Monday, June 29, 2009
Sunday, June 28, 2009
Friday, June 26, 2009
Thursday, June 25, 2009
Wednesday, June 24, 2009
Monday, June 22, 2009
Sunday, June 21, 2009
comes of a cultural need for participation. Multiple choirs, multiple
songs per choir . . but also in the prayer requests, there are just a
LOT of people sick or with problems they want to share and pray
about. As community grows and deepens, it takes time. Musunguzi
preached powerfully as usual, from Acts, challenging each member to
share the Gospel themselves. As he said, Dan Herron and Alan Lee came
here in 1986 and sat in Alinga's kitubbi and told us about Jesus. Are
they here now? No, but they don't need to be, because they taught all
of us. It was a great illustration of the way Paul and Barnabas
planted churches in Acts 14, and a sweet look back on our
predecessors. Later he also said, you only heard the gospel because
those men came far from their homes out of love for us, and that is
why missionaries are still here among us, they love our people. A
soothing moment for my frazzled missionary heart . . .
But the real excitement in church today was an earthquake. It sounded
like an explosion, the whole church shook, everyone jumped up from
their benches and looked around, then a few seconds later there was
another less intense rumble and shaking. Many of the congregation ran
outside. I made my kids go. It is the prudent thing in an earthquake
to NOT be in the only building for miles around that is large enough
to kill people if it falls. I know Paul did an excellent
construction job, but I'd rather observe the strength of the walls
from the outside . . . However nothing fell down and everyone hugged
and laughed to cover their fear, including me. Then we came back
inside and sang two vigorous praise songs. The danger energized the
service, and the preacher later used it to illustrate the nearness of
Jesus' coming and the importance of standing for Him.
Saturday, June 20, 2009
are working on homework projects and want advice, many flagged emails
and things to think about, without even coming to the food shopping
and planning and cleaning and normal home organizing that has to
happen on a Saturday, the only day in the week I usually spend focused
on life survival. So when I finally sat down to work and there was an
immediate knock on the door as Julia called "mom, someone's in the
kitubbi" my heart sank. Part of the stress of being home alone is the
no-sharing of dealing with anything. But as I walked to the door, the
ipod (on blast volume I might add) was playing a Stephen Curtis
Chapman oldie: Do justice, love mercy, walk humbly with your God. A
well-timed attitude check from a musical Micah 6:8.
In the kitubbi, two anxious parents and one very dehydrated baby. No,
they had not gone through proper channels of being referred from the
hospital. But I had seen them there during an admission less than
three weeks ago, so when the baby became seriously ill again they went
straight to the place they hoped to get help. And while part of me
wants to create protective rules for my Saturday survival, thanks to
the music in my head I was able to see them with empathy. If my baby
looked like that you better believe I'd do whatever it took to get
attention. The dad's dress indicated a different world religion, but
that is no barrier when a child's life is at stake, and I'm glad for
that, that justice and mercy offered in a humble way cross barriers of
faith and culture.
On Friday, at the "launch and lunch" celebrating the end of our week-
long Village Health Team training on nutrition in HIV/AIDS, I walked
in late just as John was graciously covering for me, and found myself
immediately invited to speak. The first thing that came to mind was
Isaiah 58, so I read a few of my favorite verses, and found that
though I was preaching to the VHT's the Spirit was speaking to ME. If
you extend your soul, pour yourself out, on behalf of the needy and
hungry . . . then God will be your guard, He will come to your aid.
As volunteers these health workers will pay a price to help others.
But their reward is from God, and He promises to refill what they pour
Today I cling to that promise, too. And to the clarity: what is
required? Just this: to do justice, to love mercy, to walk humbly
with God. This was a life verse we reflected on at my Dad's death, a
summary of the way he lived. And it provides a guide for me and for
our team. Let us pursue justice vigorously, let us live out acts of
mercy, and let us do both, not in a way that promotes ourselves or
America or World Harvest . . .but in a humble day to day walk with God.
Wednesday, June 17, 2009
Jonah's and Kevin's experiences with death: once the crowd threatened
Jesus at the cliff, and he walked through unharmed. The second time
the crowd gained deadly momentum, they pushed him to the cross. Kevin
has walked through this experience of death like Jesus parting the
crowd and leaving the cliff. Today he's out of the ICU again post-op,
eating and walking again, and once again showing the most amazing
recovery speed. God has been given glory for the miracle of his
resurrection, the timing, the people, the third-try shock, the
protocols at Duke, the surgery, everything. When the surgeons saw his
valve, they confirmed that he had very severe stenosis. In most
scenarios he would not have survived, but now they are thinking about
which day to discharge him home. Jonah, on the other hand, followed
the path of the cross. I can not explain why God worked so
differently for those two men who had dedicated so much of their lives
to the Kingdom in Bundibugyo, who had wives and young children in the
balance, and who had been our friends. But Karen's analogy of Jesus'
life shows that God's ways can not always be predicted or boxed in or
explained, that the same crisis may have different outcomes that both
turn out to be based on love.
For tonight, resting in the rescue God provided Kevin and JD, and
rejoicing that he has a new valve and a new hope for life and
relationship and work and meaning.
Tuesday, June 16, 2009
(Press release): Nairobi, June 16th 2009: Africa observes the Day of the African Child, in memory of, thousands of black school children who were maimed and killed in 1976 Soweto uprising, as they took to the streets to protest the inferior quality of their education and to demand their right to be taught in their own language.
Today is a UN-sponsored day to draw attention to the plight of the African Child, which is all too often a life of marginal nutrition, sub-standard education, fragmented family (in spite of our stereotypes few kids here grow up with both parents), and too-early shouldering of adult roles and responsibilities. I suppose I celebrated it in my own way today, struggling for the real lives of a few real African children. All in a day's work: a newborn baby with spina bifida who could be helped by referral to a neurosurgical mission hospital on the other side of Uganda; a newborn whose mother died in the process when her uterus ruptured who could be helped by milk until the family sorts out a surrogate breast-feeder; a convulsing baby whose anxious and misguided parents had been treating him for days at home with herbal enemas which were ineffective for his real problem of meningitis, but who could be helped by IV antibiotics; a five-year-old inexplicably malnourished little girl who tested positive for AIDS and could be helped by the correct medicines and counseling; a child with newly diagnosed sickle cell disease who could be helped by prophylactic antibiotics and vitamins; an infant with severe gastroenteritis who could be helped by large and fast infusions of IV fluids; and the list goes on through a crowded ward and a line of consults.
Too many days I have the sense that all the effort is for little gain. But today a small supply of anti-retroviral drugs arrived (not much, but enough for the next week) and another consignment of anti-malarials, which is huge news. Both evidence that prayers are at work, that good is gaining margin over the chaos of want. And lastly I want to share one very satisfying victory. Two weeks ago a child was admitted with severe malnutrition, and given his terrible respiratory status and his coughing skinny mother, we thought the pair probably both had TB. But the mother's sputum tests from another hospital were negative. The clinical picture was so convincing, though, that I set out to get her re-tested. I have never worked so hard for one simple lab test. It would be too tedious to describe every turn in this story, but here are a few: no frosted microscope slides, which the TB program requires because the slides have to be marked with the patients' name and saved for review, phone calls, none at another lab but the idea of using tape to mark the slide, the lab refusing and demonstrating the slide would then not fit in the right slot in their storage box, more phone calls including the District Health Officer informing him that our entire public health effort to find and treat TB was failing for lack of lab supplies, who then suggested we send someone to beg them from another health unit, paying for the fuel for the motorcycle to do so, to no avail since they did not have them either, noticing a truck from Kampala with "TB and Leprosy Programs" painted on the side and shamelessly interrupting to beg aforesaid frosted slides which they happened to have stashed in the back seat (?prayers), then finding out that a certain acetone fixative was lacking for the stain, more money for more motorcycle fuel to track the fixative at another hospital, then having the mother turned away from the lab for lack of gloves, providing gloves . . . meanwhile the interns looked at this kid and couldn't believe he was still alive. By Friday this was still going on and I decided to just start treating the child for TB anyway. He actually improved over the weekend. And today his mother FINALLY (AFTER TWO WEEKS OF RUN AROUND) got her sputum sample: triple plus positive for TB. So instead of a dying child and a more slowly dying mother, or a child who was treated empirically for TB only to be orphaned when his mother died of the disease or re-infected when he went off therapy . .. now we have hope of two people being cured and living normal lives.
And the real story here is the same story as Kevin's . . . it is God who is looking out for individual lives. Most times the degree of difficulty involved and the sheer volume of other demands would have meant that this child and his mother slipped through the cracks. Many mothers might have also wearied of the rigamarole and gone home by now. But in this one small case, God kept prompting one more step, one more try, until the diagnosis and treatment were complete. Because He cares about the African Child, not just as a politically correct concept, but as an actual flesh and blood and tubercle bacillus-infested individual who will one day take deep breaths and perhaps graduate from high school or build a house or write a story. Or just carry water for his mother.
board a BA flight to America. Scott was encouraged months ago to make
this trip by members of his high school class who REALLY wanted to see
him at their 30th reunion, but the decision was finally made to go in
response to his dad's recent bike accident and illness. They will go
to California to see the Myhres and thank the Half Moon Bay Methodists
for their support at a service on the 21rst, as well as preach three
services in the Wyoming Presbyterian Church (a Cincinnati suburb where
he grew up) on the 28th. Sadly for us, to keep the trip to two weeks
Scott will miss a Sunday at our main supporting church Grace OPC in
Vienna, VA, instead attending a mid-week Bible study to thank our
friends there. Caleb will also go to the annual Aylestock family
reunion, and there will be lots of good food and grandparent time and
hugs and stories. They will be in four states on two coasts in two
weeks, so it will be a pretty packed time.
Meanwhile Julia, Jack, and I are attempting to hold down the fort at
home. No small thing. Just before he left, Scott, with Nathan's
brave help, moved our very mean and dangerous bull away from the
paddock by our house to the yard at the old Tabb house. For safety.
But our cow DMC just stood at the fence and cried her little heart out
all evening. And I could so relate to her! Her husband is out of
sight, and her calf might as well be at boarding school since they are
separated by a fence (to prevent nursing so we get the milk). A few
hours later, the gate was left ajar and the calf Truffle entered her
mother DMC's paddock. So there were Jack, Julia, and I all with
sticks running around in circles trying to get them apart and drive
the calf back into her proper quarters, an exhausting and futile
exercise until cowgirl Julia got some dairy meal (like oats) and lured
her. Thankfully I had turned off the stove at the last minute so
dinner was saved, but if this first night is any omen for us and the
cows, the next two weeks could be a doozy. Now DMC is moaning and
alone again. She has the separation woes, and so do I.
Monday, June 15, 2009
But today John Clark launched a new wave of community health outreach. Thanks to contacts we made in the last year with a program called NuLife, we were able to send two of our great agriculture/ nutrition extension workers to be trained to teach village health workers about infant and young child feeding, particularly in the context of HIV/AIDS. This organization, funded by USAID and working in close partnership with the Uganda Ministry of Health, has developed a nice set of teaching aids to bring basic health and nutrition messages to the village level, and to teach dedicated village health team members to screen their population for malnutrition. Instead of waiting in the hospital for the kids to come to us, these village health team (VHT) members will actively search out those failing to thrive. This dovetails nicely with our other health-center and hospital based programs for moderate and severe malnutrition. And this prepares our district to receive the commercially prepared high- calorie food supplement which NuLife hopes to begin manufacturing. That is still a ways down the road, and as a medicinal food it will only be given to the most severely malnourished and those with AIDS, so again there is complementarity with our BBB local-production for moderately malnourished kids.
Over the last few months a good amount of aggressive advocacy was required to get our staff included in the trainings, and to try and hold together the various partners involved. But now I am enjoying the teamwork, dropping in to see our trainers drawing out the 20 VHT's in a participatory way, noting that a good number of those chosen for the training are HIV-positive people themselves taking an active role in their own care, thanking John who saw to all the details of transporting and feeding and informing and facilitating the people involved in this event. The training will go on all week and end with a community launching ceremony. We pray it puts information, inspiration, vision into the hands of the people.
Sunday, June 14, 2009
Friday, June 12, 2009
on his own, and even talked to JD a bit. He will rest now for the
night. This is so miraculous, such good news, my fingers tremble even
typing. Of course there is far to go and much to know, but even this
degree of recovery was faster and further than was anticipated. So
Thursday, June 11, 2009
He had gone out for a jog with Joe yesterday and collapsed within a hundred yards of the house. Thanks to Joe's calls for help neighbors called 911 and started CPR. JD ran out to find him with no pulse or breathing, and continued the CPR herself until the ambulance arrived. He was in ventricular fibrillation, the kind of arrhythmia that causes sudden death. It turns out that he has a previously undiagnosed congenital anomaly of his aortic valve, which occurs with some frequency (at least 1 out of a hundred people) but does not usually cause any symptoms until mid-way through life, and then the first sign can be this kind of sudden collapse during exercise. The paramedics had to shock his heart three times; the third time in the ambulance finally got it beating again. Kevin was without vital signs for at least 5 to 8 minutes. In the Duke ER he did try to fight the tube in his throat for breathing, and opened his eyes, so those are hopeful signs. He is heavily sedated, medically paralyzed, on life support, and cooled down to a near freezing temperature, all to try and minimize the damage to his brain from the long period of no oxygen. Preliminary tests indicate he did not have a "heart attack" (myocardial infarction) or a stroke; the collapse was due to the electrically ineffective rhythm his heart went into.
Yesterday was the Bartkoviches' 15th anniversary. I can only barely imagine JD's experience of finding Kevin lifeless on the street and doing the first CPR she's ever had to perform, on her own husband. By the time she got her 4 year old twins cared for and got to the hospital, she had no idea if Kevin was alive or dead, since she had last seen him put into the ambulance after the first two attempts at defibrillation were unsuccessful. Her family, and many friends, have rallied around her now. His prognosis is far from clear, he is certainly not out of the woods, but we hope and pray that he will recover without major impact on his brain. He will eventually need a replacement of the abnormal heart valve.
Where is God's mercy? We can not see it as clearly as we would like; we say by faith that it must be there. Here are two glimpses.
One, since this event stems from a life-long silent heart defect, it could have happened any time during the Barts' ten years in Africa. Kevin's final weekend he hiked over the mountain pass with teachers from CSB, a strenuous endeavor hours from any road or phone, not to mention hospital. He coached soccer and jogged around the school track. If v-fib occurred here, he would not have survived. Even if he had gone down most places in America, he might not have been revived in time. This happened five minutes from one of the premier medical centers in the world. This is a small vision of the way God sends His angels to keep us from stumbling, even when we don't know it.
And glimpse number two, this occurred in the midst of Christ School crisis. Yesterday the students were becoming very restless and threatening violent strikes, the immediate issue being the school's new policy of having a "spot exam" (pop quiz) period at the end of every day. The bigger issues are complex, related to being teenagers, poor, reckless, with little to lose, no skills for non-violent conflict, distrustful, many with histories of abuse and abandonment. We got the news about Kevin while students and staff were in the midst of meetings over their complaints. The meetings turned into prayer meetings for Kevin. This was a needed reality check and change in focus, at least for the day.
Please pray for the Bartkovich family, for bigger views of God's glory and merciful care as they walk through the valley of the shadow of death. And pray for the school that they devoted a decade of their lives to found, for us to see God's glory and mercy there, too.
Monday, June 08, 2009
Saturday, June 06, 2009
desperation. We are grateful for those who have written and called in
support of the AIDS-drug crisis. Lots of foot-work and phone-work on
Thursday we hope will pay off by Monday, as we have appealed for a
portion of the limited supplies. Not a long-term solution, but still
But a mercy of God is that with a kid at RVA, we take a mid-term
breath-catching pause. From Friday to Sunday this week we are a
family first and only, putting aside worries about patients and
robbers and polio and funding and the future. Our job, for the
weekend, is to be with our kids. And they're a pretty fun group to be
with. This is what they like to do: play ping pong and tennis and
soccer, swim and read novels, watch Mythbusters and World Cup Football
qualifiers, eat Thai, Indian, and Italian food, catch a movie in the
theatre, laugh at Calvin and Hobbes jokes, jump on the trampoline, and
read some more. And talk, about schools and travel and people and
chaos and God. It's a welcome break from the day to day reality of
Bundibugyo. We are usually on the move, heading to a conference, a
meeting, or at least a game park when we're on a school break. This
weekend we're just in Kampala, impersonating a normal American
expatriate family going to restaurants and relaxing. It's been great.
And we're back at the ARA (the American Recreation Association), a
place where we have history, where some of the same staff watched
these same teenagers when they were toddlers learning to walk and
later to swim. This is the very room where we landed to recover from
rebel attack in 1997 without a single change of clothes to our name,
where the managers let us rustle through the lost and found. Year by
year as Bundibugyo became home, the ARA also reminded us that we're
still Americans, too, who like a hamburger and a room with a fan. It
has been a safe place to escape into order, a place of respite.
Sometimes all the more frustrating for the illusion of American-ness
without the reality, sometimes a disconcerting dose of parallel
universes of rich and poor . . . but mostly a great escape.
So we're thankful for the weekend off, storing up the memories and the
resilience to hit the ground running again on Monday.