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Saturday, September 22, 2018

Signposts in the Fog

Some months are harder than others, and the last couple of weeks have felt like walking through a thick fog with dim lighting (more below).  But even in the cloud we see God's mercy, signposts of grace if you squint your eyes and pay attention.

This young man Mutegheki Joshua came into our life when he lost his father and landed with his mother and siblings in the care of his brother, who worked for us in Uganda.  Then his mother died too, and we took him under our family wing as we paid school fees and "fostered" his life.  He was a good friend of our kids and a good student and we have walked through loss and celebration with him over many years.  He graduated from Christ School Bundibugyo, and then two weeks ago he graduated FIRST IN HIS CLASS from Victoria University; this past week he started a job in Fort Portal, working in a business with another long-time Ugandan friend there.  This is what life should look like:  enfolding the orphan, sharing life, holding on through ups and downs, growth in discipleship, sacrifice and success, opportunities for transformation for us and for him. This is our dream for Christ School--the orphans and vulnerable children boosted to bring blessing back (if that resonates, here's a way to participate).  It's a long road ahead for him, but this is a great first step.  We are proud of his hard work and faithfulness.

These two interns are not even on the Paeds service anymore, but I found them one afternoon in the Newborn Unit helping voluntarily.  More about the health system below, but I do hold onto the signpost of gracious, humble, learning people.  Sharing their skills, working extra hours.  I've had some great interns lately, and it is a joy to see them become independent in their skills, to hear good questions, to get their concerned calls.  This is also what it's all about:  passing on the art and science and spirituality of medicine.  We started a life-of-Abraham based study and prayer group this month.  Out of over a hundred people in the orbit of internship, students, medical officers, workers . . only one has been coming.  But that's the way the Kingdom starts.  Slow, subtle, subversive? Change occurs in our hearts as well, as we choose to pray and not just complain.

This baby went home.  No small feat, because she started off less than half that size, a very tiny preemie in a very harsh environment.  The nurses later told me that her mom had been a bar maid, unhappily pregnant, and trying to abort, but the baby cried so she brought her in.  Over the nearly two months she stayed with us, this mom was caring and faithful. Perhaps this baby will bring about some transformation in her life.  We pray so. But she is a signpost of the victory of life over death.

There are more signposts, sunsets that reflect glory, good meals with friends, clean laundry in the breeze, mangoes.  Young Sergers in DRC have started a discipleship group for their hospital staff, even as ebola threatens to spread their way.  A NEW FAMILY to work on education in Bundibugyo was approved this week for Serge, the answer to several years of prayer!  Our sports-as-discipleship Nairobi leader opened roof-top playing fields to give space for youth to get out of the inner-city dangers and harshness and encounter real love. 

But frankly, this post is an exercise in the discipline of gratefulness because the last two weeks in our day to day life have been quite challenging.  All of this and more has happened:
-Scott goes in to do an emergency C-section, with no light, no suction, no cautery, wearing a head lamp and doing his best.  Another day he has to use a side-room, again with no overhead light, and he forgot his headlamp so he manages in the dimness.
a day the lights were working . . .

-Same day I find my sickest baby with AIDS in severe respiratory distress because the oxygen ran out.
-This week, on the day scheduled for elective C-sections (those done for important indications like multiple previous scars or maternal severe illness) the maintenance team decided to close the theatre and fix all the doors.  And then they didn't finish, so they closed another day.  Meanwhile cases were piling up, and lives were being lost. 
-A mom who had a c-section came back with her intestines slipping out of the wound . . the trainee who did it without supervision didn't tie correct knots.
-A baby who seems to have been burned, a child abandoned nearly dead at the emergency room, and many other heart wrenching stories.
-The politics continue to spiral downward, 1/3 staffing for nursing means 2 nurses caring for 40 patients.  Strikes from last year continue to have an effect because medical school graduations had to be delayed, so we are trying to run a hospital that depends on interns without enough of them.  The fewer the people, the more tired those left get, so then more quit.  It's a vicious self-propagating sorrow.  We briefly had a medical superintendent who was pushing back on the politics, and he was quickly removed by the county.  Very demoralizing.
-I routinely find near-death patients on rounds.  No one is noticing, or calling attention, because they are so stretched and the habits of taking vital signs are so sporadic.  There is something very unsettling about being an hour into rounds and noticing the next patient looks dead.
-Twice in the last week I had to beg, make phone calls, walk five buildings over and push, just to get xrays done that revealed life-threatening diagnoses that required emergency attention.  Having to push for what should be routine gets exhausting.
-The more stretched and discouraged the staff becomes, the harder it is to get people to do their job, which resulted in two stillborn babies yesterday.  It's impossible to pin people down to a call schedule, there is safety in vagueness.  Which means there is always a delay in finding the right medical officer or anesthetist for a surgery.
-When we come home, we counsel colleagues with even bigger problems.  Miscarriages and emergency surgeries and cancer diagnoses and new ebola cases and so much evidence of the world gone awry.

We live in the cloud, seeing only a step or two at a time.  But the main insight of our retreat speaker (Greg Thompson) and a key truth God has been impressing upon us for some time is this:  IN THE CLOUD, GOD IS PRESENT.  In fact the cloud is a physical symbol of a spiritual reality throughout the Bible.  None of the above dashed points are aspects of this life that we would choose.  But what if those very aspects were the way God was tearing away the obscuring veil to envelop us in a cloud of glory, to bring us into intimate dependence?  

That's a truth that is very, very difficult to hold onto in the midst of the chaos.  The signposts are helpful reminders God sends to keep us from totally wandering off-course.  Thanks for wading through the fog with us, and praying for the signposts to appear.

(PS to those who get our direct emails for prayer:  L's medical board results won't be out for 4-6 weeks.)

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