"I am weary of holding it in." COVID-19Uganda day 141 from Jeremiah

 141 days are feeling long for all of us in Uganda, yet our troubles are only a minuscule taste of the world's.  August finds the read-through-the-Bible-chronologically march in Jeremiah, in the final days of the crumbling Kingdoms of Israel and Judah. And perhaps because we have to Sergers in our Africa area awaiting childbirth, every time Jeremiah says "pain as of a woman in labor" it jumps out. Labor is inevitable yet unpredictable. You can learn about it but no two experiences are the same, no one can feel another person's pain, no one can really prepare you precisely for the experience. Anguish is going to grab those two, as it has women since Eve. I wonder if Jeremiah's mother or wife was a midwife, since he goes to that analogy repeatedly to warn the Jewish people of the trauma ahead. We are globally in the 8th month of being aware of the spread of the novel coronavirus. In January we read the early reports of a mystery respiratory highly contagious viral syndrome, briefly wondering if it might inconvenience us with impact on our May all-company conference. Now in the 8th month the entire globe is reeling with heaviness. Our US Embassy yesterday told us that if we were not paying attention before, it is time to pay attention now and assume anyone we meet is infected (link included as many American readers may find it more helpful than much of what they are hearing). We watched coverage from Georgia last night, with skyrocketing infections and the death of an otherwise-healthy 7 year old. Meanwhile we are about to celebrate the 7th birthday of a kid on our team.

That dissonance is weary-ing to us all. Perhaps being a doctor in 2020, a team leader, a writer, a human whose heart holds the heaviness of traumas and injustice past and present, is similar to being Jeremiah in the ascendency of the Assyrian and Bablyonian invasions of the known world. In chapter 6, he wonders, who should I warn? No one is listening to this, they have no delight in it. Therefore I am full of the fury of the LORD, I am weary of holding it in. We try to stick to policies of masks and hand santizer and distance and outdoor meeting, of limiting travel and interaction. All of these are counter to the Gospel-picture of community and openness and immersion. This is hard for all of us. We are weary of holding it all in.

I think our two women facing labor and delivery are way wearier than any of us, stuck in countries they did not intend to stay in for this process, unable to have family nearby, no guarantee a husband or friend can even enter the labor room with them. I know that having done this a few times including in some marginal places, there is always the nagging doubt, how bad can this get, and can I survive it? Am I strong enough? What if.. . .? And I think everyone is getting a little taste of that right now. How long can we deprive ourselves of human contact, of hugs, of parties, of connection? How long can we put our kids' educations on hold? How high is the price of a lonely 84th year, or 87th? 

Last night I read a story that for the first time, malaria resistant to our main medicine (artemisinin derivatives) has been found in Africa. Two sites in Rwanda. The potential loss of lives over the next five years if this mutation takes hold and spreads is 78 million cases, over 100,000 deaths. In another year, that might have been interesting or sobering, this year it is alarming and makes me want to cry. Because those deaths occur right in front of me right now, currently due to delayed care or poor systems or co-morbidity with sickle cell and malnutrition . . but if we get to the point where we are doing all that right . . .  and we are still powerless, malaria will make COVID-19 look minimal. The paediatric ward is now not even standing-room-only, because standing room is almost gone. People have to line up and wait to weave their way through mattresses on the floor because I'm squatting between two that are only inches apart. I had to put my head down on a bed fast because the umpteenth squat-and-stand left me dizzy. It is pouring rain right now. Mosquitoes are proliferating.

The childbirth analogy continues right on to the teachings of Jesus. In John 16 he is talking to his disciples prior to his arrest, and says:

"A woman, when she is in labor, has sorrow because her hour has come; but as soon as she has given birth to the child, she no longer remembers the anguish, for joy that a human being has been born into the world. Therefore you now have sorrow; but I will see you again and your heart will rejoice, and your joy no one will take from you.  . . These things I have spoken to you, that in me you may have peace. In the world you will have sorrow; but be of good cheer, I have overcome the world."

Bahati with the joy that she laboured for!

Both-and. Yes, you are weary, you are facing anguish, things look rough ahead. Yes, you will have sorrow. But . .. also yes, you will have joy and you can go forward with peace, because Jesus holds the end in hand, and all shall be well. Coronavirus and malaria, racism and poverty, greed and abuse, will all be overcome.

So prayers appreciated for our two about-to-enter-anguish moms. For a glimpse of the joy of holding those newborns to see them through with courage. 

And prayers appreciated for two weary doctors, in the unending sorrows of this broken world. Yesterday Scott found his two lost sheep: a woman who had laboured all night with zero progress . . . meaning he had to push against the inertia of the system, supply sutures and some of the anaesthesia medicines, often he has to wheel the patient to the theatre or put in the IV himself to get the C-section moving. The baby was not-quite-dead, and revived. Then as he was writing up the operative note, a nursing student begged him to ultrasound scan her sister. People love ultrasounds here, and want them for all kinds of inappropriate indications, and Scott is the only source of free and accurate ones so he gets weary of these requests. But he trudged back to maternity to discover an undiagnosed ruptured ectopic pregnancy, again having to set up and push and innovate to get the woman to surgery. Her hemoglobin was 2.4; she had 5.5 LITERS of blood in her abdomen, as he worked to remove the burst tube the anaesthetist transfused the little amount of blood available, and she survived. My lost sheep were a preemie that Ivan resuscitated on Weds when the staff generally were ready to call her dead . . . she got a respiratory infection from her 15-year-old mom 40 days into her incubator stay (and a glimpse of joy, that Ivan saw the potential for action, sent another mom to grab me for help, and saved this life for now). And two very very lethargic and weak malnourished children, little girls who did nothing to land themselves in families with HIV or TB or divorce and abandonment. Plus a little boy with sickle cell and malaria, on a mat on the floor squeezed between two other actual mattresses on the floor, whose labs I happened to find under some books on a desk while looking for something else . . . hemoglobin 3.8. This is why we keep pushing through the crowds to find those closest to death and focus the team's energy there. Meanwhile we are trying to teach students, and I personally am failing to remain calmly gracious at the fray. Repenting for my sense of self-righteous input; and yet also relating to Jeremiah's sense of "isn't anyone listening???"

This is 900 grams of vulnerable life, entering the world at 28 weeks instead of 40, just as we unwrapped the bundle brought to us 18 hours after birth . . . 

Celebrating the discharge of this little child who may not look great YET, but is 100% better than two weeks ago!

In that incubator is the baby Ivan rescued; join us in praying for her survival (baby K).

This was Wednesday, numbers were up even higher by Friday . . .