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Saturday, April 06, 2019

Between the lines: the ins and outs of normal days

In between the postable photos of football drama; most of life happens.

Medicine: though Scott has graciously stepped away from direct medical care for a few months to focus on Christ School, I (Jennifer) still try to keep a part-time finger in our primary profession. Since  arriving in Bundibugyo in January  I've been trying to spend two days a week rounding on the Paediatric Ward at Bundibugyo Hospital. Picture 40-75 patients with parents/siblings/attendants in metal beds and strewn on mats and mattresses across the floor, a pile of worn books or charts in no particular order, best case scenario so far two nurses one of whom might round with me while the other sits in a side room and waits for patients to come and ask for their medication, no vital signs, no assessment by anyone other than the admitting clinical officer or me/Marc on rounds, no charting beyond a check mark which may or may not be done when a medicine is given. And yet also picture the resilience of the staff and the parents, the will to plow through, to put in lines, to give some of the medicine . . . in fact most do get better and go home. We are a malarial jungle, an epicenter of sickle cell disease, an incubator of goop, an outbreak multiplier of measles, a no-rules safety nightmare of motorcycle taxi accidents and children stumbling into boiling pots and open fires, a low-protein culture where malnutrition stalks. On a good day I can feel some sense of purpose when I find the boy with an acute abdomen and send him for surgery, or the infant with hypoxic saturations and connect to oxygen, or the child with dissolving blood cells who never got their malaria meds and can be saved with that and a transfusion. This week I actually got a gastric aspirate and got the lab to run it and we diagnosed our sickest mystery patient with disseminated TB. To find that handful requires hours of sifting through the entire messy press of humanity. Dr. Marc and Dr. Ammon are gems; they work hard and have good ideas. Alisha, Jessie, Bahati and Clovis provide invaluable support with nutrition. But this system is infuriatingly dysfunctional and we all need fresh infusions of prayer, grace, stamina, direction to nudge it towards a path of healing.
This boy had an acute abdomen, and after begging the theatre staff to take him without an extra side-payment (!!) . . his life was saved when they found a perforated cecum. 

Our very own Ndyezika, back in the lab on a break from his upgrade-qualifications course

Malnourished twins and their smiley sister; after several weeks they put on about 25% increase in body weight and went home!

Administration: If you're following the tragedy in Mozambique, a group of citizens appealed to the international community and said, send us an accountant with every group of disaster-relief aid workers. The point was that for money to do its work for the poor, instead of lining the pockets of the powerful, a strong system of transparent accounts is essential.  We are super-thankful for John in our World-Harvest-Uganda office, and Michael the bursar of Christ School. But administration is a huge burden on us. Scott spent hours and days on the budget and now we are both trying to understand flows of money in and out. We're going to court next week for the next step in a land dispute case. We have a long list of administrative tasks undone related to permits, car, immigration, licensing.  The NGO established here has become more and more tedious to run.
this is what our lawyer's desk looks like, he's behind that wall of files as we discuss the case. Pray for us on Tuesday the 10th as the plaintiff makes their case against us.

Leadership: modeling and mentoring, working with staff, developing relationships, having meetings. Our goal is to NOT BE the leaders but to empower the leaders, which we can use prayer for! That applies to this Bundibugyo team, as well as Christ School, the hospital, everything we do . .

Relationships: Related to the above, but recognizing that we have a lot of life and history here, and not nearly enough time and energy to give the attention to each that we would like. Still, we try to have meals or reach out, to invite, to listen, to affirm.
Moments like this make it all worth-while . . lunch and fellowship with two of our young men who are walking paths of integrity and service.

Area Directing: This involves leadership and administration and relationships for sure, but not just here in Bundibugyo but for 10 teams in 4 countries and another country/team in gestation. In February and March this meant some long trips and great connections, some teaching, some meetings. In April this will mean annual reviews with all the team leaders we supervise. In between, there are daily issues handled by emails and calls, and we have a dozen or more 1-2 hour distance meetings a month.  This also involves some dedicated prayer time for each of the 47 family/couple/single missionary "units" in our care. On Thursday, we also met with all the other Area Directors and the executive leadership of Serge for a 2-hour distance-tech conference call. There are always ideas and projects moving forward globally.

The Gospel: the good news makes inroads through all of the above, sometimes when we get to pray for the sick, or share a scripture, or preach, or teach. Most often when we get to represent the truth that God sees and hears the people at the edges, that God sends love through people from near and far.
This was our view at the end of an encouraging call with some new missionaries raising support

And what is not happening? Quite a bit of what we do still care about, like writing, like research, like time with our families. Throw in some market shopping and cooking, cleaning, exercise (well, not recently, but in theory) and a daily rhythm of devotional time. Throw in no power for three days, lugging a generator back and forth to give tiny boosts to the office and home, putting up a little struggle against rats and insects, destructive storms and a prolonged viral crud. And there you have life.

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