Duty is only a substitute for love.

---C.S. Lewis, excerpt from a letter.

I do not discount the power of duty, because I know my heart to be so imperfect in love. Duty means continuing on, cooking another meal, answering another knock, accepting the burden of another patient's illness, preparing another lesson or biking another mile. Yes, it would be better to do all of those things out of love, out of the joy of relationship. . . . if I play a card game with my kids because they deserve attention and it is my duty to give it, that is good. If I play because I love their company, that is better, and more honoring to them. Which is the point. We press on towards the goal of God Himself, but I confess He remains elusive and my love hobbles forward on the crutch of duty. But I believe, by faith, that that hobble is better than a sinking refusal to go anywhere at less than a flying pace, and that the crutch will one day be flung away, useless.

But not yet. So here is a summary of the day: no milk from the cow is the first bad news of the morning, who is either rebelling the lack of dairy meal (a casualty of no truck) or is pregnant (our hope). Staff meeting at the hospital, good, about 20 show up, I give a Bible study I prepared the night before on Ezra and the concept of accountability. This is in response to accusations that at least two new staff members are illegally charging patients extra fees. Interestingly this issue came to a head through a drama group who presented a public play on corruption imitating health workers, a really interesting example of non-violent protest and expression. It seems that a certain midwife was demanding 5,000 for delivery of a boy and 10,000 for delivery of a girl, also an interesting twist justified because girls bring in bride prices later which enriches the family. Hmmmm. Good discussion of all we have been given and our accountability to God, self and others. But as I'm walking away the in-charge regrets to inform me that Ammon's just-vacated house has been given to a very unreliable and dishonest worker, one of the two charging illegal fees. I feel crushed, because just that morning Scott had made a political visit to make sure that a new clinical officer was transferred here, just to keep that from happening. I try to call the management committee to protest, the chairman's phone is unavailable. The health care of the town seems to spiral downward before my eyes and I feel a strong desire to just run away rather than continue struggling with this person. I get three steps closer to the ward when the in-charge of one of our two outpatient decentralized nutrition programs approaches to inform me that the nurse who has been leading the effort quit. She had been putting pressure on our mission for extra money, which we did not agree to give. In our view malnutrition is just one of many diseases, and a salaried government health worker should not be paid extra to treat one particular category of patients just because we supply the medicine. The in- charge assures me that he agrees with me and that the program can continue without this nurse. I'm skeptical. Now I'm through the door. My most worrisome patient, whom I had arranged for a blood transfusion, I find still deathly ill. After about 45 minutes and 10 phone calls trying to trace the murky path of requisitions and order forms and transport money and people responsible, I am no closer to understanding why the person we sent to the Fort Portal blood bank returned empty handed. But I have a commitment from Bundibugyo to send three units and a commitment from Fort Portal to send the rest of the order. I hope the child in question lives long enough for the blood to arrive. Before I can see any more patients the new doctors who have been hired by WHO to serve in Bundibugyo, a huge answer to prayer, call to say they are canceling on our invitation to come and see Nyahuka Health Center and have lunch because they don't have any transportation. I don't have a vehicle either. I SMS back that the rooster is already dead, so they should come, and then arrange for the hospital truck which is picking up the blood, to get them too. Then the rest of the patients, including one little boy whose skin-and- bones pitiful state inspires us to put in an ng tube for milk, and arguing with the mother of a patient with severe burns to the hands that she has to stay until the little girl heals, that if she runs away now the girl could have contractures which prevent normal use of her arms and hands. And so on. On the way home I drop in to greet the Pierces and hear more about the unrest in the S3 class, which Caleb had thought was just boys and girls disputing with one another but which Annelise believes could relate to a particular boy who may have been a violent ring leader in a previous school trying to stir up chaos in ours. And to check up on the food procurement officer who was arrested yesterday when trying to buy massive amounts at the market across the border in Congo. It seems that the school has to hire someone to sort the problem out and free their caterer. Back home, our nutrition extension worker waits to report that the other outpatient site is also complaining about not being paid extra money, requests that I go talk to them. I promise, but admit that I'm probably not going to make it as soon as they'd like. Then our doctor guests finally arrive for lunch at about 3, just as a hydrocephalus patient and family show up in the kitubbi and the kids are filtering home from school. There are four of them, Louis, Simon, Philip and Dennis. I try to grasp that this is exactly what we were trying to do, recruit young doctors, and here WHO has done it. They are fresh from internship, former classmates in med school. And they are already frustrated with Bundibugyo, with promises not kept, with ineffective leadership, with corruption and laziness and the difficulty of doing their jobs. Scott and I listen and sympathize and encourage and feed. Mounds of rice and chicken to soothe the loneliness of being far from their homes. We play speed UNO and take a little tour of the yard and cows; we talk about our team and our life; we invite them to make this a meeting place and feel at home. As the day fades into evening they leave, to go back to Bundibugyo Town where they are managing to survive in spite of the lack of promised housing. We clean up and convince our kids that it would be great fun to eat popcorn for dinner . . .

And so a Friday draws to a close, some love and a lot of duty,