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Tuesday, October 20, 2020

Losing and gaining, voting, and thoughts on the soul: #COVID-19 UGANDA day 214

For what profit is it to a human (greek: anthropos, one of humankind) if one gains the whole world, and loses one's own soul? Or what will a human give in exchange for one's soul (greek: psuche, breath of life)?

This was the passage I read this morning, in Matthew, Mark, and Luke. Which particularly struck me as I have seen adds and articles on opposite sides of the political spectrum urging us to vote, lest we lose the soul of America.

Ironically, the query from Jesus falls in a passage where he is speaking to his closest followers. The preceding block of narrative starts with the tragedy of his cousin John's beheading. He tries to get away to grieve in solitude, and is followed by crowds, whom he receives with compassion, teaching, healing, and feeding miraculously. This leads to a scene where Jesus demonstrates his power over the chaos of the storm, and then scenes of sparring with the religious establishment, culminating in a crucial (yes, cross-related word intended) climax of the journey towards Jerusalem where he explains to his followers that he is NOT building an empire or a religion by conquering the Romans or the Temple hierarchy, but instead he is headed towards death and intends to build a community on them. It's a lot to take in. Not only will he die, but he tells them that anyone who wants to follow him must also deny self and lift up the cross, the instrument of death.

It's a far cry from a philosophy of winning.

And yet, the promise is, that by doing so we gain our souls.

Nursing and mothering, two soul-stretching works!

In 2020, what does it mean to get down to the core of who we are? More on this as the readings settle, but I would highly recommend The Color of Compromise by Jemar Tisby for a four-century overview of history and faith in America, which I just finished. Much of what we hear now about riots, law and order, abortion, individual rights and responsibilities, fear . . . was said 50 years ago. And before. It is informative and chilling, to read. 

I think people of faith grasp that evil is afoot in our world. That is the testimony of every prophet, the experience of every person. Paul writes to us about the principalities and powers, unseen systems with demonic undertones and human complicity that justified painting this continent of Africa as a _hole to be exploited, or a dark mass of ignorance to be corrected, from slavery and colonialism to conflict minerals and debt. I don't need to list the evils afoot in 2020, but it breaks my heart nearly every day to hear that my kids in Utah are worn down by rising COVID, that an older relative died, that families can't gather safely for Thanksgiving, that we are still apart, that two of the young moms with malnourished children had not eaten anything themselves in several days until other families around them on the ward realised they had no food and shared. There is a thick heavy web of profit-at-all-cost thinking about our world from the powerful. Evil seeps into the way the world works all over the globe, both individual sins and systemic brokenness. Both-and, both abortion-as-convenience, and sub-rate gerrymandered school districts. And on and on.

The question is, what does Jesus ask us to do? 

A place Jesus asks some of us to carry crosses

And the answer is, take the cross-way, the hard-way, the risky way, the suffering way. . . not because the cross and suffering are the goal, but because they lead to life.  Sure, there is the option of losing your soul and grabbing for glory, fame, honour or ease on the world's terms. But that verse harkens back to the one I call the scariest in the Bible, Psalm 106:15. People were complaining, and testing God. "And He gave them their request, but sent leanness into their soul." 2020, and every year, are times of testing. What do we want so badly that we would risk withering our soul?

It is every American's job to think about that. Some will vote one way and some another. I think this gives us a good frame for decisions. Are we voting with courage and willingness to personally pay a price that allows for the common good? Are we living in a way that only makes sense if love is the final destination of the universe? Are we refusing to be manipulated by fear or greed? As a person who is not hungry or sick, I realise that is easier for me to say than for others to say. But I do think that evil is insidious and deadly, disguised as CS Lewis wrote so eloquently as Screwtape's urgings, tapping into our own sinful me-first tendencies and augmented by millennia of clever evolution. Yet over those same millennia, countless people have raised their children, planted crops, bandaged wounds, freed prisoners, helped the lame to walk and the blind to see, liberated concentration camps and painted masterpieces. All of that takes a conscious choice about values. Choose a cross, choose life, and find your soul.

And after voting, fill out a go form for Serge. Plenty of work to do here that will fill your soul.


Your choices matter to these little ones


Sunday, October 18, 2020

School is back, sort of . . . #COVID19-UGANDA day 212, Lamentations, and Cautious Hope

 After 7 months of abrupt school closure country-wide, the country of Uganda allowed schools to reopen on Thursday 15 October. 

And by reopen, we mean, only the "candidate classes" preparing for national graduation exams:  Primary 7 (PLE Primary Leaving Exam), Senior 4 (O-Level or UCE Uganda Certificate of Education equivalent to grade 11 in USA, almost high school), and Senior 6 (A-Level or UACE Uganda Advanced Certificate of Education equivalent to a tad beyond high school, maybe a year of community college), plus final-year University students. For our team in Bundibugyo, that was big news. While we work holistically in church planting, Bible translation, education, clean water and sanitation, nutrition, health, literacy, sports, youth outreach . . .the single institution for which we are responsible soup to nuts is Christ School Bundibugyo. 6 grades of O and A level, 350+ students, and perhaps the most significant and lasting impact over the last twenty years. 

On March 20, we had to send all our students home, only half-way through first term (Ugandan school years are calendar years). For the first couple of months, we lived in limbo of expecting imminent resumption of normalcy. Our staff put together packets of study materials that went out to students, and participated in some radio-show teaching organised eventually by the government, and even a pilot program to use What's App for the Senior 6 students to try online learning. But in a place with intermittent electricity, almost zero personal computer ownership, little capacity to buy internet data, with about 2/3 of households having a cell phone but few of those with internet capability . . well, online learning was pretty much impossible. As month after month passed, we all felt the sorrow of how places of poverty fall further and further behind. Even a pandemic does not level the world in effects: the people who live in low-resource places still suffer the effects disproportionately. 

As the lock-down dragged on, Patrick (our Director of Development) and Mike (pastor) began a program of staff development. Taking advantage of the space to invest in staff without the pressure of students, they worked several days a week to teach teachers how to improve their teaching, and to mentor them through Gospel studies. While we mourned the delay in school opening, we do see the beauty of that time. Patrick and Mike had barely begun their terms when COVID hit, and this gave them lots of time to build trust and relationship with staff. Ann joined in too. What was definitely evil in this world God enabled us to turn to some small redemptive good.

Let us take this moment to THANK all of you who support Christ School. Almost all of our 365-club donors (the general subsidy of $1/day that allows us to charge affordable tuition to Bundibugyo parents) and the OVC scholarship donors (full tuition for ten per class who are orphaned and most vulnerable) continued to give in 2020, in spite of COVID, in spite of recession. That meant that even without parents paying, we could give staff 85% of their normal salary.  Every single one stayed with us throughout the closure. I believe we are the only school that continued staff programs, and the only private school that will be able to reopen now. That is not because we are somehow immune, somehow better . . . it is because we are connected to prayerful generous people.

Which brings us back to this week.  Our staff worked hard to prepare. We procured hand-washing stations donated to schools and brought them for each classroom, thermometers for the gate guard and infirmary, soap and bleach. The desks were rearranged to be spaced 20/classroom instead of 40, dividing the senior four students into two streams (double the class time for teachers but OK since only 1/3 of the school is back). Dorms were reopened also with limited students so they could spread apart. The kitchen staff began purchasing food. On Wednesday our team and the entire staff spent about an hour and a half on a prayer walk, asking God to be present, to protect, to work, to bless each aspect of student life, from the classrooms, chapel, dorms, football pitch, admin block, infirmary, gate, staff apartments, kitchen. At the end, Patrick showed us our certificate from the District Education Officer that allowed reopening: we scored 97%, highest of the 200 or so mostly government primary and secondary schools in Bundibugyo.

And on Thursday, the allowed 64 Senior 4 and 6 candidates began to trickle back. You might think after seven months they would be banging on the gate to get back in, but in reality, most people probably didn't believe it would actually happen. Families are no doubt still scrambling to assemble fees. People are no doubt nervous about the safety of the idea for their children. Waiting to see what happens, what others do. Transitions are difficult and gradual. As of today, about half had returned. The government's plan is to ignore the missing second half of first term, have a shortened second term now until Christmas (normally May, June, July) and another abbreviated third term January and February, with O-level exams in March and A-level in April. No plan yet for how to mesh that with the return of S1, 2, 3, and 5, or how to coordinate back into a calendar-year pace.

Scott and I walked down to the CSB church service this morning at 8 am, as we had all of 2019 and the beginning of 2020. And while we rejoice in reopening, the sobering reality of what 2020 has wrought weighed on us. A gloomy morning dripped rain. Students sat one-per-bench, wearing masks, staying apart. It was a bit difficult to understand the speakers, or even connect emotionally with half-covered faces. Offerings were brought cautiously, songs were limited to three students leading from the front. The atmosphere was subdued. No hint of the normal energy of praise and worship, no lighthearted joy. And yet . . . Desmond preached from Lamentations 3, and Patrick and Scott both emphasised the same paradox. This year has brought our world loss and sorrow; nothing can separate us from God's love. We wait in faith.  Not the worship we are used to, which made our hearts heavy for these kids, for this continent. But a sign of resilience and hope nonetheless. Faithful staff. Courageous students. High stakes. The most seriously we have seen precautions taken yet in Uganda.


If the virus gets into a boarding school, we could be shut down, or worse, people could die. If we can stick to our SOP's (standard operating procedures) and teach with masks and hygiene and distance and caution, another 64 kids can take their next step in being the leaders who will serve Bundibugyo with skill and humility.  

Join us in praying for Christ School Bundibugyo over the next nine weeks. That we and our students would deeply experience the truth of the prophet Jeremiah's words: God's mercies are new every morning, God's faithfulness to us is greater than COVID or recession or insecurity or poverty or danger of any kind.

Saturday, October 10, 2020

58 years, 204 days of COVID, and Worth as a Fact without Conditions

Yesterday Uganda as a 20th century independent post-colonial country turned 58. Uganda, of course, existed from the beginning, and the people who live and congregate and cultivate and celebrate here have done so for millennia. Still, the modern state and I began our trajectories together in 1962, and it turns out we have a lot in common. African roots, European influences, British colonisation, and a delight in passion fruit, have shaped us both, and in less than a week we Myhres will celebrate the 27th anniversary of moving to this country and continent. 

On a bike ride today, I took a road I had never traveled. And it reminded me of just how significant the last 27 years have been in Uganda's 58. 

Full disclosure, I took this road because I was hoping for an easier trail . . . Scott is a biker and I am a wanna-be who has been trying since I was 18 and met him to keep up. Sometimes on a weekend he graciously invites me to join a ride. Yesterday's Independence Day holiday did not really happen for us: it just meant working harder with fewer staff, coming back to some hard phone calls with people we had hurt, then catching the end of a burial of a young man our kids' age whose dad was an early friend of the mission. I know I was depleted (and have been) so after eggs and coffee this morning we loaded our bikes on the car and parked in town so we could take a winding dirt road that hugs the mountain roots from Bundibugyo to Kikyo.  We both thought we remembered it being more reasonable than it was (which stands to reason because we last rode on a motorcycle and it's been more than a decade . . ). 7 1/2 miles doesn't sound long until you know the rough terrain, the steep climbing, and the minimal function of my gears. It was gorgeous and some fun, dramatic views into Congo, maroon cocoa leaves and little purple sprinkles of wild flowers, greeting surprised people, crossing streams.  But at the planned turn-around I decided I couldn't face repeating all that up and down in reverse, and needed to find a road into the valley and hit the paved main road, while Scott turned back along all those buttressing spiny roots of the mountains to reach the car and then take the main road to meet me. My route was a little longer but easier. Anyway, as I sailed downhill, I passed lots of homes that took me back to our earlier days. No bricks, all wattle and mud-walls, no electricity lines, quiet, no radios blaring, birds, greeting, families grouped around shelling beans or drying cocoa, long stretches with no one at all. While I found it peaceful and nostalgic, I also realise that Uganda has embraced a warp speed of change in 27 years. Ubiquitous cell phones, electric power, pavement, piped water projects, "permanent" (brick, cement) building materials, cars and motorcycles, schools and churches multiplying, doubling population. I love the simplicity of the old days, but I also love the fact that we can treat malaria with a very effective new medicine, and that dozens and dozens of young people go to university every year, and we have a local-language Bible and radio station. Bundibugyo was always on the margins of the Kingdoms that preceded the British, and on the periphery of the colonial system. So in 2020, I think we're in our best place yet. When we pray, Your Kingdom come, your will be done, on earth as it is in Heaven . . . this is what we mark with another year. That's a longing for light, a determination for goodness to rain, to reign. 

Two new Ugandans going home from NICU

Congratulations, Uganda.

And though we have poured ourselves into this place and called it home, we will always be straddling our American and African attachments. So on the same day we marked Uganda's Independence, we read an excellent editorial by the author Marilynne Robinson. It was called, "Don't Give Up on America." The gist was, the spirit of our times teeters too close to resentment. Our polarising leaders and our own fearful hearts lead us to fan anger, disappointment, alienation, suspicion into a bitter hostility. And that makes the trust in reality, in truth, very difficult to muster. Which we need in order to work together for the common good. My favourite part of the essay, though was the beginning, which I will quote here:

What does it mean to love a country? I have spent most of my life studying American history and literature because of a deep if sometimes difficult affinity I would call love. Deeper, though, is a feeling like a love of family, a hope that whoever by whatever accident or choice falls under the definition of family will thrive and will experience even a difficult life as a blessing because his or her worth is a fact without conditions.  . . . Human beings are sacred, therefore equal. We are asked to see one another in the light of a singular inalienable worth that would make a family of us if we let it.

That is grace right there.  Worth as a fact without conditions. That grace creates a family, a community, a church, a country if we let it. That grace turns a difficult life into a blessing.

Not giving up on America, or Uganda, or the human family. 

Vote, call out truth, and work for change. On Friday we lost two babies and a preteen child who all should have had better, faster care. The root causes of that lack are deep and complex, and not easy fixes. Those children had worth as a fact, no conditions needed to be proven for them to deserve life. Justice failed them. We've come a long way, but there is room for so much more. What if money was allocated fairly? What if jobs were filled with people of integrity? What if all girls learned to read? What if we had the courage of knowing that only God's opinion of us matters? My Bible reading this morning was the Sermon on the Mount, Matthew 5-7. If there is anything that shines out of those chapters, it is this: God's ways are not ways of spotlights and force, they are ways of goodness that only make sense when we see the bigger picture of a universe arcing towards justice and mercy. What if we prayed for those who treated us spitefully, and doubled down to work behind the scenes for those who asked too much of us?  

In Uganda, or America, that would make the next anniversaries in 2021 something to celebrate.

Cocoa trees, closest thing we get to Fall


Tuesday, October 06, 2020

THE 200-DAY PROVERBIAL WALL: #COVID-19UGANDA

 200 days of 2020 have now been spent in near-continuous alertness to disaster. In fact, Uganda's version of the pandemic is better than most. Our mortality rate hovers just under 1% (reported deaths/cases are 82/8965 . . which of course is not in the least bit reflective of actual deaths or cases, but the best we can do). We spent 5 months in a severe lockdown (for a long time, not allowed to drive in a car except to work at the hospital a few miles away, no movement beyond foot a few hundred yards to local markets, no churches, schools, restaurants, gatherings of any kind) with a flat curve. In the last month we're now opening a bit just as cases start to escalate, but nothing like the USA. And yet . . . the sense of impending doom lingers. If one of our team mates draws the 1 in 100 or 1 in 1000 straw, there is not a lot we can offer. Most days are spent in a miasma of respiratory virae under the hot heaviness of an N-95 mask, for which we are thankful. Help is limited, money is tight, medical supplies are sparse. It weighs.


Yesterday for instance, the morning report announced 16 sick babies in NICU (accurate) and 95 on Paeds ward (less accurate, but we probably did see over 70). When you consider that they have not been reviewed, or had vital signs, the charts are little lined paper books and the labs disappear for days, so each one is a blank slate of figuring out who-what-when-where-why . . . it takes a lot of energy. No one died on our watch, so there's that, and the sickest children from last week were all rebounding: a ten year old with cerebral malaria who had been unconscious with abnormal pupils, a six year old with severe malnutrition and anemia listless with sickle cell disease, a six-month old twin pair with pneumonia. We even discharged a 6-week old who had been critically ill on oxygen for days with a bronchiolitis. One of the preems came back looking great. We strive to hold onto those moments of thanks. Because it's otherwise a sea of insanity. It's hard to bounce from a preteen with unexplained ascites to a 1 year old with an undiagnosed complex syndrome to another kid strolling in with a massive neck tumour to then next dozen who have received variously incomplete courses of malaria treatment that needs to be rectified to a follow-up for low weight gain. A student appeared, I spent extra time on patient #3 making it a learning opportunity, he then disappeared for the rest of the day and I never saw him again. Referrals departing, referrals returning. An unexpected big-wig arriving to teach the staff about HIV diagnosis. Parents asking for discharge. A district official popping in for his own kid to get a check-up for the most minor rash. It's relentless. I am very thankful for Dr. Isaiah, without whom I might still be there lying on the floor (actually there's so many people, the floor is pretty much covered, so I'd be lying on some patients).

Scott meanwhile did two surgeries and all of OB rounds, all of which was quite life-saving, and still had time to help me get through the last few kids. We were just pulling out onto the road about 3:30 pm to get home in time for Scott to have a meeting with some of the other Area Directors when my phone rang. One of our key partners, Clovice, was at a smaller health centre with his wife. They had been at our house on Sunday with anxiety about her upcoming delivery, and Scott had checked her term pregnancy with an ultrasound and BP and reassurance, but now she was in labor and it was impossible to understand on the phone. We decided to drive straight to the health centre, and once there we confirmed she was in potential trouble. The young volunteer recent-grad doc had done his due diligence. So, forget the meeting or a drink of water or anything else, we piled her entourage and luggage into our vehicle and turned around to go back to the hospital.

It turns out that a few phone calls and a 5pm-ish timing makes for better-than-usual emergency care. Long story short, with a quick C-section and a bit of resuscitation and a few harrowing moments, the outcome was a delightfully perfect little girl and a happy dad. Mom will be happy when she feels better. 

Back to the wall: five minutes before that phone call, I was DONE. I find myself reaching the limit and resisting the stretch. And yet when it was a friend, a faithful person, a family who are not just names or diagnoses but real people, we didn't hesitate to add on a couple more hours. By 6 we were reaching home again, and by 6:05 someone was knocking on our door, and the wall was back up. 

So, truly we need transformation ourselves. Me mostly; Scott is solid. I know it is a scarcity mentality, a lack of faith, a mental wall that feels the need to be protected from one more problem. In the irony that so often accompanies life, per request of the Medical Superintendent we started a staff Bible study series on Monday mornings. On whom? Abraham. So, I was teaching about faith and courage and the unknown and sacrifice and stepping out at 8 am . . . while grumbling about exhaustion 8 hours later. Sigh. Yet, limits are also OK. They are human. They are part of the design of creation. 6 days of labor and one to rest. Three score and ten and then eternal rest. Another paradox, that we are called to embrace faith and sacrifice; we are called to let go of being superhuman saviours. I think we want inviolable lines that excuse us from the hard work of having to hold onto both of those truths. In this moment, have faith and push on, in that moment, say no and turn off. Both are valid and we won't always get it right. Which is why we need grace just as much as we preach grace. 

200 days down, unknown days to go, and asking for an infusion of courageous can-do spirit, and of peaceful let-go rest.


Sunday, October 04, 2020

God in the time of Coronavirus: churches in Uganda reopen on day 198

 I have to hand it to Bundibugyo: church resumed today after a six month moratorium. And they managed to be scientifically cautious and faithfully joyous in the proper paradox.




As per national guidelines, a church that would normally be skin-to-skin crowded, children flowing in and out, a veritable sea of aerosols and sweat, with no particular concern for time, was transformed. Worshipers arrived and lined outside to wash hands with soap and water. Then they were registered (in case contact tracing needs to be done) in a numbered list with a limit of 70, with their temperature taken and recorded. Each number corresponded to a chair. Everyone wore a mask, and sat in their carefully spaced assigned seat. Mid-service, a deacon moved around and sprayed everyone's hands with alcohol spray again. The government limited services to two hours, and they began and ended exactly on time.  The elder leading the service gave public service education on COVID prevention measures. Masks were pulled under chins for singing which was probably not 100% wise, but otherwise the protocols were quite strictly adhered to. Surely if this level of decorum, order, spacing, caution can be achieved in Bundibugyo, no one should be excused from trying.


Our building is a spacious community centre with excellent airflow, no screens or window panes, a high roof, huge double doors on three sides. It was a sunny day with strong breezes. And whether  everyone was just curious or so longing for fellowship after a long drought or afraid of being left out, I don't know, but we went at the normal time things would start to trickle towards a start and found ourselves #64 and 65, a near miss, with the choir in full swing. 

Note the assigned seat numbers, Bundimulinga Presbyterian Church of Uganda

Yes, we sang, and danced, and had offering and announcements and prayer and a sermon. We waved from our seats instead of greeting by handshakes and hugs all over the church as usual, and the offering buckets were brought to us instead of allowing a crowd to swarm the front. But the feeling was festive. The praise was heartfelt. A widow who had recovered from illness gave a passionate testimony and donated a basket she had made. And the texts were picked to be relevant to the current situation:

Deuteronomy 31-be strong and courageous, God is with you.

Leviticus 13-sensible words about leprosy prevention by case identification and isolation, with a little history from the pastor who remembers his parents talking about leprosy care and elimination here in the 1940's and 50's. Quarantine is Biblical.

2 Kings 5 and Matthew 8-two leprosy healing stories, with the point that Jesus heals, that no disease is too hard for God to disrupt, that we should not hide but come with hope to find healing.

When did you last hear a sermon on Leviticus 13?

All in all, it was a very encouraging morning to see the community that has been hammered with isolation, anxiety, potential disaster, come out in faith and respect science while looking to God to work. The world should take note.


Oct 4 Jewels: 24 years of Julia, 198 days of #COVID19-UGANDA, and a lifetime of love

 For all the 24-year-olds in 2020, we your parents bleed in the paradox of apologising for this relentless year of sorrows, and resting in the hope you represent.

Like most of the years since she turned 17, we are missing Julia's birthday. Her milestones like 18 and 21 were spent with kind community, but no shared continent with us. Today she has a brother whose break in the tortuous special forces training program for two days miraculously aligns. This is where the cross scratches our shoulders and weighs our hearts most. But in 2020, I suspect this is true of SO MANY. Grandparents unable to travel, parents unwilling to risk exposure, kids unable to have school friends, venues shut down, it's a year of wishing and yearning. This Oct 4 finds our Julia in a country beset by pandemic, with the president hospitalised and the future shaky. She's in a world where relentless exploitation of resources for wealth has damaged the environment, and where injustice has been subtly and sometimes blatantly encoded in the very fabric of society. Like many in her cohort, she's working two part-time minimum-wage jobs that don't give her health insurance, studying on the side for grad school admissions, sharing a modest house in a modest neighbourhood to make ends meet. 

Most recent photo, pc Lena from the farm, stolen from instagram . . 



two more farming photos from the newspaper article, pc Kadejeh Nikouyeh

At Maxie B's when we visited  a couple years ago

But: she IS working, studying, communing.  And here is where hope comes in. Because amongst the 24-year-olds are growing proportions of people who value a job for its meaning more than its benefits, who invest in causes that increase equality and justice even if their own power or wealth are not established, who hold onto the importance of community and faith. Who are asking hard questions and not accepting the easy answers. 

Julia gives us hope. Her first job is at New Garden Park Farm (link for recent newspaper article), a church-based community agriculture project that combines many of her passions: food for the hungry, working alongside East African immigrants, creating a healing God-filled space with the beauty of nature, encouraging parishioners to care for creation, experimenting with sustainability. Her second job is at Maxie B's, a bakery-coffee shop that provides connection and celebration. She's thinking about how to be part of the goodness of God to real people in real time. She embraces friendships across a diversity of colour, age, belief, identity. Her fridge is full of homemade concoctions, her porch is blooming, and her brother helped her rehabilitate an amazing hand-me-down espresso maker for her barista side-hobby. Her rescue-dog Chance and her fuel-efficient Prius and her broad rimmed hat go with her everywhere. She's intentional and prayerful and free-spirited and organised and deliberate and reliable and openminded. In all the best, sunny, ways. Growing up as an outsider and growing up in the faith informs who she is, but she has taken all those crazy experiences and become her own person. One of my life-long prayers for her was based on the end of Luke 2, that she would grow in wisdom and stature and in favour with God and men. She's smart and insightful, healthy and strong, and I know God and humanity keep finding more new things about her to love. We certainly do.

moving day, pc ??, she's a strong woman!


With Caleb at his Ranger grad; he gets to see her today too!



So on this October 4th, we celebrate her once again from afar. And this being 2020, let me end with two quotes from reading the papers this weekend. The first is from Viola Davis, whose movie about the blues singer Ma Rainey is coming out soon. She reflected on how the character's joy, her comfortableness in who she was, rubbed off on her as she acted, and said:

 "I have to remember that I don't have to barter for my worth. I was just born with it."  

That is about as clear a statement of grace as I have read, and it reminded me of Julia. She was born with worth, and we could not love her more. The second is from an article about the passing of Ruth Bader Ginsberg, where the author reflects that the two things she learned from reflecting on the justice's life were gratitude and good work. Being thankful re-sets our focus in this year of so many losses. Writing this blog post is an act of choosing to be more thankful for MY daughter than I am sorry for myself that I'm far away. A life of gratitude to God and good work for others is a fair summary of our aspirations:

Justice Ginsburg was a human being, an incredible woman of valor. And her passing can remind us that while there are no political saviors, we all can work to save the world. God alone saves. Yet, we, fragile humans that we are, do the work we are given to do - whether as lawyers or politicians or preachers or teachers or doctors or florists or writers or waiters or clerks. And we do our part for the common good. When we do what we are called to do well, wherever we are called to do it, with courage and grace, we contribute to the healing, the salvus (the word salvation comes from the Latin word “to heal”) of the world, what the Jewish tradition refers to as “repairing” the universe. God is the Savior, the Healer, the Great Physician, the Comforter. But we help save - as repairers of the breach, the bringers of peace and grace, the seekers of a more just world.

So here's to Julia, and all the 24-year-old women out there who are working for the common good, repairing the breach, bringing grace, breathing peace, and seeking justice. 2020 shall pass, and the road ahead is yours.


Julia in Bundibugyo 1996 (same tree, same chair, same yard still here but no Julia)

with brothers, 1997

Julia with Bear, and Jack, 1998 or 9

Bear in 2020 after Chance got hold of him

When they got to wear the birthday button for breakfast on the special day

Here are the two photos I have taped to the wall over my desk:

Learning photography with her dad

Our one time to all be glamorous together, Nov 2019

How I still think of us




Saturday, September 26, 2020

#Bundibeautyo: we interrupt these 190days of COVID to bring you a Saturday Morning reminder of where we live

 A diffuse predawn grey, we pull out onto the tarmac on our bikes as the birds and bodas awaken. Three buses are queued in Nyahuka for the cross-country trip to Kampala; they will leave in 30-60 minute intervals, sparsely populated. It has been many months since I was on a bicycle. The lockdowns and curfews and general press of work I suppose. Scott has recently resumed riding a couple times a week, but now on a Saturday he proposes we go on a longer loop together. I know I'll slow him down a LOT but the freedom of the road and the richness of the miles, the opportunity for a shared adventure, wins over my hesitation.



We take the smooth paved road almost to the Busunga border. I try to remember what it used to look like when I drove through the river which is now bridged, when I took the immunization team to smaller health centres, when we used the Uganda Community Health Care Association materials and our passion for adult learning and the integration of health and Gospel messages to do village trainings week after week, often with a baby on my back. Today the mosque in Bubandi blares a sermon through the loudspeakers, a few business people are out setting up stalls or sweeping in front of shops. At Bujilele we turn south off onto a narrow murram track that climbs and climbs the Rwenzori base to Bunyangule. Then a steep dip across the ridges, taking off shoes and socks to wade a river that is swollen, fast, the power of the water makes the bike hard to hold onto and push. Another climb to Butama where the UPDF has a post that commands the highest ground, a trading centre where we look down on the clouds that obscured our start. The road north now dips and rises across the roots of the mountain range that taper into the Semliki. It is muddy, rutted, rocky, steep, with adrenaline-inducing slippery descents, and breath-stealing pumping climbs. After a few miles, there is a single-track that veers away from the mountains to Mirambi, through shambas and streams. We pause to heft bikes across stepping stones; my awkwardness inspires a fit young man to grab mine and bring it through, which I take as chivalry until we ride five more seconds and a tree is felled in the spot we were standing. I guess he realised we were oblivious to the danger. We are in turn shocked by the total lack of road maintenance; the extreme rains this year have taken a heavy toll. From Mirambi, more rough roads, then a shockingly smooth sandy stretch that spits us back out onto the tarmac around the airstrip. The final stretch of the loop is now familiar territory to home, Saturday market traffic, neighbours we know. We've only covered 15 miles; it feels a lot longer given the 1300 feet of climbing and descending, the treacherous nature of the tracks.

Bundibugyo is beautiful. Most days, my encounter with this district is marred by sickness and sorrow, by need and suffering, by exhaustion and brokeness. So a Saturday morning tour provides a needed soul correction. The little pockets that pull our hours are important, but not the full picture of this place. We covered a wide swath of villages, gardens, homes, trails that can easily remain hidden from road-only tours. There are stretches where the muted mist of the morning, the thick carpet of leaves under the cocoa with their touches of red, the smell of earth, could almost feel like Fall in Appalachia. Others where the sun broke through to highlight the white bark of the cocoa trees like midget Aspens. There are moments of quiet, only the hum of ever-present unseen thick hordes of insects vibrating, trills of kingfishers or more distant soaring calls of the palm nut vultures. Morning clouds lift and sun begins to catch the brilliant red and blue of football jerseys drying on the edge of a rusty roof, the sprinkled yellow and purple of weedy roadside wildflowers. At most homesteads, a kid or two catches sight of us and runs to the edge of their compound to greet, and we try to greet the dozens of people we pass walking on the roads, cycling through Lubwisi, Lukonjo, Swahili and English. Solemn faces break into smiles, and we leave a wake of excited chatter, sometimes speculation, sometimes the person in the know identifying us. Mostly, there is just clarification, the first one is a man, that one is a woman. She is his wife. I don't know when non-binary thought is going to reach the surface in this place, but I often feel a little twinge of sorrow for the pioneers, it's going to be a steep struggle.  Teenagers linger with basins, on their way to gardens; four girls march in a line each with a viny bundle of beans still in the pod from their harvest. Almost everyone carries either a panga or a hoe. A segili of steaming charcoal sits perched on a tripod, waiting for the chapati stand to open. Mud and wattle traditional homes abound, brick and mortar upgrades are plentiful, and a few modern upscale cement Kampala-grade homes with glass windows can be seen. Brick making pits of mud marked by their little pulpit of a board nailed to an upright pole, the smooth surface for moulding. 

In other words, life. And life abundant. Children, banana trees, talk and laughter; cocoa co-ops and police stations and quiet churches, clothes washing by rivers and perturbed roosters. Bundibugyo is beautiful, and Bundibugyo is throbbing with a pulse of life. 

Paradoxes pervade our days and our weeks. This morning, not one. single. mask. seen. NO ONE. Except for the schools and churches being completely shuttered, there was not much to indicate a district under pandemic restrictions. Yet the day before, the staff meeting was a murmur of consternation, more positive cases, an Ebola-level gowned man spraying chlorine bleach left and right, an insistence that we police to be sure every visitor to the wards is properly masked and distanced. So we and the world continue the surreal stepping between a world that is gorgeous and fragile, between the resilient spirit of survival and the weighty sorrows of loss.



Monday, September 21, 2020

A Monday-drenched tale of a few kids on one ward at the end of the road

 First, the post below will be better than this. It has big thoughts. Today is not a big-thoughts day, it is a Monday drenched in rain and death. 

We should have had a clue when the morning report mentioned 171 patients in our 100-bed hospital. 76 on Paeds alone. It was one of those days when you have to literally move bodies out of the way to get to the patients, when you have to step on one person's mattress on the floor to get to the next. I knew the sickest baby from Friday had died over the weekend, a convulsing 1-month-old whose LP looked clear, but whose pneumonia was severe. I went straight to the other tiny-tiny, a 3 month old who would qualify as a low-birth-weight newborn, literally a starving baby. She had actually put on a sliver of weight and brightened up. From there I went to the three tables in the front by the window into the nursing-station room. These tables have a wipe-able surface and poles to hang IV's, so they are the preferred location for those needing blood transfusions, oxygen, IV fluid drips. The closest thing we have to intensive care. The first three kids I saw there were ALL UNCONSCIOUS. Two were actively convulsing with positive malaria tests and the third was pretty limp. The next two were not much better, a very anaemic child with sickle cell (and malaria) and a malarial child with a bad pneumonia. All were between the ages of 1 and 5 years.  5/6 had positive malaria tests, though 3 of those also had other significant problems. Over the next half hour or so Dr. Isaiah also joined, and three different nurses bustled. They got Kilifi-protocol septic shock isotonic dextrose-containing fluids, they got doses of the very effective artesunate and of our strongest antibiotic, I did an LP on the lone child who did NOT have malaria and while the pressure was high the fluid was crystal clear, the seizing children got correct doses of valium, the one with the worst lungs qualified for the single oxygen tank. All things considered, we attacked the situation to our maximum capacity then turned our attention to the crazy ward.


Chicken pox that should have been isolated but was not. More malaria. More sickle cell. A child with an ankle injury and a hundred little nicks in the skin for rubbing in traditional herbs. A preteen with unexplained liver failure. Another with probably leukemia. A 1-month-old who just showed up with what seems to be an omphalocele, a congenital anomaly that one does not generally just ignore for a month. Hungry kids. Irritable kids. Wheezing and coughing kids. Vomiting kids. Pale kids. A call to the lab, the blood bank is empty. At one point I got a call from Scott--he was taking a mom with cord prolapse (NOT COMPATIBLE SITH SURVIVAL of the baby if the umbilical cord comes out before that baby's head is delivered) for an emergency C-section and wondered if I could run over to the operating theatre in case Kacie needed extra hands to help resuscitate.  He said, ten minutes. I came in 12, then couldn't find a gown. No worries, Scott as surgeon didn't have one either, just scrubs and an apron, and he was still prepping (after providing the drugs, the gloves, and the sutures to get the case rolling . . . ). As he finished laying down the sterile drapes and said a prayer, he told the anaesthetist, I'm starting, and she said OK. We all noticed the mom seemed quite alert. Scott pinched her skin and she jumped. We all looked at the anaesthetist who said, the power is off so there's no monitor and my pulse ox battery is dead so I couldn't give the ketamine. I honestly don't know what she meant by her "OK". I found my pocket pulse ox in my bag, confirmed the mom had normal vital signs, and she pushed the drugs. A few minutes later Scott pulled out a blue little girl, who did not move. But she had a decent pulse, and Kacie knows what she's doing, and by five minutes she was pinkish and whimpering some cries. The baby I mean. Kacie was teaching a younger nurse-midwife how to "help babies breathe" as she went on. It was a great save, and the kind of moment that keeps us all going.

HOWEVER, when I walked back to take up the chart of the next child I had left on the ward, I could vaguely hear what sounded like an adult woman softly crying. I tried to get back up to the front (by tried, I mean, had to gently move and cajole people out of the way to squeeze between those tables) where one nurse was intently staring at a pulse ox on the hand of a baby who did not seem to be moving. I said, is this child alive? He said, yes, but when I checked for a pulse, there was none. I grabbed our grimy bag-valve-mask and started CPR. I It was good CPR too, with chest rises on breaths and compressions on heart-pumps. I asked for epi and he disappeared to look, and came back empty handed. None. We continued for a few minutes but the little boy's pupils didn't ever react and I knew he was gone long before I had returned from the operating theatre. When I said so, the mom literally fell into my arms. I was holding her up, people were wailing, it was chaos in a crowd, when the nurse said, the other one on this table doesn't look good either. I tried to comfort the mother, said a few words about Jesus, and then handed her over to a relative as we squeezed full-body-contact past each other so I could reach the second of the three unconscious kids. This one was quite febrile, so the dad kept touching the skin and feeling reassured. The nurse was again trying to read a pulse ox, but again when I checked, there was no pulse. Once again we did CPR for a few minutes, once again the pupils were already blown. Once again the sad finality dawned on the relatives and people began wailing and falling on the floor. Once again I disconnected the IV and helped wrap the little body.

Two deaths at the same time, on the same table, with the general cacophony of grief. . . and no one but me had made the decisions this morning on these two. I had interviewed, examined, poked and prodded, seen that meds and fluids were given. They were obviously very very sick. But it was so discouraging to feel that even trying to do everything right was of no avail. Did I make things worse? Or just delay the inevitable by a couple hours? It is a very physical process, pushing hard on the sternum, holding the rubber bag and mask, touching the skin and peering into the eyes with a phone light, listening for any sound of change on the chest, smelling the skin-to-skin sweat and tears of the family all around me, hugging and holding and wrapping and lifting. And then suddenly, the mourners have carried the bodies out and the rounds must go on, there are still live children to see, no time really to feel sad. 

A baby who would have died lived thanks to a fast (ish) C-section under non-optimal circumstances; two pretty normal, growing, previously healthy kids age 1 and 5 died after brief overwhelming brain-affecting infections.

And a couple hundred other people waited to be seen, heard, paid attention to, cared for.

There are so many big, important things happening in the world today. But I am left thinking about small hands and beads of sweat on little foreheads and twitching limbs and vacant stares. And the miracle it is that anyone grows up, navigates the pathogens and meets their second and third decade alive.



Saturday, September 19, 2020

Of sacred wounds and shining wonders: COVID-19 day 183 in Uganda

Ministry can indeed be a witness to the living truth that the wound, which causes us to suffer now, will be revealed to us later as the place where God intimated [God’s] new creation. —Henri J. M. Nouwen (1932–1996)

Sacred wounds of severe malnutrition

Same skin that was broken be the same skin takin' over. . . 

Most things out of focus, view

But when you're in the room, they notice you (Notice you)

'Cause you're beautiful

Yeah, you're beautiful

Them men, them gon' fall in love with you and all of your glory

Your skin is not only dark, it shines and it tells your story -- Beyonce, Brown Skin Girl

shining but not escaping

This morning we worked in our garden. The weeks are long. Most days begin before sunrise and work ends well after sunset, a stretch of  malaria and fever that seems to never end, meetings, calls, emails, prayer. So it is a gift to have a morning for a walk with the dogs, a cup of coffee, and a chance to hoe and crumble the composted dirt into rows for the next wave of planting. 

The wound in the earth, the broken surface, becomes the place of newly created goodness. 

The new rows, with papaya and banana looking on

And the journey of 2020, the journey of faith, is to not refuse the suffering but to expect it to become the actual place of glory. This is the cross, and a thousand times we learn it yet still resist the lesson. The way up is down, life comes by dying, God's power breaks through our weakness. This is the picture of the seed becoming a tree, the picture of a mother birthing a child, the picture of bodies with wounds that shine as stories.

So many stories.

COVID-19 for one. I have sticky-notes for prayer for people we know who have been infected, so far all recovered. 30 million stories, and for nearly 1 million (198,000 or 1/5 of those in the USA) the story has ended in death. Here in East Africa, we've been bracing for six months, yet the pandemic has not come with the ferocity of Wuhan or NYC. So far so good, or not. While coronavirus spread and death has not overwhelmed Africa (? some combination of younger populations/older people already dead, less travel exposure, previous similar rainforest miasmas breeding similar virae with some unknown immunity, early strict lockdowns, prayer and mercy, no one knows for sure), the global impact will be felt here for many years. The USA pulling out of the WHO; less investment in TB, malaria, AIDS, malnutrition; less access to a new vaccine; less income from tourism; school closures resulting in an epidemic of teen pregnancy; the world tending to turn inward and self-protective in the face of hardship; the list is long. After decades where child survival has improved, this new decade may look very bleak.

Is there any wound that cannot become the place of new beauty? 

African American spirituality was forged in the fiery furnace of slavery in the United States. The ore was African in origin, in worldview, in culture, and in traditions. The coals were laid in the bowels of ships named, ironically, after Jesus and the Christian virtues, which carried untold numbers of Africans to the Americas. The fire was stoked on the “seasoning” islands of the Caribbean or the “breeding” plantations of the South where men, women, and children of Africa were systematically and efficiently reduced to beasts of burden and items of private property. Yet those who came forth from these fires were not what they seemed. Despite the oppressive and ungodly forces applied against them, they forged a spirituality that encouraged hope and sustained faith, which enabled them to build communities of love and trust and to persevere in their persistent efforts to be the free men and women they had been created to be. . . Diana L. Hayes, Forged in the Fiery Furnace: African American Spirituality

If the history of America gives us any hope, it is found here. Injustice and oppression on a continental scale still cannot snuff out the shining lights.

We awoke this morning to the news of Ruth Bader Ginsburg's death. No one is obligated to agree with all her arguments, but we have to admire the way she found good right in the hardest places. Being a woman in our parents' generation, forging a way for equal pay and opportunity. Even just the example of standing on principle and being willing to work and work hard.

And this week's news in general has been discouraging; the hope of reunion with family recedes as vaccine development feels less certain and travel remains a mirage. Nevertheless (an important word) the truth remains that there is nothing too impossible for God to turn to good (Rom 8).

Let's take courage then. In spite of forces that distress us all, let us look for the forged gems. 

A gem, see story below

Remember the 15-year-old whose premature baby the nurse was wrapping up as a dead body? Innocent, we learned this week, in the Latin root means not-yet-wounded. I don't wish wounds on 15 year olds, or 15 day olds. But this pair returned for a check up this week. K smiled proudly as I paraded her little chub-cheeked baby around the NICU as inspiration to all the other moms of 1.2 kg strugglers: here she was weighing in at 2.52, very much alive and well. Every day we feel the weight of all that is broken, and yet see the glimpses of beauty. A mom of twins who was determined to leave the hospital, but because we do rounds and assess and talk we convinced her to stay, which allowed a transfusion to save one twin's life. A mother whose blood pressure had reached danger levels, who could be induced and rescued. Our young doctor Isaiah tracking down a missing lab result that made a diagnosis of possible leukemia, needing a referral. A school staff engaging with the Gospel in new ways as our team continues mentorship. An accusatory email trying to wound us, that required a soft answer because more important issues are at stake. A toddler with signs of starvation who came too late to be included in the day's milk distribution; yet our BundiNutrition staff took it upon himself to return to the hospital and start him on feeds. These are tiny sprouts of new creation, but significant nonetheless. Every single person around us has their own wounds, some open and some scarred, all telling a story of growing glory.

the toddler on his grandmother's lap that needed therapeutic milk

Lastly, here is a two-set album from Porter's Gate, worship music that gives a soundtrack to all the above. Listen to "O Sacred Neck", which talks about wounds and glory.