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Monday, February 16, 2009

It must be Monday

Early morning darkness, I am awakened from a dream in which I'm teaching someone to suture a wound which happens to be on my own foot. I'm sure there's meaning there, the wounded healer.

This must be Monday, the beginning of the week scramble for school uniforms (are they shrinking that fast, or are the kids growing that fast?), doling out yoghurt and granola, pasteurizing the morning's abundant fresh milk, making tea for my workers, checking the internet, looking for a misplaced school book, making lunches. A patient's mother arrives at 7:30 to tell me that her son (Paulo, thanks for praying for him!) finally got his surgery on Friday, to close his abdominal wall and allow him to urinate normally. She is followed by one of my students reporting back from his interview trip to the intensive Christian discipleship and boarding school work program . . no results yet, so we sit down to make a strategy and budget for beginning school locally in case he is not admitted there. Meanwhile my three kids lug their 20 pound back packs (!) onto their backs and get their bikes and helmets and head off to school, I finish my coffee and show my workers where to plant some papaya seeds. A little milk and fruit for the bush baby, and I'm off too, to the hospital.

On the ward Heidi helps me get started, then she has to head out to a smaller health unit where we are re-training nutrition outreach workers to begin another cycle of the Byokulia Bisemeya ya Bantu (BBB, good food for people) program. As soon as she leaves I discover that three one-month-olds with similar diagnoses (pneumonia) but dissimilar sizes (2, 3, and 4 kg) have had their charts mixed up, and it since mothers often don't read and don't seem to concerned about what their kids' name is (seriously I'm holding the papers and reading the names and they are all looking at each other unsure), it takes some doing to sort it all out. As soon as we get that settled (and no harm done, all were on the same antibiotics) . . . an unconscious child is rushed in, a huge looking 4ish year old, completely zonked. Mother and aunt had left him with other kids, no one seems to know what happened, later dad thinks he was hallucinating during the night . . . he's cool to the touch and floppy and sonorous, with junky lungs. Most likely thing around here is a convulsion that coincided with a major temperature spike from the release of malaria parasites, but he doesn't feel hot. I ask the mother if she sells alcohol. No. Could he have gotten into a stash, or taken any other drugs? No. But of course they weren't exactly watching. We bundle him into the treatment room, send labs, push dextrose, and put up drips for malaria. While I'm doing the lumbar puncture and the clear spinal fluid is dripping out of a needle in his back, dad remembers now that he found empty bags of alcohol at home . . this is strong stuff, vodka sold in plastic baggies. That explains a lot, but we can't afford NOT to treat malaria and pneumonia given his exam, until our labs come back. As I round, and look into each little face, I am reminded of how much children have to fend for themselves, how often they are left to their own devices. Tempting to gather them all in to my idea of safety, but I also see that they cling to their mothers (even to less- than-reliable ones). There are worse things than being ill, and being taken away from your mother must be one of them.

Roadblocks on the way home, with police. I hear someone calling on his cell phone to get help from his dad, it seems the police are confiscating all motorcycles without license tags (called number plates here). Which is most of them. The road is eerily quiet. I like it. Maybe they will find our stolen nutrition cycle. In the short ride home I'm called by the midwives who need help getting HIV test kits for antenatal clinic, and another staff who asks me to contact the water line fundi to turn the water back on for the health unit, and I get a message that our appointed doctor will not be around 4 or 5 days again this week. I try to be patient but mentally tally about 6 total clinical working days in Nyahuka in the six months of the contract . . . though many more I am sure at Bundibugyo hospital, or doing administrative tasks.

At home the blazing sun makes the laundry on the line smell like it has just been ironed, it is almost too hot to touch. The team is gathering for an afternoon nutrition meeting: we are hosting Stephanie Jilcott and Scott Ickes this week, as they follow-up on research they had begun while here. Soon our Ugandan extension workers (Pauline, Lammech, Baguma Charles) join us to discuss progress or lack thereof, what percentage of chickens are laying eggs and why, how we will improve home visit follow-up of malnourished kids.

Just as the meeting is beginning Ivan arrives to say that the CSB gatekeeper has told him the gate is closing on admissions . . . he must be accompanied by a parent to get in. I had intended to do this in the early morning, but Ivan was mis-informed by an administrator that the process BEGAN at 2 pm. Not wanting to be difficult I did not appeal based on my hospital and meeting schedule . . but now it turns out that the process ENDS at 2pm, and it is 2 pm. So I leave the meeting in progress and go through the newly organized and efficient admission process. Teachers at the gate inspect his trunk, criticizing him for having 3 casual-wear blue shirts (2 are required, so we thought 2 was minimum, but it seems they are treating it as a maximum). They make him remove one set. I recognize the entire process is meant to instill humility, to show off the bat who is boss, so I keep quiet. We sign in, confirm fees were paid, sign agreements to abide by the rules, get a meal card and dorm assignment. I like his dorm teacher, who was Jack's cell group leader last year, and I like the process of helping him carry his trunk down and seeing his bed. A half dozen other boys are in the dorm, and the boy in the next bed seems to know Ivan already. The shutters are closed and the room is dark and crowded, but livable. I shake Ivan's hand goodbye. Last year I got in the car and cried after leaving him in the miserable little unfinished brick primary school dorm. This year Ivan looks like he could cry, but he doesn't, and I think he's just nervous. We're both glad for him to be in Christ School. Back to the meeting, then back down to the gate to enroll my S5 student. It is my 5th time through the process so the teachers are beginning to expect me back . . . but this time it is less pleasant because the S5 deadline kind of crept up on us and my boy does not have all his requirements (only 1 graph book not three, only 1 belt not 2, etc.). So the teachers are harsh and I have to beg for grace. In the end though he is settled in a good dorm, a new one, with a staff member who was once a missionary-sponsored-kid in Ndyezika's class. A nice connection.

Back home in time to get my own kids snacks before they head down to sports practice . . knocks at the door, . . my neighbor with a headache and a covered appeal for moral support on her side of a family issue, the little brother of a good friend who is looking for help with school fees, a man who wants me to examine his wife because she's losing weight, a church leader who is caring for orphans and wants me to help one with shoes. Now, a debriefing respite between me and my computer which has done me good . . though I don't expect anyone but my mother and husband to read this far. Then I will go on to preparing dinner, chili, which requires tomato sauce made from actual tomatoes, beans, vegetable, corn bread made without a mix, that sort of thing which is tasty but time consuming.

The day will end with the peace of dusk, candlelight, community, food and shared life. It must be Monday.


Megan said...

Just wanted to let you know someone besides your mom and your husband read the whole thing - and enjoyed it. Funny thing, earlier today I was googling "how to make spaghetti sauce from tomatoes" and "how to pasteurize milk" in preparation for our move to Kenya. I guess I'm on the right track. I stalk your blog and love it. Thanks for letting us peek into your world. It is a great encouragement to see what God is doing through you.

Anonymous said...

I'm happy to read all the way to the end every day. I thrive on your medical detail, being a nurse here in DC and love your pictures. Thank you for letting us be part of your life!

Cindy Nore said...

Hi Jennifer - make that three of us besides your husband and mom who devour every word of your posts and are always encouraged by your faith! I pray for all of you there every day, for your family and co-workers who continue to battle on the front lines to provide justice and mercy for "least of these," for the children you describe who may be young and ill or Ivan who is overwhelmed with a new school year. Your compassion and courage never cease to amaze me. On a lighter and more practical note, I think you are an awesome Mom and wife, and I hope the chili and cornbread were delicious : )

Anonymous said...

Jennifer, I read it all, too. I don't know how you do so much in one day. Interesting side note, one of my students(community college) is Sudanese, and he was interested in finding out where Bethany was going, etc. He's heard of Mundri. So that was really encouraging to me.
Debbie F.

Jill said...

I read all the way too! I am so amazed at how much you do in a day! I'm so glad Paulo got his surgery.

Anonymous said...

I too read, pray, rejoice and weep with you Jennifer. Thanks so much for sharing your dependence on the Lord and what it is really like living in Uganda- called daily to lay your life down for Christ! It drives me to my knees for you all.-- Sharie P.

Anonymous said...

Another reader! So many of us flock daily to your sight to gain encouragement from what God is doing THROUGH you...and to find out ways to pray for you! Thanks for working for the kingdom!

Unknown said...

I look forward to your blogs daily, to remind me that there truly is life after residency! You are a wonderful reminder for me of the world outside the US medical system that I pray to someday be a part of!

Emily Pearce

Anonymous said...

Can't believe that you thought no one would read to the end. Your blog is wonderful. I check with great regullarity to see if there are new posts. I am also praying for you and your family and your team. God bless you all. Judy in HMB

KevinandJD said...

Nate is yelling in the background, "Remember in 'Ganda when we bounced on dat bouncy pillow? Remember our house is blue?" It is good to read your blog all the way down to the end and just remember our life there. Thanks for the continual glimpses.

One Dusty Traveller said...

Hey - I read your blog continually and even though late today I had to backtrack to make sure I was caught up on your "rounds" - when life seems overwhelming here in Virginia - I only have to read what it is like there for you and your family and Thank God for the many provisions and blessings- on your end and on mine - Only through HIM are we able and Thankfully !!
Praying for you, your family and especially the local children there - His Peace to you-

harryk said...

Hi Jennifer,
I had to laugh when I looked at this posting the second time and saw ELEVEN comments! I read it earlier and saw where you said only your husband and mom would read that far but boy were you wrong - and how wonderful to be wrong in this case! So many read and so many pray for you, Scott and your family as well as for the Pierces and everyone there. May it be that all of you serving the Lord there would experience the kind of encouragements that the He gave Daniel and Paul:

"And said, O man greatly beloved, fear not: peace be unto thee, be strong, yea, be strong. And when he had spoken unto me, I was strengthened, and said, Let my lord speak; for thou has strengthened me." (Daniel 10:19)

"But my God shall supply all your need according to his riches in glory by Christ Jesus." (Philippians 4:19)

What an accomplishment-filled, Marvelous Monday you had! By the grace of God alone.