Power, weakness, and a tale of three babies: COVID-19Uganda day 155

 One hundred days into the Ugandan Covid epidemic, a 15-year-old "K" walked into our hospital and delivered a 1.2 kg baby girl (that's 2 1/2 pounds) ten weeks too early. Yesterday, She took her 4-pound baby home, after a 55-day marathon of tube feeds, incubators, IV lines, antibiotics, hours of skin-on-skin kangaroo care, countless replaced ng tubes. That's still two weeks shy of her actual due date. This was a Christmas school holiday baby, a young girl who had just finished her 7 years of primary school, a dad half-way through high school. The pregnancy and COVID aside, she statistically was not likely to receive further education besides the hard way. And she learned quite a lot over the last two months. She knows how to express milk and draw it up in a syringe, measure quantities, drip it into a tube. How to secure a tiny speck of life to her chest. But mostly, she learned hope. Because at first, she was quite disengaged and reluctant. Her baby did not look likely to survive, and she withdrew into a protective shell. It took the community of other moms spurring her on, and her own mother-in-law, a spunky lady who showed up to take care of her (she's only 15 remember). But it also took Ivan.

Ivan with K and baby, preparing for discharge from NICU

Ivan grew up in our orbit, his dad having been one of the young men we sent for nursing school in the late 90's. Over time he became Jack's best friend, spending much of his time at our house, and when his parents' marriage broke apart his mother asked us to take responsibility for his schooling. He was two months short of graduating from Uganda Christian University with a degree in nursing (most nurses get diploma-level education, so this is a boost to our district's skill level) when the world shut down. In the 2020 limbo, he's been volunteering several days a week and focusing on our newly opened NICU. Kacie spent time teaching him newborn resuscitation using the Helping Babies Breathe curriculum. Dr. Marc, Dr. Isaiah, Scott and I have worked with him and explained and entrusted more and more.

So a few weeks ago, when K came down with a cold and then her tiny baby got sick . . . and then stopped breathing, Ivan was on duty. He found another nurse wrapping the infant's body up in defeat. But Ivan did CPR. He sent someone to get me. Over the next week, we did everything we could to keep this baby alive, oxygen and a transfusion and medicines and monitoring. She had to be revived more than once. And improbably, she clung onto that thread of life. 

Her discharge was a concrete moment of hope. It was really Ivan's belief in not giving up that saved this baby's life. And that's what the good news of God's rule seeping in looks like. It's a multi-decade process of relationship that gave this nursing student the courage to see the survival of a 1.2 kg apneic baby as a possibility. That brought in partnerships with Save The Children building a tiny NICU, brought in incubators and ng tubes. It's the refusal to write off a 15-year-old grumpy teen, and slowly coax her into being a skilled mother. It is little acts of faithful work, over and over, 55 days in a row.

Last week, we picked up urgently and rushed to Kampala for another birth. This one was right smack on time and in spite of a last-minute C-section, all went well as Jenna and Boas welcomed baby Nile. The day before, Karis and Stephen delivered baby Zaks in Nairobi. Neither of these moms had their ideal birth plan; both had hoped to be in other places, and with family support. But both faced the reality of 2020 with courage, and both are now holding nearly 2-week old healthy boys, with minimal help from anyone but a husband and very limited friends. We had the joy of being surrogate grandparents, ooohing and ahhing over the sweetness of Nile (with masks and clean hands of course) for days, and admiring Zaks on What's App.

Nile in Kampala day of birth 

Zaks meeting big sis in Nairobi

Two weeks ago was the last normal Saturday I sat here at this desk, and asked for prayer for baby of "K", for our two Serge moms about to deliver, for our own weary souls. I'm still plowing through the melancholy of Jeremiah and Habakkuk . . . "in wrath, remember mercy" is his prayer in chapter 3. As their global situation devolves into chaos they see ways God moves in power to show mercy to the remnant. In the wrath of 2020's insidious viral death-march, ripping open of festering racial injustice wounds, divisive tribal fear-stoked hate on multiple continents . . . the babies represent a message of mercy. Potential. Hope. Seeds for good that will grow in ways we can't predict. God's power in several vulnerable packages.

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Which, besides anxiety over survival, has been the other major current of thought in the last two weeks. Because I pulled off my shelf a 20-year old book by Marva J. Dawn called Powers, Weakness, and the Tabernacling of God. Dawn delves deeply into the Biblical passages and literature exploring the idea of "principalities and powers", something that is taken for granted to be true in African culture and Biblical culture but must be re-established for the average American audience. 

We need to recover a more nuanced and holistic view of evil, which paradoxically helps us see more clearly into good. The world is broken, people sin, and there is an unseen realm of forces that are both institutional and demonic that seek to harm us. As I was writing, I was interrupted by a phone call from a friend desperately worried about his sick child, and on the way to my car to respond to the emergency my young neighbour (another kid who grew up with ours) met me to tell me about his sick daughter. COVID-19, malaria, and other pathogens are part of the frayed fabric of our world, the brokeness of the Fall, the intrinsic sorrows that are part of being human. That these children live in a town where the hospital is out of malaria drugs and never had much oxygen capacity is not part of their personal sin, it is a world system of poverty that is stacked against them. Yet there is probably sin in these scenarios too, perhaps a nurse somewhere stole or sold off the medicines meant for needy patients, or a greedy pharmaceutical company set a price high enough to finance yachts while leaving the poor to die, or a parent spent his small fees earned by his boda business on alcohol instead of a mosquito net. And behind the scenes, though Satan was defeated on the cross, the mopping up of all spiritual powers that set themselves to harm us has not been completed. In most situations we can find multiple forces of evil, and the good news is that the cross reverses the decay of a groaning creation putting us on a path towards all things new, justifies and forgives all the sins we have committed and will commit, and chains evil powers, limiting their capacity as a promise of their eventual disappearance. 

The brilliance of Dawn's book lies in the way she moves from an overview of evil and the power of the Cross to .  .  . well, if this is most places, it would be either a name-it claim-it simplistic prosperity-promising temptation to grab the victory in full this side of time, and be financially successful, physically healthy, socially "in", and gorgeous to boot. Or a sober diatribe on personal sin and repentance that boils all evils down to individual choices and wants a uniform set of moral rules to keep things straight. But the Bible, shockingly, after affirming Jesus as victor by a literal resurrection from the dead . . . has him cooking fish and calming hearts and quietly fading away. Within a generation, his followers grasp that the rule of God is not pounding in with an army or a gilt temple, irrefutable and irresistible. The power of God comes at the end of human power, when we give up our rights, our voice, our time, our wisdom, embrace our weakness and limits, and depend fully on the grace of God. The more we get out of the way, the more people can see the glory of God.

Throughout the New Testament, then, we have seen a diversity of evidences for weakness a God's primary method, including the weakness of a suffering Messiah, the weakness of our sinfulness that necessitates a Saviour from outside ourselves, the weakness we have relative to the powers of the world, and the priority for our communities of welcoming the weak. (p 55)

I believe her final two chapters have much to say to the American Evangelical Church in 2020. If we are called to a path of the cross, of suffering, of embracing weakness . . . when did we become so obsessed with winning, with power, with control, with position, with status, with numbers? She calls us back to the basics, particularly to prayer, to fellowship, to being countercultural, in the world but not of it. She calls us to gracious generosity, to compassionate insistence on justice, to metrics of faithfulness and dependence upon God. I think that her descriptions of the early church, and of the Ephesians 6 "armour" of the Spirit, give us a challenging vision of living out the rule of God as salt and light in a world that needs to taste and see.

We need not feel overwhelmed by the cultural forces arrayed against Christianity; the battle against the powers has already been decided. And we need not feel overwhelmed when we remember that such ending of our power as we might be feeling is exactly what Christ desires for the fullness of his tabernacling.  . . .The cross is the heart of history. (p 163-164)

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If anyone is still reading, thank you. Because I want to end by saying, a robust theology of evil, and of good, matters. Putting the blame for a preem on the shoulders of a 15-year-old girl is demonstrably wrong. Did she sin? Yes, daily. Me too. But she also suffered the consequences of systemic evils so much larger than her. Does the victory of Jesus on the cross mean no more premature babies? Not yet! But yes, someday, no more tears at all. The dense and complex narrative of baby-of-K reflects the dense and complex narrative of the incarnation. Jesus, vulnerable, in the flesh, pitching his tent here amongst us in a decidedly marginalized people. Jesus, resisting the short-cut to power and glory, carrying the cross and meeting death head-on. Jesus, forgiving sin and healing disease and promising Heaven, because in that death and resurrection the entire order of the universe shook back towards a trajectory of hope. Jesus, choosing to work behind the scenes through the Ivans of this world, blowing a spirit of life into a dying baby, preaching the forgiveness of sin, breaking the power of evil. The full establishment of shalom is not yet here, but we catch those glimpses of glory and hold on for more.

Ivan on one of those 55 days of doing the next needed task (furthest from camera)

Ivan teaching NICU moms, K is in the center

Arriving in Kampala after 8 hours in the car, to celebrate a Ugandan-American miracle!

Nile and mom

The whole Fort Portal team turned out to celebrate!

Baby of K, oblivious to the drama, ready to go home

a glimpse of my weakness, a ward crowded with sick children

One more of Zaks meeting his big brother