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Sunday, January 30, 2011

Moving . . moving . . moved

Writing, at last, from home.  Yes, we now live someplace (renters, but it feels like ours).  A house with a yard and a porch, and two bathrooms, and fresh paint, where two sacred ibis were just picking their way around the wilty dry yard as Julia and I searched for a few flowers to brighten the table.

Table?  Yes, we have a table too.  First, mid-Wednesday, we had six mattresses and a stove and fridge, and decided that was enough to justify occupation.  So we moved over from the furnished apartment to sleep on the floor that evening, a much more exhausting process than I anticipated.  Had to go back and make pancakes at the first place that night since I had nothing to cook with, though there was a stove to cook ON.  Then Thursday we carried in the dozen trunks we had stored in two families' attics here, caked with dust, filled with the fragments of our life in Bundibugyo.  Way too many books, a few pans, our favorite dishes, electronics, kitengis, games, a quilt, tools, tents, Christmas decorations and Easter baskets.  And books.  We unpacked them into stacks all over the empty floor, and slowly sorted and put what we could into the few closets here.  Then Saturday Scott went into Nairobi once again, and sent back two small chests of drawers and two chairs.  Furniture!  Then he returned with the curtains we had ordered, and Caleb and Julia painstakingly attached them to the drapery hooks at every window.  Privacy!  Color!  

Saturday evening the long-anticipated six beds and two couches came, Africa-style, on the back of a little white pick-up truck.  Not exactly what we had in mind when we paid for the transport . . . especially since the light-colored upholstery was left exposed to the dust of the road, and marred by the filthy ropes used to tie it down.  It seems that these couches are my thorn.  Because I really like them in spite of all the hassle, they look a LOT better than the fabric sample made me believe, so I have to keep being reminded not to put my heart on them too much.  Today the little truck returned with the dining table and 8 chairs.  By the end of next week we're hopeful for three simple desks (tables really) and two bookshelves.  

So there you have it. With all the creative pottery (Luke) and woodwork (Caleb) displayed on our one shelf, with our throw pillows (team via Karen as we departed), with sheets and pillows and even two blankets (it is COLD at night, the first night we were shivering and broke out the sleeping bags from our camping supplies), with places now to sit and eat, this place looks like a home at last.  

A closing story on God's provisions.  When I unpacked the trunks Thursday, I realized that though I had three pans and a skillet, I had not one utensil with which to stir.  I was seriously regretting leaving so much behind.  Then Kimberly our fellow-WHM missionary texted that she was coming to the dentist at Kijabe and offered to bring something, so I asked her to pick up a spoon, whisk, and spatula, which she graciously did.  I mentioned this Friday afternoon to one of the short-term visiting doctors from New York, and he brightened up.  Come by our place, he said, our church had a "kitchen shower" for the missionaries and we brought an entire suitcase of kitchen supplies.  Coincidence?  I think not.  I did not need to be asked twice . . within and hour I was knocking on their door.  I could have almost cried when Elaine gave me two bright aprons, brand new dish towels, measuring cups and spoons, a few more utensils, a couple sharp knives AND a sharpener, even a vegetable peeler and a pastry cutter.  Many of the things I left behind, being given back to me new and spiff and free.  It's the kind of small detail that God delights in working out, to remind us of His intricate mercies.

Today feels like a corner turning, the end of leaving (Bundibugyo, team, our normal life, our HMA) and the beginning of being present in this place where we've been moved.

Thursday, January 27, 2011

More Redemption . . and CELEBRATION

More than three years ago a young lady came to our church at the urging of her Sunday School teacher, who happened to be one of my good friends growing up. He had urged her to apply to teach missionary kids in Uganda when she graduated from William and Mary. Little did we know that Sunday morning that Sarah would become like a member of our family. Meanwhile another young man was graduating from another William, this time without the Mary, Williams College. He applied to spend 18 months in Uganda with a possible interest in medical school. We took him on, partly because we were anticipating another young single guy whom we didn't want to be alone (who never came, ironically leaving Nathan alone most of his term). Little did we know then that Nathan would also become and integral part of our family and life. Sarah and Nathan served wholeheartedly in Bundibugyo during some rough years for the district, and for our team, and for us. They both did amazing jobs. But even more amazingly, they found God drawing their hearts towards each other. It is pretty ridiculous to even think about "dating" on a team where the singles function like siblings, where every moment and action is observed by a curious community, where there isn't a restaurant within hours, where privacy is culturally suspect. And where each of us is stretched to the limit. This is not a set-up for glamor or romance. And when Nathan and Sarah did realize their hearts moving in this direction, they bent over backwards to be sensitive and submissive. Even so, there was a cost to the other singles on the team, as well as their own cost. When Sarah finished her term Nathan remained, and they made the excruciating decisions about medical school/masters in public health options while they were 7,000 miles apart, taking some risks (waiting list) that panned out to put them in the same city.

So it is with more than the usual rejoicing that we received the news on Saturday of their engagement. Sarah and Nathan will be married this summer! I believe this is the fifth American wedding to come from Bundibugyo, two other couples who met there (Rick and Wendy, Eric and Joy) and two who met at MTI (Natalee and Wes, Rachel and Craig) . . . am I forgetting someone?? Bundibugyo is a place where marriage has fallen far from God's creative and beautiful plan in Genesis. Unions are temporary, sequential, financial, and too often end in violence or abandonment for women. It is NO SMALL THING when a marriage actually grows from this soil. It is the kind of amazing, upside-down, Kingdom-only work that God does to surprise us.

Nathan and Sarah remind me that we serve a God who is making all things new. Who prepares a celebration so wonderful, that a marriage supper is a weak analogy to help us anticipate the glorious reality. We rejoice with them, and pray for faith as they move forward in their life together, becoming a redemptive blessing to this world.

Congratulations to our dear friends!

Wednesday, January 26, 2011

Redemption and Rejoicing

The RVA student who has been in a coma since Saturday woke up this morning! After four days of worrisome unconsciousness as malaria parasites plugged up the small blood vessels of her brain, the prayers of the saints and the careful treatment of her medical team finally pushed her back from the edge of survival. She is quiet in that unsure sort of way, but looking us in the eye, and smiling.

Scott and I have been asked to be the first-line contact for the student health as school physicians starting in March, a sideline to our regular jobs in the hospital. We've pitched in a little this week due to crisis, not only the crisis of the young woman with cerebral malaria, but also the epidemic of 72 other students (15% of the school) out with flu and gastroenteritis. So we've felt deeply, both as parents and as doctors, the gravity of this case and the nearness of disaster. Please pray for us to have insight and caution and care with the precious burden of other peoples' children. If there is any group of kids that would be under attack, it is this one, as they represent the easiest way to remove a thousand missionaries from service.

So another small redemption occurred in student health, in the midst of the sea of flu a young man who had persistently been febrile and occasionally sprouted an impressive urticarial rash, which the excellent nurses had the foresight to photograph in case it was gone by the time we saw him (it was). Turned out he had gone rafting on the Nile and boating in Lake Victoria a few weeks ago. And we remembered the time Julia and Caleb BOTH had classic Katayama Fever, the relatively uncommon phase of acute schistosomiasis; it took us a week to figure it out a decade ago but this time we realized immediately what was going on. A little piece of suffering redeemed for someone else's good.

There is much relief and joy on campus today for the daughter that was almost lost and now is found.

Monday, January 24, 2011

The illusion of choice

There are many heavy things going down here right now, spent a couple of hours praying at the bedside of a missionary kid in the ICU yesterday. Every missionary parent's worst nightmare. But I'm way on the periphery of that story, and too tired to do justice to the pain of it. And so I'm going to write about something completely frivolous. Because life is like that, actually. A crisis can seem all-consuming, but the rest of the world continues on while someone's mother holds a pale and unresponsive hand.
There are many heavy things going down here right now, spent a couple of hours praying at the bedside of a missionary kid in the ICU yesterday. Every missionary parent's worst nightmare. But I'm way on the periphery of that story, and too tired to do justice to the pain of it. And so I'm going to write about something completely frivolous. Because life is like that, actually. A crisis can seem all-consuming, but the rest of the world continues on while someone's mother holds a pale and unresponsive hand. We were called this weekend by our Faith-Based Furniture representative. I suppose our mustard seed of faith just wasn't enough, because he wanted us to come back and choose a different fabric, seeing as the one we had selected was "finished". In Africa this word "finished" accounts for a lot of what you might THINK you had the power to choose. I was not happy about this since the couch was the primary item of color around which we had planned EVERYTHING else (curtains in particular, and the neutral "almond sand" walls. When we were in the shop originally, we had looked through several very professional appearing books of fabric samples, and chosen a woven/textured/burnt maroon. It was very nice, intended as the focal point of the room, of the house really, and not of a dirt-showing hue either. I was caught up in the wonder of this possibility: me, who had not been called upon to make a decorating decision since I got to select the paint and wallpaper for my room when I was 13, designing a living space.
When we went back to the shop this weekend, however, instead of the spiff books he showed us four little scraps of fabric he had brought from the market. Bright eye-popping orange, dark brown, gold, and a khaki/tweed. It slowly dawned on me that the fat books of samples were probably donated/stolen/whatever from some American showroom and bore absolutely NO RELATIONSHIP to the actual availability of such fabrics on this continent. They were a comfort to the customer, the illusion of choosing maintained, while the carpenter knows that he'll just take anything in the same universe of fabrics he can find. So since I had chosen a woven texture, he brought me four samples that were indeed a woven sort of fabric but other than that had little in common with the original. We just couldn't see the bright orange being compatible with anything, the brown was dull, the gold clashed with the curtains, so sadly we had to give up on our little hope of beauty and settle for the tweed.
I remembered the nights we used to go to the Mountains of the Moon when it was a run-down crumbling post-colonial hotel and the only restaurant in many hours any direction. They would bring out the menu, and we would deliberate over our choices, wanting to make the most of our one eating-out opportunity for the month or the quarter . . .then the waiter would come back, and not matter what you ordered, he would say, "Ah, sorry sorry, but the ______ it is finished". Finally in frustration you would just jettison the menu and say "So what DO you have?" And even then, when he would say "roasted chicken" what he meant was, there is a live chicken somewhere on the hotel property that could be found, chased, killed, plucked, and cooked in merely two or three hours.
So, the illusion of choice, given to us picky bajungu, we who like to think we can control, we can steer away from tacky furniture and clashing colors and tasteless food, we can select that which is beautiful and delicious. And we can select it, we just can't have it.

Saturday, January 22, 2011

This treasure in earthen vessels

Whenever a Bible passage comes my way from two directions simultaneously, I know it is time to pay attention.  This week the day my New Testament reading landed on 2 Cor 4, a friend from America wrote to say she was praying that for me.  So I have just stayed there the last few days, soaking.  

For we do not preach ourselves . . .oh, right.  I've been so discouraged by my inadequacies, running smack into the mountain of things I don't know.  But I'm not here to prove that I'm competent or smart or worth listening to.  I'm here to point people to Jesus.  Easy to forget in the more formal "consultant" teaching and pontificating role here at Kijabe.

But we have this treasure in earthen vessels, that the excellence of the power may be of God an not of us.  We are hard pressed on every side . . . Realizing our fragility and emptiness, our clay-pot-ness, does not mean smooth sailing.  We're still pressed.  As always Bundibugyo is the epicenter of hard pressure.  January means that the school year is about to start, and this has probably been the roughest pre-school month ever.  The Johnsons have had to make some hard decisions about staff in a culture that is indirect and non-confrontational and secretive.  That's their story to tell, maybe in a week or two when things settle out, but it's part of our story still too.  Our hearts are there, and as earthen vessels we trust God to fill us with spiritual wisdom in our advice from afar.  Today there was a pretty firm confirmation that something we sensed in prayer a year and a half ago God might do for the school will come into being.  Perplexed, but not in despair, persecuted, but not forsaken, struck down, but not destroyed. . . 

Therefore we do not lose heart . . . Paul speaks of the unseen weight of glory that accumulates through our light affliction.  Perhaps the church in Mundri is beginning to hope for this, sensing that their suffering prayers have led them to victory over war and destruction and hate and fear.  The initial tally of the referendum shows 98.6% in favor of secession.  

That grace, having spread through the many, may cause thanksgiving to abound to the glory of God . . Last night a state of grace descended upon our house, for no reason other than the faithful shouts of "the many" spreading grace.  Caleb invited two classmates for dinner at almost the last minute, I had enough food, candles were lit, my experimental cooking turned out well with a little borrowing from neighbors, there was fellowship and camaraderie.  It was the most relaxed and "normal" we've been yet.  So, thanks, and keep praying, particularly that the Johnsons would get a similar evening at the end of a stressful weekend.

For the things which are seen are temporary, but the things which are not seen are eternal.

Thursday, January 20, 2011

paragraph one to post below . .

(you know you're in Africa when you post this thing five times and the first paragraph keeps turning out blank??)

. . the school sends an email to all the parents warning us that a hyena was spotted (no pun intended) on one of the football fields at 4 pm yesterday. I am not making this up. We are instructed to warn our children. To do what, I'm not sure. I reminded mine of "The God's Must Be Crazy" and suggested holding a tree limb over their heads to make them look more intimidating. Seriously though, it is a bit frightening to think of a hyena prowling out there in the dark and windy night as my kids walk back and forth to evening programs at school . .

You know you're in Africa when . . .

. . the school sends an email to all the parents warning us that a hyena was spotted (no pun intended) on one of the football fields at 4 pm yesterday.  I am not making this up.  We are instructed to warn our children.  To do what, I'm not sure. I reminded mine of "The God's Must Be Crazy" and suggested holding a tree limb over their heads to make them look more intimidating.  Seriously though, it is a bit frightening to think of a hyena prowling out there in the dark and windy night as my kids walk back and forth to evening programs at school . . 

 . . and when the last admission of the afternoon is a 6-day-old vigorous baby with a bilirubin of 27.  That's high.  That's the level of jaundice that edges into the brain-damage range (and lest we forget that the risk is real, we have another child on the ward who is neurologically impaired, which made sense when I saw his old chart and his admission as a newborn for a bili of 39).  So the nursery is gearing up tonight for the second exchange transfusion in a week, a procedure that is almost unheard of in the USA.  Why?  The baby was seen at two days of age and sent to the lab for the bili test, but it took the family 4 days to come up with the funds.  So a problem that could have been resolved by light therapy (pretty cool, there is a blue wavelength that changes the toxic bilirubin into an excretable form, so the nursery glows an arctic blue in the steamy heat as infants wiggle under the eerie lights, like so many roasting chickens) now becomes a problem that will require a time-consuming and dangerous process of removing the baby's blood and infusing donor blood, a few cc's at a time, until twice his estimated blood volume has been exchanged.  Stoic and inefficient and sacrificial all at the same time, Africa.

 . . and when I notice one more mom with two kids in the ER at midnight, a fussy one on her back whom I assume to be the sick one, and a 4-ish year old passive little boy standing in front of her.  I ask what the problem is, and she lifts the standing boy's shirt to reveal a fleshy lump protruding over his lower spine.  A big one, soft and spongy.  In fact it looks like a meningomyelocele, but those are usually fatal if not repaired as a newborn.  But it must be, because she has an appointment slip for the neurosurgery clinic, and explains through staff that she lives in an IDP camp at some long distance and though she left home this morning to come to the hospital, she did not arrive until the clinic was closed.  She had no nearby relatives or friends, so there she sat.  The nurse in charge of "Casualty" matter-of-factly said "we must accommodate her so she can see the doctor tomorrow."  Once again, that stoicism, not making any fuss, just sitting there in the midst of the emergently ill, because it was the only place open by the time she could drag her two kids here.

 . . and when dinner preparation includes an evening brisk walk to the nearby town where a half-dozen ladies sit in a shed-like enclosure, each with her own table of exactly the same fruits and vegetables set out for sale.  I am almost always the only customer when I enter, and so far my strategy has been to try and buy at least something from each table, keeping everyone happy.  I try to use my Swahili, which only confuses them, they are quite used to white people and English being this close to the mission station.  I take my cloth bag and fill it with 5 avacados, 3 mangos, a squash, broccoli, two tiny heads of very dirty lettuce, a cluster of cilantro (!), a dozen or so tomatoes, a few potatoes and carrots, two zucchini, and two apples (!), spending about seven dollars I guess.  Walk ten minutes back home and put a chicken I bought from a local lady into the oven (dead and plucked though!), then the sliced vegetables.  Feel semi-competent with my Alice Water's Art of Simple Food meal until 45 minutes later I realize the propane tank is finished, and my oven is barely lukewarm.  We locate a spare tank, start the dinner cooking again, as kids hover starving.  I have one little end of a loaf of bread left and decide to toast the five pieces to accompany the chicken and veggies.  I slide them under the broiler, get distracted, until I notice the entire apartment filling with smoke.  Panic.  I open the broiler and there are five flaming balls of charcoal.  Jack is so impressed with the fire he does not even feel bad about the lack of bread now.  Finally we sit down to eat, and I realize how even a simple meal is not simple when everything is still unfamiliar and uncertain. and involves languages and interactions and equipment and disasters.

 . . and when I sit down now at 9 pm and try for about half an hour to send this post, without success, give up for the night,  and think, there is no place I'd rather be, than Africa.  

Wednesday, January 19, 2011

viruses, prayer, newborns, fabric, and a car!

Viruses (virae??) abound in our life at the moment.  Caleb is just emerging from almost a week of headache/backache/low fever/stuffy nose, the general crud that has landed over 10% of the RVA student body in the infirmary.  Ah, the joys of the tight boarding school community, one random kid returning from abroad in January with a highly contagious flu bug and it's all over.  Interestingly the rest of us are so far so good, maybe we got immune in America last Fall, naturally or through the flu vaccine?  Do pray for RVA staff as it is a heavy burden to nurse so many ill and far-from-home children.  Meanwhile we have been hit by a computer virus too.  Our Yahoo account has spent two days churning out embarrassing url links to anyone and everyone in our address book.  We have changed passwords and now accounts (to gmail) and if we can ever get a decent internet connection Scott intends to download as much expensive antiviral software as possible.  The mess kept us troubleshooting 'til midnight last night.

Scott is managing the men's ward this week (with the able partnership of a family medicine resident).  He was nearly in tears over a sweet older gentleman who was slipping away before their eyes, and decided to just pray for him at the beginning of rounds.  Within two hours he was markedly improved, and may now recover.  I've been keeping to the periphery on pediatrics, for many reasons:  to not quash the recently-arrived Kenyan paediatrician, to observe and get a feel for how things are done instead of pushing my own way, to give space to a visiting brilliant American military academic pediatrics guy who is here for a week and has way more to say than I do . . . but mostly it's not so noble, I'm just in over my head!  Medicine in Bundibugyo is circa 1960's.  Medicine at Kijabe is circa 1990's at least, possibly 2000's.  It's a big jump.  But sometimes no one else is around, and I remember that I do love this stuff, even when it is intimidating. My first semi-solo responsibility was to call in the parents of a newborn named Eugene admitted to the ICU over the weekend, explain his poor prognosis, and get their assent for the plan of trying to wean him off the ventilator.  There are only five ICU beds, and if a severely asphyxiated brain-damaged baby takes up one, others will die.  Sounds harsh, but the reality of limited resources means not  using a ventilator for a baby with little chance of survival.  The young parents actually affirmed their thanks for the staff who had done everything possible, and agreed with the plan.  It was a good meeting, they visited Eugene then opted to wait outside while we tried him off the ventilator.  And amazingly, Eugene, who had shown no signs of spontaneous breathing up to that point, decided to breathe.  We wheeled him back down to the nursery on oxygen, where he remains, floppy and unconscious, but alive, his quiet mother lingering, little hope, waiting.  And tonight my first real call night started with an urgent call to the OR for a baby about to be delivered by C-section for fetal distress.  Only by the time the intern and I wandered through the eerily empty theatre area, we figured out that the mom had delivered the baby naturally in the labor room, and there he was, massive, squalling, and vigorous, leaving us nothing to do but enjoy him. 
(Me, trying to be a good culturally sensitive language-learner:  I need to learn the proper greeting for a new mother.  What do you say?  In Uganda we say webale kwejuna.
Kenyan Intern: Oh, here we say "congratulations". )
(Oh, and did I mention, it was the same bed in which I delivered Caleb, same baby-warmer, same everything?)

Today Scott and I left early in the morning for an ambitiously long list of errands in Nairobi, which we quickly pared down, and then down again, as nothing is as quick or straightforward as one might hope.  First priority was our car.  YES WE HAVE A NEW (to us, used actually) LANDROVER DEFENDER 110, white, "ambulance" style (enclosed not a pick-up).  Only it took a couple of hours to tidy up the paper work and insurance and install a new radio and generally take possession.  Then we hit the stretch of road where carpenters and welders have shed after shed after shed of locally made furniture.  And in the space of an hour we ordered two couches, six beds, a table and 8 chairs, all for less than half of the cost of buying similar items in a store.  Then we found the row of fabric shops and chose 5 different curtain materials for the 12 windows in our new house.  Then varnish for the floors, and more paint.  Now Scott and I have never owned a house, never chosen colors, and hardly ever even bought any furniture, so it's partly fun and partly way over our heads to make this many decisions in a few hours, and partly a learning experience to realize we don't always see things the same way.  The furniture area is dusty, loud with hammering and sparks, crawling with young men who want to sell you their particular items (we were glad to realize the store we chose was named "Faith-based Furniture"), catering mostly to Africans who like heavy large impressive furniture.  The fabric and hardware are run by Indian-origin Kenyans, emphasis on the plush heavy draperies, tassles, damasks, florals.  I think we did OK, but we'll see what it all looks like.

So a full day, I'm heading back to the hospital now.  Thanks for the many shouts, and keep them calling.

Monday, January 17, 2011

we've been hacked

All our friends out there in cyberspace... it seems that our Yahoo mail account has been hacked... so please disregard any emails from us that include url links (don't click them!)... not quite sure how this has happened or how to avoid it in the future... we've changed our yahoo password and hope that will do the trick... sorry for any inconvenience to any of you out there.

Saturday, January 15, 2011

A Shout

"Then the men of Judah gave a shout ". . . 2 Chronicles 13:15

This may become our theme for the year.  Abijah, great-great-grandson of David on his mother's side and great-grandson on his father's, had been king over Judah for three years when his rival Jeroboam came against him in battle with twice the forces and over twenty years of experience reigning.  Abijah stood on a mountain and gave a rousing pre-battle speech pleading with Jeroboam's Israelites to abandon the battle because "God Himself is with us (Judah) as our head .. .do not fight against the LORD God of your fathers."  But while he was making his speech, Jeroboam had sent an ambush around the rear of Abijah's lines.  So that when he finished, they found themselves surrounded, and in a panic they cried out.  Very reminiscent of the Red Sea scene when the fleeing nation of Israel was between the water and the pursuing Egyptians.

"Then the men of Judah gave a shout ". . . not a shout of confidence I think, but one of desperation.  It was a gut-reaction, a cry for help.  

As the southern tribes of Judah shouted, God struck the attacking northern tribes and scattered them.  "The children of Judah prevailed, because they relied on the LORD God of their fathers."  A decade of peace follows this battle.  

This is a pattern that reads well in a story, but is no doubt a very different story on the battle field, if you're surrounded and facing defeat.  The build-up to the shout, the growing sense of isolation or doubt, the impending sense of doom, that culminates in a visceral yell, could not be pleasant.  And can happen in the middle of a faith-filled all-the-right-words speech, it can happen when one has followed God's lead into a potentially victorious but frightening situation.  Which brings us to 2011.  We are, in many ways, right smack in the middle of classic transition stress.  Ahead and behind, things look hard, and we feel surrounded.  Ahead we have the daunting task of language, a stack of verbs on cards to memorize, stumbling attempts at expression.  We have wards full to the brim with extremely ill patients.  Scott plunged in on Friday and Saturday, managing the adult male ward, thankfully with a very competent third-year resident . . but the weight of men on the edge of death is heavy.  We both have this sense of unworthiness, that we have lost skills over all these years and that the rustiness will harm patients or disappoint our colleagues.  It takes a lot of the joy out of medicine.  We have a house that is in the throes of repair and painting, a total mess, which we are supposed to occupy imminently, but without a vehicle yet to shop with or a place to have anything delivered, we've not managed to collect any of the essentials of living.  We're paring down expectations to mattresses on the floor (beds can follow later) and a stove and fridge.  But even that requires some effort to arrange . . . And all of that leads to a sense of restless uncertainty, restless sleep, and strained relationship.

And behind, we sense the collective intake of breath as the world waits today on the preliminary results of the week-long referendum in Sudan.  Peace, or war?  As always, the beginning of the school year in Bundibugyo is riddled with crises, new teachers to be hired, plans to be made, and we grieve for the burden that falls on Travis and Amy as we pray and interact and suggest but can not really rescue.  Doubt and guilt.  Lonely sms's from our boys there, pull our hearts.  We need to find time and energy to catch up with our Kenya teams and work on visas for an exploratory trip to Burundi with a potential new team.  Further behind still, the ache of Luke so far away, tired already as the first week of classes finishes, and he begins a part-time job on Monday.

Like Abijah, we can say with conviction that God is for us, that we are not alone.  We are thankful for this incredible community of saints in which we have landed (Saturday all three kids went on different outreaches arranged by teachers: Jack picked up trash in a trading center nearby, Julia loaded a tractor with firewood which a group of girls then distributed to a handful of widows, and Caleb went into the valley to help build a house for a needy family, and Caleb is on another outreach this morning building friendships with the young men who sell roasted corn on the road).  We are thankful that we are close to closing a deal on a vehicle.  We know God has provided this season for our good.  But like Abijah, in the midst of all that knowledge and thanks, we can look ahead and behind and see the enemy and panic.  

So we lift a shout, and invite our supporters to do the same.  Ask God to bring HELP to the Johnsons and CSB.  Ask Him to give us supernatural wisdom in dealing well with patients.  Ask Him to give us progress in communication.  Ask Him to provide what we need for a home by the end of the coming week.  Give a shout.

Thursday, January 13, 2011

Beans, bugs, hail, pink scrubs, and long needles, hope

Beans:  Ah, you know you're back in Africa when you buy a cup of dried beans at the market, bring them home, pour them out, and find out that about a quarter of the cup consists of sticks, dirt, and live bugs.  Sigh.  This requires spreading the beans out on a tray, picking out the worst debris, scooping them up as the bugs run away, then rinsing (i.e. drowning the little insects) repeatedly.  Then soaking overnight, then boiling for a few hours.  All for a bowl of chili tonight.   

Weather:  Yesterday, I ran out mid-afternoon as it started to lightly rain, because my neighbor's clothes were on the line.  But she saw me and said, leave them, the sun was going to return.  Today we had a staff meeting at 7:30 a.m., and it's pretty impossible to get the clothes washed and hung before 7:30  .. so it was about noon by the time I got back and threw them outside before our Swahili lesson.  Once again, it started to rain, and I ran outside, then remembered the lesson from yesterday.  I confidently left them hanging.  And hanging.  Through a total-afternoon down-pour, drenching.  Whoops.  Up the hill at RVA there was HAIL.  LOTS.  Yesterday a roofing sheet blew off the 3-story apartment complex under construction next door and landed in our yard.  Crazy.

Dress:  For a reason I have yet to understand, all the parents of pediatric patients are issued pink hospital scrubs which they wear instead of their own clothing on the ward.  So every bed has a pink-garbed mother (or occasionally a twin father) sitting in it, holding a child.  Hygiene?  A perk?  

Medicine:  Simply put, almost every patient we have on the Paediatric service at Kijabe would already be dead in Bundibugyo.  An 11-month old with TB pericarditis just transferred down from the ICU, and the doctor I'm following decides the effusion should be tapped.  There is a Chinese missionary radiologist handy who agrees to meet us in the ultrasound room.  He confirms the presence of the abnormal fluid around the beating heart, and then goes to search for a needle longer than the estimated 3 cm depth from skin to sac.  A little lidocaine (the radiologist), a little firm holding down (me, the mom is understandably shaken and unable, though she gives verbal consent as wanting whatever it takes for her child to be better), two tries, and then there is an abundance of light golden translucent fluid flowing out. Next bed is an 11 year old with pulmonary hypertension, echo-proven tricuspid valve endocarditis, hypoxia and fevers.  A few asthmatics, a diabetic, a sickler, a malnourished former preemie with rickets (really, classic xray and consistent labs, who would have thought on the equator, but it seems to be common because of the calcium-binding sorghum and millet in the typical porridge here), a baby with AIDS.  Two consults on infants with neurosurgical problems, open spinal cords and encephaloceles.  And not one case of run-of-the-mill malaria.  It's a different world.

Hope:  I went to my third meeting of the day in the late afternoon, and decided to try a few Swahili phrases from the day's lesson.  Which made everyone happy.  Even me.  It's a start.  

Tuesday, January 11, 2011

settling, continued

What takes up one's days as a doctor who is not really seeing patients?  I was pondering that last night as I tried to get out the door at 8 p.m. for a Bible study one of the volunteer pathologist couples invited us to in their home, and it kept getting later and later.  So, week 2 begins.  Early mornings, trying to be back in our routines of Africa, the pre-light quiet for Bible reading and prayer, the edge of dawn for a short jog (gasping, altitude, dim light and uneven roads, reluctant to venture far) and shower, kids getting up for school, breakfast laid out.  Only it gets light so much earlier here.  (We're a 23 hour drive east in the same time zone).  By 7 am we try to intersect at the table for a Bible reading and prayer then the kids head up the hill with their loaded backpacks.  Yesterday we had "senior staff prayer meeting" at 8, tomorrow "all-staff chapel".  Today we each put in a couple hours of Swahili study with our books and tape, interrupted by calls to the maintenance person to check and see if our house repair/painting could start today.  He asked us to meet him at the house which we did, and that seemed so promising, but when we checked back in the late afternoon nothing had happened.  Mid-morning we both tried to tag along on hospital rounds, to begin to get the feel for the mechanics and culture of medical care here.  There are not that many more pediatric beds in this hospital than Nyahuka, double?, but about a hundred times more staff.  Patients we saw this morning had notes in their records already done by the Kenyan medical interns, had lab results, were being sent for CT scans and echocardiograms in Nairobi, were receiving hospital-cooked food five times a day.  Patients were on oxygen, which came out of tubing from the WALL.  Nebulizers even.  Electricity.  Charts. Vital signs. No one on the floor.  

Noon, back to our duplex apartment, for another hour of intensive Swahili with a language helper.  Being used to this in our old days in Bundi, I started to tell him what we wanted to learn . . but this man is experienced.  He said, that's fine, but let's get the basics first, and then proceeded to launch into his lesson.  Lubwisi is a double-edged sword--so many of the words are close, but not the same.  Lina lianje nissioni Jennifer (my name is . .) becomes Jina langu ni Jennifer.  And all twenty times I said it, Lina threatened to beat out Jina on my tongue.  

1 pm, back to the hospital for the weekly pediatric case conference, the intern and clinical officer presenting.  This is a teaching time for the 9 Kenyan recent medical school grads serving an internship here, the handful of clinical officers in training, family practice residents, surgery fellows.  As the medical director reminded us, this hospital is 96 years old.  It is like stepping forward in time from Bundibugyo, a complicated steady institution directed by Kenyans for Kenyans, with missionaries in a supporting role.  A massive institution caring for the most complicated patients in the area, but also a teaching hospital, with conferences and lectures and research.

Late afternoons, errands.  Making rounds of the few families we know for advice or borrowing.  Running paperwork up to Bob C who switched missions and countries but is still his cheerful can-do competent self and has graciously included us in some of his administrative errands for RVA.  Walking to the dukas for flour and toilet paper and pumpkins and strawberries, carrying back an assortment of fresh foods to cook.  Taking down clothes from the line which blow dry in the breeze within hours.  Sweeping, baking, cooking, washing dishes, the basics of survival.  Homework help, emotional support.  Emails, holding my computer up at various voodoo angles on the front porch trying to catch a signal, or calls and sms's with the rest of our life outside Kijabe.  Discussing our WHM Africa fields together, thinking and dreaming, upholding.  Knocks at the door as various ladies try to sell their tortillas and muffins, flowers and crafts.  Ten days on the ground and only one direct begging ask from a stranger at the door. 

Sometimes another crack at the Swahili tapes in the evening after dinner and cleaning up.  Hearing about everyone's days.  We edge our dinner time back to 6:30 even though the entire missionary world around us sits down at 5:30 sharp, so we can enjoy candlelight at sunset.  But every few days we have to juggle the times because one kid or another has to be somewhere for something.  Reading about a patient's problem we just saw.  Following up on finances.  Advising Luke on his schedule woes.  The wind picks up as darkness deepens, and we're glad to be inside our little apartment.

Not a lot to show for these days, but the exhaustion tells me we're working hard.  I think it is the attention, the edginess of newness, the strain of listening to a new language and constantly meeting new people, the remembering of all the ways this is NOT home yet, the intimidation of stepping up a hundred notches in the quality of medical care we must offer, he dread of the even more unsettled days to come when we build up a habitable home from scratch.  

So the settling continues, and I'm wishing we could justify at least a whole month this way, but every time we're in the hospital we're told how great it is that we're finally here . . . nice to feel welcome, but a lot to live up to.  

Saturday, January 08, 2011

The Healing of the Land

If My people who are called by My name will humble themselves and pray and seek My face, and turn from their wicked ways, then I will hear from heaven, and will forgive their sin and heal their land.  Now My eyes will be open and My ears attentive to prayer made in this place . . . 2 Chron 7:14, 15

My Bible reading today included this chapter, always an amazing one to revisit.  Solomon dedicates the temple in chapters 5 and 6 with a dramatic sacrificing ceremony, a full week of butchering animals and feasting and prayer and fellowship.  It's an amazing scene on many levels.  The concreteness of the attention to the furnishing, the value of the beauty, the gold and color, the sheer scale of the spectacle, reminds us that we are embodied creatures who thrive on the tangible, that art and food can be worshipfully enjoyed, that even furnishing a home can be a holy act.  Then God comes in a dark temple-filling suffocating cloud, so thick and awesome that the priests can not minister.  God's presence stops the very activity that we would all assume to be the most appropriate and commendable, which says something about His Otherness.  But I digress.  After the whole week of festivity is over, God comes to Solomon at night and echoes back Solomon's prayers as a promise.  He commits Himself to act.  To hear, to forgive, and to heal in response to the prayers of the people.

If there is anyplace in this 21rst century where this story is currently being enacted in real time, it must be South Sudan.  A faithful remnant of true believing Sudanese have prayed, and prayed.  And today the vote that was promised six years ago begins, in spite of many odds against such a process.  Decades of war and loss are beginning to be healed.  The referendum process will continue all week, then it will take some time for the vote to be tallied and results to be announced.  Please pray for the country of Sudan, north and south, this month.  In the northern area, the president stands accused of genocide and has vowed to turn that section of the country into a homogenized state under the rule of sharia law with Arabic as the only language.  The line between North and South is disputed, with 80% of the oil reserves in the South the North wants to hold onto the controversial remaining 20% in border zones.  The fate of Southerners living in the North, and of the districts along the border, remains unclear.  The ability of the South to manage a country bigger than Uganda, Kenya, and Tanzania put together with less than 60 miles of paved roads (total), where a 15 year old girls is more likely to die in childbirth than graduate from high school, remains tenuous.  

Healing needed for this land.  Let us join the faithful who are praying.

Friday, January 07, 2011

Week 1

Week one is a mixed bag, as most week one's are anywhere I suppose.  Because we've visited Kijabe so many times, even stayed here for periods of weeks to months over the years, because we've lived in Africa longer than anywhere else, because we know this is not as difficult a place to manage as Bundibugyo, because we've moved here for a whole spectrum of good reasons . . . there is a sense of expectation I carry that this must be a relatively minor adjustment.  And in some ways it is minor.  There is a cushion, and insulation from Africa, that exists in this American community.  Well, to a certain extent anyway.

But every transition costs energy and emotion.  We all pay a price.  Scott is spending hours searching on line for a used vehicle, going into town to look at notice boards and check out used cars, making phone calls.  And hours trying to set us up on a decent internet connection.  If you thought the presence of 100 families and even full-time IT employees meant this would not be much of an issue (as I did), we would both be wrong. The famed fiber-optic cable that reached East Africa runs a few kilmoters up the road, but there is no connection here.  The hospital has a server that is erratic and slow, and we spent about two hours with their IT person this morning trouble-shooting their wireless network, which seems to be non-functional.  The school seems to have a better system but does not allow "lower station" families to use it.  People buy little USB port modems that work fairly well but eat through the money in a non-sustainable way, charging per bit of information accessed.  So, having been spoiled by a few months in America, we are now slamming up against the reality of poor and expensive internet connection, and realizing how much we lean on it.  Caleb's cost is probably the jarring conjunction of the two heretofore separate worlds of school and family, being free from dorm rules but tied to family obligations.  Julia's cost came in the I'm-in-over-my-head first day of band, and we're taking a step back and working out some music lessons.  All in all she's doing well, especially after the soccer coach called last night after the first few practices and told her she's on the JV team.  Yeah!!  Jack's cost is just the tension of remembering assignments and books and duties for 7 classes all in different rooms and times.  He already got one warning for leaving his Bible in his locker during Bible class, and his geography class assigned an 11 page report on Kenya to include history, religion, tribal groups, towns, animals, birds, political structure .. with references . . that has him feeling pretty intimidated.  So he's anxious about doing everything right.

My cost?  Hmmm.  Probably battling the expectation that I should know what I'm doing, in the home-making (literally) and medical departments, sooner rather than later.  I've been waiting to invest in a home, and I'm waiting some more, and wondering if I'm hoping for too much.  I feel a little tenuous and lost, and hesitant to commit.  They typical newcomer sense that I should probably be doing something that everyone else is doing only I don't know what that is.  And more tired than I should, though sleep is slowly regulating, the altitude and the emotional edge in the family in general drains me.  

So that's the report on week 1.  Scott and I did spend a day in Nairobi and managed to buy many gallons of paint to spur on the process of readying the "new" house.  We even noted that we UNDERSTOOD a few phrases of phone conversation overheard while waiting for a clerk in one of the stores--Swahili has begun!  I go through the lessons constantly translating into Lubwisi and English at the same time, trying not to let the Lubwisi be completely smothered by Swahili.  And the highlight of the week, dinner with the Chedesters, a full-circle from our days in Uganda, being welcomed in a big way (a special chicken dish which would be the A#1 guest food in Uganda, and 2 strawberry pies which would be remarkable anywhere) by people who actually know us.  Nice.

Keep praying for the right vehicle to pop up, for our Swahili diligence and progress, for the house to be ready and settled soon.  And more importantly for the Sudan Referendum to begin constructively and peacefully on Sunday, for our Sudan team in diaspora now to hold on in hope, for our Bundi team about to receive a visit from a supporting church in the US, for CSB hiring new teachers and getting ready to start the year, for the blood bank to supply and save lives at Nyahuka Health Center, or Luke working on grant proposals for a study in Kenya next summer.  All the places our hearts try to keep, even while we are here!

Tuesday, January 04, 2011

First Day of School 2011

Today Caleb returned to his normal 11th grade classes after a month break (casual, no big deal, glad to be back, reconnecting with friends, more of a homecoming for him). And Jack and Julia spent their first day in 8th and 9th grade, actually their first day of a generally American school ever, except for a part-time preschool for Julia when she was 4. They came home chatty, encouraged about a lot of things (like the fact that they knew all the answers on the Geometry quiz, or the wild story their Biology teacher told of being accosted by bandits in a game park). The biggest stress was band for Julia, where she felt hopelessly behind as a beginner clarinet player, so we have to review that. Otherwise they are predictably tired, the strain of new place, new names, new people, new directions, new rules, new expectations, new food, new everything takes its toll. They miss Uganda, especially RMS. Keep them in your hearts as they move through their days, juggling text books and finding a locker and figuring out where to change for PE and what kind of paper the teacher wants homework assignments written on and all those things that will be second nature in a few weeks. Julia starts soccer practice tomorrow, too, she missed try-outs at the end of first term but we hope she'll be included in one of the teams.

Meanwhile our day consisted of Swahili study, laundry (a washing machine! and a dry high-altitude climate means the clothes dry on the line by noon!), cleaning, baking, Scott catching up on several issues as a FD, emails, searching on line for used cars, phone calls . . . and in the late afternoon, finally, the key became available to peek in the house we've been assigned. Like everything here it's old, and worn, cinderblock construction with "hospital-yellow" decade-old painted plaster inside, no furniture, no appliances, bare bones. It's not one of the larger or nicer houses here, but it IS one of the best locations for kids going back and forth to RVA activities. And we're all pretty excited about it, having our "own" place this soon in our stay is a huge gift. It will take a few weeks for some basic repairs and a repaint, but we're praying the hospital work crew is motivated, because after almost a year of slowly packing up, saying goodbyes, moving out of our home of 17 years, being in limbo, about six months now of suitcases and temporary stays . . the idea of moving INTO a house where we can stay for a few years is tantalizingly appealing.

To end the day well: notes for Jack and Julia from some of their beloved former teachers, bookends of their entire Uganda school experience, Miss Becky and Aunt JD and MIss Ashley and Miss Anna. Thanks for remembering their big transition today.

Sunday, January 02, 2011

The Place of the Winds . . .

. . is the literal meaning for Kijabe. About 7000 feet high, perched on a steep escarpment overlooking the Rift Valley, below a pine-covered ridge, this is a sprawling ancient mission station. Hospitals, printing press, Bible school, nursing school, missionary kid school, dental clinic, maintenance facilities, water tanks, housing, housing, and more housing. Blending into a small town with its dukas, garage, post-office and gas station. A hundred missionary families I've been told, and I have no idea how many Kenyan families, working and living here. Most of the construction is cinderblock and cement, low-rise, though recently the space has been so squeezed that the newer buildings are three-story apartment complexes. One is under construction right next door, I can hear the whine of a saw and the pounding of hammers. But mostly I hear the wind. Rattling the windows, pounding against the walls, howling around the corners, rustling through the trees, day and night. Mid-day it eases up to a breeze, then gains momentum through the evening until the peak intensity in the darkness, when it sounds like we will be blown right off the hill. We shiver under layers of blankets as the cold air seeps through closed windows and flaps the curtains. Caleb says it is a soothing sound, like living next to the sea. That will take some getting used to for me. This is the same continent as Bundibugyo, but so far removed. We used to steam in the rainforest, mold and mud and heavy heat. Now we are high and cool and dry, brilliant sun and blue sky, expansive views and fine red dust. Ah, as Scott always says, there's a REASON a hundred families live here and two in Bundibugyo. Well, I know it's not all the climate, it's also the hundred years of sacrifice that have established this as a Kingdom fortress. I can see the cemetery from my bedroom window, and many of the graves are of the children of the early missionaries. Always a cost, and I respect the high price others have paid so that we can land here in a furnished apartment, to enroll our kids in a very decent school, and begin work in a high quality hospital.

But back to wind. The words for "wind" and "spirit" I think are the same in Hebrew. Certainly Jesus compares the Spirit to the wind in John 3. And the Holy Spirit's entrance at Pentecost is described with a sound like a rushing wind. But I always thought of those comparisons in terms of subtlety. The wind, unseen, moving, coming, entering. Two days at Kijabe and I see a whole new side to the Spirit as wind: powerful, a force that can not be stopped, cleansing, blowing away clouds of doubt, clearing the atmosphere for the penetration of the sun's warmth, wild, uncontrollable, inescapable. Sometimes harsh, sometimes overwhelming, sometimes destroying, making ready for the new creation. This is our place, for the next few years. Kijabe, the place of the winds. Praying the Spirit blows through us here.

Saturday, January 01, 2011

New Year, New Life

Exploding firecrackers, claps, and shouts echoed in the darkness of Nairobi at midnight last night, just as we settled into our beds at the Mayfield Guest house. We're back, after a very straightforward and direct trip. Thanks for prayers for that--we all had seats, all our luggage made it, and though most of the guitar-case latches were undone by the time it hit the luggage belt the guitar was still inside, not something one takes for granted here.

First impressions: the quality of the sunlight. Coming from the winter solstice in North America, with its thin cool slanted rays of horizon-hugging sun, to the equator where the brightness is once again a wholesome and welcome surprise, full and intense light. Nairobi is uncharacteristically orderly for the holidays, little traffic. We dragged ourselves out at 10 am to Java House, and met no less than four different RVA/Kijabe-associated families doing the same thing. Nice. Though this does not feel like home the way Uganda does, there is hope. We ordered water with our breakfast, and the waitress asked, do you want that cold? Yes. (Though we would have liked a touch of warmth in our freezing almost-midnight showers last night.) Ahh, we are back in Africa.

Leaving America with a child still there is an excruciating experience, for sure. Strangers and aliens, felt more acutely than ever, in a sun-drenched land with the fragrance of cooking fires and the brilliance of bougainvillea. Heading out now to Kijabe, not sure of our next internet opportunity, but thankful for prayers that have carried us this far.