Paulo, who pees. Praising persistence, a peculiar Rose, and Hope.

(Sorry for the slang but couldn't resist the alliteration)

This is the happy ending to a long story. Readers may remember Paulo, a little boy who was born with abnormal valves in his urethra that blocked his ability to urinate. His mother is one of the most persistent ladies I have met. In the face of widespread fatalism and weariness when the system fails to work, most people succumb to a lethargic and uneasy compromise with reality. Life is difficult and unfair, and there's not much hope of changing that. But not Paulo's mom, who knew that the painful dribbling urine her little boy eeked out was not normal, and not being treated by hastily scrawled prescriptions of antibiotics. By the time she landed on our ward he had some damage to his kidneys. But the struggle had just begun.

We referred him two years ago for the relatively straight-forward surgical procedure of ablating the problematic valves, i.e. getting them out. Instead the only urologist in the country performed a simpler procedure, an opening in his abdominal wall so that urine passed directly out of his bladder and onto his skin and clothes. This saves the damaging back-pressure on his kidneys, but is a socially untenable long-term solution. Over the course of the next year we sent him back to Mulago six times, the national referral hospital where citizens should get specialized care, free. Each time he was sent back with an excuse of why surgery could not be done. Once he spent TWO MONTHS admitted, was discharged with a note that he could not urinate, and told to come back in a week. In desperation we hooked him up with the private hospital in Kampala, IHK. However it turned out that they consulted the SAME urologist who was suddenly available to do the surgery he'd put off six times, but for an exorbitant fee.

Well, Paulo's mom met her angels at last, two more persistent Ugandan women. A woman named Rose, who bravely walked away from a life of witchcraft and sacrifices as a teen, to look for a better one. She was adopted by an Irish medical missionary couple, sent to nursing school, and founded a charity called Hope Ward at IHK (her dad's hospital). This visionary and passionate woman just held a huge fundraiser, to protest child sacrifice, a walk-athon of the route of her escape, and donated the money to Hope Ward. And a woman named Jemimah, who connects patients with the care they need on the ward, makes the phone calls and appointments. She found an alternative surgeon, and Paulo finally had his surgery earlier this year.

For the first time in his five years, he could urinate. But post-op, the old opening that had been made in his abdominal wall and then closed, began to leak. A few months ago we made a plan for him to return in October for a second surgery. On exactly the first day of October, Paulo and his mom showed up at our house. I thought they wanted to go back to Kampala. Instead his mom explained that God had healed Paulo, the old wound was closed, he no longer leaked through his stomach. He pees like any other 5-year-old boy.

It was a long saga, for one little boy, and I'm glad for his sake that it is finally over. The damaged kidneys will probably come back to trouble him eventually, but without the surgery he could have been dead by now. A big thanks to Hope Ward, Rose, Jemimah, the Clarks, and all the people in Uganda who stand against corruption and despair, and work to make things different.