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Wednesday, April 15, 2020

#COVID-19UGANDA Day 27, EASTER Day 5: the Paradox of the hidden sprout

Easter is more than a day, it's a season, a resurrection way of life. When I think of the open tomb, I imagine blinding light, angels, fireworks, glory. A dramatically visible moment of unmistakable turning, where everything starts to become new and true, the sadness undone. However, the only people who experienced it that way were the guards who went unconscious and were later easily bribed to change their story. So much for irrefutable drama. The actual witnesses were women walking in the dark, going about their hands-on menial labor, puzzling over mystery, encountering a humble gardener one on one. 

So we reach day 27 of living on a broken edge that got extra hard, and day 5 of living in the feast of celebrating how it's all transformed and healing and hopeful, and the two don't seem to fit together very well.



Doreen, RIP

My sickest patient, Doreen, who just broke my heart with her starving little body, her too-soon-pregnant-again mom, the lethargic inability to turn the course of that dwindling life, died on Good Friday. I suppose the timing was a small gift from Jesus to bring meaning. Four children died the day before. Monday is a blur, Tuesday night two more died, and Wednesday morning as I was starting in the NICU I heard wailing from the Paeds ward and got a message that yet another had succumbed, a toddler who had not woken up from cerebral malaria we had been treating for days. This is the baseline reality of life here, and without comprehensive ways to count and track, I can feel in my gut that there is some COVID effect but not really prove it. At least four recent deaths were from respiratory infections--but that can be a thousand different viruses and bacteria, and since our first five tests (all negative) were taken to the national lab we've been told we don't have the proper swabs and can't test any more. Mostly our deaths are malaria, malnutrition, and sickle cell, and often all three. Or prematurity, neonatal infections, difficult oxygen-starved births. And when no one can move except on foot or by the limited ambulances, there is a curfew, people are terrified of getting the disease that is killing even rich well-resourced people, schools are closed so blood drives have faltered and life-saving transfusions are becoming harder to arrange, supplies have run out for key medicines, women in labor are stuck at home . . . we KNOW that our baseline struggles have only been augmented. (SIDE NOTE: Most years, over 400,000 people die of malaria in the world. So far, 137,000 have died of COVID-19 since December . . . which is a pretty similar monthly toll of 30-35,000.  The difference is, for malaria it is 95% African children far from the cameras, and the rest of the world has no fear of the disease reaching them. And admittedly, malaria is treatable and stable and COVID-19 is still escalating and likely to exceed the average malaria toll soon.)

I want to walk into each day as if Jesus' tomb exit is still good news, and having impact. But then dozens of dysfunctions fly up in my face and there are jaundiced prematures not getting their feeds and fluids and lost lab results and confusing communication, and I quickly forget all about Easter. Where are the trumpets and power? Why is it all so hidden and slow, so yeasty and sprouty when I feel we need miracles with exclamation points?

Easter to Pentecost, 50 days of a new world, get very little print. The arc of the spinning-into-decay universe changed to a direction of justice and wholeness, but quietly. Jesus walked around with his scars and cooked fish; he didn't bring an angel army to grab the throne and set everything in order. Like the proverbial seed that died, there was a sprout that one only sees by looking closely, moving some debris and dirt away, noticing.

At the beginning of Lent which feels like 6 years not 6 weeks ago, I was going to practice the discipline of noticing resurrection. Instead I found myself by yesterday just spiralling into woe-watch, seeing the gaps and loss, and wanting the Jesus who throws the tables in the temple instead of the one that speaks peace to the hurting. I know I was not nice to be around. And I suspect the pressure of most people's lives, unaccustomed patterns, extra work at home, uncertain endings or unattainable relief, the friction of continuous closeness, monotony, grief, have often led us to look for something proximate to lash out against (where is the nurse! why was the medicine not given!) in place of a vague cloud of pandemic and sorrow that we can't do a thing about.
me with Kacie heading to the last task
My last task of the day was to find the Medical Superintendent to talk about our malaria medicine supply, as I had been buying stop-gap amounts of 10 vials here, 10 more there, over and over and we were completely out of it again. I was still in my table-turning mood, I admit. As Kacie and I walked towards his office, he was coming in another door with a few staff and a big smile. Before I could launch into my concerns, he told me, we just got 1,500 doses of artesunate from the National medical store! The chances of that intersection of need and supply and question and answer were so slim, I knew right away this was a glimpse of resurrection. A kind reminder from God that the seed is sprouting in hidden places, fragile shoots.

So, go out looking for Easter, even though we're still living in lockdowns. The week after the real resurrection, the Romans still ruled oppressively and the religious establishment still orchestrated a cover-up, the believers still hid in rented upper rooms, and even the chosen few still doubted. Don't look for fireworks, look for the tiniest green leaves. And pray for us to have eyes wide open, to look past the rising numbers (more than 15,000 COVID-19 cases now in Africa), the decision to cut off international funds like the WHO, the struggle to even treat relatively simple problems, and to have faith.

Here are some of the last few days of sightings:

Some functionality--our district has recognised the difficulty of getting patients to the hospital and now has an ambulance schedule!

Benjamin and Lindsey . . babies are always palpably places of hope

World Vision comes through with bleach and megaphones

Flowers for Easter

Dressing up for Easter even with no where to go, a cheery Forrest Faith.

We still get plenty of patients coming . . . thankful for the nutrition team and the Paeds team!

Morning mercies, sunrise.

Dr. Isaiah puts up with my angst, and even helps moms learn Kangaroo care

This baby is my high point, we actually got an LP, a result, a diagnosis, a treatment, and we're half-way to healing from serious meningitis and healing. (Kenya friends, note the post-dehydration rash!)

Uganda is the blue line at the bottom, which is the hope that the isolation and contract tracing is working to at least delay the disaster . . . 

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