Butterflies on a Bush

Flowers flame from a lush and gracious tree

Food for eye and insect, taste and see;

Abundance exploding in nourishing beauty.

Above the blossoms a dozen butterflies hover,

Fluttering, vibrant, weightless spectrum of color,

Restless, relentless, sip, lift, sup another.

Velvet back wings bordered in aqua lace,

A flash of yellow, a transparent opal trace,

Each oblivious to the other's pace and place.

Let me live in such glorious community

The burning bush an all-consuming opportunity

To feast and flit in heedless equity.

Concerned not by relative palette hues

That flicker past, glimpsed peripheral views,

But only by central beauty and truth, renewed.

Then fly, free.

-Jennifer Myhre

Homecoming

Yesterday we braved the long road home, through driving rain with seeps right into our leaky car, over teeth-rattling ruts and twisting switch-backs. The last couple of hours Jack road out on top of the load of trunks in the back, waving and giving a thumbs-up sign to anyone who looked his way, so as his gesture was returned we had the pleasant sensation of hundreds of people smiling and welcoming us back. It was a joyful journey, escorting team mates home. John and Loren Clark, with their son Bryan, have arrived to live and labor with us for the next two years. We've been eager for their help in nutrition and community outreach and nursing . . but so far the fun surprise has been what a precociously articulate, infectiously friendly, and incredibly cute two-year-old Bryan is! They traveled from the US with Heidi, who is returning from a month of HMA, from being in a friend's wedding and visiting her family and church. And their return coincided with the end of Luke's second term at RVA, so he flew into Entebbe on his own this weekend, at least an inch taller, hungry, and full of stories. Last night Ashley and Sarah prepared dinner for our now-expansive team, a real homecoming.

You know you're not in Kansas when . . .

• You come home and find a dead snake on the porch, left not to frighten but to comfort, that someone found it and KILLED it.

• You are turning in an expense report with a line item for "bows and arrows" for the night watchmen.

• You buy the national paper, and the lead article discusses which body parts are most favored by witch doctors for rituals.

• You drive by baboons on your way home.

• You attend a training workshop on nutrition, and walk in to find the current topic is breastfeeding, specifically teaching mothers to express milk from the breast when babies are too sick or premature to suck well . . . and the matronly triple-D size nurses who are teaching have no qualms about handling their own breasts, and in fact they take a sock to make a pretend breast for the males in the class . . and the males happily practice with the sock, not a shade of embarrassment. Only Nathan and I were having trouble stifling our hilarity while everyone else was quite serious.

• You note in the same training seminar that the demonstration doll is so life-like, that no one can bear to leave it lying on the table, so students keep passing it around and holding it like a real baby.

• You find yourself housed in a shadily seedy motel (bare bulbs, dark stairs, lights that blink and send shocks into the shower water, but hey at least there IS a shower) of about ten rooms, conveniently located right at the busiest intersection in town so you can hear every truck all night decelerate and honk its horn.

• You have to pay extra for instant passport photos for a form, because the power is out and the photo studio has to turn the generator on.

• You have to check five stationery stores to find a paper clip (but it is not so onerous, because all five tiny shops are on the same block).

• You wave happily to the police as they pull a nail-studded log out of the road for you to pass, because you know their road-block in a forested area is not a speed trap but rather a security measure in an area where thugs recently carried out an armed ambush.
• You meet someone while waiting to make a purchase who shows off a brand new"50 BILLION DOllAR NOTE" -- which is worth only ten cents because it is from Zimbabwe.

• You are awakened by friendly phone calls at 4 am because the phone rates reduce by 90% or more in the middle of the night, and Africans value both relationship and the economy necessary for survival.

(All of this really happened in the last 48 hours).

BundiNutrition

Our BundiNutrition team meets every Monday to strategize . . . and this week as we discussed our financial situation, I realized I had not contacted our donors in quite a while. We have been blessed this year with $36K dollars . . and we have spent this year, $36K dollars. In other words God provided precisely what was needed. That balance really boosts my faith, and I hope it does yours too as you read. How the spirit prompts one person to send $20 and another to send $3000, at random times, from dozens of states, and yet brings it all together to meet the monthly needs of . . .

• 166 severely malnourihsed inpatients between March and December of 2008 (12 on the ward right now!)

• an average of 54 HIV-infected children per month, 43 motherless babies per month, and 93 moderately malnourished outpatients per month
• 123 families who received dairy goats

. . is truly mind-boggling. Another fun number: 10,000 eggs were churned out by our hard-working chickens for the protein needs of hungry kids!

As I wrote in the post below, we have the privilege of seeing true resurrections of the body. And we pray for those of the spirit, too. I was amazed in the chaos of the ward yesterday to hear some sweet singing . . and found it was the initially hopeless and bitter mother of a severely malnourished baby, who had resisted treatment at first. Over the weeks of care, her child regained health and life, and she regained hope. They were discharged yesterday, truly transformed.

For 2009 we anticipate continuing to need about $1500 per month to fill in the gaps. As much as God has provided through donations, through the goat ornaments, through UNICEF, through sustainability projects, we continue to face an expanding population, uncertain weather and agricultural patterns, family dysfunction, unemployment and need. The BundiNutrition fund allows us to give the cup of cold water, or in this case beans, to the least of these.

If you or your group would like to be part of this process of God's graciousness to those at the margin of this world . . link on the sidebar through "how to contribute by mail" which actually takes you to the WHM donation site, with instructions for either mail or electronic giving. BundiNutrition is project #12371. This is a terribly tight economic time in the world, and we are humbled by those who continue to pray and give at great sacrifice, for the Kingdom to come in Bundibugyo. Thank you.

Time-lapse Resurrection

When Kagadisa was first admitted, I could not bring myself to photograph what seemed to me to be a being who was hours away from becoming a corpse. So I don't have the worst pictures . . but here is a time lapse of several weeks of nutritional therapy and TB medications. Last week he stood for the first time. This week he's walking, with help. In a few days he will go home. Since much of his problem stemmed from being a neglected orphan in the home of a polygamous grandfather and a less-than-able grandmother . . I called his grandfather in yesterday for a pre-discharge pep talk on God's love for orphans and his role as provider. Let us pray that the physical transformation in Kagadisa reflects some spiritual transformation in his family, a renewal of hope, of concern, of responsibility. There is one family member who is a strong believer and perhaps this will be a seed of revival throughout their clan. The need for spiritual and social transformation to accompany physical healing struck me when Birungi Suizen returned to greet us yesterday-- another miracle child, now with curly dark hair, alive and reasonably well, but still stunted and marginal with a pregnant-again mom and an absent father. Praying for unseen as well as visible resurrection.

Now available for downloading....

Now available... our latest prayer letter in pdf file format.  Even better than the snail mail version - it's got COLOR.

Click HERE for the download...(336KB pdf file)

evening prayer

Our team went outside our normal routines this evening, literally, to hold a prayer walk.  We found our Christ School beginning-of-the-year around-campus prayer walk so valuable, we wanted to expand our horizons and include other ministries of the team. In this pre-Easter season of Lent it seemed like a good time to take the risk.  I resurrected from my bed, and most of the team participated.  But we were only half the group, the rest were a handful each of Christ School teachers, hospital staff, church leaders, and nutrition workers.   We read from Romans 12 and 13:  Be transformed by the renewing of your mind (prayers again on the school campus); overcome evil with good (prayers in front of the hospital); the authorities that exist are appointed by God (prayers in front of our new Nyahuka Town Council government offices); and love is the fulfillment of the law (prayers on the mission property).  I find it powerful and poignant to have Ugandans praying for me, particularly those with whom I work daily.  Praying that we would love, would not lose heart, would persevere, would find our reward in God.  It is also powerful to pray against corruption, against the principalities and powers that enslave Bundibugyo, right on their own turf.  The intersection of our various ministries also helps people who work in one area get a vision of God's bigger picture of the Kingdom.  It was a simple hour of praying and walking together, about 25 of us including our kids, clear curiosity from onlookers but no major heckling or opposition.  Not a huge gathering, but perhaps a small seed, the initial path of revival?

Barrenness

Have spent the last two days pretty much in bed . . . which hasn't happened to me in a couple of years I guess.  Friday morning's rounds, teaching, admission, meetings dragged until mid afternoon and included the second dead baby of the week in my long line of waiting consults (newborn, held wrapped by grandmother, nurse screening the crowd of outpatients finally peels back the blanket and notes the grey-green tone of the skin and calls me, I come over and find no heart rate or respiratory effort for who knows how long, shake my head and begin to say I'm sorry as both women begin to wail) . . . the intensity of the ward combined with the lingering effects of this virus pretty much wiped me out.  I've forgotten what it feels like to be so so tired, to be convulsed out of sleep by coughing every few minutes, to arouse for ibuprofen and then lie back down exhausted.  To feel guilty about everything Scott has to do.

Today I'm marginally more alert, and reading at least.  I was struck by Carolyn Curtis James' exposition of barrenness in the book of Ruth.  Since it is a prominent theme in the Bible, she concludes that the role of the barren woman is to remind us that all life, all goodness, all power, comes from God.  That we are all barren spiritually (and to some extent physically as well).  That all our good efforts will be futile without resurrection power.  God chooses the hopeless situation in which to move and act.  

And this is good news, for me at least.  Lying and coughing, I'm completely impotent to do even the most basic activities of family survival, let alone serve anyone else.  And lying and coughing, my perspective on our life looks bleak, I can see more of the struggle than of the victory, and sense inadequacy and failing to a deeper extent, I find myself grieving losses and mourning the present problems.  In that mindset it is good to hear the words of Isaiah (54):

Sing, O barren,

You who have not borne!

Break forth into singing, and cry aloud,

You who have not labored with child!

For more are the children of the desolate

Than the children of the married woman:  says the LORD.

Resurrection will come.  

small comfort

At least Bundibugyo is not alone  . . it seems there is a nation-wide crisis of medicine supply.  Link to this article from the New Vision (national paper)  http://www.newvision.co.ug/D/8/13/675331   in which the districts blame the National Medical Store for inefficiency and the NMS blames the districts for corruption.  From our perspective both are true:  not enough money to buy the drugs, not enough supply within the country, obscure paper trails, hands dipping into the till at every point along the supply chain, lack of accountability.  But the effect is this:  at our local health center, the only medicine available right now was purchased privately by our donors through us, and is locked in a store which only I access.  So the peadiatric ward is overflowing, while frustrated outpatients increasingly abandon the effort to get care.  Any glimmers of hope?  Small ones.  A national consortium has formed to address the issue.  Locally, in our weekly staff meetings I ask hard questions bout money and how it is spent, and our staff is becoming more politically sensitive, wondering who benefits from the current messiness (the first step in understanding why a non-functional system persists).  The young World Health Organization doctor who has been appointed to help the district seems to be struggling to get a hold on the situation, and if he does not give up that may bear fruit.  Scott talked to the Chief Administrative Officer again yesterday and he still strikes us as a person who is moving within the system in the general direction of justice.  Meanwhile a kid with malaria (number 1 killer in Uganda) will be sent away from the hospital without treatment and told to forage in the local private drug shops, where the recommended first-line treatment goes for the equivalent of several days' pay.  What will happen?

Week in Review

Well, the week isn't over, but as it hurtles by I sit to think of a few highlights.

• Luke took off for Kalacha, in Northern Kenya, this morning.  Juniors and Seniors at RVA spend the last week of their second term on "interim" assignments, some adventuresome, some service-oriented, some recreational, some career-option-expanding . . Luke's seems to be a good combination of serving missionaries in a remote and harsh desert setting and exploring a different kind of African beauty.  He's completely out of touch though now, for the first time in our lives.  A bit sobering.

• We hosted a young medical missionary family, and enjoyed sharing our burdens and joys together.  Watched the Veggie Tales version of St. Patrick's story with their 2 and 4 year old kids, and remembered that Patrick began as an abducted child who found God in prayer.  How many of those are right around us, now?

• The secondary school football season started!  CSB defeated Kakuka 2 to 1 in the opening match.  Nathan probably pulled out some hair as his competent and disciplined team threw all drills and control and passing to the winds and instead played typical crowd-hysteria boot-it-in-the-air wild-power football.  Our "boys" were team captains for so many years . . no longer, but we still have a starter and two bench-warmers on the team.  And the kid who scored both goals was kept in school by a gift from Scott to his cash-strapped fellow-medical staff father, so we felt more satisfaction in the investment.  The only sad thing is once again seeing our kid (used to be Luke, now it is Caleb) on the outside again, practicing with the team but never really ON the team, wandering the side lines.  The ambiguity of his status has been hard on him.  Prayers appreciated for his continued good attitude.  

• Had to tell a mother yesterday that her baby was dead, after watching lab staff trying unsuccessfully to draw blood as she held the limp body of a frail little twin.  That is always wrenching.  And I felt like I failed to react to the baby's deteriorating status aggressively enough.  On the other hand, it was a miraculous wonder to watch a 1 1/2 year old little girl with pneumococcal meningitis who was seizing and severely sick on arrival, leave the ward giggling and intact, after a week of ceftriaxone.  Scott picked up a tumor in a little girl with a rare hemi-hypertrophy condition, and we both shook our heads over the dismal prospect of finding chemotherapeutic treatment in this country.  Precious, the child we sent to Kampala for treatment of Kaposi Sarcoma associated with her HIV, died.  It is always like that, one thing to rejoice over and more to weep over.

• Did I mention the putrid smell of our water?  Mystery solved:  two dead birds in the roof tank. This means emptying the system and cleaning and starting over.  As Scott says, the dirty jobs are all his.

• Give-a-Goat 09 begins!  The Christmas ornament fundraiser allows us to transform smooth clean models of goats into the hairy bleating smelly kind, the kind that make milk.  Lammech trained 33 new recipients, and when I went by Sarah told me that 17 had showed up, including Kosimus whom I wrote about last week.  His mother had weaned him early in fear that her HIV virus would pass into his body.  It didn't, so far as we can test, but he became malnourished until we put him on a rescue plan of boxed milk.  Now she'll be able to give him enough calories and protein to survive, available right at her home.  We're doing the distribution in more manageable small batches this year, and the first group is coming entirely from goats bred WITHIN the district through the Matiti Project.  This is a huge step in sustainability.

• Tomorrow:  CSB Board of Governor's meeting and the District HIV annual planning meeting, scheduled simultaneously (the former more than a month ago, the latter we hard about today).  Wish Scott could attend both, and ask some hard questions like why Dr. Jonah's salary has continued to come to the district it seems even though for the last 5 months it has not been given to Melen.  She was given a pay stub that seems rather incriminating.  Speaking of putrid smells.

• Lastly, all of the above is in the context of a week of bronchitis, a wracking purulent cough and migraine headaches.  I felt very sympathetic to baby Jonah who has a similar disease right now.  Being a "wounded healer" and having "God's strength perfected in our weakness" sounds a lot better on paper than it feels in person.  The physical toll of illness makes the emotional and spiritual challenge of survival much more tiresome.

real March madness

If you have not watched English Premier League football in Africa, you have not experienced the full spectrum of March Madness. This weekend we found ourselves scanning for satellite dishes in villages near the game park where we were visiting, and when the Man U-vs-Liverpool game time came around we filed into the only show in town. Picture a barn basically. A windowless split-log tin-roofed structure, with flattened cardboard boxes tacked up over the chinks. Dirt floor, narrow tottering rough-hewn long benches. 97 people (95 of them men) in an area the size of many American basement rec rooms, watching a TV on a table while a sputtering generator huffed and puffed outside to power the connection. Craning necks, shifting numb behinds. Enthusiasm. About half the crowd found it comfortable to remove their shirts (it was a bit close in there . . ). Almost all the crowd found it enjoyable to talk loudly, comment, clap, shout, jump, slap their friends' backs, and otherwise carry on. As the score stacked further and further in Liverpool's favor (much to Nathan's glee), our family became isolated in our stunned and sober stares. In fact it seemed to me that the African crowd merely wanted to enjoy the game and the win, so their passion for the team increased in proportion to the score. By the end Nathan was standing up with his new buddies, yelling and congratulating each other, as Man U was soundly defeated.

Football, or soccer as Americans call it, is truly the world's sport. Probably every person in that room kicks a ball (or a bundle of banana leaves) on a regular basis. Probably every man could imagine himself playing for a European club, as a good number of African star players have managed to make it there. In spite of the noise, the discomfort, the distant screen, the pungent barn odors, the terrible loss, I felt like it was the REAL way to watch football!

Goodbye, again

The Chedester Family will leave Uganda and World Harvest Mission in a little over two months from now, after a dozen years of service. They have served our team over all those years, hosting us when we had to evacuate, tracking down hard-to-find-supplies, processing paper work, managing mail, even simple kindnesses like shopping for vegetables or reminding us when our licenses are expiring. They were invited by Paul to be our link to the world by living in the more-accessible Fort Portal. But their ministry became much broader than that, supporting the church there, mentoring youth, teaching, praying, and raising a family including three children adopted from Uganda. They have been part of the fabric of our life for so long, it is hard to imagine the gap they will leave. Like most of us, though, the life-stage of their kids means access to more schooling options would be helpful, and the changing environment of Africa means that their gifts could be used even more fully in another setting. They hope to join AIM as dorm parents at RVA. So our lives are likely to continue to intersect, but this goodbye stands as another Ebenezer. By God's grace we have reached this far. But another parting takes its toll, too. We were thankful to be able to really honor their long years of work by our whole team hosting them at the Kingfisher, by silly songs and skits, by serious prayer and remembrance.

Holy Leopards . .

This weekend we stayed at the Kingfisher, a simple lodge of stone and thatch bandas overlooking the game park and lake east of us (about a six to seven hour drive from here). While there the entire team, in three vehicles, plied the roads on a game drive one morning. We were first out with no less than 11 people on our truck, in the darkness which melted into dawn as buffalo moved grumpily out of our path and kob darted warily away. We saw a half-eaten kob and guessed lions were in the area, but after an hour and a half without spotting them we stopped for a picnic breakfast among the warthogs and waterbuck. Just then Pat called to say that their car had stopped by another vehicle who had spotted about 7 lions basking in the sun! So we were off to find them, and later Annelise spotted four full grown female lions lazing close to the road. Amazing. Our vehicle later diverted to good old Campsite Two where we unloaded all the kids and read the last four chapters of the book of Job--God's soliloquy in which he answers the issues of the world by saying: look at the hippo. Watch the eagle. And we read that in a place where we could do just that, could marvel that we are NOT GOD, that He knows what He is doing. Great. By this time the other two vehicles, who took different routes, had headed back. We finally began the trek back to the lodge and suddenly a leopard sauntered out of the bushes, slowly rippling in the grass alongside us. We got good views for about a half a minute, then he was gone, without a trace, into the shadows of the dense vegetation.

Scott and I reflected on this later, and the parallel to spiritual discipline. If you don't drive and drive along the game paths, you won't see anything. But you can drive for three hours or two years or 15 minutes, and unless a leopard walks by at just the right moment, you won't find one. So daily Bible reading and prayer create the space for God to speak, to act, to be in relationship. But they do not force this to happen. Some days and months we can spend hours that seem fruitless. He still has to show up, mysterious, other, a sinewy rippling of beauty in the grass, a breathless wonder.

(P.S. - Leopard picture courtesy of Ashley Wood)

Evacuation Buddy

Rob P was a college student in 1997 whom God literally dropped into our life for a crucial four day period. He arrived on a MAF plane with another intern in June, just as the ADF war was spilling into our district. Four days later we ran away from an all-out pre-dawn attack, bullets flying, adrenaline-washed and dry-mouthed, joining a flood of Ugandan refugees. He "happened" to be a very fit cross- country runner from Covenant College, and we as parents were overloaded. I had a diaper bag back-pack, 8 month old Julia in a front pack, and embryo Jack as yet unannounced. Scott had Caleb on his shoulders, and another bag and a dog on a leash in his hands. And four-year-old Luke tried to walk, but the all-day panic journey which covered more than 15 km on narrow paths and passed dead bodies . . . well, let's just say we were eternally grateful for Rob's support. By the time we were helicoptered to safety, we knew we were in no position to host summer interns, and handed him over to missionaries in a more stable part of the country. Since then we've been occasionally in touch. That traumatic experience did not deter him from completing medical school and residency, and now he's a brilliant young doctor married to a lovely family nurse-practitioner with two awesomely cute kids, working in an academic hospital setting in Tanzania. Being a mere 20-some hours of ferries and road and only one country away, Liz and Rob decided to come back for a visit. So far the security situation is holding, so we hope God did not send him for another rescue. Instead we are enjoying the rare treat of reconnecting with a "student" turned colleague and friend.

On Sacrifice

The following quote was used by Scott in this week's prayer meeting. He took it from Frederick Buechner, The Magnificent Defeat, in a passage that describes Jacob's wrestling match with God by the Jabbok.  

"Power, success, happiness as the world knows them, are his who will fight for them hard enough; but peace, love, joy, are only from God.  And God is the enemy whom Jacob fought there by the river, of course, and whom in one way or another we all of us fight--God, the beloved enemy.  Our enemy because, before giving us everything, he demands of us everything; before giving us life, he demands our lives--our selves, our wills, our treasure.

Will we give them, you and I?  I do not know.  Only remember the last glimpse that we have of Jacob, limping home against the great conflagration of the dawn.  Remember Jesus of Nazareth, staggering on broken feet out of the tomb toward the Resurrection, bearing on his body the proud insignia of the defeat which is victory, the magnificent defeat of the human soul at the hands of God."

I feel the broken-footed stagger this day.  Unexpected waves of grief have come as we prepare the Gray's house for the Clarks.  The Clarks are an unkown, a promise of relationship which we anticipate.  But having them move into the Gray's old house solidifies the reality that our old neighbors will never return.  In a few minutes we leave for Fort Portal to spend two nights as a team with the Chedester family, honoring their decade of service in Uganda as we say goodbye to them.  They are moving on, and it is another loss.  Wednesday I discharged Peter John, a good thing, but I realized how much I loved walking onto the ward most days over the last three months to be greeted by his open-armed pick-me-up snotty smile, naked, infected, but unabashed.  In only one more week Pat will begin a short two-month furlough.  I miss Heidi, too.  We talk on the phone with Luke and he's in the midst of the future, colleges, tests, a world we barely touch on.   And had vivid dreams of my parents last night.  Who can explain, except that God decides to meet us and wrestle, why one week is more grief-laden than another?  Like Mary at the tomb I am sure as we wrestle we are meant to grasp reality, that what we see as loss God purposes for gain. 

The end of a nightmare

The last of the 30 Aboke girls abducted from their catholic boarding school in Northern Uganda by the LRA 13 years ago has returned to Uganda yesterday.  Her father is a doctor, and she was in Senior two at the time she was taken (Julia's grade now) which is perhaps part of the emotional impact of the story for me.  149 girls were herded out of their dorms by force that night, and most were rescued when an Italian nun who worked at the school followed the rebels on foot and pleaded for their release (yes, one person can make a difference).  The LRA kept 30, however, and over the years Sister Rachel and the parents and friends of the girls have continued to advocate and pray, slowly seeing most of the girls released, thought 2 died.  This return closes an long and painful chapter of Ugandan history, and brings to completion a remarkable story of faith and perseverance.  A book about the incident, The Aboke Girls, is recommended reading.  Meanwhile Catherine Ajok must reintegrate into a life she left long ago, and she will never be the same.  She returns with a toddler whom she says was fathered by the LRA leader and wanted war-crimes perpetrator Joseph Kony himself.  She has spent 13 years in jungle camps, moving from battle to battle, and one of a harem of war wives.  Her picture in the paper speaks of a calmness and hope.  Let us pray that her life pictures true redemption, good coming from evil.

Family Planning

We're planning to expand our team family . . . by five! No, no one is pregnant with quintuplets. Instead we participated in the conference call evaluation for Anna Linhart and the Johnson family. Anna is a teacher from North Carolina who has long had a heart for missions . . since she spent two years in Africa as a child when her parents worked at a school in Niger. She graduated with a degree in teaching and will come to work both with our missionary kids and cross-culturally with Ugandan children. Travis and Amy Johnson visited us in January, and we are so thankful that the visit was used by God to move their hearts towards Bundibugyo. Travis is a family medicine doctor completing an MPH at Harvard (well, we can't ALL go to Hopkins) and Amy is an educator with a master's degree and international experience. They have two children, Lilly and Patton. We eagerly anticipate working together, and growing into friendship while we do.

Family planning is an important part of health and survival. I pulled out an old prayer list from the summer of 2007 in which we anticipated Ashley, Sarah, Heidi, the Clarks, and two as-yet-to-be-found guys (Nathan, as it turned out, was one, and Scott Will will join as the other). For the last two year's we've been in the "spacing" phase of family planning, refraining from additions while we made sure to bring that 2007 list to life. When the Clarks land in a couple of weeks, that process will be just about complete. . . Which means we're ready to grow again. So today's conference call is analogous to the positive pregnancy test. We know new members are on the way, but there is a lengthy gestation before we actually see them. Anna and the Johnsons will spend the next six to nine months growing . . in grace, in prayer, in connection with supporters, in readiness to survive outside of America's protection. They will write letters and make phone calls and speak at churches; they will participate in WHM's Sonship spiritual formation program; they will attend MTI's pre-field cross-cultural orientation; they will shop and plan and say goodbyes. And we will have that time to be ready for them, to consider the impact of our changing family structure and dynamic, to make their entry into Bundibugyo as smooth as possible.

As in biological family planning, our plans may not always be God's plans (said humbly by the doctors who managed to have four kids in five years while "planning" . . . ). But we would like to see these five joined by several others, sooner rather than later. We still need a family willing to partner in education (could be administrators, counselors, pastors, handy-people, not just teachers); a couple or a young man to disciple and counsel Ugandan late teen/ early 20's post-secondary school kids; and a couple to serve as team leaders for us while we're on furlough. By faith, we hope to share more news of Great Expectations with you soon.

Provision, again

In great missionary stories, the need and the provision are always so amazingly timed that everyone can see that only God could manage to bring it together. Yesterday Ashley attended the district sports planning meeting for secondary schools, along with two other coaches from Christ School. She was well appreciated for her experience with tournament planning, and well supported in her desire to give girls an opportunity to compete. So today when David mentioned that the boys' soccer team would be sending a teacher to Kampala to purchase cleats, Ashley agreed that the girls' team should also get footwear (they pretty much play barefoot). She did not know where the money would come from, but measured the girls' feet. This evening we got a message from our faithful supporter Barb R . . she had decided to ask someone to fund 18 pairs of shoes for the team, God has just kept it on her heart as a loose end, and the friend said "yes" so she thought she'd pass on the news. Amazing. This is not just about winning or losing games. Girls who are part of an organized sports team grow in self-discipline, in friendship, in awareness of their God-given value. They are more likely to excel in school, and less likely to drop out for early pregnancies. So 18 pairs of shoes will give them a step ahead, in the right direction.

Mother-courage

I have to tell just one story from this morning's hospital rounds. Bed six looked rather crowded--a 13 year old boy, his five year old brother, and perched on the edge their wiry mother. The older boy held his arm at a peculiar angle, and I noticed his elbow was hugely swollen. The younger boy lay across his mom's lap with his equally swollen upper thigh raised in the air, and cried. It seems that a cobra crawled into their shared bed at home in the middle of the night and bit both children. I can barely imagine the terror of being awoken in the pitch dark by the screams of my children, in a house made of mud and thatch, with no lights. But this woman woke up and managed to kill the snake. She described it's characteristic hooding, and compared it's thickness to the metal frame of the bed. And there she sat this morning, with two injured but alive children, waiting for treatment. If only Eve had whacked the head off the snake in the garden, this woman would not have had to be battling for her kids' lives now. But here we are, and I admire her courage.

Nourishment....

After just one week, Kagadisa is improving.  As you can see from the photo, the shadows between his ribs are filling in and you can see that life is returning to his fragile frame.  Smiles and even a little chuckle today as I (Scott) showed him his picture.

On the flip side of nutrition (or lack thereof), I made an uncommon diagnosis of triplets by ultrasound two weeks ago.  The patient rode side-saddle on a motorcycle (10 kms over rocky, rutted roads) this morning to see me for follow-up.  I  told two weeks ago that "her work is to eat". To rest and eat, to try to grow these babies as much as possible in-utero before they are forced to survive out in this harsh world, competing for one of the two breasts that will be shared by these three.  When I asked her this morning how many times a day she is eating? Her reply: once.

One of my colleagues from residency at Cook County Hospital delivered triplets in the early 90s.  She gained 80 pounds during her pregnancy as her husband force-fed her as many calories as possible.  Her kids are now in college--in fact, one plays collegiate lacrosse.

What are the chances that all three of these Bundibugyo triplets survive into adulthood?  Slim to none.

I am tempted to despair, to doubt the love of God (and nothing bad has even happened yet!), but instead I will cling to the words of Michael Card and honestly lament the apparent injustice...

...lament and despair are polar opposites.  Lament is the deepest, most costly demonstration of belief in God.  Despair is the ultimate manifestation of the total denial that He exists. 

 

(Sacred Sorrow, p.55).

Linking education and health . . .

"The higher the woman is educated, the higher her chances and those of her child to survive. International studies have shown that a girl studying up to just Primary Seven reduces maternal and child mortality by 50%. In Uganda, of every 100,000 live births, 435 women die and of every 1,000 births, 76 children die.

Imagine what difference it would make to sustain our girls in school just up to Primary Seven!"

Dr Sam Okuonzi, a research fellow with the African Centre for Global Health and Social Transformation and he puts the saying, "educate a woman, educate a nation" into perspective.

On Being Found

We listened to a tremendous (as usual) Tim Keller sermon as a team last night, based on John 20:11-18, the passage where Mary comes to the empty tomb. As he points out in the sermon, Mary is weeping, lost, bewildered, and thinks she has been abandoned. She is aggressively ready to fight for the missing body in spite of her grief. But in reality she has just seen two angels, she is walking through the scene of the greatest miracle of all time, and she is speaking to the Lord. It is not until Jesus calls her name that her eyes are opened to reality. Mary. Just that word, and the entire scene for her changes. Instead of despairingly pleading to fix the burial/spice/location-of-the-body problem . . she is suddenly clinging so tightly to her friend Jesus that he has to tell her to let go!

How much of our lives to we miss? What looks like a bleak road or a disastrous outcome, like loneliness or opposition, may turn out to be the presence of Jesus. Our expectations blur our perception of reality. Grasping for what we think we need, or for what we sense to be our role, we may be missing the whole picture. Like Job and his so- called friends, we completely miss the reality of what is happening, because we assume God to be small or absent, we misread the signs, we operate in the wrong context.

May we all hear our name spoken in love, know who we are and where we are, have the veil rent to see the truth of God's unassuming and gentle walk into our lives. May we be, like Mary, called by grace.

Overloaded by Noon

Here are a few of the issues that bombarded my morning from 7 to noon, not including those that Scott deflected: calling a headmaster in Mbarara to try and get my student a place to repeat A levels, sending messages to a doctor in Kampala about my patient with a rare AIDS- related cancer whose father called me about 8 times over the weekend in distress, finding Jack's missing school uniform pants just in time to get to school, cooking breakfast and packing lunches, talking to my two workers about one of their wives who has declared herself to be dying 4 times in 5 days, helping them process what stresses might be relevant in her life and how her husband could assist her by sending away his two abusive alcoholic brothers who are sponging off his family, holding a firm line with another neighbor for whom I paid school fees to get the orphaned daughters into a better school (rather than returning to the one where the older girl had been sexually abused by a teacher) on the condition that their responsible brother pay for little things like paper and pens, negotiating surgery for a pitiful little boy who survived through our nutrition program but now has a hernia that needs to be repaired, seeing 28 very ill in-patients and about ten consults, coming up with gloves to keep the hospital functioning, receiving report back on a patient I sent for special orthopedic consultation two weeks ago (a bust it turns out, she says her money was stolen on the way and no surgery was done, just a return note with vague reference to ongoing home-based occupational therapy), seeing two staff members, a Christ School student, and a Christ School teacher all with medical issues and a sense of special privilege, and arranging MAF flights and accommodation for team mates and upcoming visitors. So if I forget a thing or two of importance by noon . . . I trust in grace to pick up the pieces.

International Women's Day/ Happy 1st Birthday Jonah

These two events are very appropriately connected.

Today, March 8th, baby Jonah Muhindo Gift Junior reached the significant milestone of 1 year. We celebrated with a party last night, his sisters and mom and a few friends. He loved the cake (!) even though he's not so interested in most food. He clapped his hands when we sang to him, and spent the rest of the evening entertained by his new blue soccer ball, or beating a bowl with a spoon and babbling.

But the real celebration is the woman who labored alone in her grief to bring him into this world, and labors on to build a life for her family. So on this day, a moment of tribute to Melen. A friend of one of our former team mates (who remains one of our real partners in provision here!) sent Melen a timely monetary gift, and both of us almost cried when Scott handed it over last night. She is quietly establishing a quality nursery school. Over a hundred students are taught by her current four teachers (3 of whom have certificates in early childhood education, and the fourth completed S6, which makes them all more qualified than the average primary school teacher around here) . . and they need more space. So she had purchased bricks and begun plans, but was out of funds, until this gift. Melen just got back from caring for the late Dr. Jonah's mother who was hospitalized. She manages the finances and supervision of her three oldest girls in boarding schools, and construction of the permanent house Dr. Jonah had planned on his village property. She has numerous family members living with and dependent upon her wisdom and resources. She is an African Proverbs 31 kind of woman, unassuming, uncomplaining, pressing on, with an inner peace and strength that have been tried by fire.

And so many women like her hold this continent together. We celebrate them today.

Guidance and Counsel

The A level results for Christ School finally arrived (the person collecting them was simultaneously graduating from University, so it took a while). This is the final two years of secondary school, Senior 5 and Senior 6, roughly equivalent to Junior/Senior high school or community college in the US.

Overall the news was encouraging--the highest score was the same as last year, and the number of kids with two principle passes which are required for University, doubled I think (to 18, out of 31 kids who took the exam). I haven't seen any official summaries, but that sounded good. However, there are a few disturbing trends. One is that students who have spent their lives at more successful schools elsewhere in Uganda are still migrating back to Bundibugyo for the exams, being allowed to enroll at the last minute at a couple of the very poorly equipped local schools and then far outscoring our students. This means that the small pool of government sponsorships which are allocated by a quota system (11 I think) will be, at least in part, siphoned away from CSB grads. Second, I think our highest scorers both last year and this year are boys who spent most of their school life also outside of Bundi, though they did come back for A level. This points out that, for the majority who schooled here, our teachers are up against a decade of poor primary school and lower secondary school experience by the time they receive these kids in A level. Combined with poor early childhood nutrition, general poverty, lack of books or a stimulating environment . . we can't expect the school to reverse all of that in 2 years of A level studies. And lastly, the science students fared very poorly. The boy who was top of his class for O level, and our own students Birungi who was also among the most promising kids, did not pass ANY of their sciences. None of the students in the primarily science combinations did well, I am told. There may be a combination of hopelessness, poor study habits, conflicts with staff, attitude . . . but it is very demoralizing for both students and staff to see these results.

So where do we go from here? The staff are busy giving students advice, and the Pierces are I am sure overwhelmed by the 18 kids who qualify for University and have to scramble for fees. We spent a large chunk of time in the last two days making phone calls and talking to trusted Ugandan friends, getting advice for Birungi, as we've done for our other graduating boys. Birungi had dreams of becoming a Clinical Officer, a physician-assistant level health worker. His grades would not even get him into a registered nursing course, maybe not even into a lower level enrolled nursing course. And the overwhelming weight of advice from both CSB teachers and our health center staff is that he should repeat A level, try another school, a new environment, with renewed passion for hard work. Two more years of tuition . . we are pondering the investment and what is best for him.

Meanwhile Luke spent a day in a seminar at RVA learning about the entire college admission process. He has already taken his first try at SAT's, goes on line to research colleges, talks to his very competent guidance counselor at school regularly. He is in an environment that is well equipped (much better equipped than we are!!) to advise and direct.

I think the way that God has overlaid our life such that we face issues with our own biological kids and the kids we have taken under our wing here, is instructive to our hearts. It reminds me of the way things could be, and will be by God's power one day in Bundibugyo. It reminds me that our boys are all very similar under their varied hues of skin, and all longing for validation and success and opportunity and love. And it shows me how important the Pierces' emphasis on counseling really is. Luke has benefited from it, and we would love to see someone here in Bundibugyo devoting their efforts in a similar manner, researching options for school, documenting processes and requirements, connecting kids to scholarships. Because mobility and working with 19 to 25 year old males are two pieces of the package, we're hoping for a mature single guy or a couple. Meanwhile the Pierces have hired two more spiritually-oriented counselors for the school, a former Bible School student sponsored by the mission now giving back to the community . . he has already led three boys to the Lord in the last month. And this week his female counterpart arrived, a middle-aged lady who was formerly a teacher but has a passion for prayer and counsel, and was led to the school by contact through her relative who teaches here. We are thankful for Tibamwenda and Eunice and pray that they will be used by God to lead and direct students in paths of life.

Peace and Justice

The President of Sudan, Bashir, was indicted by the International Criminal Court yesterday on seven counts of crimes against humanity and war crimes.  Pray for protection for the people of Sudan, for resolution, for hope. Pray for the Massos and all missionaries in Sudan, so far in their area things are calm.  Here is a quote from an African perspective, which would prefer to talk this out rather than bring it to court:

"The AU's position is that we support the fight against impunity, we cannot let crime perpetrators go unpunished," AU commission chairman Jean Ping told AFP.

"But we say that peace and justice should not collide, that the need for justice should not override the need for peace."

Stories of Survival

Kagadisa's grandmother began showing up intermittently at the hospital and nutrition programs a few months ago. He had been orphaned and left with her, and as she was scraping by in a polygamous marriage herself, there was little support for her dead daughter's scrawny six- year-old. Back then he weighed 15 kilograms and while unhealthy did not meet critical criteria for admission, so was treated as an outpatient. His grandmother did not follow-up very regularly, and we wondered if his problems were mere neglect. Then after more than a month's hiatus, he appeared again last week weighing an unbelievable 10 kg, a skeleton. Horrifyingly concentration-camp-like. While I see lots of moderate malnutrition, I rarely see a child as severely wasted as Kagadisa. His fragile skin was peeling, his pallor bespoke imminent death. We do not have the best record of reviving children this far gone with our limited care, and I assumed he would die. But no matter how hopeless a child appears, I do not want them to die hungry. We admitted him for slow refeeding, focusing on warmth, comfort, and having something in his stomach. He did not die. Days passed, each morning I checked his bed sure he would be gone. One day I noticed a whole line of healthy dark-skinned normal boys sitting on the edge of his bed. And it hit me that the woman who cared for these children (also her offspring and grandchildren) would not have intentionally allowed Kagadisa to slip away to death. He must have some disease, perhaps the same one that killed his parents. Perhaps TB. We had suspected it several months ago, but none of his lab results supported the diagnosis. I repeated everything and called in our experienced senior nursing officer, who agreed we should try putting him on therapy. He's up to 12 kilograms now, in just a week. But he's still too weak to sit or even hold his head up very long. When Scott snapped this photo and showed it to him, he smiled for the first time, a small hint of a crooked smile. I hope we will be able to show him a much more accurate picture of who he really is by the time he leaves. And I hope to see a real smile, then.

Kosimus' mom weaned him very early and very abruptly, in her effort to protect him from her own HIV infection. New evidence is showing us that early weaning (around six months or earlier) in settings like ours may save a few HIV infections, but this increment in survival is far outweighed by the decrement in survival caused by deaths from malnutrition and diarrhea. When I saw Kosimus' downward sloping growth curve, I was sure he was truly HIV-infected. But so far two tests have come back negative. It seems he was just hungry, that his little five-month-old body could not manage without breast milk. Now he's slurping boxed milk, and his dedicated parents both take their turns, investing in this little chip of a human who will long outlive them. We hope.

Ngonzi was also just hungry. His pregnant mother lied to us, even bringing an official letter from her village chairman declaring him tobe an orphan in her care, hoping that would buy her better care. Within a few minutes we figured out the truth, that she had become pregnant again too quickly and that he could not survive on her dwindled breast milk supply. We assured her that he was being admitted and fed no matter what story she told us .. so she came out with the truth. I suppose you could call this "uncomplicated" malnutrition, a simple lack of food without underlying disease. But I think poverty is inherently complicated.

And lastly, Peter John. A week and a half ago his weeping sister came to our door on a Sunday morning covered in his vomit, and he was lethargic, cool, and near death. He had been discharged from a long hospitalization (in which we diagnosed AIDS) at 10 kg and returned weighing 8, a 20% loss of body weight, severe dehydration. This morning, however, he toddled up to be first in line to be weighed, a 2 year old holding my hand, wearing nothing but an ankle bangle and a string around his waist, smiling. At 10.6 kg, he is back in the land of the living. And I have come to respect his sister Grace, who cares for him with a playful bond and a fierce dedication that outshines most mothers, perhaps also aware of her own impending mortality, investing in her two little siblings. A heavy burden for a 17 year old girl who has already survived abuse, and who cried again today recalling the details of her mother's death. But she smiles when she looks at Peter John, because she sees hope there, too.

These are a few of the stories of survival, stories that are still

being written, stories that may have joyful or tragic endings. And stories which I hope inspire prayer. In the last 24 hours I also saw a chubby baby Gloria, whose mother and twin died the day she was born, and whose survival looked equally hopeless last November. But her grandmother Bena's story touched visitng Barb's heart, and I know Barb recruited prayer, and here she is alive and well. And little Mumbere, still plugging along on treatment for AIDS years after his mother died, a mischievous grin and a frail slip of a grandmother. I noticed his chart: #4, meaning he was the 4th person to be started on anti-retrovirals at Nyahuka Health Center years ago (now we're using chart numbers in the 700's). Many prayed for Mumbere over the years, too. The milk we can measure, the medicines we can count, but the intangible realities of unseen prayers and healing power completes these stories of survival.

Pilgrim's Progress to 11

Jack turned 11 today, and chose "Pilgrim's Progress" as his birthday theme. We've read the "Little Pilgrim's Progress" several times, and this past Christmas Trinity church sent the kids a cartoon version. It actually is a good theme for Jack, because he's exceptionally literate, spiritually sensitive, and ready to do battle. Today was a typical Bday challenge for us though, juggling patients and family, and without Scott's input I would not have made it. UNICEF showed up unannounced for the key meeting that would determine whether we continue to get milk for malnourished kids for 2009. The doctor could not have been nicer, but I was also honest when he came just as I was leaving the health center, that I had to make it quick for my child's sake. I did not think it right to ignore a once-a-year visit from Kampala that determines over ten thousand dollars worth of milk formula for dozens and dozens of the neediest children. But I also did not want to short change Jack. In the end, with lots of help, it all came together, we passed inspection, signed the contract, made dinner, and organized the party!

Back to Pilgrim's Progress. We set up a full dramatization all around our yard, with stations for the Slough of Despond, the Wicket Gate (with letters from the King, and maps, and Annelise Goodwill snatching them from David Worldly Wise), the Interpreter's Kitubi with Bible stories and posters by Scott, a relay where the burdensome backpacks (loaded with heavy medical tomes) were dropped at the cross and Ashley and Sarah the shining ones put the mark of the Kingdom on foreheads. There was a Palace Beautiful refreshment stop (yours truly as the motherly Discretion), and a dangerous run through the Valley of Humiliation where Caleb as Apollyon pelted the kids with little mangos. Then the Valley of the Shadow of Death (blindfolded) and Pat tempting them to stop in Vanity Fair, the cage, the stile (we happen to have one between cow pastures) where they were captured by Nathan as the Giant Despair and locked in Doubting Castle (water tanks). A quick view from the delectable mountains gave the stamina to fight out of the Flatterer's Net (who looked suspiciously like Worldly Wise) and make it to the Celestial City for the Birthday Feast of spaghetti and cake. We have such a game team, dressing up outlandishly and going along with the program willingly. Nathan achieved the distinction of (according to him) the most ridiculous he has ever looked in his life. Jack was honored, and Quinn will probably not forget it soon, especially the very real terror of being so close to the cow. By the end of the evening Jack was plunging back into the tears that were plaguing him a few months ago. I think it was the anxiety of worrying that he would feel sad on his Birthday that put him over, but I also think we are under a significant amount of spiritual attack right now, sickness and weariness and injuries and discouragement. So Pilgrim's Progress encouraged my heart, too. As Jack sobbed going to bed "At least I know that I won't feel this way in Heaven . . ." Amen. We journey on in that direction.

collateral damage

In the theme of post-victory counter-attack on those whom we love, and in the theme of prayer . . . Ivan broke his arm on Saturday. It is his second broken bone in four months, both after relatively minor injuries. His school friends provided traction to snap the displaced bones back into alignment BEFORE they went to a teacher for permission to be brought to the doctor, so he was pretty close to passing out from pain when Annelise brought him up. A half-cast splint and TLC and rest revived him, and now we're trying to send a bottle of milk down to school daily to calcify his bones. It reminds me of Luke being injured in his first month away at boarding school . . . Ivan is 14, and though resilient, this is hard. Then last night I found out that my mom's eyesight has blurred significantly, perhaps related to problems from her old glaucoma surgery. Since she has both sever glaucoma and an epiretinal fold which impair her vision, and since she lives alone and drives about caring for numerous older relatives . . . more loss of eyesight would be extremely difficult for her. Would appreciate prayer for healing for both.

In Praise of Pee

Forgive the title, and be thankful I did not have my camera today, but 

I wanted to share the good news that after well over a year of effort, heart-ache, corruption, and disappointment, Kweyaya Paulo can pee. He is, for the first time in his five years, urinating normally out of normal openings. The hole in his stomach is closed. He is smiling. His mom is smiling. We are thankful for our gracious supporters, because our ministry fund allowed us to pay for his transport and surgical care at the main Church of Uganda hospital (not free) in Kampala and avoid the hopeless passive-aggressive public hospital where he had languished for months. His post-operative care was done through the charity ward at International Hospital, the HOPE ward. Also this morning we were able to send blind and paralyzed Kabasunguzi Grace and her mother to a rehab program in Mbarara, where they are encouraged to press on with her care. These children would otherwise simply be relegated to helplessness, sad reminders of injustice, because the access to specialty care presents too many barriers to their families. But for a hundred dollars or less I can usually hook them up with some services elsewhere in the country. It is a small side-bar to our normal patient care, but one that reflects the value of even the weakest and poorest special-needs kids, and I'm grateful that our financial support through sacrificial giving to the mission allows us to pass the blessings on.

A weekend of life

The weekend was full, and I am very grateful for the way Caleb's 14 fire-cracker sparkling candles matched the renewed sparkle in spirit that accompanied the love extended to him on his special day. He missed Luke being here, for the first time ever. A lot. But Luke made a creative collage of photos they had taken together photo-booth style using a computer cam, and emailed it in. The whole team descended as a light evening rain tapered, and we cooked pasties (meat and veggie pies) in the outdoor oven, made home made ice cream, opened presents ranging from just-like-new jeans from the used clothes piles in the crazy Saturday market, to a David Pierce sarcastic take-off on Monopoly geared to Bundibugyo with cards like "Pass go, take another wife and get another child" or "Your National Social Security Fund matured. Wait four turns to collect." Caleb was quick with the one- liners and kept us all laughing late into the night, as he allowed us to try out the new hammock made from a bright red woven African cloth that the singles brought him.

And this morning, we took the Elijah advice. We escaped, to the closest bit of wilderness available, for a nearly-all-day hike in the Semliki forest. This is a lowland tropical rainforest with more than 300 species of trees and more than 400 species of birds . . . and NO PEOPLE. We hiked for probably about 10-12 km, through sun-speckled high-canopy areas of ironwood and low scrub, through dense jungly palms and vines, through sulfurous vents steaming with hot springs, through sucking mud. We saw chimp nests (2) high in the trees, the temporary leafy structures they build for napping in the day. An empty aardvark hole. An intersecting trail stomped with elephant prints and littered with their dung. Five different monkey species crashed through the canopy above us: Grey-cheeked mangaby, black-and- white colobus, blue monkeys, red-tails, and baboons. The baboons are the boldest, and there was an amazing moment when Jack imitated their throaty call, and had a conversation. Really. This huge baboon was right over our heads in a palm tree staring at us, and he and Jack were calling back and forth. Hornbills and palm-nut vultures and bee- eaters and ibis flew into view. We glimpsed a rare monitor lizard scuttling through dry leaves across the path, and the elusively shy sitatunga antelope. One of the bizarre moments: Sarah's cell phone (which never rings) got a call from her family which was all together to celebrate her grandmother's 80th Birthday just as we were on a rotting-log bridge that broke with Nathan on it (a short fall) and we all ended up in a swarm of biting ants, running and trying to get out of the bog and the insects, and I heard Sarah saying "happy birthday grandma but I have to go we're being attacked by biting ants in the forest". Probably the most unusual conversation her grandmother had that day. We ended up at the "female" hot spring, a clearing of crusty rock and marshy grass where boiling water bubbles to the surface, and reeking steam lifts slowly into the hot air. It is believed to be the place where the spirits of women who die roam, and local women come to make sacrifices there. We came to boil eggs, very entertaining to drop eggs into the pools of bubbling mineral-laden water and cook and eat them. Home to hot soup and family time, all in all a day of complete break from routine and normal life, of being temporarily unavailable to anyone else's crises, of walking through untouched wilderness thinking about life from God's perspective.

Which means that Monday comes tomorrow morning, inevitably, and without much preparation other than the rest of soul that accompanies a good weekend break.