we started the morning with people there.  I’m going back in a few minutes, to be with people who are also grieving and praying.  I don’t know of any other death that could so severely affect this district.  Everyone is crying.

Jonah first went to investigate this epidemic weeks ago, it was probably still October then.  Rumors had reached him of a mystery illness.  I remember well the day he came into the Paediatric Ward and told us about it.  I gave him gloves and my bottle of alcohol hand gel, pitifully inadequate measures now.  We had not heard of any bleeding, just vomiting and diarrhea and unusual deaths.  We wondered if it was a cholera outbreak.  I remember him slinging his backpack on, and getting on his motorcycle, saying “If I die, I die.”  When he came back he guessed typhoid fever, due to the prominent abdominal pain and even what seemed to be two cases with intestinal perforation.  He noted the family grouping of the cases and held some community meetings to sensitize on hygiene, the basics of handwashing and latrines.  He dispelled rumors of witchcraft and poisons.  He wrote up a report.  Then over the next week or two there was a task force set up, some Ministry of Health epidemiologists came and took blood samples.  We got the good news that it was not Marburg or any Viral Hemorrhagic Fever based on samples sent . . . Not sure where.  Then there was the message that more samples had been sent to South Africa.  Days went on.  Uganda’s attention was on CHOGM.  Jonah continued to attend to patients as they came into Bundibugyo Hospital, as did Scott.  Jonah was the primary doctor for Muhindo Jeremiah, an older gentleman who had been active in visiting the sick in Kikyo then fell ill in Bundibugyo.  A week and a half ago Muhindo died.  A few days later Jonah went to Kampala on personal business; he has a house there still from medical school days with rooms he rents out, and three of his daughters are in school in Kampala, and his mother and brother stay with them there.  We went to Kikyo the day Jonah went to Kampala, all of us still wondering what this disease could be, still being told the samples had been sent from South Africa now on to the CDC in Atlanta.  Then last Thursday the bombshell announcement came, that it was Ebola, a new strain.  That day we talked to Jonah on the phone, he had a headache he said, maybe early malaria, he’d watch.  By Friday morning he found it prudent to admit himself to Mulago hospital.  That was his last act of bravery and wisdom.  We talked on the phone that day, he sounded so normal, so himself.  I went to find his wife Melen who was still here.  We prayed and wept and embraced and called him again.  Saturday morning I drove her early to town to get on transport to go to Kampala, even though she knew she would not be allowed to see him. She’s six months pregnant with their sixth child.  From Friday until 4 pm yesterday every report we got from the doctors was hopeful.  He was walking and talking, drinking.  His doctor even said he was wanting to call and talk to us but they were looking for a way to charge his phone which he had with him in the isolation.  He did have a couple of days of reduced urine output indicating an effect on his kidneys, and he did continue to have fever.  With each new symptom and passing day the hope that it was all just malaria became less and less.  Still Jonah is a strong man, healthy, smart.  He was in the country’s main hospital, not out here in Bundibugyo.  He was getting lab tests.  He had a team of doctors, including MSF Spain.  We had hope.  Then suddenly last night they called back.  He had died.  Maybe there was bleeding, involving his kidneys and lungs, I don’t have the real story yet.

Jonah was a man of integrity.  He refused to charge patients extra fees for his services, even though that is widely practiced in government hospitals.  He was completely trustworthy with his responsibilities and resources.  He was a leader who knew how to motivate, listen, draw consensus.  He was not afraid.  He worked hard, entering medical school in his mid-30’s after an initial career as a medical assistant.  We sponsored him all the way because we saw in him both the clinical prowess to save lives and the character to change the system.  He was the first person from Bundibugyo to graduate from Makerere University School of Medicine in 29 years.  He knew that God was the one who provided his opportunities, and he had a strong sense of his duty to serve.  His father was killed by ADF rebels in about 1997.  When the initial attacks came Jonah and Melen fled to our house.  We supported each other through war, school, families, children.  I was present for the birth of one of their girls (Biira) in their home.  Biira and Caleb were baptized together.  We’ve spent holidays together, traveled together, been present for each other’s significant events.  Since graduating from medical school Jonah has not found it easy to be back in Bundibugyo.  A person who stands against corruption meets obstacles here.  He has struggled.  But we always thought he would eventually prevail.  

I think I know now how Jesus’ disciples felt Friday night after the crucifixion.  What is God doing?  Will evil win?  Our hearts cry out.  Before all of this happened we sent out a December prayer letter, and now I can see that the Spirit was preparing our hearts.  I’ll try to post it some time.  But the message was:  the Kingdom coming is a dangerous business, real people get hurt and die.  I never dreamed it would be Jonah.  

Of course our grief is mixed with fear, with wondering what that means for our own exposures, though less than Jonah’s.  Scott and the WHM leadership made a decision last night that I will no longer be allowed to see patients, even non-Ebola ones, so I can wait out my incubation period and hopefully be cleared to reunite with our kids.  Scott Will is taking over my NHC duties.  I just got a message from him that there are only 12 patients admitted and no staff yet visible, but he said “God is still here”.  Scott Myhre is taking responsibility for Bundibugyo Hospital.  He said he’d like to mourn today, but it is like a battle, when your comrade falls that is not the time to quit.  We have moments of clarity and peace, and lots more moments of shivering dread.  The outpouring of prayer and posts has strengthened us.  I think we are too weak and numb to pray well, but in the body that’s OK, all over the world people are doing that work for us.